1. Robin N. Fiore, PhD Florida Atlantic University Ethics, Advocacy, and Women’s Health

2. Women’s Health Movement Goal: women’s empowerment Goal: women’s empowerment Education Education Policy Advocacy Policy Advocacy Service Provision Service Provision Critique of Sexism Critique of Sexism

3. Education Self Help Self Help Boston Women’s Health Collective Boston Women’s Health Collective Our Bodies, Ourselves1969 Our Bodies, Ourselves1969 FFWHC Federation of Feminist Women’s Health Centers FFWHC Federation of Feminist Women’s Health Centers

4. Policy Advocacy Barbara Seaman Barbara Seaman The Doctors’ Case Against the Pill 1969 Belita Cowan Belita Cowan DES -Advocates for Medical Information (AMI) 1971 NWHN National Women’s Health Network

5. Provision of Services “ Jane” – abortion referral and provision “ Jane” – abortion referral and provision Lay provision of artificial insemination for Lesbians Lay provision of artificial insemination for Lesbians Independent research on contraceptives Independent research on contraceptives

6. Critique of Sexism WHM analyzed sexism and racism in the ways in which health care is delivered, in the ways in which health care is delivered, with respect to access to high quality health care services, with respect to access to high quality health care services, with respect to women’s control of resources and their ability to influence medical decision- making and research with respect to women’s control of resources and their ability to influence medical decision- making and research

7. Snapshot of Women’s Health US women rank 16th in life expectancy US women rank 16th in life expectancy U.S. infant mortality ranks between 17th and 20th U.S. infant mortality ranks between 17th and 20th teen pregnancy rate is 2nd highest in the West teen pregnancy rate is 2nd highest in the West AIDS is the leading cause of death among women of reproductive age AIDS is the leading cause of death among women of reproductive age time from AIDS diagnosis to death is shorter in women than for men time from AIDS diagnosis to death is shorter in women than for men

8. National Women’s Law Center Making the Grade on Women’s Health: A National and State by State Report Card

11. Florida Demographics

14. Women and Aging 59% of persons over 65 59% of persons over 65 72% of the poor elderly  45% of elderly women live below the poverty line 72% of the poor elderly  45% of elderly women live below the poverty line 1/3 more years beyond normal retirement age years (20 v 15 years) 1/3 more years beyond normal retirement age years (20 v 15 years) half as likely to have pensions (24% women/46% men) half as likely to have pensions (24% women/46% men) Pensions half as much Pensions half as much

15. Gender and Care Men get care from spouses: 12million women are in-home caregivers, many over age 70 Men get care from spouses: 12million women are in-home caregivers, many over age 70 Caregiving exacerbates morbidity in women – less attention to caregiver’s needs Caregiving exacerbates morbidity in women – less attention to caregiver’s needs Women more likely to outlive spouses, must pay for home care Women more likely to outlive spouses, must pay for home care

16. Disability Free Years Men at 65: Life expectancy 80 (15 years) Age at disability 74 Age at disability 74 Years of disability 6 Years of disability 6 Women at 65: Life expectancy 84 (19 years) Age at disability 76 Age at disability 76 Years of disability 8 Years of disability 8

17. Medicare and Women’s Needs Health Insurance and Medicare covers12% more per year per male beneficiary Health Insurance and Medicare covers12% more per year per male beneficiary emphasizes good hospital coverage (men use 5% more hospital care, ¾ of nursing home patients are women) emphasizes good hospital coverage (men use 5% more hospital care, ¾ of nursing home patients are women) Undercovers chronic disease – women have more chronic diseases of aging Undercovers chronic disease – women have more chronic diseases of aging Undercovers adaptive aids, home care (2/3 of home care consumers are women) Undercovers adaptive aids, home care (2/3 of home care consumers are women)

18. JAMA 1994 Survey of Family Caregivers 34% provided majority of care for patients 34% provided majority of care for patients 31% lost all or most of savings; 6% lost house 31% lost all or most of savings; 6% lost house 29% lost major income source 29% lost major income source 20% caregiver quit work 20% caregiver quit work 12% stress impairs other family members 12% stress impairs other family members 6% delayed medical care for others 6% delayed medical care for others

19. Feminization of Poverty Creation of permanent class of poor elderly women due to burden of caregiving: lost work hours lost work hours interrupted work history interrupted work history decreased job rank decreased job rank decreased pensions and Social Security decreased pensions and Social Security decreased consumer savings decreased consumer savings excess morbidity cost of caregiving excess morbidity cost of caregiving

20. The Next Generation 3 out of 5 Palm Beach County students in grades 6-12 responded that someone lives in their homes who needs help caring for themselves 3 out of 5 Palm Beach County students in grades 6-12 responded that someone lives in their homes who needs help caring for themselves Of those, 9 out of 10 said they assist in that care and that it adversely affects their homework, or causes them to miss school activities Of those, 9 out of 10 said they assist in that care and that it adversely affects their homework, or causes them to miss school activities

21. Accomplishments of WHM Abortion remains legal, though limited Abortion remains legal, though limited Informed consent for breast biopsies, c- sections Informed consent for breast biopsies, c- sections Protection from unnecessary medical procedures, sterilization abuse, and medical experimentation Protection from unnecessary medical procedures, sterilization abuse, and medical experimentation Right to know RX side effects and contraindications Right to know RX side effects and contraindications Allocation of more federal $$$$ to research on women’s health issues Allocation of more federal $$$$ to research on women’s health issues

22. Challenges for Future Dignified, affordable, accessible, primary and maternal health care for poor women Dignified, affordable, accessible, primary and maternal health care for poor women AIDS and HIV prevention and care AIDS and HIV prevention and care Long Term Care Long Term Care

23. Florida Bioethics Network University of Miami/FBN Annual Clinical Ethics Conference April 8, 2005 Wyndham Miami Beach Resort www.miami.edu/ethics