Our final issue of the year– Volume 39 Issue 4 December 2015– has just arrived. In our last blog post series for 2015, we begin with a three-part feature of the latest publications at the journal in this new issue. In addition to the article previews in this series, our readers can access the full issue here. In this post, we explore Yael Hashiloni-Dolev’s preliminary research on posthumous reproduction in Israel (full article accessible here.)
Biomedicine, through its innovative application of technology, can reconfigure biological experiences in ways that alter or reinforce cultural beliefs surrounding life, death, reproduction, kinship, parenthood, and social roles. Most recently, this has become a central issue in the field of assisted reproductive technologies: where biomedical interventions potentiate new relationships between parents, families, and children. But while assisted reproductive medicine is often discussed in terms of generating life, these new generative technologies may also intersect with death in novel ways that challenge existing understandings of kinship and familial relationships.
Hashiloni-Dolev article studies Israeli lay perceptions of a new concept in assisted reproductive medicine called posthumous reproduction (PHR.) In sum, PHR entails the use of genetic material from deceased parents to conceive children after their deaths. This usually means a woman will opt to become artificially inseminated with a husband or partner’s sperm retrieved while the man was in a coma or vegetative state: however, it may also include the fertilization of a woman’s eggs, frozen while she was alive, and gestated in a surrogate mother. Even frozen embryos of two deceased parents (a mother and father) might be “adopted” and implanted into a female relative or another recipient, who subsequently gives birth to a child whose biological parents are no longer alive. This process also facilitates the possibility of posthumous grandparenthood, and indeed, some parents whose adult children have died may seek out PHR technologies (include allied technologies such as surrogacy) to produce grandchildren.
Israel is one of the few countries that permits some forms of PHR, and it is a progressive nation in terms of reproductive technologies: its state health system covers the costs of ARTs (assisted reproductive technologies) for couples who have difficulty conceiving. Although Israel does not permit all forms of PHR, it does allow for the collection of a man’s sperm upon a wife’s request to carry his child upon his death (what the author calls the “prototype scenario.”) In this regard, Israel served as a prime location for surveying participants and testing initial ideas about the public perception of PHR: a new frontier of ARTs yet to be studied in the anthropological literature.
Through 26 semi-structured interviews with newlywed or childless couples, Hashiloni-Dolev discovered that there were some inconsistencies between the Israeli PHR policies and the participants’ understanding of PHR technologies. For instance, the government stipulated that PHR could occur via the retrieval of sperm from a dying or recently deceased father upon the wife or female partner’s instruction. The policy states that the retrieval could occur given evidence of a man’s “presumed wish” that he would want his spouse or partner to carry his child after death. However, “wish” and “consent” were interpreted differently by men interviewed for the study. The men typically stated that while they would defer to their partner’s wishes to have a child after their death, they themselves were uncomfortable with the possibility of their partners having the child and being unable to “move on” should they pass away. In this instance, while the man’s presumed “wish” might not change a woman’s decision to retrieve his sperm posthumously, it does not mean the man would “consent” to the process if he were not already dead.
Conversely, consent becomes more complicated given the circumstances that typically surround the use of PHR. The man is presumably young, such that his female partner would be able to carry his child, and would have died suddenly: thus making it nearly impossible to obtain his consent unless he had already affirmatively offered it while still alive and healthy.
There were also issues related to the family life of a child born through PHR techniques. Both male and female participants worried about the emotional stability and security of children born out of such conditions, and expressed their concern with new policies being proposed that would allow for expanded posthumous grandparenthood rights. The participants believed that the decision to have children following the death of a spouse was between the couple, and was not between other family members. Likewise, many participants worried about the birth of a child as a living shrine to the deceased, rather than as a new and autonomous member of the family.
In these responses, it is clear that while both biomedical technologies and governmental policies may enable PHR to occur, the process is not always viewed in such liberal terms by individuals who could be most likely to use it. Posthumous reproduction thus supplies medical anthropologists and scholars of social medicine with a nuanced case of the cultural position of new technologies, and the concerns that individuals across cultures have with these new reproductive tools: particularly as they relate to consent, kinship, and the roles of parents.
Culture, Medicine, and Psychiatry 