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Family Equality and Surrogacy

Posted by Elliot Hosman on July 9th, 2015


A rainbow flag symbolizing LGBT rights waving in the wind.
Image via Wikimedia.

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On June 26, the U.S. Supreme Court ruled in a widely celebrated decision that all 50 states must issue marriage licenses to couples regardless of their sexual orientation, likely ending an era of patchwork marriage rights for same-sex couples in the United States.

In a same-day op-ed for the Los Angeles Times, Douglas NeJaime, law professor and faculty director of the Williams Institute at UCLA, argues that “equality for gay families” has not been delivered with marriage. To ensure family dignity for gays and lesbians, says NeJaime, the next step is removing legal barriers to surrogacy. By failing to embrace commercial surrogacy, NeJaime continues, states will be effectively limiting the definition of family to heterosexual couples who can bear their own children.

For many decades leading up to present day, a number of discriminatory state laws have specifically excluded LGBTQ people from adoption and parental rights. This history is heart-breaking. Lesbian, gay, and transgender parents have been deemed “unfit” for being “antisocial,” “mentally ill,” and lacking in the moral fiber of “traditional family values” required to raise an upstanding citizen. These parents have fought for the dignity of their families, in schools, hospitals, social gatherings, churches, and too often, in unsympathetic courtrooms. With the victory of marriage equality, there are pressing issues for LGBTQ rights that extend way beyond weddings—as NeJaime suggests. Yet looking to the same principles of justice and equality that the marriage decision represents, we should proceed with caution and not move to an uncritical acceptance of the commercial surrogacy industry in this moment of hope and change.

Assistive reproductive technologies (ART) have helped many couples facing fertility barriers to start families. As NeJaime explains, lesbian couples can make use of commercially available sperm, in vitro fertilization, and fertility treatments for the partner who carries the child, while gay couples can turn to commercially available eggs and gestational surrogates. Yet the ART industry is highly unregulated, with a throng of unresolved issues including the safety of women and children, informed consent, privacy versus access to information, economic access, and marketing standards.

Additional problems surface when we turn our attention to those who provide wombs or gametes— especially eggs—in assisted reproduction, and to the children who result from these arrangements. Too often in commercial surrogacy, the desires of intended parents overshadow the health, rights, and well-being of those other people: the woman who provides her eggs, the woman who gestates and delivers the baby, and even the longed-for baby.  

Women who sell their eggs to clinics, often for use as anonymous “donors,” are required to undergo drug treatments to increase ovulation that can have serious impacts on their health. Women who work as surrogates, especially in countries other than the US, often enter into contracts where the intended parents pay for both the attorney and the healthcare providers—raising concerns about compromises to the surrogate’s health and rights. A growing number of children conceived with third-party gametes and gestated by surrogates are realizing that they want to know about and perhaps to meet the people who contributed to their birth.

These and other unanswered questions hover around commercial surrogacy. And we already know that some of these ongoing practices are clearly harmful to women who bear children for others. Shouldn’t affronts to their human dignity be among those for which we fight? As we celebrate marriage equality and acceptance, we must also ensure that the voices of everyone participating in the creation of non-traditional families are heard, and that their rights are recognized and protected.

Previously on Biopolitical Times:





Talking About the Germline

Posted by Pete Shanks on July 8th, 2015


The debate about heritable human genetic modification continues, with opinions ranging from enthusiasm to dismay, and strong arguments for political as well as scientific involvement. Among the notable contributions in the last few weeks are the following. Jacob Corn, Scientific Director of the Innovative Genomics Initiative (IGI), which is “dedicated to the enhancement and proliferation of genome editing research and technology in both the academic and commercial research communities” in the San Francisco Bay Area wrote a blog post (July 6) that stated categorically:

At this time, the IGI Lab will not do research on human germline editing for several reasons, including: 1. The IGI Lab is focusing on diseases for which somatic (non-heritable) editing would be a transformative advance. … 2. Cas9 technology is currently too nascent for me to consider germline editing wise. …

Corn was an organizer of the Napa meeting that led to the call in Science for a moratorium. CRISPR pioneer Jennifer Doudna is IGI’s Executive Director. Critics may point to the phrase “at this time” as a wiggle or loophole, but he is specifying a moratorium even on research, not just applications. We may not see any stronger statements from major researchers in the field ahead of the National Academies meeting, which Corn says is slated for October. 

Daniel Sarewitz, co-director and co-founder of the Consortium for Science, Policy, and Outcomes at Arizona State University, made the important point in Nature (June 23) that weighing up the benefits and risks of gene editing and artificial intelligence is a political endeavour, not an academic one: "Science can’t solve it.”

Also in Nature (June 24), science and technology studies scholar Charis Thompson deplored the simplistically gendered nature of much of the discussion and urged a balanced approach aiming for “better science and better ethics.”   

Republican members of the U.S. House of Representatives have started to weigh in, via the appropriations process. That could be a worrying sign of political polarization. But on the Democratic side, Rep. Bill Foster, who describes himself (accurately) as “the last scientist with a Ph.D. remaining in Congress,” has also expressed serious concern. Writing in The Hill, he issued a warning about the implications of fundamentally changing the course of human evolution: 

We are on the verge of a technological breakthrough that could change the future of humankind; we must not blindly charge ahead. Now is the time to engage in serious and thoughtful discussion about what this means for the future of the human race.

Another commentary, by Craig Holdrege at the Nature Institute, discussed (June 22) “unforeseen effects” and unintended consequences, and strongly endorsed MIT and Whitehead Institute geneticist Rudolph Jaenisch’s view that “it is unacceptable to mutate normal embryos. For me, that means there is no application [of this technique in human embryos].”

By contrast, Henry Miller of the Hoover Institution at Stanford, a right-wing think tank, has no doubts, publishing a letter in Science (June 19) under the provocative title:

Germline gene therapy: We're ready

In passing, Miller accuses Baltimore et al.—the authors of the call for a moratorium in Science—of “apparent nostalgia” for Asilomar, which he regards as a failure because it “exaggerated the potential risks of recombinant DNA technology,” among other things.

There were also some relatively unhelpful pieces in the press. Newsweek published one (June 30) that conflated the upcoming Institute of Medicine report on “3-person IVF” with gene editing, and contained the confused line: “Embryo editing could allow a mother to replace faulty genes with genes from a different woman.”

An article in The New York Times (June 29) suggested that germline intervention was entirely unproblematic unless used “to change such traits as eye color or intelligence”; implied that only Chinese scientists were working on applying gene-editing technology in this way; and seemed to hint that Chinese researchers have weaker ethical constraints and standards than Americans do.

Much better was the Nature editorial (July 1) noting that

the culture wars … are a reality that all must face — and that is a good thing. … As public awareness of the technology increases, that ethical discussion will rightly be taken out of [academic] hands alone and planted firmly in those of broader society. 

Finally, Pew Research released (July 1) the results of a science-related public opinion poll conducted in August 2014. The public was split over “changing a baby's genetic characteristics to reduce the risk of serious diseases,” with 50% saying that was “taking medical advances too far,” while 46% considered it appropriate. (Young male liberals tended to be in favor, and the respondents were not informed about already existing medical alternatives to germline manipulation.) However, 83% thought that “changing a baby's genetic characteristics to make the baby more intelligent” was going too far.  

Previously on Biopolitical Times:





First Federal Bill to Acknowledge US Eugenics Would Help Victims of State Sterilization Programs

Posted by Jonathan Chernoguz on July 8th, 2015


Image via Wikimedia

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A bipartisan bill introduced in the Senate on June 25 would give a financial break to people in North Carolina and Virginia who were sterilized under those state’s official eugenics programs, and who are now hoping to receive compensatory payments that have been established by their state legislatures. If passed, it would be the first federal legislation to recognize the history of sterilization abuse that took place during the twentieth century in the name of eugenics.

Senate Bill 1698 would exclude payments from current or future state eugenics compensation programs from consideration in determining eligibility for Federal benefits including Medicaid, Supplemental Nutritional Assistance Program, Supplemental Security Income, and Social Security Disability Insurance. It was introduced by Senator Thom Tillis (R-NC), who was joined by Senators Mark Warner (D-VA), Tim Kaine (D-VA), Tom Carper (D-DE), and Richard Burr (R-NC). On July 8, Congressman Patrick McHenry (R, NC-10) and Congressman G. K. Butterfield (D, NC-01) introduced companion bill H.R. 2949, the “Treatment of Certain Payments in Eugenics Compensation Act,” in the House of Representatives. 

Between 1907 and 1977, 33 states passed laws authorizing eugenic sterilization of various categories of people (including “criminals,” the “mentally ill,” and the “feeble minded”). Populations most often targeted by the eugenics programs were unmarried women, African-Americans, and poor children.

Only two states have issued plans for reparation through monetary compensation.  North Carolina became the first to enact legislation to compensate living victims of forced sterilization laws in 2013, setting aside a $10 million compensation fund.  Following North Carolina’s example, Virginia passed similar legislation in 2015.  While North Carolina identified 220 living sterilization survivors; Virginia has identified only twelve so far. Virginia will award $25,000 to each involuntarily sterilized person who was alive as of February 1, 2015. 

Unfortunately, many North Carolinians and Virginians who were sterilized against their will do not qualify for reparations, and thus would receive no benefits from the newly introduced federal legislation.  The states’ current compensation laws say that to be eligible for compensation, the sterilization operation must have occurred under the state's Eugenics Board.  However, judges, local health officials, and social service workers were also permitting and arranging sterilizations, as in the case of Debra Blackmon

In a short video about the bill, Senator Tillis encourages “other states to follow North Carolina’s lead, as Virginia has recently done, to right this wrong in our nation’s history.”

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Forgotten Stories of the Eugenic Age #1: How “Better Babies” Became “Fitter Families”

Posted by Natalie Oveyssi on July 7th, 2015


Fitter Family contest medal, awarded by the American Eugenics Society, 1920s. Source: Center for Genetics and Society

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Forgotten Stories of the Eugenic Age is a blog series exploring the lesser-known ways that eugenics affected and engaged American lives during the first half of the twentieth century.

Eugenics became a popular ideology in the United States beginning in the second decade of the twentieth century. Concerned with producing a stronger and fitter population through the careful and often coercive control of reproductive behavior, eugenics captured the attention of a citizenry eager to use science to solve its social problems.

Many scholars divide the early eugenics movement into two branches: “positive” and “negative” eugenics. Positive eugenics was the encouragement of reproduction for those believed to be of superior hereditary stock, in contrast to “negative” eugenics, the discouragement or prevention of reproduction for those deemed hereditarily “unfit.” Many eugenists, as eugenic advocates were known, believed that the goals of positive eugenics could be achieved voluntarily through education campaigns, while negative eugenic aims would require more coercive means for attainment, such as mass sterilization and immigration quotas.

Baby health contests at agricultural and state fairs perhaps most vividly exemplify popular campaigns for positive eugenics. Judges at these contests examined infant contestants according to a set of criteria for physical health and intelligence that included factors such as shape of the head, width between the eyes, condition of tonsils, strength of spine, and ability to walk or crawl. They quite tellingly employed scorecards derived from those used to judge livestock. First begun in 1908 at the Louisiana State Fair, baby health contests spread to forty states within just a few years.

However, somewhere along the eugenic line, "Better Baby" contests, as they were known, morphed into "Fitter Family" contests that examined not only the baby but the whole family. Scholars have attributed this change to a shift in focus from the health and development of the child towards a more comprehensive look at hereditary history, in keeping with the principles of eugenics. But how exactly did this change transpire?

Mary T. Watts, co-founder of the Better Baby contests, revealed the impetus for the transformation in an address at the Thirty-third Annual Meeting of the International Association of Fairs and Expositions in 1923.

As Watts recounted, shortly after she began the Better Baby contests in her home state of Iowa, she received a letter in the mail from none other than Charles B. Davenport, a titan of the eugenics field. Davenport wielded significant influence as the director of the Biological Laboratory at Cold Spring Harbor, the Eugenics Record Office, and the Carnegie Institute of Washington’s Station for Experimental Evolution.

On a one-cent postcard, Davenport had written only, “You should give 50 per cent to heredity before you begin to score a baby.” Overwhelmed by answering inquiries from intended Better Baby organizers across the United States and Canada, Watts placed the letter aside and forgot about it.

The following year, she received yet another terse postcard from Davenport with the single ominous sentence, “A prize winner at two may be an epileptic at ten.” Watts, who had since become aware of Davenport’s authority in eugenics, understandably found the postcard “so startling it could not be ignored.”

Watts shared Davenport’s letter with her Better Baby co-founder, Dr. Florence Sherbon, who noted that many prize-winning babies likely had alcoholic fathers, diseased mothers, or insane relatives. Perhaps Davenport was on the right track; rather than examining babies alone, in order to truly test for eugenic ideals, judges must look to a baby’s family as well. How else could they tell if a baby was “better”?

Watts and Sherbon decided that they wanted to insert family and heredity tests into the contests, but were concerned that doing so would eliminate their popular appeal. It took the pair six years to develop a satisfactory approach. They presented their plan for Fitter Family contests to a group of experts who offered a mixed response.

The experts universally approved of the reasoning behind the new plan, but felt that Fitter Families would not be able to replicate the smashing success of Better Babies. Watts recalled that the experts said, “You can bring the baby to the fair because he cannot help himself, but you will never get the fathers and mothers to a fair for physical and mental examinations.” The experts were especially concerned that adults would not submit to the Wassermann test for syphilis, presumably because some would not want their spouses to discover the results.

Nonetheless, the experts assisted in making a scorecard to judge not only the babies’ physical and mental qualifications, but also those of their parents and siblings. All were shocked when twenty families entered the first Fitter Family contest at the Kansas Free Fair in 1920. The Fitter Family contest organizers continued their newfound relationship with Davenport well into the 1920s, as Sherbon and Watts sought his advice on their family history forms and contest procedures.

Critics of the Fitter Family plan had said that “we could never hope to interest educated, self-respecting families in physical examinations for adults at a fair ground.” But, Watts stated proudly in her 1923 address, the Fitter Family contests were thriving. And the organizers and contestants—as well as the eugenic cause—could thank Charles Davenport, whose postcards had provided the spark that lit the fire.

Sources:
1. Lovett, Laura L. “‘Fitter Families for Future Firesides’: Florence Sherbon and Popular Eugenics.” The Public Historian 29, no. 3 (Summer 2007): 69–85. JSTOR.

2. Selden, Steven. “Transforming Better Babies Into Fitter Families: Archival Resources and the History of the American Eugenics Movement, 1908–1930.” Proceedings of the American Philosophical Society 149, no. 2 (June 2005): 199. EBSCO host.

3. Watts, Mary. "Fitter Families for Future Firesides." Billboard 35, no. 50 (Dec. 15, 1923): 230–231. ProQuest.

Previously on Biopolitical Times:






 


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