Month: April 2018

The readings for Unit 9 focused on ethics of motherhood. In “New Reproductive Technologies: Protest Modes of Thought”, Gilbert Meilaender examines the modes of Protestant reasoning and discusses the attitudes of six Protestant theological ethicists: Janet Dickey McDowell, Paul Simmons, David H. Smith, Paul Ramsey, Joseph Fletcher, Oliver O’Donovan. It is important to note in this discussion that the standard approach of developing Protestant positions is biblical text-based and not interpretative. I belief this explains some of the variances within Protestant views of new reproductive technologies. Our other text for the unit was “Reproductive Technologies and Surrogacy: A Feminist Perspective” by Barbara Katz Rothman. The position Rothman took on reproductive technologies was reflective of her sociological background. Rothman discusses the language of the bible and modern linguistics to argue  that American contemporary society is a modified patriarchy, the relationship between surrogacy and incest, the legal history of the custody of the family. The works of Meilaender and Rothman emphasize the complexity of attitudes towards artificial reproductive technologies. The complication of position arises from biblical interpretation and societal ideas of kinship, gender roles, and parenthood.

In “New Reproductive Technologies: Protest Modes of Thought,” Meilaender briefly describes various modes of Protest thought in the context of reproductive technologies. In doing so, Meilaender fails to give a full account of any reasoning. This article seems extremely open-ended. After referencing McDowell, Meilaender states, “One can also, however, use biblical themes in quite different ways and to quite different argumentative ends.” (Meilaender, 1638) Meilaender supports this statement by referencing Paul Simmons. This tactic of briefly describing different ethicists who use Protestant thought to different ends results in confusing the reader and poorly explaining the mode of rationale. Many of the positions described were shocking. For example, the argument of Paul Ramsey on human nature was surprising and thought provoking. If human nature is characterized by “limitless self-modification” (Meilaender, 1640) then how might exercises of freedom be de-humanizing? The idea of what is human is discussed in length but no conclusions are made.

In “Reproductive Technologies and Surrogacy: A Feminist Perspective”, Rothman utilizes sociology and linguistics in order to describe their feminist perspective. Rothman’s position is that they are against surrogacy because of surrogacy’s underlying theology of patriarchy. They describe various examples that support the idea that America is a modified patriarchy. In this section of the paper, it sounds as if the author takes offense to women having children in general not just reproductive technologies. Rothman makes the stance that, “It manifests itself in the language when a Mrs. John Smith bears John Smith, Jr.–women bear the children of men.” (Rothman, 1600). In modern day Western society, women typically choose whether they take their partner’s name and what to name their offspring so it seems to me that this has now become a linguistic choice that women make in this society. The concluding sentence confuses me as genetically it is true that women bear the children of men. The connections Rothman made between surrogacy and incest were surprising. Rothman states that, “Surrogacy typically raises issues about the possibilities of incest if children of surrogates are unaware of their biological lineage.” (Rothman, 1600) Genetic testing of biological lineages is not difficult and would be a useful tool in minimizing this concern. I would not assume that reproductive technologies would be administered with no counseling beforehand.

It was interesting that Rothman uses the term “begets.” They wrote, “Reading the “begets,” each man is described as having begotten his first-born son and then sons and daughters in his likeness.” (Rothman, 1600)  They use this as apart of their argument of American modified patriarchy. The usage of “begets” was different in the Protestant perspective as shared by Meilaender. Meilaender wrote that, “Begetting implies a sharing of being — equality. Making implies that one is alienated from the maker.” (Meilaender, 1645) In the feministic perspective, the term is seen as an agent of patriarchy that implies that child-bearing is a duty women do for men. In the Protestant perspective, “begetting” lies at the heart of human significance as humanity is not made. This argument serves as a counterpoint to reproductive technologies as through science, children would be made.

Unit 9 has been extremely interesting and was not as I expected it would be. It is surprising to me that the feminist and (some of the) Protestant perspectives take a similar stance although the modes of thought that brought them to this position are vastly different. The argument of the same biblical term used differently in the two papers was striking. The abundance of different modes of thought in the Meilaender piece would have benefitted from a greater deconstruction, both by the author and by the reader. Rothman’s article made large generalized statements that I felt would have benefitted from appropriate sourcing. Rothman speaks of the woman’s perspective but fails to mention the importance or desire of child-bearing that is isolated away from any desire of pleasing men. Seeing infertility as a disability is an interesting idea as it implies that infertility limits a woman’s activities. Even if one argues that this activity serves the modified patriarchy, wouldn’t it be aligned with Feminist thought to allow women to utilize technologies that treat a female-specific disability?

Ibel Galvez Midterm

Dear esteemed Members of the Sasquatch Committee on Ethics,

I am honored to speak to you today regarding some propositions and urgencies concerning some very controversial legislation placed here before us today. We are tasked with the decision to vote on the use of certain new reproductive technologies and tests. As ethics committee members, it is our responsibility and sole duty to protect our close-knit small town values and represent the people of our great town of Sasquatch, Connecticut.

Before I address the very specific and nuanced technologies to which I refer, I want to remind you all that we must protect the dignity of procreation and human life by leaving them in God’s hands as much as we can. It’s all too easy to get caught up in the clinical setting of a hospital that we end up forgetting what we are truly considering here at Sasquatch Mercy Hospital: life and death. Real people, real bodies and real lives are affected by technological reproductive interventions. We must consider that any “intervention of the human body affects not only the tissues, the organs and their functions, but also involves the person himself…”(144, Donum Vitae).

Here in my proposal I stay true to the values and truths presented in the holy Catholic church’s decree: Donum Vitae. This precious document humbles us and reminds us that we walk the fine line of “going beyond the limits of reasonable dominion over nature” (Gen 1:28 as cited in Donum Vitae 141) when we tamper with the natural world by using too many technological interventions in a beautiful, natural, God-given miracle like reproduction. If we begin to make excessive exceptions for the use of these technologies, then we have ignored God’s decree of trusting in Him and His will.

For reasons unbeknownst to me, Sasquatch Mercy has recently dropped its affiliation with the Sasquatch Catholic church. Surely, our community is ever changing, and we have new members of different faiths, but we are all a God fearin’ folk here in Sasquatch. Whether we are Jewish, Christian, or Islamic, we all uphold conservative values that place God and His will as first and foremost in our minds and hearts. To best serve the people we represent, we- as members of the Committee on Ethics- must consider the core values these faiths have in common when it comes to the question of reproductive technologies. However, because our hospital has historically served members of the Catholic Church and receives generous donations from the Church and its members, we must place those values as first and foremost. As you all know, Sasquatch Mercy is in no position to turn away or discourage any financial support. We need all the help we can get if the hospital is to continue providing free care for the under-insured residents of our town.

Let’s take a moment to review each of the reproductive technologies that we are currently considering in an effort to regard each intervention as we rightfully should.

In the case of providing abortion services for underinsured patients, the hospital should not provide these services, save for the case in which both the baby and mother’s lives are threatened by the pregnancy, i.e. in the case of ectopic pregnancy. Here, both the mother and her baby are at risk and would not survive such this specific unsafe gestational circumstance. All other cases should not be subsidized by Sasquatch Mercy Hospital. In subsidizing abortions (aside from those that would save both the mother and her child), the hospital would essentially place an unwarranted stamp of approval on abortions. Considering that a majority of the nurses and physicians at Mercy Hospital abide by Catholic morality, they will be relieved to know that abortions will only be performed in those rare, absolutely necessary circumstances. Due to the rarity of those aforementioned pregnancies, those staff who still feel uncomfortable with performing the procedure will be allowed a temporary transfer into a different hospital department, if they happen to be at work on the day of said rare procedure. We shall not allow any other type of abortion procedure on the sole basis that as faithful Catholics we cannot support infringement on the dignity of human reproduction as God has so blessed us with.

The human embryo should be treated with utmost respect, as human beings must be respected from the very first moment in which they exist: from the time at which they are conceived (Donum Vitae 147). Prenatal testing, including amniocentesis will be allowed at Sasquatch Mercy Hospital only in the case that the tests are done without excessive, predetermined knowledge that said test(s) will more than likely harm the human embryo (Donum Vitae 150). Additionally, the tests are not to be conducted for the aim of aborting the embryo if an abnormality is discovered.

The question of whether or not to perform amniocentesis tests has come up, as there is a chance of miscarriage, however, recent technological advancements allow doctors to perform these tests while monitoring the baby in order to ensure a safer procedure. Doctors are no longer blindly poking around in the amniotic fluid without knowing whether they will harm the child. According to Rayna Rapp, in her book Testing Women, Testing The Fetus, when sonograms were finally employed in combination with “experimentally invasive techniques of the womb” they became safer and “miscarriage rates attributable to these procedures dropped dramatically” (Rapp 29). So, with the use of sonograms we may provide amniocentesis tests here at Sasquatch Mercy.

In-vitro fertilization treatments will be allowed only in infertile married couples. Catholic decree, Jewish Halakhic law, and Sharia law allow the usage of IVF with varying particularities, but the consensus is that in a married infertile couple, IVF treatment is permissible (Kahn 2). Sharia law establishes that as long as the procedure does not breach the sanctity of the couple’s marriage (i.e. placing another man’s sperm into the married woman would breach the terms of marriage), IVF is allowed. Shirin Garmaroudi Naef writes, “Fertilizing the ovum of a woman with the sperm of her husband outside of her body and implanting it in the wife’s womb is not forbidden in Islam, and the resulting child is the legal offspring of the married couple” (Naef in Inhorn and Tremayne 166). In Halakhic law the issues with IVF stem from protecting and promoting kinship relations which can be complicated by whether the gestational mother is Jewish or whether donated sperm is from male belonging a particular sect of Judaism (Broyde 316). Thus, in order to appease these three religious modes of thought, IVF therapies will solely be allowed in married couples who require it due to infertility, when the procedure consists of the sperm and ovum combined out of the woman’s body.

In accordance with Catholic morality prenatal testing should be confined to the specific use of preserving, protecting, and anticipating potential treatments and procedures the human embryo may require to aid in after birth. Consequently, Embryo donation should not be allowed at the hospital. The human embryo should be treated with utmost respect, as human beings must be respected from the very first moment in which they exist from the moment of conception (Donum Vitae 147). The embryo is human from the moment of conception because of the simple fact that that embryo will develop into a human, and human alone. Therefore, we consider the embryo as human and deserving of utmost care and protection. The use of embryos for scientific research is not in line with respect towards the human embryo.

Spiritual counseling essential for those dealing with loss, sickness, an emotional distress caused by health issues. Here at Sasquatch Mercy Hospital we take pride in our ability to not only attend to our patient’s physical needs, but also to their emotional and spiritual needs. It is so important for us to keep our faith strong in the midst of life’s trials and tribulations and keep faith in God’s divine will. As a community open to those off all walks of life and faiths, we should open our hearts and provide safe spaces in which patients can get in touch with their own spirituality. We will open our spiritual counseling to members of Jewish, Christian, and Islamic faiths so that each person is able to consult God in his or her own way during their time of need. But, each clergy representative of each religious background shall only be called upon by the request of the patient. Otherwise, these clergymen should give the patient, their family, and attending physician family ample space by not intervening in the patient’s chosen medical care. To ensure this, we will place clergy offices in the back office rooms located on the Sasquatch Mercy’s lobby floor.

 

My dear friends; brothers and sisters of the board, please remember that “science without conscience can only lead to man’s ruin” (143, Donum Vitae) and it is up to us, and us alone, to uphold this sacred value. Please vote with God’s divine will in your minds, heart, and spirit.

 

Thank you,

Rev. John Doe

 

 

Sources Consulted

Michael J. Broyde, “Modern Reproductive Technologies and Jewish Law,” In Michael J. Broyde and Michael Ausubel editors, Marriage, Sex and the Family in Judaism (Rowman and Littlefield, 2005), pp. 295-328.

Donum Vitae In Shanon, Thomas A. and Lisa Sowle Cahill, Religion and Artificial Reproduction: An Inquiry into the Vatican “Instruction on Respect for Human Life in its Origin and on the Dignity of Reproduction.” (Crossroad, 1988).

Susan Martha Kahn, Reproducing Jews: A Cultural Account of Assisted Conception in Israel (Duke University Press, 2000)

Shirin Garamoudi Naef, “Gestational Surrogacy in Iran,” In Marcia C. Inhorn and Soraya Tremayne editors, Islam and Assisted Reproductive Technologies (Berghahn Books, 2012).

Rayna Rapp, Testing Women, Testing the Fetus (Routledge, 2000)

Sasquatch hospital is seeing an influx of women and men minority groups into our region of care, minority not for the color of their skin but for the religion that they believe in. Ever since our founding, Sasquatch has been predominantly Irish Catholic—with this influx of newcomers our hospital is starting to see a change in reproductive requests. In conjunction with the state and our donor basis we aim to provide all of our patients with affordable and efficient healthcare, but as a community of historically Irish Catholics we cannot forget our faith and our morals when treating our new neighbors. Our donor base has been kind enough to aid us in the subsidizing of healthcare for underinsured patients but they have made it clear that they will not support our healthcare system if we begin to provide abortions to all those seeking them. They have also made it clear that if our efforts to provide our patients with successful reproduction technologies goes beyond the scope of the sanctity of marriage they will withdraw funding.

To accommodate our new neighbors I propose that as a community we work together to be more supportive of young women and their reproductive decisions, a key component to this will be to provide abortions on a case-by-case basis wherein the family will have to meet with a reproductive health counselor in order to get permission to abort. As a healthcare system we must respect the human body “as a person—from the very first instant of his existence” (Donum Vitae). Staying true to our faith, and the faith of our donors, we will accrue respect for the unborn child from the moment of conception and will do our best to make the right decision for the life of the child and for the life of the family. On the opposing side of this, we must also acknowledge that not all women in our growing community are Irish Catholics and that most women perceive a “tension…between human and divine agency” and that not all “women’s reproductive experiences can be clearly derived from particular religious doctrines” (Seeman). Due to these realities, as a healthcare system we must strive to meet every woman’s expectation of exceptional care when they arrive in our waiting room.

In Vitro Fertilization (IVF), as a means of reproducing within a sanctified marriage, will be a procedure that we will allow done. With respect to our Jewish community and their halakha, we will make IVF “available to individuals who need assisted reproduction” (Broyde). Couples wanting to undergo IVF must first meet with a reproductive health counselor to get permission and must also use both the husband’s and wife’s gametes. This is the only way to keep the sanctity of marriage when using IVF, and the only way to respect our own historical faith and the faith or our donor base. Any couple wishing to use donor gametes will be given a referral to a hospital that allows for these procedures, as this completely denies the sanctity of marriage and will not be allowed under the roof of our hospital. Any unused embryos will be left to the discretion of the mother with three options: they can pay to have their embryos frozen and stored in which case they can use them when they are ready to get pregnant again, they can donate their unused embryos to stem cell research, or they can have their unused embryos inserted during a period where the vagina is not conducive to a fertilized egg. In all of these decisions the life of the unborn child is respected. In line with these beliefs amniocentesis’ and other prenatal testing will also be allowed. As a healthcare facility our first priority is both the health of the mother and the health of the unborn child, as such any tests that will make more apparent the health needs of the child will be encouraged. Our donors will be pleased to know that in this regard our stance highly aligns with the Catholic teachings presented in Donum Vitae, which states “prenatal diagnosis makes it possible to know the condition of the embryo and of the fetus when still in the mother’s womb. It permits, or makes it possible to anticipate earlier and more effectively, certain therapeutic, medical or surgical procedures. Such diagnosis is permissible” (Donum Vitae). If prenatal tests come back with results that reflect complications with the pregnancy or complications with the fetus, the mother and father of the unborn child will meet with a reproductive health counselor to decide the best course of action—whether that be abortion or birth. Although the Second Vatican Council has stated that “abortion and infanticide are abominable crimes,” (Donum Vitae) we must respect the lives of the mothers and situational contexts in which the abortion would or should take place.

In addition to reproductive health counselors we will have social workers working alongside our medical staff, it will be the duty of these staff members to make sure that all of our patients are receiving the best medical care for themselves, their families, and their situations. A new change we will be making is to say goodbye to all of our religiously affiliated counselors. Due to the influx of new denominations and from the complaints of the medical staff, we see no need to hire spiritual counselors. These counselors can be sought after by our patients at their own will. Although our healthcare system is historically Catholic and we try to maintain this faith in all of our procedures, we will not subject our patients to this religious viewpoint during an already stressful time. All of our counselors will work to ensure our patients are exceptionally informed, happy with their decision, and trusting of our medical experts. As previously stated, any woman seeking abortion or an abortion-like procedure, must meet with our counselors anyway—in this way all of our patients should be informed from a well-being and holistic perspective. Those patients wishing to explore a more religious perspective, of any denomination, can do so outside of the healthcare system.

Due to our historically Catholic nursing staff we have received some inquiries about whether or not we will be forcing our staff to partake in the execution of procedures that are against their religion. This will not be the case. In order to appease both our staff and our donor base we will be initiating a system of referrals. Any abortion that is deemed necessary or acceptable, after informed deliberation between our counselors and patients, will be scheduled in our facility or will be granted a referral to another facility in a neighboring town. Using our limited budget for new hires we will hire one doctor or nurse that is certified to execute abortions—if for some reason there is no doctor or nurse eligible for hire, we will pay a doctor from the town of Swesquet (two hours away) to visit our facility twice a month to execute abortions. We have already been in communication with a doctor from Swesquet that would be willing to make the drive twice a month in order to aid our patients in their search for convenient and trustworthy healthcare. Again, if our hiring search for a doctor that would permanently reside in Sasquatch fails, the doctor from Swesquet would be introduced to our facility and put on pay roll. In this event, any patient who is in need of immediate care or cannot wait for the scheduled day will be given a referral to an abortion clinic or abortion friendly hospital in the nearest location. Although this will be an inconvenient trip for our patient they will have to both understand and respect our healthcare provider’s spirituality and agency in their decisions to deny abortion procedures.

 

Works Cited:

1. Congregation for the Doctrine of Faith, “Donum Vitae:  Instruction on Respect for Human Life in its Origin and on the Dignity of Procreation: Replies to certain questions of the Day”. February 22, 1987.
2. Don Seeman, Iman Roushdy-Hammady, Annie Hardison-Moody. “Blessing Unintended Pregnancy: Religion and the Discourse of Women’s Agency in Public Health.” Medicine, Anthropology, Theory 3 (2016): 29-54.
3. Michael J. Broyde, “Modern Reproductive Technologies and Jewish Law,” In Michael J. Broyde and Michael Ausubel editors, Marriage, Sex, and the Family in Judaism (Rowman and Littlefield, 2005), pp. 295-328.