Reproductive technologies Flashcards
What are the hidden values of technologies?
We think technologies are value-neutral, autonomous, and are sources of empowerment because they increase freedom and flexibility.
But are they?
- Relations of power in the production and application of technologies
- Differential access to new technologies
- Technologies create new elites and populations to be worked upon
- Informed consent for individuals but not families
Discuss feminist arguments against IVF
Development was technologically driven, rather than humanitarian
- The counter to this position was that the technological developers of IVF were driven by both impulses - they wanted to help infertile families, and they wanted to push the technological limits of their discipline. The parents of IVF were explicit about their desire to help infertile families. Nevertheless, the assisted reproductive field has been troubled by abuses of power before.
The technology defines women in terms of their reproductive capacity
- This was the concern of the future Pope John Paul I about women becoming “baby-factories”. Margaret Attwood’s The Handmaid’s Tale was written around this time, and reflects these concerns.
The impacts of the medical intervention on women’s health is underestimated
- The advocates of new technology may have underestimated their impact upon women’s physical health. The early trials of the contraceptive pill, for example, used such high doses of oestrogen that some of them had strokes. [Ovarian hyperstimulation syndrome] which can be fatal, was not recognised at the time as being potentially life-threatening.
Discuss the ideas central to IVF
Designed to be a tool to rescue women from infertility
Pioneering technology that re-invigorated notions of choice in biological parenting
We can see that two of the ideas that has taken hold is choice and perfection.
These technologies were designed to rescue women from infertility.
We can see now that they technologies have also re-invigorated notions of choice in biological parenting. The assisted reproductive technologies allow us to invest in trying to create the kind of baby we might desire. This is a long way from earlier approaches to parenthood, where adoption and fostering of non-biological children were the solution to infertility.
Discuss surrogacy countries
Australians have become prolific users of overseas surrogacy programs. The graph above shows the relatively slow growth in travel to the USA for surrogacy, compared with the massive growth in Indian surrogacy. The drop around 2012 reflected legal moves in India to shut down a [burgeoning industry of exploitation], in which Indian women paid a fraction of the amount given to the IVF clinic spent nine months gestating a baby to be removed via caesarian to be given to the “commissioning parent”. Thailand took over the position as chief provider of surrogacy services, until the scandal of the [Baby Gammy case], after which Thailand stepped up legislation against clinics. Travel from Australia currently seems to be going to Cambodia where the market is relatively unregulated.
List and briefly describe the different parents
social parents: the parent who raises you
gestational parents: the parent who carried you in the womb
genetic parents: the parents who give your genetic material e.g. egg and sperm donors
commissioning parents: asks for and arranges for you to be born, usually through paying someone to undergo surrogacy
‘cytoplasmic’ parents, and mitochondrial parents: the parent who in rare cases provides mitochondria to a mother with diseased mitochondria
Discuss Savulescu’s position on procreative autonomy and sex selection
Couples (or single reproducers) should select the child, of the possible children they could have, who is expected to have the best life, or at least as good a life as the others, based on the relevant, available information
There is a strong argument in favour of sex selection, based on respect for procreative autonomy – the autonomy of the couple to decide how to procreate and what children to have.
Making sex selection illegal is more akin to Nazi eugenics than allowing couples to decide themselves which children to have.
Describe the population effects of sex selection
From a population perspective, such an approach has proven disastrous for many Asian countries. The male:female sex ratio at birth is 105:100 (males are more fragile than females and more are needed to reach sex parity in adulthood). China’s current male:female ratio at birth is 115:100.
Although investigations for sex determination are illegal in all countries, it is openly carried out, with little policing.
Describe the societal effects of sex selection
There was at one stage an argument that perhaps this would result in an increase in the status of women. Perhaps the kind of ascendancy that Chinese women on If You are the One show over the hapless male contender for their affections. In practice what we have seen is an entrenchment of patriarchy, with
- more violence against women in both countries, partly attributable to the excess of young unpartnered men
- trafficking of brides from neighbouring poor countries, such as Cambodia
- bridenapping
- wife slavery, with one wife being shared between brothers
- emerging accounts of male trafficking to richer Asian countries on the promise of marriage, and being enslaved to undertake labouring work.
This, at a population level, is the result of very low level reproductive technologies (ultrasound and abortion) being widely available in a traditional patriarchal culture. While procreative autonomy may be an individual benefit, this would be an occasion where issues of non-malificence may impact upon its wide use.
Jane wants to sell her eggs to help a childless couple she read about on the internet. She had mumps as a child and ovariitis Her mother is strongly of the opinion that this is a bad idea.
List the arguments Jane would make in defence of her decision, and the ones her mother might make to dissuade her.
Jane would say: * she has the right to decide what to do with her body
* she has the right to an income from a renewable resource (her eggs) for whatever purpose she chooses
* if the technology exists, the childless couple should be enabled to have a child
* the risk of exploitation may be less if there is a price attached to her eggs – it makes the transaction more transparent
Her mother might say:* putting a price on a part of her body is morally wrong
* putting a price on a part of her body risks exploitation. She will have to physically suffer to produce these eggs (risk ovarian hyperstimulation syndrome etc) and she may not be properly reimbursed for this. The couple may place other expectations upon her which she may not be able to live up to (eg has to lead a good life, mustn’t drink alcohol or coffee)
* eggs are not a renewable resource, and her stock may already have been damaged by ovariitis as a child. Therefore, this may compromise her fertility.
Is the notion of “procreative autonomy” applied to parental decisions to screen their children just eugenics with a fancy name? Why? Why not?
“Procreative beneficence” as articulated by Julian Savulescu (former editor of the Journal of Medical Ethics, Professor of Practical Ethics at Oxford, and Head of the Melbourne-Oxford Stem Cell Collaboration) states
couples (or single reproducers) should select the child, of the possible children they could have, who is expected to have the best life, or at least as good a life as the others, based on the relevant, available information .
He defines “should” as “have good reason to” . He does not support coercion.
The distinction between procreative beneficence (procreative autonomy is the practical experience of this principle – it’s what he thinks you should have as a parent) and eugenics rests on his view that eugenics was a population-oriented approach, which could therefore be used to over-ride private citizens’ rights. Procreative autonomy is essentially invested in the private individual, and therefore the argument about population interests is secondary.
The male: female ratio among Chinese newborns is approximately 120:100 (for the rest of the world, male:female ratio is 106:100). What are the potential explanations for male child dominance in China? List at least four reasons.
Male child preference within the one-child policy underlies all the social explanations.
* Abortion of female children (identified through ultrasound, now widely available in many countries with male child preference)
* Infanticide of female children
* Redistribution of female children (sending them to rural areas, where one may be allowed more than one child, or can hide the child)
* Failure to count female children (eg by bribing officials)
There is also a biological argument that in countries with a high prevalence of hepatitis B, male children are more common (seropositive mothers are argued to be more likely to have male children).
List some of the social consequences that might be expected with a high male : female ratio for China.
Many men will not find permanent female partners
Consequences of the missing women of Asia:
* bridenapping parties in rural areas
* attaching dowries to men
* polyandry (one woman, with many husbands)
* more acceptance of male-male relationships
* importation of brides from other countries, resulting in more multiracial families
China introduced its “Care for Girls” policy in some rural provinces in 2004 to combat some of these consequences.
Why did India corner the world market in commercial surrogacy?
Perfect market conditions. It was made legal, but is not tightly regulated. There is sufficient infrastructure and knowledge to develop the business (India overproduces doctors, including highly trained specialists, so there is a great deal of competition among them to develop work opportunities), and the country is highly unequal, resulting in a population which will be willing to act as surrogates. Because wages are low, the Indian surrogacy business can offer a far cheaper service than other countries which allow commercial surrogacy.
