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New biotechnologies, like IVF and stem cell research, are constantly changing the meaning of life and death, profound and dirty, what is natural and unnatural. IVF and other artificial reproductive technologies (ART) methods are used by people who previously were not able to procreate “naturally”. This has led to ethical debates where people are faced with dilemmas of abortion and makings of new legislation to regulate the use of biotechnologies (Bharadwaj, 2012). There are, in addition to ethical forums and legal legislative, other top-down and bottom-up approaches that govern which technologies suitable for use. For instance, in some Islamic communities social and religious “fatwas” are strongly influencing the use of different biotechnologies. (Inhorn, 2012a). In other religious communities, like Hinduism, it is believed to be a more symbiotic relationship between life and death, which makes stem cell research and other infertility treatments more popular (Bharadwaj & Inhorn, 2016). In such countries the marked around biotechnologies has grown and is making reproductive treatment more popular (Bharadwaj & Inhorn, 2016: 69). These top-down approaches tend to influence people’s attitudes towards certain biotechnologies, but discrepancies might also occur in people beliefs and values. In an economic and biotechnological framework, embryos are viewed as resources rather than a potential son or sibling, which in terms can violate infertile parents’ perception. The integration of biotechnologies in communities can change existing social structures and can create conflict. An example of this is a spreading negative attitude towards genetic abnormalities and people with disabilities (Ginsburg & Rapp 2016).
What are the ethical concerns that surround IVF, artificial insemination and stem cell research?
Some anthropologists are looking at how new reproductive technologies might lead to killing and damage of excessive embryos (Bharadwaj & Inhorn 2016). Although new reproductive methods are giving hope to mothers and fathers all over the world, they are also contributing to a big killing of left-over fetuses and embryos. The anthropologist refers to it as “little deaths”, not because of the little impact they do in our society, but on the contrary how much of an impact they can have on people involved, despite their little size and short lifespan (Bharadwaj & Inhorn 2016: 68). The IVF clinics are promising life and keep the focus on embryos that actually survive. “The truth is that millions and millions of IVF conceptions end in « little deaths»” (Bharadwaj & Inhorn 2016:73). Even in the best clinics in the world is the success rate never more than 30%. The excess embryos are then destroyed or used in stem cell research.
Progress in stem cell research makes the ethical debate around the destroying of fetuses more interesting. One leftover embryo can be destroyed and produce stem cells for a thousand people. The stem cells can be used to cure Parkinsons’ disease, Diabetes, and spinal cord injuries, among other things (Bharadwaj and Inhorn 2016:73). In a utilitarian perspective is this practice considered very beneficial, as it can use one “close to living” organism, to cure many people’s problems. However, “one of death” in a utilitarian perspective can easily transform to a “one-off sacrifice” to supplement, which the rich will benefit from (Bharadwaj and Inhorn 2016:70).
Another group of anthropologists is more concerned about the potentiality to modify and extend the life beyond what’s considered natural. And one end is many everyday problems now being cured, while on the other end are we creating more social imbalance. Ginsburg and Rapp argue that many screening tools show abnormalities or variance rather than a clear diagnosis, which leaves women in a moral dilemma of keeping the fetus or not. In most cases do abnormalities lead to abortion, although the consequence of the genetic variance is uncertain (Ginsburg and Rapp 2016:528). This makes young parents the moral decisionmakers on who is allowed into the world, with guidance by some doctors who in most cases recommend abortion, although the abnormality is uncertain.
Who makes decisions about which new biotechnologies are will be used?
Biotechnology is constantly driven by innovative, societal and economic forces (Bharadwaj 2012: 305). This leads to accessible treatment for people with infertility problems or general health problems with the use of stem cell technology. Factors like legal legislative, ethical discussion, political decisions, and religious beliefs are influencing if reproductive technologies or stem cell research will be used or not. This can be referred to as top-down factors that govern the use of new innovations, as they start from the top and are influencing the behavior of individual people who are faced with the decision of supporting these technologies. For instance, ethical discussions shape the common conception of an embryo; where does life begin? These ethical reflections take place both among individuals that are consenting to use of biotechnology and in media and other societal forums (Bharadwaj 2012: 310).
Legal legislative and societal norms are also influencing what kinds of technologies that are been used. In the USA and many European countries, the debate is polarized, which has led to stronger regulations. For instance, in 2001, did W.W Bush deploy legislation saying that stem cell research would only be allowed using embryos already existing. This ethical stance influenced the perception of embryos and changed the marked for stem cells technology all over the world (Bharadwaj 2012: 310).
In India, there is a marked for biotechnological research making IVF and stem cell therapies popular (Bharadwaj and Inhorn 2016:69). Many Indian stem cell clinics have a high supply because people are willing to donate embryos after IVF procedures. This makes India, and especially New Delhi, a world elite on stem cell research (Bharadwaj & Inhorn, 2016). The economic generation from biotechnologies is making governmental regulations easier. In opposition to the increasing marked in India is the Australian marked. Here people lack the motivation to donate embryos which in terms lead to less funding of stem cell research (Bharadwaj 2012a: 306).
In Islamic communities the sharia laws and “Fatwas” are regulating the social norms for use of different biotechnologies and fertilization methods (Bharadwaj 2012b: 163). For instance, Islamic communities in Libanon, Irak and Jemen consider masturbation and semen donation “haram” which makes it harder for Islamic men to realize the goal of becoming fathers (Bharadwaj 2012b: 136). Inhorn’s ethnographic studies on muslim men reveal that there are many infertile men who are struggling personally and socially (Bharadwaj 2012b/2012c). They also deny abortion as an alternative because of a common conception that procreation must occur as natural for kindship to form (2012b:134-136).
The mentioned top-down factors are important forces governing the use of different biotechnologies, though there are also important personal and individual mechanisms influencing what kinds of methods are being used. Bharadwaj & Inhorn (2016: 71-72) tells the story of an Indian woman who first underwent an abortion and became “secondary infertile”. She later sought IVF to hopefully give birth to a second son, unfortunately without success. She was asked to donate the surplus embryos for stem cell research, in which she consented to. Although the embryos are used to productive stem cell research she could not stop blaming herself for becoming infertile, and “killing” the embryos. Because she now wanted a new child she started viewing the embryos as living beings. This connection had changed her perception on abortion and stem cell research, despite the social norms (and other top-down mechanisms) remained the same.
“Her worldview was shaped not by some rhetorical investment in bioethical, religious, or bureaucratic attempts at ascribing sentient potentiality to an embryo, but rather by a deeply personal struggle with secondary infertility and the guilt of believing that her decision to opt for termination of an earlier pregnancy was now responsible for her current predicament.”
- (Bharadwaj & Inhorn 2016: 72)
How might these new reproductive technologies challenge anthropologists trying to understand social relationships?
As mentioned earlier, the use of new reproductive technologies is giving Islamist
(muslim) men and women the possibility to realize the goal of procreation. Social norms and “Fatwas” are prohibiting the use of several innovations, which makes it difficult to actualize. New technologies like ICSI (Intracytoplasmic sperm injection) are making it possible for muslim men to maintain their social status and obligation of procreation. The same goes for women who feel obligated to give birth the “natural way” (Inhorn 2012c: 135).
Ginsburg and Rapp (2016) argue that new productive technologies and advanced screening methods are changing social structures, and especially how we view what’s “unnatural”. In IVF, and other reproductive technologies, screening methods like NIPS (Non-invasive prenatal testing) are used to check for diseases that could be dangerous for the fetus or for the mother. In most cases would detected abnormalities in the fetus’ genome lead to abortion. Ginsburg and Rapp argue that neither the screening methods nor the doctors can give accurate knowledge about certain abnormalities, and leaves families with little knowledge about the possible future and devilment span for the new-born (Ginsburg and Rapp 2016: 530). The societal image on living with a disability, or any sort of genetic variance (like down syndrome) as a “less of life quality”, are forcing women to perform an abortion. The authors draw a parallel between these tendencies and the eugenics movement and finds it to be equally discriminatory and socially destructive (Ginsburg and Rapp 2016: 527). The diseased and disability-oriented narratives will lead to more abortions but could also shape future social relationships and attitudes towards people with disability (Ginsburg and Rapp 2016: 532).
New biotechnological and reproductive methods have resulted in ethical concerns and debate. The communal conception of such innovations is largely shaped by the economic forces and politics behind. Anthropological studies also reveal that deeper and personal bonds are influencing the use of some biotechnologies. Implications for social structures have been identified, like how people with disabilities are being presented. The fast-changing biotechnologies and reproductive methods are altering the “normal” trajectory for life and death, as well as the establishment of kindship.
- Bharadwaj, A. 2012. Enculturating Cells: The Anthropology, Substance, and Science of Stem Cells. Annual Review of Anthropology 41, 303-17.
- Bharadwaj, A. & M.C. Inhorn 2016. Conceiving Life and Death: Stem Cell Technologies and Assisted Conception in India and the Middle East. In Living and Dying in the Contemporary World ed. V. Das & C. Han, 67-82: University of California Press.
- Ginsburg, F. & R. Rapp 2016. “Not Dead yet”: Changing Disability Imaginaries in the Twenty-First Century. In Living and Dying in the Contemporary World ed. V. Das & C. Han, 525-41: University of California Press.
- Inhorn 2012a. Islam and Assisted Reproduction. In The New Arab Man, 193-227: Princeton University Press.
- Inhorn 2012b. Masturbation and Semen Collection. In The New Arab Man, 161-92: Princeton University Press.
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