Religion and Healing Spring (WR) 2018

With a unique ‘inside, outsider’ perspective lens, Susan Martha Kahn explores the connection between rabbinic beliefs about kinship and reproductive technologies in the context of an overarching Rabbinic kinship cosmology. Through ethnographic study conducted in IVF clinics, hospitals, and support groups for unmarried women in Jerusalem, Kahn delves into the overlap between the secular and religious uses of reproductive technologies (ovum donation, artificial insemination, in-vitro fertilization) and examines how rabbinic kinship beliefs paved the way for unmarried Jewish women to make use of these technologies. Furthermore, she examines the legal discourse that depicts Jewish women’s bodies as reproductive resources to warrant the use of these technologies (Kahn 2).

Through interviews and participant observation Kahn explores the dominant Jewish Israeli view on IVF practices. Reproductive technologies are allowed and even encouraged as a means of furthering the Jewish bloodline and realizing God’s command to multiply. Reproduction is an “imperative religious duty,” sanctioned by the very specific economic, political, social, and historical contexts that have given rise to the use of new reproductive technologies as a way to satisfy that duty (Kahn 3). Kahn captures this overarching sentiment through her interviews, “If you’re not a mother, you don’t exist in Israeli society” (9), as stated by a social worker at a fertility clinic in Jerusalem. I personally felt the language surrounding this supposed “duty of woman” to be a bit reductive. It seems the legislation and general attitude toward these Jewish Israeli women reduces them to their baseline femininity, minimizing them to their reproductive capacities. As a non-practicing Jewish-American unmarried woman, Kahn has a unique outsider and insider perspective that allows her to conduct her ethnography from a removed yet group-accepted stance. Nonetheless, she may be subject to some semblance of personal biases, as the societal expectations she faces (or rather, does not face) as an American non-practicing Jew, vary greatly in comparison to her devout Jewish Israeli counterparts.

With our class last week in mind, in which we explored the two Genesis creation stories presented in the Hebrew English Tanakh, it must be noted that the commandment to multiply isn’t actually presented as a commandment. Interestingly, justification for the usage of reproductive practices in Israel are founded on the basis of this (supposed) command. Given that most Israelis communicate in Hebrew, one would assume the Israeli Jews featured in this ethnographical study have read the direct Hebraic version. In the first book of Genesis, “God created man in His image, in the image of God He created him; male and female He created them. God blessed them and God said to them, Be fertile and increase, fill the earth and master it” (Genesis 1.14 line 28 as cited in the Hebrew English Tanakh). Here, this excerpt states that man and woman receive the ability to procreate as a blessing, rather than an obligatory command.

Throughout Kahn’s ethnographical account, a hierarchical ordering of values is present: the need to follow the command to reproduce outweighs the social value of maintaining a normative, nuclear household. Kahn states, “…unmarried Israeli women who have conceived children via artificial insemination can be understood to preserve the honor and prestige of the traditional family at the same time that they comply with the dominant ideology of the family as the center of social life”(45). It seems here that the traditional family style- consisting of two biological parents- is ranked as not as important when considering ideals to strive for, so long as an unmarried Jewish woman is making use of her reproductive capacities in an effort to further the Jewish population and fulfill that specific duty as procreator.

When faced with the topic of reproductive technologies, Michael J. Broyde employs a case-by-case evaluative approach, modeled after the same approach emphasized by those who follow Jewish law, halakhah. While evaluating the case of cloning, Broyde references a duality often found in Jewish thought: on one hand, an obligation for individuals to help those in need, coupled with the command to reproduce, encourages the use of reproductive technologies to reach that end goal of reproduction. However, Jewish law also warns of the “slippery slope” people encounter when they attempt to medal in things out of their scope, as some things are better left in God’s hands. It is worth noting that both Broyde and Kahn reference a moral imperative to reproduce as a core justification often employed to warrant use of reproductive technologies. After a series of analyses regarding cloning, Broyde reaches the bottom-line conclusion that within the Jewish faith, cloning is ultimately a form of “assisted reproduction” (Broyde 296), situated in the same category as other reproductive interventions such as artificial insemination or surrogacy. Cloning is a permissible reproductive interventionist approach, save for the few cases in which a rabbi may override its usage. As seen in the Kahn reading, it appears that the Jewish moral imperative of reproduction trumps controversy regarding reproductive technologies, justified by the Jewish commandment to multiply. Broyde’s discussion of cloning, as viewed by halakhic law, adds to Kahn’s ethnography by detailing verdicts on specific nuanced circumstances in which parenthood may come into question. I found the discussion on gestational mothers (Broyde 316) particularly interesting, as Jewish law would consider the woman who births a child as the proper mother, despite a genetic difference (in the case of surrogacy).

Don Seeman highlights the need to add cultural contexts into the discussion on reproductive technologies. While examining whether a new medical technology is deemed ethical or not, one must closely consider the context in which interpretation occurs, referred to as a “hermeneutic strategy” (Seeman 342). In order to examine how different communities respond to the question of these technologies, we must consider the interpretative variance between communities (Seeman 340), cultural nuance, and lived experience (Seeman 357).

I found Seeman’s discussion of what is “natural” as a foundation to secular law as quite thought provoking. “Natural” as a foundation to law, in the case of France (amongst other nations), invokes the question of the natural as a secular idea. Perhaps, what is envisioned as natural is simply playing off of biblical notions of the “natural” family unit (heterosexual couple and their children) and may not actually be “natural” to us. In line with this thinking, I pose the question: what is truly natural about this nuclear family unit?

The theme of birth mothers as true mothers appears in this text well, similar to the discussion explored in Broyde’s text. Jewish law “…makes no provision for the formal transference of maternal identity from a birth mother to another woman-the birth mother remains the mother for many halachic purposes no matter who may raise the child…” (Seeman 342). However, it seems there is example of a biblical instance in which pseudo-surrogacy is employed in Genesis 16, yet the child produced does not end up belonging to the gestational mother. Here, Seeman highlights the variance in hermeneutic interpretation of a biblical passage, as many scholars of Jewish thought have chosen to selectively ignore this passage, as they feel halakhic law supersedes this biblical account.

Seeman’s inclusion of this passage from Genesis 16 serves as a means of elucidating the widespread, age old preoccupation with reproduction and reproductive technologies, present in a myriad of cultural contexts. Responses and preoccupations with reproductive technologies can only be understood within the distinct social context in which these issues arise. Often the question of kinship- which is regarded differently in each culture- plays a significant role in how reproductive technologies are employed or disregarded. Ultimately, answers to the question of reproductive technologies are inextricably tethered to social reproduction, not simply biological, contrary to beliefs Western minded individuals may assume because we typically rely on biology/bloodlines as a means of determining kinship.

For multiple centuries, there has existed a conflict between religion and science. This conflict has led to multiple debates concerning the influence of religion and science in politics. Specially, these debates have influenced laws pertaining to the use of technological intervention in the process of procreation. Looking at the King James Bible, some see these cosmological and metaphysical questions as being straightforward. The bible is a collection of texts that are at the heart of the Jewish and Christian religion. These texts are designed to explain various topics such as life, death, and social issue. The first chapter, Genesis, sets the stage for the opinion of some religious beliefs. This chapter known as the “creation story” begins directly by stating “In beginning, God [‘elohim] created the heavens and the earth” (Ball, 2000). This one sentences summarizes the entire story. At the center of this story, we are presented a major point: the claim that God, a divine being, is the creator of all things, and without him, life would not be possible. At the same time, this statement story denies any “alternative of generative beginnings” (Ball, 2000).

Cosmological beliefs, such as the ones above, have been incorporated in the various foundation of multiple countries and family’s structures. Any threat to these cosmological beliefs is viewed a threat to the foundations of the social structure. Starting in the 18^th century, The Enlightenment Era led to a rejection of traditional, social, political, and religious ideas. This new way of thinking continued and expanded into the twentieth and twenty-first century. With this new way of thinking brought extreme opposition from more conservative thinkers that have very strong cosmological views. Looking at, Nan t. Ball’s article, The Reemergence of Enlightenment Ideas in the 1994 French Bioethics Debates, and Shanon, Thomas A. and Lisa Sowle Cahill’s article, Religion and Artificial Reproduction: An Inquiry into the Vatican Instruction on Respect for Human Life in its Origin and on the Dignity of Reproduction, one can understand the moral questions raised by technical intervention on human reproduction. These articles help to show how the  complex relationship between science, religion, and politics are heavily dependent on the cultural description.

In Dr. Ball article, she “argue that the action of the Constitutional Council is but one example among many of the ways in which form and language of the legal debates surrounding art in France echo enlightenment ideas. Close analysis of the of the 1994 French bioethics debates suggests that Enlightenment polemics about the interrelationship between family, nature, and society provided much groundwork for those debates” (Ball, 2000). These bioethical laws allowed only individuals no able to produce children, heterosexual couples of age to procreate, and married to use artificial insemination and in IVF procedures.  Both the church and the government in France condemned the use of this technology because it allowed homosexual couples, virgins, and postmenopausal women to have children. Many groups saw ART as a threat to the traditional heterosexual family structure.

Similar to Dr.Ball’s article,  Shanon, Thomas A., and Lisa Sowle Cahill’s article addresses many of the same issues pertaining to technological intervention in the human reproductive process. She addresses three main issues.  First, she explains human beings from the first moment in their existence (Cahill et al, 1988). There are various opinions about qualifies “as a person”. Is it when the ovum is fertilized? Is it when the baby is born? These questions play an important role in the debate of ART. The Catholic Church believes “From the time that the ovum is fertilized, a new life begins” (Cahill et al, 1988). Due to their interpretation of the start of life, one can see their views on certain ART. Next, she explains the moral questions raised by technical intervention on human procreation and some orientation on the relationships between moral law and civil laws. These sections show the various contradictory opinions concerning the use of specific technology in human procreation. Due to various opinions, one cans understand why there is not one simple explanation on how to regulate the use of specific technology that  help with procreation.

“Thick Description: Towards an Interpretative Theory of Culture” – Clifford Geertz

Clifford Geertz, one of the most influential cultural anthropologists in the U.S., applies his knowledge and anthropological foundation  to science and the nature of evidence. I found this reading quite challenging to follow as it was dense, detailed and used relatively complex language. Ultimately, there were two main points I got from this reading:

First, Geertz emphasizes ethnography as the crucial method of anthropological analysis, allowing for the development of theories and large-scale ideologies. From one point of view, ethnography is “establishing rapport, selecting informants, transcribing texts, taking genealogies, mapping fields, keeping a diary, etc”. From Geertz’s point of view, ethnography lies in “thick description”. Borrowed from Gilbert Ryle, Geertz defines thick description as the meaningful structures behind what is being observed. Anthropological research also heavily relies on the interpretations of the ethnographer and how they perceive the culture of others, because “understanding a people’s culture exposes their normlessness without reducing their particularity” (pg. 14). Essentially, anthropological writings are interpretations and Geertz believes the best ethnographies are those full of “thick descriptions” that “take us into the heart of that of which it is the interpretation” (pg.18).

Ethnographic studies are typically conducted on very small scale – focusing on a single group of people in a small village or neighborhood. This is the problem that surrounds Geertz’s second point. There exists a methodological issue involving the microscopic nature of ethnographic research. Geertz denounces the “Jonesville-Is-America writ small” and the “natural laboratory” and instead believes that the important part of ethnographic findings is their complex specificness and realness. This allows for previously discovered facts to be mobilized, previously developed concepts to be used, and previously formulated hypotheses to be tried. In other words, the material produced by long-term, qualitative, highly participative studies allow anthropologists to build upon previous research and develop larger-scale theories about human nature. With this, “the aim is to draw large conclusions from small, but very densely textured facts to support broad assertions about the role of culture in the construction of collective life by engaging them exactly with complex specifics” (pg. 28).

 

“Does Submission to God’s Will Prevent Biotechnological Intervention?” – Sherine F. Hamdy

Hamdy’s ethnographic account delves into the ethics and and opinions surrounding organ transplantation in Egypt among religious leaders, physicians, and patients. Kidney transplants have been conducted for over thirty years in Egypt, even in the absence of any legal framework or a national organ donation program. Because of this, patients resort to purchasing organs on the black market or receiving live donations from friends or family. Despite the fact that almost all religious scholars, Muslim and Coptic Christian, have declared that organ donation is permissible, many patients with religious convictions struggle with the ethics behind the practice. Hamdy primarily reveals this struggle through interviews with two dialysis patients, Muhammad and Ali,  both of whom would benefit greatly from a kidney transplant but refuse to undergo the procedure. These patients did not believe that their religion prevents them from seeking beneficial treatment. Alternatively, they would rather die, ultimately meeting God, than be responsible for causing a family member harm (from the donation procedure) or be responsible for putting their family in debt (from purchasing an organ).

Hamdy’s primary argument is that “religious sentiments, should not be seen as passive, as anti-science, or as constraints to medical treatment” (pg. 156). Patients around the world learn to balance how to achieve the greatest benefit for themselves and their families, while simultaneously conforming to God’s will. This opposes the common perception that religious fatalism, or the notion that humans can exert little or no control over their own destinies, obstructs people from pursuing biotechnological intervention. In response to this, Hamdy says:

“To assume that religious practitioners refuse particular technologies or medical interventions because of their fatalism carries the dangers of missing the contingencies that inform when and under what conditions patients work to achieve this disposition.” (pg. 156)

It is important to understand all of the factors that play into a patient’s decisions on whether or not to undergo medical intervention. This can be extremely complex and highly variable, depending on the patient’s changing circumstances. Before a decision is made, patients must calculate their ethical disposition towards a particular treatment and assess its benefit and harms, while incorporating their understanding of the disease etiology and their specific experiences of the illness. The key idea here is that these conditions are not separate form, nor do they determine, the patient’s disposition towards divine will.

About the Author: Sherine F. Hamdy is an anthropologist who focuses on medical anthropology and science and technology in the Middle East. This paper seems to be written for an academic audience, but I think it could easily be read and understood by the general public.

My Thoughts

As an anthropology major, I have read a number of ethnographies on various topics, but I have never considered regarding them in the way that Clifford Geertz suggests. I often get lost in the specifics of the ethnographer’s research, losing the connection to the bigger picture. With Geertz’s ideas in mind, I read Hamdy’s article with a totally new perspective. The dichotomy between religious beliefs and modern medicine extends way beyond organ transplantation in Egypt but without Hamdy’s research on the specific troubles of Muslims in kidney failure, I would miss insights on how religion plays a positive role in medicine for some patients. Ultimately, understanding how religious tradition fits into a patient’s life can help our comprehension of ethical formations in devout patients’ lives (Hamdy, 157). Without small-scale ethnographies that are full of “thick description”, we would not gain the essential insight necessary to better this understanding.

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