Month: February 2019

In her ethnography, Embodying Culture: Pregnancy in Japan and Israel, Tsipy Ivry uses her own experiences with pregnancy and her research on the topic to compare and contrast two widely different medical systems. Both Japan and Israel are non-Western, highly industrialized societies that provide medical facilities and insurance subsidized by the government (Ivry 20). Their differing religious and historical backgrounds heightened Ivry’s interest in the matter and helped her understand that “there is much more to pregnancy than merely the transitory stage to birth and motherhood” (Ivry 1). She discusses the importance of understanding pregnancy as much more than just reproduction and uses Japanese and Israeli beliefs to do so.

 

One of the most polarizing characteristics between Japanese and Israeli doctors is their perceptions of the health of the patient and what constitutes as “good” or “bad” during pregnancy. Israel’s pro-natalist state provides national health insurance to their citizens, which cover most costs of gestation. As a result, Israel has the highest rate in the world of IVF clinics and has more lenient abortion laws (Ivry 38). Among the many services covered by health insurance are diagnostic tests that can detect abnormalities in the fetus. Having access to such tests has lead to a heightened awareness and resulting paranoia about knowing the health status of their baby. Ivry mentions that “the word ‘hysteria’ is often used, by doctors, male partners, and relatives, and sometimes even by women themselves, to signify an anxiety about possible abnormalities in the fetus” (Ivry 47). The women become dependent on the doctors to constantly reassure them that their baby is fine and are depicted as an external bystander of their own pregnancies. The doctors’ main concern is that the women fully understand all aspects of their own health, and the health of their fetus,  and are thus recommending procedures that are in the best interest of their patients, making them less tolerant of patient’s personal decisions (Ivry 76). Contrarily, Japanese prenatal care is focused much more on the natural changes during pregnancy and how they can affect the health of the baby. The health progression of the baby is connected with the woman’s “conduct of her daily life” (Ivry 92). Japanese doctors stress the importance of keeping the “maternal environment” as safe and healthy as possible and as a result, the fetus will grow with little complications. The patients are not as enthusiastic about prenatal diagnostic testing because they are not as threatened by statistics on fetal abnormalities. Women spend much of their pregnancy monitoring all aspects of their lives including diet, work and travel in order to ensure that no harm will be inflicted upon the fetus.

Furthermore, the way that women experience their pregnancies are significantly distinct. Japanese women and society stress the importance of bonding with the fetus while it is in the womb. The mother will often take time off of work beginning at about month five of gestation so that she can spend time with the fetus. She will talk to it, sing to it and touch her belly often in order to ensure that her baby knows that he/she is safe and wanted. The doctors also participate in this bonding by personifying the fetuses during check-ups and ultrasounds. As Ivry mentions in her work, such theories of prenatal bonding “designates women as the primary creators of the children: with every breath they take, every move they make, women make their children” (Ivry 165).  Unlike Japan where the pregnant women are virtually hidden, in Israel pregnant women are “highly visible” (Ivry 187). They do not take nearly as much time off of work and are not worried about their diet or weight gain during pregnancy. Israeli state is also more inclusive of men in gestation by providing pregnancy classes for both the mother and father and allowing the father to attend routine check-ups. Israeli society often separates the woman and the fetus, which allows them to continue on in their “normal lives” without disruption from the pregnancy.

Ivry effectively describes the pregnancy in Japan and Israel and highlights gestation as a cultural category in need of more social analysis. After reading her work, I was shocked by the wide variation of views on gestation were and how such a common natural event can be treated with such unique/varied procedures. I also wonder if Western societies, who are so stringent about prevention of diseases, would relate more with Israeli medicine or Japanese? We discussed in class last week that biotechnology is not culture-neutral and ideas about risk vary from setting to setting, which can be seen Ivry’s descriptions on Japan and Israel. Pregnancy is a universal event and is much more than just the physical changes that occur. All aspects of gestation can be understood in matters of cultural values and societal perceptions of humanity.

The attitudes towards pregnancy are highly different in separate regions of the world, as analyzed by Tsipy Ivry in her book Embodying Culture: Pregnancy in Japan and Israel. From how women are treated to abortion policies, each region has adapted their own unique cultural perspectives on pregnancy. For Japan and Israel, they can be effectively summed up by environmentalism and geneticism, respectively.

Japan’s environmentalism is entrenched in its history of eugenics. In the past, they had sterilized those with undesirable traits but later adopted a stance of “taking care of oneself/the body (odaijini)” to produce better babies (Ivry 127). This shift to taking care of the women has become a large aspect of how the Japanese treat gestation. From a careful diet to reducing anxiety and stresses on the pregnant woman, the health of the mother is core in predicting how healthy the child will be. The Japanese do not necessarily scorn birth defects such as Down Syndrome (Ivry 173); in fact, women, unless they were raped or do not have the financial means to support the child, cannot opt for an abortion. Japanese pregnant women are seen as “less threatening” (Ivry 26) because of this attitude towards children born with Down Syndrome and abortion. Wrongful birth suits are not so much seen as cases for delivery accidents.

Pregnancy in Japan has been cultivated to manage the mother and instill habits to create a bond between parent and child. Though pregnancy is “less medicalized, supervised, and socially manipulated” in Japan than in Israel (Ivry 4), there seems to be a fundamental different system of values in place. Pregnant Japanese women are heavily encouraged to monitor their diets and even talk to their children while they are still in the womb to encourage intelligence and a stable relationship once the child is born.

Israel, in contrast, has adopted an attitude of diagnosing the fetus (Ivry 4). Israel’s geneticism involves a rather fatalistic view that genes and chromosomes of their child are beyond their power. Notably, obgyns push mothers to take many more tests to monitor the health of the developing child. Though pro-natal, Israel has a rather lax policy on abortions. Despite constant legislative attempts to reign in leniency, a “defective fetus” is permitted to be aborted if the mother so desires (though may encounter some resistance past the third trimester) (Ivry 39). The conception of a child does not appear to be featured as prominently; some women cited that they “could hardly imagine…speaking of “babies” in the early stages of pregnancy” (Ivry 2). Doctors are highly stringent in their regiment of testing. Every pregnancy is at high risk of fetal catastrophe, especially given the concept of “Jewish Diseases.” The fetus is meant to be diagnosed rather than formed a bond with.

Both cultures have a wildly different outlook on how pregnancy should be treated—it is a time that should be treated with extreme caution, but Japan and Israel heavily differ on how they handle pregnant women. Though an objective truth might state that neither culture is “more correct” in how they treat pregnant women, would Western culture favor a Japanese viewpoint or an Israeli viewpoint?

Testing Women, Testing the Fetus : The Social Impact of Amniocentesis in America by Rayna Rapp is a book rich in anthropological research, documented participant observation, personal accounts of pregnant women and fathers of fetuses, and analysis centered around amniocentesis. Rayna explores the social impact of amniocentesis through 11 chapters, beginning with the methodology and routinization of prenatal diagnosis and concluding, appropriately, with a hopeful concept of endings serving as new beginnings. Rapp does an incredible job of informing the reader of the history of prenatal diagnosis and background on amniocentesis, which I believe is paramount to understanding the racial, cultural, and socioeconomic underpinnings of prenatal diagnosis’ impact on expecting mothers. Through the educational foundation she sets with readers, Rapp connects amniocentesis with an array of questions and topics; ethics, ableism, religion, cultural and ethnic background, and maternal responsibility are part of the many constructs that Rapp investigates. 

Ethics plays a large role in Rayna Rapp’s critique of the development of prenatal diagnosis and, through her third chapter on the communication of risk, sheds light on the interconnectedness of eugenics and genetic counseling. The rise of eugenicists, scientists who study the discipline of improving the human population through selective breeding, largely brought to life the field of genetic counseling; the avenue through which amniocentesis results are communicated. Rapp discusses the concept of “positive” eugenics vs “negative” eugenics, meaning sexual reproduction among people with desired traits versus people with undesired traits. The potential ethical ramifications of this field of study seem to bleed over into the medical practice of amniocentesis and the field of genetic counseling. “Positive” and “Negative” eugenics come with an implicit assumption of the rules which determine certain humans superior to others. Though genetic counselors specialize in neutrality in working with peoples of differing backgrounds and with various ideas on the science of reproduction and pregnancy, amniocentesis and the communication of its results can come with implicit laws of what is “good” and “bad” that may not align with patient’s own beliefs, especially if communicated with any amount of bias or hidden agenda by a medical professional. The idea of theological or divine determinism, for example, is a reason for many women to not seek abortion when given the news of a fetus developing with disability.  

In the chapter titled “The Disabled Fetal Imaginary”, many direct quotes from women and men suggest the immensity of misinformation that exists around disability and fetus development. There are many interviewees who describe Down’s syndrome as something entirely unlike the realities of Down’s syndrome. This chapter highlights the importance of communication throughout the pregnancy process and after the discovery of genetic and developmental disorders. Rayna attributes race and socioeconomic class as two of the primary factors in determining a patient’s response to the results of amniocentesis. She posits the likelihood of similar upbringing, educational background and cultural disposition between white patients and genetic counselors compared to recently relocated Hispanics or peoples struggling with a language barrier. On observing an interaction of a male biostatistician with a female genetic counselor, Rapp describes, “Watching such interactions, it was hard not to make two judgments: first, that male professional expertise sits uncomfortably in a room with less-credentialed but more specialized female professionalism; and second, that male anxiety is commonly and acceptably expressed through rationalized hostility.” (109) Her feminist voice certainly surfaces through this comment, as does her opinion on the challenges of genetic counselors in offering the best guidance and information to their patients. Rapp does not dive into the topic of male domination in the medical industry. Even in the subject of pregnancy and reproduction, male scientists and thought-leaders have dominated the path for women’s reproductive health. I would be so curious to know Rayna’s thoughts on the male bias of women’s reproductive health care and how it has impacted the resources, information, and support available to women during the whole pregnancy process. Perhaps it is too large of a subject that might complicate Rapp’s writing and deflect from the center of her study.  

“No one enters the decision to undergo amniocentesis trivially; genetic counseling is too sobering an experience to permit a casual use of this technology by any of the women among whom I have worked.” (Rapp, 307) Rayna articulates a question that was brought up in class; how and when do we determine a fetus to be a human? And how do our morals bend when the reality our future life deviates so far from our expectation? Described in Tsipy Ivory’s article “Outsourcing Moral Responsibility: the Division of Labor among Religious Experts”, “FLOH’s rabbis position themselves as medical decisors” (Ivory, 10) which is in direct opposition to the work of a genetic counselor. According to Ivy, rabbis are in consensus about the conditions in which an abortion is permissible following the diagnosis of fetal anomaly. What lacks from the offices of genetic counselors that rabbis offer in bounty is ethical judgement. Though Rapp emphasizes the importance of remaining neutral as a health care professional, I wonder how often this leaves women of weak or no religious affiliation with a heightened sense of moral dilemma, perpetuating the issue of defaulted maternal responsibility in pregnancy.  

 

In Testing Women, Testing the Fetus: The Social Impact of Amniocentesis in America, anthropologist and feminist Rayna Rapp explores fetal testing and how it has become a routine part of pregnancy care for some portions of the population. Additionally, she discusses the populations likely to use it, and the role and communication of the healthcare provider. Rapp makes an effort for her feminism to be intersectional by capturing not only the well-educated, financially stable, secular white woman in America but by gathering stories from women whose stories are typically not explored – uneducated, economically disadvantaged, middle class, working class, and a racially and ethnically diverse group of women. Rapp’s expertise in the subject started with going through an amniocentesis herself and subsequent termination of the pregnancy upon a diagnosis of Trisomy 21, then diving into the field to tell other women’s stories. Specifically, Rapp argues that the use of prenatal testing and intervention technologies are culturally constituted.

According to Rapp, the topic is especially complicated due to the “intersection of personal pain and national political struggles” (Rapp 1999). This goes beyond what many of us might first think with the pro-choice vs pro-life debate. The discussion also includes healthcare in a country where all members do not have equal access, disability rights, and the right to informed consent.

Rapp goes over the history of the amniocentesis procedure, informing us that it dates back to 1882, predating ultrasound technology, though it was not popularized until 1950 for the purpose of treating Rh disease. The addition of ultrasound technology made the amniocentesis procedure safer and less likely to cause miscarriage. In the 1960s, a similar test known as chorionic villus sampling (CVS) test was developed which allows for women to be tested at the end of the first trimester, though it carries a higher risk of miscarriage as well as possible birth defects. Maternal serum alpha-fetoprotein screening is also now common which can predict neural tube problems and this is also measured in an amniocentesis. One issue, which Rapp addresses, with all of these tests is results are not a definitive diagnosis – but instead, a screening.

One important point which chapter 3 discusses is genetic counselors, which became a certified career in the 20th century. According to Rapp, genetic counselors are built to be neutral. However, their role is inherently not neutral when eliminating technology for fetuses exists. Either way, neutrality is not always good. Some women do not want to be given a choice. Another problem that exists is that genetic counselors usually have no ethnic or cultural diversity training. This buttresses Rapp’s argument that the “hegemony of the scientific model can never be absolute” (Rapp 1999).

There are many reasons that women may or may not want an amniocentesis. Age, education, limitations of the test, the opinion of the father, and family history, as well as previous pregnancy history all, affect a woman’s decision. Experiences of their friends and coworkers can influence them as well. Their cultural and ethnic background may affect it as well, influenced by older women in their family who may not see a need for it or may believe that getting an amniocentesis could possibly influence a pregnant woman to abort.  Doubts about the usefulness of the test, considering the limitations of what the test shows and that it does not necessarily show how severe it can be (such as Down Syndrome ranging from mild to severe), may guide a woman away from getting an amniocentesis. Additional reasons against an amniocentesis also vary from fear of miscarriage, discomfort with the procedure, and religious reasons. The number of factors that go into their decision is not limited. However, religious reasons go in both directions. While some may argue that their god would not give them problems they could not handle, others argue that their god gives them solutions for problems. Many women also question whether a decision makes them selfish, worry about the suffering of a fetus – not from the abortion, but the life and quality of it that they have, and the burden that it could place on their family.

Regardless of a woman’s decision, communication between doctors, counselors, and women remains difficult. “Code-switching” between scientific lingo and colloquial language is an issue. Women with more scientific literacy are more likely to get more specific information from their doctor. Answering questions about background and medical history may not make sense to every patient and therefore, their answers may not be as informative. Some women made find the citing of statistics at them to be inconsiderate of their personal situation, and that counselors do not understand their specific concerns. Single mothers and lesbians often feel ostracized in their circumstances due to the stress put on by healthcare professionals to know about a paternal background. With varying reasons, there is a near consensus among women who do get an amniocentesis on a couple of things: anxiety is high during the waiting period between the procedure and nearly all of them are glad they got it after they get the results.

Another point that Rapp makes religious and science are intertwined, not to be considered individually on personal decisions such as an amniocentesis or how to go forward upon a positive diagnosis, and open to interpretation. Although pieces of work such as the Donum Vitae exist, there is no definitive Catholic viewpoint, or Jewish, or any other religion. Texts like these do exist but do not solely dictate and control the decision making of every single member of the religion.

In the latter portion of her book, Rapp begins to take a more personal approach to the subject. Chapter 8 offers an in-depth analysis of analyzing the sample gathered in amniocentesis and her experience working with the lab technicians. In Chapter 9, she discusses the myriad of emotions that women have to deal with upon receiving a positive diagnosis. Although estimates of over 90% exist for women who choose to terminate the fetus after a diagnosis, two groups tend to exist: some knew immediately they would do so, and others went through an extensive decision-making process. All of the women who received one experience severe grief from their loss of the child, likening it to a miscarriage or fetal death more than an abortion. The support these women received after vary, with some being cut off by friends or family, and others receiving their full support. On the other end of the spectrum, Rapp discusses mothers who receive diagnoses upon the birth of their child without having received a prior amniocentesis or other prenatal tests. Many discuss being scared and angry at the beginning, but ultimately loving and being grateful for their child.

Continuing on the note of prenatal testing, the article by Ivry starts off with the anecdote of a Rabbi taking on the moral responsibility of a couple’s decision to terminate in order to relieve them of the agony of the decision. Ivry’s main focus is outsourcing moral responsibility in terms of the prenatal test, diagnosis, and potential termination. Getting the approval of a rabbi gives a message that it is Halachically appropriate. This is often done on a case by case basis, as not all Rabbis feel the same. But rabbis offer something that the doctors cannot in their line of work, ethical judgment. Some are vehemently against it and others permit it in the case of fetal anomalies. This model of outsourcing responsibility offers some peace for pregnant women.

There is an interesting comparison to be drawn between the discussion that Ivry makes of rabbis taking on moral responsibility, and Catholicism, in which Rapp states that Catholic women often experience an extra layer of guilty due to their religion. Religion’s role in the decision-making process is varied and complex, not guaranteed to ease or worsen the woman’s decision.

In Testing women, testing the fetus, anthropologist Rayna Rapp draws on her personal experience with amniocentesis, when she learned that she was pregnant with a fetus which had Down’s syndrome. She then decided to study prenatal diagnosis and the patients’ feelings towards it. She finds failures within communication between healthcare providers and patients to be unavoidable. This is because she claims that though non-directive counseling aims to be unbiased, it fails to do so because practitioners cannot truly be completely objective. However, she does concede that it is also made difficult by the fact that patients’ beliefs are so diverse and complex that they can’t be fully understood. What I found impressive with her work was that she was careful to keep in mind the differences in race, religion, class, etc. throughout her investigation and was cognizant of the effects that this could have.

More intriguing to me was Outsourcing Moral Responsibility, in which I found it interesting how Tsipy Ivry and Elly Teman begin by telling a story about a Rabbinic expert on Jewish law, Rabbi Cohen, and how he handled Jewish laws and ethical considerations while offering a couple counsel on termination of an abnormal fetus. Rabbi Cohen decides that the termination is allowed and puts the couple at ease by taking the moral responsibility on himself. Ivry and Teman draw on this to inquire about the transfer of this moral responsibility. More specifically, the division of moral labor when counseling on reproductive issues. There is a lot of specialization which occurs, dividing the specific kinds of labor so that they are enacted by the proper specialists. They use outsourcing as a metaphor for the transmission of moral responsibility. They identify different strategies for dealing with moments of moral breakdown. When studying American women, who were less likely to share their decision-making process with others, one strategy was that of “non-directiveness”, which can entail genetic counseling, which allows individuals to understand the genetic information without offering any straightforward moral interpretations. In another study done on Vietnamese women, it was found that they desired to share their moral burdens with extended family, and the care they received included explicit directions for decision-making. In the case of Jewish women, they were found to request the advice of a rabbi, who in turn would begin a systematic procedure of dividing moral labors and burdens with other specialists in order to come to a conclusion. The message is that there is a Halachically-appropriate way out of an unbearable post-diagnostic decision because the diversity of rabbinic opinions can be activated…” (Ivry and Teman 11). This was surprising to me because more often than not, ethical decisions, especially about pregnancy, are often made more difficult when they try to go hand-in-hand with religion. However, we can consitently see that experts dividing the moral burden with their consultees seems to help mental health long-term. However, even Ivry and Teman acknowledge that “…even a successful division of moral labor cannot promise exemption from concomitant moral burdens…” (Ivry and Teman 24).

 

This week’s readings discuss in large part how Jewish law, culture, and kinship relations impact the use of assisted reproductive technology in a Jewish society. Sue Kahn, a social anthropologist who specifically focuses on women, explores Israel as her case study, conducting ethnography on various Israeli women to enrich her understand of the relationship between Israelis and reproductive technology. In the introduction to her book, she provides context to the subject, introducing numerous themes, two of which I’d like to focus on at the onset of this blog post. Firstly, she writes about Israeli pronatalism, saying that “the overwhelming desire to create Jewish babies deeply informs the Israeli embrace of reproductive technology” (Kahn 2000, 3). This desire stems from numerous causes including political population concerns as well as the religious sense that reproduction fulfills a God given commandment. This notion of a religious obligation to reproduce is a central theme throughout Kahn as well as the other readings, as this approach is at odds with the Catholic view of a child as a gift that stems from viewing the text as narrative rather than a binding rule book. We will discuss this contrast in further detail shortly. 

Kahn introduces another central theme in her introduction: the emphasis on the mother as bearing the main, central role in the reproductive process. Kahn notes that “Israeli Jewish women are left as the primary agents through which the nation can be reproduced as Jewish,” relating directly to the desire to create Jewish babies but also emphasizing that woman are the means to this continuity, as the mother is the medium through which babies are reared (Kahn 2000, 4). One example of the Israeli focus on motherhood is found in Kahn’s discussion of the Nahmani case, which we already began to discuss in class. A married couple elected to begin the preliminary stages of infertility treatment in hopes of successfully yielding embryos. Before they went through with implanting the embryos in the woman, the couple got divorced. The woman wanted to bear children with these embryos, and despite the man’s resistance, the court ruled in her favor, bolstering the woman’s right to a child. Kahn writes that the reason for and implied message of this decision is that “motherhood is the deepest desire of women and should be pursued at all costs” (Kahn 2000, 70). The court allowing the mother to implant these embryos again ties back to the theme of the centrality of women in the reproductive process. These embryos equally belong to the man, who, despite wanting not to father these children, is clearly less of a priority in the eyes of the court than the mother. “I chose life,” said Judge Ya’akov Turkel, not only recognizing the mother’s right to a child but also encouraging more reproduction of Jewish babies (Kahn 2000, 68). The Nahmani case is an important example of how both of Kahn’s main points are deeply related. The Jewish concern with creating Jewish babies and the proper treatment of the mother given that she bears the child are two of the major factors that lend to Israel favoring the use of reproductive technology. 

Where does this emphasis on the mother stem from? Judaism is inherited matrilineally, so Jewish heritage is passed down through the mother. Kahn logically points out that “the creation of a Jewish child can only be accomplished via gestation in, and parturition from, a Jewish womb.” (Kahn 2000, 167) Back during biblical and rabbinic times, there was no genetic testing or any way to prove kinship other than viscerally, by witnessing the baby emerge from the mother. Seeing as the baby comes directly from the mother, that is the most foolproof way of confirming heredity. Thus, “the specific identity and origin of sperm is conceptualized as irrelevant to Jewish reproduction” (Kahn 2000, 166). Jewish conceptions of kinship and reproduction does not care necessarily about the identity of the sperm, as the mother passes on her Jewishness to the child. Obviously, some recognition of the father is granted, as boys are referred to by name as the son of their fathers. For example, in Hebrew, I am referred to as “Noah ben Hayim,” Noah,  the son of Hayim, my father’s Hebrew name. Another example of a Jewish tradition passed patrilineally is the Cohanic legacy. Yet, the religious status of being Jewish itself is granted through the mother. This total concern for the mother and lack of concern about the identity of the father allows for a cultural the permits and even favors the use of reproductive technology, including sperm donation and IVF, as a means of reproduction, the ultimate Jewish goal. Yet again, we continue to see the theme of centrality of the mother in the extremely significant process of creating Jewish babies. This notion of the lack of a need to identify the origin of the sperm invites us to consider the Jewish view of kinship. We see not only the emphasis on the mother rather than the father in reproduction, but we can also infer a sense of flexibility when it comes to demarcating kin. A mother is a mother so long as she rears the child (according to the Rabbis, this is how Jewish heredity is granted), and while a father is a father if he provides the seed, a baby born to a Jewish mother with sperm donated by a non-Jewish man is considered fatherless according to Jewish law. This very flexible view of kinship allows for reproductive technology to gain traction in Israeli society and ultimately work toward creating as many Jewish babies while working within the confines of Jewish law. 

Given this discuss of kinship, I would be remiss not to mention another underlying theme of Kahn’s book. Given the widespread accessibility of assisted reproductive technology in Israel, how does this affect kinship relations in Israel? She poses the question “what will marriage come to mean if it has ceased to be the exclusive locus of legitimate reproduction” (Kahn 2000, 86). While this question is written as a rhetorical one, the resulting views of kinship is certainly a significant ramification of allowing the use of reproductive technology. While it is obvious that the use of reproductive technology invites a change in kinship relations, Kahn writes “the choice of unmarried women to get pregnant via artificial insemination does not threaten to destabilize foundational assumptions about kinship among Jewish Israelis, for these foundational assumptions are grounded in rabbinic notions of kinship that do not delegitimate children born to unmarried women” (Kahn 2000, 62-63). Kahn clearly expresses that the Israeli use of ART does not contradict and is actually in line with the fundamental Jewish understanding of kinship.

I’d now like to return to the question of the Jewish perception and use of ART as opposed to the Catholic one that we discussed last week in our reading of Donum Vitae. The emphasis on motherhood and desire to create Jewish babies is one reason why we see a more willing approach to IVF from Jewish political and religious leaders as opposed to Catholics. Another stems from the notion that “reproduction… [is] not imagined simply as a biological process that creates human beings, it is imagined as a cultural process constitutive of humanity” (Kahn 2000, 168). The Rabbis, who, again, had no concept of science, did not view child rearing as empirically as the Catholics. According to Kahn, rather, it is a more holistic process of raising a human, only a part of which is biological. ART is more permissible to Jews than Catholics because, as opposed to the hardline commitment to the institution of marriage found in Donum Vitae, the Jewish desire to reproduce grants a more flexible conception of kinship than that of the Catholics. 

One crucial, fundamental difference between the Jewish view of ART and the Catholic view is their approach to Bible and following the laws. Professor Seeman, in his article about reproductive technology in Israel, writes “unlike Jewish writers, Catholic and Protestant writers who use the Bible tend to focus on what can be derived from narrative rather than legal portions of the biblical text” (Seeman 2010, 348). Here, we see a conflict. The Jews read the text as binding; they must follow the letter of the law. Thus, when it comes to reproductive technology, if there is no law against it, then it is within their system of morals to embrace reproductive technology given that it supports the survivability of the Jewish people by increasing rates of reproduction. Catholics, on the other hand, have a different approach to text. They read the Bible as narrative, and thus prioritize values such as the sacredness of marriage over being flexible when it comes to ART because it does not contradict the letter of the law. As Dr. Seeman writes, “it is precisely the legalistic emphasis on discrete prohibitions that has given Jewish bioethical deliberation so much more flexibility than that derived from narrative based ‘foundational anthropology’ approaches,” highlighting both the tension between Catholic and Jewish readings of the Bible and also the focus on the text as law of the Jewish reading that allows for flexibility when it comes to reproductive technology (Seeman 2010, 349). Given a better understanding of the Jewish approach to scripture, we return to Kahn to add an additional layer of understanding to the Jewish approach to ART, as she says that “reproduction is not conceptualized as a choice in Jewish law, but as an obligation, the infertile couple’s decision to take advantage of the new reproductive technologies does not evolved out of a consumerist impulse but out of a compulsion to fulfill a divine commandment” (Kahn 2000, 170). Last week, we discussed the line from Genesis 1:28 “be fruitful and multiply,” noting that the Jews read this as a commandment while the Catholics read this as more of a general lesson rather than a requirement. The Catholic view of the child as a gift is starkly in contrast with the above quote from. Kahn, who describes reproduction as a religious obligation to the Jews. While a child certainly is a gift for them as well, having a child is also not an option. Jewish parents must do whatever it takes to reproduce, even if it compromises traditional conceptions of marriage or strict boundaries of kinship. 

Before I conclude, I will quickly mention Dr. Broyd, who writes an article about the Jewish view of cloning. When discussing the question of who would be considered the mother of a clone, he writes that “the Jewish legal tradition would, in my opinion, be inclined to label the gestational mother (the one who served as an incubator for this cloned individual) as the legal mother of the child, as this woman has most of the apparent indicia of motherhood according to Jewish law” (Broyd 2005, 298). Even given a technology as exciting and controversial as cloning, Dr. Broyd notes that Jewish law gives motherhood status, and thus heredity of the faith, to the woman who bears and delivers the child. This matrilineality directly relates to our analysis of Kahn in our discussion of the focus on women in Israel in considering reproduction. 

Kahn develops a strong, holistic argument for how and why reproductive technology is so accessible in Israel. She describes the political and religious conditions and the Jewish conceptions of kinship and reproduction such that Israel embraces these technologies as opposed to some other traditional and religious cultures. I can only appreciate the work that Kahn has produced. While there is certainly a spectrum of varying Jewish opinions on this matter, I believe that Kahn captures very well the essence of the mainstream Jewish views of today.

In her book Reproducing Jews, anthropologist Susan Kahn submits three main ideas for the reader’s consideration. The first is that in Israeli culture, “…it is considered much worse to be a childless woman than it is to be an unmarried mother” (16). This view of motherhood being accepted as the highest goal to which a woman can attain is something explained and developed in Kahn’s book in tandem with assisted reproductive technology making this goal more and more achievable. The second theme is that of the continuation of the Jewish people; Kahn writes, “Because reproductive technology offers the potential to reproduce more Jews, it is understood to be a positive tool for Jewish survival” (93). There is a deep pull within the collective Jewish consciousness to follow the mandate set forth in Genesis to be fruitful and multiply. The third theme Kahn sets up for the reader is that of the evolving ideas of kinship in Israeli and Jewish culture as a result of assisted reproductive technology becoming more and more widespread. Kahn asks the reader to consider new ideas about paternalistic roles, family units, and individual rights in terms of emerging systems of reproduction, showing how new methods of reproducing Jews have the ability to impact our understanding of reproduction on a global scale.

The first of these three themes that Kahn goes into is shown clearly in the title of the first chapter: “The time arrived but the father didn’t” (9). This effectively captures the feeling of much of Israeli and Jewish culture that Kahn details in the first chapter and throughout the book: women are supposed to be mothers, and they must be allowed to fulfill this role through any means available to them. The new wave of assisted reproductive technology being made available to Jewish women in Israel is a direct result of this deeply-rooted cultural view that women are best suited for motherhood and it is their natural right and directive to have children. In this way, the method of the conception means relatively little in comparison to the actual fact of conception. Kah writes of this phenomenon, “Motherhood itself remains understood as a deeply natural desire and goal, despite the extraordinary technological measures necessary to achieve it” (62). Assisted reproductive technology allows women who are unmarried, barren, homosexual, or in a relationship with an infertile man to have children and fulfill their natural role in motherhood; for this reason, Kahn suggests, the barriers that may be in place elsewhere between women and assisted reproductive technology are not as much of a hurdle for Jewish women in Israel.

The legal hurdles that many women face in using assisted reproductive technology were not uncommon for women in Israel until, Kahn posits, the internationally publicized Nahmani case in which Ruti Nahmani went head to head with her ex-husband to gain custody of the frozen embryos that had been fertilized while they were still married. The details of the case are not as important to Kahn as the public opinion that the case generated in regards to the image of assisted reproductive technology and the attitude towards childless women. Kahn writes, “The public’s sympathy for [Ruti Nahmani] reinforced not only the rights of barren women but also the popular ideology that motherhood is the most important goal in a woman’s life, regardless of her marital status” (69). This case, a landmark case for assisted reproductive technology in itself, achieved something equally important in how it drew attention to the “pitiable state that must be ‘cured’ by any means necessary” that childlessness is seen as in Israeli culture (69). No longer is motherhood reserved for married women with complete health; assisted reproductive technology allows women in any state to have children and fulfill their natural role.

The second theme of Reproducing Jews is the deeply embedded cultural directive of the continuation of the Jewish people. Kahn argues that this desire to fulfill the creation mandate of Genesis 1:28 influences not only religious Jews but their secular counterparts as well. Israeli law is bound up with Jewish religious law and customs, both implicitly and explicitly. Israeli legislation on assisted reproductive technology cannot be created or upheld without some form of input or reaction from Jewish religious law and the rabbis that maintain it. Israeli laws that determine the use of assisted reproductive technology are bolstered by the fact that Jewish people – whether secular or religious – are deeply invested in making more Jewish people.

The state, concretely pronatal, is in agreement with this drive to continue reproducing Jews. Kahn writes of this phenomenon, “…the children conceived via artificial insemination and born to unmarried women inherit the same cultural, religious, and social identity as those born to married women… [artificial insemination] is not a choice that runs contrary to one of the most central goals of the state: the reproduction of Jews” (62). In rabbinic law, children born to unmarried Jewish women enjoy the same rights, status, and privileges of those born to married Jewish women. This further supports the idea that the actual reproduction of children is more important than the way the reproduction occurred. Kahn writes that “since reproduction is not conceptualized as a choice in Jewish law, but as an obligation, the infertile couple’s decision to take advantage of the new reproductive technologies [comes from] compulsion to fulfill a divine commandment” (170). Rabbinic law continues to evolve in reaction to emerging reproductive technologies so that it may, in its own specific and ordered way, facilitate the Halakhic use of these technologies in order to reproduce more Jews.

Jewish religious culture has also influenced public perception of childless women in much the same way as the Nahmani case, allowing it to be more widespread. Kahn writes, “Consent for the new reproductive technologies is all but universal in Israel, a pronatalist state where the despair of the barren woman has deep cultural roots” (70). She goes on to mention how this may even be an appeal to the biblical story of Rachel, a barren woman who cried out to God to give her a son (70). The influence of Jewish religious culture and law on that of secular Israel cannot be disregarded, as it informs the ways in which laws of assisted reproductive technology come about and are integrated into society. Rabbinic law is also informed by this desire to further the Jewish people; Kahn writes that “It is important to point out that a powerful motive behind the creation of new rabbinic rulings regarding reproductive technology is rabbinic concern for the survival of the Jewish people” (93). Assisted reproductive technology allows for more Jewish women to have more Jewish babies, and this is a matter of great importance to the Jewish religious community.

Nevertheless, there does exist a significant amount of discussion and concern over evolving kinship roles as assisted reproductive technology develops in Israel. This is the third point that carries throughout Kahn’s book and one that is the most fraught with disagreement between secular Israeli law and orthodox Jewish culture. There are obvious points of heated debate that emerge in discussions of assisted reproductive technology, be it IVF, artificial insemination, or surrogacy; the most basic of these are those that deal with questions of who the “real” mother or father is, and what roles biological “parents” play in a system where they may have nothing to do with the child who shared their genetic makeup.

Kahn writes strikingly of evolving paternal roles surrounding artificial insemination: “[the state] assumes a paternalistic role, both literally and figuratively. The role of ‘inseminator’ moves laterally between the imagined father and the state… the maintenance and welfare of the child is dependent on the entity that produces sperm for conception, whether that entity is the father or whether it is the state” (29). In this view, the role of “father” goes to the state, both in terms of physical mechanics and the role of provider. This introduces an interesting understanding of the ways in which parental roles can be transferred to entities far removed from the individual, personal father. As Kahn writes, “…Jewish paternity exists along a continuum” (101).

In the same way, the role of motherhood can be similarly understood to be grafted onto the state in situations of surrogacy or egg donation. Kahn writes that “By forcing the biological roles of maternality to fragment into genetic and gestational components, ovum-related technologies force a conceptual fragmentation of maternality as well” (112). These questions of who the “real” mother is are especially important with regards to a system that “determines religious identity matrilineally” (128). Jewish law depends on the identity of the mother to determine Jewish identity, and if the understanding of motherhood is fractured into various aspects, the fracturing of a straightforward understanding of Jewish religious identity is equally present.

Kahn suggests that, in these evolving kinship units forming as a result of assisted reproductive technology, the role of parent and “family” can be transferred not only to the state, but to the staff of the laboratories in which assisted reproductive technology takes place. She writes, “One could argue that the matrix of relationships that exists in these fertility laboratories can be imagined as a fictive kin network, for it is within these relationships that conception occurs” (116). This view sheds light on an incredibly intimate relationship of social and kinship bonds that surround the events, locations, and personnel involved in assisted reproductive technology. The whole network can, in this way, be imagined as a sort of family unit in which conception is achieved, children are born, and families are created. This humanization of assisted reproductive technology is a vastly interesting phenomenon; Kahn calls it the “technological creation of motherhood” (127). This can be applied to fatherhood as well, and it gives readers an insight into the blending worlds of “the medical realm of the operating room and the symbolic realm of kinship” (127) that are emerging from the culture surrounding assisted reproductive technology in Israel.

This week’s readings concern the reactions of the Catholic Church and the French Government to modern reproductive technologies, such as IVF.  Interestingly, both institutions are not only critical of reproductive technologies but also presuppose an a priori natural law.  While the Catholic Church’s and the French Government’s reasoning is somewhat different, the fact that they both presuppose natural laws and are critical of modern reproductive technologies reflects that advancements in technology—especially in reproductive technologies—brings up anxieties about nature and natural law.

The central anxiety reproductive technologies evoke from the Catholic Church, as shown in Donum Vitae, is that the technologies may go against human nature.  The Church believes that “each human person…is constituted not only by his spirit but by his body as well” (Donum Vitae, 144).  Since the body and soul are inseparable from the human being, the Church reasons that any physical intervention (such as a medical procedure) will always affect the soul.  As such, the Church instructs that any medical intervention “must be given a moral evaluation in reference to the dignity of the human person, who is called to realized his vocation from God to the gift of love and the gift of life” (Donum Vitae, 145).  Because of this logic, the core principle of the Church is that medical technology must respect the dignity of the human being.

Regarding reproductive technologies, the authors of Donum Vitae outline three basic principles that are relevant to determining the morality of reproductive technologies.  The first principle is that embryos and fetuses are to be respected as human beings.  This principle reflects Church doctrine that life begins at conception.  The second principle is that human life cannot be purposely destroyed or viewed as an end.  This principle reflects a Kantian attitude towards humanity and is rooted in the teaching that human life is extraordinary due to its creation by God, in God’s image.  The third principle is that procreation ought to happen only through marriage.  This principle is derived from Church doctrine that a child has the right to be born into a marriage.  The logic the authors use to defend this principle is that married parents bring stability and growth for the child.  Using these three principles, the authors evaluate some issues stemming from modern advances in reproductive technologies

The authors spend a considerable amount of space evaluating the morality of in-vitro-fertilization (IVF).  In particular, they question the morality of heterologous IVF and homologous IVF.  The authors determine that heterologous IVF, defined as fertilization outside of marriage, goes against Church doctrine because it “violates the rights of the child; it deprives him of his filial relationship with his parental origins and can hinder the maturing of his personal identity” (Donum Vitae, 159).  In other words, heterologous IVF is prohibited because it denies the child married parents.  Unlike their judgment on heterologous IVF, the authors seem to have difficulties judging homologous IVF, defined as fertilization within marriage.  Ultimately, they rule against it because “such fertilization is neither in fact achieved nor positively willed as the expression and fruit of a specific act of the conjugal union…the generation of the human person is objectively deprived of its proper perfection: namely, that of being the result and fruit of a conjugal act” (Donum Vitae, 165).  In other words, homologous IVF is prohibited because the child was not conceived through “conjugal” relations.

From my perspective, the authors of Donum Vitae fail to provide adequate reasons for why IVF (any form) is prohibited.  I can understand the logic of how they reached their decision, but I do not view their reasons as sufficient to declare IVF prohibited.  The prohibition and reasons appear to be a reaction against change.  While it remains debatable if the authors of Donum Vitae prohibit IVF due to a fear that it will change normalcy, it is undebatable that the actions of the 1994 French National Assembly were made out of fear that IVF will disrupt the status quo.

Nan Ball, in the 2000 article “The Reemergence of Enlightenment Ideas in the 1994 French Bioethics Debates,” does an excellent job at investigating the conditions present in France’s decision to limit IVF treatment exclusively to heterosexual couples of childbearing age.  Ball argues that France’s decision reflected Enlightenment thought on nature and was made in order to maintain what was then viewed as normal.  According to Ball, the French legislature viewed “artificial insemination of homosexual or post-menopausal woman…as ‘unnatural’ because equivalent modes of procreation were not to be found in nature” (Ball, 571).  Ball explains that the “polemical groundwork” for France’s decision comes from the Enlightenment.

Ball explains that Enlightenment thinkers revitalized the importance of the family, which were later adapted to the French bioethics debate.  According to Ball, the Enlightenment caused the family to transform into “a moral and spiritual function, it formed bodies and souls” (Ball, 560).  Jean-Jacques Rousseau took the idea of the family a step further by linking “the importance of the family to the well-being of society” (Ball, 561).  Rousseau, in other words, believed that the family was connected to society and a happy family would result in a happy society.  Unsurprisingly, two-hundred years later, one of the primary reasons why the French legislators restricted IVF is that they “wanted to slow down the possible social changes signaled by unrestricted use of biomedical technology” (Ball 571).  In other words, the French legislators restricted IVF because they believed that by allowing people deemed unnatural to have children—such as homosexuals or post-menopausal women—society would collapse.

Nan’s article does a great job of showing the motives of the French legislators and explaining that it was out of fear.  I am stunned that a “western” European country had such a rigid view of normality not too long ago.  The 1994 French bioethics debate, as well as the Donum Vitae, illuminate the motives behind why certain medical practices, which are inherently benevolent, are banned.  I find it interesting and perplexing that neither case discussed the reasons why procedures like IVF were invented.  I am not surprised, however, that a reason against reproductive technologies found in both cases is an unwillingness to accept that norms may change.

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Works Cited:

Ball, Nan. “The Reemergence of Enlightenment Ideas in the 1994 French Bioethics Debates.” Duke Law Journal, vol. 50, no. 2, Nov. 2000, pp. 545-587.

“Donum Vitae.” In Religion and Artificial Reproduction: An Inquiry into the Vatican’s “Instruction on Respect for Human Live in Its Origin and on the Dignity of Procreation,” edited by Thomas A. Shannon and Lisa Sowle Cahill, Crossroad, 1988, pp. 140-174.

In the world of medical ethics, there are several topics so controversial that they dominate the literature.  Artificial reproductive technology is one of these topics. I looked at two historical pieces, as well as one version of Genesis, to examine some of the arguments surrounding artificial reproductive technology.

The first piece, Donum Vitae, discusses the Roman Catholic Church’s position on in vitro fertilization as of 1987.  The arguments put forth in Donum Vitae were all extrapolated from a clearly defined set of moral principles.  The first principle, “The human being must be respected-as a person-from the very first instant of his existence,” argues that all embryos are human and must therefore be treated as sacred (Crossroad 1988).  This principle is interpreted to mean that no person, be that a medical professional, a parent, or another individual, may kill, harm, or endanger an embryo.  This principle comes from an interpretation of religious literature by a religious authority from which they then try to justify with a biological basis. However, this is a flawed justification.  They argue that when a single new cell with a unique genetic code is produced, a new human is born. There are several flaws in that train of thought. One example is single human cells (such as a single skin cell) may have a unique genetic code due to a mutation (such as the case with cancer) yet does not have a human identity.  Therefore, the contrapositive argument—single cells with a unique DNA identity must have a unique human identity—cannot be true.

The second principle is a functional corollary of the first principle; medical technology may only be used in a therapeutic sense.  This follows logically as this principle prohibits any sort of medicine or medical imaging that puts any person (or fetus) at risk without a sincere intention to help cure that individual.  The third principle is that every child has a right to “be conceived and to be born within marriage and from marriage” (Crossroad 1988). Marriage, according to the Roman Catholic Church, must be between a man and a women.  Overall, when looking at the Roman Catholic Church’s stance on medical issues, it is important to consider these three principles as these are fundamental beliefs derived from religion. Just as the Roman Catholic Church makes its decisions based on a set of criteria, so did the French government circa 1994.

In 1994, the French National Assembly passed laws regulating artificial reproductive technology based on recommendations from the French National Bioethics Committee.  The policies that were chosen seemed to echo enlightenment ideas. These policies were mostly based off of two principles: preservation of family and preservation of nature.  To clarify, the ideas of both family and nature differ greatly between cultures, and even within a culture, so these were the definitions held by the French National Bioethics Committee at that time.  The Bioethics Committee looked at how Rousseau drew importance to the family and decided that the “bi-parental heterosexual family unit” was the proper familial unit (Ball 2000). This principle also implies that other family styles (such as single parents and homosexual parents) were a detriment.  I attribute this blatant homophobic principle to the Committee’s (irrational) fear that these non-traditional family units will change or destroy the current French values system.

The second principle the French National Bioethics Committee used is the idea that policy should preserve nature.  This principle is based on the erroneous logic that nature is always good. The Committee seemed to arbitrarily decide what is considered natural and justified policy based on that.

When we examine policy regarding reproductive technology, it is vital to examine these policies through the viewpoint of the policy makers (the Church or the Assembly).  One must examine policy with the understanding that each groups assumes their principles are sound. Once those assumptions are made, we can somewhat account for cultural relativism.  It is logical that the Roman Catholic Church disagrees with IVF. If it is heterologous IVF, it violates the child’s right to have a mother and father. If homologous IVF for married individuals, the destruction of “spare” embryos as part of IVF violates each embryo’s right to live and thus is equivalent to murder.  The French restrict IVF to heterosexual couples who either have lived together for over two years or are married to prevent the violation of their established principles. Homosexual couples and single individuals were not permitted to use IVF as it violates their idea of a family. Postmenopausal woman were also not permitted to use IVF as it violates their idea of nature.

I also looked at the first two chapters of the Chabad version of Genesis with Rashi’s (a Jewish authority’s) commentary.  The line that discusses procreation talks about the fetus as “one flesh” which Rashi took to interpret as coming from both the father and mother (Genesis 2:24).  I see how it is possible to interpret this passage as every child must have a mother and father, but my personal interpretation is strictly biological; each child comes from a man and a woman but nothing more.  Therefore based on this passage, I personally would not believe any principles exist that would ban IVF.

Overall when looking at how different groups treat IVF, looking at the specifics of each policy will only bring you back to look at the principles, or justifications, each group gives for their actions.  Studying those assumptions allows us to be able to understand these cultures better than policy alone.

 

The readings this week took what we have learned so far and expanded upon it while also bringing in a Christian and Catholic perspective.

The first reading was on the book of Genesis, chapters one and two. This reading was much different than what we have considered before in this class. Instead of an anthropological text, the book of Genesis is a religious text which forms the basis of the Christian religion. The first chapter, also known as the creation story, focused on how God created the world as we know it, with the sky, ground and waters as well as day and night. Furthermore, God created humankind in His image to rule over all the other creatures on the Earth. What I found to be particularly interesting in relation to this class was section 1:27-1:28: “So God created humankind in his image, in the image of God he created them; male and female he created them. God blessed them, and said to them, ‘Be fruitful and multiply, and fill the earth and subdue it; and have dominion over the fish of the sea and over the birds of the air and over every living thing that moves upon this earth.’ “ I believe these lines have two distinct points. First, it gives humans the belief that they have authority over all and are created perfectly “in his image.” I’d like to emphasize that both male and female were created this way and so here there is no authority given to man over woman. Second, these lines give humans a purpose – to procreate and fill the earth.

The second chapter slightly contradicts the equality of male and female. In this chapter, the woman is created out of man to be his helper (Genesis 2:18-2:24). These lines suggest a lower status for woman to serve at man’s need. Furthermore, these lines recognize the purpose of a wife. Once a man has passed a time of needing his parents, he moves to a wife to be “one” with. Where do these roles come into play when considering reproductive technologies?

Donum Vitae is an explanation of the Catholic Church’s view on reproductive technologies. The Catholic Church’s stance is important to both Christians and non-Christians because many “recognize the church as ‘an expert in humanity’ with a mission to serve the ‘civilization of love’ and of life” (Donum Vitae 142). Thus, the impact of these teachings can be viewed as more universal.

Donum Vitae references the same lines of Genesis that I referenced above, 1:27-1:28. The purpose is different than I described previously; it is about how science and research are taking the role of human domination to a new level (Donum Vitae 143). The power to create life out of seemingly nothing can be viewed as an attempt for human’s to obtain too much power. Nonetheless, the church’s stance on these issues are not strictly against them. The church supports any medical intervention that respects the life and dignity of human life, specifically the embryo’s. It is mainly against intervention that is not explicitly therapeutic and “aimed at the improvement of the biological condition” (Donum Vitae 145). While this text addresses many different, specific reproductive technologies and their moral complications, I am going to focus on a couple that I felt summed up the church’s thought as a whole.

Abortion is a reproductive technology that questions when human existence begins. When considering abortion, the church claims, “Life once conceived, must be protected with the utmost care; abortion and infanticide are abominable crimes” (Donum Vitae 148). The church believes life to start at conception because that is when the human’s spiritual soul is created. Once this soul is created, a human being exists and the life must be protected. This same argument is the backbone for the church’s view against research on embryos that are not strictly therapeutic and working to preserve the child. Additionally, “The corpses of human embryos and fetuses, whether they have been deliberately aborted or not, must be respected just as the remains of other human beings” (Donum Vitae 152). Again, this all relates back to the belief that a human soul is created at conception and lives within the embryo. These same rights apply no matter how the embryo was created, whether through sexual intercourse or in vitro fertilization.

In regards to reproductive technologies, the church is against any technology that involves anyone outside the husband and wife. These technologies are “contrary to the unity of marriage, to the dignity of the spouses, to the vocation proper to parents, and to the child’s right to be conceived and brought into the world in marriage and from marriage” (Donum Vitae 159). The case of technologies used solely between a husband and a wife are more complicated and relies on a careful analysis of certain principles related to the marriage of the husband and wife. Overall, I believe the following quote sums up this decision making process: “Homologous artificial insemination within marriage cannot be admitted except for those cases in which the technical means is not a substitute for the conjugal act but serves to facilitate and to help so that the act attains its natural purpose” (Donum Vitae 166).

The last section of Donum Vitae addresses the role of civil authorities. The church views civil law as a way to prevent immoral behavior from being legitimized. If the law does not support a behavior, people will be less likely to practice the behavior and attempt to justify it as morally acceptable. Thus, “The task of the civil law is to ensure the common good of people through the recognition of and the defense of fundamental rights and through the promotion of peace and of public morality” (Donum Vitae 170). I find this view quite controversial because it relies on civil authorities to know what is morally correct. I would argue that leaving certain practices legal would allow each individual to decide what is morally correct and make the decision since most of these issues are not as black-and-white as the church seems to believe.

The article written by Nan T. Ball demonstrates the power that civil law has when it comes to reproductive technologies. While this is not written from the religious perspective, it integrates itself with Donum Vitae in that it emphasizes civil authority taking on the debate of ARTs to prevent its abuse. Ball describes how the French used civil law to limit ARTs to only traditional families in order to keep order in French society. He describes the history of the French, emphasizing the natural family as heterosexual parents and children. Furthermore, Ball dives into Rousseau as an explanation for the traditional French family unit serving as a sign of stability. For example, “Rousseau hoped to signal political change through familial discourse” (Ball 564). This idea stemmed from the view that each family was like a miniature society. These miniature societies together made up a larger society, the nation. Thus changing each miniature society could change the nation. Therefore, any threat to the traditional family could threaten the stability of the nation. This also answered the question of why so many people cared about ART when it only affected a small population of the nation (Ball 559).

As a result of the politician’s fear of destroying the traditional family, ART was legalized under certain strict constraints: “The man and woman forming the couple must be alive, of procreative age, married or able to prove that they have lived together for at least two years and have consented to the transfer of embryos or insemination” (Ball 571). These constraints eliminated the fear of homosexual couples and couples above procreative age having genetically-related children and hence kept the traditional family unit alive.

The last section of Ball’s article addresses the concept of nature. The French argued that ART is an unnatural form of procreation because it is a form of human manipulation (Ball 571). Therefore, they were able to restrict access to ART on a moral level. Since homosexual couples and older couples could not conceive naturally, they should not be able to use ART to conceive. This relates back to Donum Vitae in that it is keeping reproduction between a husband and a wife, within the family unit.