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The World's Not Ready for This: Globalizing Selective Technologies

DOI: 10.1177/0162243913516014

Martin, L J. “The World's Not Ready for This: Globalizing Selective Technologies.” Science, Technology & Human Values 39.3 (2014): 432–455. Print.

p.434-435: The United States has become an ideal marketplace for those seeking selective technologies that are illegal, inaccessible, or unavailable in their own countries. Specifically, technologies such as commercial egg donation, preimplantation genetic diagnosis (PGD), and sex selection are prohibited or highly regulated in many nations, but remain legal and largely unregulated in the United States. Based on in-depth interviews with US fertility industry providers, including physicians and egg donor and surrogate brokers, this article analyzes how the ideologies of genetic determinism and consumer choice are embedded in the industry. These are transformed into competitive advantages that may appeal to foreign nationals unable to acquire the technologies, services, and reproductive materials to which they feel entitled. Regardless of providers’ particular attitudes regarding the uses of selective technologies, their overall practice reinforces intended parents’ desires to have some control over their potential children’s appearance, temperament, abilities, and behavior. Despite other nations’ laws and policies, ideologies supportive of the use of selective technologies do not, obviously, end at the US borders, and the globalization of communications, media, and transportation technologies enable their spread. -- Highlighted apr 28, 2014

p.437: Building on the argument made by Hashiloni-Dolev and Weiner (2008) about clinic workers in Israel and Germany, in this article I draw on indepth interviews with US fertility program providers to show evidence for a shared American cultural and ethical perspective. The shared perspective of US providers not only shapes their industry, but it also impacts the global reach of American attitudes and ethics regarding reproductive technologies. -- Highlighted apr 28, 2014

p.437: By focusing on the attitudes of US providers regarding the use of selective NRTs by domestic and international clientele, this article combines several streams of literature, including analyses of reproductive tourism, ethnographies of assisted fertility, and studies (largely outside the United States) about the attitudes of clinic workers. -- Highlighted apr 28, 2014

p.438: Policies that regulate, restrict, limit, or ban reproductive technologies act as push factors for reproductive tourism. Such policies include restrictions on types of services, bans, or limits on compensation for third parties, and guidelines regarding age, sexual orientation, and marital status of intended parents. Since this article deals with the use of technology to select traits, this section focuses primarily on national policies and guidelines about gamete donation, PGD, and sex selection. -- Highlighted apr 28, 2014

p.439: Countries have a variety of reasons for instituting bans and restrictions on reproductive technologies. Such factors include religious doctrines about the moral status of embryos or when life begins, ethical orientations informed by histories of eugenics, attitudes about the commodification of human bodies and body parts, the rights of offspring to know about their genetic origins, and medico-scientific protocols regarding informed consent and laboratory procedures. Despite the presence of nationwide prohibitions or regulations, all residents and citizens of a given country (including intended parents and fertility industry providers) may not personally agree with the normative principles underlying bans and regulations—or with the absence of bans and regulations. -- Highlighted apr 28, 2014

p.439: Larger themes of genetic heritability and consumer choice are embedded in the US fertility industry and transformed into marketing tools broadcast to appeal to foreign nationals unable to acquire the technologies, services, and reproductive materials they desire and demand. Understanding and analyzing attitudes of fertility industry providers in the United States matters because they work in a particular ethical context where they serve international clients who choose their services precisely because their own country’s laws hinder their desire to use reproductive technologies as a means to select particular traits for their future offspring. -- Highlighted apr 28, 2014

p.441: Megan, marketing director of an L.A. egg donation agency, acknowledged recruiting specific ethnic populations in order to appeal to intended parents of that particular background: "Like, oh, we don’t have any Armenian donors. I need to get us some Armenian donors." -- Highlighted apr 28, 2014

p.442: Catalogs and advertisements remarking on sterling qualities of egg donors only feed into the desires of prospective parents to breed a certain caliber of child. Demand for donors with advanced degrees, musical ability, and Ivy League pedigrees implies that these markers of class and rearing are genetically transmissible; cultural capital is thus a manifestation of, and shorthand for, genetic capital. Egg donors’ genetic capital becomes a marketable commodity, with their cultural capital as convenient shorthand. -- Highlighted apr 28, 2014

p.442: Those who work for these organizations are not ignorant of the implications of ranking donors by intelligence, grade point averages, or subjective criteria such as beauty. -- Highlighted apr 28, 2014

p.446: What makes the United States exceptional in the fertility industry becomes a competitive advantage in the global marketplace. Eggs from US donors cost much more than eggs in the United Kingdom, for example approximately $8,000 versus $1,200 per cycle, but this higher price tag brings greater consumer choice over the "commodity" being purchased. Additionally, paying thousands of dollars to an American egg donor may symbolically indicate that recipients are purchasing high-quality ova. -- Highlighted apr 28, 2014

p.446: Egg donation and other selective technologies are matters of "consumer sovereignty," in which consumers enjoy "freedom in the form of personal liberty" to which institutions must adjust to remain competitive (Slater 1997, 35). -- Highlighted apr 28, 2014

p.448: Deirdre, a San Francisco family law attorney with a social work background, described how she tries to educate her clients about the realities of assisted fertility and genetics: "We talk about ... what they’re really looking for. If they’re looking for a clone of themselves, there’s usually a detour to discuss that, and to discuss expectations of what a child produced will be." Deirdre saw it as part of her job to convey to intended parents that having children always involves risk, and that technology cannot be used to completely control the process or to create "an idealized person." -- Highlighted apr 28, 2014

p.451: Without any regulations against the uses of PGD within the United States for nonmedical reasons, market forces help determine the types of services that clinics offer. Dr. Silverstein of Los Angeles claimed that his clinic had developed technology to determine eye and hair color. However, after releasing this information to the media, "The world went berserk. My publicist in New York called me up and said, ‘Doctor, the pope’s talking about you.’ ... So we said, okay, the world’s not ready for this, and we just withdrew it. A huge media thing, designer babies ... Okay, fine, forget it." As consumer demand increases however—including the demand from overseas clients—Dr. Silverstein and others are prepared to offer these selective services. -- Highlighted apr 28, 2014

p.451: In the age of globalization, intended parents of means and privilege are not limited by culture or policy. Enterprise culture, which Strathern (1992) describes as a consumerist orientation to procreation and kinship, is not regionally bound, and those intended parents who wish to enact this particular orientation regarding procreation may search for providers—in whatever country—who will help them on that path. -- Highlighted apr 28, 2014

p.453: By emphasizing the individual right of the consumer (regardless of residence or citizenship) to negotiate with an individual provider about what services will or will not be offered, my informants emphasized the market relationship between provider and client, and deemphasized the role of the state in governing that relationship. In contrast with how they viewed the regulatory landscape in their international clients’ home countries, providers presented the US fertility industry as a free marketplace that can meet the desires of intended parents worldwide. A market relationship is two-sided, however. In its promotion of the quality of donors and the availability of selective technologies, the US fertility industry not only meets global demand, it also shapes it. -- Highlighted apr 28, 2014