Family Structure in the Wake of Genetic and Reproductive Technologies Conference – Day 1, AM Session

– The purpose of this
presentation is to give you a general overview and background of this, of this conference, but also, the larger Islamic Bioethics Project, which started here at
Georgetown University in Qatar back in 2009, even before I
came, so one year before I came. The colleagues here, former director, together with the Director of the Kennedy Institute of Ethics, they put together a proposal to develop a specialized collection on Islamic bioethics resources and the application was successful. I came, I joined and the
journey started from there. Overall, the project,
Islamic Bioethics Project, has been quite fortunate to receive the
generous funding from QNRF, three in total, three three-year grants. The first one is this one
that I just mentioned, the bibliographic project. It was a collaboration between the Kennedy Institute
of Ethics on the campus and the School of Foreign
Service here in Qatar. The overall objective
of that was to develop the physical collections
which was produced, housed now in the library,
our wonderful facility here. I hope you will have an
opportunity to visit. And also, an online database. The second project. This is just the interface. It’s free online, so you can visit it from anywhere in the world. Currently the database contains more than 5,000 records of the
Islamic Bioethics resources. The physical collection consists
of about 800, 900 volumes. The second grant that came
right after this was to expand the scope of the first
project, to continue it, but also to build the infrastructure of the Encyclopedia of Islamic Bioethics which is currently on the advanced stage of development with
Oxford University Press. Right now, the finished
articles are published on Oxford Islamic Studies Online. It’s projected to have about
from 130 to 150 articles. We’re going to have about 50 published when all the articles are finished, then we’ll go with the print version. The third project is the one that actually inspired this conference. It’s called Family Structure
in the Wake of Genetic and Reproductive Technologies,
and this is an area that I personally would have
interest in since I came here. Again, we have been extremely
fortunate to receive the generous funding from QNRF three-year project to explore this theme from three the angles or dimensions, being restricted discourses,
from critical dimension and positive legal dimension. Currently, we are in the
third year of this grant. So, over the years the
Islamic Bioethics Project has inspired these related, wonderful initiatives
in three main domains. Teaching so one (mic static
drowns out speaker) course is inspired by this
project and its resources. It is being offered here. It has been offered for
several times since 2015. So it aims basically to use students to (mic static drowns out
speaker) and questions. In terms of research, the project team met the promised outcomes
or goals of all these grant-funded projects and also, a number of
scholarly academic articles and publications have been also generated through these projects. In terms of outreach and public service, The project team over the
years has been able to organize three international conferences. The first goes back to 2012, Islamic Bioethics: Interplay
of Islam and the West. My colleague Mohammed Ghaly is here, back then he was part, he
continues to be part of the team, so the idea came actually from him. The second was The Human Person: Challenges for Science,
Religion and Governance. That was held in 2014 and
it was a collaboration with The Contending Modernities Initiative with the university, or at
the University of Notre Dame. And, this is the third
international conference or slash, symposium. Again, organized within the general framework of the
Islamic Bioethics Project. In addition to this, conferences that were held here in Doha. The project team also
participates in many important local, regional and
international conferences on Islamic bioethics, Islamic
law and culture and societies. So, this is just the interface of Oxford Islamic Studies Online where the front page shows the page of the Encyclopedia of Islamic Bioethics and here it shows the number
of articles or at least some of them that have been
already published online. This symposium, as I
said, was generated mainly as a result of the third grant. And this conference, this
symposium aims to expand the scope of the Family Structure Project in the three areas, juristic,
empirical and legal dimensions and this is reflected
in the presentations. (clears throat) Sorry. That will be given during this symposium as you can see from the program
that you have in your hands. It’s a two-day event. Today is a public conference and tomorrow will be a closed workshop just amongst scholars to
explore further steps, possibilities also for
publications, et cetera. This is also for more information about the Islamic Bioethics Project. You can visit our working
website, it includes, we try to update the, give updates, regular
updates about developments in the three concurrent initiatives. Finally, I would like to
conclude with acknowledgement. This symposium has
received generous funding from two main entities, QNRF, the Conference and
Workshop Sponsorship Program and also from Georgetown
University in Qatar, mainly the Research Committee. The Research Committee matched the amount that we received from QNRF. So, thank you very much to these two entities, organizations. Also, a special thanks to many people. I don’t want to mention
anybody by name because I don’t want to forget
anybody, but many people worked for the organization of this symposium. I’d like to thank the Dean’s office, Grants and Research
Compliance team, Events team, Communications team,
Facilities and IT team, the Library team and
finally, all the members of the Islamic Bioethics Project. I don’t see the Dean yet, perhaps he’s still stuck in traffic. So, perhaps we can start
for the interest of time move to the presentation by QNRF and it will be given by Dr. Omar Boukhris. (speaking in foreign language) – Dean of Georgetown University
in Qatar, Dr. Ayman Shabana, professor at Georgetown
University in Qatar, VIPs, Organizing Committee, guests, ladies and gentlemen, good morning. (speaking in foreign language) This is Dr. Omar from the
Qatar National Research Fund. I’m here to substitute on my colleague who is more indulged
into such kind of topics because I’m from the engineering world, so excuse me if I’m not
that deep in this area. Though, I admire and I’m
much interested in this area, that’s why I thought, when
I learned what the topic, and I learned that I am the one to present something for the audience, I thought about approaching
this in a broader aspect so, excuse me if you see some deviations a bit from this area. It is without doubt that
we live in a very active and creative, innovative world, perhaps in the heart of a
golden age of discoveries. As you know, new breakthroughs
come to light almost daily. Recently, new states of matter at fundamental level were discovered, stunning advances in high
computing performance, healthcare is being personalized,
and much, much more. This makes it clear that,
should we want to remain an active and a recognized
player in providing the means of well-being to
our citizens in our societies, and should we want to remain involved in driving research innovation, we cannot simply ignore
these technologies, but we must embrace them
and further develop them. Governments all over the
world have engaged heavily in scientific research, have
engaged in building capacities, capabilities, infrastructure, attaining international visibilities, recognition-generating
knowledge and innovation. In fact, moving towards
a sustainable lifestyle seems to be the ultimate
goal of everybody. QNRF is playing that role here within the state of Qatar the region and on a broader scale as well. However, if we move away a bit from the theoretical aspect of things and come down to Earth, to see
the real side of the issue, we, the scientific
community, are often faced with immediate need to deliver results, a need to produce very
quick and efficient impact. This is not only because
human being, by nature, looks for a quick
satisfaction, an immediate one, but because our life
circumstances dictate so in an ever-increasing frequency. Yesterday we were dealing,
for example, with Ebola virus. We had to act quickly and
produce immediate results. Results were up to expectation
in a very short time. The day before, we had the swine flu, the bird flu, et cetera and today, we have the
Zika virus to deal with. We will find a solution
hopefully, an efficient one. But, so much investment
has been put in research like AIDS, cancer, malaria, diabetes. We don’t see much progress, do we? Nor can we feel any tangible
impact or expectation. So, the expectations are
far away from reality. Similarly, an increasing number
of questions are being asked about climate change, carbon
capture, food security, public health, education
system, renewable energy et cetera, et cetera, et cetera. In this hassle of
running to find solution, we often forget to step back and ask, what did this or that technology do to us? Where is the human aspect? Where is the behavioral aspect? And where is, on a broader
scale, the societal component? As simple as it sounds,
a question such as, what did the DNA technology do to me, to my family and to the society, is difficult one to answer. Too many parameters play heavily therein, maybe the ethical side
of it is quite important for our society and for
this region of Earth, and hence we are happy to
fund such topic to Georgetown, the Bioethics, the Islamic
Bioethics more specifically. So, QNRF, the Qatar
National Research Fund, thrives to fund topics
that link the development of a given technology to its usefulness within a given context at
individual and societal level. Again, we are happy to
sponsor this symposium and you are pleased to
contribute to its success. We think this symposium is
very important and timely. We are looking forward
to its recommendations. Let me conclude by saying the following. This is a general belief
we have here in QNRF. Parties involved in research,
and by parties I mean literally everybody from the technician to the colleagues in the lab,
to the facility management, to the research management,
to the policy makers, parties involved in
research and innovation need to carry the message of value, a message of contribution
to the people who, in the long run, will pick
up that given technology. I’m not suggesting this to be a lecture, but rather a simple dialogue
one would carry out in schools, community organization,
symposiums like this one, and maybe in TV interviews. We should not suppose that just because this might be an unsolicited
task on our part, that the public will not be interested. I think they will,
especially if we engage them in a dialogue which aim to learn from them about their perception and their needs and then provide information they want in a language they can understand. Now, you may ask me,
why should we do this? I will answer, because only
us, the scientific community, really understand the
science and technology and the need for this. And, unless we do that,
nobody’s gonna do it. Thank you very much. (speaking in foreign language) – Conference committee,
faculty, staff and students. On behalf of Georgetown
University in Qatar, it is my pleasure to
welcome you to our campus to participate in today’s symposium on Family Structure in the Wake of Genetic and Reproductive Technologies. To begin, I would like to acknowledge the impressive effort
of Dr. Ayman Shabana, the Director of the
Islamic Bioethics Project and the project team including
Georgetown University Library staff and other
members of our community who have contributed to this project in order to make today’s forum possible. The Islamic Bioethics Project has been continuously supported
by three generous grants from Qatar National Research Fund’s National Priorities Research Program and we’re grateful for that as well. This year’s, Family Structure in the Wake of Genetic and Reproductive
Technologies, conference aims to continue the role of
the Islamic Bioethics Project that Georgetown University in Qatar as a comprehensive resource
for research in this area. Through this role, GUQ
aims to serve research and community needs within
Qatar the region and beyond. This conference also aims to promote scholarly communication,
collaboration and networking with the particular focus on
connecting local researchers as well as professional stakeholders with major international
research activities, interests through the work of
leading research personnel. We also hope to provide
an excellent opportunity for training and capacity building, especially for outstanding undergraduate as well as graduate students. In particular, the
conference should be useful in contributing to
capacity-building efforts by providing a valuable
training and exposure experience for early career researchers
as well as students within Education City
and throughout Qatar. So, for example, Georgetown
University in Qatar, the Islamic Bioethics Project
inspired the successful semester-long undergraduate
course on the interface between religion, culture and bioethics within the Islamic context. The course has already
been offered three times during the past few years. Finally, the conference aims
to create a lasting impact by contributing to scholarly literature in this emerging interdisciplinary field. I should note here that the
field of Islamic bioethics is a relatively young and evolving field. And, if I may boast, two of the most grounded
scholars in the field are here in Education City,
namely Professor Mohammed Ghaly at the College of Islamic Studies
and our own Ayman Shabana. This means that we, in Education City, are uniquely equipped to make
significant contributions to this important emerging field, and I think that both scholars and others have actually made such
formative contributions, thereby reinforcing the
role of Education City, not just as a leader in
education but as a center for the production of
cutting-edge knowledge. The ideas and discussions
in this conference are relevant to the vibrant
research ecosystem in Qatar. Several research entities
are already engaged to different aspects of
the various application of genetic and reproductive technologies, both at the technical,
scientific level on the one hand and at the ethical, legal and
social levels on the other. So, the conference aims to
contribute to these efforts by creating an opportunity
for researchers and experts representing these different
fields and disciplines to meet and share perspectives. I would also like to take this opportunity to highlight that GUQ is also working on other related topics in this area, including palliative care
and we will be organizing a conference on palliative
care in collaboration with the Paul Vatican in early 2019, the Palliative Care
Institute at the Vatican. We are excited about the knowledge-sharing and learning opportunities
that will be nourished here and also about the new
ideas and collaborations that will begin to take form
through the interactions between academic colleagues
in the next couple of days. So, I wanna thank you for
joining us at this conference and I wish you the best
in the upcoming sessions. Thank you. – Today the first panel’s
on the Future of the Family and we have a distinguished panel of three scholars who are very well-versed and very deeply involved
in research in this area. We are going to change the order a bit and we are going to begin
with Professor Fadel, Professor Mohammad Fadel from
the University of Toronto. And, I haven’t seen you in a little while. It’s good to see you here at Georgetown. And, his talk will be
about The Admissibility of DNA Evidence as Proof of Paternity in Light of Maqasid Al-Sharia. – I’ll be talking about this question from what’s known as Maqasid al-Shari’a. First, I think it’s important
to say what my conception of Maqasid al-Shari’a are,
because I will be using it to organize my investigation. Anyone who speaks about Maqasid al-Shari’a sort of begins with this basic notion that’s well-attested in
pre-modern Muslim jurisprudence that Islamic law, indeed
all law revealed by God, all true law, furthers five
universal interests of humanity. The first being the
protection of religion. The second being the protection of life. The third being the protection of progeny. The fourth being the protection of rational capacity of human beings, and the fifth being the
protection of property. So, all rules of Islamic law, in theory, serve one of these five functions. That’s the basic idea
of Maqasid al-Shari’a. Now, where do we find these Maqasid? How do we go about investigating them or confirming their existence? From texts of revelation. These are the Quran, Quran Sunnis, the Quran, the sunna, and consensus. And then also, there’s the ancillary assumption
in interpreting these rules that specific texts of revelation have a rational relationship
with human flourishing, which is how I’m
translating the Arabic term. (speaking in a foreign language) So, the idea is that these
specific rules of revelation, when they call for interpretation, must be interpreted in
connection with some connection, some conception of human
well-being or flourishing, not subjective utility, right. So, it’s not a utilitarian doctrine. Finally, the substance of rules
of law that jurists derive must reflect, then, this
connection between revelation and a relevant conception of flourishing. And so, I also take the
historical record of Islamic law reflected in the (speaking
in a foreign language), broadly speaking, to be
another source of Maqasid, because I assume that
jurists knew more or less what they were doing. So, at least I quote prima
facie legitimacy to their rules and try to recognize the
conception of flourishing that is implicit in
those historical rules. I try to then use all
this data to bring out, I think what I call the
metaethical issues at stake, and then try to apply them
in a different context namely that of ours, right. So if we look at the rules regarding, I’m gonna begin by talking
about the rules of affiliation of children to fathers
in classic Islamic law. Now, I’m not gonna talk about the rules of affiliation to mothers because there was a complete consensus that a child always
belonged to the mother. Right, another important
point to understand is, in Islamic law, a parent
could never repudiate a child or to put it differently,
a mother could never abandon a child in terms
of legal obligations. A mother might physically
abandon her child, right, but the legal duties a
mother owes to her child and the duties a child owes to her mother can never be dissolved. Right, same thing with a
father, but the problem is, how do you know who the father is? Whereas you always know who the mother is, you don’t know who the father is. But in principle, once those
relationships are established, they cannot be disclaimed or dissolved. So, this is the basic
text that people cite when talking about rules of affiliation. God did not make those whom you call your sons your actual sons. That is merely an
expression of your tongues, but God speaks the truth and
guides to the correct way. Attribute them to their fathers: That is more just in the eyes of God, but if you know not their fathers, then they are your brothers
in faith and your dependents. Now, this verse is
actually not talking about rules of affiliation
in the first instance. What it’s doing, is repudiating a pre-Islamic practice of adoption. The pre-Islamic Arabs would adopt. Now, this is a very
different kind of adoption than is current in the modern world. I’ll hopefully have time
to talk about it now, but here you basically have the contrast between a conventional set
of rules of affiliation that the pre-Islamic Arabs had and a more biologically-centered, apparently, principle of affiliation that’s set out in this verse. And it says, if you know
who the fathers are, attribute them to their fathers, and if not, then they’re
your brothers in faith and your dependents. (speaking
in a foreign language) Okay, so it rejects the pre-Islamic custom of affiliation by adoption. So presumptively here, as I’m saying, father seems to mean biological fathers. Now, the second text is an exception to this principle
of biological paternity. It says the following. (speaking in a foreign language) The child belongs to the legitimate bed, and the male adulterer receives nothing. Okay so, even if the biologic, even if the child’s, even if we know who the
biological father is, if that biological father
conceived the child by virtue of adultery, then he
could get no paternal rights. Now, I’m saying adultery,
(speaking in a foreign language) right, which includes
fornication in English, as well as an adulterer, right. So, the second rule of affiliation is that the male adulterer is never
entitled to any paternal rights. There was the juristic principle. (speaking in a foreign language) The sperm of the
adulterer has no standing. It’s not given any legal recognition. The third text is, despite this exception, there’s a return to the biological principle, namely, where you can recognize biology for certain other purposes
besides affiliation. Some of the versions of the hadith, the aforementioned (speaking
in a foreign language), it concludes with the Prophet allegedly saying the following. (speaking in foreign language) In the original case of the
hadith that I just mentioned there was a paternity dispute, one man claiming the child as his brother, the other, excuse me. One of them claiming
the child as his brother through a deceased father and the other claiming
as the brother of a man who had a adulterous
relationship with the mother. So, the Prophet ruled
(speaking in foreign language) meaning that the, affirming
the idea of paternity based on legitimate relationship, but then turns and says
to the sister of this boy, conceal yourself in his presence, i.e., when you’re physically with him, treat him as though he’s a stranger. So, I was saying Rule Number
3 is biological descent trumps legal descent with
respect to marriage bars. In other words, the adulterous male cannot marry his illegitimate
daughter, for example, even though she is not his legal daughter. Now, this is not a matter of consensus. This is affirmed by the vast
majority of Muslim jurists. Al-Shafi’is permit, in
theory, an adulterous male to marry his illegitimate daughter, but that’s very much
considered a notorious position which people use to mock the Shafi’is. In any case, I don’t give
it much normative weight in the Islamic tradition. The basic view is, you
give affect to biology outside of the rules of affiliation, but not internal to the
rules of affiliation. The fourth text that is relevant here, the rules of formal accusation of adultery known as (speaking in a foreign language). The verse in the Quran is, as for those who accuse
their wives of adultery, but whose only witnesses are themselves, they may testify against
them by swearing four oaths, by God, that they are telling the truth. Now, one of the consequences
of a formal accusation of a wife of adultery
is that if it turns out that she has a baby
subsequent to that accusation, the father is not, or the husband is not
responsible for that child. But there are conditions
to invoking this procedure. A husband can’t just come home one day and decide that he wants to
accuse his wife of adultery. First, he has to claim
that he was an eyewitness to her adultery, right, in the same way
as third-party witnesses would testify before a judge. So, he has to witness to
the actual penetration, not simply that they were
caught in bed, for example. In addition, he has to
immediately refrain thereafter from any sexual relations with her. So, unless those
preconditions are established, he can’t initiate a formal
accusation of adultery. The second circumstance is he doesn’t say that he saw her in the act, but he claims it’s
impossible that he would be responsible for the pregnancy either ’cause of incapacity
on his part or absence, but in order to avail
himself of this procedure in this circumstance, he
must make the accusation immediately upon realizing
that she is pregnant and she must give birth at
least six months thereafter. And that’s to exclude the
possibility that the child is his. So again, here you have a reaffirmation of the biological principle
but the conditions on which it can be used
are extremely narrow. Some other interesting twists here, what I call Rule 4.a, and
this is in the Maliki school, I don’t know what the
other schools have to say, but, even if a man witnesses
his wife commit adultery, it is preferable that he
not formally accuse her, rather, he should conceal it. That’s counterbalanced by Rule 4.b, if he is certain that
her pregnancy is not, he’s not responsible for her pregnancy, then he must accuse her of adultery. So, again, here you
have a flipping back to the biological principle where
he has subjective certainty that he could not be the father. All right, okay. So, we wanna step back and ask, what are the (speaking
in a foreign language) that are at stake in these various rules? What are the purposes, what’s
the sort of metaethical values that are at stake here? The first one that I would say is the well-being of the child. (speaking in a foreign language) Medieval jurists go to
extreme lengths to make sure that a child born in illicit relationship is not deprived of a lawful relationship with their father or
with paternity, right. And so, that’s reflected
to the extent to which they deny or refuse admissibility even plausible charges or
even plausible evidence that the legal father is not
actually the biological father. So, there are lots of
different rules like this in this case, let me
just back up a second. For example, most famously, I think somebody’s gonna
talk about it later today, the sleeping fetus doctrine, that a child can gestate in the womb of its mother for four years. Now, they weren’t idiots, they knew that pregnancies
lasted nine months. This was a rule intended
to try to make sure that children had a lawful father, even in situations where it was, from a common sense perspective, absurd. Another example, too, in the context of (speaking
in a foreign language), a man comes back from a journey, he’s been away from his wife
for 10 years, he comes back, finds her having given
birth to several children. The children are still his until he makes a formal
public accusation of adultery. In the ordinary case where
illicit relationship exists, the well-being of the child
is given greater priority than biological truth, and as I said, there are lots and lots
of cases about that. That’s what I would call
the ex post perspective. The ex ante perspective is different. There’s a desire to
deter men from engaging in illicit intercourse
with unmarried women and that’s reflected in the notion that the child cannot be affiliated,
if it’s an unmarried woman, the child cannot be affiliated
to the male adulterer. And then, giving effect
to biological paternity in other areas of the law, bars
to marriage more precisely, that’s where you have (speaking
in a foreign language), that value is most
clearly vindicated there. It has lesser status in the issue of unsettling
legal paternity. So, a husband can have
very powerful suspicion that his wife is having an affair, nevertheless he is not allowed
to accuse her of adultery, even though there’s a palpable risk that the child is not his. Only when there is certainty
of that, may he do so. So, what I would say is that again, (speaking in a foreign
language) is not necessarily the most important ethical
value that’s at stake in all these rules, it’s certainly there, it’s just not necessarily
the most important one. And then finally, there is the protection of public reputation for good character. Again, we see that in what
I said earlier as Rule 4.a, even if a husband catches his wife in the very act of adultery,
he should not form, he should not proceed with a
formal accusation against her, but rather practice (speaking
in a foreign language). Now, (sighs) I think
these historical rules give us a good idea of how the jurists weigh these different ethical values. From a practical perspective,
it creates a big gap, particularly with the problem of the illegitimate
child of the free woman. Now, in the pre-modern
law, the illegitimate child of a free woman could
never have a legal father. An illegitimate child born to a free woman could however have somebody known as a (speaking in a foreign
language), a caretaker. So, jurists developed this system called (speaking in a foreign
language) which essentially is equivalent to what we
would call today foster care. Because again, well-being of children is a very, very important
value in this system of rules, and so, if you couldn’t have
a father for these children, you had to develop an
alternative system of care and that was what’s called
(speaking in a foreign language), is the second-best solution. But, as I’m saying here, it
entails its own problems. The biggest problem with
(speaking in a foreign language), compared to parentage, is that a (speaking in a
foreign language) caretaker is considered legally a volunteer. So there is no, the
caretaker has no obligation toward the child prospectively. So, if you are the foster
parent of the child, you can take care of
him for six years or so and then you can get bored
and sort of give him back, and there’s no penalty involved. You’re not obliged to continue
taking care of the child. Likewise, the child owes no reciprocal duty to the caregiver. In the mature system of
(speaking in a foreign language), this was under the
supervision of the state. So, in theory, if you
were acting as a caregiver who had found an abandoned child, you would take the abandoned
child to the judge, register it with the judge and
then you could get a pension from the treasury to take
care of the child, right. If anybody is aware of the
problem of public services, you can imagine that there’s
probably chronic underfunding, lack of supervision, et cetera, et cetera. (speaking in a foreign language) is an attempt to solve this problem but it’s not an ideal situation. In fact some jurists,
particularly the Hanafi school, recognizing the defects of the (speaking in a
foreign language) system, allowed a caregiver to claim the child as his own without any evidence of paternity, even though they considered
that to be counter-analogical, they said that the child has
a legitimate need for a father and the father has a
legitimate need for a child. So, therefore they abandoned
ordinary evidentiary proof of paternity in those cases. Interestingly, the child of a slave, the illegitimate child of a
slave woman, was better off than the illegitimate
child of a free woman for one of two reasons, either the child would be affiliated to the mother’s master because, at least in Maliki (speaking
in a foreign language), if a master admitted to having
intercourse with a slave, even once, he would subsequently become strictly liable for all her children. So, a master did not
have the right to accuse a slave living under
his control of adultery, unlike a man with a wife, right. A master could never
repudiate responsibility for children born to his slave once he had slept with her once. Even if he never had
slept with her, right, the illegitimate child
of the slave is his, it’s his property, and the destiny of the
slave is manumission and upon manumission, the
slave becomes affiliated to the master through (speaking
in a foreign language). So he becomes his (speaking
in a foreign language) and it’s a quasi-kind of
adoptive relationship. So, again here, it’s only
the child of the free woman, the illegitimate child of
a free woman that becomes somebody almost of no standing in society. Now, the question here is, should the ready
availability of DNA evidence change any of these historical rules? Well, it depends on your view
of the balance of values. If you agree with me that
the balance of values is not necessarily skewed
toward biological truth, then you’re not going
to automatically assume that DNA evidence should change anything. What I argue is that historical rules are not just a consequence
of limitations of knowledge, but they’re also a legal
slash ethical determination that some values are more
important than truth, right, namely, well-being of the child. So the best case for the
use of DNA evidence however, is the child born to
the unwed free mother. Okay, but here what we need to do is, we need to try to reconcile
these different ethical values. So, I would say that in the
case of an illegitimate child born to an unwed mother,
DNA evidence can be used to prove the responsible party, but not to afford him parental rights. So, he could be subject
to duties of a parent without affording him rights of a parent, and that would reconcile the
different values at stake. The worst case use of DNA
evidence would be to challenge already existing legal paternity on the grounds that pregnancy
was a result of adultery. In that case, if people
wanna go in that direction, I would say that if
you’re going to do that, it should only be allowed, you should only be allowed to introduce it in circumstances where the
husband could have formally accused his wife of
adultery in the first place. Not after the child is born. Not in the context of some
kind of divorce proceeding. So, oh by the way, I think
that child’s not mine, get a DNA test, no, okay. The middle case would
be to use DNA evidence, if you can imagine a state
that could be trusted with genetic data on every person to ensure that persons are
not unknowingly marrying within prohibited degrees of kinship. There’s always that risk and with the spread of
things like alternative, I don’t know that, it’s ATRs,
that risk just increases. So you could imagine a
justification for using DNA evidence before people marry and have children to make sure, in fact, that
they’re not secretly related. Okay, thank you very much. – I’d like us to move now to move now to Professor Marcia
Inhorn of Yale University, an old friend. (laughs) Good to see you. And, her presentation’s
title is Fertility Decline, Small Families, and Son
Selection in the Muslim World: The Controversial
Convergence of Contraceptive and Reprogenetic Technologies. – Thank you so much. It’s delightful to have Amira
be the chair of our panel because we have gone back a long time.
– A long way. – In sort of Middle East Women Studies. And this is my first time
meeting Dr. Ayman Shabana. (laughs) Who I feel like I’ve known for a long time over email and I’m really delighted. Thank you for inviting us all here. So yes, I am 25 minutes. I’m gonna take you through
a sort of a story here and I’m moving from law to, I’m a medical anthropologist,
so we actually, some of the papers are legal
Islamic bioethical papers and mine comes from the
field of anthropology. Over the past three decades, fertility rates have plummeted
across the Muslim world. A fertility decline
that has been profound, even revolutionary. I wanna chart this fertility decline, particularly in the Arab world, a decline that has been facilitated by the rise of contraceptive technologies, but also new attitudes
towards family formation on the part of both men and women. This Arab fertility
decline and the much wider Muslim fertility decline,
of which it is a part, has been described as a quiet revolution hiding in plain sight. How did this revolution happen? The introduction of
family planning programs and contraceptives in the Arab world is an important part of the story, but increased contraceptive
usage is not the only factor. Instead, attitudinal change or
the desire for fewer children on the part of both men
and women has led to what anthropologists have
called the new Arab family, a small family that is a tangible result of the Arab fertility decline. So, where did it all begin? It began in the post World War Two period when a growing rhetoric of overpopulation in the under-developed world
led Western population analysts to recommend government
interventions into fertility. In this post World War Two
period, these organizations, International Planned
Parenthood Federation, Pop Council, Ford Foundation and the United Nations Fund
for Population Activities, which was later renamed the United Nations Population Fund, were formed to initiate
population control activities. In the Arab world, initial
focus was on Egypt, a purportedly overpopulated country with a projected population doubling rate that was deemed alarming. Egypt was the first country to adopt a family planning program, one that promoted scientific
methods of contraception including diaphragms, foam
tablets, contraceptive jelly, douches and eventually
birth control pills. Soon the North African
countries of Tunisia and Morocco followed the Egyptian lead, establishing national
family planning programs in 1964 and 1966 respectively. By 1980, nine other Arab
countries had instituted either direct government
family planning programs or had agreed to establish voluntary family planning associations. This table, it’s a big table, but it provides a kind of overall picture of fertility rates and fertility policies in 18 Arab nations during the 1980s. Total fertility rates,
or the number of children a woman could be expected
to have over her lifetime, they’re in the second column. They’re very high across the region. In fact, they were so high
that several Arab nations had TFRs or total fertility rates of more than seven children per woman. So, a very, very high TFRs. Given these high total fertility rates, it should come as no surprise that contraceptive prevalence
rates across the Arab world in the 1980s remained very low. In a survey of 11 Arab
countries conducted in 1982, the mean contraceptive
prevalence rate was only 19%, but by 1985, female
contraceptive prevalence rates began to rise significantly
in several Arab nations. In Jordan, for example, the
contraceptive prevalence rate rose from 40% in 1990 to 60% in 2009, and by then 82% of ever
married Jordanian women had used contraception at some point in their reproductive lives, with the average Jordanian woman able to describe nine different
contraceptive methods. It’s fair to say that by the year 2000, knowledge of contraceptive
methods among Arab women had become widespread. Surveys showed that between 90 and 98% of married Arab women reported knowing about at least one modern
method of contraception. And by 2010, a survey
showed that more than half of Middle Eastern countries
had all seven core components of successful family
planning programs in place. But, the story is not just about women and female contraception. Part of the story of the
Arab fertility decline involves Arab husbands, not only men’s support of
female contraceptive methods, but of male-controlled methods as well. The studies conducted in a
variety of Arab countries demonstrate men’s strong advocacy of male-controlled birth control, not necessarily with
condoms but rather through the time-tested method of
(speaking in a foreign language) or coitus interruptus. Coitus interruptus has
played an important role in the history of Islamic societies where it has received support
within the Islamic scriptures as a viable means of
male-enacted contraception. So, that men and women
together are enacting a quiet reproductive revolution
is evident in these numbers. This table charts the momentous decline in Arab fertility levels. When total fertility rates or TFRs were first recorded in the 1975 to 1980 period, women in all 17 Arab nations had TFRs far exceeding the world
average of 3.85 children. Seven Arab countries
including Algeria, Kuwait, Libya, Oman, Saudi Arabia, Syria and Yemen had TFRs greater than seven. So that means more than
seven children per woman, with the highest recorded TFR at the time being 8.58 in Yemen. Today, if you look in the
final column, 2015 to 2020, only three Arab countries,
Egypt, Jordan and Yemen have TFRs above three. In nine Arab countries, including Qatar, TFRs have declined by nearly
four births per woman. Of the world’s top 15 fertility declines occurring between 1950 and 2010, seven Arab countries can be counted with fertility levels
declining by more than 60%. So really, of the top fertility declines, half of them occurred in Arab countries. What is most impressive about
this Arab fertility decline, is that it occurred even in
resource-poor Arab nations. Put another way, the Arab world has achieved its reproductive revolution with fewer pre-existing
resources or advantages. This decline has occurred
largely through human agency namely, the actions of Arab couples wanting fewer children
to love and support. And so we need to talk about
this so-called New Arab Family. Between the reproductive
efforts of both Arab men, practicing coitus interruptus, and Arab women using contraceptives, Arab couples have brought into being what anthropologists have
called The New Arab Family, a small nuclear family with two to three children on average. A variety of anthropological studies conducted in the Arab
world since the 1980s have explored the emerging
norms and practices supporting this smaller family size. For example, in my own
early study with poor women, urban women living in Alexandria, Egypt, they were clear that
they and their husbands wanted only two children, no more. They used the Arabic term
(speaking in a foreign language) to describe this small nuclear family, differentiating it from
the larger extended family, or (speaking in a foreign language). Already in the late 1980s, the (speaking in a foreign
language) had become the well-entrenched norm among the urban Egyptian working
poor who realized that two children were all that
they could reasonably afford. Middle-class couples, too,
wanted smaller nuclear families as shown in anthropologist
Rhoda Kanaaneh’s path-breaking study, Birthing the Nation. Many of Kanaaneh’s middle
class Palestinian interlocutors were convinced of the merits
of small, high quality family. Thus, they were limiting their fertility through contraception in
order to invest more time, more energy and more
money into the education and success of each individual child. Similarly, in my study
in neighboring Lebanon, I found that Lebanese
men of all social classes and religious sects were
eager to become fathers. Fatherhood in their view was one of life’s most important joys and
masculine ambitions. Yet, with very few exceptions,
Lebanese men were adamant that having more than three
children was unfeasible and unwise in the current
political and economic climate. Two boys and one girl was often stated as men’s ideal family composition. Yet, some men were insistent that girls were superior to boys in
terms of their affection and lifelong commitment to their parents. Thus, they intended to
stop at two or three even if all of their
children were daughters. In The New Arab Man, the book that I wrote
following this research, I coined the term emergent masculinities to capture all that is
new and transformative in Arab men’s lives in the 21st Century. These emergent masculinities
may be most apparent in the intimate domains of
marriage and family life. For example, today many
Arab men are eschewing arranged marriages in order to
enact romantically-committed companionate marriages
with women they love. Within marriage, men are more likely to want smaller family
sizes in order to provide adequate financial support
and good educations for their daughters as well as sons. In other words, new Arab
men’s fertility attitudes and practices are changing
along with women’s, but as we will see, strong
preferences for families with both sons and
daughters are leading to an emerging pattern of sex selection, a phenomenon made possible through the birth of an Arab IVF industry. So, the Arab IVF Revolution. The world’s first test-tube
baby, Louise Brown, was born in England exactly
40 years ago in 1978. Less than 10 years later,
the Muslim world’s first test-tube baby Heba Mohamed
was born in Egypt, in 1987. IVF, the assisted
reproductive technology or ART used to conceive both of these children rapidly globalized in the 1990s, subsequently spreading to many
parts of the Muslim world. For example, Egypt was the first country to open an IVF clinic in 1986, followed in the same year
by Saudi Arabia and Jordan. By the mid-1990s, Egypt was
experiencing an IVF boom period, with more than 50 IVF
clinics eventually opening up in Cairo, Alexandria
and other major cities. Other Middle-Eastern
countries soon followed suit, and so by the mid-2000s,
the Middle East could boast one of the largest and most successful IVF industries in the world. Among the 48 countries performing the most ART cycles per
million inhabitants, eight Arab nations could be counted. So, this eager uptake of
IVF across the Middle-East has been due, in large part,
to the permissive attitudes of both Sunni and Shia
Islamic religious authorities who have viewed assisted
reproductive technologies or ARTs as biomedical tools
to overcome human suffering. In the now-rich scholarship
on Islam and ARTs in Egypt, Iran, Lebanon and Turkey, anthropologists have demonstrated how the continuous emergence of new ARTs has led to a concomitant emergence of mostly supportive Islamic
bioethical discourses and religious decrees, or
(speaking in a foreign language), on how these technologies
should be used appropriately by Muslim physicians and their patients. One of the ARTs that Islamic
authorities have supported is Preimplantation
Genetic Diagnosis or PGD. As with IVF, PGD was invented in Britain, with the first successful PGD
baby born in London in 1990. PGD was a technological byproduct of IVF, designed specifically to identify genetic defects in IVF embryos. Before transferring these embryos back into a woman’s uterus,
PGD testing could be performed on an eight-cell embryo to determine whether it carried a genetic defect. Those embryos with defects
could be culled and discarded so that only disease-free embryos would then be transferred
as part of an IVF cycle. PGD could also be used to
determine the sex of each embryo with the intent of preventing a number of important X-linked genetic disorders such as hemophilia or
Duchenne muscular dystrophy. In the Muslim world, Islamic authorities immediately accepted the use of PGD for genetic screening but
not for sex selection. Sex selection against girls
including female infanticide has a long history of
moral opprobrium in Islam with the Prophet Muhammad
specifically condemning this pre-Islamic practice. Thus, the notion that Muslim parents should eliminate daughters
either through abortion or other sex-selective technologies, has always been viewed as
anathema in the religion. Having said that, the belief that sons are mandatory within family life is widespread across
the Muslim Middle East, as shown in numerous
anthropological studies. Even if Arab parents say
they love their daughters and prefer them as lifelong companions, they still need their sons in order to complete their families. Sons ensure the reproduction
of the father’s patriline, are expected to contribute to family labor and are widely regarded as a
family’s social safety net, guaranteeing the financial
support of their aging parents. Given these realities, ensuring the birth of at least one son is vitally important
to most Arab families. Arab couples wanting to
plan their small families while still ensuring the birth of a son, thus face a major predicament, especially when one or more daughters have already been born. In such situations, Muslim
couples may consider sex selection, seeking answers from both physicians and clerics who have
thus been forced to grapple with the issue of
PGD-assisted gender selection. Egypt has again played a
leading role in this regard. By the early 2000s, Egypt’s Dar Al-Ifta issued the first fatwa
on gender selection, making a clear distinction
between gender selection at the individual versus community levels. The fatwa claimed that
PGD should be permissible on the individual level
because nothing in Islamic law prevents the practice of gender selection so long as it does not harm
the fetus now or in the future. However, the fatwa ends
with the note of caution about gender selection
at the community level. As the fatwa states,
the matter is connected to disturbing the natural balance which Allah the Almighty has created, as well as disturbing
the male-female ratio which is an important
factor in human procreation. On this level, gender
selection is tantamount to objecting to Allah’s creation by trying to change His system, disturbing the structure He
has created, and undermining the means upon which He
has based human life. So although the fatwa
clearly shows a concern for the society-wide use of
sex-selective technologies, it nonetheless does give permission for individual couples to use PGD for the purposes of gender selection, and, not surprisingly, many
Middle-Eastern IVF clinics have begun employing this practice given the religious support. So, by the year 2008, at least
nine Middle-Eastern countries were documented to be performing PGD primarily for the
purposes of sex selection. So among these countries, the United Arab Emirates could be counted. PGD was introduced into
the Emirates in 2007. It became widely-available
to patients the year later by 2008 and it was
formally legalized in 2010 when the country enacted ART legislation known as Federal Law number 11. Initially PGD was
intended for the purposes of sex-linked genetic
screening, which was deemed a medical priority in a
nation with one of the highest frequencies of genetic
disease in the world. PGD was sanctioned by UAE Federal law specifically for the
elimination of sex-linked genetic disorders in
IVF-conceived offspring. Yet, as early as 2007, it had become clear that the new demand
for PGD in the Emirates had little to do with genetic screening. In an ethnographic study
I conducted at that time, in 2007, in the UAE’s largest IVF clinic, I began to meet Emirati couples who were clearly not infertile
but rather who wanted a son after the birth of one or more daughters. In some cases, PGD-assisted son selection seemed to be occurring as
a form of family planning among Emirati professional couples who wanted to have only two children. Such was the case of Samya and
Najib, not their real names. They were high-powered
Emirati professionals. Samya worked as a senior broker in an Emirati investment
firm while Najib was employed as a hydraulic engineer
for the government. Married for 11 years, and parents of a six year-old daughter, Samya and Najib were careful planners who wished for only one more child in the context of their busy careers. But, in order to ensure
the birth of a son, Samya and Najib traveled to the IVF clinic where I met them on their first IVF cycle. Samya, I have to say, she was
a very stylish-looking woman; she had dyed hair and stylish glasses. Nonetheless she told me
she was deeply embedded in her Emirati community and
that she had specifically chosen to travel to this IVF clinic outside of her home
emirate in order to avoid the possibility of being seen
by her friends and family. Samya was most worried about running into several physician relatives who might learn of her
IVF and sex selection, viewing it as morally dubious
from an Islamic perspective. Samya and Najib were not alone in trying to select their
sought-after Emirati sons. My brief encounters with
these Emirati son selectors made me realize that
technologically and legally-assisted gender selection for sons had found a new home in the Emirates. In a follow-up interview
I conducted in 2012, one of the UAE’s most
well-regarded IVF physicians reported an alarming new
trend of sex selection which he had observed
among his Emirati patients as well as among south
Asia couples who constitute the single largest ethnic
population in the Emirates, even though they’re not
granted citizenship rights. And as this physician explained to me, there is a lot of demand
among locals and Indians, and the Indians more
than among the Emiratis. They seem even more
interested in getting a boy. Another IVF physician offers
it to all of his patients and 60 to 70% of them do PGD. Here, if the couple brings it
up, then we have a discussion. The only times I recommend PGD are for recurrent miscarriages where there could actually be
some genetic translocations and then this is the correct thing to do. Also for repeated
unexplained IVF failures, we offer it to them then. But some couples ask for sex selection. We’re not doing PGS often, maybe only five to six cycles a month, but my colleague is doing 40
to 50 cycles of PGS a month, and then you could
really start running into problems of gender imbalance. 90% will want to select for
boys and only 10% for girls. Among Arabs and Indians, all
will want a boy, I’m afraid. This new sex selection in the Emirates is no longer a secret. Many Emirati IVF clinics now, in 2018, openly advertise gender selection
as part of their services. Even if they cast the technology as a form of family
balancing and enhancement, using pink and blue color
schemes on their websites, these clinics implicitly
direct their clientele toward gender selection
even if the service is not cast as son selection
or gender selection but as family balancing. And so, to summarize, this growth of a sex selective PGD
industry has occurred amidst massive Arab fertility declines, facilitated by family planning
programs and the influx of contraceptive
technologies into the region. Such population control regimes
have clearly been effective. Today, most Arab nations
are close to achieving replacement fertility or only two children for every two parents. Some Arab Gulf countries including Kuwait, Qatar and the UAE have decreased their fertility rates
below replacement level. However, this massive decline
in Arab fertility levels has brought with it a new
demand for sex selection. In IVF clinics across the Middle-East, the very existence of PGD as
a sex-selective technology has exacerbated son preference, which prior to the
advent of this technology had been shown to be in decline. Although the future is
always difficult to predict, it is important to ask about the potential bioethical aftermath of PGD, the term that Soraya Tremayne
and I have coined to signal the unintended consequences of
ARTs across the Muslim world. So, I’d like to conclude by discussing four possible consequences of PGD, which future Middle-Eastern
bioethics scholars will need to follow. First, the increased
prevalence of PGD-assisted son selection in the Middle East will likely exacerbate
daughter discrimination, even leading to the endangerment of girl children already born. Because PGD promotes son selection, it invariably contributes
to daughter discrimination, especially toward
higher-order girl children who are considered
superfluous to their parents. Second, if PGD comes to be
routinized in prenatal practice, we may begin to see the distortion of natural sex ratios at birth, a phenomenon that has already happened quite profoundly across
large swaths of Asia. Where sex-selective technologies
are readily available distorted sex ratios
have invariably followed. In Asian countries where sex
selection is widely practiced, men ultimately suffer when
female marriage partners are missing from the general population. Third, PGD may eventually become promoted as a more humane method of sex selection, reducing the incidence of
sex-selective abortions. The idea that there are more
or less acceptable forms of sex selection can be
viewed as morally dubious. In the coming decades, it
will be important to follow the ways in which PGD
might supplant abortion as a sex-selective reproductive
technology of choice, including in parts of the Muslim world. And then finally, as a
reprogenetic technology, PGD may lead humans
down the slippery slope of designer babies and
eugenic removal of the unfit. Choosing embryos of only one sex, culling embryos of the other sex and eliminating all embryos
with perceived genetic defects are selective reproductive practices that ensure the births of
some children but not others. Indeed, from an Islamic standpoint, the potential bioethical aftermath of PGD raises troubling questions
about the intersection of science, religion and
reproductive technology. If PGD is increasingly used by Muslims for the purposes of son selection, then the result will be
a fundamental imbalance in human populations in the Middle East and in Muslim societies far beyond. From a bioethical standpoint, the very practice of PGD as
a sex selective technology seems anathema to Islam as a religion. For it’s important to
end by citing scripture, particularly this famous
Surah from the Quran, to Allah belongs the dominion
of the heavens and the earth. He created what He wills. He bestows male or female
according to His will, or He bestows both males and females, and he leaves barren whom He will. For He is full of knowledge and power. Thank you. – I now call Dr. Inmaculada de Melo-Martin from Weill Cornell Medicine,
Cornell University. Her presentation is titled,
Reprogenetic Technologies and the Valuing of the Biological Family. – Thank you for inviting me. I’m very happy to be here,
discussing these issues, which I have been working
on for quite a while. I’m gonna be talking
about some of the values that actually are
embodied by technologies, in this case by reprogenetic technologies. And we have actually just seen one example of that embodied of values. In this case, values about
what the gender balance of a family needs to be and how technologies actually help us accomplish those goals. This is what, let’s see. I am going to be discussing
just a very brief overview of what reprogenetic
technologies are. Then I am going to be talking about how actually these technologies embody the values that we have regarding biogenetic families. So, this question about how are reprogenetic technologies
affecting nuclear families is, they’re affecting them in a way that they are reinforcing
that value as I will show. And then I will discuss
why it is a problem that we think of
technologies as value-neutral and just some quick conclusions. So. Okay, there, okay. So, just quick overview of
reprogenetic technologies, we just heard about a little bit about PGD in combination with IVF,
with in vitro fertilization. Some of these technologies are very new, some of them relatively new. PGD, for example, since
the ’90s is relatively new, but not as new as mitochondrial transfer
technologies, for example. With these technologies,
reprogenetic technologies, are trying to accomplish is combining reproductive technologies
with genetic technologies. So, IVF, by itself, allows
people to have children, people who presumably
couldn’t have children in a natural way, allows them to have children in this way. The combination of IVF
with genetic technologies allows people to have
particular kind of children. A particular kind of child, either a child of a
particular sex for example, or a child without
particular disease or trait or with a particular disease or trait. So, the goals of these
technologies are different and, although the concern
that I have today, the issue of the biogenetic family is actually something that is shared by both reproductive technologies and reprogenetic technologies. It is particularly the case with these reprogenetic technologies. So again, here are just some examples of what these technologies can do. The first is an example,
it’s an image of PGD, which allows us to select embryos that lack particular, normally that lack particular diseases or genetic mutations. Actually, embryos are not diseased but, that have particular
genetic mutations of variants but, you see some images
of what these technologies might help us accomplish in the future. Particularly with the development of the new gene editing technologies that might allow us not just select for or against particular
genetic variants, but actually tinker with the human genome in ways that allows us to
modify particular traits. We use PGD today for many, many variants, genetic variants to select against many genetic variants and one of the consequences
of the technology initially was proposed
as a way to help people to have children without a
particular genetic disease. Today it’s used actually for sex selection as one of the highest increases of PGD has been actually for sex selection. Like many reproductive technologies or reprogenetic technologies, they are introduced with a particular aim and then they expand to actually, to be used in many other ways. Some of the technologies again, presumably would allow us to select not just against particular diseases or disabilities, but also for particular traits or against particular traits that have nothing to do
with disease and disability. We cannot do that today,
but that’s one of the goals of some of at least some
of these technologies. One of the technologies
that for the first time is going to allow us to
tinker with genetic material and transfer that to future generations is this new technology,
mitochondrial transfer techniques. There has been, that we
know of, at least one child who has been born through
this technology in Mexico, but Britain has been the first country that has legalized the
use of this technology. It’s now in clinical trials,
they are recruiting people. They are recruiting women
to use the technology. And what this technology allows is women who have mitochondrial diseases to actually have children,
genetically related children, who would not be affected by the disease. To do that involves the use of egg donors. The mitochondria is transferred to the egg of the woman who is going to be the mother of the child, in such a way that the
embryo actually would have the genetic make up of
three different people, the egg donor, the mother, or the person who’s going to
be the mother, and the father. So again, this is a
very, very quick overview of what these technologies can do today and what they might be
doing in the future. Often, when we evaluate technologies, all technologies in general
but these ones in particular, we think of them as value-neutral. We think of them as having particular impacts. Normally when we evaluate, we think about the health
impacts of these technologies or the environmental impacts
that they might have, but we rarely think of
them as actually embodying particular kinds of values. This is a mistake, I will argue, not just me but many other people. And, I will say why in
particular in the case of biogenetic families this is a problem. Technologies are, again, value-laden. They come with particular values. They transform some of
the values that we have. They might challenge them. They might reinforce
them in different ways. So, what I am going to argue
is that these technologies, reproductive and
reprogenetic technologies, actually reinforce the value
of the biogenetic family. When I talk about technologies here, I don’t mean just the devices, you know, the particular techniques that we use to do these kinds of things, but all the social aspects
that involve the technology. So, the medical practices
that come with it, the legislative practices
that come with it, the cultural aspects that actually surround the use of these technologies. It might be surprising to
think that these technologies are actually reinforced by
your genetic family norms because one of the main
criticisms of these technologies when they were introduced
in the late ’70s, was precisely that they
were going to transform the biogenetic, the nuclear family, the so-called nuclear family. These technologies, for the first time, allow people to have multiple parents, up to six parents depending
on how we identify or we define parenting, parenthood. But certainly allow
homosexuals to have children. They allow single people to have children and they allow people
who are not connected to have children, not genetically connected
to have children. In principle, it seems that
these technologies actually are able to rupture or to transform in ways that might be meaningful this norm of the biogenetic family as the standard. But, what I am going to
argue, actually, is that although we can certainly, technologies can do this, as
I mentioned, they can rupture and transform particular values, if we don’t think about how those values can actually be modified, the ways in which these technologies actually embody these values, it’s unlikely that we can use them in ways that can be
transformative in important ways. I’m going to give some examples of how, although the technologies, as I was mentioning, appear to be disrupting this value of
the biogenetic family, in fact, they reinforce it. One of the technologies that… One of these reproductive technologies that may appear as disrupting the value of the biogenetic
family is gamete donation. Gamete donation allows people who are not genetically related to their children to
actually have children. Gamete donation has
increased exponentially since it was introduced, and many women and men use
today these technologies. It appears again that these technologies would allow this disruption
of the biogenetic family, the traditional nuclear family. But, in fact, when we reflect on the ways that these
technologies are being implemented, on the legislative practices that surround these technologies, we see that these might not be so clear. The normal practice for
gamete donation is anonymity. The majority of countries still today, though this is changing, use anonymity as the
practice for gamete donation. In some cases, in some countries this is legislatively the case. Spain for example, or
France have anonymity as mandated by law in gamete donation. What these practices do, these legislative practices do is in appearance, it appears that, insofar as they allow the genetic progenitors to actually disappear somehow, they would disrupt this
notion of the biogenic family. But in fact, what the practices do, this practice of anonymity
does, is interestingly enough, in combination with the medical practices that surround gamete donation, to reinforce the value
of the biogenetic family. In most countries again,
even if they have anonymity, either clinics or the system allows people to select for the donor, characteristics of the donor. Even if they don’t know who the donor is, they can select particular
characteristics. Overwhelmingly, the
characteristics that are selected in donors are physical characteristics or trait characteristics that are similar to the intended parents. So, if a woman, for example, is going to be using an egg donor, the kinds of characteristics
that they would ask in the egg donor are characteristics that are physically similar to the woman who is going to be carrying the baby. The same for sperm donors. In countries where women
actually cannot select for particular donors
like Spain, for example, Spain people are not allowed
to select characteristics but the medical team by law is actually charged with selecting donors that are phenotypically similar
to the intended parents. What this does is actually allow people to have children whom they
are not genetically related to but who appear to be
genetically related to. So, the family, the
biogenetic notion is kept in spite of the fact that the children are actually not genetically related to at least one of the parents. So again this, both
the legislative aspects and the practice aspects of how we use reprogenetic technologies allows us to maintain the standard, the nuclear family as the standard. They allow, these practices
actually allow families that are not standard
to pass as if they were. Now, someone might be
thinking, well great, because now we have new
legislation in many countries, there is actually a push in many countries to prohibit anonymous donations. One of the arguments
is precisely that they allow for these masking of genetic relationships and reinforce this idea
of the biogenetic family. So, it should be a good thing
that these new practices, they might actually allow us to challenge these biogenetic notions, the ideal of the biogenetic family. But actually again reflecting
on how these practices are used and how they
are defended, argued for, it’s interesting that the
reason why this anonymity criticism, the criticism
against anonymous donation, the argument that is
being used is that people have a right to know
their genetic origins. It is with this argument, for example, that England about 10 years ago passed legislation that allows people, people who are conceived
through gamete donation to actually have access to
the genetic progenitors, to identifiable characters or information of the genetic progenitors. The argument that is being given for why we ought reject anonymity is actually that people have a right to know their genetic
origins, and this notion that we have a right to
know our genetic origins is actually a way to reinforce this value of the biogenetic family. In fact, the kinds of
arguments that are being given for why we have this right is that people who don’t have access to their genetic origins,
to information about their genetic origins, are harmed. They are harmed because they lack access to information that is
essential to our well-being. So again, they ways that these
technologies could be used to transform or to challenge
particular kinds of values, in this case they actually
reinforce those values in ways that are problematic. So, why is this a problem? I have used only the example of gamete donation, but actually, I could use similar
examples for other genetic, bio-reprogenetic technology, sorry. So that the ways in which
they appear at first sight to actually challenge this
notion of the biogenetic family, but when one digs a little bit into how these technologies are being applied, the ways in which we again, legislate or practice these technologies it turns out that they
are not as disruptive as they might appear at first sight. This might be a good thing for those who criticize the technologies
because they are disruptive. But, insofar as one thinks that this notion of the biogenetic
family is problematic, then we might think that these legislative and social practices that surround these technologies are not that great. I am one of the ones who
think that the notion, this standard of the biogenetic family is actually a problem. So, I am not particularly
fond of technologies or again, the things that
surround the technologies that reinforce these values. So, why do I think that
attending to values, the ways that values that embody, that technologies embody is important? Well, one is because they embody values. So, we should know what values those are, rather than thinking of
technologies as neutral and they are just being
used in good or bad ways and then what we have to
evaluate is how they are used. This prevent us from
actually realizing that some of those things that we call
unintended consequences, they are not unintended at all. They are actually part of
what the technologies embody. So, they are only unintended in the sense that we haven’t been very careful about thinking about these technologies, but not unintended in the
sense that we couldn’t have thought about this
being a consequence of this technology. For example, the use of this
technology for sex selection. Anybody could have thought
that these technologies were going to be used for that purpose, if we had just thought a little bit when the technologies were introduced. So again, that some of
these effects are unintended is only the case because
often we don’t reflect on the ways in which the technologies actually embody particular
kinds of values. Insofar as thinking of
technologies as value-neutrals prevents us from doing
that, that’s a problem. We lose the opportunity,
we miss the opportunity to actually try to transform
our social practices in ways that might actually allow us to challenge values that
we think problematic. Of course, the value of
the biogenetic family comes associated not only
with particular relationships between parents and
children or between siblings but also with a particular
notion of motherhood that is problematic
for many other reasons. So, insofar as that’s the
case, their reinforcing of the biogenetic family
is also problematic because it’s part of this notion, this traditional notion of motherhood. So, one of the reasons why
attending to values is important is because it allows us
to reflect on these values and the ways in which these
values might reinforce, might be reinforced or challenged when we don’t want those
values to be challenged. But another reason in the
case of the biogenetic family is that actually harms people. It harms those who don’t conform to the traditional biogenetic family. In many cases, and this is the argument that is being given again for
access to genetic information for those who are donor conceived, is that they have some kind of pathology. These families need some
kind of psychological help and in fact, there is a phenomena that is called
genealogical bewilderment. That people who are born
through gamete donation or adoptees for that
matter, apparently suffer because they lack access to
their genetic information. So, when we reinforce this
idea of the traditional family, the traditional, the biogenetic
family is the standard and we compare all the other families, so-called non-traditional
families to this standard. So whatever is missing in these families, the biogenetic connection,
is something that we need to try to meet in some other ways. So, in the case of donative
families for example, we try to meet by having legislation that allows people to have access to their genetic information
that they are lacking. In other cases when this is not possible, we recommend that people
have psychological treatment so they can deal with
the psychological scars of not having parents to whom
they are genetically related. So, we pathologize families that actually don’t meet
the biogenetic standard. Insofar as these technologies actually reinforce that value that
seems to be problematic given that people are
harmed by that value. But, not only does this notion, this value harm families
that don’t meet the standard, it also harms the hundreds
of thousands of millions of children who are adopted
or who could be adopted and who are not because
we have this notion that people should be
related to their children. So, insofar as this notion
of the biogenetic family prevents people from adopting, those children who actually
need loving families are also being harmed by this notion. Of course there are many other reasons why people don’t adopt children that don’t have to do only
with the biogenetic norms, but there is little doubt
that the biogenetic norm is actually one of the main reasons why people choose to
use these technologies, in spite of the expense
and the risk to the women and the potential risk to the children. They choose to use these
technologies rather than adopt. Again, clearly the norm
of the biogenetic family is one of those reasons. I could give many other arguments for why indeed these
technologies are problematic and this value, the
biogenetic norm is problematic and why we need to think about the ways in which we can use technologies
to transform these values and I’ll be happy to do
that during the questions. Thank you. – What we saw… What you told us today
is very interesting. For one thing, Professor
Inhorn is talking about more nuclear family, but Professor Inmaculada
was actually telling us about alternative families. So, we really are talking
about two distinct and different directions taking place. I would be very interested to hear about this a little bit more. I should add another level. I, myself am working on a
chapter for a book I’m finishing. It’s on marriage in history, but I’m finishing with a
chapter called singlehood. And that’s the trend towards singlehood because the statistics that are coming out and information coming out from everywhere particularly Egypt,
where my work is focused, is the choice of being single
rather than actually marrying. I see the whole idea of family itself as disappearing, and perhaps we’re going back to the extended family from before the coming of the (speaking
in a foreign language), going back to (speaking
in a foreign language), maybe because of the
problems with economics, if nothing else that the
people, housing, everything, people are choosing to go back and many cases for the
rising divorce rates which is today higher
than the marriage rate, that women are actually opting to go back or have no choice but to
go back to their family. We have too many trends to
talk about in all of this. At the same time, the folk
are trying to catch up, I don’t know. I’m trying to see what Professor Fadel has to tell us about this. Is there a way out to try
to find some solutions or are we all on a merry-go-round and where do we go from here with all these alternative families that are coming into being? So, I thought this question actually could go to the three of you. – I’ll start and then, okay. Right on Amira, (laughs) because
we just had this conference at Yale called Waithood:
Global, oh I know, I wish I knew that you
were working on singlehood ’cause that was a huge
theme of the conference. So, there’s a notion, it was put forward first
by Diane Singerman, a political scientist who
works in Egypt, of waithood. Waithood, the notion
that in Egypt, Tunisia and other North African, Morocco, especially in the economically-stressed parts of the Arab world,
you see this phenomenon of young people who can’t
afford to get married. They might be educated, but they can’t afford to get married, they can’t afford to
leave their family’s home and so they are in these prolonged periods of what she called waithood,
but it is singlehood. They can’t possibly be with anybody. They can’t form a nuclear family and it’s mostly out of the fact
that the financial is grim. And that’s found in many
countries around the world where young people just, they can’t begin to even
think about getting married, the costs are too high. So, there’s that form of waithood. But in our conference we started talking also about the sort of
aspirational waithood especially you see it among
women in the Arab world. Women who have become educated, they don’t wanna enter marriage quickly. They want to use their
educations, they want to work. They have aspirations to be professionals. There was an excellent
paper by an anthropologist Fida Adely from Jordan, and she was working– – She’s my old student. – She’s your old student. She has a fantastic project
on singlehood for women, especially women who are STEM,
people in the STEM fields of science and so forth
in Jordan, who basically, they aren’t married, they’re
living in the cities. They’re working, they love their jobs. But in a way they’ve sort
of educated themselves out of the marriage market because they’re considered
to be so educated. And so all of this waithood and singlehood is now happening in the Arab world and per your comments about
Qatar, high divorce rates, people are reassessing their commitment to the (speaking in a foreign language), to the nuclear family. And so there are real sociological shifts going on in the region
that are very interesting. I just wanna say something
about your discussion of the biogenetic family,
the sort of pressure to have these biogenetic connections through assisted
reproductive technologies. Just to say that in the Arab world, the Sunni Muslim Arab world,
those pressures are acute because there is no gamete donation. It is not allowed in the Sunni countries to do egg donor, sperm donor,
embryo donor or surrogacy, and so here you’ve got a
really accentuated focus on the biogenetic family and
that complicates adoption which Amira has really worked on. The notion that you can’t
technically and legally adopt in the same way, you
brought this up, Mohammad, in your paper, that adoption the way we do it in the
West is not allowed here so you do (speaking in
a foreign language), but it’s not the same thing. And some people are really advocating for adoption in the region. So, there are many, many
issues of family life in the region that are emerging that need to be studied and
are not adequately studied. This whole notion of
singlehood and waithood, not adequately studied. So, I will stop there, just to say that it is a very, very
important research topic, all of this discussion of what’s happening to families in the Arab world. – So, I’m going to say that actually, at least in the Western world, this so-called traditional
family doesn’t exist. The overwhelming majority of
families are non-traditional, in the sense that they do not conform, but this is the issue with norms. It doesn’t matter that in
fact the majority of families do not conform to that ideal, the ideal is still what we are aspiring and what the rest of the
families are compared to. So, what I am more interested is in challenging that ideal as problematic. That’s the reason why I think that insofar as these technologies
reinforce the ideal, they are problematic. But interestingly, I think that even in this context of the singlehood, I’m always a little concerned with when we talk about singlehood
as a choice by women because often it’s not a real choice in the sense that there
are lots of aspects, there are lots of factors that actually– – Play.
– Play a role in someone– – Such a decision.
– Not be married. In fact, in the United
States, it has been said that actually marriage is
now a status marker, because only people who have–
– Money. – Money are able to get married. So, this is a problem not
because people who don’t have it might not want to get married, but just because as you
were mentioning, they can’t. But, interestingly enough,
in this context of how career might play a role in
women’s not getting married and waiting to have children later. This is, they are another way
in which these technologies reinforce these notions in
problematic ways, in my opinion. So, cryopreservation of eggs today is one of the newest ways
of using this technology. Actually if you go to
New York for example, in the subway, you have ads, asking women to cryo-preserve their eggs. So, this is aimed at
single women, in their 30s, career-oriented, so-called
career-oriented women who don’t have the time and are
choosing to delay motherhood and again, all of this
between lots of quotations, and who, and who are asked to cryo-preserve their eggs so that when they decide
to become mothers, they can do so with their own eggs. And they can actually do it in a way that then they can also
allow their partners to be genetically related
to their children. So, this cryopreservation
actually both reinforce the notion of maternity and also this
biological relationships. So again, I’m always
interested in how things that appear in principle to be disruptive, might not be so disruptive. – Can I just comment?
– Yes. – I did a huge study,
an anthropological study of egg freezing and I do wanna say that women who are freezing
their eggs in America which is now the newest technology, you can freeze your eggs, they actually were not doing
it to delay their fertility because of career,
they’re actually doing it because they can’t find an
available, educated partner. It’s a partnership problem,
not a career problem. There are not enough educated
good men out there (laughs) for the educated good women
of the world. (laughs) Sadly. – Amir, I think your question
raises empirical issues and normative issues. Just to echo something you were saying, I think from an Islamic
normative perspective, singlehood is not considered
a normative choice. It’s just not considered a
way of human flourishing, in fact, it’s considered very clearly a bad way of human life. That doesn’t mean that
you’re forced to get married, but there is a strong, strong normative bias toward married life. And so that, generally speaking,
people who are not married are considered sort of missing out. And so I think it would be interesting for people who are
engaged in empirical work to disaggregate between people who are unable to marry
because they cannot, and that sort of speaks to much broader failures of development in the Arab world. And then, maybe a movement that seeks to embrace some kind
of normative solitude. That would also be
interesting in its own regard. But I don’t think from an
internal Islamic perspective one could imagine endorsing
a choice of solitude. I think there is lots of
flexibility in terms of, I mean, I would argue, at least, in terms of adoption, other sorts of issues, but these, I think, are
kind of low-hanging fruit compared to something like solitude. Right, I mean, solitude
seems sort of unthinkable because in some respects it
was one of the ways that Islam contrasted itself fundamentally
from Christianity. The embrace of conjugal
life is what distinguished early Islam from Christianity. So, it’s a formative
notion internally to Islam. – Yeah, actually, in my research, I’m connecting it to
the growth of violence and the choice of women not to stay in families or marriages that are abusive, and that do not fulfill the purpose of marriage to begin with. So, it’s a little bit
different than, but, thank you. Today you’ve opened too many questions, the three of you to us. Amir? – [Amir] Thank you very much,
wonderful presentations. I want to follow up on a few points that were raised
in the three presentations. So, I’ll start with Dr. Fadel. You mentioned, it seems
to me that you are somehow sanguine or supportive of what
we can call emerging trend to distinguish between (speaking
in a foreign language). Would that be kind of accurate to capture what you’re trying to explain? But, I will appreciate
further clarification on that. The other point, also related
to something you mentioned, the possibility of using
genetic information for other purposes, perhaps later for individuals on behalf
of individuals to verify, for example, questions
of relatedness or… Absence of certain diseases
at the time of marriage. But, don’t you also
see that there could be some harmful consequences of that, like violation of privacy later on, abuse of this kind of very
sensitive information? To Dr. Inhorn, you mentioned the issue
of this rising again, we’re talking about trends today, (laughs) the rising trend of son selection. In your research, do you see
a possibility of certain, again, policies that could be implemented to kind of reverse that
somehow or at least control, so, to put some guidelines? Has it been used somewhere? If yes, could you elaborate on that? Dr. Martin, you mentioned… You reiterated several
times that technology is not value-neutral and that it is laden. Could you elaborate a little bit more on what kind of values are, you know, imbued or subsumed or involved in these technologies? Thank you. – Okay, he asked you questions. – I must not have done a good job in my presentation, which I freely admit. I don’t want, actually
I’m strongly opposed to conflating (speaking
in a foreign language) with biological descent. I think (speaking in a foreign language) is purely a legal concept and it entails reciprocal rights and duties. In an ideal world there
would be perfect overlap between legal categories
and biological categories, at lease from an Islamic perspective. But, since we don’t
live in the ideal world, the issue is what do you do? And, I’m saying in most
cases Islamic law preferred the formal legal categories
over biological categories, even when that information
was reasonably available. But that doesn’t mean we
shouldn’t use biological evidence in other categories that
wouldn’t undermine this, when I’m talking about the
reciprocal rights and obligations that arise out of (speaking
in a foreign language). Now, you’re absolutely right
and I sort of mention this is that the promise, the
beneficial promise of genetic, accurate genetic information
for therapeutic reasons and other sorts of reasons are not going to be fulfilled unless you have adequate
institutional safeguards to protect against abuse
of that sort of data. But, I don’t think there’s an
Islamic objection necessarily to having access to accurate genetic data about descent for those other purposes as long as privacy safeguards are in place and there are sufficient
institutional safeguards to make sure that that data is not then exploited
for nefarious reasons. But, it’s sort of hard to imagine how that could happen given what we know about the states where
Muslims are majorities. – Yeah, go ahead. – Yeah, I mean, to be quite honest, to prevent son selection from
happening in this region, laws could be made. I mean, the UAE interestingly
has a very restrictive federal law that came down the
pike and has been legislated, and there are many things you
cannot do legally in the UAE in terms of assisted
reproductive technologies, but interestingly, this
one slipped through. It was like well, for the
purposes of family balancing, and actually I don’t
really even understand why the fatwa allowed it in Egypt where it sort of started, the discussion of using
this for family balancing. I understand, I understand
that having sons is seen as an important reality, but it could’ve just
not come out that way. It could’ve been said that you can use PGD for genetic screening only,
but not for the purposes of selecting the gender of the child. That would, in my view,
I’m not a bioethicist, but in Islamic bioethics that, in my view, would’ve been much more consistent with the sort of Islamic
background of the issue. And, there are many
countries that have ART laws and you could just legislate and say, no, you cannot do this,
but that hasn’t happened and so now we’ve seen this booming demand across the region for sex selection. It’s costly, so only people
who’ve got economic resources are gonna be able to go through this ’cause it involves an IVF
cycle, but, it’s becoming, it’s becoming an industry in this region. It’s attracting so-called
fertility tourists who are coming for PGD. And I don’t necessarily see it because in places where this has happened, we have a lot of evidence from Asia that when you allow sex
selective technologies to come into a society, it
always ends up badly for girls. And I’m just afraid and despite, there was a lot of evidence,
demographic evidence, some wonderful work by
Carla Makhlouf Obermeyer showing how son preference
was really diminishing across the region, you
could tell in the rates of child health and the survival of girls, things were getting better,
better, better throughout the 80s and 90s and so forth. And now with this new
technology, you could really see a reversal of the status of girl children and to me that is a troubling trend. – Can I just have a quick
comment on the Egyptian fatwa? – Yeah. – I think it’s reflective
of a much bigger problem that you see in fatwas coming out of the official authorities in Egypt, in which they adopt a very extremely, for lack of a better term, licentious view with respect to individual action even when they recognize it,
it undermines a common good. So there was also a fatwa,
a few years ago about (speaking in a foreign language) like unregistered marriages, in which they said that it’s
not haram, it’s not sinful even though it undermines public order. And so to me, it’s kind
of a shocking fatwa, that you say, yeah, it’s asocial behavior, but you know, go ahead. And so, it’s the same kind of fatwa, it’s asocial but go ahead. – Yeah, well that’s
clearly this fatwa, too. It’s like okay on the individual level but not on a social level. But once you allow it
on the individual level, it becomes a social reality, right? That is the problem with the fatwa. – If I may follow on. I wanted to ask, is there even a possibility amongst the, particularly the (speaking
in a foreign language) and the kind of setup
that we have in Egypt, where they would actually
think outside of the box of (speaking in a foreign
language) traditionalists of going beyond the book? Is it possible for them to
actually come up with some, except when it’s convenient, that is the state wants
them or something else but, are they capable
of, can you, being the scholar you are, find,
I’ve heard you before show ways by which this
can be done differently, but they need some guidance. – I don’t think it’s a question of going outside the box or anything. There’s a deep problem of,
for lack of a better term, a neo-liberal conception
of religious morality in which it’s purely
individualistic and consumer choice. And so, they see themselves as making religion easy by facilitating consumer
choice, basically. And so, they don’t wanna tell people, no, you can’t do this. Because they think people resent
being told they can’t do it because they’re used to being
able to get what they want by going to the market and
buying it, so they’re afraid of alienating their
customers, essentially. I mean, that’s my opinion. – We’ll talk about this a bit more. – There was a question
way up there in the back. (speaking in foreign language) – There are many ways in
which these technologies are value-laden, and many of
the values that are embodied by these technologies, one
of them is sexism. (laughs) So, in case it was not obvious. (laughs) Even in places, even if one
of the things that we could do for example, Europe prohibits the use of sex selection with PGD. The United States
doesn’t, but Europe does. The problem is, and I think
this is a good thing obviously, but the problem is that
even if that’s the case, once you allow the use of PGD, then the decision is going
to fall on the clinicians because now the clinicians
have information that is relevant to the
patients, whether, you know, the embryo has a chromosome XX or XY, and so the clinician now needs to keep that information
away from the patients in order to be able to
fulfill the duties to the law. And this is very problematic because now they are the
clinicians making choices it’s not clear that
should be their choice. So again, even if we pass legislation that might help with these cases, it’s difficult then to
put it into practice. Another of the values that it seems to me, this is in the case of the
reprogenetic technologies more obviously, is quality control. Quality control as an individual issue. It is not health and disease become the duty of prospective parents, in particular prospective mothers, to ensure that children don’t have particular genetic conditions
or particular disabilities, so that concern about
disease and disability become an individual problem rather
than a collective one. This has, it seems to me, terrible consequences for our societies. And unless again, we
reflect on how this is being implemented and the ways in
which we develop practices that promote these notions, we are not gonna be able
to do much about it. – That’s great. – Welcome back to the
conference on Family Structure in the Wake of Genetic and
Reproductive Technologies. What was the 11:15 session
is now the 11:40 session on the Implications of
Biomedical Technologies. I am Jeremy Koons, I am
Associate Professor of Philosophy here at Georgetown University in Qatar, and I will be moderating the session. Today, we are fortunate to hear
from Delfina Serrano Ruano, a researcher with the
Spanish National High Council for Scientific Research. She’s affiliated with the
Institute of Mediterranean and Near Eastern Languages,
and also from Jennifer Lahl, who is an author and documentary filmmaker who is founder and president of the Center for Bioethics
and Culture Network. Angel Foster was also scheduled to speak but unfortunately, is
unable to join us today. We will first hear from Dr. Serrano Ruano and then from Miss Lahl
and then after that we will open the floor for questions. – Good morning. First of all I would like
to thank Ayman Shabana for the opportunity to come
back to Doha and to Georgetown, and for the opportunity to
present results of my work before an audience of experts in bioethics and Islamic bioethics. The established legal
durations of pregnancy in Islamic law are relevant to determine paternal affiliation, the waiting period after divorce or widowhood,
maintenance, inheritance rights and unborn children’s
eligibility for bequests. The agreed upon, the agreed-upon minimum duration
of pregnancy was six months whereas the maximum length remain subject to strong disagreement
given the lack of any relevant instruction in the
Quran and prophetic tradition. Be that as it may, the fixed
maximum lengths far exceeded the average nine months,
spanning from two to seven years. The Egyptian Maliki
jurist, Ibn Abd al-Hakam, diverged from his schoolmates who held for either four
or five years maximum and proposed one complete year at longest. The latter position is
close to Ibn Hasan’s view that pregnancy cannot last
more than nine months. For Ibn Rushd al-Hafid,
better known in Europe and the Latin West as Averroes, who was a Maliki jurist
but also a physician, the relevant legal norms should rely on common experience rather
than on exceptional cases. In his view, Ibn Abd al-Hakam
and the Zahiris were closer, the Zahiris means Ibn Hasan, were closer to the truth than the rest. The famous Quran exegesis
(speaking in a foreign language) held exactly the opposite. That is to say, the relevant legal norm has to be decided on a case-by-case basis and taking the most exceptional durations registered thus far into account. Actually, the view that pregnancies should be considered according
to attested experience and the observation of nature entered the Sunni laws schools long
before the 20th Century to argue both for and against the reality of extended durations. However, the dominant
positions were not always ruled by medical or pseudo-medical criteria but rather, by the practical consideration to guarantee the stability
of the Islamic social order. Meanwhile, from the
first, this is classical. (speaking in a foreign language) Meanwhile, from the first quarter of the 20th Century onwards, legislators in the MENA
and most GCC countries submitted the legal duration
of pregnancy to medicine. Yet, the minimum duration continues to be fixed in six months, not withstanding that
successful birth cases before the sixth gestational
month have been attested whereas either 11 or 12
months mark the maximum limit despite modern physicians agreement that pregnancy cannot
last more than 280 days. Concurrently, the rules
preventing paternity establishment out of wedlock, whatever the
evidence of genetic tests, on the one hand and criminalizing
extramarital relationships on the other, remain enforced. My paper deals with
assessments of the paradoxes brought about by modern medicine in contemporary (speaking
in a foreign language) and legislation on the
Islamic family by contemporary Sunni (speaking in a
foreign language) experts. Most of them approached
the duration of pregnancy with a normative advisory purpose. Their assessments present the (speaking in a foreign
language) jurisprudential norms relevant to pregnancy
in the Sunni law schools followed by our research in
the methodological foundations, a personal evaluation of
the soundest legal view in terms of methodology and compliance with the evidence of modern medicine, and finally, a proposal for
national legislative bodies to best accommodate that evidence to sharia’s ethical and legal standards. Most of them strive to demonstrate that classical (speaking
in a foreign language) and modern medicine are
perfectly compatible. They emphasize that despite the occasional flaws
in their methodologies, certain pre-modern (speaking
in a foreign language) were particularly accurate
in their estimates of either the real duration of pregnancy or the causes for its extended durations. In their view, modern medical
computations and findings have quite naturally come to replace the old reliance on shared
experience and women’s testimony. The transition has been
made easier by the lack of any specific indication
in the sources of the sharia regarding the maximum
duration of pregnancy. For this presentation, I am going to focus on Hatem al-Haj, an Assistant Professor at the Faculty of Sharia of the
Islamic American University, of the Islamic American University. He questions the ideal
of a total agreement on the minimum duration of pregnancy among pre-modern Muslim jurists. More interestingly, he’s the only author, of those I have examined,
who makes explicit the connection between scientific evidence on embryology and
genetics on the one hand, and the Islamic prohibition
to mix filiations, which provides the rationale for the prohibition of
extramarital relationships, (speaking in a foreign language) and paternity establishment
out of wedlock. Well, as regards the minimum
duration of pregnancy, according to al-Haj,
the agreement on fixing the minimum duration of
pregnancy in six months among pre-modern (speaking
in a foreign language) results from the reading Quran 233 jointly with Quran 46:15. In doing so, they deducted the 24 months implied in the first verse from the 30 months
mentioned in the second. Hatem al-Haj argues that
the consensus reached by the Prophet’s companions on that regard did not refer to the
impossibility of survival in case of delivery before the six month but rather, to the possibility of survival when birth occurred from
the sixth month onwards. The confirmatory consensus
of the Muslim jurists of subsequent generations, he adds, does not provide conclusive
but only conjectural evidence, and may be replaced by a sounder argument. The object of their agreement
is that a child born after six months of pregnancy is attributed to the mother’s husband. Obviously, one can’t legitimately conclude that a child born before that period should not be attributed
to the mother’s husband in case of survival. However, it is important to
keep in mind al-Haj remarks, that the implication of the
claim that the child born before the six month
does not used to survive or only lives for a very short time, is that the cause of
death is premature birth. To strengthen this point,
al-Haj makes reference to Ibn Hasan whose opinions
he treats in the same way as those of the Sunni legal scholars. In case of preterm deliveries, the (speaking in a foreign language) is reported to have
advised to take the shape of the baby or the
expelled fetus into account in order to determine its
age and hence its filiation with the mother’s husband or ex-husband and the validity of the
most recent marriage. In this connection, al-Haj reminds, that survival of a premature baby for one or several days creates
inheritance rights. Al-Haj openly advocates for
reducing the established minimum duration of
pregnancy in contemporary (speaking in a foreign
language) legislation. He refers to a statement made by the (speaking in foreign language) the Islamic view society
on some medical practices. Based on the advances of medicine in terms of resuscitation
of premature babies, the (speaking in a foreign language) fixed the minimum duration of
pregnancy in 154 days, whereas the six months
proposed by the jurists amount to 177 days. Al-Haj concludes, that a child
born less than six months after marriage and who manages to survive cannot be declared illegitimate without determining its age
via medical consultation. Maximum duration of pregnancy. After reviewing the relevant (speaking in a foreign language) positions on the maximum duration of pregnancy, al-Haj concludes, that modern medicine is able to determine the age of the fetus with total accuracy during
pregnancy or after birth, as well as its biological identity. Gestational periods
going beyond nine months have been declared impossible on the grounds of conclusive
scientific evidence, he says. He too, tries to reconcile classical (speaking in a foreign language) and modern medicine by suggesting that the latter has ended up by confirming the opinion of pre-modern scholars like Dawud, the founder
of the Zahiri school, and Ibn Hasan, another prominent member of the Zahiri school, and by the Maliki Ibn Rushd al-Hafid or Averroes. To explain Ibn Rushd’s case, al-Haj makes a distinction
between his position as a Maliki jurist in
the capacity of which he subscribes to the
maximum five years duration and his personal preference, likely motivated by his medical knowledge. Al-Haj is critical with
those modern jurists who, in his view, subscribe
to the doctor’s opinions without sufficiently arguing their shift. At this point, he introduces his own 10 months maximum duration proposal. He’s aware that this opinion
lacks any explicit precedent in the Islamic legal tradition
and he hints at al-Shawkani’s interpretation of Quran 15:8
as a possible textual basis. Al-Haj adds that some modern (speaking
in a foreign language) have argued that the one
year maximum duration of pregnancy adopted by most
Muslim majority countries relies on the authority of the Maliki Egyptian
jurist Ibn Abd al-Hakam. According to al-Haj,
new medical technologies compel contemporary Muslim
scholars to reassess the legal interpretation of
the many rights and obligations related with the length of pregnancy. In the list of legal norms affected by the duration of pregnancy, he includes (speaking
in a foreign language) or imprecatory oath, the punishment of (speaking in a foreign
language) and its postponement until after delivery, when the
accused is a pregnant woman. Al-Haj finds it also necessary
to react to the obvious implications of medical advance
over the traditional belief that a female egg can be
simultaneously fecundated by two or more men, giving way to a (speaking
in foreign language) confounding a filiations case and two competing paternity
claims over her child. The (speaking in a foreign
language), he explains, disagree regarding the possibility
of multiple fecundation. Some considered it possible that a child could have more than one procreator. Yet, al-Haj stresses, that their main concern was
not biological viability, but rather, due action in case of competing paternity claims. Al-Haj draws on a maxim
transmitted by Adn Nyati to argue that the expression, draws on a maxim transmitted by Adn Nyati a jurist from the, a scholar from the 13th Century, to argue
that the expression, mixing of the two sperms or (speaking in foreign language) must not be understood literally. Yet, he admits that certain jurists did understand the expression
in its literal sense, relying on several arguments. For example, a hadith transmitted in Muslim (speaking in a foreign language) according to which the Prophet
forbade sexual intercourse with a pregnant captive woman, those jurists believed that
if a man has intercourse with a slave who is
pregnant from another man, the sperm of the former
contributes to the growth of the fetus so that a
biological bond is created that prevents that man
from claiming ownership of the child after birth. The same idea is expressed
by another hadith, transmitted in the Sunan Abu Dawood, and reinforced further
by a view of Ibn Hanbal transmitted by Ibn Qayyim al-Jawziyya, that sexual relations during pregnancy improved the fetus ear and sight. Those who understand
mixing of the two sperms or confounding of filiations
as multi-perfecundation refer also to Umar, Umar
Benhal Hataz’ decision to assign a child to two men who had intercourse with the mother. Without that, the
companions objected to it. Rather, the decisions started
to be considered as consensus. (speaking in a foreign language) In another tradition, Ali is reported to have acted as Umar did. This is all according to al-Haj. The partisans of awarding joint paternity of a single child to
two competing claimants pointed out that from a
medical point of view, the possibility exists that a womb already comprising
the sperm of a man receives the sperm of a second man. The womb, they argued,
has a very strong capacity to attract and receive the sperm. They compared the sperm in the womb with the food in the stomach, and the stomach’s appetite for food. According to those jurists,
these experiences are confirmed by sensory perception as can be witnessed when the female dogs and cats are mounted by several males and their cubs are born with different colors as a result. Those who assert that there can be no association in (speaking
in a foreign language), in filiation, and deny
that pregnancy may result out of the sperm of two
different men rely on Quran 49:13 Ibn Abd al-Barr, jurist from Al-Andalus, from the 11th Century
and Ibn Rushd al-Hafid held this opinion as well. The opponents of joint paternity also used the tradition from Ali in support of their argument. According to this tradition,
Ali solved a dispute among three men who claimed
the paternity of a child by drawing lots, on
condition that the winner would pay one third of
the child’s blood price to each of his opponents. This solution pleased the Prophet so much that he burst out laughing
when he got to know about it. Henceforth, al-Haj
recounts, custom was ruled by the principle that each
child has only one father. The source of al-Haj as regards
relevant medical arguments is Ibn Qayyim al-Jawziyya’s
Al-Tibyan fi aqsam al-Qur’an. In this work, Ibn Qayyim explains that once the sperm arrives in the womb, fecundation causes the cavity to close, except by a tiny exit
equivalent to a needle’s eye. This tiny exit may
occasionally get occluded so that closure of the
womb becomes complete. In any case, the cavity cannot be opened by sperm arrived subsequently in the womb by contact with other men. For al-Haj, the soundest (speaking in a foreign
language) view is that pregnancy cannot result from
the sperm of two or more men. The child can be exclusively
attributed to one of them and in case of doubt, the
child is to be given the option to choose among the
claimants, as Umar did. If the child has not reached
the age of discernment yet, the decision must be taken by drawing lots like Ali did with the
endorsement of Allah’s messenger. Al-Haj says, his preference is determined by the strength of the indications
supporting that opinion from both a legal and a
sensory point of view. Be that as it may, Al-Haj
insists that holding in favor of joint paternity
does not necessarily imply belief that a woman may get pregnant from two different men at a time. Modern medicine, al-Haj proceeds further, has given credit to those
premodern jurists who held that joint or multiple
fecundation was impossible. Yet, he warns, this has not put an end to divergence of opinions. Okay. Regarding joint filiation. When the egg is fertilized
by several sperm cells belonging to different men, he claims, a molar pregnancy, (speaking
in foreign language) takes place without embryo. In theory, he adds, multiple
fecundation is possible but such a thing has
never happened in humans, whereas the phenomenon is quite widespread among canine, ovine and equine females. Though technically possible in the future, multiple fecundation of a
single egg is legally forbidden. Al-Haj concludes that the day
this possibility is realized, the relevant laboratory
experiments will confirm that the old cases of shared
(speaking in a foreign language) and belief in multiple
fecundation of a single egg were not totally unfounded. In conclusion, the shortening
of pregnancy duration provides another instance
of how modern medicine in Islamic societies may
turn detrimental to women and increase imbalance in gender justice. Susan Miller has explained that
during the colonial period, the authority of traditional
practices was undermined especially among the younger generations so that clinging to the old legal opinions about extended pregnancies
put religious scholars at risk of looking ridicule and
of losing their credibility. Thus, in the specific case
of pregnancy duration, religious scholars and
national legislative bodies had sound reasons to keep pace with the societal transformations brought about by technological advance. This fact does not make the
present state of affairs less inconsistent with the
premodern interpreted framework in which admission of
pregnancy as evidence of adultery or of
extramarital relationships and the rules governing paternity were conceived and legitimized. For certain groups of people, that flexible chronological umbrella that once covered
pregnancy has now shifted towards increased exposure
to legitimacy and conviction, and conviction (speaking
in a foreign language). Such inconsistencies foster claims that contemporary family legislation reinforces the gender
barriers already present in classical (speaking
in a foreign language), adds to the vulnerable position of widowed, divorced and abandoned women, and sounds too much to
selecting only those parts of the legal tradition
and of modern medicine that are most detrimental for them. If most contemporary (speaking
in a foreign language) have accepted that the
legal duration of pregnancy has to accommodate modern medical evidence by the same token, a new
interpretation of classical Islamic law on (speaking
in a foreign language) is called for that faces the challenge to justify its
criminalization in our days, despite the available
scientific knowledge. To hint at prospective experimental tests that will demonstrate that from
a biological point of view, the premodern notion of
(speaking in a foreign language) or confounding of filiations
was not totally unfounded, looks like it’s unconvincing and seems a tactic to evade the task. Thank you. – Thank you so much for inviting me. It’s been a privilege to listen to the speeches so far this
morning, I’ve learned a lot. But, I’m gonna change gears a little bit. I am American, I’m from California. So, I hope to give a little
bit of our perspective of what’s going on in the United States as it relates to assisted reproduction. And my work specifically focuses
on third-party conception. So, the use of egg and sperm
donation and surrogate wombs. More often, it’s my
understanding and my observation that we focus on the intended parents, the infertile couple who wants a child, who wants a child of a particular design, the single person who wants a child through assisted reproduction
or, more recently in the United States, with the
passage of same-sex marriage, now the same-sex married couple that wants to have children through
third-party conception. As was introduced by Jeremy, the fact that I
am a documentary filmmaker, I found out early on in my, I was doing a lot of writing and speaking in the space of third-party conception and I would have people
contacting me all the time that had been either egg
donors, sperm donors, born of third-party conception
or surrogate mothers. And so, I moved into
documentary filmmaking because like it or not,
people will watch movies where they won’t often have time to read important research publications or books, as somebody who’s published research and also written in books, (laughs) I produced Eggsploitation which is many stories of
young women in America who made the decision to sell their eggs, university students. Soon after we released
Anonymous Father’s Day which looks at the whole
third-party conception through the eyes of the
children now grown up who were born of third-party conception, oftentimes anonymous. And then we produced,
Breeders: A Subclass of Women? Question mark, to look at surrogacy. And two weeks ago, we released Big Fertility: It’s All About the Money, which is one American
surrogate mother’s story as she was a surrogate for
a same-sex couple in Paris, which was why I was in
France two weeks ago. She was a surrogate mother
for an American couple and her last surrogacy
was for a Spanish couple and so I will be in Spain in two weeks, showing Big Fertility there. A little brief primer, being
from the Silicon Valley, in this context AI is not
artificial intelligence, but it’s artificial insemination which, when I was a nurse many years ago, I was a pediatric critical
care nurse for many years, we used to, many of the
nurses I worked with would do artificial insemination. They called it their little
home turkey baster parties. So, it’s low-tech. We called that the low-tech
assisted reproduction. It’s been around for a
very, very long time. And, what we know about
artificial insemination and much of reproductive medicine today was learned from farmers
and veterinarian medicine. So, it wasn’t til 1978, you heard earlier on a presentation about
the birth of Louise Brown. For many, many, many decades
there was a lot of research going on because it’s
quite difficult to get eggs out of a woman’s body
and to create an embryo in a laboratory and get it
back into a woman’s body in order to have a live birth. And so, Louise Brown
was kind of a big moment in reproductive medical history. If you read Gena Corea’s
book Mother Machine. There was a lot of research
that was being done on women for many, many decades, oftentimes without their
knowledge or even their consent. Of course, in my work it’s clear that much of assisted reproduction is eugenic from the beginning until the end. Five years after Louise Brown was born, we have the first documentation
in medical literature of a baby born through a donor egg. So, Louise Brown was born
through Mrs. Brown’s eggs and Mr. Brown’s sperm, but five years later Dr. Alan Trounson, down in Australia, documented the birth of the first IVF baby using a donor egg. We have a saying in bioethics, that the birth control
pill allowed us to have sex without having procreation, and now we have reproductive technology that allows us to procreate without sex. Being from California, I use
the example of Elton John. Elton John and his partner, David Furnish, came to California twice in order to buy eggs from one woman and rent a womb from another woman and they now have children and there was actually no sexual act involved in the creation
of those children. So where we find ourselves
situated here today is that we have a global, chaotic, unregulated fertility industry. You literally can buy
and sell eggs and embryos and sperm and ship them
all around the world in order to help people make a family. We have post-menopausal pregnancies. You know 40 is the new
50, 50 is the new 60. So, we have literally women
that are the age of grandmothers who are now through assisted
reproduction having babies, and post-menopausal
litter births, Octomom. Again, my State of California, Octomom was transferred six embryos. Two naturally, twin gave birth to eight and then the list goes on and on. As a pediatric nurse who saw
a lot of savior siblings. Savior sibling is when
you have a sick child, you create a bunch of embryos in the lab, you find the genetic
match for the sick child and you allow that
genetically matched embryo to come to birth so that
at the birth of that child, the umbilical cord blood is collected, which is rich in stem cells, which is then transferred
into the sick child in order to provide a cure or treatment. Single mothers by choice. Again, being in the Silicon Valley, a lot of women are either
banking their eggs, freezing them for later, hoping
for a marriageable partner or they’re just becoming
single mothers by choice. The old issue of gamete
donation within families, inter-familial, anonymous donation. Do we have sisters give
their eggs to sisters or do we just go on
Craigslist or the internet and search for a suitable donor? Grandmothers are now giving birth to their own grandchildren
in order to help their daughters who can’t
carry a pregnancy to term. As one who’s followed the
success and the failure rates of assisted reproduction
for decades, it’s still, it hasn’t really made
lots of leaps and bounds in its efficacy in producing live births. It still overwhelmingly
has a 30% failure rate. So, in Eggsploitation, I like
to put faces to the stories. You’ll meet a lot of women,
these are all American women who made the decision to sell their eggs. They were all university students. They all saw this as a win-win opportunity in order to help somebody have a baby and/or in order for them to make money that was either gonna pay
for their student loan debt or graduate program or whatnot. And all of these women suffered. They were one-time egg donors and they all suffered short-term harms, immediate short-term harms. And they all went on to
suffer long-term harms too. For example, Calla was
a student at Stanford who suffered a massive
stroke within about two days of taking the fertility drugs and she will never be able
to have children of her own. So, in her desire to help
somebody have a child, she lost her ability to
have her own children, and it’s one of the risks
of being an egg donor is losing your own fertility,
that’s a possibility. Kylee’s similar in that
she is not sure yet if she will be able to conceive, she’s having much difficulty. And both Calla and Kylee suffered strokes during their egg donation process. It’s interesting, Alexandra went on and immediately suffered a torsion ovary, had to lose an ovary about 10 days after the eggs
were retrieved from her. And then she went on and developed bilateral breast cancer as a young woman who had absolutely no
history of breast cancer. These women are screened
’cause we don’t wanna buy eggs from women who have histories
of genetic diseases. So I’ve done a lot of research
with Jessica’s mother. Jessica went on and died of colon cancer, but her mother and I have published in the medical literature a case report of five otherwise healthy
young egg donor women who were not genetically
at risk for breast cancer who went on, as young women,
and developed breast cancer. Just calling attention to the
fact that we’ve never once studied the effects of these drugs on otherwise healthy women,
women that aren’t patients. So we don’t have any data
in the medical literature to know what these women are
specifically at risk for. I think it’s important to tell all sides of the new assisted reproduction. You’ll see a lot of the
ads that we’ll talk about use always very altruistic language, You’re an angel. You’re doing this
benevolent, wonderful act. They’ll tell you that we
inform the donor of risks when you can’t inform donors of risks of something you’ve never studied. They’re told that it’s
just a minimally invasive, light surgical procedure and
there’s little to no risk, and that you’re helping
somebody have a baby and you’re gonna be
compensated generously. But the reality is, is that and these women are often exploited for their genetic material. That’s why we go to Stanford,
that’s why we go to Columbia. We go to the Ivy League schools, we want beautiful, intelligent women. And that informed. (coughs) Informed consent is
impossible, like I said. And then it is an invasive surgery with anesthesia and all the risk. And, you’re not helping
somebody have a baby, you’re helping somebody have your baby. Your baby that’s genetically
related, looks like you, will carry your genetic
history and whatnot. We’ve done a lot of surveying and polling of attitudes in America, and what we found overwhelmingly is there was a huge educational gap. People just think it’s a good thing. It’s donation, it’s helping. But in fact, we’ve polled audiences and we’ve screened the film
literally all around the world, and we polled prior to
watching the film and after. And how quickly people
go, oh, I did not know. They didn’t even think that there could be risk to the young women’s health. In California, in my
State, we had a huge battle because in California,
egg donors are allowed to be paid to sell their
eggs to make babies, but they’re not allowed to sell their eggs for scientific research, and that’s just the way the
law is written in California. The researchers, of course,
they’re clamoring for eggs in order to do reproductive research, in order to do CRSPR gene editing. Many forms of research
depend on women’s eggs, and Jerry Brown vetoed
the bill (clears throat) and that was very important
because his opening sentence to the California legislators
when he vetoed the bill was, not everything in life is
for sale, nor should it be. And he really understood
that once California, which has a huge scientific
community out there doing this particular type of research, he knew that the egg market
would shift to low income women. Because a bench researcher doesn’t care if you go to Stanford. The bench researcher doesn’t care if you’re pretty and you’re
bright and attractive. They just need eggs for
basic bench research. These are just some of the ads. I have children that went to university and I always was
collecting advertisements. You can see again, the
eugenics side of it. We want genius egg donors,
highly intelligent egg donors. This is from the Stanford paper, again, a genius egg donor was wanted. Moving quickly to Anonymous Fathers Day. Again, back to the fact
that we don’t track, we don’t monitor when a child
is born all around the world, the birth certificate doesn’t say, born of anonymous egg donation. Born of sperm donation. Born of surrogacy. So, there’s really no way of tracking when you see the whole
international tourism side of this. Where are these children being born? Where are they connected to? The global market of
sperm is estimated to be about five billion dollars
in about five years, and the U.S. controls almost 75, 80% of the global sperm market. Not that all the sperm donors
are coming from America, but these are U.S.
agencies around the world that are controlling the
whole market of sperm. Some of the people that we interviewed tell different stories, they tell stories of how they found out,
when they found out. Some were young, some were older. Some of them are quite
active, doing advocacy work and either making the anonymity go away. So, Damian and Narelle
are down in Australia, and Australia and some other
countries have just recently changed their laws so
that it doesn’t allow for the anonymity to be allowed anymore. Barry is interesting, ’cause he estimates that he
has about 1,000 half-siblings. Barry lives in Canada, but he was born through sperm
donor in the United Kingdom who happened to be married to a very prominent fertility physician, and so her husband was her
star donor for three decades. So, if you can imagine
one man for 30 years being a regular donor to his wife who was a fertility specialist
in the United Kingdom. He’s met, I think, about 13 half-siblings through DNA testing, but I
haven’t kept up with Barry in the last couple of
years, so he may have met more of them by now, I’m
not really quite sure. And Stephanie is interesting. Stephanie found out when
she was 35, I believe. She was just driving
in the car with her mom and her dad was very
sick and she was worried that she was gonna get what her dad has, and her mom just basically told her in the car while she was driving, there’s something we’ve never told you. Your father isn’t your biological father, you don’t have to worry
about getting the illnesses that he has ’cause you’re
not genetically related. She instantly knew because
there was a family picture in the house and she kept
looking at that picture all the years growing up, going, something doesn’t look right. I don’t look like these people. But she’d seen pictures
of her mom pregnant so she knew she wasn’t adopted. So finally all of it made sense to her in that one moment when her mom decided, we’ve never told you, your
father is not your father. You could argue that
sperm donation’s safe. It’s certainly not going to
be harmful to the man’s body, and they’re of course told
that they’re helping out. But what about the children? Hollywood produced a
movie several years ago, that said the children are alright, and I would beg to differ that
some of them aren’t alright, and some of them are questioning
and raising their voices. Do they have a right to this father? Do they have a right to know who he is? How many half-siblings do they
have out there in the space of the years that their biological father was donating his sperm? And again, you’re helping
somebody have your baby, not just a baby. Elizabeth Marquardt did one of the first earlier studies in America
called My Daddy’s Name is Donor, and it’s no surprise that
some of, it’s a very, very comprehensive study,
but overwhelmingly, the kids say that they really wonder what this family is like
that I technically belong to. And they overwhelmingly, of
course, feel that they have a right to know who that person is and who their biological family is, whether be it siblings, cousins. The ads unfortunately aren’t
as glamorous and as sexy. Sperm donors aren’t paid as
much as women egg donors are. But again, they want healthy,
intelligent, generous men. This one ad in the United
Kingdom offers $150.00. But, you know, a guy can donate his sperm, in the United States,
every day if he wanted. There’s no restrictions on how many times. And then finally our, film on surrogacy, Breeders: A Subclass of Women? We thought it was really
important to tell the story around how the policy debate is
taking place around the world. So, we interviewed altruistic surrogates, meaning they weren’t
paid, they just did it because they wanted to
truly help somebody. They weren’t looking
for any monetary gain. Then we interviewed commercial surrogates, who needed the money
and thought that it was win-win for them and for the
couple they were helping. We interviewed people that
were surrogates for strangers. Tanya, Heather, surrogates for strangers. Or Gail was a surrogate for her homosexual
brother and his partner. So, do we just help friends out, or do we help family out,
or do we help strangers out? So, we thought it was
important to tell the story through all the different
ways surrogacy happens, whether it be for money or not,
or for strangers or for not. Or traditional surrogates,
where you’re not just providing your womb, but you’re also
providing your genetic material, and also the gestational surrogate who’s just providing
her womb, if you will. And then Jessica is a young
woman who’s born of surrogacy, so her voice was included
because we need to hear, I think, from the children that
are also born of this. Jessica’s interesting. She showed me, when she came
for our interview on camera, she brought her first baby picture. And the first baby
picture she has of herself is in the attorney’s office
where her surrogate mom is handing her over to
the new intended parents, and the surrogate mom is being
handed a check for $10,000. So, she raises… Her blog is called a product,
A Product of Surrogacy. She feels like she was a
product who was bought and sold. The ads are similar to
those of the egg donors, that you are an angel. You’re doing this
benevolent, wonderful thing. Legal issues are rare. All the problems that a
surrogate might anticipate can be contracted away, as
long as we have good, strong binding contracts that
everybody agrees to the terms, there aren’t gonna be any problems. That it’s easy for surrogates
to detach from the children. They don’t get connected, it makes no difference to the baby, there’s no maternal bond
connection that’s happening. But the reality is oftentimes surrogates either feel like
they can’t surrender the child or they still feel attached to that child once that child is gone. I’ve read way too many surrogate contracts that are signed in America by
American surrogate contracts and the language in many of
the contracts is enough to really cause me to weep at times. There’s the silly trivial things like they have to eat a particular diet or they can’t do a particular thing like exercise or wear perfume or eat organic or vegan, but then there’s the
more distressing things where everything is contracted down ’til they waive their
patient confidentiality. So, if they’re surrogates
for total strangers, these total strangers have
access to their medical records. One surrogate contract, she signed away her
end-of-life decision making, so that if she required life support during the course of the pregnancy, the intended parents who
she never even had met had control over if or when
life support would be pulled. The whole issue around
commercialization of procreation and what happens when
this becomes an industry like in Big Fertility, my new
film that’s just come out, really sort of looks at
this with the lens of not medical ethics or helping
people, but an industry that’s just growing by leaps and bounds in the hundreds of billions of dollars. And the whole issue of class,
the haves and haves nots. I live in the California area. So I’m surrounded by the
Hollywood celebrities, it’s the rich who have
the money and the means, who either bank and freeze
her eggs or hire surrogates or buy eggs and enter into
this kind of enterprise. And it’s the lower income, poor or in the case of the United
States, it’s the lower income, oftentimes, military
wives that are offering their bodies if you will, for surrogacy. Again, as a pediatric nurse,
the womb isn’t arbitrary. It’s not just this arbitrary
organ in our bodies. In pediatric nursing, we work really hard in
high-risk pregnancies to encourage bonding
between mother and child. That’s good psychologically,
it’s good healing. Medically it’s good. And then in the area of surrogacy, we just sort of wave it all away, that these bonds and these
connections don’t matter. And, it’s important for
moms and children to bond. The ads again, A Beacon of Hope. How do I get started making money today? That’s a more brazen one that’s driven, drawing on people’s need. The issue of take home baby with no visa. In Big Fertility, the surrogate who was, the couple was in France. What she didn’t realize
once the children were born it was difficult in getting
passports because France doesn’t recognize these
children as French citizens. So, a lot of the agencies will advertise, well, we’ve worked out all those hassles, so you won’t have to worry,
you’ll get your take home baby. This is a huge problem,
reproductive tourism. I interviewed a surrogate
broker in San Diego, California, and her clientele was the
VIP clients from China. I said, why were they The VIP clients? And she says, well, they
have just tremendous wealth, and they come to the U.S., because once the children are born, the children have U.S. citizenship, and that’s a real perk in
case once a child grows up and wants to attend university in America. And she said it wasn’t uncommon
for the Chinese to come and they hire three surrogates and then they get them all pregnant and then they decide which
pregnancies they want to keep and which ones they want to terminate based on whatever the
whims are that they have. They don’t want boys,
they don’t want girls. She said that one ultrasound
showed that the baby didn’t have a finger,
and so the Chinese couple decided to terminate that pregnancy. So, the whole issue around
commercialization, consumerism, the industry, and of course,
my European colleagues will attribute this to
sort of the newest form, if you will, of human trafficking, and the need for international laws to protect all the stakeholders, not just the intended
parents who want a child. Thank you so much.

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