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Society's Choices: Social and Ethical Decision Making in Biomedicine
This persistent distrust of public health officials could thwart efforts to reverse the current decline in the health of minority groups. Indeed, the documented disparity between the health status of Americans based on race and class reinforces the view that current health policies are not responsive to the specific needs of these groups. These and other health inequalities likely reflect differences in access to and quality of health care services for minority and poor populations. While recent initiatives have been established to improve the health of minority groups (National Institutes of Health, 1991), the sad history of medical racism and the suspicion it engendered remains to be addressed.
Women: A Struggle for Control
The women's movement began to take shape in the late 1950s and early 1960s, on the heels of early successes in the civil rights movement. The first mainstream women's organization, the National Organization for Women (NOW), was organized in 1966 to focus on attainment of women's legal rights; other groups followed with a less traditional agenda. By the early 1970s, the "women's liberation movement" emerged full force, composed of both the more traditional groups and a younger, more radical, cohort. A slogan of the movement, "the personal is political," highlighted its concern not only with discriminatory legal barriers to women, but also with more subtle, pervasive cultural sexism (McGlen and O'Connor, 1983; Rosenberg, 1992).
The women's movement was unique in its concern, from the outset, with health-related issues-namely, the need for women to control their reproductive lives as a prerequisite for individual autonomy. Reproductive politics surrounding both abortion and contraception engaged feminists early on. Women exerted enormous pressure toward the repeal of restrictive abortion laws from 1968 to 1973. Women's groups were also instrumental in facilitating access to illegal abortions; one group in Chicago organized an underground abortion clinic where abortions were performed by self-trained women (Petchesky, 1990). Access to contraception, previously the purview of the population control movement, arose as another leading demand of the women's movement, centering on theories of self-determination, sexual discovery, or "sexual liberation" (Gordon, 1976).
These reproductive issues became the catalyst for the formation of a distinct women's health movement in the early 1970s. As restrictions on reproductive freedom came to be seen as an issue of male domination over women's sexuality and autonomy, the movement expanded to encompass a broader challenge to the male-dominated medical profession's authority to dictate women's health in many other areas. With the first publication of Our Bodies, Ourselves by the Boston Women's Health Book Collective in