Profitable Promises: Essays on Women, Science, and Health.br> By Ruth Hubbard,br> Common Courage Press, 1995, 238 pages, $11.95 paper.
It is sometimes convenient to dismiss appraisals and criticisms like these as opposing progress or as anti science. But that is altogether too facile. Science is a useful way to learn about nature, including ourselves, and with proper guidance and supervision, its technological results can make life better. The problem is that, at present, the benefits science can bring us are overvalued, as compared with the benefits we could derive from othercreations of the human imagination, be they cultural or political. And when technology is harnessed to yield profits for the few rather than to improvethe lives of most people, science and its technological products underminerather than enhance our lives. (14,15)
THE ABOVE QUOTATION is illustrative of the crux of Ruth Hubbard’s latest work in the movement to transform science and society’s perception of science, and our complicity in its control of our lives.
In Profitable Promises, a collection of essays building upon Hubbard’s earlier works Exploding the Gene Myth and The Politics of Women’s Biology, she hopes to dispel some of the myths generated in the popular press about the capacity of science and technology to solve many of our social problems, and to waken our critical caution as modern-day consumers of technology. Hubbard synthesizes the research and views she presented in these earlier works to explain the reality and relevance of feminist and radical critiques of science to the very fabric of our lives, specifically in the defining of health/illness, normal/abnormal, and nature/nurture.
Herself a biologist, Hubbard is adamant in her assertions and warnings about the evolving genetic and technological trend in science and in our society. Her major focus is on the trend toward medicalization and geneticization at the expense of sociopolitical realities, and the underlying forces driving genetics research, reproductive technologies, and sociobiology.
In the first section of Profitable Promises, "The link between genes, illness, and behavior," Hubbard presents examples of the geneticization of our lives and the distortions it presents in biological ideology and material outcomes.
The ideological underpinning of the "imperialization of human experience" through the labeling of desirable and undesirable genetic traits was solidified with the exposition of DNA as the master molecule and blueprint for human characteristics. Scientists have endowed DNA with a "mythic potency" and Godlike control: Ideas of health and illness, as well as human behavior, she states, "are being shaped by scientific knowledge of the way DNA functions."
The problem with this ideological framework is the fallacy of its narrow and limited assumption of DNA control, as well as its propensity to allow dismissal of other biological, social, political, and economic factors which contribute to the character and flavor of our lives, including our health.
Within this context, science is dominated by genes and molecular biology. Recombinant DNA techniques, designed to provide a certain type of information, have a natural propensity toward demonstrating interactions in identifiable and predictable ways – based upon the ideology from which they were designed. The complexity of gene interactions and biological systems are ignored, in favor of reduction to more simplistic renditions that allow manipulation (and subsequently prediction of action) by the techniques and instruments of molecular biology.
The search for molecular markers of "broken genes" becomes the focus of scientific attention, regardless of the multiplicity of interactions which may determine the extent to which that altered gene may have on the individual. Armed with DNA testing technology, science/medicine increasingly labels peop before symptoms appear, and regardless of whether the disease ever occurs. Hubbard is disturbed by this trend and points out that the actual basis of the diagnosis is statistical probability. The problem, she says,
with such predictions is that, for most so called genetic conditions, the severity of the symptoms can vary a good deal, both from person to person and for the same person over time. This can be so because other biochemical or environmental factors in addition to the specific inherited change in DNA may affect the manifestations of that condition. Also, different alleles of thesame gene can lead to different outcomes. A predictive diagnosis, or name, attached to a future genetic condition usually cannot take the effects of such variables into account. (41)
Furthermore, especially with regard to prenatal testing, "predictive labeling always involves prejudgements and prejudices." Inherent in this process are people "diagnosed" with diseases, many for which there are no preventive measures to take or treatments (e.g. Alzheimers), and resultant material social costs, such as health insurance discrimination, whether or not disease exists.
The connection between capital and economic interests and genetic testing goes even deeper, Hubbard explains, because predictive tests (for entire populations) are more profitable than therapies (for those with disease) and are thus promoted and favored for limited resources fundingtheir development. (50)
The enterprise of using genetic prediction in relation to behaviors isequally dubious, Hubbard warns. She outlines problems with current trends in relation to mental illness, homosexuality, and criminal behavior. The political climate around the debate over homosexuality and gay rights and the gay rights movement stimulated the scientific interest in the search for the "gay gene."
Though Hubbard does not necessarily agree with many gay rights activists who believe naming such a gene would be beneficial for gays and lesbians, she points out the connection between the scientific search and the political construction of the so-called problem. She argues that the ideology which supports searching for a "broken gene" accounting for the sexual preferences of gays and lesbians ignores the long cultural history of same-sex attractiveness, as well as the fact that people have all sorts of different strong and consistent sexual orientations – those to certain hair colors, body sizes, ethnicities, etc. (83)
In perspective, the search for a gene for same sex attraction makes as much sense as searching for a gene for attraction to blondes or brunettes – a genetic marker which would need to be present in all people who preferred blondes, but absent in all people who did not. Such preferences cannot help but be influenced by environmental and social factors; trying to distinguish a specific gene is futile.
Another example she provides is the 1992 controversy regarding NIH’s Genetics and Crime conference. Despite the fact that people commit many different crimes, she argues, only certain crimes are linked to genes. No one tries to identify genes for committing Savings & Loans fraud, insurance scams, or perjury when testifying before Congress. Current attempts to "biologize" criminal behavior distracts attention, she explains, from the obvious economic and social reasons why certain groups of people are more likely to be in prison. Recognizing these would require much more difficult social and economic remedies addressing more pertinent problems such as malnutrition, hunger, poverty and infectious disease. (79)
Hubbard does not deny a role for genes in behavior and mental functioning, only the useful value of information about DNA sequence variations when there are numerous uncontrollable and varied factors and people involved in shaping our individual psyches. Prediction and classification "cannot substitute for the social and psychological help people need in times of stress and pain ...[and] the renewed focus on genes weakens the fabric that holds families and societies together by individualizing responsibilities for the breakdown of what are their core interpersonal and social relationships." (75)
In her second section, "Women, Science and Power," Hubbard concentrates specifically on women’s health issues. She disucsses the fact that "women’s health" still often refers to pregnancy and childbirth, although procreation has become a smaller portion of women’s lives and there are many more prevalent and pressing medical concerns for women.
Furthermore, women’s needs and concerns are often overlooked in preference of the fetus, by technology which focuses on the fetus and in effect renders women "transparent." Hubbard discusses three main areas of medical neglect with respect to women: breast cancer, AIDS, and occupational health. She then expands upon the gendered ideology guiding research of sex differences and its subsequent support of gender ideologies; the constructed maternal/fetalconflict; and the patriarchal desire to understand nature by controlling it, associating it with the female, and creating false "nature/nurture" dichotomies through by associating certain traits with male and female as determined by genetics.
The combination of male domination of the medical profession with social inequities has greatly affected women’s health, Hubbard asserts. Women have long been ignored in health research and excluded from clinical trials. This has been rationalized based upon dual assumptions: first, that women are the same as men and that their physiological systems will respond the same as men’s; second, that using women will confuse the data due to their more complex hormonal systems.
Ironically, due to the different physiology, women may not respond similarly to men, as scientists (mostly male) have recognized. However, since this inconvenience may "confuse" the data, it is expendable. This bias manifests itself in the selection and definition of problems for study, the choice of experimental subjects, and conclusions drawn from the data.
A recent example illustrating Hubbard’s concern was the 1989 study of the effects of aspirin on cardiovascular disease. Although heart disease is the biggest killer of both men and women, all theapproximately 22,000 subjects were men. A study examining mortality from coronary heart disease used 12,866 men, and the follow-up study on coffee consumption and heart disease used 45,595 men only.
Since heart disease has traditionally been designated a male disease because it generally occurs at younger ages in men, the majority of funding has been appropriated to studies of predisposing factors using white, middle-aged, middle-class males. Even though heart disease is the leading cause of death for older women (who on average live eight years longer than men) and is frequent in poor and African-American women who have had several children, research and funding has not reflected this information.
AIDS research is another area where there has been very little study on the symptoms and progression of the disease in women, despite the fact that women constitute the largest growing group to contract AIDS. The life expectancy of a man diagnosed with AIDS is 30 months whereas for women it is 15 weeks.
In addition to this discrepancy, Hubbard points out that the focus of attention has been on prostitutes and pregnant women: "The questions that are debated most assiduously are not how to protect women from becoming infected, and how to keep infected women healthy and alive for their own sake, but how to keep them from becoming ’vectors’ of infection to men and babies." (95)
The strategy of educating women about AIDS prevention by encouraging use of condoms is also deficient, she asserts. Without taking into account the sexism and patriarchy in society which results in violence against women and the often impossibility of negotiating condom use, women will not benefit from such a narrow tactic. Society must begin holding men accountable for their actions or women’s infection rates will continue to increase.
Another aspect of the medical neglect of women regards breast cancer research. The media and the medical establishment "advertise" the breast cancer epidemic and scare women into the medical system. Hubbard points out the inflation of breast cancer incidence statistics, the lack of knowledge about the biology of women’s breast, and the impact of different factors upon mammary tissue physiology.
Despite the advance of mammography and earlier detection and therapeutic intervention, breast cancer death rates have changed minimally in the past 50 years. Until very recently, research into environmental factors such as toxic chemicals and diet was sorely neglected and rejected. Yet "manufacturers of mammography machines and tamoxifen and other ’preventive’ drugs and devices stand to make a healthy profit off women’s fears of this cancer" – and therein, for Hubbard, lies the logic behind the intentionally misleading numbers given by The American Cancer Society. (94)
Several years ago, the hotly promoted breast cancer "prevention" trial was not a low fat diet or environmental chemical restrictions, but revolved around the drug tamoxifen. This trial was based on the premise of a 30-40% reduction in cancer of the second breast among women with breast cancer who had been treated with tamoxifen. This rate was not based on women without cancer, however, and risk factors of the drug were gravely minimized.
The concept of this trial as prevention was attacked by several women’s groups, but greatly promoted by the scientific/medical establishment, and the drug companies who fund research of these drugs. Additionally, many (mostly male) scientists are not concerned about women’s total health when they design experiments and ask questions about these drugs, but rather the containable efficacy of the drugs involved.(1)
In a recent issue of Science (vol. 270, 12/8/95, 1562), it was announced that the long term tamoxifen therapy experiment (National Surgical Adjuvant Breast and Bowel Project, B 14 trial) was canceled because it is now believed that there is no advantage to taking tamoxifen for greater than five years, and indeed it may even be detrimental. Nonetheless, although women who are in clinical trials will receive this new warning, it will be difficult to change the use of the drug by physicians who are not participating in trials – since "many people in this country feel that tamoxifen is a wonder drug."
According to the NCI, as many as one million U.S. women are taking tamoxifen, and up to 20% of these for more than five years. It is precisely because of the many issues Hubbard raises that tamoxifen is considered a "wonder drug," and promoted as the best possibility for prevention, even though there are likely detrimental effects associated with its use.
More importantly, the concept of "prevention" as giving a drug to healthy women is a dangerous concept. Hubbard points out that successful prevention campaigns throughout history have not involved giving drugs (with known side effects and unknown effects on healthy people) en masse to the population, but by more social interventions, such as improving sanitary conditions.
The growing grassroots women’s activism around these issues and the greater involvement of women scientists in policy have helped bring these concerns to light, and research regarding women’s health and the impact of high-fat diet and environmental toxins on breast cancer risk has begun to be supported, but is still secondary to drug intervention and genetic-based research.
Another example from breast cancer research that supports many of Hubbard’s criticisms is the recent finding of the "breast cancer gene (BRCA1)." Although breast cancers that fall within this category are few (5% or less; approximately 10% are heriditary and approximately 50% of these are due to BRCA1), this gene has received major attention.
Women are calling hospitals and diagnostic centers to find out about testing. But even for the small number of women whose breast cancer is associated with this gene, there is little that can be done once a diagnosis is made. This type of testing could in fact be harmful, in that if women find out they are negative for this gene they may be less likely to follow habits that all women (and men) should follow in order to stay healthy and increase their chances of avoiding cancer – more important than being tested for a genetic marker, or taking a drug which may in itself induce other cancers or health problems.
A woman tested positive may get a prophylactic mastectomy to reduce her chances of developing the disease – or may be prescribed tamoxifen. But the reality is that these are drastic procedures to take given that prediction is uncertain. The focus on this gene capitulates to the prevailing geneticization of our world view, especially given the proportionate cases of cancer due to this gene.
This is not to deny that this is a valid research area, which may indeed lead somewhere. The issue, however, is the disproportionate importance associated with the gene and the way in which it is embraced by the media and society. A review article in Scientific American (Science & Medicine, Jan/Feb 1996), a journal aimed at the scientifically minded general population, touched upon the lack of preventive and curative measure, but in its large type side bar claims: (U)nderstanding how the gene functions normally and what processes are affected by mutation will provide important information on development and prevention of breast cancer." (12)
The same article’s final section, entitled "Prediction does not mean prevention," speaks mostly to technical aspects of testing and the lack of treatment technology. The closing statement is that "some types of pharmacologic intervention may help to address technical problems associated with gene therapy. As researchers around the world provide clues, it may one day be possible to fight breast cancer with a drug, hormone, or small molecule that can be administered on a regular basis. However, until such intervention is available, options for breast cancer treatment and prevention remain limited." (21)
Although the word prevention is used, there is no mention of environmental, chemical or dietary factors in terms of "prevention," only gene therapy and drug intervention. Such high-tech ideas of prevention focuses on individual culpability and releases government, corporations and society as a whole from responsibility.(2)
Associated with the medical neglect of women in research is the overemphasis on procreation and childbirth. Varda Burstyn in her essay "Women, Medicine and Choice" (ATC 49, 19-26), describes this – and here I believe Hubbard would agree – as "patriarchal technology (which) might be understood as technology that serves to reduce women’s agency and subjectivity in fertility control and childbearing."(ATC 49; 20)
The current regressive atmosphere for women is not solely due to the work of the anti-abortion movement, but also to the increasing technology which allows society access to the fetus without consideration for the woman, states Hubbard. In fact, this technology goes beyond the woman as these tests are not understood without "expert" interpretation to tell us what they mean. Such technologies as ultrasound and in vitro fertilization encourage this focus on the fetus as opposed to the woman.
In vitro fertilization and "contractual pregnancy" helps foster the illusion of "eggs and sperm...and embryos, fetuses, and gestation as commodities that can be ordered from catalogs." Ironically, Hubbard points out, people do not have the same reaction to the many "abortions" which happen in the test tube as opposed to when the fertilized egg is in a woman’s body.
In Wisconsin a bill was introduced late in 1995 which created more than 20 crimes against an "unborn child," defined as "any individual of the human species from fertilization until birth." The "Feticide" bill would essentially establish legal recognition of a fetus as a separate and distinct individual, and indeed was presented at the request of the Wisconsin Right to Life. The legislation substitutes the fetus as the focus of the crime: The woman who wasbeaten, assaulted, or shot by an offender was not the victim of a crime.
Proponents of the bill stated that the bill was the only way to create proper punishment for someone who beats a pregnant woman and opposed the alternative, bill which made the woman the primary focus (i.e. imposing additional penalties if the woman was pregnant instead of increased penalties for harming a fetus). This legal example demonstrates potential legal and social ramifications of biological ideology and technology.
Based upon this patriarchal technological ideology, crimes have been created which place the woman and her fetus in conflict of interest. Women are increasingly criminally charged for endangering their fetus, yet when women attempt to gain access to drug treatment and other assistance programs, they are denied, and funding for social programs are being cut at every turn.
What is more effective for women, children and families, as well as cost effective? The alternatives to punitive charges (with costs to the legal system), potential emergency care, and more intensive medical needs fostered by the current system are proper nutrition, housing, job security, and health care from the outset.
Unfortunately, liberals and progressives, even socialists think very little about science, medicine and their respective institutions as they exist in reality. Attention is sometimes given to works like The Bell Curve, when people speak out against the blatant racial prejudice it contains; yet not enough is said about the science behind such prejudice, including ideology, methodology, history, and other factors.
One of Hubbard’s great attributes is her ability to counter prejudices cloaked in scientific treatises, including her work exploring the day-to-day activities of science as well as larger expositions like The Bell Curve. This type of analysis is exactly what Hubbard provides in the second section, with two specific critiques of books written by scientists attempting to "resolve" social debates via science.
The first is a critique of E.O. Wilson’s 1975 Sociobiology: Toward a New Synthesis, and the other is a book about abortion. In these reviews, Hubbard does in part what she calls for progressives, including scientists, and activists to do in the third section of Profitable Promises.
Hubbard’s article about Wilson’s Sociobiology was originally written as a "countercelebration" to Harvard’s 350th anniversary, to remind us that prestigious scientists (and institutions) have a history of using science to support social prejudices. She links Wilson to Edward Clarke, the chair of Harvard Medical School from 1855-1872.
These two Harvard scientists, nearly 100 years apart, both wrote popular books "lending scientific respectability to sexist practices and opinions of their time." Both books and authors received great attention, more than would or should have occurred, Hubbard believes, due to the elaborate publicity and promotion by Harvard and the popular press.
Edward Clarke responded to the women’s movement of the 19th century, which focused on access to education and the professions, birth control and the vote, with several articles and his 1873 book Sex in Education; or A Fair Chance for the Girls. The previously prevailing argument about the inferiority of women’s brains was no longer able to stand up, since women’s colleges and coeducational colleges and universities had graduated many successful women students. The question thus became whether it was good for them.
Clarke argued vociferously to keep women from higher education, and invoked a biological explanation for this reasoning. Using his medical andacademic authority and posture, Clarke posited that "women’s physiology would be injured if girls were educated the same as boys." Thus, "the physiological motto is, Educate a man for manhood, a woman for womanhood, both for humanity. In this lies the hope of the race." (106)
In similar fashion, Wilson’s Sociobiology came in response to the increasing political significance of the women’s movement of the 1970s. Wilson similarly maintained the physiological basis for excluding women, based on his prejudiced belief in the reproductive investment theory. Hubbard provides an impelling conviction of the asymmetry argument regarding sperm and eggs and the disparate "investment" theory, which sociobiology used to explain why women are biologically destined to homemaking rather than equal participation in politics, business and science.
Her main point is that "sexism lies at the center of sociobiology because of the way sociobiologists deal with the concept of ’reproductive success.’" She explains that "females form eggs as part of their metabolism as do males sperm, and it takes no more effort or energy to produce one than the other." And indeed, one sperm fertilizes one egg, and thus no more sperm than eggs become adults. Hence the fallacy of E.O. Wilson and other sociobiologists who account for the gendered division of labor by invoking asymmetry in "reproductive investment," a culturally prejudiced and biologically inaccurate argument.
Overall, "what Wilson perceives to be ’human nature,’ is in its essential features a stereotyped description of how things are in capitalist countries, with their divisions of sex, race, and class that determine great differences in the power people have over their own and other people’s lives." (117)
Wilson further believed that the basic elements of human behavior could be identified via Darwin’s evolutionary theory with the addition of the twentieth century concept of genetic fitness. Adaptive behaviors he fits into this category included various sexual behaviors, religion, and dominance hierarchies including males over females.
Yet it is suspect to speak of human nature separate from culture and society. Methodologically, Hubbard exlains,
(I)t is impossible to prove that adaptive behaviors are inherited biologically and handed on through cultural learning. We transform our ultural and natural environments all the while they transform us. To sort genetic from environmental contributions to traits, one must be able to specify and quantify and completely control the organism’s genetic makeup and environment. This can be done only for a few traits of organisms that can be grown under careful monitored laboratory conditions. It is, of course, impossible to use this method with people. (115)
While genes have a role, it is not something we can determine and distinguish from social and environmental factors. The danger scientists bring to such discussions is that "when something cannot be proved, yet the pretense that it can be or has been proved is used to argue for or against social policies and forms ofgovernment, the effort is not a quest for knowledge. It is a political campaign." (121)
Thus the importance for Hubbard and other critics that scientists and society understand and acknowledge the social values and beliefs inherent in human activity – not "pretend scientific detachment."
The second book reviewed by Hubbard, The Facts of Life: Science and the Abortion Controversy (1992), is an attempt "to ground the abortion debate in modern science." Hubbard includes this review to again show how natural scientists" can be surprisingly unaware of the limited applicability of their expert knowledge to real life situations." The authors’ focus on the biology of fertilization and embryonic development, Hubbard points out, again leaves women out of the account and obscures the fact that the embryo develops within the body of a woman.
A main problem with the authors’ attempt to resolve the abortion question is assigning a "cutoff" point for abortion acceptability by ascribing "humanness" to a fetus at a particular point based upon a certain time in its brain development and referring to the previous time as more animal like. Hubbard articulately clarifies the problem with this argument, showing it to be based not upon biology or evolution, but rather Judeo-Christian tradition(3) (126), "In which Jehovah gave humans dominion over the remainder of creation."
She also points out real political questions the authors supersede by their claim of scientific detachment: e.g. the definition of murder according to whether the killing is sanctioned or non-sanctioned by the state, and the historical reality of abortions regardless of its legality.
In the third section, "Toward a political understanding of science," Hubbard rounds out her arguments and looks to political questions that have been inappropriately answered through or promoted by science e.g. race, gender. Hubbard wants to assist in increasing our political understanding of science and medicine and expose the pretense of scientific objectivity.
Specific examples demonstrate the interplay between cultural and political commitments and science and technology. The concept of science itself is not truth, but rather our "shared experiences of nature," she explains:
Our understanding of nature is, by its nature, even more limited. We construct not only our interpretations, but also the very nature we choose to interpret. Working scientists don’t just ’look at nature.’ We first circumscribe and define what aspects of it we will examine. That is true even if we work ’in the field,’ studying ecology or animal behavior. If we work in laboratories or do theoretical calculations at our desks, we further select, or indeed deliberately create the models, the metaphors, which weallow to stand in for nature as we do our scientific work. (164)
Hubbard’s view is not anti-technology or anti-science, but rather one that demands that we as a society critically evaluate and take an active interest in science and technology, and its development and use. It is not feminism versus technology, but rather utilizing a feminist perspective to evaluate science/technology, and to recognize the social forces pushing science, technology, and medicine.
Hubbard puts forth a call to action, a new "Science for the People" movement. We need organization, advocacy and education at the grassroots level, she says, and we need to ask if all the high tech solutions to health problems are justified when we are still not implementing known and proven measures to prevent deaths around the world and our own society. Our aim as a society should be to return to a preventive, healthful and democratic model and practice.
Activists need to include science and technology into their call for an end to rich and elite control of the world’s resources. Hubbard wants us to understand that as a society we do have a choice about the direction of science, medicine, and technology, and that the current direction is not the inevitable progression of knowledge.
Our biggest challenge now, says Hubbard, is to convince people that they want to be informed and knowledgeable about science and technology. As she points out, people have much more of a link to technology than to the natural world. People lack understanding of both, but are confronted with technology on a daily basis and see it promoted as solutions to our health and social problems. Naturally, people do not want to challenge government funding for medical research which will benefit us; we or someone we know will die or has died of cancer or some other disease for which we want research funded.
Yet the real goal is to question how such money is used, dominated, and manipulated and how "progress" for the wealthy often has negative impact upon the poor and disenfranchised. We need to have an understanding of what really goes on in a laboratory and lose our wide-eyed wonder of science. The institution of science is affected by the same factors and influences as society in general, the same prejudices, assumptions, biases and power plays.
To recognize this enhances our ability to understand nature and helps brings us closer to the unachievable goal of objectivity. The existence of an educated and interested populace monitoring science will help keep society informed and help to ensure that resources are utilized in ways which benefit the most people.
There is no need to create false dichotomies between understanding the subjectivity of scientific enterprise and responsibly utilizing and evaluating scientific methodology. Nor should such critiques be labeled as anti-science and anti-rational. Quite the contrary:
(N)ot only is the personal political, but it informs all our thoughts and actions. We can deny our subjectivity only by ignoring it, because we cannot eliminate it. This realization puts us at odds with scientists who make objectivity a cornerstone of what they believe about their method of investigation. But in science, as elsewhere, objectivity exists in dynamic, dialectical tension with subjectivity. If anything, it would be enhanced to the extent that scientists acknowledged their social, philosophical, personal, and other locations relative to the objects they study. (207)
Whether or not you believe in the strong program of the social construction of science, believe in socialist ecofeminism or in liberal feminism; whether you believe that the act of dissembling nature in order to understand it inherently creates a bias based upon interpretation and language, or that science is pure and that only methodology needs to be corrected; the fact will remain that human agency is involved in scientific pursuits and thus that there is subjectivity and error.
As a trained biologist, Hubbard contends, she believes that a Nature exists, "but there are better and worse, more and less accurate, interpretations of it." We cannot assume, as traditional science would have us believe, that no mention of politics means no politics are present.
What must happen, she says, is better evaluation of the effects of our science and technology within the larger picture of society, where "there are no side effects...and no waste products." These effects are all there, affecting nature, whether we acknowledge it or not, and we cannot afford not to do so.
To counter the reductionist tendencies and narrow focus of science and to encourage integrated and contextualized models, "We must ground scientific inquiry in the needs and questions of ordinary people, if science is to be understandable and useful. This may seem a daunting task, but we must take it on if we want to help make scientists partners in a democratic enterprise. And as feminists we cannot afford to settle for less." (217)
ATC 62, May-June 1996