Unbearable Weight: Feminism, Western Culture, and the Body (44 page)

30. Vanderheyden et al., "Very Low Calorie Diets and Obesity Surgery." 31
. Time
(April 18, 1988): 89.

1. "Girls, at 7, Think Thin, Study Finds,"
   New York Times,
   Feb. 11, 1988; Jeffrey Zaslow, "Fat or Not, 4th Grade Girls Diet Lest They Be Teased or Unloved,"
   

   Wall Street Journal,
   Feb. 11, 1986, p. 28.
   

2. Brumberg,
   Fasting Girls.
   

3. A. Anderson and A. Hay, "Racial and Socioeconomic Influences in Anorexia Nervosa and Bulimia,"
   International Journal of Eating Disorders 4
   (1985): 479 87.
   

4. SteinerAdair, "The Body Politic"; Christine Tinko et al., "Femininity/Masculinity and Disordered Eating in Women: How Are They Related?"
   International Journal of Eating Disorders
   6 (1987): 71011.
   

5. Garfinkel and Garner,
   Anorexia Nervosa,
   pp. 1023; Simon Gowers and John McMahon, "Social Class and Prognosis in Anorexia Nervosa,"
   International Journal of Eating Disorders
   8 (1989): 1059; Janet Gross and James Rosen, "Bulimia in Adolescents: Prevalence and Psychosocial Correlates,"
   International Journal of Eating Disorders
   7 (1988): 5161.
   

6. James Gray et al., "The Prevalence of Bulimia in a Black College Population,"
   International Journal of Eating Disorders
   6 (1987): 73340; L. K. George Hsu, "Are the Eating Disorders Becoming More Common Among Blacks?"
   International Journal of Eating Disorders
   6 (1987): 11324.
   

7. Retha Powers, "Fat Is a Black Women's Issue,"
   Essence
   (Oct. 1989): 7578, 13436. See also Georgiana Arnold, "Fat War,"
   Essence
   (July 1990): 5253, 1045; Kathleen Hiebert et al., "Comparison of Outcome in Hispanic and Caucasian Patients with Anorexia Nervosa,"
   International Journal of Eating Disorders
   7 (1988): 69396; Lionel Rosen et al., "Prevalence of Pathogenic Weightcontrol Behaviors Among Native American Women and Girls,"
   International Journal of Eating Disorders
   7 (1988): 80711.
   

8. Mary Mohler, "A New Look at Anorexia,"
   Ladies Home Journal
   (April 1986).
   

9. See note 2, above.
   

10. See Dalma Heyn's interview with Steven Levenkron: "Body Hate,"
    Ms.
    (July 1989): 3536.
    

11. Michael Strober, "Anorexia Nervosa: History and Psychological Concepts," in Brownell and Foreyt,
    Handbook of Eating Disorders,
    p. 241.
    

12. Brumberg,
    Fasting Girls, p.
    3.
    

13. It is tempting to conclude that Brumberg simply does not understand what metaphor and analogy are or grasp notions such as
    unconscious
    process or the fact that our bodies may carry meanings unintended or only dimly understood by the subject. But Brumberg's attitude is all the more perplexing when later, borrowing heavily from the feminist theory she criticizes, she argues that the food refusal of Victorian anorectics should be interpreted as a symbolic "voice," "a silent and potent form" of rebellion against family expectations, emotional repression, and lack of autonomy
    (Fasting Girls,
    p. 140).
    

45. Brumberg,
Fasting Girls,
pp. 3537. Revealingly, this example of schizophrenia was taken nearly word for word by Brumberg from an article by an author who was advocating forced feeding of anorectics: Eliot Goldner, "Treatment Refusal in Anorexia Nervosa,"
International Journal of Eating Disorders
8, no. 3 (May 1989): 301.

46.
Newsday
(Feb. 12, 1984): 2.

1. Brumberg, Fasting Girls, p. 14; Garfinkel and Kaplan, "Anorexia Nervosa: Diagnostic Conceptualizations," pp. 27071; Gina Kolata, "Bulimia Epidemic Fears May Be a False Alarm," New York Times, Aug. 25, 1988, p. B6; Susan Squire, "If You Think a Woman Can Never Be Too Thin ," Mademoiselle (Oct. 1984): 18081, 25254.
   

2. Here, even those who
   have
   incorporated elements of the feminist critique need to go still further in the direction of systemic, political understanding. In the absence of such understanding, influential findings such as SteinerAdair's can easily be interpreted as suggesting that women's eating problems are the result of our "trying to be like men" and not developing our nurturing, empathic inclinations as nature intended. Analyzed systemically, the superwoman syndrome reveals, on the contrary, how little alteration of fundamental relations has taken place. Women who participate in the professional sphere and who are obliged, while in that sphere, to embody its masculinist styles and values are not thereby permitted to abandon their "femininity." Rather, at the end of the public workday they must return to their already fulltime careers as devoted wives and mothers and to the "feminine" styles and values demanded by these roles ("The Second Shift," as Arlie Hochschild calls it, in Arlie Hochschild with Anne Maching,
   The Second Shift: Working Parents and the Revolution at Home
   [New York: Viking, 1989]). The superwoman syndrome
   

   reveals that whatever else women are ''permitted" to do in this culture, they are still required to do "their" work.
   

3. Weir Mitchell quoted in Elaine Showalter,
   The Female Malady: Women, Madness and English Culture, 18301980
   (New York: Pantheon, 1985), p. 130; Hilde Bruch,
   The Golden Cage: The Enigma of Anorexia Nervosa
   (New York: Vintage, 1979).
   

4. Bruch,
   The Golden Cage,
   p.
   ix.
   

5. Rudolph Bell,
   Holy Anorexia
   (Chicago: University of Chicago Press, 1985).
   

6. Brumberg,
   Fasting Girls,
   p. 46.
   

7. Jennifer Woods, "I Was Starving Myself to Death,"
   Mademoiselle
   (May 1981).
   

8. Brumberg,
   Fasting Girls,
   p. 7 (emphasis mine).
   

This essay could not have been written without the generous help of Katherine Bartlett and Susan BehuniakLong, who provided me with court

cases, articles, and incisive advice about the legal issues discussed, as well as crucial encouragement as I embarked on the study of a discourse unfamiliar to me. Earlier versions, under different titles, were delivered at the eighteenth annual Scholar and the Feminist Conference, the State University of New York at Binghamton, McGill University, Carleton University, and the Syracuse Consortium for the Cultural Foundations of Medicine. As the paper went through various drafts, many people provided useful criticisms, suggestions, and material; in particular, I want to thank Lynne Arnault, Robert Bogdan, Jack Carlson, Ynestra King, Ted Koditschek, Edward Lee, Paul Mattick, and John Wilcox.

1. Union Pacific Railway v. Botsford, 141 U.S. 250,
   251
   (1891).
   

2. Gilbert Ryle,
   The Concept of Mind
   (New York: Barnes and Noble, 1949), passim.
   

3. Stephen Wermiel, "Legal Beat: Bone Marrow Test,"
   Wall Street Journal,
   Oct. 1, 1990, p. 16.
   

4. McFall v. Shimp, No 7817711 (C.P. Allegheny County, Pa., July 16, 1978), quoted in Lawrence J. Nelson, Brian P. Buggy, and Carol Weil, "Forced Medical Treatment of Pregnant Women: 'Compelling Each to Live as Seems Good to the Rest,' "
   Hastings Law Journal
   37 (May 1986): 255. Many newspaper commentaries that appeared before the Illinois decision (cf. note 3, above) emphatically echoed such sentiments, insisting that "one person's right to life stops where another person's body starts" (Lynn Baker, "Are We Safe in Our Own Skins?"
   New York Times,
   Aug. 21, 1990, p. 27) and declaring the father's efforts to have the twins forced to become donors "a potentially dangerous precedent for allowing bodily invasions without the consent of the donor" (editorial,
   New York Times,
   Aug. 29, 1990, p. 20).
   

5. Nelson et al., "Forced Medical Treatment," p. 723.
   

6. McFall v. Shimp, quoted in Nelson et al., "Forced Medical Treatment," p. 755.
   

7. 342 U.S. 165 (1952), quoted in Nancy Rhoden, "The Judge in the Delivery Room: The Emergence of CourtOrdered Cesareans,"
   California Law Review
   74 (1986): 1983.
   

8. Other bodily invasions that have been constitutionally permitted are compulsory vaccinations and nonconsensual treatment of institutionalized persons. The former have been permitted because they serve a broad public interest and are required of all members of the society reciprocally. The history of nonconsensual treatment of institutionalized persons (one aspect of which—sterilization abuse—will be discussed briefly later in this essay) is a scandal in itself. Those who have been deemed "mentally defective" or "mentally ill" clearly represent another major category of persons whose rights to bodily integrity and informed consent have regularly been ignored and effaced. It is outside the scope of this essay to discuss that effacement except insofar as it intersects with the specific themes developed here, but this limited treatment should not be understood as minimizing its relevance or importance.
   

9. Schmerber v. California, 384 U.S. 757 (1966).
   

1. Winston, Sheriff, et al. v. Lee, 470 U.S. 753 (1985).
   

2. Even the subjectivity of persons in persistent vegetative states is respected; determination of the wishes of such patients is always one of the central issues raised in decisions involving termination of their life support (e.g., the Nancy Cruzan and Helga Wanglie cases). And our cultural horror of unconsentedto bodily intrusion extends, as well, to
   dead
   bodies; cadavers are legally protected against the unconsentedto use of their organs and tissues, even when their use could save the lives of others. Here, respect is extended to the "subjectivity" of corpses far beyond the value placed on those
   living
   beings who could be benefited if a purely mechanistic, depersonalizing attitude toward body parts prevailed.
   

1. Rust v. Sullivan, 59 USLW 4451 (1991).
   

2. Philip R. Reilly,
   The Surgical Solution
   (Baltimore: Johns Hopkins University Press, 1991), p. xiii.
   

3. Angela Davis,
   Women, Race, and Class
   (New York: Vintage, 1983), pp. 21521.
   

4. Reilly,
   The Surgical Solution,
   pp. 9495.
   

5. Walker v. Pierce, 560 F.2d 609 (1977). Pierce won the case, but with an extremely strong dissent from one of the circuit court judges, who argued that beyond doubt Dr. Pierce's policy pertaining to sterilization was based on economic factors instead of the health of his Medicaid patients.
   

6. Veronika Kolder et al., "CourtOrdered Obstetrical Interventions,"
   New England Journal of Medicine
   316, no. 19 (May 7, 1987): 1192. 18. In re: A. C. Appellant, 523 2d 611 (1987).
   

19. These procedures, moreover, may turn out not to have been essential to the life of the fetus. In Jefferson v. Griffin Spaulding Hospital Authority (GA 86, 274 S.E. 2d 457 1981), Mrs. Jefferson, suffering from placenta previa, was ordered to undergo a cesarean. The order was never enforced, and she wound up uneventfully delivering a healthy child vaginally.

20. Taft v. Taft, 446 N.E. 2d 395 (Mass. 1983).

1. Performed when there is high risk of thirdtrimester miscarriage due to weakness of the cervix (often described as "incompetent cervix"), cerclage involves suturing the cervix closed in order to maintain the pregnancy.
   

2. So the District of Columbia Court of Appeals described it, in overturning the circuit court's decision on Angela Carder (too late, unfortunately, to affect Carder, but extremely meaningful nonetheless, as I will shortly discuss).
   

3. Tamar Lewin, "Court Acting to Force Care of the Unborn,"
   New York Times,
   Nov. 28, 1988, p. 1.
   

4. See Nelson et al., "Forced Medical Treatment," and Rhoden, "Judge in the Delivery Room," and also Janet Gallagher, "Prenatal Invasions and Interventions: What's Wrong with Fetal Rights,"
   Harvard Women's Law Journal 10
   (1987): 958.
   

Some judges
have
attempted to offer a legal rationalization for such contradictions. The dissenting judge in the District of Columbia Court of Appeals overturn of the A.C. ruling, for example, argued that the third trimester pregnant woman belongs to a "unique category of persons," by virtue of her having "undertaken to bear another human being" and having carried it to viability, and thus having "placed herself" in a special class of persons, those upon whom another's life is totally dependent. Against such arguments, it might reasonably be asked why such a commitment, if indeed it can be said to exist, ends with the birth of the child, and why it does not apply as well to the father of the child. That it does not so apply, legally, is manifest in the decisions that have consistently refused to order parents to donate marrow and organs to their children (even when their lives are "totally dependent" on the donation). I suspect, too, that the element of voluntarily "undertaking'' the preservation of the life of another would hold no legal water against broken commitments to donate organs or marrow or to take blood tests.

Finally, the question remains: Does the undertaking to care for another entail a commitment to do so
at all costs?

1. Nelson et al., "Forced Medical Treatment," p. 714.
   

2. This construction seems to be in the background of the many frequent misapplications of Roe v. Wade, arguing in favor of forced cesareans on the basis of the "state's interest in protecting the life of the fetus." The Roe decision does indeed acknowledge that this interest increases as pregnancy advances. However, it emphasizes that it is never to supersede that of the life and health of the mother, right up to term. Rather, as American College of Obstetricians and Gynecologists v. Thornberg made clear, "the woman's life and health must always prevail over the fetus's life and health when they conflict" (737 F. 2d 283 [1984], quoted in Nelson et al., "Forced Medical Treatment," p. 744). The slippage from state interest in fetal life (which Roe grants) to the elevation of that interest above the preservation of maternal health (which neither Roe nor its progeny accept) converts the protection of fetal life into a doctrine of maternal selfsacrifice. (For an interesting discussion of the misapplications of Roe, see Susan BehuniakLong, "Reproductive Issues and the Applicability of
   Roe v. Wade:
   Limits and Essence," in
   Biomedical Technology and Public Policy,
   ed. Robert Black and Miriam Mills [New York: Greenwood Press, 1990].)
   

3. Walker v. Pierce.
   

4. District of Columbia Court of Appeals No. 87609 In Re: A.C., April 26, 1990, p. 1142.
   

5. Kolder et al., "CourtOrdered Obstetrical Interventions."
   

6. See, for example, Robertson, "The Right to Procreate and In Utero Fetal Therapy,"
   Journal of Legal Medicine
   333 (1982): 35161.
   

7. What is most chilling about these cases is how rarely they occasion real moral controversy, and how casually newspapers describe the procedures in terms that utterly dehumanize the mother. In Syracuse this year, a braindead woman who had suffered a brain aneurysm was kept alive for more than seven weeks until her baby could be delivered by cesarean