Medicine as a Site of Gendered Social Control: Making Provision Decisions Based on Patients' “Deservingness”

• In Event: 284 - Regular Session. Gender

Abstract

This article uses the case of Emergency Contraceptive Pills, post-coital contraceptives that have received significant political attention, to examine how medicine acts as a site of gendered social control. Drawing on theories of medicalization and the social control of women’s bodies, I theorize about how healthcare providers act as “moral gatekeepers” by drawing on broad cultural narratives about women’s sexuality when making decisions about providing reproductive healthcare. This theoretical approach contributes to existing literature by taking a micro-level approach to understanding gendered social control, focusing on the discretion of purportedly subordinate professionals, examining the construction of “deservingness,” theorizing about the power of refusal as a mechanism of social control, and addressing the role of politicized environments in shaping healthcare delivery. I conducted 95 interviews with pharmacists working in four states with different “pharmacists’ responsibility laws” that dictate whether pharmacists can refuse to dispense drugs they morally oppose. I analyze these data by comparing pharmacists’ narratives about dispensing ECPs to their narratives about hypothetically dispensing RU-486, the medical abortion pill. Through these narratives, pharmacists express constructions of patient deservingness that are closely tied to broader cultural narratives about women’s sexual responsibility. I demonstrate how pharmacists construct these narratives and use these findings to theorize about gendered social control. Findings from this study advance theory in new directions, particularly by addressing incomplete medicalization, the social control of normal rather than deviant behavior, and the power of refusal as a mechanism of social control.

Author

• Elizabeth Chiarello, Saint Louis University