Opening Plenary Session
FEMMSS 4
May 10-12, 2012
Pennsylvania State University
Feminist Interventions in Science:
Pragmatic Limits
or Metaphysical Impossibilities?
Sharyn Clough
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
I set my discussion of feminist interventions in science
against the following social conditions:
 across the globe, power, including the power associated
with the practices and knowledge claims of science, is
differentially defined, produced, and distributed according
to complex social hierarchies;
 these hierarchies are calibrated according to a matrix of
embodied markers, such as (presumed) secondary sex
characteristics, gender roles, ethnic backgrounds, and
abilities.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
“Feminism” names a political response to these conditions
that includes (minimally) the following claims:
1.empirical evidence, broadly construed, shows these embodied
markers to be irrelevant when considering the possibilities of
human flourishing;
2.empirical evidence, broadly construed, shows these embodied
markers to be socially and historically contingent features of
human lives, always and already in play, even within feminist
theorising;
3.empirical evidence, broadly construed, shows that when
power is distributed under these conditions, citizens are actively
discouraged, via a variety of social and psychological
mechanisms, from investigation of and commitment to 1) and
2).
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
“Pragmatism” here refers to a naturalised, socio/historical, and
holistic focus on the relationship between knowers and the world
— including relationships between scientists and the world –
according to which:
• knowers (that’s all of us) are ontologically continuous with/coconstitutive of the world we know,
o hence the commitment to naturalism;
• knowers’ beliefs about the world arise from complex historicallycontingent, social intra-actions with, and in our world,
o hence the commitment to socio/historicism;
• this socio/historical claim applies holistically across the board, such
that the meaning of any one of our beliefs - scientific, philosophical,
political, personal, technical, emotional - is best understood:
o by holistic appeal to the empirical conditions that give rise to the
belief in the first place;
o these empirical conditions include the inequitable embodied
definition, production, and distribution of power.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
Pragmatism shifts the burden of proof back on to those who
want to make metaphysical, that is, non-naturalised,
ahistorical, ontologically-robust distinctions:
 between knowers, including scientific knowers, and their
world;
 between minds and bodies;
 between subjective beliefs, say about values, and objective
beliefs, say about facts.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
It is important to keep this pragmatist perspective in mind
when examining the strategies used by feminists to justify our
critical and value-laden interventions in science.
Failure to keep pragmatism in mind, leads to seemingly
impossible metaphysical quandaries such as:

how can the justifications for our feminist criticisms of
science,

produced by feminists, in particular bodies, under
particular descriptions,

be understood by, let alone persuasive to, scientists
whose lives are constrained/shaped by embodied
markers very different from ours?
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
My thesis today is that, by taking pragmatism seriously, we can
show that these quandaries are really (just!) very difficult
practical problems that we feminists already have the tools to
solve.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
I was inspired to take up this argument after reading
Kristin Intemann’s recent essay:
“25 Years of Feminist Empiricism and Standpoint
Theory: Where Are We Now?”
Where she focuses primarily on the empiricist work
of Helen Longino and standpoint theory as
articulated by Alison Wylie.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
And again, by way of background definitions,
“Feminist Empiricism” and “Feminist Standpoint”
refer to:
 two different rhetorical strategies for showing how and
why feminist value-laden interventions in science can
actually make science more objective and/or
empirically adequate.
Intemann argues that, as these strategies have
become more sophisticated over the years, they are
becoming more similar, and she suggests blending
them.
However, there is one place where she thinks
standpoint theory is the stronger of the two.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
According to Intemann:
Feminist empiricists maintain that it is easier for us to identify
when and where values are influencing scientific reasoning, if
those values or interests are different from ours.
Thus, feminist empiricists have advocated for scientific
communities comprised of individuals with diverse values and
interests.
However, for feminist empiricists, the content of the values is
largely irrelevant to the project of increasing the objectivity
and/or empirical adequacy of any given scientific project.
This is a problem.
Why include feminist values?
Why not include sexist values?
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
In contrast, standpoint feminists maintain that it is a particular kind
of diversity of social position that is epistemically beneficial in
science.
 this is partly, she says, because standpoint feminists take knowledge to




be embodied.
and when power is produced, defined, and distributed relative to an
inequitable privileging of some embodied descriptors over others,
then including/appealing to the embodied knowledge of those who
have less power can result in more objective and/or more epistemically
adequate science.
taking up a feminist standpoint involves paying attention to the
differential power relations producing and affecting embodied
knowers,
and presupposes very particular, feminist values, for example, that:



oppression is unjust;
revealing gender is valuable; and
hierarchical power structures ought to be abolished.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
Regardless which, if any, camp, or mix of camps, you find
yourself aligned with on this score (Intemann has me in the
empiricist camp), she successfully identifies a tension with
which feminists involved in science studies have long
struggled:
 How do you argue both for the superiority of feminist
values in science,
 while at the same time taking seriously the embodied
nature of these values?
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
There are a number of other areas of feminist research
where the relationship between embodiment and
knowledge is a primary focus.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
My colleague, anthropologist and midwife Melissa Cheyney, has
discussed the embodied knowledge claims arising in the context
of pregnancy and childbirth (“Homebirth as Systems-Challenging
Praxis”)
Part of what women who choose to give birth at home are doing
is trusting their embodied knowledge (sometimes referred to as
trusting their “intuitions”).
One woman in Cheyney’s study explained how at some point in
her home delivery she came to know that she should walk
around the house, lifting her knees high in an exaggerated
march.
The woman’s midwife later explained to her that this was a good
thing as it helped the baby’s head to reposition in the birth
canal.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
Those of Cheyney’s respondents who had their first delivery
in a hospital reported how this kind of setting encouraged
in them an epistemic passivity.
For better or worse, they became the focus of the
knowledge claims of the experts who surrounded them,
and gave up some of their own epistemic authority.
Indeed the point of epidurals is to limit the mother’s access
to her embodied knowledge.
Regardless of the setting, being pregnant and giving birth
makes a difference to the (kinds of) knowledge available to
that woman, to her midwives, and her doctors, at any given
moment.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
Philosopher Jackie Leach Scully writes about the limits of the
“moral imagination,” between people who are differently
embodied with respect to physical and mental abilities.
In “Moral Imagination, Disability and Embodiment,” she and
Catriona Mackenzie argue that:
 there are barriers to imagining oneself differently situated, or
imagining being another person, arising in part from the way
imagination is constrained by embodied experience;
 these barriers do not mean there is no role for the imaginative
engagement with others;
 while we can never understand the other ‘from the inside’ we
can make use of imaginative engagement to expand the scope of
our moral sympathies.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
Let’s see where we’re at…
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
Feminists have played an important role in successfully
communicating the following claim:
 the lived embodied experiences of knowers is important to
understanding and evaluating knowledge, in science, as elsewhere;
 given that we currently live in a world where power is inequitably
distributed according to embodied variables;
 then these differently embodied variables will make a difference to the
kinds of knowledge produced, and evaluated, even in subtle ways, even
in science.
However, the more successful we are at communicating this claim,
 the more it can seem that the world is populated by isolated embodied
knowers;
 our embodied experiences as women, as men, as economically
privileged, as poor, can seem radically incommensurate across those
differently embodied;
 isolating us epistemically and ontologically from each other and from
the world.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
According to Intemann, feminist empiricists fail to
account for the embodiment of knowledge,
which leaves us with no justification for the inclusion of
feminist values in science.
But it is also clear that there are certain ways of
construing embodiment that set limits on our ability to
imagine and share the very content of those values.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
Here is where pragmatism can help.
(I sometimes imagine a woman with tights and a cape
with a big P emblazoned on it.)
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
By way of review, pragmatists argue that:
• knowers are ontologically continuous with/coconstitutive of the world known,
• knowers’ beliefs about the world arise from complex
historically-contingent, social intra-actions with, and in
the world,
• this socio/historical claim applies holistically across the
board,
• such that the meaning of any belief, including our beliefs
about values,
• is best understood by appeal to the practical, empirical
engagements that give rise to the belief in the first place.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
If pragmatists are right about this, and I think they are,
then, while we are embodied, the very different ways we
are embodied are constituted by our practical intraactions with each other and the world.
There is no metaphysically private, inaccessible “inside”
experience to which “outsiders” have no epistemic
access:


because the very content of our embodied experience
arises and shifts in a continual interplay with other
bodies,
even as we communicate and work with each other to
reveal the ways that power is inequitably embodied.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
Even as Cheyney argues for the epistemic differences between
the differently embodied mother, midwife, and doctor,
this difference is made available through Cheyney’s successful
communication with her respondents.
The differential embodied experiences of birthing in a hospital
versus birthing at home provides the very entry point for
epistemic evaluation of those embodied differences
for the women respondents,
for Cheyney,
and for us, her readers.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
As Joan Scott writes in her germinal essay
“The Evidence of Experience”:
We can know the inner workings and logics of the
repressive mechanisms at play in embodied
experiences,
as long as we attend to the socio-historical processes
that, through communication, position subjects and
produce their experiences.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
As women who are differently-abled, successfully
communicate the facts of their difference, as mothers
write of their differently embodied knowledge,
the very fact of their communicative success is premised
on shared intra-actions with and in the world;
a shared world against which these differences are
articulated,
within which differently embodied values can be heard,
seen, felt,
understood,
and justified…
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
…or not, as the case may be, and often is.
Feminist Interventions in Science:
Pragmatic Limits or Metaphysical Impossibilities?
When there are failures, and the fact of continued
inequities in power shows these failures to be very real,
 the failures are the product of
practical, material limits
 limits to our sympathy and
patience, for example,
 but not to limits defined in
terms of metaphysical
incommensurability,
 not to limits in our ability to
understand, to know, to
justify.
Thanks to the pragmatist philosophy
reading group at Oregon State
University:
 Sean Creighton
 Matt Gaddis
 Natasha Hansen
 James Eric Reddington
Flower photo credits:
http://xaxor.com/other/29956flowers-growing-out-of-theconcrete-photography.html
Nancy McHugh
Wittenberg University
May 2012
Evidence-Based Medicine (EBM)
 Randomized controlled trials and meta-analyses of RCTs
are considered the “gold standard” because they are “so
much more likely to inform us and so much less likely to
mislead us...” than other types of evidence (Sackett 1995
p. 72).
 Scott Sehon and Donald Stanley write “[w]hat separates
EBM from other approaches is the priority it gives to
certain forms of evidence, and according to EBM the
most highly prized form of evidence comes from RCTs
(including systematic reviews) and meta-analyses of
RCTs…. [W]e will take the term “evidence-based
medicine” to refer essentially to the practice of taking
RCTs as the strongly preferred form of medical evidence”
(p. 3).
Challenges to EBM
 There is persuasive evidence that at least with
marginalized communities the epistemic reliance on
RCTs and meta-analyses is more likely to misinform
us and more likely mislead us than EBM practitioners
have acknowledged.
 Many of these challenges come from those working
in epistemology of medicine and health justice, but
also from those working directly in medicine.
Epistemology of Medicine
 Patients respond differently to treatments, which can
arise from a number of factors—genetic, behavioral,
environmental, gender, and morphological.
 Patients also differ in their likelihood of experiencing side
effects related to treatment. These differences frequently
are the result of genetic and environmental differences.
 This is worrisome, because as Kravitz et al. argue
“average effects pertain most often to the average
patient. Accordingly, those who deviate far from the
average patient trial participant based on risk,
responsiveness, or vulnerability may behave very
differently” (p. 675).
 Marginalized groups are those whose members
individually and collectively are most likely to differ
from the average patient, these same people are
those that are the least likely to benefit and may be
harmed by EBM.
 This only serves to further disadvantage and
marginalize these groups.
Health Justice
 The perceived context of objectivity that results from
the hierarchy of evidence obscures the ways that
EBM is failing in two areas.
 Lack of plurality in who designs and funds research
 Lack of diversity in research participants
 These result in serious problems of evidence in EBM
that tie back into the problems that Kravitz et al.
highlight.
A Pragmatist Turn in Biomedicine
 Experimental Inquiry:
 Key Concepts:




Explicit connection between knowing and doing, knowing
and ethics.
Recognizes and seeks to understand the multiple factors
that are involved in a problem.
Frames these within a particular historical trajectory, body,
location, time, and conditions.
An overarching methodology that uses problems as an
initiator for targeting and employing particular, and
frequently multiple, methodologies (directed activity).
 Transaction
 Key concepts



Embodiment such that there is no separation between mind
and body and no firm demarcation between body-mind and
the world in which we live.
Complexity and interdependences, seeks to understand
relationships within a dynamic system.
Recognizes individual-social-political-economicenvironmental system as one complex system in which
people have different levels of power and agency.
Ecosocial epidemiology as a
pragmatic alternative to EBM
 Key Concepts:
 Embodiment, referring to how we literally incorporate,
biologically, in societal and ecological context, the
material and social world in which we live.
 Pathways of embodiment, via diverse, concurrent, and
interacting pathways.
 Cumulative interplay of exposure, susceptibility, and
resistance across the lifecourse
 Accountability and agency (Krieger, 2011
Epidemiology and the People’s Health: Theory and
Context)
Alessandra Tanesini
Cardiff University
May 2012
‘We philosophers of science are faced then with a
hard job. Here as elsewhere in the natural and social
sciences, in policy and technology, we can help. But
to do so we need somehow to figure out how better
to engage with scientific practice and not just with
each other’ (Cartwright, 2010).
41
What’s to come….
 Main Thesis: Constraints on what
counts as admissible evidence for
the effectiveness of policy
interventions have several
distorting consequences:
 Measurable proxies are
conflated with or selected
instead of desired outcomes.
 Accuracy is sacrificed for
Generalisability.
 Service deliverers
professionalism and epistemic
authority is undermined.
 Loss in democratic
accountability.
 Sect 1: Evidence Based Social
Policy in the UK.
 Sect 2: What is Evidence?
 Sect 3: Trust in numbers - Why
worry?
 Sect 4: How could a feminist
pragmatist philosophy of science
help?
 Sect 5: Measuring Poverty: A Case
study.
42
Sect. 1: Evidence-Based
Social Policy in the UK
The Policy or ROAMEF Cycle
 The Green Book (HM Treasury, 2003)
43
Sect. 1: Evidence-Based
Social Policy in the UK
The Green and the Magenta Books
 The Green Book (HM Treasury 2003)
 Emphases that economic principles that should be
applied to both appraisal and evaluation
 The Magenta Book (HM Treasury 2011)
 Provides in-depth guidance on how evaluation should
be designed and undertaken.
44
Sect. 1: Evidence-Based
Social Policy in the UK
Evidence Based or Informed Policy & Practice (EPPI)
 In the UK and the US there has been a shift to
Evidence Based or Informed Policy.
Motivations:
 Efficacy
 Transparency
 Predictive Power
45
Sect. 1: Evidence-Based
Social Policy in the UK
Evaluating what works
 Only impact evaluation can determine whether a
policy “worked” (Magenta Book, p.81)
 ‘Impact evaluations attempt to provide an objective
test of what changes have occurred, and the extent
to which these can be attributed to the policy.’
(Magenta Book, p. 17)


Individuation measurable effects
Attributing effects to policy
 A solid evaluation is one that offers a good estimate
of the counterfactual.
46
Sect. 2: Evidence - What is it?
 Evidence: many things in theory, and work in social policy is more
alert to the difficulties than their counterparts in Evidence-Based
Medicine.
 Impact assessment requires estimating the counterfactual and thus
requires using comparison groups.
 Randomness is seen as crucial in achieving this estimate. Thus, the
following are seen as best (Magenta Book, ch.9):
 Randomised Controlled Trials (RCTs)
 Meta-Analyses
 Narrative or Systematic Review
47
Sect. 2: Evidence – What is it?
‘An RCT is usually regarded as the strongest possible means of
evaluating a policy, because of its ability to balance out the
differences between the groups. As was pointed out above, policy
allocation by its very nature is not usually random, so
opportunities to use it in practice are limited. If the policy is by
intention “experimental”, however, then randomised allocation
might be more readily acceptable. In these instances the policy
will usually begin with a pilot in a restricted number of areas only.’
(Magenta Book, p. 103)
48
Sect. 3: Trust in Numbers -Why worry?
A. Measurability drives policy
 Tends only to select measurable outcomes
 Confuse measurable proxies for the outcomes
 Skews the range of actions chosen in favour of those for which
evidence can be more easily collected
B. Trade offs: Applicability versus Accuracy
 Loss in heterogeneity results
49
Sect. 3: Trust in Numbers -Why worry?
C. Deprofessionalises service deliverers:
 The difference made by the individual practitioner is not
generalisable; hence, no point in recording or cultivating it
 Their expert judgement is no evidence; hence, their epistemic
authority is undermined.
 Epistemic authority is transferred to statistician or the expert in
econometrics
 The views of the users of services are also no evidence; their
epistemic authority is undermined.
50
Sect. 3: Trust in Numbers - Why worry?
D. Makes policy decisions less accountable to
the public
 Adopts the rhetoric of impartiality and value neutrality
for what are value-laden appraisals and evaluations.
Hence, prevents full scrutiny of the political will of
governments and funders.
 Deprives deliverers and users of ownership of
services.
 Might undermine trust
51
Sect. 3: Why Worry? Specific Issues
 RCTs and the problem of applying to different
situations (Cartwright, 2010)
 How to extrapolate from it worked there to it will work
here.
 Meta-analysis and the problems of (Pawson, 2005)
 Classification into sub-groups
 Hidden heterogeneity of outcomes
 Hidden contexts
52
Sect. 4: How could a feminist
pragmatist philosophy of science help?
 By investigating the role of values and of judgments
about salience
 EPPI by focusing on evidence (true propositions in
support of the policy intervention) ignores the ways
in which values guide
 which studies are conducted
 the concepts in which the studies are formulated
 the way studies are classified into sub-groups
 the conceptualisation of the outcomes
53
Sect 5: Measuring Poverty
- A Case Study
 There are at least four notions of poverty:




Relative Poverty:
Absolute and Quasi-Absolute Poverty:
(Majoritarian) Subjective Poverty:
Material Deprivation
 The groups defined as poor depend on the definition.
54
Sect. 5: Measuring Poverty
 Relative Poverty
 Measures social exclusion
 Based on egalitarian grounds
 Problems:
 Poverty rises and falls in counterintuitive ways
 Income is not closely related to living standards
 Ignores regional and global variations
 Ignores cost of living variations
 Ignores across time trends
 Assumes fairness within household
55
Sect 5: Measuring Poverty
 Why was it chosen?
 Egalitarian considerations
 Ease of measurement
 Income based measure also used in the US
(although it is absolute)
56
Sect 5: Measuring Poverty
 Material Deprivation (inclusive of social goods)
 Subjective Poverty
 Both rejected because ‘subjective’
57