“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.