Month: June 2018

Invasive Genetic Screening: How Funding Allows Reproductive Advancement of Society and Innovation

The growing industry of medical technology has been promising for individuals in almost every part of the medical field, especially in the reproduction sector. I will be discussing specifically one type of reproductive technology, invasive screening procedures. As someone with a medical degree and a master’s in public health, I would like to share my increasing knowledge and experience with you all in order to give you important insight on the need for progression of this technology. Funding for screening along with prenatal diagnostic testing provides the parents with the best knowledge for them and the child, in addition to giving them options for further prenatal care. Not only will I persuade you all with concrete evidence provided from proven models, but I will also introduce the reasoning behind each model and the effects brought to benefit the people affected. The main arguments for funding of invasive genetic screening include the chance to prevent, the ability to prepare if something abnormal results, and the power of couples to be reassured with the option to know if their baby is healthy. These three arguments solidify why funding should be continued for prenatal and invasive testing.

Prevention constitutes a term that not many people know the true value of. To prevent is to take care of the problem before it exists, which is the problem itself for people. It’s easy to take prevention for granted because you carry on without knowing that what you’re doing might exacerbate the onset of the problem. When it comes to genetic testing, prevention is the central element of play. The probability for a certain disorder can occur in said pregnancy, so if there’s a chance to prevent it or ameliorate the situation, why not? If the mother and father have moral or religious grounds to keep the pregnancy going with negative results, it’s due to their way of thinking, so we can respect that, but raising awareness is key. Even if we can raise awareness in the end and prevent a small number of pregnancies in order to help not only the parents, but from fetal suffering, then the technology does justice. Technology allows us to do this.

As technology in medicine progresses at a rapid pace, it gives us the amazing capability to test for fetal diseases and abnormalities.  Rayna Rapp, author of Testing Women, Testing the Fetus : The Social Impact of Amniocentesis in America, describes the invasive process of amniocentesis, which screens for genetic abnormalities of the fetus, and delves deep into the world of prenatal diagnostic testing. She describes the political support or condemnation of prenatal diagnoses as dependent on state legislators’ opinions on certain topics, while if we contrast America with European countries, they usually have established healthcare programs covering prenatal diagnostic services. (Rapp 43) Informed consent and continuing routinization of prenatal diagnostic testing is crucial because it can result in the outcome that parents didn’t ask for. For example, Rapp describes a wrongful birth case in which a 37-year-old woman received her child’s medical costs for life after “suing over not being given information about amniocentesis. Her case influenced the American College of Obstetricians and gynecologists and the American Academy of Pediatrics to advise their member doctors that the offer of prenatal diagnosis to medically appropriate candidates was now constituted as the standard of care, at risk of a lawsuit.” (Rapp 40) Rapp’s discussion of this historic outcome set the precedent for routinization of diagnostic testing because it proved that if the test were offered, it could have resulted in a different, beneficial outcome for the mother, whether that be preparation for or prevention of the pregnancy.

Along with a right to know, there’s also a right not to know. However, when the knowledge can benefit the parents and the child, it can be used to create a better future through preparation. Looking at models of other countries’ policies on prenatal diagnostic testing and screening, Tsipy Ivry, of Embodying Culture: Pregnancy in Japan and Israel, compares and contrasts Japanese and Israeli models on prenatal testing and screening. These two culturally different models on prenatal attitudes will portray the importance for the need of prenatal care.

The Japanese treat the mother and fetus as one unit and place emphasis on the maternal environment more than genetic factors, however their system for prenatal care is well-established into low-risk and high-risk factors. For example, “The guidelines of many institutions state that amniocentesis—known in Japan for its 1:300 rate of endangering the pregnancy—should be offered to patients above the age of thirty-five; in practice ob-gyns use a variety of age thresholds that do not always accord with the guidelines.” (Ivry 111) However, there is a nondirective conservation that most doctors have with their patients, and probability is not used enough in society as Dr. Tanaka argues “In Japan the concept of probability is underdeveloped. I think it is normal that people cannot associate these figures with themselves. For example, if you say that there is a probability of 1:300that the child will have Down syndrome, most people do not think that that has anything to do with them.” (Ivry 111) This statement helps us understand the need to raise awareness and prepare parents for the health of their future baby. Dr. Tanaka’s words showcase the international need to implement genetic testing. The need for understanding probability and pregnancy outcomes are crucial as age and medical pedigree can influence the baby’s health. As the average rate of women having children is increasing, so is the risk factor. Invasive genetic screening uses advanced technology to measure this probability and prepare the parents to make an educated decision. Ivry also examines prenatal care in Israel.

The Japanese prenatal care system contrasts with Israeli regulations, because in Israel, classes are held that explain the detailed procedure and concerns for those interested in amniocentesis. In addition, amniocentesis is state-subsidized for women who apply and meet the qualifications. An example of a woman Ivry interviewed, in all her three pregnancies she also made sure “to take a three-hour ride from her house to undergo intensive ultrasound screening at the clinic of a leading specialist and did not skip amniocentesis either. She told me about a friend of hers whose son had died ten months after being born with a metabolic disease that had not been diagnosed prior to birth. whose son had died ten months after being born with a metabolic disease that had not been diagnosed prior to birth.” (Ivry 224) From this example, we see that the outcome could have been different if the mother had gotten the genetic screening test. It could have diagnosed the metabolic disease which could have informed her of the effects and his lifespan. We can infer that Israelis emphasize the genetic environment rather than the maternal, and support, usually, the prenatal testing and screening as in the fertile culture of Jews lies a fear of medically worst-case scenarios and anxieties (Ivry 228), which leads them to prepare by using medically proven examinations.

The increasing standardization of pregnancy screening tests can be attributed to not only advancing technology, but also changing circumstances. In the beginning, “the technology of prenatal diagnosis was developed explicitly to allow the selective abortion of fetuses facing serious disabilities because of atypical chromosomes and genes” (Rapp 70). When one thinks of genetic screening, abortion might be the first option to come to mind. However, time and better understanding of these tests has made them evolve not for the sole purpose of abortion but as a tool of reassurance. A factor for women that increases the chances of chromosomal problems is age. Prenatal diagnostic tests such as amniocentesis makes screening for these problems possible. An important statistic to consider is the average age women are becoming mothers. In 1994, the average age was 23, now it is 26. This is due to a large number of older age women giving birth. A dramatic shift occurs in the age group of never married women aged 40-44, who in 1994, gave birth 31% on average, and now, the statistic has climbed to 55%. (Pew Research Center 2018) With the growing age of women giving birth, the need for prenatal diagnostic testing is also growing.  In addition, hereditary diseases in a medical pedigree allow those concerned to have the knowledge that is available from getting genetic screening. As a medical doctor who sees pregnant women over a certain age, it is important to give the necessary precaution and advice to get tested for the health of the fetus. Increasing funding will aid the process of reassuring most women that their baby is healthy from knowing certain characteristics of the pregnancy.

One of these characteristics is probability of the child carrying a hereditary disease that the parents might have in their family. Rapp states “Consciousness is also shaped by a more capacious sense of family history, and the memories of kinship through which that his- tory is constructed. Some women and men have had extensive experiences with disabled children, and they told richly detailed stories of growing up with affected siblings or cousins. Others recounted skeletons hidden in the family closet.” (Rapp 150) An important consideration when emphasizing the need for invasive genetic screening to take into account that hereditary diseases are still being transmitted from generation to generation. Rapp precisely states how more and more people are being aware of this fact and getting tested for their probability of a certain familial disorder in the baby. Genes shape who we are and form a sense of kinship, but the capability, recently discovered, to confirm or deny a baby’s chance of acquiring a disorder exists now and should be used.

In a society that is improving daily with the fostering of medical care technologically and scientifically, genetic screening gives pregnancy a security. A security in knowing what the future holds, a reassurance in the health of the baby, and a chance for the parents to be prepared. Rapp says “The technologies of prenatal diagnosis, like all technologies, are produced at multiple intersections where the work of particular scientists, research clinicians, and health service providers engages social relations far beyond the purview of their laboratories, clinics, and consulting rooms. What come to count as the technologies of prenatal diagnosis, now and in the past, are shaped by large-scale transformations of biomedical knowledge, our legal structure, widely shared and sometimes contested cultural values, and the social identities within which service providers and patients encounter one another.” (Rapp 24) As society and its technologies advance, people are advancing with new knowledge and are better equipped for the future. Nevertheless, with all issues, moral, religious, and ethical concerns can arise, but while looking at models done in different countries, an evolution of opinion occurs based on many different factors. At the end, the decision is up to the parents to proceed with the screening, to terminate if the baby faces a serious disability, or to keep the baby as it is. However, in providing funding to this procedure, we are increasing the opportunities for pregnant mothers to get tested in the first place, to let them have a decision based on scientifically proven results, and to guide them with their pregnancy with assistance from medical and health-related professionals.

References

Ivry, Tsipy. Embodying Culture: Pregnancy in Japan and Israel. Rutgers Univ. Press, 2010.

Livingston, Gretchen. “They’re Waiting Longer, but U.S. Women Today More Likely to Have Children Than a Decade Ago.” Pew Research Center’s Social & Demographic Trends Project, 18 Jan. 2018, www.pewsocialtrends.org/2018/01/18/theyre-waiting-longer-but-u-s-women-today-more-likely-to-have-children-than-a-decade-ago/.

Rapp, Rayna. Testing Women, Testing the Fetus: the Social Impact of Amniocentesis in America. Routledge, 2000.

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. 24 Jun 2018.

Bhattacharyya communicates a focus on moral dilemmas and the significance of life, suffering and death in making decisions (Bhattacharyya 11)–in the early pages, she explores distributive justice: “How just is it to spend one million on a 25 week premature baby when in the same city, neighborhood, street children are suffering from malnutrition and lack of immunization?” (11). Likewise with prenatal testing, is it more just to assess and address potential risks or hindrances that could and would impact the livelihood of the child so much so that the quality of life may not be one without suffering? So much so that the baby dies upon delivery without a brain? That the baby will suffer from indescribable pain always due to sickle cell? That a predictable, preventable condition could have been assessed and diagnosed far before the potential delivery of the child? Even the risk of a child being born into a family unable to contribute the necessary time, monetary means, treatment mechanisms and around-the-clock care for a severely hindered child bears in mind what causing minimal harm is, can be and could mean under infinite circumstances. The risks associated with prenatal testing would far outweigh the potential harm it could cause; it causes far less harm than so, and the potential to prevent a lifetime of pain and suffering is worth the drawing of fluid and potential, though relatively uncommon, for a defect due to prenatal testing (Bhattacharyya 11). Bhattacharyya references stories that reference many ways of attaining a child–birth, gift, barter, adoption, etc. (Bhattacharyya 51) and while this literature is not taken as law or instruction, it sets the ground for clear acceptance of a multiplicity of acceptable family dynamics and child-attaining measures, from which I would claim support reproductive agency. Though it is said that abortion is morally condemned (Bhattacharyya 45), those in class told us that many who identify as Hindu both accept and perpetuate modern science and consequently would support the use of assistive reproductive technologies–even if drawn from this text, Gandhari goes beyond conventional methods in order to spawn children and if adapted to the times, I am sure assistive reproductive technologies would be included in her pursuit! Bhattacharyya also cites Narayanan’s interpretation of the definitive priority of children-making as contemporary grounds for Hindu individuals to seek assistive reproductive technologies (Bhattacharyya 51). She cites also Desai, who states that the myths explored could be further advanced to show the “ethical acceptability” of alternatively-conceived children for Hindus (Bhattacharyya 51). Likewise, Desai is cited in his belief that Mahabharata narratives also endorse other reproductive measures such as ovum donation and implantation of zygotes (Bhattacharyya 52). If competent care requires cultural competence (Bhattacharyya 24), then I would expect scientific literature and the empirically supported measures allowing for assistive reproductive technologies to be supported by Bhattacharyya. Competent care also involves “a triad of attributes: empathy, curiosity and respect” (Bhattacharyya 25) and if one is to adopt a competent care regime, their decisions are ones made with the well-being of others in mind and their views on reproductive technology are consistent with their intent to better the quality of life for all/humanity through research and the use of preventative measures such as those available through prenatal testing, genetic testing, vaccinations and research on by-products/elements of these procedures (discarded embryos, the fluids of impacted fetuses, terminated fetuses, even..). She cites Radhakrishnan, that “Hinduism is a conglomeration of movements, not a position; processes, not a result; growing traditions, not a fixed revelation–the traditions themselves do not acknowledge a single authoritative body or voice; they celebrate diversity”(Bhattacharyya 26). In this, “having the ability to hold a variety of perspectives is a sign of a sage”(Bhattacharyya 26)–unlike in some lifeworlds, Hindus are not bothered by the pluralism of Hinduism (26). Texts not as literal instruction that has no transience over time and Hinduism as the conglomeration that it is mark a striking difference between Hindu-esque and live-by-the-text-die-by-the-text, often archaic platforms whose spiels, especially in the South, may occupy the Facebook wastelands–as discussed in class, the stories and things encouraged or learned by these popular, influential Hindu texts is more complementary than mandating. The investigation into Hindu bioethics is/was very much novel. Christian bioethics has contributed to Bhattacharyya’s views in that she juxtaposes Hindu ideals with Jewish and Roman Catholic ideals and uses this as foreground for bouncing around the freshly cultivated Hindu bioethics debate. The view of procreation as interpreted by the Roman Catholics from the bible differs heavily from Mahabharata views on procreation as for the former, “God is unquestionably in control of the process of producing offspring” (Bhattacharyya 56)–God, even, is the solution for a barren couple’s strife. The bible also mentions women taking control of their childbearing situations (Bhattacharyya 58); perhaps those interpreting these texts for the masses in different, current times should instead look to these situations as instruction to utilize technologies and hoist all measures necessary to pursue desired life. She compares Roman Catholicism in that it insists that sexual intercourse and procreation go hand in hand inextricably (Bhattacharyya 58) which is seen throughout Donum Vitae and the insistence of all aside from homologous relations being forbidden (Bhattacharyya 59). Bhattacharya notes that the church refusing to delegate between different stages of an embryo and the fact that 1/3-1/2 of all fertilized ova never survive implantation would result in many, countless, beings being damned for eternity on the daily (Bhattacharyya 84). Dharma is a central concept to Hinduism (Bhattacharyya 63) and in its centrality, it is inherently flexible: “new twists and meaning and different times and different groups [make for a] dauntingly broad semantic range” (Bhattacharyya 63) of interpretations and living-forths of dharma. All are also subject to that of karma, which is action—all action is tied to consequences, brought to fruition in either this or another life (Bhattacharyya 65). While one should pursue assistive reproductive technologies cautiously, Hindu texts “reflect a respect for the developing fetal life and argue that it is deserving of protection from harm (Bhattacharyya 86), while they also reflect “support for utilizing various means” for producing children (Bhattacharyya 87), alas insinuating that there is “nothing inherently wrong with IVF, gamete donation and surrogacy” (Bhattacharyya 87). Another dominant worldview shows Hinduism as centric regarding “the sanctity of life of every creature, sympathy for sufferer, service without expectation, contentment and efficiency in all activities (Bhattacharyya 88) — without that which is “selfish and hedonistic” (Bhattacharyya 90). It is said that the ““right” course of action is often dependent on the particulars of a situation” (Bhattacharyya 97), further emphasizing the need to evaluate each circumstance as it is presented and in the context and particulars of the second, week, time, predicament. One can be a good Hindu through living a multitude of truths— “a commitment to the sanctity of life does not automatically prescribe only one acceptable course of action” (Bhattacharyya 107) nor does it preclude one from considering the situation at hand or what would cause the least harm overall, but acts as a guide “helpful for negotiating a path through complicated issues” (Bhattacharyya 107). As stressed before, the lack of a text as a clear guideline, belief that all are acting to cause the least amount of harm and belief in both the agency and ability of Hinduists to determine the best course of action resonate heavily in Bhattacharyya explanation and integration of Hindu beliefs/popular texts and bioethics. The use of many scientific technologies and methods in the lives of these individuals is prevalent; the integration of the learned six key elements of Hindu belief as the centrality of society, the underlying unity of all life, requirements of dharma, multivalent nature of Hindu traditions, the theory of karma, and the commitment to ahimsa collectively result in, again, the crafting of a lifeworld, mechanism of thought, way of thinking which influences all actions and would allow Hindu individuals to discern regarding the use of assistive reproductive technologies.  The methodology of the two authors does not differ so much as the texts and traditions of their respective faiths; Judaism stresses the following of the Hebrew bible while focusing on kinship relations and not violating Jewish law: Broyde does not allow the traditional elements of the text or law to discount all methods of assistive reproductive technologies.

Broyde addresses reproductive technologies and the actions behind it from a point of view based on established norms based on what is appropriate ultimately based on interpretations of Genesis and established Jewish law.  Some differences from Bhattacharyya lie in the focuses of the bioethics discussion– though the length of mentioned texts varies, Broyde heavily focuses on kinship and reducing problematic instances within the family ultimately focusing on parturition and birthday, labeling the gestational mother the mother (Broyde 300), nuances of maternal vs. paternal donation, declaration of Jewishness especially in instances of surrogacy, so on and so forth (300). Another focus of Broyde’s is the halakhic disputes that must be made en route to fulfilling the duty to procreate; he says, even, that to many parties cloning or reproducing without sexual relations would not fulfill the biblical obligation to “be fruitful and multiply” (Broyde 301): however, it is the belief also that the inseminator is the legal guardian of the child and in inseminating, a good deed or “mitzvah” is taking place (301). Regarding kinship, Broyde’s foci lie in the technical relations to the child and how problematic or unproblematic the conception is – this can be easily understood in the proclamation that the child carried to term by a surrogate would, in theory, be forbidden to have relations with not only the genetic mother’s family but with that of the surrogate and hold true with past explorations of how Jewish communities keep records of donors and parents alike to prevent forbidden ties as the child grows older. He finds the halakhic permissibility of reproduction via cloning “without precedent in Jewish law” (310) – this is likely due to the archaic nature of these laws and commands sought in translation. Broyde also emphasizes that the “be fruitful and multiply” obligation is solely paternal – while women are necessary participants in this in theory, “it is quite clear that the normative Jewish traditions assigns no obligation upon a woman to reproduce” (312). Spawning via clone would not result in a mitzvah (313) and the activity itself is neither good nor bad (albeit secondary activities could be bad!)  as the entirety of the process can take place without violating Jewish law, namely so as it does not involve any reproductive technologies aside from implantation – Broyde cites also problematic happenings associated with artificial insemination, in vitro fertilization and surrogate motherhood. If by a male, cloning happenings can even result in mitzvah, but if female, it is simply permissible, morally neutral. Broyde is comfortable explaining and exploring reproductive technologies in relation to Jewish law and would happily provide with kinship and various reproduction scenarios in abiding by Jewish law. As “the death of pre-embryos in the process of attempted implantation” (313) is not violative of Jewish law, Broyde supports many reproductive technologies as viable solutions, even though many are “less than ideal” (314), when the “ideal” method of conception is not viable (314). Moreover, the fact that these technologies oft result in one being able to fulfill the be fruitful and multiply obligation is a plus, recognizing a variety of motives for reproducing as both valid and permitting the use of reproductive technologies to attain the goal of children. Unlike some other populations, “the Jewish tradition adopts a policy of reducing the risk and minimizing the scope of potential Jewish law violations” (315) seeking not to “prohibit that which is unknown” (315) but to help allow Jewish individuals, especially those in need of assistive reproductive technologies, to utilize these measures while abiding by Jewish law to the best of their ability and circumstance. Broyde also, in conclusion, emphasizes that cloning is but an example of a facet of the conquest to conquer the earth (317), “without theological problem in the Jewish tradition” (317). I think Broyde would not find “screening to abort” halakhically permissible but sometimes the proceedings often involved in such necessary, especially in the cases of individuals who did not receive genetic screening otherwise and for whom serious disorders could be an especially pertinent risk. On preimplantation genetic diagnosis, Broyde has said, “Using PGD to create a child without a specific illness would seem to be permitted according to Jewish law at the discretion of the child’s parents. The same can be said for PGD that is designed to enhance any given characteristic in a child that increases the child’s ability or functionality, in the discretion of the parents.” (Broyde, 2004, 65) he also says, “Pre-implantation genetics diagnosis as a form of enhancement of one’s ability is much more complicated as a matter of Jewish law than as a treatment for an illness or a disease or to save the life of one’s sibling in need of a blood or bone marrow transplant.” (Broyde, 2004, 75). That being said, I think other prenatal testing i.e. amniocentesis would be evaluated on a case basis and also possibly encouraged by Broyde at times based on my findings from a prenatal testing/Jewish law search in which I found that “prenatal testing that will benefit the health of the mother or fetus is permitted (and even encouraged) in Jewish law” (NISHMAT) and while the implications of each test should be considered on an individual basis, prenatal testing is not in itself prohibited by Jewish law (NISHMAT). Further investigation confirmed my speculations: in his 2004 essays, Broyde notes, “As others have noted, amniocentesis is a genetic test, which, independent of the value of the test itself, must be evaluated in the context of the possibility of abortion. Presumably, the correctness of a fetal genetic test very much depends on what one does with the data after the test is done. Genetic tests designed to induce abortion when the ‘wrong’ genotype is found as a result of the test, would presumably violate Jewish law except in one of the few situations where abortion is permitted. On the other hand, the exact same test, when its results are used for treatment or therapy of the fetus or child, or merely to address pastoral concerns of the parents, is without any intrinsic Jewish law controversy” (Broyde 2004).

Ultimately, both parties would encourage the evaluation of circumstance and necessity when considering measures regarding all reproductive decisions but especially prenatal testing dilemmas. The each-circumstance-varies view holds true and though Broyde’s lenses are those familiar with and seeking to follow/interpret Jewish law, Bhattacharyya’s emphasis on both cultural competency as key and impactful decision making allow them to row similarly in these respects.

Works Cited

Bhattacharya, S. (2006). Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology. Suny University Press.

Broyde, M. J. (2005). Modern Reproductive Technologies and Jewish Law. Marriage, Sex, and the Family in Judaism, 295-328. Rowman & Littlefield Pub, Inc.

Broyde, M. J. (2004). “PRE-IMPLANTATION GENETIC DIAGNOSIS, STEM CELLS AND JEWISH LAW.” Essays, 54-75.

NISHMAT. “Prenatal Testing.” NISHMAT Jewish Women’s Health, NISHMAT, www.jewishwomenshealth.org/article.php?article=32.

 

 

 

 

When comparing both authors’ approaches to reproductive technology I could identify various differences in the narrative and the arguments each present. The first difference is that Bhattacharya offers comparative analysis when the Hindu approaches are compared and contrasted with those of the Torah, the New Testament and especially Roman Catholic teachings. In contrast, Broyde’s approach is solely based on Jewish Law and its views on reproductive technologies. The Halakha views cloning as less than the ideal way to reproduce people, but when there is no other method available then it accepts having children through cloning – it even considers it a mitzvah (commandment/good deed). In the third chapter of Bhattacharya’s book, there is a narrative of the Mahabharata that is used as an ethical guideline. It explains that in it, there is a priority placed on having children while accepting a variety of creative means to ‘produce’ offspring. In Broyde’s approach, there is a clear intent to explain the reason behind the hesitancy towards avoiding the use of cloning as means of reproduction while in Bhattacharya’s approach there seems to be a more open perspective towards – in general – every type of reproduction system.

Furthermore, it is important to note that in both cases there is a different basis for the narrative used. Even though both touch upon alternative reproductive systems as a possibility alongside respective reasonings, the texts used to argument each of the perspectives is vastly different. In Broyde’s work there is vast reference to the Jewish ‘Law’ – a set of rules that are to be abided by – as well as reference to biblical stories like the Golem on page 306 as well as interpretations from various Rabbis such as in page 304 referring to the comments on the ‘Identical Twin Issue. On the other hand, in Bhattacharya’s book there is no reference to a practical set of rules apart from a set of “theoretical” laws written in the Laws of Manu, however, in chapter 2 there is a synopsis of the Mahabharata and an extensive reference to the stories of how the three queens Kunti, Munti, and Gandhari overcome the challenge of infertility to provide for their descendants. In these stories there is an underlying tone of reproductive manipulation; for example, how Kunti and Madri deal with the curse placed upon their husband to call upon the G-ds to impregnate them or how Gandhari manipulates the product of her conception to bring the births of one hundred sons and one daughter. Bhattacharya extrapolates from these stories to show how they can be used to discuss bioethical issues such as fertility medications, sperm banks, donor artificial insemination, in vitro fertilization and embryonic transfer.

In the latter piece there is more of an emphasis on the importance of women to take control of their reproductive choices (Chapter 3), her approach is interdisciplinary in that she brings up examples and evidence from nursing, bioethics and Hindu culture and religion (with interviews from a contemporary Hindu community in California) this gives the book an appropriate focus on women’s experience throughout. drawing. However, in Broyde’s narrative, there is no such distinction between the roles of each of the biological genders. It clearly defines that a clone is seen as a full human being and that is should be treated as such. It also defines the parent-child relationship as to be equal to the usual parent-child relationship.

These differences are not to be considered specifically because of the differences between Hinduism and Judaism but also because of the specific methodologies of these authors. There is a natural tendency to get away from what is not known, this is mainly because the consequences of the action are yet to be understood. However, not addressing the possibility of knowledge – permanently – is considered regrettable. Jewish tradition imposes an obligation on those who are capable, to resolve the issues and submit a preliminary analysis for others to comment and critique it, after that the Jewish Law or Halakha will establish the policy concerning a variety of issues related to the issue, in the case of Broyde’s piece it would be cloning. Bhattacharya’s methodology – as mentioned before – is interdisciplinary and it draws evidence from nursing, biology, ethics, Hindu culture, and religion as well as contemporary perspectives from a Hindu community; she sets out to examine how key elements of Hindu thought can deal with the complex issues involved in infertility and reproductive technology. Thematic unity is provided by grounding the analysis of creative insights drawn from the epic Mahabharata and the ways it deals with challenges of infertility.

Overall, both authors address the topic of reproductive technologies in a similar fashion. They both bring up histories of their respective religions as well as books of law to argue for an idea. Differences arise when looking at the proportion to which each of the authors reach to these sources to argue. It is noticeable that in Broyde’s piece there are more Law-based examples in comparison to Bhattacharya who analyses more in-depth the Mahabharata which in it of itself is a collection of stories like the ones mentioned above. Additionally, the methodologies vary between the authors in a sense that – apart from the fact that they are 2 different religions – each use a different set of resources due to the inherent nature of the state of each faith. In terms, Hinduism lacked a base to which attribute a perspective on reproductive systems, therefore the author saw a necessity for a complete analysis and incorporation of Hinduism into the subject. In turn, Boyde’s work is based upon building on top of something that already existed – i.e the Jewish Law or Halakha.

As reproductive technology continues to rapidly grow and develop across the globe, an increasing number of anthropologists seek to understand the role these technologies play within different cultures, societies, and civilizations. In order to understand the importance and permissibility of reproductive practices cross-culturally, anthropologists turn to religious texts to form the foundations of such bioethical conversations. In this paper, I will explore the work of Swasti Bhattacharyya in her book, Magical Progeny, Modern Technology: A Hindu Bioethics of Assisted Reproductive Technology, which delves into her interpretation of how the Mahabharata can be used to explain various bioethical issues in India. I will also look at Michael J. Broyde’s Marriage, Sex, and Family in Judaism, in which he forms a preliminary analysis of reproductive technologies, specifically cloning, from a Jewish normative law perspective. Through a careful analysis of both works, I will characterize some of the main differences found between Bhattacharyya’s and Broyde’s works, and draw conclusions about their perspectives on the cultural implications of reproductive technology found in two, different countries.

Bhattacharyya uses the Mahabharata, the longest epic ever written, as her primary source to analyze and draw bioethical conclusions from a Hindu perspective regarding reproductive technologies. She begins her book by establishing that because Hinduism has no formal law regarding reproductive technology, she will use her interpretation of three stories from the Mahabharata describing three women and their efforts to bear children, to create a Hindu perspective of bioethics. She uses the Mahabharata because its “paradigmatic narratives are mines that upon excavation will reveal the jewels that reflect India’s past, its present, and Hinduism’s ethical ideology” (Bhattacharyya 32). Ostensibly, the book seems to emphasize the stories which are told in great detail; however, it becomes increasingly clear by the end of the book, that the level of detail in these stories is not as important as her overall message and goal: religion and culture play a large role in bioethics and it is thus extremely important to establish and understand cultural competency. Bhattacharyya’s description of the stories in the Mahabharata serve as a cosmology and foundation for her formation of different bioethical principles from a Hindu perspective. She describes Hinduism as a religion, “overflowing with options, alternatives, and divergent beliefs” (Bhattacharyya 49) and that it is for this reason that Hindus welcome pluralism, embracing a variety of different voices, and are bothered by any “attempt to eliminate alternative views” (Bhattacharyya 50). It is important to recognize that Bhattacharyya does not claim to represent the Hindu voice of reproductive technology and morals, but rather seeks to take many, different voices into consideration in attempt to draw more broad and abstract conclusions about such technology usage in India.

With a significantly different methodology, Broyde uses various sets of Jewish laws emphasized by rabbinic authorities in attempt to draw conclusions about cloning. Broyde uses these concrete laws and morals to guide his thoughts throughout the article, leaving little room for interpretation. Unlike Bhattacharyya’s attempt to draw analogies between the stories in the Mahabharata and bioethics, Broyde focuses on how specific Jewish laws and beliefs about reproductive technology affect kinship rules and situations while simultaneously interweaving the scientific process of cloning. Broyde’s goal is “not to advance a rule that represents itself as definitive normative Jewish law” (Broyde 304), but rather, to “attempt to outline some of the issues in the hope that others will focus on the same problems.” This goal lends itself to his preliminary analysis regarding the effect of cloning on marriage, parental status, and other related kinship issues. Through a series of examples regarding other reproductive technologies, Broyde’s article argues that fundamentally, cloning is a form of assisted reproduction. He suggests that cloning is “no different from artificial insemination or surrogate motherhood” and that this form of assisted reproduction should be made available those who need it (Broyde 305). Rather than drawing on analytic philosophy like Bhattacharyya, Broyde uses the American legal system to help compare his ideas for Jewish perspectives on reproductive technology. He describes that, unlike the American court system, “genetic relationship does not establish legal relationship” (Broyde 328). According to Jewish law, the gestational mother is almost always considered to be the “real” mother of the child. From here, he establishes that because the surrogate mother or gestational mother is considered to be the real mother, this directly creates a kinship issue as it then prohibits the surrogate mother from marrying any relatives of the surrogate mother. Broyde’s scientific methodology can be characterized as one that uses current Jewish laws regarding reproductive technology to address the questions of cloning and public policy.

Bhattacharyya’s methodology leads her to use comparative works from specific texts that have “significantly influenced modern ‘Western American’ thinking, namely the Hebrew Bible and the New Testament” (Bhattacharyya 56). She uses texts from the Hebrew Bible and Roman Catholicism to serve as guidelines for comparison in order to drive her own opinions regarding Hindu perspectives on reproductive technology in India. Most notably, she asserts that “in the Hebrew bible and New Testament, though humans are involved, God is ultimately in control of human procreation” (Bhattacharyya 58), immediately comparing this to the notion that in the Mahabharata, gods and humans are often co-equals in the procreative process. She uses the Church’s belief that “the soul is infused into the embryo at the moment of conception” (Bhattacharyya 62) to assert that the Church views IVF, ZIFT, and other reproductive technologies as “destroyed ensouled zygotes”. She ultimately uses the official teachings of the Roman Catholic Church to draw a sharp contrast of how these beliefs do not find their equivalent within Hinduism. Instead, she uses what she refers to as the “six key elements of Hindu thought” to underline the construction of Hindu ethic with respect to reproductive technology.

Although Broyde and Bhattacharyya take vastly different approaches to the exploration of reproductive technologies, I believe they would share similar perspectives with respect to the dilemmas of prenatal testing. Because Broyde explains that “reproductive technologies are neither prohibited nor permissible in the eyes of Jewish law, but rather subject to a case-by-case analysis” (Broyde 295), I believe he would advocate for the same mentality with respect to prenatal testing. Throughout his work, Broyde revisits the Jewish obligation for man “to be fruitful and multiply” and because possible consequences of prenatal testing may include termination of the pregnancy, Broyde might be hesitant to assert that rabbinical authorities would be accepting of such technology. However, Broyde may also add that “moral conservatism is an objective morality and not everything that humanity wants or can do is proper,” ultimately arguing that God is the only power that can dictate such decisions regarding the state or health of the child (Broyde 303). Similarly, because Bhattacharyya describes Hinduism as a collection of different voices and ideas, I believe she would subscribe to a comparable perspective regarding prenatal testing. She would most likely suggest that prenatal testing is an example of a “case-by-case” situation that must take into account the different “Hindu voices” as well as resonate with the six key elements of Hinduism she outlines: centrality of societal good, belief in the unity of all life, dharma, the multivalent nature of Hindu traditions, karma, and commitment to do no harm (ahimsa). Prenatal testing would most likely fall under the elements of dharma and karma. The decision to engage in prenatal testing would follow the action of dharma, while the decision to take responsibility for that action would fall under the element of karma. Essentially, the decision for a mother to partake in prenatal testing would not be dictated by a Hindu law, but would be left to the individual to decide and take responsibility for that action.

Both texts are clearly intended for different audiences and thus, take vastly different approaches to the subject of reproductive technology. While Bhattacharyya draws on analogies she makes from the Mahabharata as the foundation for her creation of the Hindu principles regarding bioethics and reproductive technologies, Broyde uses the normative Jewish laws that help frame his discussion for reproductive cloning. Ultimately, with the rise of reproductive technology and its increasing usage, it is important to recognize and characterize such differences in order to gain cultural competence in order to understand its effect on kinship and society as a whole.

 

Swasti Bhattacharya, Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology (Suny University Press, 2006).

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

Many questions regarding the ethicality of reproductive technology continue to arise with the increased utilization of and desires for such processes. Though some may argue that decisions of ethicality and legality towards these procedures should be determined independently of religious influence, many scholars, religious leaders, and individuals continue to produce evidence as support or opposition towards such technology (Bhattacharyya 6). We were given two texts that address the topic of reproductive technology from differing religious perspectives. Through her Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology, Swasti Bhattacharyya pioneers the topic of new reproductive technologies specifically from a Hindu perspective. It has been difficult to declare ethical stances for this religion because of its differing origins and mass of religious texts and stories. Bhattacharyya describes Hinduism as a conglomerate that “has no Pope or Magisterium, no central, overarching authority figure or governing body” (Bhattacharyya xvi). The lack of central, concrete sources of information have made it difficult for scholars to form a collective response to the religion’s perspective on certain topics such as in vitro fertilization. The term “Hindu” can describe a community geographically and religiously, thus revealing “fluid boundaries between various categories and internal diversity among official, unofficial, orthodox, and popular expression of Hinduism” (Bhattacharyya 20). Michael Broyde’s “Modern Reproductive Technologies and Jewish Law” addresses the reproductive technology of cloning from the standpoint of Jewish law. This text was written through the view of a religion that has strong fundamental understandings of the religious laws that are relatively uniform throughout the communities that practice it.

Key differences between the approach of Broyde and Bhattacharya towards reproductive technology is foremost apparent through their intended audiences and purpose for writing their perspective texts. Bhattacharya incorporates ethnographical recounts from Hindu patients as well as her experience as a student, nurse, and Hindu practicer into her book, giving it a more personal and open approach (Bhattacharyya 8). Her intended audience could possibly be Hindu followers considering artificial reproductive technologies. She does not claim religious authority but rather makes claims argumentatively. Broyde, however, is more direct with his approach and leaves little room for interpretation. He employs direct connection with his claims to Jewish law, or halakhah, which has been developed and applied within the Jewish community for over fifty years (Broyde 11). Broyde provides many examples for further clarification of the Jewish law but besides these, he is very clear on the circumstances and bioethical stances in accordance with written passages and Jewish law. For example, Broyde addresses the Talmud when considering the “humanness” of an artificial anthropoid (golem) in reference to cloning, eventually concluding that they are considered to be human and cannot be killed according to religious law.

The purpose of writing for both authors seems to differ as well. Broyde influences authoritatively and focuses his writing on the permissibility of cloning and the familial status of the resulting individual (Broyde 296). Bhattacharyya’s approach focuses more on making connections between passed down mythical stories that are well-known among Hindu followers. More specifically, a majority of Bhattaryya’s claims have been derived from connections to Mahabharata narratives (Bhattacharyya 28). For example, she argues that Hinduism places higher significance on the results of reproduction rather than the process of getting there, and she does this by referencing religious narratives that exemplify the creative ways of procreation from divine figures (Bhattacharyya 56). Alternatively, Broyde uses religious texts but also does so in indirect ways by referencing established Jewish law in addition to popular religious figures within the Jewish community, such as Rabbi Bleich in the case of Jewish surrogacy (Broyde 302). Though Broyde was able to reference such things as evidence and support because of the universal beliefs shared among most Jewish members. Overall, the two authors differed in their approaches to explaining religious perspectives on reproductive technology because of their intended audiences, purposes, and the type of resources available and accepted by the majority of the religious communities.

Though differences between the proposed religious perspectives can be partially attributed to the methodology of the authors, I believe that a majority of the differences are ultimately the results of the fundamental beliefs and structures of the two faiths. Hinduism more specifically appears to be more difficult to pinpoint perspectives on issues because of its existence as a religion made by encompassing the beliefs of a whole region. Hinduism lacks a “fixed and formal doctrine concerning any matter,” thus there is neither an insistence or an objection to the use of artificial reproductive technologies (Bhattacharyya 53). Bhattacharyya formulated her argument on well-known religious texts, and did so through her personal, open-ended interpretation of the text and her personal experiences as a practicer. Although she did have contributions from mentors and other Hindu followers, the potential for bias in their collective interpretations is very likely due to their shared interactions and residence in similar communities. In other words, there is a large chance that the presented interpretations and connections of the Mahabharata narratives do not align with those in other countries or even different parts of the United States because of the nature of the Hindu religion. While there is the diaspora of the Jewish faith as well, the religion has a centralized text and establish Jewish law that Broyde can confidently reference as an essential component of a Jewish community (Broyde 11).

Furthermore, and inevitably, the content and fundamental beliefs of the religions cause a contrast between the two perspectives as well. Bhattacharyya specifically references six key elements of Hindu thought that should be addressed when considering the ethicality of artificial reproductive technologies from this religious perspective (Bhattacharyya 57). When looked at holistically, these elements emphasize the connection between the individual and their surrounding environment. For example, it is argued that the consideration of procreation and fertility, or infertility, should not be viewed as an individual issue but should instead incorporate the interests of the public as well (Bhattacharyya 81). Whereas Broyde focuses on the artificially reproduced individual or even the Jewish family unit that it is born into, Bhattacharyya claims that Hinduism examines the issue of procreation with the betterment of the society in mind as well. This emphasis can be attributed to the six key elements of Hindu belief referenced as the centrality of society, the underlying unity of all life, requirements of dharma, multivalent nature of Hindu traditions, the theory of karma, and the commitment to ahimsa. The six key elements are driving factors that cause the overlap of concern regarding procreation to be between the individual and the public’s interest.

The resulting perspective of Hinduism on artificial procreation proposed by Bhattacharyya is more open-ended and less authoritative than that proposed by Broyde for the Jewish perspective. Though the manner in which they make their claims differ, their basic dependence on religious texts is undeniable because of the importance and conclusions drawn from these stories by religious communities. Bhattacharyya mentions the increasing concern for religious influence in legislative action, but she also touches upon the significance of these religious interpretations in clinical settings when individuals are directly faced with heavy decisions involving precious human lives (Bhattacharyya 7). Academic or declarative texts such as these by Bhattacharya and by Boyde are significant in the application of religious perspectives to the technologies of modern day, and it is important to continue developing and assessing these interpretations on religious perspectives, regardless of any discord that may arise from the analyses themselves.

SOURCES :
– Bhattacharya, Swasti. Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology (Suny University Press, 2006).

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

In looking at the way both authors approached reproductive technology, I think it’s important to remember that Broyde approaches Judaism from an already well-established perspective towards reproductive technology and argues certain perspectives within this. Bhattacharya, on the other hand, is trying to build up Hindu bioethics. Up until this point, there hasn’t been a defined bioethics for Hinduism, specifically one that is in the Western world or that fits the Western world’s views. Thus, in looking at the two approaches the two authors take, they seem steps behind: one is building upon something that has been built upon for centuries, while the other is starting to build the foundations for a, basically, non-existent perspective.

Nevertheless, there are other fundamental differences between their approach to reproductive technology. Broyde focuses a lot on the definition of kinship-who’s the correct mother, what about if it was the father, how would the child be considered a Jew and through whom, how could this be done so it is not problematic for any of the parties. This is something that we saw in Susan Kahn’s book on IVF in Israel. Judaism focuses a lot on making sure that a child that is born, is born properly as a Jew. Bhattacharya, on the other hand, approached reproductive technology by basing it off 6 basic Hindu principles. She uses these principles to show how they would be used in a case-to-case situation. Additionally, she used one of the texts of Hinduism to base her reasoning off. Broyde didn’t necessarily base his arguments from any scriptures, however, the ideals discussed were based off rules that had been established by interpretations of the first and second chapters of the Genesis.

There were a lot more differences between the two approaches the authors took, yet, it would be difficult to properly compare the two when Broyde is looking at reproductive technology from a specific aspect, whereas, Bhattacharya is looking at a more general perspective of it. Again, as I mentioned before, this isn’t necessarily a difference in the religions, but a difference in how well established the ideologies on this topic are. Bhattacharya is trying to make a very diverse religion into something that can be understood simply, which is very difficult. By defining these six principles, she is trying to define a set of fundamentals for the religion, as seen with Christianity and Judaism. However, that isn’t really possible. From a personal point of view, Hindus come from one God. From this God comes all beings, including the other common forms of Brahman, like Vishnu, Shiva, etc. When God comes to Earth, He takes on different forms, as seen in the Mahabharatawith Krishna (a form of Lord Vishnu). Wherever He comes, that area of India is more likely to worship that form of Him. This makes Hinduism a very diverse and complex religion. For Bhattacharya to try to put all that diversity into a box by only talking about Mahabharatais bold but terribly difficult. In a religion where there is no one set scripture, like there is with other monotheistic religions, trying to find one scripture that can be interpreted for a topic that isn’t talked about is challenging. Bhattacharya does a good job at it, however, throughout her book, it seemed like she was explaining what Hinduism was more than how it significantly differed in bioethics compared to Judaism or Christianity.

Nevertheless, that doesn’t mean some of the differences in reproductive technology weren’t due to religion. Judaism has a more stricter view on the use of reproductive technology than does Hinduism. The six elements of Hindu thought – emphasis on centrality of societal good, a firm belief in the underlying unity of all life, the expectation and requirements of dharam, the multivalent nature of Hindu traditions, a theory of Karma and a commitment to ahimsa- are all ideas that are not concrete; there is no one right way to interpret them. Thus, grouping things into categories is difficult. Judaism, on the other hand, has a set of principles that one needs to keep in mind and abide by when conceiving. For example, Broyde talks about whether the “process is permissible (mutar), prohibited(asur) or a good deed( mitzvah)” (Broyde 296). This is brought up when he discussed activities that were obligatory, like having 2 kids or acts that were permissible, like getting artificial insemination with sperm other than the husband’s (with his consent). Cloning, though not the best option, would be something that would be permissible. The problem comes when defining who the mother is. Here we see a fundamental difference between Hindu thought and Judaic thought. While Hindu principles seem to be up to the interpretation of the individual, for Jews, though it is case-by-case, their principles are more concrete and distinct.

In looking at a specific example of this difference, one can see this underlying distinction through motherhood. Broyde, when looking at cloning, said that motherhood could either go to the gestational mother or the clonor. He agreed with it going to the gestational mother because she was the one who had “conceived” the baby, although the clonor was genetically related to the mother. This is an idea that aligns with was discussed in Susan Kahn’s book, in regards to an IVF. Bhattacharya didn’t necessarily disagree with this idea, but she believed it depended on the situation. The first-born of Kunti, for example, was conceived and genetically-related to Kunti but he didn’t think of her as a mother-figure because she didn’t raise him. Additionally, in the Jaycee case, the surrogate parents wouldn’t be considered the parents and neither would the individuals who donated their egg/sperm; it would be John and Luanne. These two cases do align with Jewish thinking as well, if everything is planned so that the child is Jew and not related to either the husband’s family or the wife’s. Through the stories talked about by Bhattacharya, it is important that the child is related to either parent, but does not necessarily have to be from both parents if one of them cannot procreate. Nevertheless, the extra details of making sure the child is Jew and relatedness aren’t emphasized in Hinduism.

If Bhattacharya and Broyde were to discuss genetic testing, I believe it would have some similarities and differences. Bhattacharya would deal with it based on the 6 elements. If the results of the prenatal testing came back positive for something like Down’s Syndrome, not only would it be analyzed in terms of how to deal with it, but it would also be looked at to see what had the parents done through their actions or practices that they had gotten a child with problems. Using those same elements, they would then make their decision about what to do with that information, such as should the child be aborted or should the child live. If a Jew couple went through this same test with the same result, they would probably go ahead with the child because of the emphasis on having kids to fulfill your duty. Broyde would see how well it fit in with the halakhah. Both of them would agree that aborting the child would be seen as a sin. The reasoning behind each is complex, nevertheless, the common idea that life begins at conception and that having a child is part of one’s duty in life holds greater value than does (or should) the problems the child has been screened for.

After reading Bhattacharya’s work, it was interesting to see how she was trying to fit Hindu bioethics into Christian and Jewish bioethics.  By attempting to westernize Hindu principles, she was able to build a basis for bioethics. However, it was a very broad base that was very similar to Christian and Jewish ones. While she was trying to show how straightforward and simple their bioethics was, she was also trying to simplify Hindu’s bioethics by attempting to mimic it. This is seen through her use of one scripture, as well as defining a set of thoughts/principles that guide Hindu decisions. Through defining Hinduism as a very interpretive religion, it’s important to recognize that all religions can be interpreted in different ways. Broyde’s work helped emphasize this point by looking at the rules we see in Judaism on who the rightful parents, which depended interpretation of who the rightful mother or mothers are. Additionally, by looking specifically at Roman Catholicism, it diminishes the broadness of the Christian view to a specific, orthodox sect. So, while her work attempts to show Hindu bioethics like the Western religions, it is done at the expense of a more constrained view on all 3 religions.

Works Cited:

Bhattacharya, S. (2006). Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology. Suny University Press.

Broyde, M. J. (2005). Modern Reproductive Technologies and Jewish Law. Marriage, Sex, and the Family in Judaism, 295-328. Rowman & Littlefield Pub, Inc.

In addition to participant observation, there are other methods of understanding a religion or culture’s guiding principles for life and decision making. This extends into bioethics. Both Bhattacharya and Broyde use texts traditional and central to the religion to guide their discussions of bioethics. Though there are several obvious differences between the structure of Hindu narratives and the Bible, it is important to note that “Though the Mahabharata does not share the canonical status of the Hebrew Bible and the New Testament… it is a formative text for India and many within Hinduism” (56). More specifically, Bhattacharya largely focuses on stories and narratives from the documents, while Broyde incorporates more specific laws and highly scientific descriptions of fertility treatments and technologies that are prevalent in bioethics conversations.

Furthermore, there is overlap in the goals of the books. Bhattacharya aims to both “inform and to enrich the ongoing bioethical dialogue concerning assisted reproductive technology and to increase the cultural/religious awareness and sensitivity of the healthcare team” especially in relation to incorporating Hindu culture (2). Futhermore, Bhattacharya notes, “By utilizing [the] ancient epic as a source for ethics and exploring how it deals with issues relating to the challenges of having children, we obtain a unique and relevant entry point into the central sacred teachings of the Hindu traditions [and] by working from within the narrative, we participate in and contribute to articulating… ‘Hindu’ dialogue” (3). In addition, Bhattacharya comments on the frequent lack of consideration of Hindu principles in medical care.

Broyde similarly describes his purpose for the chapter: “This chapter is an attempt to create a preliminary and tentative analysis of the technology of cloning from a Jewish law perspective… as an attempt to outliner some of the issues in the hope that others will focus on the problems and analysis found in this chapter and will sharpen or correct those evaluations. Such is the way that Jewish law seeks truth” (Broyde 295). While the religions are very different and the documents that each author focuses on are very different, there is an overlap in desire to further analyze and contribute to bioethical discussions and add new perspectives. These additions might be useful to caregivers, academics, and policy makers (and perhaps even patients that are exposed to the literature).

Both authors list several principles they deem potentially important when creating a bioethics framework. Bhattacharya lists six key principles: “1) An emphasis on the centrality of societal good; 2) a firm belief in the underlying unity of all life (Advaita Vendanta); 3) the expectations and requirements of dharma; 4) the multivalent nature of Hindu traditions; 5) a theory of kharma; and 6) a commitment to ahimsa (no harm)” (63). While some of these principles have more obvious implications for specific bioethical decisions, the author lays out a list of key values that can slowly be incorporated in different and unique ways, and which can expose healthcare workers or ethicists to fundamental ideas patients may come in with.  Within these principles likes a general theme of duty to fulfill a role, which often includes childbearing, and kid treatment of children. Broyde also provides guidelines for making decisions on fertility and reproductive technologies such as cloning. There are five general principles to take into consideration: activity that is obligatory (mitzvah hiyyuvi), Activity that is commendable but not obligatory (mitzvah kiyumi), Activity that is permissible (mutar), ctivity that is discouraged but not prohibited (bittul mitzva), and Activity that is prohibited (asur)” (Broyde 309). These principles embody Jewish law and culture. When considering a reproductive technology in a Jewish context, it is necessary to consider Biblical or Hebrew law and the roles of the individuals involved in the creation of a new human. While these guiding rules are not quite as immediately open to new technologies as Hindu beliefs may appear based on popular narratives, there is still room to consider them as potentially legitimate, especially in special circumstances.

Even with very different texts as the backdrop for analysis, there are beliefs that are shared between the two cultures and religions. For example, even though some reproductive technologies are regarded differently in Jewish culture and occasionally not permitted, women in the Bible often adjust their situations to facilitate childbirth and having a family (Bhattacharya 57), and many technologies are allowed in both Hinduism and Judaism due to the high value on family and perhaps even duty to have children. For example, “Hindu texts reflect a respect for the developing fetal life and argue that it is deserving of protection from harm” (86). Though, as mentioned, Hindu thought is likely more immediately open to new technologies, it is still careful to actually evaluate the technology over time and both cultures emphasize the idea that “some caution is advised” no matter what the new technology is (Broyde 315).

Overall, the two books are different for two main reasons. First, they have slightly different objectives and methods; implications of widely known narratives versus dissection of strongly religious texts. Second, and more critically, they are representing different religions and cultures. In addition, the Broyde piece explained the technology of concern, mainly cloning, in great detail (297-298). This was not as prevalent in Bhattacharya’s article. But there was still a strong overlap in emphasis on consideration of children and family obligation, as well as proper treatment of all people.

Swasti Bhattacharya, Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology (Suny University Press, 2006).

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

Upon reading the works of Michael Broyde and Swasti Bhattacharyya on paradigms of thought and rationalization on reproductive technologies, I was able to gain an understanding of how religious texts make for foundational bioethics. These texts help us navigate a religious perspective on these technologies. There were some key differences that I noticed between the works of Bhattacharyya and Broyde; for instance, there was fundamental differences in methods and texts used as referential material.

Bhattacharya uses the Mahabharata, which is one of the two major Sanskrit epics of ancient India and Broyde uses Jewish law, which is built upon the Torah. The Torah has narratives and so does the Mahabharata, but the Torah also contains commandments, statements of laws, statements of ethics, and other scripture that is essentially a universal doctrine for Jews. The Mahabharata does not hold that type of weight among the Hindu community and is not as universal. Additionally, Christianity and Judaism has had a role in foundational bioethics that Hinduism did not have simply because Christianity and Judaism also function as powerful institutions in Western society (Bhattacharya 28) . This is a fundamental difference between Hinduism and Judaism that influences the Western understanding of bioethics. Bhattacharya argues that until recently, North American ideologies on issues involving reproductive technologies such as infertility have been “primarily shaped by concepts and beliefs grounded in traditional Jewish and Christian perspectives” (Bhattacharya 12).

Beyond differences in power and influence, there are also differences in religious structure such as the idea of scholars and officials that have a certain amount of power and say within the Jewish community, while this sort of position does not exist in Hinduism. Broyde highlights this structure as a fundamental aspect of Jewish law. He notes that Jewish law recognizes the rabbinical authorities of every generation to have final declarations on what is permissible and what is not (Broyde 508), which is how decisions on reproductive technologies were/are made.

Another notable difference is how Broyde and Bhattacharya use the religious texts they focus on. Bhattacharya made it very clear that she is not claiming authority as a religious institution of Hinduism with her writing on reproductive technologies. She was simply aligning narratives from the Mahabharata with common themes of kinship and reproduction that is discussed in Jewish and Christian bioethics. Therefore she uses subjects such as infertility, paternal surrogacy, sperm donation from Jewish and Christian bioethics, but uses cosmology and stories of kinship to illustrate portrayals of those subjects in Hinduism. For instance, the story about the royal families, the Pandavas and Kauravas, demonstrated the difficulties of having sons when the women could not reproduce (Bhattacharya 46). By using examples such as those, I agree with Dr. Seeman that her role with this text is to be an “authoritative interpreter.” Additionally, when looking at the language Bhattacharya uses compared to the language Broyde uses, Broyde uses more authoritative language. Although Broyde acknowledges that Jewish law inspects new reproductive technologies on a case by case analysis, (Broyde 504) he states exact conclusions on specific technologies such as cloning. He presents both perspectives clearly on cloning: the moral conservatism perspective and one of Jewish obligation (Broyde 504). Broyde is able to do this since he can fall back on Jewish law and Jewish institutions that abide by these proclamations, which means a majority of Jews probably do as well.

Another distinct difference Bhattacharyya highlighted was views of religious and societal figures in themes of kinship and reproduction. For instance, in Judaism (and Christianity) God is viewed as a figure with ultimate control and power when it comes to procreation (Bhattacharya 70). The traditional uses of prayer are directed to God in religious narratives such as the story of Sarah and Abraham, when Sarah gave birth at age 90, which also reflects God’s ability grant Sarah the ability to give birth when she shouldn’t have been able to due to menopause. There is also a special relationship between God and women as God enables women and they usually take more initiative when it comes to praying for children. While in Hinduism, Bhattacharyya highlights that there is a coequal existence with God (Bhattacharyya 62).

I believe that most of differences when discussing religious perspectives on reproductive technologies is due to the specific methodology that I highlighted earlier, but I definitely believe that differences between Hinduism and Judaism contribute to these differences as well. Bhattacharyya acknowledges that there is no governing body within Hinduism that can make proclamations about bioethics and that defining Hindu ethic would be impossible (Bhattacharyya 16) and also problematic. However, she does believe that the characteristics of Hindu thought should be essential aspect of Hindu bioethics, which makes sense since these characteristics describe how all aspects of life including reproduction should be approached by most Hindus. While Jewish law distinguishes these ethics very specifically within reproductive technologies even to the point of labeling who would be the legal mother of a child in the case of cloning (the gestational mother) (Broyde 511).

When looking at contemporary bioethics and considering technologies that are controversial today like prenatal testing, I believe that Broyde would approach this by the law that when no other method is available, Jewish law allows for a certain reproductive technology (Broyde 533). By using this approach, I thought that prenatal testing might be viewed as supplementary and therefore prohibited, however, I realized I was mistaken upon doing some research. An article published by the National Institutes of Health (NIH) stated that genetic screening is permissible if used for treatment, cure, or prevention of disease (Rosner). As for Bhattacharyya, I believe that since she too would consider prenatal testing permissible, because, as discussed in class, she has rationalized secular bioethics well by using the Mahabharata.

By investigating these two works, I was able to begin to understand Hindu thought and Jewish law more in its applications with reproductive technologies. This was my initial exposure with both religious texts, but through reading these works I better understood how Jewish law was built upon Judaism as an institution which has more influence and power within Western society compared to Hinduism. Although there were some obvious differences between the two works and their approaches to reproductive technologies, being able to understand how influential Judaism (and Christianity) was in establishing Bhattacharyya’s understanding of HIndu bioethics demonstrated how deeply rooted religion is in fundamental aspects of bioethics.

 

Bhattacharyya, Swasti. Magical Progeny, Modern Technology a Hindu Bioethics of Assisted Reproductive Technology. Albany: State U of New York, 2006. Print.

 

Broyde, M. “Cloning People: A Jewish Law Analysis of the Issues.” Connecticut Law Review 30.2 (1998): 503-35. Web.

Rosner, F. “Judaism, Genetic Screening and Genetic Therapy.” The Mount Sinai Journal of Medicine, New York 65.5-6 (1998): 406-13. Print.

In Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology, Bhattacharya seems to be very well versed on the topic at hand, as she worked in a clinical setting in New York as well has also earned a doctorate in Hindu Bioethics. Typically, when creating a stance on bioethics based on a religion, the first source a person turns to is a Holy text, such as The Bible, The Torah, or the Quran. In the Hindu faith, there is no one true holy text, so Bhattacharya turns to the Mahabharata and relates her ethics to the story of how three queens overcame infertility to provide heirs to the kingdom. In 4 she boils Hindu down to six main factors that provide a basis for Hindu Bioethics. This book has a more of a virtue ethics approach that is based on character formation instead of a decision making approach.

While Bhattacharya speaks to traditional reproduction. Broyde writes upon the stance of Judaism on cloning. In Judaism, the code of law is called Halakah, and on page 296 Broyde breaks down three of the main subcategories of acceptable actions / goods: mutar, asur, and mitzvah. These mean permissible, prohibited and good deed, respectively. Broyde rarely if at all interjects opinion and sticks to the objective Jewish law. He constantly brings up questions of legal guardianship such as who is the mother of a clone? Can there be two? In his conclusion he has 2 different stances depending on if the clone is of a male or a female. For a male, it is a Jewish mandate to be fruitful and multiply, so as a sort of last resort cloning of a male is mitzvah, a good thing. For a female, on the other hand, it is considered neutral. It would be interesting to see other religions opinions on cloning as we have leaned not ever religion interprets “be fruitful and multiply” as a command rather as a guiding principle (Genesis 1:28)

When it comes to comparing methodologies, it’s hard to say with complete confidence that the differences in methodologies are the only contributing factors. Like Emerynn said in her post, even with in the same religion, there are many different sects and sub-sections of a religion with different interpretations of the same words. The methodologies differ between Bhattacharya and Broyde, I think the largest differences are cultural, which is often a direct or indirect reflection of religion. When comparing western Abrahamic religions such as Christianity or Judaism to Hindu bioethics, we see it to be quite difficult. Hindu is a conglomerate of different beliefs and then centered on a geographical location, modern day India. In modern western civilization there are usually codes or laws that people obey, whether they be ethical or legal, these codes usually come from a religious background of a holy text. In Hindu, as mentioned earlier, there is no one holy text that sprouted the religion. What Bhattacharya did was essentially put Hinduism in a frame or template that was cut from western religious stances on bioethics.

One thing that many people have already touched on is the importance of looking at cases on an individual basis and not making generalizations. I believe both Bhattacharya and Broyde would agree. Broyde would most likely base his decisions on the impact of the kin, or the closest family members, such as how much of a burden would this place on those who are around the child with possible disabilities. On the other hand, Bhattacharya would run the idea of amniocentesis through her sixpoint checklist. Some of these main ideas are centered around the idea of Karma, Ahimsa, and Cosmic order. Which begs another ethical question is it better, in a cosmic sense, to terminate a pregnancy or being a child with possible sever disabilities into this world?

 

Sources:

Book of Genesis, chapters 1.

Swasti Bhattacharya, Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology(Suny University Press, 2006).

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

Even in today’s world, the differences that remain apparent among people simply based on choice of religion are astounding. One’s religious identity can completely define who they are and what they believe in. Within the (very) specific lens of assisted reproductive technology, a facet of Bioethics, potential lines of thought can reflect religious roots that trace back to the very narratives that shaped religions. The modernization of these thoughts show consideration of the ancient origins throughout them. With two works on this matter in particular, both Michael J. Broyde’s Modern Reproductive Technologies and Jewish Law,and Magical Progeny, Modern Technologyby Swasti Bhattacharyya, there are differences that are quite noteworthy. While Broyde’s piece, which recognizes material from Jewish law (Halakhah), focuses more on approach to reproductive technology from the perspective of Judaism, Bhattacharyy attempts to construct a bioethical code for Hinduism, which is a field that was yet to be previously explored before her time.

Initially, Bhattacharyy and Broyde do not even attempt to pull their interpretations and bioethical conclusions from the same genres of work, as each explore essentially unrelated types of historical record. The basis for most of Bhattacharyy’s writing comes from the Mahabharata, an ancient Indian epic poem that was considered to be created after the ancient Vedascriptures. This text falls into the category of ‘traditional literature’ according to the author. She writes, “Smrti [traditional literature] literally means ‘recollection,’ but it is used practically to signify ‘tradition.’ This traditional literature ‘is the set of rules for acts of dharma[cosmic order] that are not explicitly declared by sruti[sacred texts with no orirign], but are implicitly derivable from it.’” (Bhattacharyy Location 443). Bhattacharyy is inferring that although these texts do hold weigh in Hinduism, they are more stories of recollection than they are of creation or the religion’s Cosmology. Contrarily, Broyde approaches his views by way of Halakhah, or Jewish law. This derivative of thought is more fluid in a sense, and less defined than historically recorded recollections such as the Mahabharata. Broyde notes, “… even when conduct is permissible or perhaps even a mitzvah [good deed], Jewish law recognizes that the (rabbinical) authorities of every generation have the authroity to temporarily prohibit that which is permissible based on the perception that this intrinsically permissible activity could lead to other, serious violations” (Broyde 296). By this token, Broyde is essentially quoting a source that is perpetually being updated as time progresses, and for all intents and purposes, is situational. The keen differences between these two works from which both authors derive their arguments are important when understanding their texts, both separately and in cohesion.

Although the differences in both Bhattacharyy and Broyde’s stances on bioethics are clear, the roots of those differences come from open interpretations of not only the style of texts they are drawing their conclusions from, but also the religious background of each of these religions themselves. Broyde is quick to break down acts in Judaism to three basic levels of acceptability: permissible (mutar), prohibited (asur), or a good deed (mitzvah) [Broyde 296]. Oppositely, Battacharyy focuses on storylines and six key characteristics of Hinduism: the centrality of society & underlying unity of all life, the flexibility of Dharma and multiplicity of Hindu practices, Karma, and finally Ahimsa. The very constructive frameworks through which each author writes are fundamentally different – they are essentially comparing interpretations based on two differing fields of literature. Additionally, there are key differences between Hinduism and Judaism to begin with, such as Jewish monotheistic practices versus Hindu polytheism & multiple deities, and the histories of each religion as their peoples mostly populated separate areas of the world. In addition to this, it is important to note that Battacharyy writes her work in light multiple other Judeo-Christian on the matter, acknowledging various works throughout her book, whereas Broyde is mostly using Judaism and its set of laws as the focal point for the basis of his argument.

Interestingly enough, Battacharyy and Broyde do seem to have some similar views on the prenatal stage of human life, in the sense that they both encourage respect and care for the offspring. Battacharyy, citing Hindu texts and Cambridge professor Julius Lipner, is able to draw the conclusion, “… Hindu texts reflect a respect for the developing fetal life and argue that it is deserving of protection from harm” The fetus is conscious and even has a memory of his or her previous births” (Location 1312). She is clear with her implications here – even in the prenatal stage of human life, a person deserves respect, and to be treated well, abiding by the principles of Ahimsa (non-harm). In an analogous way, words from Broyde on cloning can be interpreted in the same fashion regarding those that are birthed with defects that would be potentially uncovered prenatally. He writes, “I am hard-pressed to find any rational Jewish law argument that could justify the categorization of a person produced through cloning as not human… the absence of a human parent does not necessarily make one nonhuman – and a clone (of current technology) clearly as a mother at the very least” (Broyde 313). By this token, Broyde is inferring that having a (human) mother is a key characteristic of being human. Evidently, it could be argued that his statement can be further interpreted as saying a human with a mother, even if the human is in a prenatal state, is still is considered human. Both authors do not seem to directly respond to the concept of prenatal testing, but both have outlined clear assumptions regarding their specific interpretations of the texts they have studied, each suggesting that human life does have some value even before that human in birthed.

 

Sources:

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

Swasti Bhattacharya, Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology (Suny University Press, 2006).