Despite recent social movements and increasing public awareness, gender disparities persist. These affect daily forensic and clinical practice by providing unexpected obstacles to women professionals and evaluees who face centuries of established bias. State laws may conflict with professional ethics, women experts may be sidelined in important cases, pregnant substance users are prosecuted aggressively, and fetal personhood laws challenge the autonomy of competent adults. Such inequities call for a review of professional ethics and the common male-centered lens of traditional theory. Feminist thinking has played a key role in highlighting the way traditional views of autonomy and rights undervalue the narratives and perspectives of disadvantaged populations. Applying the cultural formulation, telling the full story, and taking a default position in favor of the vulnerable individual, this article advances intersectionality, positionality (narrative), and credibility for understanding the profession's interaction with women. Systematic exploitation of working women in the United States has recently given rise to the sweeping #MeToo and TimesUp movements.sup 1 /sup At the 2018 Golden Globe Awards, Oprah Winfrey famously called out “Time's Up” to those who sexually exploited actors seeking movie roles; and public figures from Hollywood to Wall Street joined the list of prominent figures saying “Me Too” when their colleagues reported harassment or abuse.sup 2 /sup Political leaders from the U.S. Congress are joined by CEOs, journalists, and entertainment moguls in facing explosive charges of abuse of power. U.S. Representative Trent Franks, for example, allegedly approached women in his office to serve as a surrogate for his child, while news and entertainment magnates like Roger Ailes and Harvey Weinstein were accused of outright assault. Recently appointed Supreme Court Justice Brett Kavanaugh faced three accusers, while the U.S. President has almost twenty.sup 3 /sup Scholars and commentators are consistent in identifying gender norms and biases at the core of such egregious behavior.sup 4 , – , 7 /sup The fields of psychiatry and law are not immune from the gender norms that influence professional life. Data on the presence of women in the courtroom reflect the inequities of society as a whole. For example, women attorneys are more likely to experience courtroom incivility, unprofessional forms of address, conflict in family life, comments about appearance, exclusion from politicking, and being mistaken for non-lawyers.sup 8 /sup Similarly, in medicine, female faculty are two and a half times more likely to perceive gender-based discrimination; approximately 50 percent report sexual harassment, slower career advancement, and lower pay.sup 9 , 10 , 11 /sup In forensics, Edniesup 12 /sup noted early on that female experts are viewed as having less authority and power, are recruited less often by attorneys, and have difficulty finding referrals and mentors. More recently, Price et al. ,sup 13 /sup recognizing that the number of female forensic experts had increased, found that women of the American Academy of Psychiatry and the Law were underrepresented in criminal work, traditionally a male-dominated field. Women in the survey also worked in fewer categories of forensic practice. Walterssup 14 /sup noted that women testified infrequently as a party's sole expert, accounting for just seven percent of solo appearances. “This skewed ratio,” he suggested, “may indicate that litigants feel testimony by women must be supplemented to satisfy the same evidentiary burden” (Ref. 14 , p 636). Overall, jurors rate male experts as more likeable, believable, trustworthy, confident, and credible.sup 15 /sup Traditional ethics frameworks fail to capture these broad inequities or to explain the deeply ingrained cultural norms that bias the daily practice of forensic medicine. Approaches that elevate single principles or clusters of principles above others, or take perspectives with a distinct Western viewpoint, are insufficient in a world of diverse peoples, cultures, and genders. Indeed, a woman's voice can be drowned out by a language and culture of patriarchal values and traditions. Forensic authors themselves recognize this shift by moving toward ethics theories of cultural narrative, human rights, and social justice.sup 16 , – , 18 /sup It is no longer enough to adopt a traditional frame for the complex work of courtroom medicine.
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