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Few diseases have made more difference to our understanding of illness, the relation of the patient to the physician and other health care professionals, and the social context of disease than breast cancer. Breast cancer activism has provided a model of public policy advocacy for women, as well as for sufferers from other diseases, and even in causes unrelated to health. In many ways it has become emblematic of issues in women’s health. This volume offers a discursive analysis of breast cancer. From multiple perspectives—historical, philosophical, psychological, socio-political—these essays explore the competing narratives that have made breast cancer a contested site. It addresses debates about the autonomy of the patient in relation to the authority of the physician, as well as the importance of patient narratives in understanding disease. It analyzes the relation between the community and medical practice, particularly with regard to the effect of breast cancer activists and feminists on the medical understanding and treatment of breast cancer. And, it questions the intersection of medical science with political institutions and agencies of public policy in determining priorities of research and strategies of treatment.
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THE VOICE OF BREAST CANCER IN MEDICINE AND BIOETHICS Philosophy and Medicine VOLUME 88 Founding Co-Editor Stuart F. Spicker Editor H. Tristram Engelhardt, Jr., Department of Philosophy, Rice University, and Baylor College of Medicine, Houston, Texas Assistant Editor Lisa Rasmussen, University of North Carolina, Charlotte, North Carolina Associate Editor Kevin Wm. Wildes, S.J., Department of Philosophy and Kennedy Institute of Ethics, Georgetown University, Washington, D.C. Editorial Board George J. Agich, Department of Bioethics, The Cleveland Clinic Foundation, Cleveland, Ohio Nicholas Capaldi, Department of Philosophy, University of Tulsa, Tulsa, Oklahoma Edmund Erde, University of Medicine and Dentistry of New Jersey, Stratford, New Jersey Eric T. Juengst, Center for Biomedical Ethics, Case Western Reserve University, Cleveland, Ohio Christopher Tollefsen, Department of Philosophy, University of South Carolina, Columbia, South Carolina Becky White, Department of Philosophy, California State University, Chico, California The titles published in this series are listed at the end of this volume THE VOICE OF BREAST CANCER IN MEDICINE AND BIOETHICS Edited by MARY C. RAWLINSON Stony Brook University, Stony Brook, NY, U.S.A. and SHANNON LUNDEEN University of Pennsylvania, Philadelphia, PA, U.S.A. A C.I.P. Catalogue record for this book is available from the Library of Congress. ISBN-10 ISBN-13 ISBN-10 ISBN-13 1-4020-4508-5 (HB) 978-1-4020-4508-0 (HB) 1-4020-4477-1 (e-book) 978-1-4020-4477-9 (e-book) Published by Springer, P.O. Box 17, 3300 AA Dordrecht, The Netherlands. www.springer.com Printed on acid-free paper All Rights Reserved © 2006 Springer No part of this work may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording or otherwise, without written permission from the Publisher, with the exception of any material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Printed in the Netherlands. TABLE OF CONTENTS ACKNOWLEDGEMENTS vii INTRODUCTION Negotiating Personal and Political Settlements with Breast Cancer: Women Finding Their Own Ways to Live with Human Contingency Rosemarie Tong . . . . . . . . . . . . . . . ix DISCOURSES OF BREAST CANCER: WHO SPEAKS FOR BREAST CANCER? 1. Personalizing the Political: Negotiating the Feminist, Medical,