Cultures of Testing

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

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