Religion and Healing Spring (WR) 2018

To whom it may concern:

Before I begin, I would like to introduce myself and provide information about my background, both professionally and religiously. First of all, I am a doctor, a FEMALE doctor. I personally want what is best for my patients, and I want nothing more than to reduce a person’s discomfort in the safest way possible. Secondly, I identify as a Roman Catholic. While I do skip some Sundays and in no way claim to be the most “devout” Catholic in the Church, I do resonate with a majority of Catholic beliefs. That being said, after attending a college where the majority of my peers were Jewish and spending time over seas experiencing new cultures, I have become very open minded and accepting to other religious practices, and I have spent a lot of time observing their role in medicine. Due to the diversity in beliefs I have been exposed to, I have definitely struggled with addressing the ethical issues presented to me while being a part of this committee. This is mainly because I value practices and ideas in both Catholicism and other religions, such as Judaism and Hinduism. I hope that what I have to say next will be taken into consideration with respect and an open mind.

This hospital, which was initially under Catholic influence, now has the opportunity to introduce the procedure of abortion. While abortion is a very controversial topic, we—as a hospital—must respect all views and beliefs in the growing community and consider permitting the procedure in the hospital. I personally do not align with the pro-choice movement, as I am Catholic and this procedure goes against my moral belief of “right to life from the moment of conception.” I am also aware that other religions have similar moral beliefs as Catholics do, such as the Hindu belief that people should “do no harm” to other people (Bhattacharyya, 2006). However, abortions are in fact legal in the United States, and we should be providing the service to whoever may need it, regardless of their or our own religious practices. With that said, there are several religions that are more flexible with the idea of abortion and see it as permissible as long as it violates no other “moral code” in the religion.

I find it important to note that we are essentially the only hospital in this community, and it is necessary for us as humans to help the people within our diverse community. In order to do this, we must set aside our religious differences and embrace a utilitarian approach, where we put our community first and our beliefs second. We cannot expect our community to grow and prosper without being accepting and accommodating to others. Prohibiting the procedure of abortion may drive away many of the people in this community, as they may seek protection and help from a more cooperative hospital in another town if we do not.

Now, let us address the under-insured patients. My personal belief is that we should subsidize abortion; however, I can see the problem with providing funding for every abortion. Unfortunately, it is seen that one-third of abortions are repeat abortions. Therefore, my proposition is that we should not subsidize more than ONE abortion per patient. As a catholic and a mother, I would like to our community members to practice safe sex and/or abstinence until they are ready to bear and take care of the child. By subsidizing only one abortion, we will be able to avoid these repeat abortions as well as promote safer sexual habits in our community. After attending University and after I had finished my time abroad, I realized that a majority of people explained that life begins 40 days after conception, not at the start of conception. With this in mind and looking beyond the laws of Catholicism, we can allow for abortions to take place ONLY within a certain time frame. This guideline should accommodate most religious practices.

In regards to our doctors, we should NOT openly suggest abortion as an option to patients. While we should allow abortion to be an option, we should not necessarily advertise it. Advertising such a controversial procedure may drive away some patients that are pro-life, such as our large Catholic group. Our first goal is to respect the patient’s request, and if that request is abortion, then we must honor that request without judgment. However, our second goal is to minimize the number of abortion procedures we conduct. Our doctors should suggest alternative solutions, such as adoption or following through with the pregnancy. Perhaps introducing a policy that supports a pregnant woman considering adoption could aid in reducing the amount of abortions that occur.

As I mentioned, I struggle with the idea of abortion as a Catholic; however, I fully support prenatal testing, so long as it “respects the life and integrity of the embryo and the human fetus.” My belief is “directed toward safeguarding or healing,” and I do think prenatal testing can be extremely beneficial, as doctors can catch or be aware of disease before it becomes fatal (Shanon, 1988). This procedure, amniocentesis, can prove to be stressful for many women, so I suggest again that we do not advertise it. If a woman requests it, then we should perform the procedure; however, plenty of woman have gone through pregnancy without prenatal testing and have given birth to perfectly healthy babies. Thus, unless the woman expresses concern, our doctors should not promote it. With the integration of prenatal testing, we can appeal to our Jewish patients, who are typically concerned with “geneticism” and strongly favor genetic testing (Ivry, 2009). At the same time, we can appeal to our Japanese patients, who rarely request amniocentesis, by not promoting or suggesting the procedure to them. This creates a “no pressure” environment that patients can feel comfortable in, whether they favor genetic testing or not (Ivry, 2009). I’m sure the next concern with this is about how the results of the prenatal testing will affect the rate of abortion. While many people may argue that knowing test results will increase abortion rate, I believe that if we stay true to the idea of “limited advertisement” of abortion and prenatal testing, then there will not necessarily be a spike in abortion. The reverse situation may even occur, where a woman realizes her baby would be perfectly healthy, and then refrains from aborting it.

Another topic of concern is assisted reproductive technology, namely in-vitro fertilization. I typically diverge from the Catholic view towards IVF, as I support it while the Church does not. This is because I resonate with women and their desire to have children. I believe it is important that we, as doctors, give any woman the ability to have a child. The Church states that “it is a gift” to have a child, and if a woman is infertile then “God has a different plan” for her. However, being a mother has given me the opportunity to realize how important and special it is to bear a child, and I want to be able to help an infertile woman experience it. If this hospital allows IVF to occur, we can appeal to many members of our community. For example, Jewish women strongly support IVF because they feel that they need a child to be accepted into society (Kahn, 2000). Another example is in the Shi’ite community, where women are willing to break bonds with their own religion in order to have a child (Clarke, 2007). Therefore, I will make the point again that we should attempt to be more accommodating to other religions other than Catholicism. Permitting IVF can result in growth in the community in terms of population and diversity, not to mention many more women may be happy with families.

In order to support the women that desire IVF, we should encourage other women to donate embryos. I don’t see this as controversial of a topic as abortion, amniocentesis or genetic testing because there doesn’t seem to be any life-threatening consequences from it, and I don’t particularly see women being opposed to or offended by it. Therefore, I think it could be beneficial to promote embryo donations, which could not only provide another woman the chance to have a child, but could also allow for more research to be conducted within the hospital. Selfishly, I think this could also be a great opportunity for the hospital to gain recognition if we are able to produce new and exciting research from these embryos. Holistically, I do not necessarily see a down side to embryo donation and the advertisement of it, but if you feel that there is a problem with it then I would love to hear your opinion on it and see how we could work out a solution.

I am well aware that this hospital holds a strong tie to Catholicism, and moving away from Catholic views may upset staff and community members. Since I am Catholic myself, I would still love to incorporate the religion into the hospital in some way. I think the best way to do this is to keep the Catholic Clergy for counseling. I have learned that healing and religion go hand in hand, and while these patients are undergoing stressful procedures they need something to keep their mental health in tact. By having a patient meet with a religious counselor, they may gain new knowledge of their faith or of a new faith that can help them make their decision more confidently. Meeting with a religious counselor, either Catholic or non-Catholic, can also simply provide the patients with hope. As a doctor, I have come to realize that patients simply desire hope through a dark time, and to know they are in the hands of a non-judgmental and supportive system. I believe keeping counseling within the hospital will provide that support and guidance that is needed by many. This also allows the doctors to remain focused on just the procedure at hand, as the counselors can take on the more spiritual-support role.

If and when we allow all of these procedures to be available at this hospital, there follows a concern involving our staff and whether or not they agree with the decision. We are bound to have nurses and doctors that differ in opinion, and it is important that we address it. The only solution I have for this, given we have a limited budget, is to expose these nurses to new cultures and practices. I became open minded after being around people with different beliefs than myself, and if we can simulate that environment in this hospital then perhaps our staff will also become more secular. If you have suggestions of ways to do this, I would love to discuss them further with you. In the meantime, we would have to assign staff members that are able to put religious differences aside in order to perform the procedure at hand. As stated earlier, I do not think abortion/amniocentesis rates will increase much if we do not advertise them, and I do not think we would lose staff members to this switch.

Finally, I will reiterate the most important points I have made. We are a growing community that is becoming more and more culturally diverse. In order to provide proper care for all of our patients, we need to be aware of the differences in beliefs and acknowledge them. We are a hospital and our main purpose is to serve and heal any person that needs it, regardless of their upbringing, religion, culture, or social class. We should pressure no one into any procedure, and we should be sure to provide ALL information to patients about any procedure they wish to go through. The staff may practice their own beliefs freely, but may not force their beliefs on other staff or their patients. My hope is that allowing these procedures to be available will create an atmosphere of “culturally competent” staff and extremely hopeful patients (Bhattacharyya, 2006).

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.

In the article “Reproductive Technologies and Surrogacy: A Feminist Perspective,” Barbara Katz Rothman describes her experience through the lens of her involvement in media. While her background is in sociology, writing, and feminism, she explains that a majority of her “title” is centered around feminism. The media coverage at the time was centered on the “Baby M” case. She emphasizes that from her personal stance she is against surrogacy yet simultaneously recognizes a different perspective from a religious point of view. She also expands on the importance of understanding the true definition of patriarchy, which she explains as “a system to which men rule as fathers.” She makes a strong point about control, with which I personally disagree; she believes that the only way to maintain control of the seed planted into a woman is to also maintain control of the woman. While creating a baby happens in the woman’s body, I do not think that it necessarily means the woman’s body is being controlled by the man. Of course, there are circumstances where this type of control could potentially occur and could lead to negative implications, I do not believe It can be generally applied.

I find it very interesting the way she describes and defines surrogacy. She relates surrogacy to incest in a fascinating way, through varying cultural perspectives. For example, she says that some societies would find it acceptable for two children with the same father to get married while for us that would be “distasteful.” She makes the argument that there is potential for incest when it comes to surrogacy because we all define it differently. In my opinion, the problems and obstacles that cultures face defining “right” from “wrong” within themselves is very challenging. Furthermore, when bringing together varying and often opposing cultural norms, defining “right” from “wrong” is nearly impossible. I agree with how she describes the potential of seeing surrogacy as incest, yet this is based on one culture. It makes me think more critically about the process of distinguishing right from wrong as well as the foundation upon which societies base it.

The Baby M case is described as a family with privilege who essentially took advantage of a 17-year-old catholic girl by seducing her and then claiming patriarchy through the dad in a custody battle. At the time of this case, it was a misconception that women got rights to their children; they would sometimes get half of the rights. Women faced a lot of adversity when it came to bearing and keeping children and were seen as “simply dirt” for the seed to grow. She also talks about inheritance, exclusivity of marriage, and changes in human reproduction. The author describes how many religions reject reproductive technologies on a broad scope and not just when it comes to the use of surrogates. I find it particularly complicated for women to know how to interact with their religions, especially if they are expected to have the role to reproduce. On one hand, religious leaders can ban reproductive technologies, while on the other hand they expect women to have the role of mother. This dichotomy puts women in vulnerable circumstances. I think that in this instance the patriarchy plays a detrimental role as it is one of the foundations that leads to women having challenges such as these. It makes me question and wonder if religion and patriarchy share the responsibility of placing women in this tough circumstance or if one plays a more substantial role. I connect strongly with her conclusion that every instance is, different, and every family should be able to choose how they approach their disabilities, in this case infertility.

In the article “New Reproductive Technologies: Protestant Modes of Thought” Gilbert Meilaender emphasizes the “creative chaos” of Protestantism. He clarifies that he will be focusing on the reasoning behind modern Protestant thought more than the conclusions themselves. I specifically appreciate his openness and admittance to the fact that there are many other valuable perspectives and opinions out there on this topic specifically. I believe this creates a more open space for productive interpretation and understandings of his text. One aspect of his argument that I have a hard time understanding is when he says: “lacking an accepted teaching magisterium within the church.” He emphasizes that a typical protestant approach has been to reject the way the church interprets biblical text. An author named Janet Dickey McDowell looks at the Bible to better understand parenthood as the Bible does not explicitly focus on surrogacy. He brings up the interesting juxtaposition in how the Bible can be interpreted and that we are two-sides as human beings, “both finite and free.” The idea that we are brought into this planet by God’s own spirit is not only what protestants think but it is central to their beliefs. However, if we are free as humans, the issue of artificial reproduction becomes hard to oppose. The idea Smith brings up when it comes to partnership is interesting. He argues that with adoption parents remain equal partners while with the case of a surrogate the focus is only one partner, the mother. I don’t entirely agree with this idea as I think it is hard to take a stance when each partners dynamic is different. Perhaps, a mother who cannot have children prefers a surrogate over adoption.  I see the idea as freedom and power to be very personal and varies based on the individual, which makes it challenging to interpret through a religious stance. In addition to looking at human duality, he emphasizes that we should also look at Jesus to understand what is truly human. This challenges the idea of reproductive technology as it makes the birth of those children seen as “the creature of the doctors who assisted her conception…not as begotten but as made.” In conclusion, Protestantism often looks at the general themes of the Bible rather than specific themes and has a strong focus on the “duality of finitude and freedom.” This theme plays a large role in understanding and creating societies relationships with various reproductive technologies.

This week’s readings focused on the heavily debated topic of abortion in the United States, which began in the mid 1900’s and has only become more controversial as time has gone on. The reading by Ginsburg, Contested Lives: An Abortion Debate in the American Community, is an ethnography published in the late 1900’s that delves into the conflict of abortion by using a community in North Dakota as a miniature model for the larger scale society of the United States. The other reading by Thompson, “A Defense of Abortion,” was published prior to Ginsburg’s reading and presents the ideas behind the right to life movement while also arguing against it. Overall, these two readings cover the moral reasoning behind and the consequences of the ongoing abortion debate, and the rights a woman holds in the American society in the late 1900’s.

While it is a small detail, it is important to take note of the publication dates of both of these readings and analyze how one publication may influence or inspire the other publication. In this case, Thompson’s work was published before Ginsburg’s Contested Lives and therefore created a stage for Ginsburg to organize her ethnographic paper. In Thompson’s “A Defense of Abortion,” she supports the right of choice for a woman going through a pregnancy and potentially an abortion. As suspected, this defense of abortion sparked a lot of criticism and debate over whether a woman truly has the right to abortion, polarizing society into pro-life and pro-choice even more. Thompson claims that most of the debate over this issue stems from the idea that “the fetus is a human being, a person, from the moment of conception (47).” According to Thompson, most pro-life supporters do not draw a definitive line defining when abortion starts to become impermissible.

Thompson goes on to propose a thought experiment involving an unconscious, famous violinist to explain her point (48). The scenario is presented as such: you are the only person that can cure a famous violinist of his fatal kidney ailment, and because of that, the Society of Music Lovers kidnaps you and “plugs” you into the violinist. If you unplug yourself, the violinist will die. Thompson then presents a series of moral questions such as “is it morally incumbent on you to accede to this situation?” (48) She also proposes adding a time frame and asks the reader if their decision to unplug would change if they had to be plugged in for only an hour versus nine months versus 9 years. This thought experiment is meant to parallel the scenario of pregnancy and deciding if abortion is permissible if it is desired. This part of Thompson’s reading highlights the argument between saving a mother’s life versus holding a mother accountable and responsible for supporting a fetus at the start of conception and onward.

Initially, this thought experiment seemed logical, and it was easy to resonate with the analogy. However, there seems to be an issue of oversimplification of abortion and pregnancy, and it can be concluded that there is a lack of emotional attachment in the analogy. A famous violinist does not hold the same value in a woman’s life that a fetus would. A famous violinist also does not parallel a fetus, because a famous violinist is already an established person in society while a fetus only holds potentiality. It is important to note the difference between actuality and potentiality, as the two states hold different values in society. The analogy also focuses on “against my will” scenarios, comparing kidnap to rape or imminent death of a mother during pregnancy. There are other scenarios where a mother may want to consider abortion, and those cannot be paralleled with this thought experiment.

Some questions to consider after reading this work include:

• What could have made Thompson’s argument more convincing? Did the analogy strengthen or hinder her argument?
• How could she have included emotional ties between mother and fetus in this analogy? How could she have addressed other scenarios of abortion besides rape or death?

After reading and analyzing Thompson’s work, we can use it as a background and better understand how and why Ginsburg developed her argument the way that she did. Ginsburg explains that her identity as a “young, unmarried, Jewish, and urban visitor from New York City might pose serious barriers to communication with Fargo residents.” (5) Ginsburg was very clear with the audience while explaining that she was about to communicate with a conservative, homogenous, and secluded town that has “the highest rate of church attendance of any standard metropolitan area.” (4) It is no surprise that Ginsburg’s identity made it difficult for her to understand and communicate with the Fargo residents, as their identity was much different from her own. This underscores the division of ideologies and opinions across the nation and how reactions toward abortion vary, specifically in different areas of the country.

Ginsburg’s ethnography was conducted and written post-Roe vs Wade, and it was interesting to see how strong opinions on abortion were, even after the decision to allow women the right to privacy and choice to abortion. Ginsburg’s short summary on the history and legislation of abortion aided in my understanding of her work, and strengthened her credibility once she started to address her findings in Fargo. Her credibility was also strengthened when she acknowledged that her findings in Fargo might not actually reflect the entire society of the United States, as there are different conflicts and debates going on about abortion in other cities across the nation and at different paces and gravity.

With the background of Thompson’s work explaining the national controversy over abortion, Ginsburg’s anthropological study can build upon it. The abortion debate in Fargo started with the opening of abortion clinics shortly after Roe vs Wade, specifically in 1981. This proved to be a social drama, which included a “sequence of phased conflicts typical of ‘social dramas’: breach, crisis, redress, regression to crisis, and eventually stabilization either through schism or reintegration.”(121) Essentially, after this abortion clinic opened, there were waves of pro-choice support and pro-life support throughout the late 1900s. These waves proved to be a large focal point in Ginsburg’s work, and she sought out narratives from both sides of the debate.

After several interviews and investigations, Ginsburg came to the conclusion that pro-choice women thought inequalities rose from gender discrimination. The pro-choice women believed that the issue could be mollified via economic and political solutions. Ginsburg also came to the conclusion that pro-life women thought opposition to abortion “like other moral reforms, is a gesture against what they see as a final triumph of self interest, a principle that represents both men and the market.” (216) Interestingly enough, it seems that there is an underlying feminist approach from both sides of the abortion debate. All the women that were interviewed assumed the issue of abortion came from gender discrimination and a woman’s identity in society. Ginsburg also points out that there is no socioeconomic role in the difference of opinions from the women in Fargo, as they all came from the same socioeconomic class and all seemed to have the same social identity within the city. This is incredibly important because it shows, once again, that these women are extremely similar yet they have completely opposite viewpoints on the debate. Essentially, it is the ideologies that are in opposition, not the women. Perhaps these ideological differences come from where and how the women are raised.

Overall, it seems that Ginsburg’s goal in this ethnography was to “understand how this grass roots conflict shaped and was shaped by activists’ experiences of self, gender, family, community, and culture in a specific setting.”(6) Ginsburg concludes that the differences in opinion stem primarily from the way a woman’s concern for feminism is manifested, rather than socioeconomic differences or religious differences.

Some questions to consider with this reading:

• How can women with the same inherent goal have polar opposite opinions on the abortion debate?
• Ginsburg suggests that opinions on abortion are due to where and how you are raised. What do you think is the true root to opinions on abortion?
• Ginsburg mentions briefly the role of media in society and in the debate about abortion. Does media portray the pro-life and pro-choice sides in a negative or a positive light, and how does that affect the progress of coming to a solution?

In the most recent centuries, ethical debates have been dominated by Euro-American perspective, which has largely been influenced by the Judeo-Christian religious texts and principals. Swasti Bhattacharyya’s book entitled Magical Progeny, Modern Technology: A Hindu Bioethics of Assisted Reproductive Technology, and Bob Simpson’s article entitled, “Impossible Gifts: Bodies, Buddhism and Bioethics in Contemporary Sri Lanka” attempt to freshen the discourse by introducing Hindu and Buddhist thought and principles. Simpson locates the underlying spiritual influence of donated body parts, including sperm and eggs, and discusses its ongoing implication in modern society. Bhattacharyya advocates for the use of religious language in debates raised within the public sphere, and emphasizes the importance of acknowledging all religious perspectives when working with others in the clinical, university, and legal settings. Together, both of these works use the thoughts of Hinduism and Buddhism to challenge the conventional approaches of ethical discussion platforms and aspire to revitalize an understanding of diverse perspective from that of just passive acceptance of others’ opinions into embracing such variable opinions and religious perspectives as a collective group’s source of strength.   

Simpson’s article observes Buddhist practice of tissue donating as granting a “gift of life”, and further embellishes this topic through discussion of gamete donation specific to Sri Lanki. In the spirit of Buddhist tradition, “the act of giving parts of the oneself keys into deep rooted ideas of merit, rebirth, and public virtue” (Simpson 852). However, in contrast to giving the somatic elements of life, the donation of gametes used for developing life proves to be much more complicated. On the one hand, ova donation from females is generally accepted, as the actual development of the child will still take place in the female. On the other hand, male sperm donation is usually rejected because it must be obtained through masturbation, which is an act generally frowned upon by the public, and the fact that no other genetic material would be available to make the mother’s husband the father, which is an unwanted because that man would raise a child that is not his. Buddhist tradition in Sri Lanki has therefore proven to have longstanding influence on the public’s ethical approach to complex reproductive issues, and the language and symbolism surrounding these approaches have aided the society in dealing with such issues.    

Bhattacharyya’s work stresses the importance of narratives in centering discussion on ethical debates. According to Bhattacharrya, “Stories capture the essence of what it means to be human; as we engage the narratives of the past, we engage the experience and wisdom of those who came before us. Through studying these myths, we gain insights that contribute to our understanding of ourselves, of those around us, and of life” (Bhattacharyya 100). Narratives serve as a guiding force for developing ethical actions in what could possibly be a scenario containing many different perspectives. Therefore, Bhattacharrya emphasizes that there does not exist a single Hindu perspective, but a guided approach that can be applied to many contexts and must be met with personal responsibility to act in favor of the good of society.   

The narrative of the Mahabharata (summarized on page 30) highlights the kinship and reproductive challenges faced by peoples thousands of years prior to modern reproductive technology. Filled with ancient histories and sometimes magical occurrences, the texts raises outstanding questions still present in today’s debate on reproductive technologies, such as, What is the moral status of an embryo or fetus? What measures are ethical to take in cases of infertility? Who are the biological and legal parents in cases of surrogacy? Although these types of questions still largely remained unanswered, the Mahabharata contributes to the debates by first raising the contextual narrative and allowing its readers and listeners to consent to traditions and values present within the story. After, the reader is able to adopt perspective when evaluating the issues put forth, and responsibly act under the influence of and through their own interpretations of the six elements of Hindu thought (summarized on page 63). Ultimately, Bhattacharyya concludes that in regards to reproductive technology, the Mahabharata encourages creativity and supports the utilization of reproductive technologies, while also strongly advocating restraint and limiting the extent to which one utilizes the technology (Bhattacharyya 53).   

Although Judaism and Christianity also derive ethical values from foundational narratives of the patriarchs and Jesus, respectively, these narratives do not embrace differing perspectives nor function as a dynamic and multifaceted tradition like that of Hinduism. Instead, these religions structure ethics as a list of laws to be adopted by every descending generation. Although this type of method may provide a platform of consistency that maintains an articulated understanding of right and wrong throughout generations, one could make the argument that this method fails to channel that understanding into appropriate behaviors within the modern context. Through use of narratives and openness to opinions of such narratives, Hinduism adapts to changing cultural of each generation and recognizes the importance of maintaining dynamic values that can be effectively transmitted to each generation. Rather than marking into stone ethical laws that will shape human behavior, Hinduism values the ability for the humans to shape how they understand and implement the ethics. By keeping grounded on laws that emphasize acting responsibly and for the good of the collective whole, the Hindu tradition can be open to diverse opinions and accept the influence these differences have on answering moral questions.    

Overall, I found both works to be insightful, and thought that both provided excellent support for integrating more diverse religious perspective into bioethical debates. Embracing this diversity would be helpful in the clinical setting for doctors and nurses when interacting with and attempting to clarify medical options. Additionally, embracing diversity would be especially helpful for academic settings that already attempt to integrate complex ideas into a clearer and more unified understanding. However, one question that left lingering for me after reading Bhattacharyya’s work was how exactly Hindu principals could transfer to the legal and public policy setting. My understanding of the reading was that these diverse approaches can exist on the basis that everyone in the society understands and acts in the best interest of the whole society. Though we are a society that embraces diversity, I would think that when writing laws or policy, one cannot assume we always act responsibly or in the best interest of others. So I am left wondering how someone in public policy would transpose these values without necessarily promoting the religion?

Coinciding with our previous discussions on kinship, unplanned pregnancy, reproduction, and prenatal testing—this week’s readings on abortion bring the entirety of our class discussions full circle. Faye Ginsberg, in her book Contested Lives, The Abortion Debate in an American Community, explores the main arguments behind both Pro-Choice and Pro-Life activists in the small town of Fargo, North Dakota. Through extensive research on the national history of abortion throughout the nineteenth and twentieth centuries, Ginsberg is able to take an educated and wholesome view on how abortion grew to be the heated and controversial topic it is today. Further, through years of immersion and ethnographic research, she is able to tell the story of the rise of the abortion controversy in Fargo, which she refers to as a “grass roots setting”. In doing this she attempts to “show how the consciousness of ‘big issues’ is constituted from and in people’s everyday lives” (pg. 61). Finally, through various interviews with pro-life and pro-choice activists she sets out to analyze how their lives and experiences have shaped their perception of the abortion debate and how this reflects in their current activism (pg. 133).

Throughout Ginsberg discussion on the controversial nature of the abortion debate, she establishes three themes of the pro-life movement that have been seen as a result of American culture. First, that abortion is a response to “irresponsible sexual behavior” (pg. 9); this sexual behavior had historically been known to be acceptable among men but extremely shameful amongst women, and thus abortion serves to provide women with a way to cover up their shame. Secondly, that in America we devalue the dependent human. Our devaluation of the dependent person, as a society, is rooted in our view of what it means to live out a normative lifestyle. This affects people like the elderly, the young, the sick, the impaired, and the unborn child. Whether one is pro-life or pro-choice, both sides agree that there is never a perfect time for having children, but that life is not always perfect. Shirley, a sixty-three-year-old pro-life activist, tells Faye a story about how in 1980 her congressman sent her a letter congratulating her on her daughter Jane being teacher of the year. Instead of seeing this as a kind gesture Shirley got upset, in her words “It was very inconvenient to have this daughter…we thought we needed other things besides a child. And had abortion been available to me, I might have aborted the girl who was teacher of the year. What a loss to society that would have been” (pg. 173). Shirley seems to be asking a bigger question that she thinks her congressman, and thus our national policies, is blatantly ignoring by being pro-choice: who has society lost as a result of giving women the chance to choose, especially since—for most women with unwanted pregnancies, there is always a better alternative in the form of abortion. The last theme she explores of the pro-life movement is how our current culture, based on capitalism, globalization and dramatization, is affecting the common person and the trends of society. Most of the women Faye interviews talk of this in light of the work force and how they feared leaving their jobs to be a mother to their children, but Shirley talks about the rise of television drama and the values (or lack of values) that it was instilling in the younger generation of American women.

On the other side of this argument, and one that I would say she delves into much less, is the pro-choice movement. In her research on the national history of abortion in America, Faye found that the legalization was a push that came mostly from doctors; this push came not as an attempt to help women, but as a way to regulate the practice of it and thus put more money into the pockets of doctors qualified to do the procedure. Upon speaking to activists in the pro-choice movement of Fargo, Faye found that the common theme seen among all of them was involvement in the feminist movement—their involvement in this movement helped them to establish their female identities as adult women. One of the women, Janice, talks of her passion to the pro-choice movement as a way to combat the American culture that, in itself, is creating the necessity for abortion: “it’s restrictions on abortion coupled with failure of sex education and a general social milieu that points to sexual activity as some means of personal fulfillment…that leads to the increased rate of unwed parenthood among young women” (pg. 161). This disparity between the health and sex education given to the younger generation and its consequences is a problem that is resolved through abortion. Although her analyzation of the pro-choice movement is supposed to be based on life stories, it instead analyzes in great depth the role of the feminist movement on the pro-choice movement. Feminism is about so much more than womens’ rights for their reproductive lives but many of the women in the pro-choice movement found their ‘adult feminine identities’ through their involvements with feminism. Another woman, Jan, said that she regrets to say that her believe in the pro-choice movement is not based on her disagreeance with the fact that life begins at conception—of this it is assumed she agrees—instead her belief stems from her feminist view that “the very most fundamental right [for women]…is the right to bear children…to not be able to control that single most unique part of us would devastate our entire sense of independence in every other aspect of our lives” (pg. 168).

 

Faye aims to provide a holistic view of the abortion debate in America, although her argument is compelling, I think she fails to really provide an adequate view of both sides of the story. She greatly analyzes the lives and history of the pro-life movement but only skims the pro-choice movement. The majority of her research into the pro-choice movement is instilled in the feminist movement and how that impacted women’s lives. This failure to provide the multi-faceted view on abortion that she set out to provide takes agency away from her and her argument, though does not take away or affect the story she has told and the lives she has let us into.

Lina Du  Week 6

In the era of increasing attention on cutting-edge reproductive technologies, pregnancy is brought into light with Tsipy’s Ivry comparative illustration of the pregnancy experiences within the Israel and Japanese cultures. Through a “contrast-oriented comparative” methodology and ethnographies collected through participant observation and in-depth interviews, Ivry suggests two distinct forms of power structures shaping the perceived responsibilities as well as emotions of ob-gyns, pregnant women, and their partners in respect to pregnancy; she argues that while Japanese take a “environmentalism” approach to pregnancy, focusing on nurturing environment for optimal fetus growth, Israelis are rather fatalistic in a way that more attention is brought to the pre-determined, or genetic qualities of the fetus. It is only through viewing cultures as irreducible and through comparison of the two sociocultural whole could such powerful argument be generated. And within this socio-cultural play of power in these two countries, biotechnology is more or less introduced as a tool, of which it’s fate is determined by the “truth regime” of the culture itself and thus serves to reinforce the already existing cultural notion.

 

Ivry begins her account with doctoring of pregnancy in the Israel culture, raising questions derived from a macro perspective of national policies and statistics, and answering them with her following microscope analysis of the observations and conversations. Ivry represents ob-gyns as “purposeful agents who continuously negotiate and rethink their professional standards of practice among themselves and with their patients.” In other words, they serve as the central roles of this socio-cultural play on pregnancy; rather than informing patients of universal medical knowledge, they pass on certain cultural perceptions to them. The common notion of the “Jewish disease,” and the phenomenon of “hysteria of patients” perceived by the physicians prelude a sense of fatalism and high risk in the Israeli view of pregnancy. When pre-natal diagnosis (PND) is introduced in this country, it is therefore considered as “risk reducing” or even “anxiety reducing” to women, rehearsing the fatalistic ideologies of threat.

 

Presented in similar structure, pre-natal care in Japan focuses on “Gamburu,” or to “make an effort.” Thus, ob-gyns are viewed as the coaches to guide women in developing spirit for pregnancy rather than the directors of genetic tests in the Israeli context. The focus of Japanese culture is to nurture the child with environmental care from the mother, as mothers are viewed as “ohukuro,” or respectable bag of the children. With this perception in mind, premature birth and miscarriage are viewed primarily as the women’s responsibilities. Thus, the introduction of PND, weakening the cultural ideologies of environment with it’s emphasis on genetics, is often treated with lack of enthusiasm.

 

Ivry’s depiction of the direct experiences of pregnant women then add another distinctive layer to the socio-cultural play; women, in this context of power structure, are the receivers, resistors, cultivators of this culture prevalence of “geneticism” and “environmentalism.” Through descriptions about their classes, pregnancy guides, weight record keeping habits, and even the perception of pain, Ivry demonstrates how Japanese women focus on the the maternal-fetal bonding whereas “a range of emotional strategies is used to limit bonding between pregnant women and her fetus (222)” in Israel. Ivry further analyzes the distinction of these culture through gender power dynamics and notions of selfhood and disability. Ivry thus illustrates the schemes on which pregnant women draw to interpret their fetus is similar to that on which medical doctors rely for directions – the agencies shaped by power structure of the cultural ideology as “in the Japanese setting women are caught up in a ‘somatic agency:’ a collaborative enterprise of disciplining their bodies as a form of pleasure and a display of an ethical pregnant maternal self. In the Israeli setting, women are intimidated by the idea of reproductive catastrophe and are caught up in an ‘agency of choice’ and heavy reliance on the use of diagnostic technologies (243).” The cultural ideologies that shape the power structure have permeated the layers of medical professions to the pregnant women themselves, to some extent unconsciously forming their schemes of thinking regarding their pregnancies as well as biotechnologies.

 

With the argument of “Environmentalism” and “Geneticism” presented in the two cultures from a range of perspectives of both the care providers and the care receivers, Ivry reflects on the emotional postures comprehensible in ones’ culture seen in the event of pregnancy. She suggests that a culture affecting pregnancy as well as any biotechnology could be viewed on a spectrum from “Environmentalism” to “Geneticism,” and calls attention to the socio-cultural schemes of thinking regarding biotechnologies, with a focus on pregnancy which adds emotions and powerful meaning to reproductive politics.

 

Unit 5: Kimberly Farmer

Access and Agency in Prenatal Testing

Transitioning from our topics on kinship and reproductive technologies, this week’s readings explore women’s outlook on unplanned pregnancy and the use of prenatal testing. Rayna Rapp’s book Testing Women, Testing the Fetus and “Blessing Unplanned Pregnancy: Religion and the Discourse of Women’s Agency in Public Health” written by Dr. Seeman and colleagues discuss these concepts primarily through the lens of the woman. Together, these ethnographies illuminate the complexity of decisions made after conception and the religious, social, moral, medical, and ethical considerations that accompany women’s decisions and beliefs about reproduction.

Testing Women, Testing the Fetus was the result of Rapp’s extensive research on amniocentesis, or prenatal testing, and the relationship between women and their caregivers. Through interviews with and observation of expecting women, physicians, geneticists, and other professionals, Rapp strives to gain an omniscient understanding of women’s decisions to seek or evade prenatal testing. In addition, Rapp has personal stake in the topic as her study was fueled by her own decision to terminate a pregnancy. Throughout her work, Rapp finds that responses to prenatal testing vary across racial and socioeconomic lines. Rapp writes, “middle-class patients (disproportionately white) usually accept the test while poorer women (disproportionately from ethnic-racial minorities) are more likely to refuse it (168). As Rapp proceeds, she uncovers that there is complexity to this statistic. For example, in two hospitals that each serve low-income areas one, Middle Hospital, had a higher rate of prenatal testing than the other hospital, City Hospital. Rapp explains that, “Middle’s prenatal clinic provides a stable and welcoming environment in which women tend to be very comfortable” while “City Hospital, by contrast, has been a site of struggle over services for many years, and the prenatal clinic is a difficult environment in which to receive healthcare” (169).  This finding of inequity even within the same socioeconomic status brings the concept of access into the discussion. Access to properly funded medical services, professional patient-centered help, and available counseling appointments are crucial factors in determining the prevalence of prenatal testing. In the Dr. Seeman et al piece, the notion of access is furthered by introducing a discussion on agency. The article suggests that access is not always a limiting factor in the prevalence prenatal testing because often times agency is influenced by a spiritual or religious belief that impacts a woman’s view on her pregnancy. The article highlights a group of young African-American mothers in a shelter in the southeastern United Sates. Through interviews and participant observation, the researchers gathered that unplanned pregnancies we not viewed negatively and were actually seen as a blessing leading some to avoid terminating the pregnancy. The authors write that the women in the study, “experienced divine blessing as a kind of life-giving and life-affirming agency beyond their control” (Seeman et al.) which leads them to reject family planning models. This shows that even with access and education about ending pregnancies, a woman’s outlook on the pregnancy, be it a blessing or not, influences the type of treatments or procedures they may undergo.

These two readings attempt to explain the complexity of a woman’s decision regarding her pregnancy. I found the Dr. Seeman et al article to be particularly interesting in the way that it described how an unplanned pregnancy is a way of enriching a woman’s life in the sample population. As a human health and sociology major, I wonder what other societal factors could be responsible for such a finding—particularly that African-American women are able to find comfort in things that are out of their control. African-Americans and individuals of low socioeconomic statuses are often at the mercy of things outside of their control, be it inner city pollution, high unemployment rates, institutionalized racism or an overall lack of power as suggested by sociology’s Conflict Theory. Essentially, in order to survive these women are forced to accept things outside of their control. I wonder if we could view the women in the study’s acceptance of a pregnancy out of their control as an extension of a survival mechanism used in everyday life rather than a religious barrier that limits agency.

Overall, from these readings one can see that the responses to a woman’s pregnancy are not clear cut nor homogenous across demographics. In addition, the concepts of prenatal testing and unplanned pregnancies cannot be understood without addressing societal, religious, moral, medical and ethical implications. Mothers are the ones burdened with the duty of weighing each of these obligations in order to make the best choice for herself, her family, and her child.