Swasti Bhattacharyya wrote and published Magical Progeny, Modern Technology: A Hindu Bioethics of Assisted Reproductive Technology in 2006. Dr. Bhattacharyya is a professor of philosophy and religion and has a background as a nurse. Her healthcare background provides her insight into pragmatic bioethics with consideration of Hindu and Indian ideologies.
Bhattacharyya acknowledges that Westerners have reified religion, and consequently, dominated discussions while non-Western voices have mostly been excluded from shaping American ideology, including bioethics, despite the ever-expanding pluralism and diversity brought in and cultivated by immigrants. Religion permeates through our ways of being and is inseparable from culture, philosophy, politics and the social, which is why cultural competency, or cultural humility, is necessary for medical competency. It is necessary to listen to perspectives that are different than our own in order to understand people and communicate effectively because no one knows everything, and we cannot expect to intuitively know everything. So, here we are, listening to what Dr. Bhattacharyya has to say about Hindu bioethics while keeping in mind that Hinduism has many facets and voices. If I had to choose an excerpt from the book to reflect what Bhattacharyya wants to highlight about Hindu thought, it would be this:
“Rather than focusing on prohibiting various actions, the Hindu ethic… emphasizes the presupposition that all are ultimately interconnected, that each of us has a particular dharma a commitment to ahimsa, and that karma ultimately holds each of us responsible for all of our actions” (108).
Dharma is difficult to define but essentially informs people how to behave. Individuals should live on “a path of ahisma, ‘no harm’ or nonviolence’” and act with nonmaleficence and benevolence (73) with consideration to the greater good of society because everything is interconnected and interdependent. Individuals should also live with respect to karma, which means “action,” that fundamentally “ is the cause of current situations and the determinant for the future… making humans directly responsible for both the positive and negative fruits of their actions” (73).
These elements are highlighted by the Mahabharata, a wide-read and influential text that includes narratives that inform Hindu and Indian way of life. For example, if we look at stories about Kunti, Madri, and Gandhari, we find that matriarchs participate in actions that can be related to reproductive technology. Kunti rejected niyoga, which is a “levirate marriage or traditional practice that allows a women to have sexual intercourse with a man other than her husband for this express purpose [of producing heirs]” (35) and instead, she used a mantra gifted by the God Durvasas to produce three sons engendered by the gods of her choice. This was a form of genetic selection and models modern sperm donation. Niyoga reminds me of Jewish law, which allows temporary marriage for the purposes of conceiving children. Similarly, Madri used Kunti’s mantra to produces sons engendered by the God of twins. Gandhari’s story involves an extended pregnancy that produced a ball of clotted blood. After asking a God to give her the 100 children she was promised instead of a clotted ball, Gandhari was given instructions that allowed her to create 100 embryos out of the clotted blood, and she used clay pots to incubate the embryos. A connection could be drawn from this story to “’artificial wombs’ that gestate the developing embryos until they are brought to term” (46) as well as modern day “Clomid (clomiphene citrate), IVF, GIFT, ZIFT, etc. which often result in development of multiple embryos” (47).
These narratives illustrate the importance of procreation and kinship for the purposes of continuing the family line. Bhattacharyya says that “there are few if any limitations on the utilization of creative means in one’s attempt to produce [a] son,” and the Mahabharata would condone surrogacy, sperm donation, gene selection, and embryonic manipulation based on the stories (51-52). Unlike the Catholic Church’s clear stance against conception without sexual intercourse, the Mahabharata does not consider the act of sexual intercourse necessary for procreation. Additionally, the matriarchs of the Mahabharata stories take control pretty much as equally as the Gods. This contrasts the stories in the Bible where God takes charge of procreation and humans to have little to no control. Biblical stories of Abraham and Sarah, Issac and Rebekah, Rachel and Jacob, Elizabeth and Zechariah as well as Mary illustrate God’s control over procreation. To that end, the stories of Tamar and Judah, Naomi and Ruth show us that humans can still take some control.
Bhattacharyya shifts from narrative to pragmatic bioethics and introduces us to the case of Jaycee Buzzanca. John and Luanne, a married couple, decided to use IVF to conceive Jaycee, and commissioned Ms. Snell to be the surrogate mother. After the fact, John claimed “dissolution of marriage” and did not wish to financially support Jaycee (78), but the California Court of Appeals ruled that “even in the absence of a genetic or biological relationship, parental relationships may be established when the intended parents initiate and consent to reproductive medical procedures” (79). The court considered individual rights and what would be best for individuals, which reflects American cosmology.
Hinduism, on the other hand, puts emphasis on individuals in the context of their communities and societies. Hinduism does not construct a rigid definition of family and does not require people to be blood-related in order to be considered family. “Family” could include immediate family members, extended family members, neighbors, or community members. A father would not necessarily need to be biologically related because Hinduism is more concerns with the father that “invests time and energy in the process of raising the child” (92). To that end, since John intended on creating Jaycee and was circumstantially able to provide a means of support for Jaycee, then John was obligated to do so according to the dharma of parenthood. Hinduism emphasizes that for the good of society, parents like John need to see their commitments through and take responsibility for their children. It is important to point out that, unlike the Catholic Church whose opinion on conception and responsibility to children is black and white, Hinduism dabbles in liminal space and considers circumstance, intent, dharma, karma, and ahimsa, which can modify the results and ethical implications of cases. All in all, if we take lessons and make bioethical interpretations and applications based on the Mahabharata, we should make decisions and carry out actions that maximize elements of dharma, karma, and ahimsa.
Reading Magical Progeny, Modern Technology, I wonder how the American healthcare system can include voices that have historically been left out and integrate these voices into its systems. Do medical schools have education on medical ethics involving culture and religion? Should healthcare workers be held responsible for understanding different cosmologies or should religious consideration and consult be left to pastors, rabbis, and chaplains?
Hi Pamela,
Thank you so much for such a great response. You did an excellent job of not only summarizing the main points of the text but also of analyzing and comparing them to the other topics we have covered so far this semester.
I would like to focus on your last question: “Should healthcare workers be held responsible for understanding different cosmologies or should religious consideration and consult be left to pastors, rabbis, and chaplains?” I believe that it is extremely important for healthcare workers to take religion into understanding when they consult their patients. While they do not need to fully understand every religion, I think medical practitioners need to be prepared to deal with beliefs different from their own that stem from a different religious background. We have discussed fatalism in this class already and I think that this question loops back to that. Medical practitioners might misinterpret a patient’s concerns and choice to opt out of certain treatments as fatalism because they do not understand the patient’s perspective. I think that if medical practitioners had a stronger background in understanding different cosmologies and religions, they would be better equipped to find the right treatment for their patient.
Hi Pamela,
Your blog post is comprehensive and relates key elements of the reading back to larger society – thanks! I especially appreciate your questions at the end of your post, which I will not address at length in this response, but I will note that I support efforts of healthcare workers, pastors, and religious figures from all aspects of society working together to best include voices in the American healthcare system, though I do not know where to begin in making that a reality. I’d first like to respond to your quote that “The court considered individual rights and what would be best for individuals, which reflects American cosmology” with respect to the Buzzanca case. While I do agree with your comment, I wonder also if there is more value placed in a traditional American, patriarchal family structure than that which we give credit – a duty more focused on cultural norms and less on individual desires. Despite the technical contractual aspects of the Buzzanca case, I am wary that ruling an obligation to have and support a child based on “intention,” as Bhattacharyya describes, might create a slippery slope for future cases of the like that might come at true detriment to an individual’s wishes (Bhattacharyya 79). A greater motivation for such a court decision might be underlying notions of kinship and patriarchy that is so reflected in the United States’ society today, though this creates a dichotomy with the actual outcome of the case.
Assumptions in intent later provide dilemma in other instances of bodily duty other than reproduction, for example in questions of organ donation that may not be easily assumed in different cultures. In “Impossible Gifts,” Bob Simpson references intent in the context of donating eyes in Buddhism. He states, “Intention to donate is expressed in life but mercifully the extraction takes place after death, when, according to Buddhism, the body is an empty shell from which all trace of consciousness has long since been distinguished” (Simpson 847). In other words, there is no opportunity for question of intent after death, having the potential to create a more definite decision in cases of organ donation. This view is somewhat certain and established by religious precedence. In the case of Jaycee Buzzanca, however, a her father expressed disapproval of having a child after exiting a traditional family structure. Why does his original intent still hold in court despite the fact that the child would not be raised in a traditional, married family and the father changed his mind about wanting children (albeit the fact that Jaycee was already conceived and on the way)? Does this case indicate that the United States is becoming more progressive in its views of family or that having a supportive father present is important in any instance? The dichotomy in American family structure with this ruling fascinates me and makes me curious to hear your thoughts. Thanks!
Pamela,
Thanks for the post! I really appreciate how you not only summarized the material, but you also engaged with it by offering your personal opinion and questions for the reader to consider. I really enjoyed how this reading portrayed a definition of kinship that we have not discussed much in this course so far. As we have learned, different cultures value different lines of kinship, as the biological and social contributors of kinship are weighted differently in different societies. Bhattacharyya highlights the value of affinal kinship in the application of hindu values, and how this creates a society that looks different from a Catholic, Jewish, or even French group of people which we have previously discussed in this class.
This equally valid, but different perspective of kinship offers meaningful contribution to the consideration of medical ethics. Your questions provoked thoughts about educating medical students and the importance of conveying how to understand others’ opinions to future doctors. I do not think it’s necessary that healthcare professionals should be responsible for a deep understanding of various cosmologies; however, they should be equipped to handle disagreement in an exam room or hospital bed, how to convey their thoughts respectively, and understand the cultural bias that they, themselves may have. The combinations of beliefs that a patient can hold are endless, however, if a doctor is equipped to handle conflict respectively, they will be better suited for encountering cultural differences in medical care.
Hey Pamela!
I thoroughly enjoyed reading your blog post. It had great flow, was structured nicely, and presented very important information with direct quotes. I was, however, confused by your comment about Nigoya reminding you of temporary marriage in Jewish law, as I remember temporary marriage being an Islamic thing. I could be mistaken.
As a student who is aiming to become a physician-scientist, religion is something that comes up a lot when I think about how I might treat a future patient or even any person I strike up a conversation with. I want to respect their religion and see where they’re coming from, so to answer your second question, yes, I think healthcare professionals should have some semblance of understanding different cosmologies and a sense of responsibility to treat their patient with their dignity intact. Meaning, respecting a patient’s wishes, not forcing a treatment option upon them, and obviously not treating the patient without their consent. I do not, however, think that healthcare workers should be held responsible for knowing religious cosmologies from the back of their hand. If that were so, there would be no need for religious authorities such as pastors, rabbis, and chaplains. I think that understanding a person and their religious background can provide valuable insight to how they might come about decisions and in some cases allow for a healthcare professional to influence how that patient will respond to a treatment proposal or results of a test.
A benefit of having religious consideration for healthcare providers is that there are teachings from religious texts that are applicable to people not practicing that religion. An example would be the practice of karma or ahimsa of a healthcare provider to a Catholic. If a Catholic believes in karma, they would probably not condemn or refuse to treat a Muslim who had a complication with delivering their child from a temporary marriage as they know that “all action, [and] all karma, is followed by results (Bhattacharyya, 72). While that could be a rather rash comparison, I think it paints a rough picture of the benefit of having religious consideration/tolerance for a healthcare provider.
Hi Pamela! Thank you for the summary and commentary on the readings. I liked how your explanation went more in depth on the narratives provided by the Mahabharata, because I think that as an influential text with interpretations relating to reproductive technologies, it parallels influential texts in other religions we have discussed such as the book of Genesis in Judaism and Christianity. I also saw a similarity between Hindu ethics and Jewish law in terms of their flexibility towards reproductive techniques for the sake of allowing mothers to have progeny.
I like a point you brought up from the reading about the emphasis Hinduism places on social parenthood rather than genetic parenthood. I think that this viewpoint allows for a lot more flexibility concerning reproductive techniques, especially in comparison with other major religions we have looked at such as Islam, Judaism, and Christianity. This might be due to the fact that Hinduism is not monotheistic and doesn’t rely on set rules or commandments but rather concepts such as dharma, karma, and ahimsa to guide morality and ethical debates.
Hey Pamela, thank you for great blog post! I enjoyed reading your summary and analysis of Bhattacharyya’s work. I found it much easier to understand apply to reproductive technology when you related it to dharma, karma and ahimsa. We have examined a number of religions in this class in regards to their view about ART. Hinduism is special because it seems to be less strict about what would be considered right or wrong in medical procedures. I think this reflects their values of acceptance, non-violence, and individual responsibility. Every person can create his/her own destinies and they do not merely seek a single “God” to guide them through life. As you mentioned, Hinduism does not have a strict definition of the perfect family and thus followers are able to engage in certain reproductive technologies that those in other religions cannot. Those practicing the Hindu religion ultimately make decisions based on if it will contribute to the greater good of society now and even after death. While some might oppose these beliefs, I do believe that all medical professionals should be exposed to all religious views in order to fully understand a patient and to form a cultural competency toward them. I do not believe that religious consideration should be left out of medical culture because most patients will seek guidance from a religious leader in order to make decisions about certain medical procedures. A doctor can merely tell a patient what they believe to be the best course of action, but if it goes against a patient’s’ religious values then they must understand and respect their decisions.
Hi Pamela,
Thank you for a very well written and comprehensive post! I really enjoyed how you not only summarized the readings but also included personal input. Something that I found interesting were the threads of similarity on moral thought between Hindu, Jewish and Christian religions. Similar to how the Bible is a moral guide, the Mahabharata is an influential text that guides individuals on dharma, which informs peoples behaviors, ahimsa, and karma. But as you point out, the moral guidelines explained in the Mahabharata are not constraints or rigid, rather places agency in the hands of the individuals rather than have strict definitions placed by God. This can be seen in the way that the Hindu stories place the power in the hands of the Matriarch almost as equally as the Gods or that there are no rigid rules defining kinship.
I also wanted to point out that I think you may have been mistaken when you state that “Niyoga reminds me of Jewish law, which allows temporary marriage for the purposes of conceiving children”. The practice of Niyoga can be seen as similar to the Shi’a Islamic practice of Mut’ah that allows for legal gamete donation.
I think you provide a very thought provoking question of “Should healthcare workers be held responsible for understanding different cosmologies or should religious consideration and consult be left to pastors, rabbis, and chaplains?”. When taking a class in Medical Anthropology, my first thought was that anyone going into the medical field should have a background in this. I believe that while in-depth knowledge of all religions and cultures is necessary for medical practitioners, I believed having some type of understanding is needed in order to understand the way that people perceive these reproductive technologies. With growing technology and differing views, by understanding the cultural context in which patients recognize these technologies is important in order to provide effective and efficient care.
Hi Pamela,
Thanks for the excellent read. You did a great job discussing the key arguments by Bhattacharyya in her book. I really liked how you introduced the book as well as how you explained the key points. I found it interesting that western beliefs such as Christianity and Judaism focused on living within the confines of rules while the eastern beliefs such as Buddhism and Hinduism focused more on living according to certain concepts like dharma, dana, and karma.
In response to your question, I believe that healthcare workers should be concerned primarily about the health aspect of the issue. Moral and religious considerations should be handled by the patient or a party such as a rabbi or pastor. However, I do believe that having a basic understanding of there different perspectives would greatly improve how workers inform their patients on the best treatment. Issues with communication are a major obstacle in the field of health as American patients come from such a wide variety of backgrounds and education levels. Having a general understanding of the different perspectives would definitely help towards this problem since the healthcare worker could better understand what choices the patient is more likely to make.
Thanks for your post. I agree that Hinduism’s position on ART isn’t as easily explained as some of the other cultures we have studied. I think Pamela did a great job explaining what Bhattacharyya was trying to emphasize. Instead of trying to lay out explicit mandates as to what is allowed and what isn’t when it comes to ART, Hindu values, particularly a woman’s dharma, or social duty to have a child, a commitment to do no harm to any living creature (ahimsa), and karmic consequences drive what Hindu’s do. As such, Hindus are free to use most ARTs (Bhattacharyya, 52). While it isn’t directly stated to be allowed in the Mahabharata or other texts, Kunti and Gandhari are important examples that serve to demonstrate that procreation is possible outside the typical husband-wife scenario.
I also wanted to address the common question of whether Buddhist and Hindu stances on bioethics will ever be taken into consideration. Personally, I doubt that they will ever be given as much consideration and importance in American bioethical debates as religions we have studied since they are a very small minority in America. Also, they are not a vocal minority; they tend to be more flexible in their beliefs than other cultures so perhaps they try less to make their position be known. However, I do value the importance of having clinicians understand religious and cultural contexts a little bit better. As Pamela mentioned, I think courses in medical school that teach students about facilitating patient communication with patients of different backgrounds would be greatly beneficial: it would improve a patient’s satisfaction and help give another dimension to medical treatment.
Thanks Pamala! I loved your discussion of Dharma and how this is essentially the central principle of morality in Hinduism. Truthfully, my past knowledge of Hinduism is limited and only really extends as far as Bhattacharya describes it in this book. It seems to me that Dharma acts much in the same way G-d’s judgement acts in other religions. In Christianity for example, you are judged at the end of your life by a divine power to determine if you deserve Heaven or Hell (this is obviously an overgeneralization for the purpose of making an argument) while I interpret dharma as more of a position on a spectrum between moral and immoral where your position moves based on your actions. Your final position, or Karma, determines your state of reincarnation. Additionally, while the Catholic Church has a set of rigid rules that make morality black and white, Hinduism relies on individual subjective decisions based on the stories of the Mahabharata. On the first hand, I feel as this could generate anxiety in making individual moral decisions. Without clear guides, I would imagine that individuals would worry about reproductive technologies such as abortions where the ethics are morally ambiguous. On the other hand, Hinduism allows for greater flexibility in making these decisions relative to organization with an authority such as the Catholic Church. As the American medical community is generally secular in patient care, I would imagine many doctors do not understand how Hinduism and thus have difficulty helping American Hindus make ethical decisions with respect to their culture.
Hi Pamela,
I hope your night is going well. I am impressed by how well you captured the main themes of the book. All in all, I thought Bhattacharya was extremely clear with her organization and structure of argument, and you followed suit with your blog post. I thought your discussion of perspective at the beginning, reflecting perhaps on Bhattacharya’s introduction, was an extremely relevant piece of writing for this class. Especially given that this text deals with material we’ve covered previously, namely the Jewish and Catholic views on assisted reproductive technologies, it is crucial to see beyond our own frames of reference and adopt a methodology of hermeneutic generosity, if you will. I find it interesting that while we are certainly reading Hindu narratives, we are reading them as presented by Bhattacharya, who takes from them excerpts to make them palatable to the Western mind. I suppose that this reading is the closest I will get to fully understanding Hindu scripture, but it is noteworthy to recognize that even this reading offers me only a partial insight into a true Hindu understanding. While this comment is somewhat meta, I do appreciate your thought provoking reiteration of Bhattacharya’s emphasis on perspective taking from the beginning of her book.
Thank you for your response. I thought it was very comprehensive and really summed up the reading well. I wanted to focus on the last paragraph. I think it is interesting to consider healthcare different from other aspects of American society When it comes down to it, the healthcare system is just another business. The business is to cater to people who have money, as well as to cater to the majority to be the most profitable. While I obviously do not agree with this, it is unfortunately how I view it. In terms of your first question, I am not sure, but definitely believe that medical ethics should be included to give doctors the most comprehensive outlook. However, I think the Doctor should act like a consultant in the capacity that he/she offers the best medical option in his/her opinion. Which brings me to the second question. I don’t think it is the duty of the healthcare system to cater to a whole host of different beliefs, but provide a range of solutions and leave it up to the patient. Whether the patient wants to pursue pastors, rabbis, and chaplains should be ultimately up to the patient.
Excellent post, Pamela! I think your questions at the end of your post really got to the heart of the matter when considering who should be responsible for accounting for the religious beliefs that inform many people’s decisions when it comes to bioethical debates, specifically in regards to reproductive technology. Religious beliefs are undeniably one of the major factors that lead people to decide on certain actions and cause them to have particular opinions about reproductive technology. We must account for these beliefs in one way or another in order to understand the whole story. Even when religious beliefs are accounted for, discussion mostly revolves around Christian and Jewish opinions and beliefs. Bhattacharyya’s argument that integration of non-Western voices, specifically with regards to traditionally non-Western religious practices, is a necessary component of the conversation around reproductive technology is a valid one. In order to understand how people make decisions regarding reproductive technology, we must understand the beliefs that inform their decisions. Because of this, we should be working to integrate a deeper understanding of different religious and cultural beliefs into the current ethical debate surrounding reproductive technology.