Our Bodies, Our Cells: Feminist Ethics and the New Reproductive
by Laurie Zoloth-Dorfman
Martine Rothblatt, UNZIPPED GENES: TAKING CHARGE OF BABYMAKING IN THE NEW MILLENNIUM. Philadelphia: Temple University Press, 1997. 201p. index. $49.95, ISBN 1- 56639-522-4; pap., $18.95, ISBN 1-56639-554-2.
Laura Purdy, REPRODUCING PERSONS: ISSUES IN FEMINIST BIOETHICS. Ithaca: Cornell University Press, 1996. 257p. bibl. index. $45.00, ISBN 0-8014-3243-X; pap., $17.95, ISBN 0- 8014-8322-0.
Rosemarie Tong, FEMINIST APPROACHES TO BIOETHICS: THEORETICAL REFLECTIONS AND PRACTICAL APPLICATIONS. Boulder: Westview Press, 1997. 280p. bibl. index. $69.00, ISBN 0-8133- 1954-4; pap., $22.10, ISBN 0-8133-1955-2.
Valerie Hartouni, CULTURAL CONCEPTIONS: ON REPRODUCTIVE TECHNOLOGIES AND THE REMAKING OF LIFE. Minneapolis: University of Minnesota Press, 1997. 175p. bibl. index. $39.95, ISBN 0-8166-2622-7; pap., $16.95, ISBN 0-8166-2623-5.
Susan Wolf, ed., FEMINISM & BIOETHICS: BEYOND REPRODUCTION. New York: Oxford Press 1996. 398p. bibl. index. $55.00, ISBN 0-19-508568-X; pap., $29.95, ISBN 0-19-509556-1.
It was the first insight of the women's movement that personal knowledge of a woman's life empowers the writer to understand and to write from a truthful perspective, and that such a stance would at last enable women to both describe and then control the events in our lives that are central. Of all the events in a woman s life, the complexities of reproduction surely are key. The ability to know and control one's reproduction and sexuality animated nearly all the early discourse in women's groups. Of course, in the early 1970s what we wanted to control was access to abortion, and what we collectively feared was the burden of too many children too early. We had big dreams to pursue.
How times have changed. In the latest rush of feminist scholarship, what is at stake is control over the making of babies, and, as the technology has grown exponentially, how to slow the biological "clock" for hundreds of women. What now draws our scholarly attention is the goal, purpose, and meaning of this technology. Yet in this next generation of reproductive issues, how is feminist scholarship responding?
Several collections and single-authored texts have emerged that attempt to create a heretofore critically absent feminist ethics of reproduction in particular, amidst a more general feminist bioethics. These texts range from rather panicked responses to the extraordinary power of reproductive research and therapy to careful, magisterial work toward a definitive theory to illuminate our response.
The fact that reproductive technology has developed so dramatically has depended at least in part on the very women's movement that has produced such fine women's studies departments. As women postponed childrearing, fertility decreased and reproductive choices were altered. Americans also began to expect that choices, so important to a self-definition, would include positive as well as negative ones: hence the expectation was raised, far beyond the right of access to abortion, that the decision to have a child would translate into the fact of a perfect, healthy baby, an expectation that would have been ludicrous in an earlier era, or seen as a matter of faith, prayer, and community. Astonishingly enough, medical science was eager to try, and the field of advanced reproductive technology quickly expanded to meet the rising expectations, and the emerging marketplace that supported them.
Now that the desire, the industry, and the technology are in place, the ethical questions begin to emerge. When we are making babies, what is it that we are doing? Who really has the power to control this technology? Are there limits to what medical science ought to strive for, and who should set the limits? What conception of the female body are we constructing by the use of the parts of the body (cell-by-cell) to make new life? How far ought we go in a search for motherhood is the use of other women's bodies permissible? Lurking just below the surface of such questions is the problem of what we meant when we spoke of freedom to choose. Ought it mean that women should be able to do whatever they want with their bodies and the fetuses they carry within them, including act as surrogates, or sell their eggs, or buy any aspect of the reproductive cycle they need? Or are there externally derived ethical standards and what might those be? Does having these standards in the hands of women necessarily protect against abuses of power?
Now we never said it would be easy, but such questions can seem nearly intractable. For scholar Rosemarie Tong, good ethics begins with careful categorization of all the available responses. Her book is divided into two sections, one that describes both the "non-feminist" and the range of feminist responses to standard epistemological issues in philosophy and ethics: method, politics, ontology, principlism,1 virtue theory, and duty. Here the reader will find a thoroughgoing analysis of how feminist theories differ from theories developed by men in the literature (from Aristotle to contemporary bioethicists) and from one another. Tong has explored how such stances as essentialism, the ethics of care, and socialist feminism can enhance our understanding of the maternal-child relationship, or of the problems of utility. The second section is devoted to the practical applications of the theory, yet the issues addressed are all about reproductive events abortion, conception, and genetic therapy. If all this leaves one wondering what other issues feminist bioethicists think about, one need look no further than Susan Wolf and her co-authors (Tong is among them in what is essentially a reprise of the early chapters of her book) in Feminism & Bioethics: Beyond Reproduction. For the reader who wants an in-depth and nuanced view of the issues Tong addresses, this book will provide a strong, serious beginning. Of particular interest is her review of feminist discourse on the issue of genetic counseling. Here we see the problems of a mature feminism engaged with the realpolitik of non-binary choices. Should genetic therapy and abortion be used to select against gender, or disabilities? If so, what is implied about our relationship to the disabled?
It is in these ontological questions that the work of feminist scholar Laura Purdy is located. Purdy, who in addition to being a formidable scholar has been central in the practical organization of feminist bioethicists, offers a convincing argument about the problem of constructing an idealogy of choice in a society marked by such desperate choicelessness. All yearning, Purdy would remind us, including the yearning for children and the willingness to submit to any intervention, is culturally framed by a social understanding of what is "natural" and appropriate for women. Purdy spends a full chapter of her work responding to a classic theory in the bioethics literature best articulated by legal scholar John Robertson. Robertson's rights-based argument serves as the interlocutor for Purdy to examine how poverty, limited life choices, and the marketplace itself can shape the purchase, sale, and use of the various pieces of the reproductive process, all of which rely on the compliant female body as the only available location for the technology itself and all of which make the ideal of "inalienable rights" suspect.
Valerie Hartouni, in her riveting and complex book on reproductive technologies, deepens Purdy's critique. The body, Hartouni tell us, has become "open to the public," especially the interior space that is the womb, in which the developing fetus is then seen as "housed." It is this visualization of the body that allows us to see (to read) the body as a social text, even when it appears to be the most natural or "objective" of objects. The social nature of reproductive technology is made ever starker by the hearing of contentious cases in courts of law. Here, where reproductive practices enter the legal discourse, we see how notions of property and contract then shape our understandings of who "owns" embryos and babies born of surrogacy arrangements. For example, the surrogacy cases that gave legal parameters to the discourse were decided on the basis of contract laws. What was seen as critical was how the money changed hands, what the deals had been, and what had been spelled out in writing. For such confusions, the remedies suggested are better contracts and tougher deals - the definition and naming of the problem as a legal one directs us to legal solutions. Hartouni's insight is that even this primary ordering or arrangement is freighted and, not tangentially, based on a view of women that names them as "fetal containers." Like the very act of vision itself (and here Hartouni uses the work of Oliver Sacks to remind us of how the ability to see is only in part physiological, and in part linguistic,) claims are plausible if they make logical sense within the terms of this legal discourse. Hence the claims of surrogate mothers who change their minds and become attached to the baby they carry are seen as incomprehensible, and then dismissable, since they violate a contract which "sees" a baby as merely a type of purchase, payable in advance, rendering the process and the meaning of pregnancy itself invisible.
New reproductive technology will only intensify the basic ethical challenges. Like most of the books noted, Hartouni's ends with a chapter about that most captivating of technologies, human cloning. Cloning is the most profound example, of course, of a discourse about the crossing of borders we had seen as natural and God-given, identities and relationships long mediated by religion, culture, and family duties, and Hartouni clearly sees it as one more social yearning to control the whole disruptive act of women's reproductive capacity.
For such an excursion, for such a "dangerous time," as Hartouni reminds us, the reader needs a skilled guide. Yet such care and thinking are not inherently the case for feminists writing about reproductive ethics. One reads, for example, the work of Martine Rothblatt with a sense of growing unease. Rothblatt is worried about the Human Genome Project and about reproductive genetic interventions; in fact she has given us "a manifesto" about the "coming Holocaust of sex." Now this reviewer does not approve of using the historically specific term Holocaust to describe anything that a writer thinks is very upsetting, but that is the least of the problems one encounters in this volume. Here one will find a clear example of what feminist ethicist Karen Lebacqz told her student ethicists never to do in graduate school: "you cannot simply tell me, oh golly it's awful!" Yet this book goes even further than describing the genetic material as "the seeds of sex" terribly mishandled by sinister forces; it proposes a solution called "inocoseeding," which would have (someone) banking all men's semen and performing a vasectomy on each, and using the "seeds of sex" to then make babies. ("See how logical?," one can almost hear the author cry.) Such a book might find a use in a course about the workings of the popular imagination, but the serious reader who wants to know what issues in genetics will confront feminist scholars in the next several years ought to refer instead to Julie Gage Palmer and Leroy Walters' book2 on ethical issues in genetic intervention. Palmer gives a clear and lucid account of how genetics works that will ground any discussion of what moral meaning we will need to make of it.
In the late 1800s, Americans headed out for the borders, for the frontiers, full of certainty and armed not only with police power, but with the ideology for mastery of the environment and of the people they found there. It was a time of frontier logic, a linguistic discourse, Hartouni might have observed, in which moral rightness had most to do with property ownership and the means to protect it. Reproductive technology is in its cowboy years, during which much is justified by a logic of the manifest destiny of medical science a shootout in which, once again, girls don't have the guns. The social order, however, that will be needed to organize the project, the treatment of those persons whose bodies are the terrain of the project, and even the naming of the project as a discourse of illness and cure rather than a faith journey, a call for community, or a feminist challenge, is still not decided. These scholars lead us to the considerations of how such a discourse might be constructed and might be ascendent.
1. A set of ethical principles to be used when considering bioethical cases, proposed by Tom Beauchamp and James Childress in Principles of Biomedical Ethics (New York: Oxford University Press, 1979).
2. Leroy Walters and Julie Gage Palmer, The Ethics of Human Gene Therapy (New York: Oxford Press, 1997).
[Laurie Zoloth-Dorfman is Associate Professor of Social Ethics and Jewish Philosophy and Chair of the Jewish Studies Department at San Francisco State University. She is cofounder of The Ethics Practice, a clinical ethics consultation firm specializing in bioethics education, research, and case consultation.]
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Mounted September 8, 1998.