Inventing Bioethics

In Swasti Bhattacharyya’s book Magical Progeny, Modern Technology, she discusses the Hindu perspectives on reproductive technologies, including IVF, adoption, and surrogacy. To do so, she cites many traditional Hindu stories, relying primarily on the Mahabharata and the messages it carries. In addition to this primary goal, Bhattacharyya also speaks extensively about the importance of cultural competency in a clinical setting, as well as the presence (or lack thereof) of religion in both academia and clinical environments. Bhattacharyya sets the scene by stressing the relevance of incorporating Hindu perspectives into bioethics debates. In the United States and globally, those ascribing to a Hindu tradition are numerous and growing, yet bioethics tend to be centered around Christian and Judaic perspectives. The importance of learning from and about different perspectives is increasingly important as America continues to become more diverse, and second/third/fourth generations immigrants formulate their own unique worldview that incorporates a great many set of identities. These religious beliefs underscore the perceptions and actions of many people, but religion tends to be marginalized in academic settings and poorly understood in clinical settings. This problem has seeped into bioethics discussions as well. But to cast aside religious perspectives is to leave out the most important factor for individuals when dealing with dilemmas involving life, birth, and death. It is therefore important and relevant to expand current religious influences on bioethics to include perspectives that accurately represent what individuals deal with when considering procedures such as IVF or abortion.

Hindu perspectives on reproductive technologies present themselves quite differently from other religious traditions. Whereas it was simple for us to read Donnum Vitae and understand wholly the position of Catholicism on reproductive technologies, there is no one central Hindu authority, or even a clear consensus about what a “Hindu perspective” would entail. It is multivalent, subjective, and malleable, and focuses more on acting ethically in a given situation rather than establishing absolutes. Bhattacharyya reconciles this by presenting a foundation of Hindu values and stories from which they’re drawn, and then discusses the perspectives that could be formulated from them. The mythologies presented in the Mahabharata serve as Bharracharyya’s key evidence for how Hindu perspectives about ART are structured. These stories discuss extensively the ideas of childbirth, procreation, kinship, and lineage, and include many fictive parallels to modern day reproductive technologies. Mythical stories about gods as sperm donors, surrogacy, adoption, exogenous birth, and more, establish an already fairly liberal precedent for the modern day equivalents of these stories. The characters in the Mahabharata “reflect a creativity and moral openness” (99) in finding ways to circumvent “normal” procreative processes. The author then identified six Hindu characteristics that embrace “a diversity of thought and experience”: emphasis on societal good, unity of life, dharma, the multivalent nature of Hindu thought, karma, and commitment to ahimsa. Each of these parts can be easily applied to bioethical debates about ART—for example, the idea of dharma and a woman’s responsibility to fulfill her childbearing responsibilities. All of these six characteristics intersect to provide a diverse, complementary worldview where alternate views are not only tolerated but are welcomed and internalized. The case study of Jacyee Buzzanca exemplifies this commitment to “viewing and honoring the views of life from many perspectives” (97) and is compared/contrasted to a Roman Catholic perspective, a tradition much more concerned with establishing absolutes and universal rules.

A Hindu perspective on bioethics and ART is one that contains ideals commonly represented in religious traditions—ideas of doing no harm, responsibility for actions, and one’s prescribed role in this world. However, the way that these concepts come together is quite unique, and is a perspective that is important to incorporate into bioethical debates. In many cases, involving religion tends to place limits on what one can and cannot do. Hinduism opens it back up and provides grounds upon which case-by-case moral dilemmas can be creatively managed.

The article by Bob Simpson, Impossible Gifts, takes yet another approach to viewing reproductive technologies, as well as organ and tissue donation. Interestingly, he talks about Ayurvedic medicine and how sperm donation is not a well-received practice due to issues of paternity. This contrasts quite heavily with the previous reading about Hindu bioethics, which also have links to Ayurvedic medicine. Beyond this, the article gives another very distinct view of tissue donation as “gift giving,” a practice deeply rooted in Buddhism that carries a lot of weight. Both of these readings truly show the process of “inventing bioethics” and how groups come to form their own ideas of what is moral and right.

After reading and reflecting on both of these very nuanced schools of thought, I wonder if we will ever reach a point in America where all of these diverse opinions will be incorporated in bioethics conversations? America, although nominally secular, definitely takes Christian viewpoints more seriously than others. Will Hindu or Buddhist perspectives ever carry much weight when it comes down to making legislative decisions about what is right or wrong?

16 Replies to “Inventing Bioethics”

  1. Thanks for your extensive post Emma. Your post as well as the others from this week were very informative and created a good overview of our readings.

    One thing I found particularly important from Swasti Bhattacharyya’s book is the point you mentioned about cultural competency. Bhattacharyya mentions an example in which a Hmong family has a child with epilepsy, yet cannot convey the nature of the ailment to medical professionals, leading to subsequent misdiagnoses and incorrect treatment. In a more severe case, this would lead to death and possibly more harm. The fact that some institutions did not see cultural competency as a salient factor in treatment was mildly concerning: are immigrants or people unable to communicate in the native languages doomed to receive improper care as a result?

    The parallels that Bhattacharyya drew between the stories told in the Mahabharata and contemporary reproductive technology was also very interesting to me. Specifically, in the case where the husband died during sexual intercourse and the woman was told in a dream to produce an heir using his body despite that fact, Bhattacharyya easily compared it to the utilization of postpartum sperm. Other parallels such as the embryos in the gees did not have a contemporary technological mirror, but the story recognizes and condones the possibility. With these comparisons so easily drawn compared to Christian views on reproductive technology, the Hindu view is quite unique.

    Bob Simpson, in his essay on organ donation, reflects an eastern point of view as well – Ayurvedic medicine. He reflects on the influence of religion on how people view the giving up of their bodily parts as charity (or, dana). Compared to the Hindu view that Bhattacharyya drafts, there is a significant value attached to sperm. Family replacement was introduced as a referral concept to constantly replenish the supply of donated blood or sperm, though it saw lackluster success due to how the Ayurvedic view values bodily fluids.

    These two views, though both entrenched in Eastern religion and beliefs, have their own characteristics that reflect the culture, and draws fascinating contrasts to Christian views that Western culture is familiar with.

  2. Hi Emma,

    Thanks for your post. I really enjoyed all of the questions and different opinions that you brought up throughout the post. In particular, I found it really interesting when you said, “In many cases, involving religion tends to place limits on what one can and cannot do. Hinduism opens it back up and provides grounds upon which case-by-case moral dilemmas can be creatively managed.” I think it’s interesting that you view religion to be more likely to place limits. In Christianity, that definitely seems to be the case with ARTs but this is not the case with Judaism or as you pointed out Hinduism. I think this reflects your idea of how in America we focus the most on Christianity and have set that as the norm for religious views. I also think another way to look at it is that Christianity attempts to provide more specific guidance so people do not have to make the tough moral decision while Hinduism provides a way for one to evaluate their decision using the six characteristics you mentioned.

  3. Hi Emma,

    Thanks for your summary and notes! I enjoyed your observations on the importance of learning from different cultures as societies take shape, as I agree that it is important to be fluid in beliefs and practices as one’s environment and relationships change. Your contrast between the ease of understanding “Donum Vitae” and Catholic teachings with the seemingly muddled views of Hindu authority make me wonder about the true root or intention of Hindu values. I am by no means a scholar in Hinduism, and this is really my first exposure to Hindu teachings in an academic setting, but I wonder if the consensus of a Hindu perspective is that there is no definitive consensus. Instead, commitment to ideals both you and Bhattacharyya mention such as dharma, karma, and ahimsa govern actions and behavior. It is also precisely because of this that I am hesitant to think that Hindu or Buddhist perspectives will ever be able to carry as much weight as more rigid, Christian ones in American legislative decisions.

    For example, the concept of purely altruistic gift giving with regard to organ donations in Buddhist beliefs, as discussed by Simpson, contains consequences that American legislation might not be equipped to handle. The purely altruistic concept of giving organs as gifts functions without physical evidence and may not be possible to conceptualize in an American courtroom. Lack of definitive structure and rigid regulations would result in an inability to create precedence and regulations – both critical to the modern American legal system – surrounding this practice of gift giving. Although Sri Lanka has not encountered as extensive organ trafficking problems as other countries where altruistic organ giving is not the norm, I would caution the placement of such an altruistic and conceptual practice in modern-day America (Simpson 851). Even though Hindu and Buddhist religions contain less rigid and more conceptual guidelines of action than Christian ones, their incorporation into mainstream America might prove problematic in lack of understanding and lack of the legislative system’s preparation to approach such broad and inclusive perspectives today. What are everyone’s thoughts on this?

  4. Hi Emma! Thanks for the summary and commentary on the readings for this week. A point you touched on from the readings I found interesting was about the role religion and culture have in a clinical setting and in academia. I thought this was interesting because it provides a stark contrast to that of the United States and other diverse countries. If religion and specific culture in clinical/academic settings had a big role places with a very diverse culture, it might seem rather insensitive or just useless to make it a big consideration. That being said, culture and religion still play a role in the policy of institutions, and I agree that the opinions of bioethical debates need to be more diverse and not just limited to the monotheistic religions.
    I thought the comparison of christianity and hinduism was an interesting one to bring up, because we have spent a lot of time how many monotheistic religions rely on the word of a central authority to navigate ethical dilemmas. Furthermore, I thought there was a similarity in the reading by Ivry, because similar to how the rabbis evaluate pregnancy abnormalities on a case by case basis, the “hindu perspective” is also guided in a more fluid and personalized manner. It allows for a more subjective discourse of controversial topics such as IVF, surrogacy, and adoption. This causes me to believe that if Hindu perspective on bioethics is incorporated more in modern bioethical debates, it could result in a more liberal attitudes towards reproductive technologies.

  5. Emma,

    Thanks for the great discussion of ideas in Bhattacharyya’s novel and Simpson’s paper as well as your own opinions and interpretations of the readings. I agree with both you and Elizabeth in the sense that the ability to listen to and understand others as personal contexts may change is becoming increasingly important in American society, which is diversifying with each new generation. However, to counter Elizabeth’s comment that the lack of a Hindu consensus and instead the reliance on dharma, karma, and ahimsa in governing one’s life is the weakness of the religion and its ability to be incorporated into American bioethics. I believe it could be argued that a Hindu perspective is the only way that one could imagine the coexistence and incorporation of more than just Christian and Jewish input. The openness to other perspectives while maintaining adherence to core values that Hinduism is founded upon is a practice that I think American bioethics can learn much from.

    I agree with your point, Elizabeth, that overarching Buddhist rule might be problematic in an American courtroom, but I think this perspective I’m speaking to is less intended to suggest Hindu or Buddhist ultimate rule in American bioethics, but instead to take their advice to accept and incorporate others opinions into bioethical conversations. I am not sure that one who believes in Hinduism would even advocate for an entirely Hindu interpretation of American bioethics, as I would think that they would favor inclusion of several highly valued religious opinions in American society. While structure and regulations are necessary in a functional society, there is much to take away from Hindu perspectives as American bioethics reshape and reform over time. I don’t think I can see something like incorporation of Hindu beliefs in the near future, but maybe as Christianity and Judaism become more diluted through new kinship ties, the following generations of scholars will hypothesize differently.

  6. Hey Emma,

    Thanks for your blog post. It was very informative and touched on important parts of the readings. I like how you elaborated on the six Hindu characteristics.

    The two readings we had this week drew stark contrasts to traditional Western culture and religious views. I would venture to agree with you that Christian viewpoints are taken more seriously than others in American society. Just take the recent example of people claiming President Obama was a Muslim and how he shouldn’t be in office due to his religious viewpoints (which, firstly, he is a Christian). For a country that was founded on religious freedom and a separation of Church and State, it’s hard not to see the hypocrisy. To answer your question, I think there needs to be a focus on education of people (and not just religion majors) on these different viewpoints and at least a basis on different religions’ core values. As people can understand and accept different religions as valid and not malicious, bioethics debates will likely shift and incorporate those opinions.

    In regards to the feasibility of the incorporations of these practices into an American setting, such as the issue of organ “gifting”, I’m not sure how it will work out. Personally, I would like some sort of receipt or record of the organ that I’m getting from someone else because if my body rejects an organ due to me being O-type and the donor being AB-type, at least I’ll know a reason. But that’s just me. Like I proposed before, I think that with the incorporation of different voices in bioethical discussions, there will probably be a general consensus on how to treat the problem of something like altruistic organ donation in Buddhist cultures.

  7. Hey, Emma thanks for a great blog post! I appreciated how you opened up your discussion on Bhattacharyya’s points about cultural competency. As some people have already mentioned, having cultural competency is crucial for medical professionals because it allows for a full understanding to why patients make certain decisions in regards to their health. I agree with you that bioethics in the United States is mostly centered around the Christian and Jewish religion. This may be due to the increasing numbers of those practicing the religion, but it is important to understand that there are many other religions that patients follow. Hinduism is a religion that has very differing views from Christianity and Judaism. While Christianity and Judaism sets strict rules about different forms of assisted reproductive technologies, Hinduism has many relaxed and open views. They emphasize the importance of identity and contributing to society. Assisted reproductive technologies are more accepted in Hinduism only if they follow dharma, karma, and ahimsa. As long as the procedures bring goodness to the community it is allowed and encouraged.
    Additionally, involving religion in medicine does place limits on what one can and cannot do, which is why it is important for medical professionals to practice cultural competency. I think that most people would hope that religions such as Hinduism and Buddhism will carry more weight when it comes to making legislative decisions, but I think that since Christianity and Judaism have historically been involved in bioethical topics, it would be difficult to incorporate more religions.

  8. Hi Emma,

    Thanks for the great read. You did an good job explaining the key ideas of this week’s readings. One point that you focused on from Bhattacharya’s book was the argument that there should not be one universal set of laws governing Hindu decision on reproductive technologies. I agree with this statement because having so many different Hindu perspectives could be a bad thing. Simpson’s article gives an extreme example of how a universal set of rules led to conflict and problems. When Simpson was discussing blood donations, he discussed how only the Buddhists were much more likely to donate blood than non-Buddhists due to the stigmas behind blood donations. Thus, this lead to problems in obtaining enough donations as well as conflict from the Tamil militant groups.

    In regards to your question about whether Hindu or Buddhist perspectives could be incorporated into American law, I personally believe that this will be highly unlikely within the next half century. For such perspective to gain weight in this country, there would need to be a strong voice for it both within the masses and the politicians. While I do not think that their perspective are unagreeable with American perspectives, I feel that until there is a big enough push for either perspective, no ground will be made in order to incorporate them.

  9. Thank you Emma for your wonderful blog post! I think your first paragraph really emphasized an important point that Bhattacharya made. When first reading the book I initially drew less importance from the first chapter that discusses why understanding Hindu tradition is important relative to the later chapter that discuss the Hindu bioethics. Currently, Americans base large amounts of bioethical law on Christianity. Even topics such as abortion, where the secular point of view is adopted as law, we define secularism as opposition to the Catholic Church. Much like Bhattacharya, I also feel as if this neglects many people and their cultures. In the US where cultural diversity is increasing, this is a significant and increasing issue. Bhattacharya describes how the until very recently, bioethical shift is not moving to include more cultures but actually away from religion all together. Religion has been historically marginalized in the academic community.

    Bhattacharya in the remainder of the book discusses Hinduist thought and often contrasts it with Catholic thought. Both religions look at texts and stories to learn ethical behavior and moral law however unlike Catholicism, Hinduism is subjective. While hinduist scholors exist, there are no central authorities in Hinduism so one unified interpretation of the text with its implications is non existent. While many traditions and common interpretations exists, there is no president for studying new reproductive technologies. This allows for individual subjective decisions.

  10. 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.

  11. Hi Emma!

    Thank you for a wonderfully written summary of this weeks readings! I especially like how you input your personal views with the summaries as well. Specifically, I wanted to address an important point you emphasize from Bhattacharyya’s book, specifically the idea that “religious beliefs underscore the perceptions and actions of many people, but religion tends to be marginalized in academic settings and poorly understood in clinical settings”. You explain that as America becomes more diverse and more people follow Hindu tradition, as a society, American bioethics center around Christian and Judaic perspectives.

    It is interesting to observe that while the Hindu perspective is much more subjective than Christian or Judaic perspectives, there is less to interpret about reproductive technologies since there are mythologies that discuss in detail procreation and kinship. One would assume since Christianity is much more rigid in its beliefs, that there would be less interpretation. However the Donum Vitae had to be written in order to portray the Catholic Church’s views on reproductive technologies. In Hindu practice, however, there are specific stories about sperm donors and adoption. This leads me to question that if bioethical technologies were based in Hindu beliefs, would they be more open to interpretation or would they follow the mythical stories?

  12. Hey, great post…I would definitely have to agree with your point that the Hindu Perspective “is multivalent, subjective, and malleable, and focuses more on acting ethically in a given situation rather than establishing absolutes.” I think that because there is no commonly accepted view, that people tend to go with a case-by-case basis. Which honestly, I think is probably better than having concrete absolutes. In regards to your question, even though I think that all perspectives should be encompassed in healthcare, I think that there are so many different schools of thought that it’s idealistic to think that almost every single one can be incorporated. I do think however, that as the conversation about bioethics continues to grow, more light will be shed on ideologies which were previously unrepresented.

  13. Emma,

    Thank you for this incredibly thoughtful, articulate post. I was happy to see you mention so early in your post the issue of religious illiteracy in medical practice. Religions so expansive and non-conforming as Hinduism combined with reproductive health care and medical authority creates a dense conversation over the ethics of ART. Furthermore, for the debate of ethics and reproductive technology to be one that includes the voices of all peoples seeking to use ART, it is increasingly paramount for the continued education of all religions to be emphasized. Furthermore, I agree with many other posts that the American Hindu and Buddhist populations deserve to be heard during the deciding process of various policies and regulations revolving around reproductive rights and technologies.

  14. Emma,
    Thanks so much for your reflections. Your understanding and summary of Bhattacharyya’s book were excellent, and I believe you covered her main arguments very well. I will begin by responding to the question you posed at the end of your blog by admitting that I do not believe that a Hindu perspective could ever gain as central a role in the American cosmology as the Christian doctrine that America was founded on. The abortion debate in America today, of course, is certainly a question of politics and rights but also a question fundamentally rooted in religious ideals. I believe it is safe to say that the “pro choice” camp will not be citing the Mahabharata to support their beliefs. Yet, your question does lead to wonder about the Indian conversation about reproductive technology, a society purportedly “less distorted by an egocentric worldview,” contra-America (Bhattacharyya 89). We already looked at a case study of the relationship between Jewish cosmology and the availability of ART in Israel, yet Bhattacharyya does not discuss in detail the policies surrounding ART in India. Sorry for the tangent… I appreciate your summary and closing questions. All the best

  15. Thank you for your response, I thought it was very well written and thought out. Much like the previous post, I wanted to focus my attention on your thoughts at the bottom, and offer a very similar response. I think we are far from a time where diverse opinions will be incorporated in a bioethics conversation. I believe that it is very difficult to do this in the first place, as well as the fact that we have trouble applying diverse opinions to things that are much easier in society. Like I answered in my last blog, the healthcare system is a business, so if there is a way to create a market for these diverse opinions it is definitely plausible. Essentially then, if there is enough people to create a market, then it should be included. I obviously have this view as I am an economics major, where everything is based on markets.

  16. Great post, Emma! You pointed out in your post that “bioethics tend to be centered around Christian and Judaic perspectives” from a more global viewpoint, and I think that and your discussion about how our views of bioethical debates need to be broadened to accept more diverse opinions is really important. As cultural and religious diversity is celebrated more and more, we must also allow the inevitable difference of opinion that will be and has been arising to be heard, especially with regards to morally weighted ethical debates. You pointed out that religious beliefs are rarely acknowledged in clinical and academic settings, and even when they are they are handled and understood poorly. Even though religious beliefs create the foundation for many people’s actions and choices, those same religious beliefs are swept under the rug in many cases when trying to account for the choices people make and the opinions they have. Therefore, like you said, we must make an effort to account for religious beliefs when surveying public opinion surrounding bioethical debates on reproductive technology, especially religious beliefs that are not specifically Christian or Jewish.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.