Religion and Bioethics Spring 2019

Leon Kass’s Reflections on Public Bioethics: A view from the Trenches looks to explain what the councils mission was, how it worked with the public, and review the final outcome of the Council’s first term. Leon Kass breaks down his remarks into three parts: the discussion of some special features of public bioethics, overview of the highlights of the Councils work, and some general observations. He starts with the Council’s Public Ways, explaining how the council was created and defending that they were indeed a public body subject to “public scrutiny”. Leon continues detailing that this committee was different than most as it was tasked with a very morally controversial subject in the midst of a president whose presidency was already under fire for how he was elected, along with very strong conservative and religious ties. The council was also different, as it wasn’t tasked by just asking the morality and justification for stem cell research, but rather 5 main functions. It seemed to me that the council was tasked with not only giving it’s advisory on cloning research, but giving it’s remarks on the state of bioethics, and how this specific technology would affect bioethics as a whole. However, outside of the philosophical discussion, Kass also mentions that the council needed to promote public discourse of the issue to allow for the general public to be able to comprehend the issue at large. I found it kind of ironic though because while one of the councils objectives were to inform the public, the makeup of the council was not indicative of the population. As we discussed in class it predominately was made up of all white males. This only became more ironic as Kass went on to identify the types of individuals who were on the panel. None the less, Kass continues to defend the members of its council by continuing to describe the diversity of it’s panel and discrediting any notion that the panel was a “hyper-politicized group of right-wing fundamentalists, seeking to impose pro-life views on the nation”. I thought this was amusing because he was basically labeled such in Ruth Macklin’s article. As Kass continued to defend the council and it’s task, I couldn’t help but wonder, why weren’t these explanations of the council included in the original paper? Surely, they could’ve anticipated the backlash that could’ve come from such an issue, and since informing the public was one of the main goals of the council, why not highlight these points in the preface?

Kass than goes onto the second point of the Councils work. Kass insists that he is very proud of the council and it’s work, and tries to give a summary and evaluation of what they did, as all the 5 published works of the council “try to embody our search for a richer bioethics”. Kass outlines each of the 5 publications starting with Human Cloning and Human Dignity: An Ethical Inquiry. Given that this was the one we read for class, I will primarily focus on it. Kass gives the 5 major features of the report starting with “the larger human contexts in which controversies over this innovation must be considered”. Following this, the next feature is that surrounding terminology of “human cloning”. I thought this was particularly interesting because last week as a class we struggled to differentiate the difference between “cloning-to-produce-children” and “cloning-for-biomedical-research” which Kass neatly outlines in this section. The third point outlines how the council unanimously opposed cloning to produce children. I found their reasoning suspect, as they say, “it never could be attempted safely”, which I think is honestly ignorant, however their following arguments were more convincing. The fourth feature gets into the meat of the subject by displaying the diversity that the council had on determining if cloning-for-biomedical-research should be allowed and deemed morally all right. Both sides of the argument are coherently and well displayed in the brief, not giving a conclusion on the matter, which I thought was appropriate given the purpose of the council. Finally, they offered proposals for a permanent ban on cloning to produce children, while the consensus varied on cloning for medical research.

Lastly, Kass talks about the general observations and challenges that came about. Kass concludes that their works success is not truly known, other than the fact that it has made some noise. I personally believe that since it created such a response, that it was successful in bringing the topic into the spotlight. Kass thinks that the success in terms of policy making fell short, as he remarks that it is “hard to educate anyone about an issue unless you are prepared to tell them what they ought to do”. The last thing I noticed was Kass arguing that the “life principle”, although an important issue and one that is highly publicized, is not the only issue that should be considered in public bioethical discourse. I found it more intriguing given his label as a conservative bioethicist. Ultimately, since these councils publishing are over 15 years old, I want to know what has changed since then? Has this council impacted the way we engage discourse about bioethics and morality? Also, has the stance on cloning for reproduction, and cloning for research changed since then?

 

The next reading was The New Conseratives In Bioethics: Who Are They and What Do They Seek? By Ruth Macklin. This articles is just what the title is, discussing the new conservative movement in bioethics, who are the proponents, and what are their positions. Macklin argues that this new wave is being branded by bioethicists who self-proclaim themselves as “conservatives”, consequently causing all those that oppose them to be liberals. However, Macklin claims that this isn’t the case. Since there are “an array of widely divergent and often nuanced positions”, just because a bioethicist disagrees with a conservative should not make them by default liberal. The new wave of self-proclaimed conservatives differ from those past like Leon Kass who she mentions. This new wave are opponents against biotechnology with any term “artificial”. They also are against any reproductive freedom such as abortion and stem cell research that involves destruction of human embryos. Her main point spotlights that it is very difficult to pinpoint broad views on these issues into two categories of either conservative or liberal. She cites the FINRRAGE as an example of a group having very radical ideas that could be labeled conservative, but is not necessarily so. The ultimate argument is that not only are the lines blurred now, but shifts throughout history have also made the categorization very difficult. Macklin then shifts to the specific “mission” of the new conservatives, which is, “to prevent our transformation into a culture without awe filled with people without souls”. Macklin also points out that these conservative bioethicists claim that their points are 100% true, which is nonsense. Macklin then moves on to the faults that the new conservatives have such as not relying on empirical evidence and sound arguments, but rather “metaphors and slogans”. Given the evidence that Macklin presents against this new wave, why doesn’t Macklin just go out on a limb and proclaim that these “conservative bioethicist” aren’t bioethicist at all? If such arguments are grounded it weak metaphors, slogans, and absence of critiques of opponents, what gives them any credibility in the grand scheme? Macklin presents the same case by saying, “the latter are  not  bioethicists  at  all.  They are  something  else—social  critics, perhaps—who  rely  on  dramatic impact  and  rhetorical  persuasion  rather than  rational  argument  to  convince their  readers.” However, she mentions refuting them is a mistake as it is possible to be “a bioethicist and also a social critic”.

 

What I found to be of particular interest were the ways the conservatives deployed their arguments against opponents, many of which relate to how President Trump handles his opponents. It makes me think that since Trump had such success with it, will these conservative Bioethicists have a strong pull over the public? I guess the last thing to be asked about this article is it possible to bridge the gap between mainstream bioethicists and conservatives?

 

 

 

This week’s readings tie closely with our discussions from last week regarding the bioethics debate, human cloning, and embryonic stem cell research. Kathrin Braun’s account of the debate on reproductive and genetic technologies in Germany talks about the various discourses in linking ethics to politics surrounding the debate in bioethics. Macklin then goes into the neoconservative view on bioethics, as well as some of the criticisms in the rhetoric of new conservatives, thus increasing the split of the two “camps” (Braun, 43). The third reading up for discussion goes back to last week’s reading Human Cloning and Human Dignity: The Report of the President’s Council on Bioethics, as Kass offers his remarks regarding the work of the President’s Council on Bioethics to essentially lay the groundwork for which the Council operates and to challenge the debate on public bioethics.

Braun closely examines the interconnectedness of policy and ethics in Germany and the ways that the German view might decrease polarization between the conservative view and liberal view. She goes into a discussion on the differing views of techno-skeptics and techno-optimists and how they primarily differ on how they interpret the issue of biotechnology. “Techno-optimists” give more credit to society in their ability to calculate risks associated with new technology and recognize the benefits of technology. Ethics is a deliberate choice and should add structure to the delicate task of “balancing diverging values,” best done by professionals in medicine and research (Braun, 43). On the other hand, skeptics believe that technology is limited, and society does not benefit from it as much as it pays. Motivation of techno-skeptics can come from either a primarily religious standpoint, or more secular. To me, the more noteworthy of the two is the secular view of “common ethos” coming from a post-Nazi era view that every life is worth living (Braun, 43). In order to discuss these diverging views, as Braun claims, a certain type of discourse must be present. Taking a more “managerial” approach, one focuses more on the potential benefits and risks posed by biotechnology and that ethics can help mitigate these risks. The “republican” discourse is a more social view in that risks associated with biotechnology can cause social problems and can only be amended by “citizen engagement” (Braun, 44).

In terms of a legal context, both the German Embryo Protection Act of 1991 and the German Constitution highly value human life and human dignity. Whereas the restrictive law focuses more on the human embryo, human cloning, and other reproductive technologies, the Constitution ties back to the common ethos views of secular techno-skeptics regarding the unmatched status of human dignity above all other rights. The techno-skeptics extended this argument to their denouncement of prenatal genetic diagnoses (PGD), claiming that it “endangers the moral foundations of German society” (Braun, 45). I ask you all to weigh in here: how would a techno-optimist view PGD in terms of the moral risks and benefits? Yes, they try to look at the benefits of technology, but how do you think they would overcome the battle between knowledge and emotionality/moral fundamentalism?

The split between techno-skeptics and techno-optimists furthered upon Nida-Rümelin’s article about human dignity only emerging with self-esteem, as well as with Singer’s views on newborns not having a right to life (Braun, 47). Braun then concluded with her own views of the benefits of the republican discourse and how it increases democracy in legislation, as well as broadening the discussion on ethical issues by means of considering these “medical issues” as more social ones (Braun, 49).

The debate on bioethics is not as much a recent topic of discussion as is the labeling of conservatives and liberals. Macklin, a “liberal, humanitarian bioethicist” speaks avidly against the new conservative bioethicists and the way they speak/write about issues regarding biotechnology and ethical concerns (Macklin, 42). She thoroughly criticizes the rhetoric of neoconservatives with four main points: the use of poetic language instead of empirical evidence, misleading terminology, offensive analogies, and generalizing without citing or quoting (Macklin, 38). A prominent example of the use of metaphors to overshadow reasoned arguments is in Levin’s mission statement on conservative bioethicists: “to prevent our transformation into a culture without awe filled with people without souls” (Macklin, 37). This rather extreme and “mystical” statement is quite vague, but emotionally charged. To me, he is trying to say that the practices of ART, human cloning, and embryonic stem cell research are “soulless” and that the outcomes will create generic, non-diverse individuals. What do you all think this mission refers to?

Another noteworthy example of one of the criticisms of conservative rhetoric concerning sweeping generalizations is in reference to the “unquestioning” and “unswerving commitment” (Macklin, 35, 36) to the conservative view. Both Kass and Meilaender, names we have studied in this course, hold these narrow views on conservatism and divergence from “the natural.” In an article written by Meilaender, he essentially claims that the ulterior motive of bioethicists is to have a say in committees and ethics boards in exchange for supporting the progression of science and technology (Macklin, 36). This seemingly “mutual” transaction 1. assumes that bioethicists have no limits on the growth of scientific advances, and 2. ignores the significant contributions that they have made, especially in legislation to protect individual rights (Macklin 37). This ties in quite well with the next reading for the week, as well as our classroom discussion on the makeup of the President’s Council, as this merger between scientific research and bioethics is what keeps policymakers and elected officials grounded in this debate.

As per our discussion last week, Kass’s appointment to the Council was quite controversial to many. Not only this, but President Bush’s Christian ties were also seen as a point of controversy, especially in the appointment of officials to the Council. In Reflections on Public Bioethics: A View from the Trenches, Kass defends the work that the Council has done on the debate of bioethics and the creation of the Council to give more legitimacy to the pro-life, Christian president. He contrasts these goals with those of the National Bioethics Advisory Commission (NBAC), saying that the focus is less on “human subjects research” and more on advising the President on bioethical concerns and to “search deep into human matters” (Kass, 223, 224). He commends the diversity of religious backgrounds, political affiliations, and professions of the members of the Council, emphasizing twice in his report that they are NOT a council OF bioethicists, but more a council ON bioethics. While I do appreciate the acknowledgement that the members of the Council are, like the rest of the country, divided in their views on embryo research, I still find it troubling that some of the members are quite extreme in their views. For example, drawing upon the example that Macklin provided, Gilbert Meilaender, a professor in Christian ethics, is a prime example of someone who is unwavering in the thought that bioethicists are “allies” of medical technology. His views are known to be extreme and flawed, as he makes sweeping (and inaccurate) generalizations (Macklin, 36). Does this create a more “stacked” council in which reaching an “artificial consensus” is more likely to occur (Kass 227)?

The second part of Kass’s report goes into more detail on the five reports that the Council has published. Human Cloning and Human Dignity: An Ethical Inquiry focuses on the issue of cloning and the broader context of human procreation, healing, and the value of research. The Council also unanimously agrees that the practice of cloning-to-produce children is unsafe and jeopardizes liberty and freedom of the family (Kass, 231). In Monitoring Stem Cell Research, they simply discuss where the issue of stem cell research stands today and provide an overview of ethical and policy debates, as well as the scientific background of the practice. Beyond Therapy tackles the complex issue of future directions and uses of biotechnology that go beyond simply healing the body, but that center around human desires of “sharper minds, “stronger bodies,” and “happier souls” (Kass, 235). Being Human is a more holistic account of the delicate balance between appreciating being human and staying human amidst new technologies being developed. The main question of this report (and for us to reflect upon) is: “molding or beholding?” or in other words, do we change nature in order to improve it, or do we appreciate it as it stands? The last section, Reproduction and Responsibility, discusses and reviews all the regulatory activity surrounding ART, sex selection, and human embryonic research. They break down 6 of the legal proposals made about practices in reproduction. All in all, the Council, according the Kass, has made great efforts in extending the debate on bioethics. Their aim is less to “advance public understanding” on this complex issue, but more to make these topics more visible to the public (Kass, 245).

This week’s readings discuss policies and discussion on cloning. We see a Christian view in Kass’s report to the President George W. Bush and then Jewish views in the work of Breitowitz. Lastly, Prainsack discusses how Jewish and Israeli views on reproductive technologies arose which will allow us to compare and contrast the policy of the United States with the policy of Israel regarding cloning.

In the first reading, Human Cloning and Human Dignity: The Report of the President’s Council on Bioethics by Leon Kass, the committee first discussed the science behind cloning and then separated the concept of cloning into two distinct categories of “reproductive” and “therapeutic”. Reproductive cloning referred to cloning-to-produce-children and “the goal is the production of a (cloned) child” whereas therapeutic cloning referred to cloning-for-biomedical-research with the goal of “the development of treatments for diseases “suffered not by the clone, but others” (Kass 43). The exact science and possibilities of each form of cloning were then discusses before arguing the positive and negative consequences of pursuing each form of cloning. The purpose of cloning-to-produce-children could be summarized by “replacing” a related member, replicating geniuses, being used for reproduction of the unviable and obtaining organ matches (Kass 79). Contrasting the positives were five categories of concern: “(1) problems of identity and individuality; (2) concerns regarding manufacture; (3) the prospect of a new eugenics; (4) troubled family relations; and (5) effects on society” (Kass 102). Based on these criteria, the council concluded unanimously that cloning to produce children was unsafe and should not be attempted due to safety concerns (Kass 115). On the other hand, the committee could not unanimously agree on a ruling on cloning-for-biomedical-research. While this form of cloning could potentially “lead to important knowledge of human embryological development and gene action”, this form of cloning would also lead to the “deliberate production, use, and ultimate destruction of cloned human embryos” (Kass 115). The inherent complexity of these issues lead to a lack of unanimity in regards to policy on cloning-for-biomedical-research.

These discussions and beliefs surrounding the two forms of cloning lead to the committee to create six basic policies. In essence, these six policies were: (1) “self- regulation”, (2) “ban plus silence”, (3) “ban plus regulation, (4) “regulation of both”, (5) “ban on both”, and (6) “ban plus moratorium” (Kass 186). For all of the policies regarding a ban and an additional action, the ban was referring to cloning-to-produce-children with the later action in reference to cloning-for-biomedical-research. Each policy’s morality, enforcement, and acceptability were then discussed before the committee decided on the best course of action (Kass 186). Ultimately, the majority of the committee (10 members) agreed on a proposal to ban cloning-to-produce-children with a four-year moratorium on cloning-for-biomedical research (Kass 205).In addition to this proposal, a minority (7 members) recommended that cloning-to-produce-children should be banned with regulation of the use of cloning-for-biomedical-research (Kass 218). Both recommendations call for a ban on cloning-to-produce-children, but the first policy emphasized giving more time to observe and gather more information before discussing policy on cloning-for-biomedical-research (Kass 215). On the other hand, the second policy sought to regulate cloning-for-biomedical-research as the potential discoveries of such research was extremely valuable and should be allowed to proceed (Kass 219). Additionally, the second policy also called to review previous regulations on embryonic research (Kass 222).

In regards to these two policies, something I found interesting was who supported which policy. All of the science or medicine related members favored the minority policy with the exception of a psychiatrist and a human biologist. Additionally, the only non-science or medicine related members to favor the Second Proposal were a professor of law and a professor of ethics emeritus. Additionally, gender did not seem to play a major role in the decision as two females members favored each proposal (Kass xxxvii-xxxviii, xxxix). This reminded me of last week’s class where there was a clear disparity between science and society when we discussed if an inherent bond existed between a gestational mother and her child. Another interesting connection I noticed was the similarities that these proposals had with Catholic beliefs. Banning cloning-to-produce-children falls in line with the catholic belief that humanity begins at conception and a major issue seen with cloning-for-biomedical-research was the safety of the embryo which also falls in line with catholic beliefs.

As someone who grew up in a primarily Christian community, What’s So Bad about Human Cloning by Yitzchok Breitowitz really broadened my views on cloning. Breitowitz addresses Judaic perspectives on the topic of cloning for reproductive purposes in his piece by addressing six areas of concern regarding reproductive cloning. Breitowitz first notes how Judaism would reject the argument that cloning is playing God and it is wrong to play God. According to Jewish tradition, “that wisdom and skill and knowledge are, in themselves, gifts that come from G-d” (Breitowitz 328). This is in reference to the usage of technologies that blur the lines between natural and unnatural such as in vitro fertilization and reproduction cloning. Therefore, when new technologies and medicines are developed, “G-d gives us that wisdom with the hope and the expectation that we will use it responsibly (Breitowitz 328). Breitowitz then argues how there are at least two positive uses of reproductive cloning: “response to infertility and generating genetically compatible tissues for transplantation” (Breitowitz 333). After listing these two positive uses, Breitowitz then discusses the six areas of concern regarding cloning.

The six areas of concern for Breitowitz are: issues with justice and governance, issues of quality control, psychological burdens, impact on relationships, immoratlity, and genetic diversity. On the topic of justice and governance, Breitowitz discusses the economical cost behind cloning and justifying who would be eligible to be cloned. Additionally, who regulates cloning and the worth of a cloned human are also discussed (Breitowitz 333-334).  In regards to issues of quality control, the morality of instituting technologies that creates human suffering is questioned. To this question, Jewish beliefs are not clear on choosing between no existence and an impaired existence as existence at least means there is potential (Breitowitz 335). Breitowitz then addresses the idea that a clone would have the psychological burden of living up to their parents. He notes that Jewish belief is that while there is a “mazal” or predisposition towards certain traits, everyone has the ability to make autonomous decisions (Breitowitz 337). The fourth area of concern discussed was on the impact on relationships. The main issue was “that in every child there are three partners: father, mother, and G-d” (Breitowitz 338). However, reproductive cloning would allow a woman to remove the relationship of a father and thus create reproduction without relationship (Breitowitz 338). Breitowitz then discusses how believing that one’s genes are immortal would fill one with “arrogance that can undermine one’s relationship to G-d” (Breitowitz 339). Lastly, a discussion on genetic diversity takes place as widespread genetic cloning can skew genetic diversity. Due to these concerns and benefits, Breitowitz believes that reproductive cloning should not be completely prohibited but rather strictly regulated such that it could be “available under narrow constraints” (Breitowitz 340).

The reading by Barbara Prainsack takes this a step further and discusses policy on cloning in Israel, a predominantly Jewish nation. In her work, Prainsack argues how a different system of morals is used to justify human embryonic stem cell (ESC) research and cloning, in reference to the usage of and also that a “demographic threat” and pro-natalist storyline influence the permissive Israeli approach towards technologies (Prainsack 172). Prainsack notes that according to Jewish law, ECS research is justified due to four reasons. The first is that embryos outside of the uterus do not enjoy a high level of protection since they are not considered a human life. Second, born humans life has priority over developing human life. Third, responsible interference with God’s creation is acceptable, and lastly, procreation has a very important role in Jewish tradition (Prainsack 181). These views contrast greatly with Christian views that dominate many countries. Prainsack then addresses the issue of a “demographic threat”. According to Prainsack, many feel that Israel follows such permissive guidelines in regards to reproductive technology because it wants to retain a Jewish majority population (Prainsack 185). Prainsack argues how this perspective is wrong and Israeli policy on reproductive technology lies in its healthcare system (Prainsack 186). Along with the healthcare system, Jewish beliefs and Zionism teaching promote science and technology (Prainsack 187). Lastly, Prainsack concludes that those two arguments alone are not sufficient on their own, but it is the overlapping of the two narratives that complement each other (Prainsack 176). From this, we can see how Israeli policy on reproductive technology is not a lack of morality but rather something well thought out and grounded in the culture and society of the region.

Works Cited

Leon R. Kass, Human Cloning and Human Dignity: The Report of the President’s Council on Bioethics.  (2002).

Yitzchok Breitowitz, “What’s So Bad about Human Cloning?” Kennedy Institute of Ethics Journal (2004): 325-341.

Barbara Prainsack, “Negotiating Life: The Regulation of Human Cloning and Embryonic Stem Cell Research in Israel.” Social Studies of Science 2006: 173-205.

 

Our readings this week focus on the ethics and morality of cloning and embryonic stem cell research. Our first reading is written by President Bush’s Council on Bioethics consisting of 18 members in various disciplines from physicians to ethicists, where they weigh in cloning to produce children and biomedical research. The second reading is from Yitzchok Breitowitz, a Rabbi, who argues for two benefits of human cloning- one being “a response to infertility, and the other is a way to generate genetically compatible tissues for transplantation” (333). “Negotiating Life” was written by Barbara Prainsack, a political scientist currently on the National Bioethics Council advising the Austrian federal government, and delves into cloning in Israel.

The President’s Council on Bioethics came to a conclusive decision to ban cloning to produce children (spoiler!). This is a viewpoint that the majority of the American public holds and a priori for me prior to reading for this week. I wanted to stress on this spoiler, as this viewpoint is very different from the following readings and something I want readers to keep in mind as we all develop our opinions on this topic. The reasoning behind this assertion is that there are “high rates of morbidity and mortality in the cloning of other mammals” and thus the cloning process would be “extremely unsafe” (Kass, 2002). Even if the cloning of other mammals were to be perfected, it would be not only difficult but also unethical to determine whether or not “cloning-to-produce children can become safe, now or in the future” (Kass, 2002). If you consider the fact that humans share the majority of their genome with other mammals and the fact that we already engage in embryonic stem cell research, would it really be “unsafe” to clone humans if we perfected the practice in other mammals? Where do we draw the line?

Cloning to produce children would diminish the uniqueness among all people and could motivate the discrimination of clones. I see this in another light, as cloning could motivate the discrimination of people born normally if these clones were able to undergo “beneficial” genetic modifications (because why not, cloning is already astronomically expensive, might as well get a “better” clone). Clones could receive a decreased quality of life, as they are burdened by expectations or mistakes in the cloning process. They could also be exploited as test subjects, not unlike the way we experiment on rats (Kass, 2002).

The Council was split on the policy recommendation for cloning for biomedical research, with the majority supporting a four-year ban and the minority supporting the regulation of cloned embryos for biomedical research. The reasoning behind the majority consensus was that it would provide time to develop a system of national regulation for embryonic stem cell research, while some believed that cloning for biomedical research could never be ethically pursued (too late now, I suppose) (Kass, 2002). The minority recommendation supports the regulation of cloned embryos, which allows for the research of cloning for biomedical purposes without significant delay, which would help benefit patients and families whose suffering such research may help alleviate (Kass, 2002).

I expected an article titled “What’s So Bad About Human Cloning?” to be a biased push towards the legalization of cloning for reproduction and research. Although the author seemed to favor cloning as opposed to a complete ban on it, he did provide evidence and anecdotes to support his claims. Breitowitz presented his reasoning in a logical fashion and I agreed with much of it. He starts off his article by touching on the different religious approaches to medicine, providing a clever analogy of how rejecting medical intervention because God will heal me is like rejecting food because God will feed me (Breitowitz , 328-329). This reminded me of Tom Cruise in the movie A Few Good Men, where he rebuttals the claim that the Marines don’t practice “Code Reds” because of it not written in the manual by asking if Marines eat at all because the mess hall was also not in the manual. Breitowitz adds that we as humans are created in the image of God (326) and that “wisdom and skill and knowledge” are gifts that God provides us (328) to develop not only solutions for our problems but also to fulfill our Commandments (330).

The Rabbi then moves on to reproductive cloning, which he seems to be a fan of. After glossing over the Catholic Church’s position on the topic, he moves on to a hypothetical scenario where cloning could provide a child for a man who is incapable of producing sperm and how it could provide a child that is on some level a genetic product of both the mother and the father (Breitowitz, 331). In addition, he touches on “cloning” in the instance of using a stem cell to regenerate tissues for transplant, all of which I agree with. I don’t agree with his follow up point that cloning a child with even a “primary purpose” to save another child’s life is not immoral and that there is a “mitzvah for one child” to save another’s life (Breitowitz, 332). Creating another life for the sole purpose of helping a life survive is not devoting love and affection for the cloned child-it’s using a person just like how one would use a machine. I also find it contradictive that Breitowitz mentions Kant and how he believes that “it is not moral to use one human being as a guinea pig for the potential benefit of another human being” when he claims that it is moral to have or clone a child for the primary purpose of harvesting their bone marrow, albeit to save a life (335). That’s my opinion, what did y’all think about Breitowitz’s claim here? Tying this into the Kass reading, how and where do we draw the line for cloning to benefit our own lives? Will we be able to raise these clones as children or will we just see them as a method to save ourselves (donation of a kidney, bone marrow, maybe even heart transplants!)?

Breitowitz raises the question of accessibility even if cloning was made commercially available with the added question of possible eugenics. Who would get access to this technology-would it be privatized or run by the government? If you could have genetic manipulation during cloning, would these children be superior to “normal” egg and sperm children? He also touches on the morality of cloning, as there is a psychological burden to being a clone. Although there are such things as epigenetics that influence the development of a clone, they may still feel that they are living a life that has been already lived (Breitowitz, 336). The psychological burden reminds me of Jerome in the movie Gattaca, who was designed to be the best human but just wasn’t. In addition, the clone may feel disconnected from their parents and have no genetic diversity. Do you guys think that clones will have this psychological burden, or will they go on to become their own people?

After brief introductions on regulations and ethical considerations on cloning, Barbara Prainsack dives into the Jewish interpretations of the Bible and how those interpretations shape viewpoints on reproductive technologies, including IVF and cloning. Prainsack also notes that the debate in Western countries is partially due to bad terminology, as her interview with a Rabbi revealed that “the chances for viability of an ‘embryo’ created through research cloning are close to zero” and that it would be misleading to call that an embryo at all (183). This is supported by four major assertions. First, embryos outside of the uterus are not regarded as human life and thus don’t deserve the same levels of protection as humans enjoy (Prainsack, 181). This would explain the viewpoints of adultery we discussed last week, where some Rabbis viewed that an egg fertilized outside of the uterus would not be considered adultery. Secondly, human life is given priority over human life development, which is very different from the view of the Catholic Church in Donum Vitae (Prainsack, 181). Third, altering God’s creation in a responsible manner is viewed as a virtue as opposed to a sin (Prainsack, 181). Lastly, procreation is regarded as binding for male Jews (Prainsack, 181).  How did y’all interpret these viewpoints? Do they hold merit and if not, why not? Overall, I found Prainsack to not delve into her own viewpoints on the issues that she tackles, but rather providing the viewpoints of the people she interviewed. Whether or not she simply used excerpts from interviews to convey her own viewpoints, I’m not too sure about. What’s certain is that she provides considerations on cloning from the Jewish perspective. In terms of cloning itself, it seems that the general consensus is that it is morally permissible.

The current problems with cloning itself due to potential implications and unsafe procedures is the main reason why there is a ban on human cloning. This follows in line with Rabbi Breitowitz’s train of thought, in that “God creates something out of nothing and humans create something out of something”, which is different from the Catholic Church’s view that humans shouldn’t interfere with the “natural” process of procreation (Prainsack, 183). Like we’ve touched on many times in class, Orthodox Jews focus on the legal portions of the Bible as opposed to drawing on interpretations (Prainsack, 174). Therefore, the ban on human reproductive cloning for this time being focuses on unsafe procedures and unawareness of potential implications, which would cause too much collateral damage for a reproductive technology whose consequences are not fully grasped (Prainsack, 182).

If I could use one quote from the passage to describe this reading, it would be this:

“Cloning per se did not pose any problems; the only problem was with scientific experimentation on humans. Since Israel had introduced consistent guidelines concerning experimentation on human beings as well as on animals, the committee concluded there was no need for any new law” (Prainsack, 191).

It seems that the limitations and concerns on human cloning are more rooted in the preservation of human and cultural identity. For me, it almost seems that the treatment of cloned individuals is foundational in the controversy surrounding human cloning.

I found it curious that there is a “halachic prohibition to use sperm for other than procreation purposes” but there was no such prohibition on ova-in fact, “surplus IVF embryos and embryos created through somatic cell nuclear transfer for research purposes is ethically permissible” (Prainsack, 181). Why do we have this difference, and why would it be ethically permissible to even use more embryos than necessary for the purposes of research? I personally found this paragraph very intriguing and am curious about the discussion in class related to this topic (maybe?).

References Cited:

Leon R. Kass, Human Cloning and Human Dignity: The Report of the President’s Council on Bioethics. (2002).

 Yitzchok Breitowitz, “What’s So Bad about Human Cloning?” Kennedy Institute of Ethics Journal (2004): 325-341.

Barbara Prainsack, “Negotiating Life: The Regulation of Human Cloning and

Embryonic Stem Cell Research in Israel.” Social Studies of Science 2006: 173-205.

Two years into his first Presidential term, George W. Bush formed a council of scientist, ethicists, doctors, lawyers, and other intellectuals to debate the rising concerns of human cloning. Given six months to deliberate, this council approached the issue in an organized, professional manner, reaching policy decisions and providing explicit rational for each choice.  While this approach to bioethical policy creation was not new (the report explicitly mentions the “National Bioethics Advisory Commissions…report on the subject of cloning-to-produce-children in 1997” (2)), the historical and topical context of Bush’s Council is a comprehensive dive into the ethical considerations of a developing technology with immense implications. The President’s Council on Bioethics’ report provides a scientific and ethical approach to a topic of increasing prevalence, providing new information and a surprising amount of pre-established ethical reasoning.

To first understand this report, one must look at the Presidency of George W. Bush. Without delving into his politics, it is commonly agreed that Bush saw himself as a leader of a Christian nation in a complex world. Whether it was his creation of ‘Jesus Day’ while he was the governor of Texas (Goodstein) or his referral to the war on terror as a “crusade” (Archives), Bush’s traditional view of religion is widely accepted public knowledge. This perspective adds a great deal of complexity to understanding this report; while religions have repeatedly grappled with the morality of reproductive technology, these arguments are usually based in interpretations of biblical parables rather than intense scientific reasoning. Yet, even among this group of ‘secular’ scientist and doctors, a shared idea of morality begins to form between religious rulings and those of the Council. One of the most prevalent examples of this link is in the Council’s ethical considerations of the “child to be” (xxvii).

Early in the report, the Council establishes terms to describe different forms of cloning. Of these forms, the two most debated are cloning-for-biomedical research, described as “production of a cloned human embryo, formed for the (proximate) purpose of using it in research or for extracting its stem cells” (55), and cloning-to-produce-children, defined as “production of a cloned human embryo, formed for the (proximate) purpose of initiating a pregnancy” (54). This distinction at first glance seems like a harsh departure from literature such as Donum Vitae, which explicitly states that “the human being must be respected as a person from the very first instant of his existence” (Shannon, 147), yet I argue that this divide instead represents a merging of scientific and religious ideology. After the group’s deliberation, they formed majority and minority opinions, differing on their views of cloning for biomedical research. Yet, both groups adamantly agreed on a “ban on cloning-to-produce children” (xxxv), sighting issues with the wellbeing of the child and how in “transgressing the natural boundaries between generations, cloning could strain the social ties between them” (xxix). Anyone familiar with Donum Vitae can immediately identify the shared argument of a muddling of ‘social ties’, due to an upheaval of the natural order of the creation of life. This fear of societal issues is explicitly mentioned as an ethical consideration in the report, as these academics join with the Catholic Church in pondering the implications “for all of society” (7). An even more obvious connection between the Church’s rulings and the Council’s pondering appears in their shared view of procreation and the natural order. Donum Vitae‘s extended title references “Respect for Human Life in its Origin and on the Dignity of Procreation” (Shannon, 140), suggesting that the act of procreation has as much relevance in debates on reproductive technology as pregnancy and childbirth. This idea is directly shared with the Council, who question how cloning for children would “challenge the basic nature of human procreation and the meaning of having children” (7). Much like how Bush was a modern leader with firm religious roots, the ethical considerations of this Council contain many parallels to the religious rulings of the Catholic Church.

Despite the wide range of connections between Vitae and the report, the scientific writing of the Council clearly presents the different paths each group took in arriving at these conclusions. An early distinction is the specific definition the Council uses of when an embryo can be used for research, “strictly limited to the first fourteen days of development—a point near when the primitive streak is formed and before organ differentiation occurs” (xxxii). A departure from the Church’s definitive stance of life at conception, the scientific background of the Council allows them to  present firm reasoning on how they differentiate human from zygote. Additionally, the report gives primary information on the processes involved in cloning, with full diagrams on natural and cloned reproduction on page 61 , and a diagram on the collection of stem cells on page 68. It is in these diagrams and definitions that the most apparent difference between Donum Vitae and this report emerge. While Vitae’s stated purpose is to provide “some specific replies to the main questions being asked” (Shannon, 140) on the general topic of reproductive technology, it is ultimately a list of rulings by the Church, and the reasoning behind said rulings. The report instead presents itself as “an ethical inquiry” (i), with the purpose to provide a “worthy contribution to public understanding of this momentous question [of cloning]” (ix). This report was first provided directly to the President of the United States, a man with immense political power, to best educate him and the public on the scientific and ethical considerations of the specific reproductive technology of cloning. As such, despite providing policy recommendations, this report does not lay down ultimate rulings, but rather gives council to a man capable of such rulings. This report and its authors can thereby be interpreted as a modern form of the king’s advisors, noted academics gathered to give an educated perspective on an issue, and this principle is echoed in each diagram and explanation throughout the report.

One final point is the exact considerations and issues that the report grapples with. While Vitae is concerned with the child to be, the Council shares that concern with the “conflict of competing sets of concerns and priorities, each in the service of vital human goods” (16), with goods referring to the medical advances that cloned-biological research could provide. In framing the argument as a tug-of-war between bioethics and the advancement of medical science, the Council looks to reach a middle ground between the two issues. It is easy to see how the Council reaches “full agreement that cloning-to-produce-children is not only unsafe but also morally unacceptable, and ought not to be attempted” (xxix), yet cloning’s use in biomedical research presents a complicated moral quandary of potential life versus established life. In my midterm, I wrote on how Vitae limits the positive rights of the parents to preserve the negative rights of the fetus through rulings such as the “child’s right to be conceived and brought into the world in marriage and from marriage” (Shannon, 159). In this way, the President’s Council on Bioethics acts a mirror image, reducing the negative rights of the cloned zygote, fetus, human, or whatever you define it as to increase the positive rights of people who are suffering. It is therefore understandable how the disagreement between the Majority and Minority opinions originates not in the permissibility of cloning-for-biological-research, but on the “regulation of the use of cloned embryos for biomedical research” (xxxviii). In this gray area the majority recommends a “four year moratorium” (xxxv), with a federally-funded review of the practices of said biological research, while the minority calls for no such moratorium, and only for less defined ‘regulations’. Much like each question we’ve discussed in class, and at all levels of education and academic expertise, issues of reproductive  technology are debated not for definitive answers, but to increase the reasonings with which we comprise our perspectives. This report represents a pure form of these debates, presenting two respectively researched and debated recommendations for the purpose of advisory to the President, and the nation as a whole. The report acts as a meditation on conception, scientific and religious ethics, and the value of life, both pre and post birth. While the lack of a unanimous answer to these questions may seem like a failure on the part of the Council, it is instead a perfect indication on the incredibly complex and varied topic of reproductive technology.

Works Cited:

Bush, George W. “Remarks by the President Upon Arrival.” National Archives and Records Administration. September 16, 2001. Accessed April 07, 2019. https://georgewbush-whitehouse.archives.gov/news/releases/2001/09/20010916-2.html.

Goodstein, Laurie. “Bush’s ‘Jesus Day’ Is Called a First Amendment Violation.” The New York Times. August 06, 2000. Accessed April 07, 2019. https://archive.nytimes.com/www.nytimes.com/library/politics/camp/080600wh-bush-jesus.html.

Human Cloning and Human Dignity: An Ethical Inquiry. Report. July 2002. Accessed April 7, 2019. https://repository.library.georgetown.edu/bitstream/handle/10822/559368/pcbe_cloning_report.pdf?sequence=1&isAllowed=y.

Shannon, Thomas A, et al. “Religion and Artificial Reproduction: An Inquiry into the Vatican ‘Instruction on Respect for Human Life in Its Origin and on the Dignity of Human Reproduction.’” The Thomist: A Speculative Quarterly Review, vol. 53, no. 1, 1989, pp. 141–175. Emory University Library, Canvas, doi:10.1353/tho.1989.0058.

To start things off I will be discussing Shirin Garamoudi Naef’s “Gestational Surrogacy in Iran.” Gestational surrogacy is a form of surrogacy in which the surrogate is not the provider of the female gamete and only gestates another couples’ embryo. In other words, this reproductive science requires the involvement of another woman (that is not the mother) who is able to carry a specific couples’ baby and ultimately give birth to it. It is a very viable solution to infertility for couples that want to have children, and has been on the rise in countries like Iran. As this form of surrogacy has become increasingly popular, public debate surrounding it has also risen particularly between Shia and Sunni branches of Islam.

The majority of Shia Muslims consider this method of assisted reproduction as viable and legitimate through the lens of Islamic law, as long as it is only accessible for infertile couples that are married. Although Shia Muslims approve this method of reproduction, in Sunni Islam, the use of donor gametes and surrogacy is unacceptable and is regarded as analogous to Zina, which basically means it is considered adultery. The basis of Shirin Garamoudi Naef’s reading is focused on an analysis of Shia legal positions regarding the appropriateness and legitimacy of gamete donation and surrogacy.

A primary reason Shia authorities disagree with the mindset that surrogacy and the use of donor gametes is adultery, is because this form of reproduction does not involve or require the physical act of sexual intercourse. The Shia notion of unlawful sexual intercourse (zina) is not dependent on the biological result that stems from the contact and transfer of bodily fluids, but rather it is dependent on the illegitimate physical act that occurs via illicit sexual intercourse between a man and a woman primarily for pleasure and not for conception. It is in the lens of this logic that a large number of Shia scholars have put their stamp of approval on the use of third-party donations and surrogacy as means of assisted reproduction under specific conditions. Shia culture essentially “leaves room for the legal permissibility of a third-party donation and surrogacy” (page 158).

Additionally, Shia support of these reproductive methods are centered on the question of Nasab, which is a term derived from a series of patronymics, that ultimately indicates a person’s heritage in Arab culture. Sunni notions of Nasab take an agnatic stance, having means of heritage pass through the male figure. Meanwhile, Shia notions of heritage take a gender-balanced approach and recognize that maternal and paternal filiations are distinguished in many regards to be equal or proportional in determining one’s ancestral roots. Thus, leaving more room in regards to accepting artificial insemination and gamete donation.

However, an issue in the debate between Shia and Sunni Muslims in regards to these reproductive methods is that the definition of bodily substances is clouded, and still remains extremely tied to defining kinship and incest. A key example the author uses is breast milk and questions the notion of if it should be discussed when considering something to be incest or adultery.  Ultimately, rhetoric of incest does not follow a universal grammar. “For the definition of incest in Shia thought and practice is not dependent on the transfer or contact of bodily substances, rather it depends on the illegitimate physical act of illicit sexual intercourse and not on the act of conception itself” (Page 163). The author is using this to show how one can do something that is considered adultery in Sunni culture, yet not in Shia culture.

Overall, the act of insemination and conception resulting from the physical and social act of sex without a marriage is considered adultery, thus getting assisted conception involving third party donation to not be considered adultery is essentially the only way to legitimize the practice and is how Shia culture defends their stance that is severely opposed by Sunni culture. As I transition into the 2^nd reading of this week, I must note that this first reading was extremely focused on religious’ viewpoints and stances, while our 2^nd reading by Elly Teman was quite the opposite, taking the refreshing approach of a social constructionist.

Elly Teman’s article focuses in on surrogate mothers, and their motivations for agreeing to agree to   such a thing. Teman essentially analyzes the cultural assumptions that “normal” women would never volunteer to do such a ridiculous thing as become pregnant with the predetermined decision to give away the child for money. She starts of her analysis by discussing how basically the entire majority (over 99%) of surrogate mothers do not bond with their newborn babies after they are given away to the infertile couples that have hired them. Most surrogates have even reported that giving away the baby has been a satisfying event or celebration and that they would consider engaging in surrogacy again. The narrative of the surrogate mother who begins to regret her decision and attempts to reclaim the child she gave birth to has very little foundation in reality, despite its stereotypes that exist in television, film and popular journalism (one such example that comes to my mind is the movie Baby Mama with Tina Fey and Amy Poehler).

As Teman is enabling her audience to view surrogacy via a social constructionist lens she had one sentence that really captured my attention. Teman writes, “Surrogacy constructs families through the marketplace, making them a matter of choice rather than fate and revealing that families are social constructs” (page 2). A key phrase that struck me in this sentence is “marketplace” due to its connotations that surrogacy is in fact part of the financial markets. I find it fascinating how such a complex concept of forming families relates directly back to such an artificial socially constructed concept such as money.

I also want to note that Teman mentions that giving birth to a child for the sole purpose of giving it away way is extremely threatening to dominant ideologies in many cultures that rely on an “indissoluble mother-child bond,” as we just read about in this week’s first reading and have been constantly discussing throughout the semester. For surrogacy truly does present itself as a direct challenge to the ideology of motherhood, despite its blatantly positive impacts on infertile couples. Yet although surrogacy shatters conventional religious beliefs surrounding motherhood, it also reveals that our entire belief in motherhood is entirely socially constructed, and does not have to be the natural, desired and concrete goal of all women should they want to be considered normal.

From here, Teman focuses on how many psychologists have tried to run tests that would distinguish surrogate mothers from “normal” women. Some of these studies focused on finding differences in terms of morality, while others focused on surrogate mothers’ attitude toward attachment and bonding. Teman writes, “To my knowledge, none of the studies have successfully located any ‘‘abnormal’’ personality traits among surrogates, yet continuous attempts have been made to prove otherwise over more than 20 years” (page 3). It is almost laughable how modern psychologists think there must be something wrong with a woman who agrees to be a surrogate. I’m not implying that I do not find the concept a little strange, because I definitely do, due to the fact that it violates such a concrete norm in our society. I’m just amused by the fact that for over 20 years they have kept trying to find some kind of abnormality when one clearly doesn’t exist based on the evidence. Nonetheless I found this reading very refreshing in the sense that it discussed the topic of surrogacy through a non-religious lens and was very easy to follow and comprehend.

Furthermore, our last reading of the week by Arthur Kleinman discussed how despite the advancements in bioethics over the years and the clear benefits the science poses to society, it is still clouded by extreme controversy that is only getting stronger. There has been a vast amount of efforts to repair and reform bioethics in recent years, yet none of these have come close to solving the unprecedented morale issues such a wide ranging of cultural and religious groups have with the science. For bioethics is extremely tied to morality and certainly requires a loose view of certain “traditional” aspects of society and life should it be worthy of any one man or woman’s support. In essence, Kleinman discusses how the only way to change the light in which bioethics is considered in, someone would have to work extremely hard to mediate the “immense differences in the social and personal realities of morale life with the need to apply a universal standard to those fragments that can ultimately foster not only comparison and evaluation but also action” (page 2). In reading this quote it becomes clear that bioethics will not be able to continue functioning unless someone finds a way of relating ethical deliberation and validity to the many religious and cultural groups that oppose it so venomously.

Kleinman takes on a really challenging task towards the beginning of his article, and that is that he attempts to define morality. He talks about how one forms their own morale experience or sense of ethical deliberation due to their own multidimensional experience with life. Kleinman implies that moral experience is about the local processes one has that realize values in ordinary living. I’m not entirely sure what this means, but to my best guess, Kleinman is basically saying that everyone develops their sense of the term morality differently, and this variation in morality across the entire world is dependent on one’s upbringing, the values they are taught by their parents, the way they learn to interact with people and how they experience interpersonal connections throughout their life, as well as the subjective values they observe in the society in which they exist in. Furthermore, in my attempt to address what this all means and why Kleinman wants his audience to know this, my best guess is that this is a key reason as to why bioethics is so widely controversial. So many different cultures and societies across the world have their own definition of morality, thus it is essentially impossible to appeal to everyone’s sense of ethical deliberation and justify such a controversial science. And this state of unknowing what to do, this state of perplexity surrounding bioethics is what Kleinman deems the quandary.

Kleinman’s first proposal as means of approaching the quandary of bioethics is centered on human nature. He suggests that ethical standards can be applied to different issues across the world because a shared human nature is present in all humans that provide them with some common sense of morality. Kleinman then uses ethnography as means of validating the morale complication surrounding bioethics. In other words, he uses ethnography to allow people to find common morale ground in their discussion of bioethics because he feels that ethnography represents a very viable way to get people to solve the bioethicist’s dilemma.

Notably Kleinman mentioned the Rayna Rapp ethnography that we discussed earlier this semester. Kleinman writes, “It is hard to imagine a more illuminating approach to such controversial issues as abortion across distinct ethic and social class networks” (page 17). I completely agree with him and think this is such a good example for him to use in his argument. Rayna Rapp focuses on the ethics and morality that accompany different people’s experience with reproductive technology and the dramatic life choices the science creates. In doing so, she is exposing the different morale landscapes of each of her subjects, and Kleinman is using her findings to show how people of different morale backgrounds and senses of ethical deliberation have acted extremely similar in the sense that they have all judged the quality of a fetus and made the decision of whether it will or will not enter the moral community of which they exist in.

Conclusively, a key theme I have found across all three readings is that of policy and how to best form it on reproductive technologies and methods. From this course I have learned that there are so many contrasting viewpoints based on such different religious and cultural stances, causing the whole idea of forming policies to become quite overwhelming. Thus, I will leave you all with this question. What do you think is the best way to form policies? I personally don’t think there is one and am not sure if there ever will be… I think our best shot is in Kleinman’s approach.

 

 

This week’s readings build upon various concepts we’ve discussed so far and exhibit similar themes to the movie we watched in last week’s class. Each of this week’s articles focuses on concepts of surrogacy and overarching ethical dilemmas through definition, practice, and acceptance in various populations. Shirin Garmaroudi Naef delves into gestational surrogacy’s place in Shia Islam, exploring academics’ opinions and interpreting and arguing for the importance of juridical and social factors in interpreting the use and acceptance of gestational surrogacy in Shia Islam. In this, she pays particular attention to the concepts of zina and nasab. Elly Teman fights for the recognition of unbiased surrogate experiences in research and delineates various ways in which current research on surrogate practice embodies Western ideals of natural family and motherhood that ultimately bias findings and influence public perception. Finally, Arthur Kleinman’s work presents an argument for the use of ethnography as a valuable tool in understanding the increasing number of complex bioethical dilemmas today. He references various other researchers and qualifies his own position as he asserts that bioethics should account for moral and ethical relationships. Below, I briefly summarize each of these readings and pose questions that might be of interest for class discussion this week.

Shirin Garmaroudi Naef’s chapter, “Gestational Surrogacy in Iran: Uterine Kinship in Shia Thought and Practice,” in Marcia C. Inhorn and Soraya Tremayne’s Islam and Assisted Reproductive Technologies: Sunni and Shia Perspectives discusses Shia attitudes and acceptance of gestational surrogacy through concepts of gamete donation and other assisted reproductive technologies as mechanisms of reproduction. Naef conducts her research through participant observation, ethnographic interviews, and casual conversations with patients and workers in infertility and IVF clinics in Tehran (Naef in Inhorn and Tremayne 2012, 160). She also interviewed respected religious scholars for academic perspectives on Shia practice and belief (161). She begins by discussing foundational concepts that contain the root of disagreement in matters of gestational surrogacy. Nasab, or “legitimate or lawful,” lineage cannot be the product of zina, or “adultery” (158). Shia nasab, unlike more agnatic Sunni nasab, includes equality in male and female roles and importance (158). Shia Islam’s equal recognition in agnatic and uterine kinship relations allows Naef to argue that zina occurs not through bodily fluids coming into illegitimate contact and creating an embryo, but by physical sexual intercourse between two people (158). There is flexible interpretation of Shia nasab that permits gestational surrogacy as a legitimate practice. Naef first recognizes that universal kinship relations result from bodily substances. Naef then deduces that accepting this common belief allows Shia Islam to focus arguments of assisted reproductive technologies elsewhere, such as the importance of physical contact being the true root of zina rather than conception. In order to preserve nasab, Shia practice forbids contact of donor sperm with a woman’s uterus but allows the implantation of an already-formed embryo in a surrogate’s uterus (165). After the acceptable conditions are met to prevent zina in surrogacy, however, scholars vary in their views of what uterine kinship relations nasab permits. One view Naef describes is that the mother is the woman who births the child, regardless of egg ownership (166). Others, following the more “symmetrical” view of agnatic and uterine filiation, consider a mother of a child to be the woman who supplies the original egg (167). One might relate this view to one presented by Rothman, considering a mother and father each as a “half” contributor to an embryo. A final view of uterine kinship is that maternity is established by 1) conception and 2) gestation and birth (168). A child born of a surrogate in this view thus might have two nasab mothers, one of conception and one of birth and gestation. Naef holds that these flexibilities in juridical interpretation place less emphasis on bodily substances in reproduction and more on social and physical contact to produce nasab family structures.

The second part of Naef’s chapter attempts to describe actual experiences of surrogates in Iran – their motivations for and attitudes towards surrogacy and its place in society. In Naef’s studies, surrogates in Iran expressed financial and altruistic motives for agreeing to be a surrogate (175). Research participants’ personal views also aligned with scholars’ arguments that adultery is a result of intercourse itself and not the contact of bodily substances (177). All surrogates clearly viewed sexual intercourse and reproduction as two separate worlds and acts with different meanings. I find this observation worth more consideration, as it parallels the beliefs that sexual intercourse serves a purpose greater than just reproduction. Donum Vitae shares sentiments in the significance of intercourse in marriage. Naef further concludes from this observation that “the grammar of kinship is used to maintain social order in dealing with infertility” (182). People seek sources of normalcy and definition in abnormal situations. Placing significance and interpretation on different aspects of reproduction allows people to respond to changing environments and new technologies while preserving natural order.

Turning to a more Western perspective on surrogacy, Elly Teman critiques new views towards surrogacy research itself. She challenges the public perception that surrogates quickly bond with babies they birth and wish to keep them, a belief that is often a result of one or two popular media cases (Teman 2008, 1104). The foundation of Teman’s argument rests on the importance of family and motherhood in Western culture. Any new threat to such structures will be met with opposition in various forms (1105). She argues that research on surrogacy itself is biased because of Western researchers’ ignorance, assumptions, and resistance to change. Using literature, she presents three common assumptions researchers hold regarding surrogacy. The first assumption, that “surrogates are not ‘normal’ women,” frames surrogate mothers as deviant in their maternal emotions and tendencies. Teman lists various attempts of researchers to show the deviant emotions of surrogate women, but concludes that there lacks evidence to defend the thought that surrogates contain “abnormal” traits (1106). Anything considered normal must have an abnormal counterpart, thus surrogate experiences should be considered individually with their lives and external factors taken into consideration rather than generalizing them into a larger group. The second possible assumption Teman claims researchers make, that “surrogates are ‘normal’ but have a good reason [to be a surrogate]” also fails in its attempt to justify classifying surrogates as deviant. Researchers list financial, altruistic, and reparative reasons for a surrogate’s choice to bear another person’s child. Teman explains that when researchers found little evidence supporting these cultural assumptions, they sought an explanation for the lack of association in evidence. They construct surrogates as deviant again for their motives as being extreme to justify their position that there is a morally acceptable reason for a woman wanting to be a surrogate (1107). A third listed assumption is that surrogates are victims of nature – that “nature gets the better of them.” Proponents of this suggested that surrogates must exhibit trauma or a form of loss in giving up the child they birthed. When researchers found lack of evidence supporting this hypothesis, Teman again shows that they attempted to explain a lack of association by constructing a “deviant” surrogate who tricks herself into thinking that they can detach their emotions from their life (1108). In this, researchers attempt to maintain the idea that pregnancy is a special experience for mothers although evidence suggests otherwise (1108). How might Barbara Katz Rothman respond to this assertion in Teman’s research as it relates to her feminist argument?

Teman holds that researchers fear a change to the status quo of their Western perceptions, and that they make every attempt to prevent such change to norms. Instead of being influenced by popular opinion, Teman urges researchers to be truly open to each woman’s individual experience as a surrogate. She notes that grouping surrogates into categories that might not represent all of them can have detrimental effects on current and future surrogates’ experiences, and if this is to continue as a method of ART, is not beneficial to any party involved (1110). Instead, it is important to focus on other aspects of a surrogate’s identity, such as motherhood or citizenship. Regarding last week’s Made in India movie, how does Aasia (the surrogate in India) balance her role as a surrogate and a mother (particularly with respect to Teman’s points)? What common themes are seen in Teman’s article and Aasia’s case? How does Teman’s research support or undermine the progressing use of ART as a mechanism of family formation?

Continuing with a theme of ethical research, in “Moral Experience and Ethical Reflection: Can Ethnography Reconcile Them? A Quandary for ‘The New Bioethics,’” Arthur Kleinman supports the use of ethnography as a tool in formulating and understanding bioethical dilemmas for practical purposes. He explains the difference between “moral” and “ethical,” the former being “[…] what really matters to people locally in the social processes themselves […]” and the latter being “[…] the articulation of the value-based issues in a self-aware language that aspires to universal reflection, comparison, and criticism […]” (Kleinman 1999, 78-79). Ethnography, he says, gives insight into the murky area between people’s moral and ethical worlds (78). Kleinman notes that ethnographers join people’s moral worlds and then apply situations and circumstances to larger societal understandings, and that doing this shows areas where there is lack of the means necessary to apply understanding to action. As no local moral world can be understood in a vacuum nor should it be generalized on a larger scale, ethnography allows researchers to apply general understandings in specific cases to recognize pitfalls of systems (75). They do this by gaining “ethnoethical orientation” to learn culture-specific ethical beliefs and then apply such beliefs to larger, global ethical debates (79).

Kleinman then provides examples of applying ethnography to bioethics. Among others, he discusses the work of Rayna Rapp, commending her for using ethnography as a means to discover more about impacts of amniocentesis testing and her research’s illumination of true ethical dilemmas people experience in prenatal testing – no two of which are the same (85). Rapp’s work furthers Kleinman’s claims for the use of ethnography in ethical debates because it successfully depicts a social dilemma as well as the complications it involves, and shows that national ethical policies and beliefs do not affect everybody in the same manner. Finally, Kleinman critiques his own ideas throughout his work. I appreciate that he does more than express certain limitations of ethnography – he goes so far as to question the success of using ethnography in understanding ethical dilemmas, an aspect of his paper that I believe does not weaken his argument, but makes him a more credible academic. He recognizes his limitations as a researcher and urges for further consideration of his ideas. Using prior knowledge from readings and class discussions, do you agree with Kleinman’s distinction between the “moral” and the “ethical” and his theories for the ways in which ethnography can cover the shortcomings of each? What might be ethical barriers to ethnography’s ability to do this in cases we’ve read?

References

Haimowitz, Rebecca and Vaishali Sinha, dir. 2010. Made in India. USA: Chicken and Egg Pictures and The Fledgling Fund. DVD.

Inhorn, Marcia C. and Soraya Tremayne editors. 2012. Islam and Assisted Reproductive Technologies: Sunni and Shia Perspectives. New York, NY: Berghahn Books, Incorporated. Accessed March 27, 2019. ProQuest Ebook Central.

Kleinman, Arthur. 1999. “Moral Experience and Ethical Reflection: Can Ethnography reconcile them? A Quandary for the ‘New Bioethics.’” Daedalus 128: 69-97.

Teman, Elly. 2008. “The Social Construction of Surrogacy Research: An Anthropological Critique of the Psychosocial Scholarship on Surrogate Motherhood.” Social Science and Medicine 67 (2008): 1104-112.

 

This week’s readings discussed reproductive technologies in the perspective of motherhood. The reading by Rothman, specifically, critiqued surrogacy from a feminist point of view, while distinguishing the critique from the religious point of view. Rothman mentions the term patriarchy to make the distinction – due to the essential social relationship of the father and son that underlies the patriarchy, women are described in relation to men. For example, when “women bear the children of men” (Rothman, 1600). The matter of control is also discussed, as men may implant their seed in women, but they then lose control of that seed and must control the woman in order to control the seed (Rothman, 1600).

In the case of surrogacy, patriarchal notions are present – children are defined as legitimate based on the father. The mother’s own role does not matter, like in the biblical case of Abraham, Sarah, and Haagar. Although the child borne is not Sarah’s, the child is fundamentally defined by the relationship with Abraham. The privilege of claiming children is extended to women only to a point congruous to men. Women’s claim of children does not emerge from the foundation that the children grew in their own bodies, but that the child retains half of the woman’s genetic material. Rothman describes surrogacy as serving women’s interests only some of the time, as surrogacy typically depends on how privileged men and women may be.

The Baby M case, a surrogacy case which Rothman worked on where the surrogate mother changed her mind about keeping the baby after giving birth, was compared to a man walking into a bar, seducing a religious girl who would not have an abortion, supplying her with basic maternity goods, and then taking the child away from the girl (Rothman, 1602). Baby M highlighted the notion that children’s social relationship with the father are given priority when, at the end of the case, custody was given to the father. Women being able to gain custody of children has typically had some relation to how the father of those children were reacting in that same situation. If, for example, a man wanted the child, then he would gain custody of the child.

Rothman concluded that surrogacy and reproductive technologies could not be considered in the same manner for men and women, as each group has a very different experience of the same occurrence. Pregnancy, for women, is continuous from conception itself as women, while pregnancy, for men, is only present when the egg is fertilized. The social relationship of pregnancy itself should, therefore, be considered when deliberating kinship. Rothman’s argument was compelling and pregnancy should be regarded as an important social relationship, but the argument itself represents only some women and disregards those who are infertile and wish to have a child. Rothman herself maintains that not all infertile people should have to turn to adoption for a solution, but then what solution remains for these infertile women?

Meilaender approaches the topic of reproductive technologies with perspectives previously taken by Protestant ethicists. The story of Abraham, Sarah, and Haagar is mentioned in this reading as well, but only in how it emphasizes the importance of procreation. McDowell suggests that surrogacy, based on biblical themes, is misplaced compassion or “compassion gone awry” (Meilaender, 1638). Surrogacy, according to McDowell, does not illustrate the loving commitment of a couple nor the intention to care for a child conceived purposely. It instead emphasizes that a child can be created for the mere purpose of giving to someone else. Simmons biblical analysis differs from McDowell, as he thinks that the concept of surrogacy allows for children to be recognized as the gift they are by parents who can truly appreciate and care for them. These two viewpoints summarize the theological duality of finitude and freedom that are later deliberated on in the reading as central to Protestant thought of reproductive technologies. The reading emphasized the vastly differing perspectives that can be taken when considering religious texts. Conclusions in the reading did not matter as much as approaches did to elaborate on the patterns of thought.

The ethnography by Seeman et al. followed homeless, primarily African American, mothers in the United States. Most of the mothers did not become pregnant deliberately and cited the pregnancy as a factor contributing to their homelessness, but they also had an inclination to describe motherhood as a positive force or a “blessing.” Such a description can demonstrate a vernacular religious concept, or a religious nuance that affects the distinction between the intentions of pregnancy. The methods of the ethnography in the urban shelter Naomi’s House included observations, interviews of residents and staff members, and a focus group where residents where asked about the decisions they had taken for their reproductive health.

The shelter emphasized strict rules for their residents stressing personal responsibility and planning. Such planning was not necessarily taken in by the residents, as they were unable to make a specific plan when given a hypothetical situation where both a night job and day job was offered. Although the residents insisted that they had to take both jobs, they could not formulate a plan to do so; however, the insistence matched the concept of persevering “with God’s help, despite serious obstacles” (Seeman et al., 33). The residents also did not idealize their situation in Naomi’s House, but did compare it to much worse situations which allowed them to view their pregnancies positively. In fact, motherhood was utilized as a reason for why these women bettered themselves and achieved something. Even Diana, one of the few women who had not used the word blessing to describe her pregnancy, still cited her pregnancy as a positive turning point in her life. The spirituality and religious perspectives of these cases are closely tied, and the perspectives are internalized in the residents.

The residents discussed their fear of side effects and the poverty which influenced their use of birth control and inevitably led to their pregnancies. A negative attitude toward medical professionals also influenced their reluctance to discuss their reproductive health with these professionals. These factors and the internalized vernacular religious concepts of the residents of Naomi’s House emphasized the importance of ethnographic research and cannot be taken out of concept. Other homeless women may consider the agencies that affect their pregnancies in a completely different manner. In this specific ethnography, the agencies the affected the rational choice of many of the residents had to do with a religious discourse.

This week’s readings are interconnected by their discussion of the carefully calculated decisions that are made before and during motherhood. Broadly, all of the readings beg the question of the acceptance of reproductive technology in altering conventional motherhood. Surrogacy, for example, is considered an alteration to motherhood by challenging the long-established idea that a child delivered from a woman’s body is in fact her child. Before reproductive technology such as in vitro fertilization (IVF) and surrogacy were introduced, there was little question of who the mother of the baby is. Both Rothman (1992) and Meilaender (1992) give careful thought to the question of the role of surrogacy and artificial insemination and blurring kinship lines in human reproduction from a feminist and Protestant perspective, respectively. Seeman et al. (2016) address motherhood from a slightly different angle, investigating poor women’s’ reactions to their unintended pregnancy. The ethnographic study raises the concern of abortion as an alteration to one’s experience as a (potential) mother, and specifically addresses how women perceived their decision to continue the pregnancy or not long after the fact, and how religion and spirituality have roles in their autonomous decisions. With the discussion of these three readings, I highlight the important themes that are central to each article as well as motherhood in a broad sense.

Barbara Katz Rothman, a self-proclaimed feminist sociologist whose work is central to birth and motherhood, wrote her article as a personal stance on surrogacy given her feminist perspective that takes issue with patriarchal norms and control of women. Rothman is quick to point out that although her opinion might lie “on the same side of this particular fence as the religious leaders, we are coming from a very different place, and we are going to a very different place” (1599). She separates her argument from religion and focuses instead on the overarching patriarchal view of motherhood that puts women and mothers in a subordinate place. Careful not to conflate “patriarchy” with “sexism” or “men’s rule,” Rothman distinguishes between the concepts and emphasizes that her focus is on the “rule of fathers” in a patriarchal society, and not sexist claims. She argues that in the United States, a “contemporary patriarchal society,” the defining relationship is the father and son, from which derivations are formed, such as children being referred to as “the children of men out of the bodies of women” (1600). When a man loses control of his reproductive autonomy by allowing his child to grow in a woman, he therefore must control the woman to maintain a sense of power and certainty of his kin. Rothman accounts for the differences in societal determinants of kinship, but acknowledges the general American perspective that consanguineal kin is true kin. “Seed,” or gamete, is the “essential underlying concept of patriarchy,” thus, because America recognizes the gamete of a woman to be half of the genetic makeup of the reproductive cycle, some patriarchal privileges are extended to women.

It is through this lens that Rothman opposes surrogacy for a number of reasons. Even with extended rights, surrogacy perpetuates class differences, as there is often a large payment from the woman who cannot carry the fetus to the woman who can. She argues that surrogacy is hardly different than adultery with respect to the case of “Baby M”, claiming that if a man impregnate a woman who was not his wife then sued for custody, the same goal would be accomplished because the courts favor paternal custody (1603). Through this point, we see a connection to past class conversations of the father providing the seed for the mother who is simply fertile soil, which is how Rothman argues that women are used and perceived as houses for the seed to grow. Although Rothman spends some time emphasizing her separation from religious opinions of surrogacy and argues that it is instead the patriarchal norms that are reinforced through society (and commonly religion) that feminists should take issue with, I found one specific part of her argument to be challenging to her views. Rothman emphasizes that reproductive technology is perceived as a threat to “the family and natural order” (1604). Although the paper is twenty-seven years old, Rothman indicates that feminist discourse is concerned with maintaining the natural sanctity of the family, which I argue would be challenged heavily today by the disapproval of the dichotomy of natural and unnatural that her argument suggests. This concern Rothman raises seems to coincide with Catholicism and Natural Law, therefore I would argue that this claim is not distinct from religious influence or opinion.

Rothman’s conclusion emphasizes that all of this would look very different from a woman’s perspective. She particularly caught my attention with her discussion of reproductive autonomy and the control of reproduction for the benefit of society, which infers that women are mechanisms that support what society needs, stripping away the woman’s autonomy. Rothman concludes her paper with a call to action of others to oppose surrogacy because it is a violation of autonomy, emotionally and physically exhausting, immoral, and “unnatural” for a woman to give birth to her kin just to hand it over to the father. This closing thought is “regardless of the sources of the egg and or the sperm,” which allows the reader to infer that Rothman is arguing pregnancy and birth are the most determining factors of motherhood, and that “any woman cannot be a mother of a child who is not her own” (1607). With this powerful conclusion, how well do you feel Rothman’s thoughts are constructed? Do her arguments support or refute one another? Would you consider them to be feminist if this was written today?

 

In his paper, Meilaender (1992) outlines the various Protestant interpretations and opinions of reproductive technology, giving credit as well a critique to the arguments. He clearly explains how many Protestant views of reproductive technology are entrenched in the self and obligation of the self to God among other common values. Through this understanding, artificial insemination and other reproductive technologies are often but not always disapproved of for their dehumanizing nature. This is described by different Protestant scholars to have consequences for different individuals. For example, Ramsey argues that the union of the biological and the personal is essential for moral parenthood, and their separation through technological intervention would prove to be dehumanizing and cause enslavement to “whatever new technological advance becomes possible” (1641). Smith, however, argues that surrogacy or artificial insemination by donor (AID) should be prohibited for its dehumanizing of the child’s world, as well as the unequal parental representation. He argues that if only one partner in marriage has their genetic information passed to the child of AID or surrogacy, there is unequal representation of the marriage in the relationship, which is argued to be destructive to the self (1640).

In my opinion, the most important concept from the reading is that while the same religious influence can be considered with respect to an ethical issue, very different outcomes and thus opinions can arise under the same denomination. Meilaender portrays this with a contrasting opinion under Protestant reason that does not condemn AID. Fletcher argues that “kinship is essentially a matter of human intention and will, of love and not blood” (1642). This interpretation is rooted in Fletcher’s greater value in freedom of self than reproduction. While Ramsey and Smith condemn this very idea, Fletcher celebrates it as “‘rational and human choice’ over ‘blind worship of raw nature’” (1643). In conclusion, Meilaender claims that although these opinions of reproductive technology are different, it is the theological approach and use of the Bible in Protestant theory that is systematically followed to address controversial issues that one should practice in human society, in order to maintain the ideals of what is truly human. I cannot say that I agree that the fundamental Christological understanding of Jesus as the son of God to be a starting point for this discussion moving forward, especially after reading Rothman’s critique of contemporary patriarchal society and its stripping of women’s autonomy. As a woman, I cannot help but wonder how different these conversations would look if one’s ability to identify as male or female was not so telling of their rights and privileges in American society. I also begin to wonder how much of the American contemporary patriarchy is truly rooted in religious text or values…please feel free to share your thoughts on this.

 

More recent literature has investigated the nature of altering motherhood from a woman’s perspective. The authors of Blessing Unintended Pregnancy study how poor African American mothers who experienced unintended pregnancies now perceive their decision to raise their child(ren). The woman in the ethnographic study were all staying at a homeless shelter, which many found comfort in because it offered a new beginning. Regardless of their financial state, the majority of the women who carried unintended pregnancies to term regarded their pregnancy to be “meant to be” or “a blessing.” (Seeman et al. 2016, 34) This tribute to a higher power than oneself can be seen as a denial of some human control over pregnancy. The authors attribute the ambivalence of human control of reproduction to be rooted in an “existential tug between human and divine agency” (34). Throughout the study, the authors unpack the personal accounts of women who most often attributed their unintended pregnancy to something beyond their control.

While some women struggled to gain approval of family and community members, others took the opportunity to move out and “start over,” commonly escaping habits or situations that might pose consequences for their child such as drug use or physical abuse from their partner: “Each of these women described motherhood as the primary reason that they managed to reframe their lives around achievement and success rather than endless struggles and disappointment” (36).  Being able to make a drastic change for oneself by attributing something like unplanned pregnancy as a “gift” cultivated impactful change, which these women felt empowered by. The authors proceed to portray that coming to the homeless shelter was more than a place to temporarily raise their children, but it also provided some shelter from male dominance that many of them felt subordinate to.

The use of “blessing” and “meant to be” can be seen as a religious comfort offered to explain unintended pregnancy; however, many of them women who were most involved in local religious groups declined that they were religious and instead felt that “spiritual” better described their faith. The authors argue that to woman at the homeless shelter, spirituality is not posed as an alternative to religion, but as a part of “Christian discourse that includes a critique of some institutional Christian practice” (41). In the context of this study, this definition of spirituality made great sense to me and helped to understand personal experiences of these women and what’s at stake for them in their local moral world. Arguably the most important port of this paper is the call to action of further studies to not assume that “religious conceptions always mediate against planning discourse” (42). It is therefore not our place in academics to assume that “we know what religion means in reproductive settings,” and instead to pay close attention to how perspectives are shifted and where agency lies through different contexts of reproductive decisions.

This paper serves as a call to action for public health discourse to consider ethnographic studies of the local moral world instead of abstract debate regarding fetus and maternal rights or when life begins in the womb. Ethnography holds great validity, and through ethnographic study research can unpack the role of more than just religion in order to understand personal accounts of reproductive autonomy in order to shape public health policy moving forward.

This week’s readings shed light on a very controversial topic in our world today.  In Hadley Arkes’ piece, he writes about abortion in an instructive manner that touch upon key elements of argumentation.  Early on in the reading, Harkes declares that the human life, and the right to law, are a matter of theology (360).  He furthers this by saying that, “it has become common public figures to declare in public that “they personally disapprove” of abortion, but that abortion is a “deeply religious and moral question,” and therefore that the laws should not impose an official policy on this matter” (361).  I found this to be quite interesting and prevalent to our world today, since the topic of abortion poses both a political and religious problem for high-up officials.  Although it is unproductive for the progression of whether abortion should be legal or illegal, it is advantageous for politicians to place the power in the hands of the mother and her religious values.  Instead of implementing something that changes the lives of all people, both good and bad, politicians declare the right to choice.

 

When discussing the case of Roe vs. Wade, Arkes breaks down the decision that was made in regards to when a human life begins.  More over, the fact that a human’s beginning means the ability for protection by law, and the effect that this has on abortion.  With the technology that we currently have, it is possible to save the lives of many of these embryos that will become humans with the proper, continuous process of growth. Another interesting point that Arkes brings up is the “benchmark of twenty-four weeks” that Blackmun set when specifying the viability and recognition of a child.  Consequently, “Blackmun and his colleagues had framed a momentous decision without even bothering to draw on the most informed technical understanding available to them”(376).  This decision and the technology at hand create a technological fallacy when speaking of viability.  He mentions that if the Roe vs. Wadecase, “really accepted the notion that fetuses may be protected by the law when they are “viable,” then that decision contains the grounds for its own dissolution as our technology makes it possible to rescue these threatened fetuses almost at the very beginning” (377). Modern-day technology has created the possibility for a human life to be established through other means at a very early stage in the pregnancy.  The takeaway here is the questioning of when a fetus gains the equal rights as the mother. This is seen in Judith Jarvis Thompson’s work, “A Defense of Abortion.”

 

Thompson does say that a fetus does become a person prior to the birth, but there is no specific point in which it can be marked simply because the process is nonstop.  One thing is for certain and that is a fetus is a person, and a person has rights. Both the mother and the child have the right to life, but there are instances in which one must sacrifice the other.  With the example of the woman who would die due to her cardiac condition if she gave birth to her child, Thompson poses some thought-provoking questions.  Her conclusion from these questions was that a mother is performing an abortion on herself, and therefore has the right to do what she sees fit.  Thompson states that, “it cannot seriously be thought to be murder if the mother performs an abortion on herself to save her life.  It cannot seriously be said that she must refrain, that she must sit passively by and wait for her death” (52).  It would be one thing if a person murdered a completely separate individual, but the idea of an abortion creates much more room for debate since it is the woman who is housing the fetus.

 

In Ginsburg’s reading, we are able to get some clarification on the difference between pro-life and pro-choice, something that is crucial in the debate on abortion.  Pro-choice activists see abortion as an, “essential safeguard against the differential effects of pregnancy on men and women” (7).  As seen in her example of rape, Thompson cites that abortion is beneficial in that aspect. This counteracts the view of the pro-life activist, who preach that women are distinguished from men due to their ability to become pregnant and assume the role of mother.  As we have seen in prior week’s readings, becoming a mother is an extremely coveted position in certain religions, and it is clearly wrong from these perspective to abort a child as that would take away this role.  In the end, for Ginsburg, she notes that pro-life and pro-choice activists come together at the end of the day to support the livelihood and well-being of women regardless of the view on abortion.  The opening of the Women’s health organization is a great example of both sides coming together.