Module 6: Public Policy and Human Dignity by Caroline Olson

Introduction

  This module explores the intricacies of human cloning technology. The two major readings for this week cover two separate approaches to this topic: a very formalized review of the ethics of cloning from an American committee for the purpose of legal recommendation and a less formal, but wonderfully rich account based on Jewish ethics. Reading both of these was very helpful in order to see a depth of response and the raising of different issues. There were topics covered in both that were not covered in the other, simply due to the intention of the writing and the cultural context of the document. The other readings which I focus much less on, revolve around who should be empowered to make ethical decisions in our society.

Human Cloning and Human Dignity by Leon Kass

In this lengthy, but digestible work, Leon Kass and other members of the President’s Council on Bioethics lay out in a very explicit way the entire concept and ethical debacle of cloning, from its history to its scientific uses to policy recommendations. It could be- and probably is- considered an American roadmap to cloning. Though it provides a number of policy recommendations for each use of embryos, the document provides a wide range of both pros and cons to each. This made the article overwhelming in a way because it was constantly switching sides, and I felt like my moral compass took a small (but fascinating!) beating in reading so many consecutive, well-developed arguments. In reading through such an immense and morally murky subject, I found  the abundant discussions of terminology, context, and cases to be extremely helpful. 

Ultimately, the council unanimously agreed on very little except that the act of cloning-to-produce-children should be prohibited due to technological underdevelopment and inherent moral issues. To clarify, “underdevelopment” meaning that when this was written in 2002, there was a 90% failure rate among offspring produced through cloning (Kass 20). It led me to wonder if in today’s world (17 years later), where genetically-edited humans have already been accomplished, great technological strides have been made, and use of biotechnology has become much more entrenched in society, a council would come to the same conclusions. This reading really emphasized the ethical gauntlet that cloning creates. The dilemmas that most provoked me were issues of individuality, how far we should go to help those who are ill, and how allowable the manipulation of some human beings to help others is. This was a wonderful, though morally taxing, read, especially when followed by the subsequent reading.

“What’s So Bad about Human Cloning?” by Yitzchok Breitowitz

In this article Breitowitz confronts the issues of human cloning through the lens of the Jewish faith. In this work, the author introduces us to the construct of technology and man in the Jewish tradition, then continues to address the benefits and subsequently the many issues he finds with cloning. He, first, richly describes the tensions between humans’ autonomy in making the world in the image of God and being submissive to the “wonder of the Divine” (Breitowitz 327). He justifies the autonomous use of biomedical technology by, first, describing that the Torah fully supports medical intervention, then continuing by saying that “we are, as it were, collaborative partners with the Divine in improving the world, in conquering illness, and in trying to make the world better for others” (326). Then, he shows how in Genesis Chapter 2 men were made from dust and charged with the preservation of world order. The author deftly shows how the Jewish faith in a modern society must “walk a tightrope, to achieve a precarious balance between two alternative, but complementary visions of human beings…” (328). 

I found Breitowitz’s analysis of this tightrope very balanced indeed. The author is supportive of cloning for the opportunities it provides parents to viably reproduce and the benefits it has for organ and tissue donation to help those in need. Keeping his practicality about him, he then turns his attention to the allocation of this technology, which he determines is, in itself, an ethical dilemma. There is not yet a fair way to determine eligibility and equal access to either reproductive cloning or cloning for the intention of donor products; neither a market, nor lottery system make any ethical sense. He emphasized that with the advent of eugenic technology, reproductive cloning becomes hazardous moral ground when considering some people value some genetics and types of lives more than others. The other section of this work I greatly appreciated was the analysis of the psychological burden of being a clone. I personally feel that uniqueness and individuality are an inherent part of the human identity (at least in the American culture) and that that quality of a unique human should be preserved. I’m also entirely aware that I am a product of my own culture and that the “individuality, autonomy, and self-expression” he mentions are fundamental rights that should be afforded, uninhibited, to all (336). Ultimately, he beautifully wove the Jewish narrative with a modern discourse on cloning. 

My favorite part of this article was his brief discussion of predetermination of behavior based on genetics versus autonomy and free will. Will clones be their “own” person with their  “own X-factor,” as he calls it (337)? He believes they will, stating that a clone of Hitler could become another Mother Teresa (338). Although I’m a believer in choices and the relevance of environmental factors, I think the tension created between genetics and autonomy is endlessly fascinating. 

Considering Both Sides

I truly enjoyed reading from two totally opposite cultures. Both articles were cognizant of the benefits and problems of cloning and, in my opinion, not too forceful with any one view.  Though less comprehensive, I favored Breitowitz’s article due to its straightforward, coherent writing style; I felt less battered at the end of it with the same amount of provocation. Both viewpoints really emphasized the same themes of what good cloning could do for the world, the limits vs. expanse of human technology, and the impact on society as a whole. I think the main contrast is that America’s ethical mode of thinking seems to be determined in a more legal way, compared to the Jewish culture, which relies upon its ancient texts to be contextualized in a modern environment.

Other Readings 

-“Reflections on Public Bioethics: A View from the Trenches”  : This article offers a frank, in-depth look at the President’s Council on Bioethics, including the details to how they were chosen, what tasks they were charged with, and the projects they undertook. 

-“The New Conservatives in Bioethics: Who are they and what do they seek?”  : An intriguing look at the “new conservative” bioethicists who in this author’s opinion cloud logic with emotion in order to oppose all forms of biotechnology. 

-“Not Just for Experts: The Public Debate about Reprogenetics in Germany.”  : This reading covers the link between ethics and policy in the German culture. The author describes how the two American “camps” of thinking (techno-optimists vs. techno-skeptics) are much more convoluted in Germany, due to its tragic history of employing eugenics at a large-scale.

References

– Leon R. Kass, Human Cloning and Human Dignity (President’s Council on Bioethics, 2002).
– Yitzchok Breitowitz, “What’s So Bad about Human Cloning?” Kennedy Institute of Ethics Journal (2004): 325-341.
-Leon Kass, Reflections on Public Bioethics: A View from the Trenches,” Kennedy Institute of Ethics Journal 15 (2005): 221 -250. 
-Ruth Macklin, “The New Conservatives in Bioethics: Who are they and what do they seek?” Hastings Center Report 36 (January-February 2006), pp.34-43.
-Kathrin Braun, “Not Just for Experts: The Public Debate about Reprogenetics in Germany.” Hastings Center Report 35 (2005): 42-49.

Module 6: Public Policy and Human Dignity: Liza Stapleford

The readings for this week cover a full spectrum of perspectives on the topic of the bioethics of human cloning.  While previous modules have frequently focused on contrasting views from authors with different religious beliefs or countries of origin, this week’s readings primarily focus on authors within the United States who span different regions of the socio-political spectrum.  Although authors like Leon Kass[1], Ruth Macklin[2], and Kathrin Braun[3] assert that bioethical positions are not necessarily tied to political philosophies, I was not convinced by their arguments.

 

Regardless of one’s perspective on how closely bioethics is tied to religious or political beliefs, the arguments for or against human cloning tend to revolve around similar core themes.  As Yitzchok Breitowitz points out, we as a society must weigh the costs and the benefits of cloning.[4]  In their report “Human Cloning and Human Dignity,” the President’s Council on Bioethics spends over 300 pages detailing the ethical arguments for and against human cloning.  Despite devoting hours and hours to discussing and writing about the topic of human cloning, the President’s Council remained “divided on the ethics of embryo research.”[1]  Perhaps the root of the division, is not an ignorance of the many costs and benefits of human cloning, but merely a different opinion of how much weight to give each of these factors.

 

The defense of human cloning mainly focuses on its potential for relieving human suffering.  That may include the emotional suffering of an infertile couple or single individual who desires to have a child.  Cloning may directly impact physical suffering by providing a source of genetically matched tissues for transplantation for a sick child or adult.  The President’s Council on Bioethics delves even deeper into the more indirect benefits of cloning in the field of biomedical research.  Their report details the potential benefits of this type of research, including increasing understanding of disease, developing novel treatments for disease, and progressing the field of gene therapy.

 

The arguments against cloning include the more immediate effects on participants as well as the downstream impact on society.  Regarding the immediate effects of human cloning, two of the major concerns are safety and efficacy.  As both Breitowitz and the President’s Council on Bioethics remind us, the past animal cloning experiments have frequently yielded non-viable animals or those with severe deformities.[4] [5]  Breitowitz also discusses the potential psychological stress that might arise for a cloned individual, who perhaps was born into a set of unfair expectations due to their pre-determined genetics.[4]  The President’s Council mentions similar concerns for cloned individuals in regards to issues of identity and individuality.[5]  The more far-reaching, society-level concerns are the exploitation of cloning for profit and eugenics.

 

In her discussion of the ethical debate regarding reprogenetics in Germany, Kathrin Braun details the extent to which the history of the Nazi party in Germany has impacted policy decisions regarding reproductive and genetic technologies.[3]  The reality of their country’s past has left many Germans determined “not to be the sort of people who distinguish between a life worth living and a life not worth living.” [3]  The past has so strongly influenced the present that German law has made abortion illegal and created stringent limits on the use of embryos for research or reproductive intent.

 

Braun and Macklin examine the subject of bioethics more broadly and offer their opinions on the types of people and groups who comprise the different sides of the debate on genetic research and cloning.  Macklin argues that the traditional labels of conservative and liberal are somewhat meaningless in bioethics because many “liberals” would oppose artificial technology and many “conservatives” should support the biotech and pharmaceutical industries that stand to benefit from technology.  However, despite her argument that labels are not applicable, she goes on to criticize conservatives for not fighting fair by using “poetic language,” appealing to “emotion,” and being “mean-spirited.”[2]  Meanwhile, the liberal bioethicists, a group amongst which she includes herself, have far nobler goals of reducing disparities and fighting for social justice.

 

Some of this module’s readings remind me of political debates where each side claims to be unbiased and interested in compromise, but the viewer ends up feeling like neither side is being truly forthright.  I’m left wondering if the President’s Council on Bioethics was truly non-partisan, or merely a reflection of the views of a conservative president and a conservative chairman.  Macklin’s article eerily brings to mind the aftermath of the most recent presidential election, where liberal academics were left dumbfounded by the results.  Ironically, I think the most balanced discussion of cloning comes from Breitowitz, who is writing purely from a Judaic perspective.  Rather than trying to convince the reader that he is unbiased, he states his perspective clearly in the first sentence.  As opposed to criticizing those who may think differently, he simply goes about examining all sides of the issue from his Judaic perspective.

 

I think bioethical discussions need to include both science and morality.  Dismissing moral or faith-based perspectives serves to increase the divide between academia and the general public as well as the divide between different faiths and moral viewpoints.  I am also skeptical of any field where the experts see themselves as far superior to the general public, such as Braun’s claim that job of bioethics is “educating the public and correcting public opinion – of making public opinion rational.”[3]  This assertion has some dark undertones when viewed in light of Germany’s past.  I do not have an answer to the human cloning debate, but these readings have convinced me to seek further information by studying scientific and religious perspective texts as opposed to those authored by bioethical experts whose motives are unclear or political.

 

  1. Kass, L.R., Reflections on public bioethics: a view from the trenches. Kennedy Inst Ethics J, 2005. 15(3): p. 221-50.
  2. Macklin, R., The new conservatives in bioethics: who are they and what do they seek? Hastings Cent Rep, 2006. 36(1): p. 34-43.
  3. Braun, K., Not just for experts: the public debate about reprogenetics in Germany. Hastings Cent Rep, 2005. 35(3): p. 42-9.
  4. Breitowitz, Y., What’s so bad about human cloning? Kennedy Inst Ethics J, 2002. 12(4): p. 325-41.
  5. The President’s Council on Bioethics: human cloning and human dignity: an ethical inquiry–executive summary. Issues Law Med, 2002. 18(2): p. 167-82.

 

Module 5 Inventing Bioethics – Elizabeth Lee

Dr. Seeman’s Ethnographic Triangle: Social Structures and Cultural Features

I read and watched Swasti Bhattacharya’s Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology, Michael J. Broyde’s “Modern Reproductive Technologies and Jewish Law,” in Marriage, Sex and the Family in Judaism, and the film Made in India in the listed order. Initially, after reading Bhattacharya’s book and Broyde’s “Modern Reproductive Technologies and Jewish Law,” I found myself leaning more towards the social structures and the cultural features corners of Dr. Seeman’s ethnographic triangle towards understanding the various religious perspectives on assistive reproductive technology. Religions shape many social structures and cultural features of most societies.

Bhattacharya starts off laying an overview that Hindu sacred teachings are effectively passed down through oral and textual traditions, and religious teachings like these play a huge role in societies. Hinduism is a religion that can be defined as polytheistic or monotheistic depending on different perspectives. Regardless of how Hinduism is defined by different followers or scholars, a multitude of traditions and numerous gods are present that provide a guideline for how individuals function, communicate, and make moral decisions.

Specifically, the story of Mahabbharata, as described by Bhattacharya, is of great significance to Hindus. In this story, the Kauravas (Dhrtarastra’s one hundred sons) and the Pandavas (Pandu’s five sons) are in a constant fight for the throne. The eldest Kaurava, Duryodhana, comes up with various schemes to prevent the success of Yudhisthira (eldest Pandava) and his brothers, and they end up commencing a war. Although the Pandavas win, everyone dies except for one embryo, the grandson of the third eldest Pandava. Yudhisthira and his family end up in hell, while Duryodhana and the Pandava brothers were in heaven. However, after purification, the Pandavas also attain moksa, which is commonly understood as enlightenment and liberation.

In Sanskrit, the title of this story, “Maha” and “Bharata” means “great/complete” and “Indian/human” in following order. Thus, it serves as an origin story for the that can bring Hindus into salvation. From Mahabhrata, Bhattacharya identifies six elements relevant to the discussions of gametes, IVF, and surrogacy:  “1) an emphasis on the centrality of societal good; 2) a firm belief in the underlying unity of all life (Advaita Vedanta); 3) the expectations and requirements of dharma; 4) the multivalent nature of Hindu traditions; 5) a theory of karma; and 6) a commitment to ahimsa (no harm)” (Bhattacharya 113). Thus, Mahabharata serves as an origin story for many Hindus.

Additionally, Bhattacharta mentions multiple perspectives on assistive reproductive technology. He claims, “Responses within Hindu traditions also vary. As discussed in chapters 3 and 4, the attitudes expressed in the examined narratives of the Mahabharata would presumably support John and Luanne’s use of donor gametes, IVF, and surrogacy. However, we cannot say it enough: Hindu perspectives are neither simple nor monolithic.” (Battacharya 1222) Another perspective he mentions comprehend assistive reproductive technologies as abusive towards women, so it’s not the technology that is impermissible but the role of women that corresponds with it because it disagrees with the sixth element, a commitment to ahimsa (no harm) (Bhattacharya 1229). Although different applications of these six elements cultivate differing perspectives on permissibilities of reproductive technology, the significance and inevitable presence of these six elements remain the same because Mahabharata serves as an origin story. With Mahabharata, I became more aware of the inevitably significant roles religions play that impact the social structures and cultural features, thus perspectives of societies on assistive reproductive technology.

Similar to Bhattacharya, Broyde lays out different perspectives on assistive reproductive technology under the same principles of Judaism. Bryode’s article focuses on the case of cloning. Even though in the Jewish tradition, reproduction is an obligation, a number of halakhic doctrines restrict sexual activity. Reproduction itself could be perceived as controversial. Broyde discusses different cases regarding the permissibility of cloning. For instance, Broyde suggests that cloning could be permissible if the genetic makeup of the child born from a gestational mother is identical to the genetic makeup of the donors (Broyde 298). There seems to be no substantive violation of Jewish law that occurs during cloning, yet people are skeptical about it and arguments stating the cloning is not permissible exist.

As exemplified by both Bhattacharya and Broyde’s analyses, there are many gray areas that lie within the religious principles of both Hinduism and Judaism. These ancient religions don’t specifically indicate the permissibility of assistive reproductive technology but do provide guidelines that shaped social structures and cultural features of societies. Therefore, there will be contradicting views on assistive reproductive technologies. Followers of these religions may have different interpretations of religious guidelines and principles, but the significance of these guidelines and principles remain the same for followers regardless of their perspectives.

Dr. Seeman’s Ethnographic Triangle: Lived Experience

From reading Bhattacharya and Broyde, I initially  put more weight on social structures and cultural features corners of Dr. Seeman’s triangle in understanding different perspectives on assistive reproductive technology and the how different interpretations cultivated such different viewpoints. However, Made in India brought into consideration the lived experiences corner of the ethnographic triangle.

Made in India portrays Lisa and Brian’s journey in hiring a surrogate from India with help from an organization called Planet Hospital. Even after the multiple contracts were signed, the surrogate, Aasia Khan, successfully got pregnant for nine months and gave birth to Lisa and Brian’s twin girls, Lisa and Brian were not able to have custody of the girls because legal regulations on international surrogacy were not yet established at the time. Eventually, Lisa and Brian were able to take their babies back to the States after DNA testing and many documented papers with help from the US embassy in India.

One thing I found interesting was the fact that Aasia was ashamed of and hid the fact that she was a surrogate. Instead, she told the people surrounding her that she was pregnant with her husband’s child and was planning to gift the baby to her sister. Aasia even converted from Hinduism to Islam.

Looking at Aasia struggles through the lens of social structures and cultural features of India, surrogacy does not seem to be accepted or scientifically understood well by the Indian society. But is it bad that she is going against the norm?

If we look at Asia’s case through the lens of lived experiences from Dr. Seeman’s ethnographic triangle, she is making income for her family and her own well-being through this process. Lisa and Brian are also benefiting off of this process as they had trouble reproducing on their own and were not able to afford surrogacy within the States. Though there were issues with Planet’s Hospital’s financial distributions as well as legal issues because surrogacy regulations were not yet established, no one was directly harmed in the act of surrogacy itself.

Made in India deepened my insight on assistive reproductive technology beyond the significance of religious principles that shape social structures and cultural features that Bhattcharya and Broyde’s taught me. It added a third dimension of lived experiences, specifically the aspect of choice, to the ethnographic triangle narrative with real life examples. In the case of Made in India, Aasia made the choice to become a surrogate and chose to convert to Islam. Lisa and Brian also made the choice to utilize the IVF and surrogacy technology during the time when international surrogacy regulations were not yet established. Social structures, cultural features and interpretations of traditions do no matter in world of applying assistive reproductive when a pioneering choice is not made.

Conclusion

In conclusion, I agree with Bhattacharya statement in the beginning of Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology that dynamic conversations are cultivated through the considerations of diverse perspectives and that plurality and endedness are demonstrated through these conversations. I believe these heated discussions, regardless of what perspective, should continue so that more diverse religious perspectives that were once surpassed by secular, universal and philosophical voices marginalized by primarily Christian traditions could have a loud voice in academic discussions and a big influence in clinical and public settings. Also, especially after learning about lived experiences and the importance of choice from Made in India, I think that it is of high significance to establish, change, and raise awareness of regulations that are at the same pace with the modern day heated discussions cultivated by diverse perspectives.

Module 5: Adrienne Lodise

“A Baptist, a Catholic, a Muslim surrogate and a Hindi doctor” (Made in India)

Medical tourism observed in this documentary embodies only some of the intersectionality seen within reproductive technologies. The aforementioned quote relates to a small category of cross sections represented by such a pregnancy. This medical venture involves people from various religions, cultures and social classes and these dissimilarities create unique dynamics which are investigated throughout the movie.

The movie follows the journey of an American couple, Brian and Lisa who have been unable to conceive a baby. After seven years of various attempts, they decide to explore surrogacy. Unfortunately, the commission of surrogacy in the U.S. is beyond their financial means. Lisa then learns of the possibility of cheaper reproductive technology in India.

Eventually they make the trip to have Lisa’s eggs harvested, fertilized, and implanted into a surrogate, Aasia. During Aasia’s pregnancy, Lisa and Brian find themselves becoming spokesmen for this type of medical tourism.

As Brian is reading some of the online backlash, he encounters a common argument often used during ethical conversations regarding reproductive technologies, why not opt for adoption rather than IVF and surrogacy? His response is simple, “that is placing the whole orphan issue on infertile couples.” While I think his response is a touch hyperbolic, I found myself agreeing with the basic principle. Moreover, Brian’s response made me think of Jewish law outlined in Michael J. Broyde Marriage, Sex, and Family in Judaism.

“Jewish law insists that new technologies- and new reproductive technologies in particular- are neither definitionally prohibited nor definitionally permissible in the eyes of Jewish law, but rather are subject to a case-by case analysis.” (Marriage, Sex, and Family in Judaism)

With that being said, the two main sides of the cloning argument can be summarized by the Jewish obligation to help those who are in need and the Jewish morality that there is a God-driven purpose, and subsequently not everything that humanity can do is ‘right and proper’. Furthermore, the first point is made increasingly more complicated by the fact that according to Jewish tradition, reproduction is crucial; thus, helping people who could not otherwise attain that goal does seem to align with Jewish law. A moral obligation to help those reproduce does not seem to exist in Brian and Lisa’s culture, instead there seems to be an obligation to the children already born, an obligation to adopt. I wondered if this cultural difference could lightly reflect the debated distinction between a potential life and a baby who has already been born? Or perhaps difference in value of genetic kin over chosen kin?

** It is important to note that Michael J. Broyde Marriage, Sex, and Family in Judaism’s subject was cloning and not surrogacy, but, nevertheless, I find the parallel to be significant. Additionally, it touches on using clones for medical needs like bone marrow and other situations that I did not mention. **

Later on, when asked about the seemingly exploitative nature of this transaction, Lisa states that, relative to their economic situation, surrogates are well compensated, “they have adapted, it’s us [western people] who haven’t adapted but you still want people to live a better life if they can.” I found this to be a noteworthy use of cultural relativism where we question someone’s ability to be happy and content based on what would make us happy and content. What is a ‘better’ life? Nevertheless, this comment touches on ethical relativism which I find fascinating but complicated, especially regarding reproductive technologies.

Aasia, who was originally Hindi but converted to Islam for her husband, has turned to surrogacy as a way of providing for her children. In India, a surrogate must not only be married but must also have her husband sign the papers in agreement. Aasia told her husband she was only accepting the initial contract funds which did not mean she would necessarily get pregnant. When Aasia does then in fact become pregnant her husband is shocked. Even though he’s angry because he considers this to be a sin, Aasia explains that getting rid of the babies (she had twins) would be an even greater sin and so there was nothing to be done. Aasia’s case demonstrates the intersections between different cultural norms regarding women’s rights, religion, social class, and reproductive technology.

Although it is stated in the movie that Aasia’s Muslim husband finds surrogacy to be a sin, how does Hinduism view surrogacy and do these religious views alleviate some of the moral quandaries of the Hindi doctor? Magical Progeny, Modern Technology: A Hindu Bioethics of Assisted Reproductive Technology written by Swasti Bhattacharyya, states that Hindu ethics are not absolute, that instead they are “[woven] from strands of… philosophy, religion, and culture preserved within the narrative of the Mahābhārata, a formative Hindu epic.” (Magical Progeny, Modern Technology). From these various perspectives, Bhattacharyya concludes that similarly to Jewish law, Hindu ethics are more akin to guidelines rather than rules and laws. To be able to make these case by case judgments in Hinduism, Bhattacharyya suggests using six elements of Hindu thought: an emphasis on the centrality of societal good, a firm belief in the underlying unity of all life, the expectations and requirements of dharma, the multivalent nature of Hindu traditions, a theory of Karma, a commitment to no harm. Consequently, I wonder how these Hindu bioethics integrate themselves in the business model of a clinic such as this one.

Aasia ends up needing an emergency C-section at a hospital that was not chosen by the surrogacy clinic. This results in numerous problems with who can sign the birth certificate and who are the ‘actual’ parents. The concept of ‘actual’ parents in this situation not only represents the debate between genetics and kinship but also nationality since the babies are ‘biologically’ American.

At the end of the movie Aasia states she will be putting the money in a bank to collect interest over the years for her children since money is needed for when they decide to get married. I found this parallel to be ironic since Lisa and Brian used money, given to Aasia, to start their family, and now Aasia will be using that money for her children to be able to begin their own families. In basic superficial terms both Lisa and Aasia are ‘buying’ families but then in what way are monetary transactions culturally reflective?

The more I learn about ethics the more confused I get. I find it increasingly more difficult for me to be able to say what I think with certainty because although, I want to consider all the intersections and cultural differences within each argument, I wonder at what point am I educated enough to make a verdict? However, I do think that without the ability to question myself and my beliefs my arguments would be weak and one dimensional.

“Individuals exposed to different cultural and religious beliefs and practices have the opportunity to broaden their own perspectives, thus enriching their stock of conceptual and axiological resources from which to draw when making difficult decisions for themselves.” (Magical Progeny, Modern Technology: A Hindu Bioethics of Assisted Reproductive Technology)

Work Cited:

Bhattacharyya, Swasti. Magical Progeny, Modern Technology : A Hindu Bioethics of Assisted   Reproductive Technology, State University of New York Press, 2006. ProQuest Ebook         Central, https://ebookcentral.proquest.com/lib/emory/detail.action?docID=3408357.

Broyde, Michael J., and Michael Ausubel. Marriage, Sex, and Family in Judaism. Rowman & Littlefield Publishers, 2005.

“Made in India.” Kanopy, emory.kanopy.com/video/made-india.

Module 5-Ben Zedeck

Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology

Through her book, Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology, Dr. Swasti Bhattacharyya enters the debate on the bioethics of reproductive technology through a Hindu and Indian cultural and ideological perspective. Dr. Bhattacharyya began as a nurse, and is now a philosophy and religion professor. Her background in the healthcare field is exemplified throughout her book by her knowledge of the medical and scientific side of reproductive technology. As a philosophy and religion professor of Hinduism, Dr. Bhattacharyya is able to bring a new and important perspective into the debate. In order to better understand the topic of the bioethics behind reproductive technology, it is important to seek viewpoints different than our own, from cultures that are not our own.

Dr. Bhattacharyya uses examples of Indian tradition, Hindu beliefs, and stories from the book of Mahabharata, an Indian epic with stories that can be related to real life, to explain her cultures perspectives in regards to the debate of reproductive technology. In America, people don’t typically see procreation as the general public’s business, and tend to have babies for their own reasons. In Indian culture however, procreation is viewed very differently, as exemplified by the quote, “Infertility, fertility, and having babies are not considered private, individual issues… The actions of individuals, particularly regarding procreative issues, affect the family, society, and ultimately all of life” (Bhattacharyya 87). This quote serves to demonstrate that Dr. Bhattacharyya’s views are coming from a culture that’s vastly different than our own, and she is able to provide a perspective that we may not have thought of. Another example is Dr. Bhattacharyya’s use of the story of Kunti from the Mahabharata. In the story, Kunti struggles with her fulfillment of Dharma, basically a path that individuals should follow that informs them on how to behave fairly and compassionately in society. Kunti is gifted a mantra that can bless her with children. Kunti first uses this mantra while unmarried, but fears what society will think of her having children when not married. After Kunti is married, she realizes that she now has a responsibility to procreate, which she didn’t have before. Kunti again uses the mantra, and feels she has fulfilled her Dharma.

It seems in Hindu cultural that it is imperative to have offspring when married, in order to fulfill a societal expectation. I see a connection between this and the Mitzvah of having many offspring for Orthodox Jewish people. If a woman is unable to conceive, she may feel she let her family, cultural, or even herself down. This is an interesting point that brings a new stance to the debate, as reproductive technology can be used to provide women with children, leading to many living more fulfilled lives.

Marriage, Sex, and the Family in Judaism

Marriage, Sex, and the Family in Judaism, written by Emory University law and religion professor Michael J. Broyde, provides the reader with various perspectives and opinions on the concept of reproductive technologies and how they relate to Jewish marriage and life. The book does not seek to give one definitive stance on the subject, rather it presents the reader with essays, research, and viewpoints, that range from all sides to help the reader form their own beliefs on the topic of how modern fertility treatments could be permissible or prohibited in Jewish law.

This was an interesting subject to read about, as the answer can not be found in any one text alone. Even the Torah states that we should ““Be fruitful and multiply, and fill the earth, and master it” (Genesis 1:28), while later giving rules and laws that seem to contradict this. Much like Hinduism, Judaism seems to place a great importance on the responsibility to procreate. However, when traditional procreation is not an option for some people, it becomes important to discuss if reproductive technologies should be allowed in Jewish law. One form of reproductive technology discussed is sperm donations. A sperm donation is when a man who is not the woman’s husband, donates his sperm to be injected into a woman, leading to fertility. In traditional Jewish law, the husband is seen as the offspring’s father, and the woman is the mother. Through a sperm donation these concepts seem convoluted as a man who is not the husband, would technically be the biological father of the offspring. To help with this issue, Jewish law states that a sperm donation is only permissible if the sperm donor is not Jewish. This way the woman would not be able to validly marry the sperm donor in Jewish law, since he is not Jewish, and the father of the offspring would be considered the woman’s husband. It was interesting to see the ways Jewish law sought to explain the various forms of reproductive technology.

Made in India

Made in India is a film that follows an American woman, Lisa Switzer, in her journey dealing with the complicated world of outsourcing a surrogate mother. Lisa and her husband Brian have wanted and tried for children for years, but sadly Lisa is infertile. The couple decide to try a surrogate mother, but find the process to be too expensive in America. They decide to “outsource” a surrogate mother in India. The story continues in Mumbai, India as the selected surrogate mother, Aasia Khan, is implanted with the couple’s embryos. What follows is a complicated view of the ethical and social implications that arise from reproductive technologies. The film shows the hardships of going through such a process from the side of both the surrogate mother and the couple trying to conceive. Aasia Khan, the surrogate mother, must contend with social backlash from her friends, family, and culture, to go through with the delivery of the couples’ twins, in order to be paid for her service. The couple, back in America, also struggles with the legal issues that arise, and the ethical issues that India’s culture has with the topic of surrogacy. An example of this is when the hospital that delivers the couple’s twins refuses to recognize Lisa as their real mother, until the couple fights for a DNA test to be done. This was a very interesting movie, that was based off of real life stories, as it provides a visual context for the debate of the ethics and social ramifications for reproductive technologies.

Module 5-Jason Klamson: Inventing Bioethics

Previously, we learned that people will go to extraordinary lengths to extend their kinship, by whichever and in whichever ways they see fit. The readings and video from this module showed us that seemingly, Hindu and Jewish cultures are similar in their beliefs and views of kin, and how to extend it through use of assisted reproductive technologies.

In the Made in India documentary, Lisa is a middle-aged American woman who has a condition which essentially renders her infertile. She always wanted to have a child of her own, and has tried seemingly all obvious options including fertility drugs, intra-uterine insemination and IVF, but all efforts have failed. Thus, she considered the option of a surrogate. Unfortunately, U.S. surrogates can cost anywhere from $31,325 to $75,000. Due to the American-based cost hurdle, Lisa expanded her search worldwide to India, where the “surrogates are plentiful and…[it’s] a country of one billion people]. (Rudy, Surrogate Facilitator) More importantly, the typical cost is only around $18,000. The Indian doctor stated that most times men are not comfortable with the thought of their wives being injected with another man’s sperm; however, once she explains to them that since the eggs are not even the surrogates, and she truly only is just carrying another couple’s baby, by use of her uterus, they begin to “understand”.

A primary issue regarding surrogacy in India is the government’s regulation of it; while the national government seemingly protects surrogacy, it is seldom enforced, and many states and hospitals do not follow it. One key example of this was the hospital refusing to name Lisa, the biological mother, as the mother on the children’s birth certificates, but instead, named the surrogate mother. The hospital finally agreed to run a DNA test on the twins and Lisa, in order to determine if she is in fact their mother, but were hesitant due to surrogacy being such a complex and controversial issue. This is because surrogacy, as the documentary notes, does not have a blueprint for which countries and governments need to adhere to and whether it is rightor wrong. Ultimately Lisa and her husband were able to get their babies, carried by the surrogate, but at what cost? A long, grueling process due to the differing views of reproduction, which directly leads to differing views of kinship.

In the book, Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology, Swasti Bhattachary, who is a professor of religion and philosophy, and was a nurse, connects sacred Hindu beliefs held in the Mahābhārata with modern (and ancient) forms of assisted reproductive technology. She essentially contrasts Hinduism from most Western religions, as a catch-all, overarching religion which determines one’s viewpoint on issues, rather than being made up of specific, individual issue stances. For example, she states that “Rather than focusing on prohibiting…actions… [Hinduism]… emphasizes the presupposition that all are …interconnected … and that karma ultimately holds each of us responsible for all of our actions” (Bhattachary 108) This quote laid her groundwork for showing that, in her opinion, Hinduism itself does not (or should not) dictate whether followers of Hinduism favor or oppose assisted reproductive technologies, but rather, whether or not there is any good that may result from them.

As we have learned in our last module, devout followers of Western religion, especially those of Christianity and Catholicism tend to be much more pro-life than secular individuals; seemingly neither side sees a grey-area in this debate. However, even though Bhattachary believes that the Hindu religion calls for its followers to effectively choose what is right, it too is guilty of creating a myriad different beliefs as to what is rightvs wrong, and why. She mentions that it is deemed societally pleasing for married women to have sex with men other than their husbands, if it is for the sole purpose of reproduction. This is expressed through the stories about Kunti and Gandhari (the “Matriarchs of Mahabharata”). Additionally, the Mahābhārata does not explicitly limit reproduction by act of sexual intercourse only, as do Western religions, such as Christianity. This suggests to me that reproduction and procreation are the top priority in the Hindu culture, as based on sacred text, rather than the traditional methods of conceiving, opening the door to new assisted reproductive technologies. What is interesting to note however, is that is was so important for Lisa, the Western (American) woman to have a child of her own DNA, made from her own eggs and her husband’s sperm, which seems to go more along with the important Hindu view of  reproduction, thus these two cultures seem to be linked in these situations.

Michael J. Broyde, is a professor of law and religion at Emory University, who has written an article (Marriage, Sex and Family in Judaism) in an attempt to decipher what is acceptable in Jewish Law/tradition/religion/ethics; when breaking down new technologies in modern reproduction and how it pertains to established Jewish law.   This article does not answer the question, but rather gives the reader the opportunity to explore possibilities. One should consider whether cloning is permissible, prohibited or a mitzvah (good deed).

Cloning struggles between helping those to reproduce, and God’s law not to interrupt what is morally acceptable. Who is truly the mother; the woman who shares genetic material (clone) or the egg donor (clonor). Although Jewish tradition is to procreate between a man and a women, when those circumstances are not valid, Jewish Law will “allow” cloning as a “mitzvah” and somewhat on the fence in other circumstances. Traditional Jewish Law sees the man as the father and only women as mothers.

Ultimately,  it is extremely evident throughout the book, article and video that reproduction and procreation are essential to the Hindu and Jewish cultures, and new, assistive reproductive technologies are not necessarily frowned upon…mostly. Of course the use of technology is not “natural” and thus may be seen as not following tradition or historic methods of reproduction, but scripture and laws seem to allow for it. The prime examples we learned from the readings were that in Hinduism, a woman is allowed to have sex with a man other than her husband in order to reproduce a child; in Judaism, cloning is seemingly allowed as a last-ditch-effort to procreate. Additionally, as Dr. Seeman stated, temporary marriages are also accepted, under certain circumstances. Thus, the ultimate goal seems to be increasing procreation and reproduction, above all else, in both Hinduism and Judaism, even at the expense of technology meeting tradition.

The Ethnographic Triangle

Hello all,

Nice to meet all of you today, digitally. For a couple of reasons, rather than upload to Canvas I’ve attached the Word document of the Ethnographic Triangle and its three sides in a link below. You should be able to download it from here:

The Ethnographic Triangle

If you have any difficulties, please feel free to comment on this post.

Jackson

Lindsay Guyette: Module 4

Testing Women, Testing the Fetus

In this book, Rayna Rapp explores the many factors that come into play when a woman chooses to terminate a wanted pregnancy, inspired by her own experience in having an abortion to terminate a Down syndrome fetus. This report comes in the form of her own notes and quotes from interviewing a diverse group of women being treated by the Prenatal Diagnosis Laboratory of New York City. The women came from many walks of life, with notable differences in care cropping up between working class and middle-class women, minority and non-minority women, and American women versus immigrant women. Most of these women were scheduled to receive amniocentesis, which is a test often administered to pregnant women over the age of 35 that is used to identify genetic disorders in fetuses.  This is commonly used to test whether the fetus has Down syndrome or another chromosomal abnormality.

When met with a positive diagnosis, women may be given the option to terminate the pregnancy. In fact, this ‘option’ is often shaped by the personal views of the clinician providing care. Some women may have to fight and change facilities to be given access to abortion services, while others find themselves nearly asking for permission NOT to have an abortion. This brings up the issue of how medical information is not distributed equally across different populations. A common theme in Rapp’s report is the issue of mathematical and scientific literacy, which is both presumed by the clinician and used to alter the medical information that is distributed to the patient. There are many problems with this setup. Namely,

  1. Patients who are unfamiliar with genetics, statistics, and prenatal disorders are at a disadvantage to be able to make an informed decision about their pregnancy.
  2. Patients who are members of a minority group and/or are working class are often presumed to have low medical literacy, limiting the knowledge being offered to them at all.
  3. Patients who do not speak English as a native language are at risk of being given medical information by interpreters who do not fluently or even accurately translate for medical personnel. This is, naturally, an impediment to learning about a topic as complicated as genetic testing.

Admittedly, I had previously only thought about basic physical access to prenatal care and abortion services. Even if these services became more geographically accessible, the biases of the clinicians can impact the quality and nature of the information that is given to pregnant women looking for genetic testing or abortions. This adds another layer of nuance regarding the ethicality of aborting fetuses with genetic abnormalities, given that information about these disorders is shared dynamically.

Another interesting issue is the multi-layered stigma with which we view abortion and pregnancy as a whole. The amount of responsibility attributed to a woman for carrying out pregnancy and ‘making’ a healthy baby is beyond what can reasonably be expected. This pops up in a number of different ways.

  1. Many women felt that they did not need to receive fetal testing because they themselves were healthy. When babies were born with genetic or physical abnormalities, it was seen as evidence that the mother engaged in some kind of ‘bad’ activity while pregnant.
  2. The distinction between ‘good’ and ‘bad’ abortions. Getting an abortion because of young age or financial instability was considered irresponsible or selfish by several women who were receiving abortions for a wanted pregnancy. The latter group tended to identify as getting ‘good’ abortions, chosen due to a high risk of mental or physical disorders.
    1. This community who received ‘good’ abortions felt ostracized by others who lost wanted pregnancies, due to their role in choosing to terminate.

We discussed in class how abortion is often presented as a debate between religion and secularism, even if it exists at the heart of a more complicated web than that. As noted in the book, a significant number of women who received abortions identified as religious, but depended just as much on the input of local, familial, and personal religious authority when formulating their views on abortions.  A woman’s choice could not be determined by religious background but was more easily influenced by her own views and pregnancy history. It’s just as the following concept was interpreted in two different ways:

  • When God provides problems, he also provides solutions.

By this, one could envision genetic abnormalities as a problem and abortion as a solution, or by providing the strength to raise a disabled child. Again, the meaning of our knowledge and support systems are dependent upon our background and on those around us.

The Burden of Knowledge

This video is very effective in using anecdotal accounts to illustrate the reality of wanted pregnancies with unexpected genetic outcomes. I believe that this movie tries in good faith to present both ‘sides’ of the abortion debate. The experiences of each woman are very genuinely expressed, in which women either reported terminating a wanted pregnancy due to a positive diagnosis of a genetic disorder, or women who reported carrying a pregnancy to term despite the diagnosis of a genetic disorder.

In a way, it seemed like this movie served to present the complex circumstances of abortion described by Rapp in a more digestible format. That is, someone who finds reading literature to be a barrier to understanding issues in depth may prefer a movie that presents a more consistent visual narrative.

My Thoughts

I personally enjoyed the reading and movie for this module. I especially feel that Testing Women, Testing the Fetus, is such a good book that I’m surprised it hasn’t been a reading for another one of my classes yet. For me, abortion has primarily existed in a bubble that only had to do with unwanted pregnancies. I had heard of terminating wanted pregnancies, but I had never engaged with so much content explicitly grappling with the issue.

It’s unlikely that I would have to consider terminating a wanted pregnancy for several more years at least. If I found out I was pregnant today, I’d be coordinating an appointment with the nearest clinic providing abortion services. I’m lucky to exist in circumstances that would enable this, as the nearest clinic is 300 miles from my home. This module has given me the opportunity to consider the very diverse group of women who are met with positive genetic results and must, either implicitly or explicitly, decide whether or not they will make the already difficult decision to abort their wanted pregnancy.

Module 4, Nahire Abdalla

Testing Women, Testing the Fetus

Rayna Rapp is an anthropology professor at New York University specializing in gender and health, health and culture, and science and technology. Rapp published her book, Testing Women, Testing the Fetus in 1999 in order to explore the social impact and cultural meaning of prenatal diagnoses. Amniocentesis and prenatal diagnostic technologies are used to determine the health of fetuses. These tests can detect any birth defects or health issues such as chromosomal anomalies and neural tube problems that may affect the baby. Because these tests take place during the second trimester or before, mothers are given the choice to terminate the baby if there are serious health issues. After the screening of her own child and receiving the diagnosis of Down Syndrome, Rapp chose to terminate her baby. As a result, she began to interview women who shared a similar story to her in hopes of bringing more awareness to the discourse.

Because of her fieldwork in anthropology, Rapp uses standard anthropological methods and feminist activism to explore and assess the matter. She credits participant observation for its open-endedness because it allowed her to enlarge upon her own research questions and become more educated as she met and interviewed individuals. Throughout her book, Rapp explores overlapping aspects of amniocentesis and prenatal diagnostic technologies and hopes to make a contribution to the technological transformation of pregnancy, the practical intersection of disability rights and reproductive rights, and the role of scientific literacy in the late 20th century.

The Unexpected Baby

Rapp’s book holds a number of interviews and recollections from women’s experiences that are heart-wrenching. However, the comments from the chapter “The Unexpected Baby” stuck with me the most. The comments from doctors that delivered babies with down syndrome were very cruel to me. Rapp includes the comment, “My doctor was so angry with me. He couldn’t believe I didn’t take that test. ‘How could you let this happen?’ he yelled at me (317). The doctor’s reaction is kind of frightening and he appears to have too much power to feel that entitled and yell at his patient. It is almost as if he believes he has the solution to this ‘problem’. His comment reminds of how advanced reproductive technology is often compared to “Playing God”. Perhaps there is too much power that comes with this technology that we are not mature enough to handle.

The Burden of Knowledge

Similar to the novel Testing Women, Testing the Fetus the film The Burden of Knowledge explores the experiences of women who choose to undergo prenatal testing. The film underlines 3 reasons why women explore prenatal testing: as a method of prevention, preparation, and to provide reassurance to mothers. The film is presented in chronological order, initially explaining the different types of testing available to mothers and ending with the birth and life of children who are born with down syndrome. There are a number of families that are interviewed throughout the film who do not all share similar values. For instance, one family believed that the more knowledge the parents are given the better judgment they will have when making a decision. However, another interviewee believed that this advanced technology is interfering with God’s work and society is not mature enough to handle it.

After watching the film a multitude of questions began to fill my head. Today, there is a stigma that surrounds individuals who are born with down syndrome and other birth defects. Some parents even viewed having a child with a birth defect as a burden on them, so this causes me to wonder are these prenatal tests being used selfishly by parents? Is society manipulating technology to eradicate individuals who are born with these disorders? The biggest question I had after watching this film and reading Rapp’s novel was whether or not the technology is being taken advantage of. It became difficult to weigh the benefits and negatives of amniocentesis and prenatal testing because both sides of the argument became convincing to me.

Conclusion

All in all, I find the arguments that support each side of prenatal tests and amniocentesis to be very compelling. However, the decision to take the test and what a mother chooses to do with the information is completely up to her. As long as there is no pressure from a doctor who is conducting the test, then I do not believe that a doctor is interfering with nature or “playing God”. Some benefits such as prevention (treatment during pregnancy) and preparation can help parents become better prepared if a child is diagnosed with a birth defect. Raising a child with down syndrome or another disorder may be more difficult for some families more than others in terms of financial costs, taking off work, and other factors. Depending on one’s situation, a mother may even choose to not terminate her child. Ultimately, I believe the decision is unique for each family and should not be compared to one another.

Module 4; Melissa Cook

Summary of Testing Women, Testing the Fetus

In Testing Women, Testing the Fetus, Rayna Rapp discusses the social impact and cultural meaning of prenatal diagnosis which is one of the new reproductive technologies. Prenatal diagnostic technologies including amniocentesis are used to screen fetuses for chromosomal anomalies and neural tubes problems during the early period of pregnancy. They are routinized in the United States and women, especially those who are over age 35, take the tests. As an anthropologist and a feminist activist, Rapp introduces the history of amniocentesis and shows how related people think about prenatal testing by using standard anthropological methods of participant observation.

In general, a woman experiences pressure of multiple responsibilities especially when she considers herself both as a mother and an individual. This is one of the examples that Rapp used in her argument. While facing a moral and critical life question, women often struggle with prenatal testing and their decisions after they get the testing results. It is because they are socially trained to play the “proper” roles as mothers. Another main argument that Rapp discusses is the communication of risk. She explains that the reason why people perceive prenatal testing differently is because they are not all from the same environment and cultures. For instance, depending on their cultural or religious backgrounds, people may go through different processes of making decisions to keep or end pregnancy. In addition, Rapp explains that communication of risk is the result of stratified reproduction. She states that “Reproductive futures are embedded inside other forms of hierarchy: Access to respectful, competent prenatal   care, eugenic attitudes toward “excessive” or “wasteful” pregnancies, and financial and social resources for differently abled children are socially stratified in familiar patterns.” (Rapp, 311). Because the social hierarchy allocates resources unequally to each stratum, it is more likely to bring about differences in scientific literacy and, as a result, different ways of understanding prenatal testing and its results.

In my opinion, this book was a meaningful attempt to analyze the social impact and cultural meanings of prenatal diagnosis from the perspectives of many different kinds of people. Her observations and interviews are extensive: she met genetic counselors, geneticists, laboratory diagnosticians, pregnant women who accepted amniocentesis and those who refused it, women who received a positive diagnosis and chose to end their pregnancies, and families with children who have conditions that the test can now reveal before birth. Among the first-hand observations, it was particularly impressive when she described the pressure and dilemmas that pregnant women had to cope with when they received the testing results. I think it is because the observer, Rayna Rapp, seemed to deeply sympathize the interviewees when they shared their experiences. As a mother who had to make a courageous decision for XYLO, her family and herself, I think she has made it true that endings are really beginnings.

 

Summary of The Burden of Knowledge

The Burden of Knowledge is an interesting video that shows both positive and negative sides of prenatal testing. While watching this video, I kept asking myself about the meaning of “the burden of knowledge.” Since I used to think that knowledge is good, “the burden of it” does not make a sense to me at the beginning. After watching a series of interviews in the video, I got to understand that “the burden of knowledge” indicates the enormous fear and pressure when a pregnant woman get the results of prenatal testing which is essentially probabilistic.

In this video, many women express their anxiety while waiting on the results from prenatal testing. As commented in the interview, the prenatal testing can be emotionally difficult for a pregnant woman because she can actually feel the connection with the baby. Although I cannot imagine what it would be like, this connection makes her struggle even more when aborting a pregnancy is suggested as a better way for her and her baby than keeping it. On the contrary to the worries of mothers about the possibility that their children may go wrong, Aubrey Milunsky claims that compared to the “chaotic” outcomes that children with disabilities will be brought into a life of pain, it is better to cope with anxiety that results from prenatal testing. According to him, “there may well be some anxieties, but when ultimately one compares these minor anxieties to the literal chaos of a lifetime that results from the absence of such testing or the opportunity of such testing and life for the child with serious handicap thereafter, there are no comparisons whether you admit it.”

This video also makes us to think about how to understand disability. A female interview in the video states that “technology has evolved and is being offered to individuals with the implicit assumption that the technology will be used to eradicate people with disabilities.” Right after her comment, the video shows a contradicting statement coming from a different perspective that people fail “to recognize that many people with disabilities suffer, have pain, and repeated surgery.” The video points out that the advances in reproductive technologies may decrease our pain of suffering from birth defects, but also raises important questions about eugenics. It was interesting when one of the women in the video talked about her wish for having known the options other than abortion, such as giving the baby up for adoption. What she said sounded like her decision could have delivered her baby if she had known about the adoption before aborting, even though the fact that the baby had to live with Down’s syndrome did not change.

Overall, this video made me think about what I would choose if I were in their shoes. It was also  interesting to know that people have different priorities and may respond differently to the knowledge on prenatal testing.

The social impact of amniocentesis and its meaning

Let me ask you quick questions. Imagine you are making an awesome plan for a trip with your best friends. Your insurer with a good intent (let’s believe it for a moment!) is telling you that she can give you a useful prediction of the risk you and your best friends may encounter during the trip. Are you going to get it? Let’s say you get to know that there is a 70% of chance that some awful accident may happen during the trip. Let’s suppose that you really want to go on a trip (you can’t make any changes that may cause that terrible accident) and the 70% is a quite good prediction based on probabilistic thinking like a blood test result. If going or not going is your only choice, will you still go on a trip? Although the context is different, this is conceptually similar to the problem that is discussed in Testing Women, Testing the Fetus and The Burden of Knowledge. If you are a 35-year-old pregnant woman before the second trimester, will you take the prenatal testing? If you take the test and find out that the baby has a 70% of chance to have Down’s syndrome, will you keep a pregnancy? What if the chance is 90% instead of 70%?

 One of the things that The Burden of Knowledge made me to think about is reproductive consciousness. It made me to question myself on whether it is better to be informed of my child’s probability of getting disability through prenatal testing or is it better not to know about this information at all? Will it be better to know if the probability is high? What if the chance is only 20%? Will it not matter because the number is too low? When I asked a series of questions to myself, I could not come up with answers immediately. Imagining that it is real and trying to answer to the questions was literally burdensome. However, I made up my mind to gain the information from prenatal testing and be aware of all the possibilities. I think it is important for people to know what situation they are in because this might help them to protect themselves from what may come up ahead. Without any information, there are not many options because of ignorance. Regardless of what would be their ultimate decisions, I think it is better for mothers to take prenatal testing and have information in their hands so that they can arrange and prepare the best decision for themselves and their babies.

This reproductive consciousness is one of the factors that leads to stratified reproduction. Because people come from diverse culture and environment, their “risk” is perceived differently from one another. There are many factors which lead people to have different perception of prenatal testing such as education, experience, religion, age, economic status, and such. Depending on the level of education people receive, they may have different attitudes toward and interpretation of prenatal testing. For instance, people who have more medical knowledge and are used to probabilistic thinking may be more capable of making better decisions of taking prenatal tests and dealing with the test results. As illustrated in the book, “an African-American public school teacher had to convince the staff at her local City Hospital that she wanted an appointment for prenatal care, not abortion, when a late, unplanned pregnancy was diagnosed; a sibling of an adult with Down syndrome felt pressured into having amniocentesis by her obstetrician’s attitude toward mental retardation” (Rapp, 311).  As a result, people may have different opinions on prenatal testing because of different access to some resources. In a stratified society, there are limits to who can, cannot, have access to certain resources and people are situated in different circumstances. That is, due to different levels of scientific literacy, advanced reproductive technologies may result in stratified reproduction.

Amniocentesis makes pregnant women become “moral pioneers” because it places them into a situation where they have to make one of the most crucial decisions in their lives. They would feel guilty and unimaginably big pain to abort pregnancies because they have special connections with the baby. Moreover, amniocentesis leads women to raise moral questions which include the ones regarding their babies’ lives. If the baby is highly likely to be born with serious (or even life-threatening) disability, it is wise for mother to keep a pregnancy? I do not think that there is necessarily a right or wrong answer for this because there are too many things to consider and women must have different (but important) reasons to keep or end their pregnancies. I think that amniocentesis is useful. Nevertheless, if I have a fetus that has a prenatal defects that is only limited to physical health but not mental, I would not abort the baby. It is because I think there is still hope that I am obliged to show the baby a good part of life and live with it. Disability may make us suffer, but isn’t pain a part of our life? I want to quote a sentence from the book and conclude my short writing. “Thus, a limit might be drawn by articulating individual experience and values as, for example, when the mother of a child with spina bifida accepted the possibility of bearing a second one with the same condition with confidence and determination, but refused the possibility of down syndrome or any other condition involving mental retardation” (Rapp, 308).

Sources:

Rapp, Rayna. Testing Women, Testing the Fetus : The Social Impact of Amniocentesis in America, Routledge, 2004.

The Burden of Knowledge: Moral Dilemmas in Prenatal Testing. Dir. By Wendy Conquest, Bob Drake and Deni Elliott. Distributor: The Fanlight Collection, 1994. Docuseek2. Web. 5 Jun 2019.