Zairu Nisha in her work outlines the medicalization of women's bodies, the working of medical gaze as Foucault theorized and the improvement in technology has rather lead to perpetuation of patriarchy by looking and treating women's bodies as procreative machines which is profited by pharmaceuticals and medical practitioners (Nisha, 2021). The field of medicines is seen as universal, neutral and objective which helps society at large. The treatments by medical sciences and research have invented life saving treatments and drugs for diseases. But despite given the neutral character, the practice of medicine is culturally and socially constructed and influenced (Kang et al., 2017). Feminists have noticed the various power dynamics and gender-power intersections in the practice of medicine which plays a role in medicalizing the bodies, this continues to shape sex and their status-quo(Kang et al., 2017). 

Irving Zola lays the foundation by introducing the notion of medicalization and social control mechanisms which has medicalized daily lives of people (Zola, 1972). Peter Conard, a sociologist, asserts that medicalization is a process “when a non medical condition is prescribed and understood in medical terms and responded to with medical interventions”(Conard, 2008). There is a medical authority which is established according to Conard- ideology, collaboration, technology, surveillance as a form of medical social control. Medical surveillance, as Foucault suggested, takes the form of “medical gaze”. According to him, the medical gaze is based on presuppositions and penetrating illusions (Foucault, 1973). Therefore, in a society with multiple identities intersecting, bodies come under the medical gaze and are under constant investigation and experiment (Nisha, 2021). Medicalization penetrates the patriarchy- where “procreative bodies are seen are inferior, deviant, and mutilated and cause of all diseases that require proper medical care, treatment and control that led to medicalization of their body and self”(Nisha, 2021).  The medicalization and shaping of women's bodies has been under the scrutiny of many feminist scholars, from De Beauvoir to IM Young, existential in their accounts they reject the determinism and argue to question and define the existence of being a woman. There is a need to de-medicalize understanding of bodies and maternity and research towards non-medically alternatives.

BIOETHICS

In her article, Tong(2022) tries to lay out the need for global Bioethics by taking into rights based approach and care based approach and the transition to global bioethics. Initially, the goals of feminist Bioethics were to be achieved by emphasising women's "sameness" to men. However, as Shanter and Tong point out, this framework is not without its limitations. Primarily, it privileges traditionally male spheres, implicitly suggesting their superiority over domains historically associated with women. Furthermore, it overlooks the distinct physical and psychological needs that women may possess, thereby potentially advancing policies or practices that are misaligned with their actual well-being.

Under the Rights based approach, along with Bunch, feminist scholar, Susan Moller Okin also claims the need to talk about women's need, “generally as well as specifically”(Okin,1994). But the rights based approach faced many problems, these came to surface in women's international conferences where the Western feminist approach significantly rejected the differences from Third World feminists. While Western focus was on rights and its universal claim, as we later saw these rights centred the needs of nations like the USA (McCarthy et.al, 2020). As feminist political theorist Anne Phillips observed, that universal human rights may have been placed as central in western cultures but for many indigenous cultures the value of community and family ties are placed over personal autonomy (Phillips, 2022).There was an attempt by Nussbaum by theorizing the state to provide all the imaginable capabilities like “life, bodily health; bodily integrity; senses; imagination and thought; emotions; practical reason; affiliation; other species; play; and control over one's environment”(Nussbaum, 2002). But this approach was criticised by thinkers like Engter as not a reflection for all women rather mostly voluntarily Western women (Engter, 2005).

For Rosamarie Tong, bioethics can be made global through the writings of care based thinkers(Tong, 2022). Kittay characterizes the need for a certain epistemic skill set, an understanding of context with the moral aim to maintain the connections(Kittay, 2006). Care based bioethicists have questioned the abstract right based approach of people of Global North(Robinson,1999). According to them, care based ethics and practices needs to develop for people to carefully work with each other where everyone can thrive (Mohanty et al., 2003).

UNCONSENTED AND UNSEEN: THE IRWIN COUNTY DETENTION CENTRE INCIDENT 

In September of 2020, a nurse at the Irwin County Detention Centre in Georgia stepped forward with allegations that exposed the troubling connection between immigration control and reproductive injustice in the United States. Dawn Wooten, the whistleblower, revealed how migrant women, many of whom were undocumented and Spanish-speakers, were subjected to gynecological surgeries, including hysterectomies, without proper consent or even a clear understanding of what was happening to them. 

This isn't simply an isolated incident. It is a part of a disturbing historical trend where state and medical institutions work together to monitor and assert their control over reproductive bodies. Here, the rhetoric of care and necessity was twisted to rationalise procedures that ultimately did not promote healthcare or healing. Sociologist Peter Conrad’s theory of medicalisation sheds light on how institutions transform social issues into medical diagnoses. At the Irwin County Detention Centre, immigration and vulnerability were not seen as humanitarian matters but were instead reframed through a medical perspective that allowed for control. 

This case challenges the very idea of bioethics. It forces one to think about who gets to define what ethical treatment looks like, and when these medical decisions are being made within a political framework, who reaps the benefits? Who is left to suffer? The Irwin County Detention Centre Scandal isn't simply a tale of malpractice; it's a deep dive into how structural racism, misogyny, and state surveillance come together in the clinic. 

In India, as in other countries one can find correlation between healthcare and political economy.  Kailthya and Kambhampati(2022) in their article have set down the relation between politics and healthcare- the lack of visibility in the area of public goods and its distortion of competition among the healthcare provisions. Down(1957) observed that information is costly to obtain and the cognitive deliberation required to be aware of the policies, people tend to remain rationally ignorant. Schilbach et al. (2016) commented that the people facing scarcity tend to make judgmental errors. There is an information friction in healthcare which impacts the choices of voters(Arrows,1963; Das et al., 2016).

They also unveil the emphasis of the state on highest visible goods over the less visible public goods. The political competition induces the need to focus on health care centres than actual services provided (Mani and Mukand, 2007). In politics, the intersection of caste, religion, gender, ethnicity also becomes important in ones access to healthcare(Wantchelcon, 2003; Adida et al., 2017). Political alignment of doctors becomes an important factor during election years as the ones who do not support are, at many times, fired. (Kailthya and Kambhampati, 2022). 

THE TUSKEGEE SYPHILIS STUDY 

In Tuskegee, Alabama, from 1932 to 1972, hundreds of black men were knowingly left untreated for syphilis by U.S public authorities, under the guise of medical research. This was not a failure of science; it was a triumph of institutional neglect, racial control and medical paternalism because even when penicillin became widely available, the doctors withheld it. However, the violence did not end with the men. Wives were infected. Children born with congenital syphilis. And the women, whose pain was collateral and whose agency was never acknowledged, became invisible casualties in a system that saw neither gendered consequences or racial accountability. 

The infamous Tuskegee Study exposes the brutal efficiency of the medical gaze when it operates without ethical resistance. A feminist bioethics does not treat Tuskegee as a historical footnote. It reads it as a warning. It reminds us that consent without information is coercion, and care without justice is surveillance. To reflect ethically on the body, we must first reckon with those whose bodies were never seen as fully human to begin with.

References:

Tong, R. & The Author(s). (2022). Towards a feminist global ethics. In Global Bioethics (Vol. 33, Issue 1, pp. 14–31) [Journal-article]. https://doi.org/10.1080/11287462.2021.2011002

Nisha, Z. (2021). The medicalisation of the female body and motherhood: some biological and existential reflections. Asian Bioethics Review, 14(1), 25–40. https://doi.org/10.1007/s41649-021-00185-z

Roy, A. (2021). Biopolitics and IM/Possible Citizenship: Gender, Epidemiology and ‘Panoptic Citizenship’ in India. Journal of Decolonising Disciplines, 3(1). https://doi.org/10.35293/jdd.v3i1.3717

Khanday, Z. A. (2013). Review on Medicalisation: A critical appraisal with special reference to India. International Journal of Medical Sociology and Anthropology, 2(2), 066–075. https://www.internationalscholarsjournals.org

Kailthya, S., & Kambhampati, U. (2022). Political competition and public healthcare: Evidence from India. World Development, 153, 105820. https://doi.org/10.1016/j.worlddev.2022.105820

Sequeira, R. (n.d.). Care before the Primary. Bioethics Is Non-negotiable.

Gideon, J., Asthana, S., & Bisht, R. (2024). Health systems in India: analysing barriers to inclusive health leadership through a gender lens. BMJ, e078351. https://doi.org/10.1136/bmj-2023-078351

Project South. (2020). Whistleblower complaint filed by Dawn Wooten. projectsouth.org/wp-content/uploads/2020/09/OIG-ICDC-Complaint-1.pdf 

House Committee on Oversight and Reform. (2021). Investigation confirms abusive gynecological practices at ICE detention center. oversight.house.gov/news/press-releases/house-investigations-confirm-allegations-of-abusive-gynecological-care-at-irwin 

Gamble, V. N. (1997). Under the shadow of Tuskegee: African Americans and health care. American Journal of Public Health, 87(11), 1773–1778. doi.org/10.2105/AJPH.87.11.1773 

Centers for Disease Control and Prevention (CDC). (2023). Tuskegee Study Timeline. www.cdc.gov/tuskegee/timeline.htm 

Washington, H. A. (2006). Medical Apartheid: The Dark History of Medical