Unit 10: Surrogacy -Selina Liu

The three readings for this unit show how Iran and Israel differ in the reception of assisted reproduction, surrogacy and the social relationships formed through the process through ethnographic methods by authors Shirin Garamoudi Naef and Elly Teman. Arthur Kleinman’s article touches upon the failure of bioethics in the lack of consideration of the poor when discussing bioethics and policies. I believe that one should read Kleinman’s article first and then reflect on how often the socioeconomic class of the people interviewed came up in the first two readings.

In Shirin Garamoudi Naef’s “Gestational Surrogacy in Iran” covers surrogacy in a Muslim society. Naef focuses on Shia thought on assisted reproduction involving a third party. Naef was able to take an ethnographical approach by interviewing people in infertility clinics undergoing ART procedures similar to Teman interviewing surrogate mothers. Naef’s in depth research and methodology gives her credibility. I appreciated how she presented the differing views of Shia religious scholars on assisted reproduction. Unlike Sunni thought, most Shia scholars do not consider surrogacy as zina (“adultery”) because it does not involve sexual intercourse. Naef argues that Shia notion of zina depends on the “illegitimate physical act that occurs through illicit sexual intercourse between a man and a woman and not on the act of conception itself” (Naef 158). The transfer of bodily substances in order for assisted reproduction to happen is not considered zina. Senior Shia clerics give their take on when it is acceptable for another man’s sperm to fertilize the woman’s egg. Permissibility of another man’s sperm fertilizing the woman’s egg mostly depended on physical contact and whether or not a gaze, a touch or illicit sexual intercourse transpired. I found it interesting that one cleric took issue with placing a stranger’s sperm directly into the woman’s uterus despite the lack of physical contact. Due to the presentation of diverse views on the subject and extensive research, I believe that Naef wrote this article for scholars who want to learn more about surrogacy in Iran. I found her chapter to be informative and the differing views she refers to does not take away from her argument.

 

Elly Teman’s “‘Knowing’ the Surrogate Body in Israel” touches upon the concept of “authoritative knowledge” and the relationship between intended mothers and surrogate mothers. She argues that the surrogates and intended mothers along with the professionals involved in the surrogacy process collectively determine what relationship the surrogate and the genetic mother would have. The concept of “authoritative knowledge” refers to the way knowledge is produced and received in interactions. Intuitive, technological and medical knowledge come together to provide “authoritative knowledge” for the intended mothers. Intuitive knowledge is when the intended mother senses or feels what the surrogate mother feels during the pregnancy: “Masha vouched that her intended mother, Tova, would call her ‘knowing’ that the baby inside her had just kicked, or that she was feeling cramps in her left side” (Teman 265). Although there is no physical evidence, these accounts given by intended mothers and their surrogates should be considered quantitative data.

Technological intervention in surrogacy further allows the intended mother to picture and conceptualize her unborn child. I find it interesting that all the surrogates interviewed acknowledged the importance of having the intended mother at every ultrasound appointment versus the film we watched in class where the surrogate and the genetic parents do not meet during the process. Where’s the concern that surrogate will grow attached to the fetus? I partly attribute this openness between the surrogate and intended mother to Israel’s cultural view of fertility and “Israel’s pronatalist impulse” (Teman 262). Technological and medical knowledge are closely linked together. The medical system structures surrogacy so that there is a hierarchy in which information is provided and to whom. This allows the intended mother to decide if she wants to “generate alterations in received scripts about the maternal nature of pregnant bodies and the non-maternal makeup of infertile bodies” and share that information with the surrogate to create a stronger relationship with the surrogate (Teman 262).

In Arthur Kleinman’s article criticizes bioethics for not considering “local cultural realities”. He believes that bioethics are removed from the socioeconomic status of the people and therefore irrelevant. “The irrelevance of ethics can be seen when considering universal ethical formulations of justice and equity that do not begin with the local moral conditions of poor people” reminds me of our discussion on natural laws in Unit 3 (Kleinman 72). It is difficult to agree on whether there is a shared human nature moreover universal ethics. I agree with Kleinman that more often than not bioethics and medical policies neglects the poor and underprivileged. They do not receive the same benefits and information as those who are able to pay for procedures and treatments. Kleinman suggests that bioethics require an ethnographic approach to connect “moral context with ethical reflection” (76). Kleinman refers to the ethnographic works of Paul Farmer and Rayna Rapp towards the end of his article as examples of ways to create an argument that fulfills his beliefs that “bioethics require both approaches: it must possess a method for accounting for local moral experience and a means of applying ethical deliberation” (73).

15 Replies to “Unit 10: Surrogacy -Selina Liu”

  1. Hey Selina,

    I just wanted to start by saying I liked the way you told your audience to read Kleinman first in order to connect the three readings. However, I felt like your actual connection was a bit weak, and I found myself asking at the end of the post, “how does Kleinman’s claims connect to the topic of surrogacy?” Perhaps we can we connect it by looking at different cultures, and comparing how those cultures look at surrogacy as a process and how they define relationships between the surrogate and the mother. We can also connect Kleinman to the other two readings by pointing out that there are always disagreements about surrogacy, demonstrating that there is “no underlying universal understanding of moral law” and there are no “agreements on human nature.”

    Building off of that, I thought you did a great job of summarizing Naef’s reading. You pointed out the major points that I personally picked up, including the difference in Sunni and Shia Islamic view toward “zina.” I honestly thought it was very interesting how these two Islamic religions disagreed so distinctly on the idea of “adultery” in the process of surrogacy. Here I think you could have easily incorporated Kleinman’s claim about the lack of “agreement on what human nature is.” It is clear that the shia have certain practices and guidelines, specifically in surrogacy, that are very different from Sunni and other religions that are not Islamic. It seems that religions vary on their opinions about what is morally permissible and what is not, demonstrating Kleinman’s claim again that there aren’t actually any “universal moral laws.”

    I also thought it was interesting that the shia try to involve the mother as much as possible with the surrogate. You highlighted my exact thoughts about how different the relationship between the surrogate and intended mother was in the Shia Islam from the couple in the video we watched in class. Overall, this made me think that there should be no laws/policies for what kind of relationship can be formed between a surrogate and mother because it is a unique experience for all couples/surrogates.

    Overall, great job summarizing and highlighting the main points in all of the readings!

  2. Hey, Selina

    Thank you for your post this week. Among these three readings, my favorite one is Shirin Garamoudi Naef’s “Gestational Surrogacy in Iran”. As you mentioned, it covers surrogacy in a Muslim society. I found it is fascinating that most Shia scholars do not consider surrogacy as zina(“adultery”) because it does not involve sexual intercourse. However, in Sunni scholars hold a totally different view toward surrogacy.

    When I read Elly Teman’s “‘Knowing’ the Surrogate Body in Israel”, I also kept to think of the movie we watched last week. I think the relationship between the maternal and surrogate mothers are complicated. In the movie, they did not meet until the baby was born. There was not much attachment building up. It may be more beneficial because once attachment builds, it will be hard to separate the surrogate mother from the baby.

    I do not agree with the Arthur Kleinman’s believes that bioethics is removed from the socioeconomic status of the people and therefore irrelevant. People who are more educated totally hold different view towards bioethics. For example, in the past reading women who are white and from good neighborhood mostly likely accept the idea of prenatal testing but women who are black and from poor neighborhood choose to not do these testing.

  3. Selina,

    I liked your introduction to the readings for this week. I especially enjoyed that you told the readers to read Arthur Kleinman’s article first. This would give the reader a different perspective to the assignments, and a better understanding of your claims in this post.

    I think you did a great job summarizing Naef’s reading. The adultery aspect is very interesting because they are basing their beliefs on common moral standards; The fact that most societies deem adultery as bad. This would make sense that IVF would be considered zina or permissible. I agree with some of Kleinman’s claims. I believe that most health issues need a holistic understanding of social, economic, political, and biological factors. However, I don’t think it is as extreme as Kleinman states.

    I wish you would have compared the three readings a bit more in depth. We haven’t spoken about Muslim ethics in depth in class yet, so the comparison of these beliefs with other religions would create a greater understanding overall. In conclusion, you had a well-written summary of the readings. Thank you for writing!

  4. Selina,

    Naef’s text is another example of how there can be strongly differing views on the same procedure based off religious differences. I found it interesting that despite more flexible Shia positions on surrogacy, this reproductive process is still only permissible for infertile married couples (Naef 183). This shows that the Shia religious view still wants to keep clear guidelines for what constitutes families. This view reminded me of the French Bioethics Debates we read in the beginning of the semester, which limited artificial reproductive technologies to married heterosexual couples of reproductive ages (Ball 553). I kept this in mind throughout my reading of the text because while it much more accepting than the Sunni view on surrogacy, there are still strict guidelines.

    I think I read a different Elly Teman text than you – I read “The Social Construction of surrogacy research: An anthropological critique of the psychosocial scholarship on surrogate motherhood.” The text you described and this one both speak of surrogacy as more of a concrete agreement between parties understood throughout the entire process, such as inviting intended mothers to appointments with the surrogate. The text I read spoke of the media dramatizing surrogacy in a way that does not reflect the reality of process for most. In reality, surrogate mothers do not bond with their babies and feel satisfied with the process. In other words, they do not suffer psychological stress from giving the baby to the intended parents. This statement is backed up with data that less than 1% of surrogacy cases resulting in court (Teman 1104). Like Kleinman’s complaint that bioethics does not include everyone, such as the poor, the topic of surrogacy often does not reflect real personalized experiences (Kleinman 72; Teman 1105).

  5. Selina,

    You did a really great job of summarizing and highlighting the major points of this week’s readings. I think your post is missing the integration of all three works and establishment of any underlying connections. In the very beginning, you suggested that we read Kleinman’s article first in order to best connect the readings. What made you say this and why? I felt that you didn’t really explain your reasoning behind this statement.

    Personally, I agree with you and would actually go as far as saying that we should have read this article earlier in the course. As I read it, I felt that many of the themes and definitions we’ve used throughout the course were being defined in ways we have not necessarily considered yet. I think that Kleinman defined the “purpose” of bioethics really well, saying it was meant to “reconcile the clearly immense differences in the social and personal realities of moral life with the need to apply a universal standard to those fragments of experience” (70). I also agree with the way he talks about the importance of ethnography in bioethical work. Practically everything we read and the videos we watch are ethnographic in style, which has allowed us to see how “everyday life experience in communities and networks – no matter how influenced we are by global forces of communication, commerce, and the flow of people – centers on what is locally at stake” (70). This concept, I believe, it what allows us to determine morality.

  6. Selina

    This was an interesting read and I think you summed up a lot of important concepts well. I agree with Nikki that the connection between Kleiman’s text and the topic of surrogacy was not fully formed, but I think the spirit of the thought was there.

    I enjoyed reading your take on the different opinions of what “zina” were as I felt as though that the idea of making a universal definition of adultery was slightly foreign to me. I had never thought about it until now and simply assumed that something as personal as adultery could not be effectively defined outside the context of any specific marriage. It was interesting to read the different definitions that exist in the Islamic faith.

    I thought the different relationships the mother and surrogate mother had in India versus in the readings was intriguing and definitely highlighted the need for regulation over the industry. I do not believe these differences came about due to any religious differences or preferences, but rather as a result of the tourism surrogacy industry’s youthfulness in India. In other words, the only party who may object to such a change occurring in that relationship is the company that brought the surrogate mother and donating mother together. This highlights the dangers of viewing such procedures from a business angel rather than a medical one.

  7. Hi Selina,

    Thank you for the well-written summary and analysis of this week’s readings.
    First, I loved how you pointed out the different perspectives on “adultery” between Shia and Sunni on Naef’s reading. It was very interesting how the two major denominations of Islam can differ in interpretation on the notion of zina. However, I thought it would be more clear if you explained or analyzed that even though Shia does not consider surrogacy as zina or adultery, they still only allow surrogacy to infertile married couples.
    Secondly, I was little surprised by the term “intuitive knowledge.” I personally did not believe in this since like you said, there is no physical or scientific evidence available. However, it would be interesting if scholars can collect quantitative data on this and see what it shows.
    Lastly, I agree to some extent to Kleinman’s claim on bioethics. I do think that bioethics are partly removed from the socioeconomic status of the people after watching the surrogacy video last week. I strongly felt that it was unclear and unfair of the payment that the surrogate received. However, I don’t want to say that it is irrelevant and wrong since laws are changing to protect the poor, and consider the local cultural realities.

  8. Selina,

    Thank you for positing this week! Your blog post is well-written and a good balance of summarizing and analyzation.

    I like how you attempted to connect the Kleinman article to the Naef and Teman texts. With that being said, I agree with the other commenters who critiqued the connections you made. The organization of your article has you addressing each article individually in a systematic manner. Your content is great but I feel like greater attention could have been paid to integrating the pieces together.

    I noticed that for the Naef piece you mentioned what you believe the intended audience is. Reflecting on the intended audience is a good way to analyze the text and it would have been great if you had done it for all of this week’s readings. In some instances, your quotes feel disconnected from the rest of the piece. You ended your blog post with a quotation, I would recommend not doing this as it is important to support the citations you use.

    Organization aside, your content was thorough and your statements were well-supported. Specifically, I liked how you closely looked at “zina” and “authoritative knowledge” and brought up insightful questions associated with them. I agree with your statement that testimonials by intended mothers and their surrogates should be considered quantitative data. The collection and interpretation of such data would be insightful to questions regarding surrogacy.

    One of the questions you had regarding the Teman text was concerned with the surrogate/fetus relationship. Prior to this course, I felt that an attachment of the surrogate to the fetus would be the largest issue with surrogacy. The film on surrogacy we watched in class last week, “Made in India” (2010) changed my mind on this issue. The systematic, transaction-like process of surrogacy in this case cleared up the misconception I had that there was always a surrogate/fetus relationship.

  9. Hi Selina,

    You did an awesome job on summarizing the three articles this week but as mentioned in some other comments, connecting the two articles on surrogacy in Iran and Israel to Klainman’s article on bioethics could make your blog more insightful. As suggested in your first paragraph, the socioeconomic class of people interviewed should be taken into consideration of Shirin and Teman’s ethnography research. In addition, I feel that their ethnographical research could be evaluated based on Klainman’s “ethnographical method.” For example, did both Shirin and Teman incorporate a mix of self-disclosure and self-reflexivity in their research? If so, what makes self-disclosure effective? How do the diverse views presented by Sunni and Shia scholars relate to other internal and external approaches? No matter how the ethnography research is presented, it always has certain limitations attached. While Naef focuses on only the religious authorities in Iran, Teman targets her research on the interaction of surrogate and intended mother. Both Ethnographical accounts well-compensate each other, and together reveal a holistic picture of surrogacy.

  10. Hello Selina,
    Overall great work with your response to Unit Ten’s readings; great job with capturing the unique cultural vantage points offered in the Naef, Teman and Kleinman articles.
    At the end of your first paragraph you mention socioeconomic class. Are you referring to an ethnographer’s own bias due to originating from a specific socioeconomic class? To which part in the Kleinman article are you referring to; is there a direct quote you can provide?
    Kleinman’s article is so important in the context of our class and in our studies in college. The tension between generalization (theory) and particularism (case study) is highly contested across the disciplines. Where do we draw the line between creating theories that try to explain a phenomenon at large versus trying to capture the various specificities of nuances in particular circumstances? Instead of simply stopping at acknowledging this dilemma, Kleinman proceeds to state a call to action: “…bioethicists, like clinicians and policy implementers, simply cannot function without finding a way of relating ethical deliberation to local contexts (Kleinman 70).” In essence, what is local (particular) is required for proper and thorough consideration of ethical dilemmas.
    Great work with your inclusion of the word zina in both the Shia and Sunni Islamic contexts. I found this distinction quite illuminating, as two Islamic forms of thought consider adultery in vastly different terms. The proponents of a Shia belief system claim bodily fluids play a crucial role in whether something is determined as adultery or not. So long as the sperm and ovum are combined to create an embryo outside of the woman’s body, she is in the clear when it comes to committing an act of zina. In contrast, the Sunnni perspective does deem surrogacy as an act of zina. This difference, when compared to Shia belief, demonstrates the variability even within one religious sect. As Kleinman suggests, it is important to always consider the particularities and nuances.
    With that said, here is a quick suggestion on grammar and syntactical stricture in your response. In your first sentence, you state, “The three readings for this unit show how Iran and Israel differ in the reception of assisted reproduction, surrogacy and the social relationships formed through the process through ethnographic methods by authors Shirin Garamoudi Naef and Elly Teman.” It seems this sentence requires a verb added and seems a tad redundant with your usage of the word ‘through.’ Perhaps you could state “…the social relationships formed, as explored by authors Shirin Garamoudi Naef and Elly Teman using ethnography.”

  11. Hello Selina,
    I don’t think you should say, “one should read Kleinman’s article first and then reflect on how often the socioeconomic class of the people interviews came up in the first two readings.” I think you should explain why this is the case. From my point of view, I figured you thought the other readings were not as clear or the first two articles could have presented additional information. In the end, I could understand the connection being made, but I think it would have been better if you would have explained this in your last paragraph. Overall, I think you did a great job summarizing the reading. What shocked me was how Shai and Sunni come from the same religion, but view surrogacy different. I think a little more explanation at some parts in your summary would have helped. You should also think about more counter arguments that could have been brought up. This would have covered all grounds in your summary.

  12. Hi Selina,

    Great job on your blog post. I enjoyed reading it and felt that you did a wonderful job summarizing the readings.

    I found the Naef reading very informative and found the difference between Sunni and Shia Islam as it relates to incest and breastfeeding to be profound. Naef’s work definitely exemplifies how people of the same religion interpret the same text differently–where Sunni and Shia Muslims utilize the same passages from the Quran to justify their different reasonings and stances. I did have a critique where I felt that Naef could have expanded her claim about artificial insemination. To be honest, I was confused why artificial insemination was not allowed. She didn’t really explain well why artificial insemination is forbidden. Naef focuses more on female significance in regards to reproduction, which I thought was very interesting considering the strong patriarchal notions that Islam entails–where men are seen as head of the household and have dominance over their wives and children.

    Overall I thought your post was very interesting and informative!

  13. Selina,

    Thank you for writing an insightful post this week! Your explanations of the readings did indeed hit all the major points and you did raise a very pertinent concern regarding the feelings of the surrogate mother.

    One critique I would make of your post this week was that I noticed many grammatical errors. There were many times when I had to go back and re-read certain sentences because the main idea was either missing or got lost in too many words. In conjunction, some of your sentences were a bit confusing and either had too many words or were missing key elements of a clear sentence.

    On another note I really enjoyed your point of view on the order the readings should go in. I have read Kleinman’s article for another class I am in and I would definitely agree that he provides a very effective critique of western biomedicine and the culture that surrounds it. With his reading in mind, I believe the other readings provide a much more open outlook on surrogacy cross-culturally.

    The question of what happens if the surrogate mother gets attached to the baby (or fetus) is a very concerning question and I am sure that this is something that happens more often than not. I strongly believe that there is a connection between a mother and child, not only do they co-inhabit the same body for nine months but the baby also hears the mother’s voice and feels the mother’s heartbeat everyday. As Adam calls Eve in Genesis 2:23 a baby (or fetus) is literally “bone of [the mother’s] bone and flesh of [the mother’s] flesh”. In an article titled Your Cells are My Cells that was published by Scientific American they discuss the fact that “in utero we receive an infusion of [cells] from mom. And women who become pregnant also collect a sampling shed by the developing embryo”. I think this is very interesting- we have talked a lot about the fact that a surrogate is just a body for a baby (or fetus) to grow in but this science seems to ignore that these two bodies nourish each other for a very extended period of time, growing together and changing together. So does the baby have part of the surrogate within itself and does the mother have part of the baby inside herself? These are both ethical and moral questions that have yet to be addressed.

  14. Selina,

    I really enjoyed reading your blog post for the week. You did a thorough job in analyzing extremely contrasting point of views. I appreciate the point you make regarding the order in which you recommend reading. When you talk about credibility, I think you should expand how this happens. While I like the following examples you provide, I think an expansion on this point preemptively would make your stance clearer. I also think it would be helpful if you provided a bit of background on the Shia religion. While understandably the post focuses on the readings, I think this information could help provide more context. I agree with the point you make about the differing views not interfering with maintain a strong argument.
    I understand the individual points you are making when looking at Surrogacy in Israel, but having a hard time with the flow. Perhaps, it would be helpful to explain your points alongside the context as opposed to afterwards. This way, while we learn about the context we are simultaneously getting your take on how you view the subject.
    Your description of bioethics flows really well and I agree with what you say and also agree with Kleinman. I like the point you make about underprivileged and not having the same accessibility. I think especially when talking about things such as reproduction, this is imperative to be aware of. I would like to know more on your opinion about the quote you share at the end.

    Thank you for a wonderful blog post!

  15. Selina,

    I enjoyed your take on the readings for this week. I like how you mentioned that the order of the readings may lead to a different understandings of the pieces. Personally, I didn’t read the Kleinman article first, but I still felt that it helped me understand the biases of the bioethics perspective. I think that reading the other articles first helped me gain a basic understanding of the topic since I have not encountered may readings about surrogacy in Iran. Overall, I like how you mention that we need to take a different approach when reading pieces like this, however, I still think it is a good opportunity to address our own biases and cultural biases that impede understanding in everyday life.

    I also found it interesting that you mentioned how these technologies help a woman visualize her child. While I agree that this is a good use of technology, I think people of other cultures may argue that there is no need to visualize an unborn child and that creates room for unnecessary pre-judgement.

    Overall you had a very well written post and I enjoyed your perspective!

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