Surrogacy, Ethnography, and Bioethics

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

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

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

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

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

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

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

References

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

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

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

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

 

18 Replies to “Surrogacy, Ethnography, and Bioethics”

  1. Hi Elizabeth, excellent and detailed response,

    One of the most intense and long-running conflicts is the disagreement between Sunni and Shiite Muslims over the true successor to the Prophet Muhammad. While this debate has spilled over into tribal violence, and remains an undertone to violent conflicts even today, it is refreshing to read an account of nuanced differences in opinion between the groups. In that way, Shirin Naef’s “Gestational Surrogacy in Iran” was the most interesting to me out of all the readings for this week.

    By itself, the justification of gestational surrogacy is a particularly fascinating topic. Defined as surrogacy in which the surrogate “only gestates another couple’s embryo” (Naef, 157), the non-involvement of the surrogate in the formation of the embryo allows for an open interpretation of ownership and involvement with the fetus. Iran, a country that many Westerners view as a ‘backwards’, conservative nation, is majority Shiite. This is of great relevance, as Shia rulings on reproductive technology “recognize a bilateral filiation” (158), which provides a background for the legality of gestational surrogacy in Iran.

    The true value of this reading comes from Naef’s methodology, in which she conducted interviews with medical professionals in an IVF clinic in Tehran, the capitol of Iran. By comparing these interviews with religious texts, such as the Sunni view that surrogacy is “analogous to zina” (Naef, 164), Naef presents a view of what is written, and what is in terms of Iran’s reproductive policy. Through this method, Naef’s Anthropological study displays the distinction between clashing religious interpretations and medical reality in Iran.

  2. Thank you Elisabeth and Daniel for the very thorough discussions on our readings about surrogacy for the week!

    The main concept that I took away from Naef’s chapter on surrogacy in Iran comes down to one sentence: the idea that Shia scholars and followers believe that putting a seed in a womb is prohibited, but not an embryo in the uterus (Naef, 165-166). This ties into the Shia concept that the touching of identical bodily substances is what is prohibited, such as in the physical act of sex, where the man’s sperms enters the woman directly. The flexibility in this interpretation are what allow Shia scholars to deem surrogacy as permissible, so long as the zygote is implanted into the uterus if the sperm comes from someone other than the husband. Interestingly, some scholars deem the use of donor sperm as morally impermissible but will view the child as legitimate and not an act of zina. Some scholars, such as Sane’i (Naef, 168) view surrogacy much more flexibly in that the surrogate mother can be nearly any woman, even a sibling of the infertile couple, since she is not the true mother of the child. He views the surrogate mother as simply the carrier of the child; as simply the womb in which a child is carried for nine months. This comes from the idea that maternity and paternity is determined at conception, not gestation and parturition. I find this idea extremely interesting, especially given how much variation there is in views of kinship in Sunni and Shia Islam. These ideas are the fundamental groundwork in what is allowed for interfile couples and is crucial to the study of reproductive rights and technology.

    The latter half of Naef’s article ties nicely into the article by Elly Teman about wrong assumptions surrounding surrogacy. The accounts presented by Naef highlight financial and altruistic reasons to be a surrogate mother, as well as the love for family members that cannot themselves procreate. These women rely heavily on the ideas of kinship in Islam to “maintain social order” (Naef, 182) in issues about infertility. These rather positive accounts are crucial in considering the general public’s view on motherhood and childbearing. Many people critical of surrogacy assume that the “emotionally volatile” (Teman, 1109) notion of pregnancy makes many women reluctant to give up a child that they carry for nine months and rely on the assumption that the surrogate mother is “deviant” in personality and morality. As noted by Kleinman in his discussion of using ethnography in bioethics, one’s ideas of morality are locally driven (Kleinman, 71) by personal experiences and values. Research about attitudes toward surrogacy are clearly biased by researcher’s trying to find deviances and lack of conscientiousness in surrogate mothers, when, these women are actually very self-aware and intelligent. I appreciate Teman’s account immensely because these statistics get buried in the negativity around surrogacy and narrow-mindedness that many people can’t seem to shake.

  3. Thanks for the posts Elisabeth and Daniel.

    Naef did a fantastic job describing the different aspects of surrogacy and the concept of motherhood in Muslim culture. The differences between Shia and Sunni when it came to donation of sperm/blood/other aspects of the body very interesting. Certainly there was a potential for adultery (mixing of bodily fluids specifically), but given a very specific circumstance eg. the wife can licitly be artificially inseminated so long as no “forbidden act” such as a gaze is exchanged.
    Motherhood is a convoluted topic with no clear answers, but Muslim scholars are continually debating the standards for which maternity can be established: should the woman who the child is genetically related to be the mother or the woman who gave birth to the child be the mother? Some Shia scholars believe it is the latter that should bear the weight, establishing motherhood at the act of giving birth. Other Shia scholars argue the countering point, stating maternity begins at conception. There also is those who hold the opinion of having two mothers: one that donates their genetic material, and one that bears the child.

    Tehman’s essay delves into some of the public opinion and discussion of surrogates and what drives them to make their choices. She postulates that circumstances of childbirth are reliant upon two things: the natural and normal. Research has been investigating if there is something “abnormal” about surrogates that drive them to make their reproductive decisions, and studies have not produced any fruitful results: surrogates appear to be average, regular people.
    A second theory was that surrogates are normal people, but have a “good reason” for their decisions. Tehman argues that this diminishes the surrogate’s decision to monetary (greedy) or demeaning (self-punishing for past sins). One clever quip she notes is a comment explaining how “the tendency to cast surrogate’s motivations into dichotomous…categories such as altruism or monetary gain may reveal more about American culture than it does about surrogacy itself.”

    Kleinman’s essay I could relate to concepts we had discussed earlier in the year about cultural relativism and imperialism. He discusses how ethics are birthed and are dependent on personal circumstance and culture, but then questions if ethnographers are really approaching situations correctly. They are too focused on abnormalities – they live so much among the people they lose sight of the larger scope of what matters to the people they are with versus the universally translatable system of ethics. Knowing what is at stake is a core tenet to what makes ethnography a valuable tool of study, defining the border of the moral and the ethical.

  4. Thanks for your blog Elisabeth. The summaries of the three readings were very informational and touch on the main topics discussed in them.

    The responses thus far have focused heavily on Naef, and I have to agree with the others that Naef has done a fine job discussing surrogacy in the context of many different interpretations of Islam. I think it’s an interesting debate, as the question of “Who is the mother-the one who supplied the genetic material to the child or the one who physically gave birth to them?” comes up. I think many would consider that a major part of motherhood is physically giving birth, as it is considered a stepping stone, if you will, to becoming a mother (experiencing the entire process). The question of what is considered to be adultery also comes into play. I personally don’t think it is adultery if someone gave birth to a child other’s conceived as I think adultery is not only the physical act of conception (intercourse) but to some extent the emotional act of deciding and engaging in intercourse. However, like you mentioned, I would expect the authors of Donum Vitae to have a different opinion regarding adultery and allowing the child to grow up in a “good” environment.

    I did want to address your questions. For last week’s Made in India movie, Aasia performed a delicate balancing act, where she tried her best to be a good mother, tend to her children, and work while pregnant. It was only in the latter months when she physically was unable to tend to her children as she needed to prepare for delivery that she stopped balancing. This could be the proof that Tehman needs to support her point even further that surrogates are not “abnormal” women and that they do not have trauma or felt a sense of loss after the child was born. However, I think some may argue that Aasia is indeed abnormal, as she was in a special situation of extreme poverty.

    I think ethnography provides a special viewpoint that mass studies cannot provide. By grouping individuals into groups, you lose unique data points that are specific to an individual. For example, if a study was done on surrogates with an income from 0-20,000 USD yearly, the surrogates who make 20,000 USD may have different beliefs, personal reasons, and reasoning of becoming a surrogate that will be grouped with surrogates who make 5,000 or even 0 USD. This data could then be manipulated to fit a certain narrative for surrogates by researchers (which may or may not be biased), which is something that Teman addresses.

  5. Hi Elizabeth. Thank you for the summary and commentary on the readings. I thought the reading by Naef was interesting because it brought up a new perspective on topics we have discussed throughout the semester. Instead of focusing on the rights of the child when discussing the acceptability of various reproductive techniques, the authenticity of a marriage is more of a concern. Because only physical contact is unlawful, it makes the acceptability of surrogacy more widespread. I think the stability of the marriage is an underlying issue many people may have with various reproductive techniques, however, it is an issue that is hard to address because people do not like to doubt the strength of their marriage. Furthermore, I thought it was also interesting the equal recognition of men and women in kinship relations was brought up because I thought it contradicted how the role of the mother is defined concerning egg donation and surrogacy. The father is obviously the sperm owner, but who is designated as the mother becomes less clear when these reproductive techniques are introduced. The gestational mother may be considered to be the mother regardless of egg ownership, which is inconsistent to the standard of the father. Lastly I appreciated the point you brought up about the role of sex in reproduction, which we have seen this before throughout the semester. I feel that ethnographic accounts of reasons why people engage in sexual intercourse often disprove the claim in Donum Vitae that sex is for reproduction alone.

    The reading by Teman was interesting as you pointed out, because it sought to disprove common claims about surrogates that go against surrogacy. I think it’s common for surrogates to be thought of as the victims for reasons including the difficulty in giving up a child and financial need. However, Temans counter arguments provide logical reasons that surrogacy does not cause trauma for the surrogate mothers. Furthermore, the choice to become a surrogate mother is completely voluntary. The choice to carry another person’s child is one that requires a lot of thought, because of the physical and lifestyle changes that accompany the decision.

  6. Elisabeth,
    This is impressive work. Not only do you provide thorough summaries of the readings, but you also put them in the greater context of the course. One example of such a link between concepts is in your discussion of the lived experience of surrogates in Iran as described by Naef. You made the claim that “all surrogates clearly viewed sexual intercourse and reproduction as two separate worlds… it parallels the beliefs that sexual intercourse serves a greater purpose than just reproduction.” This is a clear reflection of a very common theme in Naef’s article, that the “shia notion of zina… depends on the illegitimate physical act that occurs through illicit sexual intercourse” (Naef 2012, 158). In my opinion, illicit is the operative word here. I get the sense that the Shia wordview frowns upon illicit sexual intercourse, as that is undoubtedly considered adultery, but my question is what greater purpose does sexual intercourse serve? Do you simply mean that the two are not mutually exclusive?
    I’d also like to highlight one more of your quotes that encapsulates very well many of the themes of this course. You write that “placing significance and interpretation on different aspects of reproduction allows people to respond to changing environments and new technologies while preserving natural order.” This reminds me of our discussion of how the Jewish and Catholic hermeneutic approaches to bible impacts their stances on reproductive technology. In this week’s readings, the Shia understanding of zina and the sunni understanding of zina create for two very different approaches to reproductive technology. I am fascinated by the conversation about how different religious approaches to text impact their acceptance or lack thereof of reproductive technology. I suppose a theme here is not that all religions have traditional, homogeneous views, but rather than even within each religious system there are numerous perspectives, which are bolstered by ethnography as discussed by Kleiman and utilized by Seeman in last week’s reading. Looking forward to continuing our dialogue tomorrow!

  7. Hello Elizabeth, thank you for a great post. I thought that you raised many thoughtful questions that tied in the readings well. Although we had learned about Islamic views on assisted reproductive technologies at the beginning of the semester, I had never realized how differing Shiite and Sunni views were. Shia Muslims have less strict laws and give women more opportunities to reproduce. They still hold many strong beliefs about adultery, but since surrogacy does not involve the physical act of sexual intercourse, it is permitted. Naef states that “Shia notions of nasab are more gender-balanced and recognize that a bilateral filiation under which maternal and paternal filiation are clearly distinguished are symmetrical” (Naef 158). They are more inclusive of the female and recognize that the male and female reproductive substances play an equal role in the procreation of the child, and therefore, and rules should take into consideration both the father and mother.

    Further, I wanted to discuss your analysis of Teman’s work and the questions you brought up about Aasia in Made in India. Teman expresses how researchers focus on what is normal and what isn’t, in relation to surrogacy. In India, it is very common for people living in Western countries to come and have a baby through surrogacy. For Aasia, a woman living in poor conditions was baffled by the thought of surrogacy but agreed to it because of the monetary gain. She did not tell anyone it was happening and even covered her face at doctors appointments. I think that this reflects Teman’s point that surrogates are perceived negatively and are not “normal.” Although many women in India are surrogates, Aasia felt embarrassed because she felt that she was going against the norm, but still continued because she needed financial help. As Teman discussed, the surrogates who are viewed as “normal” are because they are doing it for money or to repair a damaged past. For these differing views, I think it is necessary to include ethnography into bioethical debates because it allows researchers to understand multiple facets of surrogacy. Kleinman describes ethnography as a way for the researcher to step into the lives of others and think through bioethical problems.

  8. Elizabeth and Daniel,

    Thank you both for the well summarized and easy to read blog posts. I felt that you each successfully captured the main points of each reading and drew connections to past material we have discussed in class, and I particularly enjoyed the questions you posed throughout the blog post, Elizabeth. I very much appreciated this week’s readings because I felt that there was a smooth transition of the material from last week to this week. The movie we watched in class, Made in India, was a great segway into this discussion and I am glad it was mentioned it in Elizabeth’s post.

    I particularly enjoyed Elly Teman’s paper this week and her challenge of Western psychosocial research on surrogacy. I felt that it was very relevant to the concept of Western biomedicine, and the recognition as biomedicine as a form of cultural belief itself, too. As Teman is calling her readers to follow, she outlines how Western kinship ideals that are portrayed through media and entertainment influence the opinions of general Westerners, and even research teams. Her main arguments are rooted in the idea that each case of surrogacy should be individually studied, rather than focusing on surrogates as a group. I found her subarguments to be extremely valid, and again, well summarized in each blog post. This broad issue Teman takes with generalization of surrogacy in research can theoretically be carried out through what Arthur Kleinman’s proposal of using ethnography to reconcile moral and ethical thought.

    I felt that the film Made In India came close to executing this ideal nature of surrogacy ethnography. While the film focused on one surrogate that carried the children of one American couple, I did not feel that Western ideals or expectations were removed from the portrayal of the surrogate’s and the couple’s experiences. The American couple who hired the surrogate, Aasia, often displayed their frustration and difficulty while navigating the Indian hospitals and health care spaces, despite their uncoerced decision to travel abroad for a surrogate mother. Aasia seemed to passively agree with what was expected of her and many of her interviews showed her concerns regarding being paid, providing for her children, and keeping her surrogacy a well kept secret from others – all ideals that Teman argues are inaccurate and over-represented in research. It is quite possible that this is all that she or the movie producers wanted to share, however, we have to remember that the film itself is not an ethnographic study, it’s a documentary. The film was produced in 2010, which genuinely surprised me because it was produced years after Kleinman and Temen had their work published. Clearly, the film’s purpose is not only to educate the audience on something they might not know much about, but also to morph the audience’s view of surrogacy through a Western lens and provide entertainment to the viewer.

  9. Thank you for your wonderful post, Elisabeth!

    You thoroughly summed up the main takeaways from all three authors. I enjoyed these readings paired together, and each author’s perspective made me question the others in ways I was not anticipating. Naef’s discussion felt startlingly detached and unconcerned with the individual impact of surrogacy. Though this makes sense in the context of her exploration of surrogacy in the ethos of Sunni and Shia Islam, it makes me think of the relationship that Arthur Kleinman discusses about our lives and opinions being entirely formed around “what is locally at stake” (70, Kleinman). As you hinted to throughout your post, I feel as if the one common thread between these three writings is the idea that reproduction through ART is separate from sexual intercourse. There is a notion of surrogacy as a “transaction” between two parties, something that seemed to be challenging to acknowledge for the surrogate and contracting mother in our film last week.

    Teman’s article discusses the issue of stigma surrounding surrogacy and the biases that result within surrogacy research. Again, there seems to be this thread of issuing with what is at stake. Furthermore, she suggests that much bias is founded in the worry of deconstructing the normative family unit and perhaps questioning the kinship constructs that many people frame their familial ideals around. I am curious to know if Teman has studied much of the relationship between these surrogacy stigmas and the overall irrationalizing of women’s emotions. “The psychosocial literature has a tendency to frame the study of surrogacy in such a way that it presupposes that the surrogate possesses personality traits which define her as psychologically aberrant. Given the assumption that ‘‘normal’’ women are ‘‘naturally’’ predisposed toward keeping the children they bear, most of the psychological researchers attempt to isolate explanatory factors that might account for the surrogates’ unnatural choice in relinquishing the child by determining what makes the surrogate population different from ‘‘normal’’ women. Often, deviance is implied in the way the researchers formulate the questions themselves” (1106, Teman). Perhaps what Teman is suggesting here stems more from the overall sexism that exists in research. In the wider frame of women in Western culture, our emotional landscapes have often been painted as tumultuous and inconsistent. The judgement placed on a surrogate’s willingness to surrender a child once born is a judgement on that woman’s choice to not conform to maternal responsibility in a way most people assume a woman would post-birth.

  10. Hi Elisabeth,

    Thanks for providing a thorough summary and commentary for this week’s readings. The way that Naef argues the role of “zina” in the context of surrogacy and how this refers more explicitly to the physical act of sex is interesting. This theme continues throughout all three of the readings and I find myself to agree with the separation of the two items and treating surrogacy much more like a business item, similar to the movie that we watched in class last week. One thing that I find particularly interesting about the discussion is the deep differences between Sunni and Shi’a Muslims. This is a big contrast to Christianity, as with the readings last week, we learned although Protestants do identify themselves very differently from the Catholic church, on reproductive issues they end up falling rather in line with the Catholic church’s view.

    Teman’s reading was my favorite as it provided a strong defense of the women who do act as surrogates. I like that she dissuades the popular misconception that women are likely to attach themselves to the baby after birth, because there is nothing more frustrating than a notion like that becoming popular and thought to be correct when it is nothing more than an anecdotal case that doesn’t represent the majority. I know that biases against women exist in other branches of research but I had never considered it in this specific light. Additionally, there is massive heterogeneity in the women who choose to be a surrogate which can make it difficult to provide a summary for in research. Like Fiona suggested, it would make sense that this is based off of sexism and what is generally expected of women in the role of motherhood – or to be in the role of motherhood.

  11. Thank you, Elisabeth and Daniel, for your incredibly thorough analyses on the readings of this week.

    The discourse on surrogacy in “Gestational Surrogacy in Iran” reminded me of Inhorn’s article on IVF in Lebanon and how married couples would get around Islamic law by marrying a woman, having her donate her ovum, and then divorcing her – in that case, the child would be the man’s child by Islamic law and the man’s original wife would be allowed to raise the child. Naef’s reading goes more in depth on the arguments for why the specific technology should be allowed rather than focusing on how couples may get around the law. The Shia’s practice of preserving nasab does indicate that some regulations must be followed before surrogacy can be supported and does mean that the Shia’s do believe that zina may be considered if the rules are not followed.

    I thought that Teman’s reference to families as social constructs was interesting because it links back to our previous discussions of social fatherhood and social motherhood – if the definition of the mother and father can change depending on the circumstance then social construct might be a good way to describe all familial relations. Teman discusses the lack of evidence to consider surrogates as abnormal which indicates the importance of ethnography as the reasons why a woman becomes a surrogate differs and those reasons may be good reasons that others are not privy to.

    Kleiman’s article elaborates, once again, why ethnographic accounts are so important, as one must understand the different communities and varied cultures in the world, rather than assuming that everyone falls under one umbrella – ethnographic accounts are especially important in the case of bioethics because the consideration of ethical dilemmas do not have one response.

  12. Hi Elisabeth!

    Thank you for a very well written and organized blog post! I enjoyed who you took the time to relate the themes of this weeks readings to the overall themes we’ve learned about in class. I found Naef’s argument on surrogacy and what is considered zina very interesting, specifically in the definition of what is considered and defined as “adultery”. Through the flexibility of defining adultery and sex as physical contact rather than the exchange of bodily fluids allows for surrogacy to occur. I found it intriguing how while Shia believe in more equal roles between the male and female, it is still not acceptable for donor sperm to come into contact with a women’s uterus. The embryo must already be formed. I felt that this view was slightly contradictory, especially with the definition of adultery to be centered around the physical act of sex.

    Both Teman and Kleinman’s works emphasize the importance of using ethnographic research in order to better understand the perspective of those using this technology.
    Specifically, by focusing on the individual experiences rather than the collective are much more meaningful in collecting data. In regards to your questions, I feel that the theme of deviance of a surrogate was something that was present in how Aasia handled her surrogacy. She hid her pregnancy and from her friends and even the specifics from her husband so that they could have monetary gain. The movie demonstrated how there were many outside influences that impacted how Aasia decided to become a surrogate, how she handled it during the pregnancy, and how she came to terms with it afterward.

  13. The reading discussing Shia attitudes toward surrogacy is very intriguing, especially because “Shia practice forbids contact of donor sperm with a woman’s uterus but allows the implantation of an already-formed embryo in a surrogate’s uterus.” I found this surprising because I never considered the different implications of when/what type of ART is used. What’s also interesting is the conversation about the parents of a child through ART. There was a discussion about which woman, the one giving birth or the one who donates the egg, is the real mother. I was surprised that there was not more discussion about the male role, as Shia nasab includes a more equal role for a mother and a father.
    In Teman’s reading, like you pointed out, she emphasizes importance of family and motherhood in Western culture, and that “any new threat to such structures will be met with opposition in various forms.” Initially, this can be a little intriguing because western culture is usually thought to be very open and free, so the fragility of social/kinship structures is not the first thing that comes to mind.

  14. Hi Elisabeth,

    Thank you for your response. It was so detailed and well-written, I can hardly think of anything to add!

    I’d like to focus on the last quote you cited from Naef’s chapter: “the grammar of kinship is used to maintain social order in dealing with infertility” (182). I think this quote is extremely powerful in describing both Naef’s points as well as Teman’s. Both these authors demonstrate how surrogacy does not align with traditional views of motherhood, pregnancy and kinship. Surrogacy raises questions that require a new paradigm through which to view motherhood, pregnancy and kinship. For example, traditionally, a child has one mother. As discussed by Naef, there are questions raised about who the mother is and whether there can be more than one person considered the mother. And if we decide to consider both the surrogate and the genetic mother to be mothers, then how do we decide who keeps the baby after brith? In the movie from class last week, we saw that this was a difficult decision in that the hospital believed the birth mother/surrogate was the mother but the babies were supposed to be given to their genetic mother.

    I also found Kleinman’s article interesting in how much credit and power he gave to ethnography. I believe that we do not currently utilize ethnographies as much as we should. There is a lot of work being done by people “far away” from the actual situation. Ethnography is a chance to take real people’s stories and situations and figure out how they can be generalized to the whole population. Then those with the power to help create change can do so even from far away. Kleinman describes this to be the concept of ethnoethical orientation.

  15. Hi Elisabeth,
    Thanks for the very detailed post. I thought you did a great job introducing each topic and then synthesizing the content of this week’s readings with content from other weeks. The Naef reading really opened my eyes to the differences between Sunni and Shia beliefs. I found the Shia concept of allowing an embryo to enter the uterus but not the sperm to enter the uterus to be a novel concept for me. This idea really made me rethink my views as I had always considered fertilization and reproduction to be linked. The concept of separating fertilization and reproduction as a justification for reproductive technology really made me rethink my views. Additionally, I found the concept of a surrogate’s child having two mothers, one of conception and one of birth and gestation, to be interesting. Compared to other beliefs we have covered in class, I felt that the Shia views on reproductive technology was similar to Jewish views where lineage was very important.
    In regard to your question about how Teman’s article related to the Aasia in the film we watched in class, I felt that while Aasia seemed normal, the incentive of money played a major role in her decision to become a surrogate. Jeffrey mentioned how one could argue that Aasia was “abnormal” because she was in a situation of extreme poverty, but I would argue the she was normal in relation to her community. How a western perspective would define normal would be different from how a eastern perspective would define normal and that is why I agree that people should be open rather than influence by popular experience.

  16. Hi Elisabeth! Thanks for your great summary and reflection on this week’s readings. One topic that I thought was really interesting that Karen also touched on a bit was the idea that Teman presented about “the tendency to cast surrogate’s motivations into dichotomous categories such as altruism or monetary gain may reveal more about American culture than it does about surrogacy itself.” Teman also referenced the use of surrogacy as a method of constructing families through a “marketplace.” I would agree with her view that the way we look at surrogacy practices is very culturally produced, and I would also argue that surrogacy is a practice that is actually very representative of the Western world that we live in. Relying on contracts, monetary exchange, corporate worlds, etc., surrogacy practices reflect the reality of what Western, and specifically American, values and practices are.

    I also liked that you related these readings back to the film from last week. The theme of normality vs abnormality is clearly represented in both the film and Teman’s writing. Aasia was very worried about what others would think about her for being a surrogate– the company even went so far as to try to isolate the women in a surrogate home. Although I do not think that she would have been viewed as abnormal for the same reasons that Teman outlines, I think it was more so just because surrogacy was not a very common practice. The idea of motherhood is very interesting here as well, because by being a surrogate Aasia was increasing her ability to mother her own children (by earning money for them) even though she was carrying children that she would eventually “give up.”

  17. Thank you for your post!

    I really enjoyed Naef’s take on the various aspects of surrogacy and Muslim ideals that impact the way that motherhood is perceived. This article, in combination with Marcia Inhorn’s article earlier in the semester, helped me understand how Sunni and Shia Muslims may differ in their opinions on the use of ARTs. As we have discussed all semester, motherhood is a complex topic with no easy answers, and we have seen these Muslim scholars debate and use their experiences to show how Muslims see motherhood. Shia scholars seem to be split on how they see motherhood: some emphasize the woman who gave birth to the child while others emphasize genetic relations. Even other opinions exist as the idea of “milk siblings” would show.

    We discussed Arthur Kleinman earlier in the year as well. In his current writing, he discussed how ethics come to be based on each individual’s personal circumstances and experiences. He says that to truly understand one’s personal situation and how he or she balances ethics with morality, high-quality ethnography is necessary. I think that your description of Kleinman was well-done. He noted that ethnographers try to use their work to understand peoples’ local moral worlds; then, they try to apply these individual circumstances to the larger society they are studying. While I see the value in such an approach, it has its shortcomings. A scientist might argue, for example, that there using specific situations to representatively describe a larger population would be failing to account for the external validity of such a study.

  18. Hello Elizabeth!

    Really appreciated your post. One note you made that helped clarify the readings for me and spark further reflection was “Placing significance and interpretation on different aspects of reproduction allows people to respond to changing environments and new technologies while preserving natural order.”

    In this comment, you argue (and the reading supports) that cultural interpretations change and shift in order to accommodate more important cultural concepts and/or the desires of the populace, ultimately to preserve and protect the “natural order.” ( Here I assume that with “natural order” you are referring to the dominant social structure of the society and culture-specific kinship relations as the term “natural” has many implications beyond that which is the societal status quo in this course. ) It is interesting that the Shia Muslims interpret similar religious texts to accommodate the cultural value of pronatalism over the concern of adultery, zina, just like the Jewish tradition interprets the Old Testament to allow IVF and abortion whereas Catholicism adamantly does not.

    The text also mentioned that the concept of “milk mothers” was recently constructed by Islam to accommodate adoption of non-genetic kin. To me, this adoption of milk kinship is an example of how religious doctrine is often structurally altered to create and maintain order in society as times change. While I recognize that religion changes so slowly over time that individuals feel that it is immutable, I wonder what Kleinman would say regarding how to weigh what seems mutable and circumstantial like religion into a formulation of a universal ethic code.

    Anywho, thank you for your post!

    Emma

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