Facts Intrude on Feminists' Dance with Science


June 28, 1991|By RONALD DWORKIN

Feminism has provided valuable insights into the habits, customs and mores of Western society. As a scholarly discipline, however, it has traditionally concerned itself with non-scientific issues, such as male-female relationships in the work place and in the bedroom. It has centered its attack on Western beliefs and opinions, avoiding the preserve that is scientific knowledge, thus incorporating the supposition that there is a difference between the two.

But more recently, feminists have allied themselves with a new and more radical position of the extreme left, which states that there is no difference between knowledge and belief. Fact and art, truth and opinion, blend into a common perspective. The new school, known under such titles as post-modernism and deconstruction, has emboldened traditional feminists and encouraged them to spread their attack to natural science and, in particular, to medical science.

Medical practitioners have long been chastised by feminists for their insensitivity shown toward women in clinical settings, and with some justification. After fixing the attention of the medical community on this problem for more than a decade, feminists have had some success in making graduating male medical students and residents more aware of women's issues.

Now, however, it is the actual scientific content of medical science, not the attitudes of its practitioners, that is being challenged by some feminists. I believe that this more radical change in feminist goals is misguided and physically dangerous.

For example, one feminist study describes the insensitivity of male physicians relative to female midwives in their management of pregnant patients. It was reported that midwives are more sensitive to the symptom of nausea experienced by women in labor, evident in the midwives' increased willingness to feed these patients immediately prior to delivery in an attempt to ease the symptom.

However, the failure of male physicians to feed their patients while in labor is not grounded in chauvinism but in well-researched data that show a leading cause of death in pregnant patients to be aspiration of stomach contents under anesthesia. The practice of physicians appears to be insensitive, but that view is distorted for, in actuality, it rests on a firm bed of knowledge.

To support the actions of the midwife, who is ''sensitive'' but not a physician, would lead to an increase in the maternal mortality rate.

In another study, a feminist researcher observed that during Caesarean sections, the pregnant patient on the operating-room table was always tilted to the left, with the male physician standing on the right side and the female assistant standing on the left. She concluded, with the input of nonmedical personnel, that this arrangement occurred because the male physician did not want to soil his feet with the patient's blood and fluids, thus he tilted the patient to the left so that the contents would spill on to the feet of the female assistant.

A perfect example of male domination and female humiliation, right?

Wrong. For pregnant patients are tilted to the left because the enlarged uterus compresses the vessel which returns blood back to the heart, which happens to be on the right side of the body. The uterus is lifted off that vessel by tilting the patient to the left, thus preventing a catastrophic drop in blood pressure.

Since most physicians are male and right-handed, and because it is easier for a right-handed physician to deliver the baby from the right side, the male physician generally stands on the right side of the patient. His nurse assistant, who often happens to be female, must stand on the left side. Hence, what appears to be an example of domination and subjugation is merely an example of distortion grounded in a lack of knowledge.

To ''correct'' the situation by preventing the patient from being tilted to the left could lead to a dire result for mother and baby, including cardiac arrest.

The intrusion of radical politics into medicine, and science in general, has obviously occurred without invitation. Physicians and scientists consider their disciplines to be apolitical, and many would remain content to observe the turmoil in other corners of social and political life in the peaceful role of spectator.

But radical politics sees in medicine and science another opponent, for radicals have already cowed the quasi-scientific disciplines, such as sociology, criminology and psychology. These disciplines have not been successful in proving a claim to knowledge because their theories are not reliably predictive of outcomes. In those fields, opinion and fact seem to blur.

But to the chagrin of feminists and radicals, medicine can offer a rational, nonpolitical, account of itself. It can reliably predict. Its practice is grounded in real knowledge. There is a difference between medicine and cookery, between science and art.

Hence, the attempt to politicize the content of science and medicine will fail. By launching an attack on the apolitical behemoth that is science, feminists and radicals will find that their marching songs are childish and their weapons are dull. They will succeed in doing nothing more than arouse a sleeping giant.

Ronald Dworkin is a physician doing graduate work at Johns Hopkins University.

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