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- Convenors:
-
Cathy Herbrand
(De Montfort University)
Nolwenn Bühler (Unisanté, Institut Universitaire de Médecine Générale et Santé Publique)
Send message to Convenors
- Chair:
-
Joanna Latimer
(University of York)
- Stream:
- Discovery, discussion and decision
- :
- Welcome Centre Lecture Theatre 4
- Start time:
- 25 July, 2018 at
Time zone: Europe/London
- Session slots:
- 2
Short Abstract:
This panel explores the practices and politics of 'innovation' at the intersection of reproduction and genetics through the lens of a feminist STS perspective. It asks how scientific breakthroughs in both fields (re)produce and/or subvert hierarchies of difference and associated inequalities.
Long Abstract:
Since the double helix was 'discovered' and the first IVF baby born, techno-scientific breakthroughs, such as genome editing, 'three-parent' IVF, non-invasive prenatal testing and epigenetics, have marked the fields of both reproductive medicine and genetics. While developing separately, these two fields frequently intersect and their encounters have significant implications in terms of gender identity, embodiment, reproductive and life choices. Genetics might be used to disentangle relationships in third-party conception, to naturalize gendered behaviours, to identify chromosomal abnormalities, or to select specific embryos considered worthy of a future. Reproduction in turn becomes crucial when epigenetic changes might be transmitted over generations, or when fertility or inheritance are affected by genetic disorders.
As innovations and their narratives of open-ended progress characterize the development of both fields, this panel will explore the practices and politics of 'innovation' at the intersection of reproduction and genetics through the lens of a feminist STS perspective. In particular, we would like to question how these innovations and related scientific knowledge contribute to (re)produce and/or subvert hierarchies of difference and associated inequalities. How do categories such as gender, race, ethnicity, class, kinship and species matter when genetic and reproductive innovations are made in and out of the lab? How do they frame promissory discourses at the intersection of these two fields and with what effects? How to critically account for the materiality of these new possibilities? What are the political implications of uncertainties in both fields and how do researchers, policy-makers, patients, and clinicians manage such uncertainty?
Accepted papers:
Session 1Paper short abstract:
This paper stems from a broader research project that investigates the case of the diffusion of Time-Lapse Imaging (TLI) tools in IVF and explores the promissory discourses on visual predictive tools as a non-invasive innovation enabling knowledge production.
Paper long abstract:
Embryo selection is essential in IVF practices to increase pregnancy rates and reduce the negative effect of repeated failures. Embryo selection techniques are currently based mainly on morphological and morphokinetic criteria or pre-implantation genetic testing (PGD/PGS). Contrary to genetic testing, TLI tools are presented as non-invasive and therefore preferable alternatives to routinely support embryo selection. In this paper, we examine the promissory discourses on TLI and its potential for knowledge production in embryology.
TLI has been recently introduced in fertility treatments and it represents a controversial and arguably revolutionary tool for IVF practice. Before its introduction, embryologists had to materially remove embryos from the incubators at rigidly defined stages of embryo development, in order to assess them and record progress. TLI tools take pictures of embryos at regular intervals and produce a large number of images for each embryo. The visual data require the creation of new knowledge infrastructures to be translated into "short videos" that allows professionals (and patients) to carefully and non-invasively observe embryos during their life in vitro.
Based on ethnographic data (observations in IVF labs and interviews with professionals) and document analysis (medical literature, manufacturers' and clinics' websites, public documents produced by other relevant stakeholders), the paper examines different laboratory practices aimed at "predicting success", including the design of in-house algorithms and patented automated tests. Particularly, the paper explores how professionals face the political implications of uncertainties, investigating how embryo prediction methods based on contentious knowledge are co-produced in the scientific research on embryo development.
Paper short abstract:
This paper attempts to analyse how women account for risk-centred prenatal genetic screening and testing in Taiwan. It discusses the reduction of uncertainty from non-invasive prenatal diagnosis and its risk accountability of NIPD to the context of Taiwanese women's reproductive choice.
Paper long abstract:
This paper attempts to analyse how women understand and account for risk-centred prenatal genetic screening and testing in Taiwan. Application of cell-free foetal DNA screening, which is also called 'non-invasive prenatal diagnosis (NIPD)', has become a routine part of prenatal care since 2012 and has brought attention from several academic studies. NIPD makes it possible to detect certain types of disabilities easier and earlier in the pregnancy and with fewer risks. However, it also brings issues to women and society. As argued by feminists, innovative genetic screening and testing technology bring medical intervention and individual choice to women, and these construct them as decision-making subjects and turn them into moral pioneers. Based on participant observations in the obstetric consulting room and interviews with pregnant women, this paper asks how women understand and make decisions with NIPD during their pregnancy. This paper pictures women's pregnancy as 'risky pregnancy' because of risk-centred biomedical practice and risk accountability in women's prenatal diagnosis. By looking at risk-reducing intervention and women's choice, it will provide an account of pregnant women's risk accountability in NIPD and show how women's choice is embedded in medical-socio-technical networks. In the end, this paper will contribute to science, technology and society and feminist studies by bringing the discussion of risk accountability of NIPD to the context of Taiwanese women's reproductive choice.
Paper short abstract:
This paper uses the concept of 'reproductive responsibility' (Novas and Rose, 2000), the perceived reproductive obligations that follow from genetic knowledge, to discuss the gendered nature of women's choices around reproduction in the context of Turner Syndrome (TS).
Paper long abstract:
This paper uses the concept of 'reproductive responsibility' (Novas and Rose, 2000), the perceived reproductive obligations that follow from genetic knowledge, to discuss the gendered nature of women's choices around reproduction in the context of Turner Syndrome (TS). TS is a non-heritable chromosome disorder affecting females; 90% of girls are born without ovaries, or their ovaries fail before puberty.
Developments in reproductive technology bring increasingly complex family-building choices. In addition to egg donation or adoption, reproductive preservation techniques introduce the potential for some pre-pubertal girls to freeze their own ovarian tissue or ovaries for reimplantation in adulthood, while some mothers of girls with TS have frozen their eggs for their daughter's use in later life. The perceived benefits of pregnancy are balanced against significantly higher rates of miscarriage and maternal death (Abir, 2011; Karnis, 2012).
This paper examines how TS affects women's choices around disclosure, relationship formation and family building. It further explores how perceived expectations of mothers affect the decision of mothers of girls with TS to freeze their eggs. Finally, it addresses the gendered aspects of reproductive responsibility and how it is predominantly assumed by women with TS and their mothers.
Paper short abstract:
This paper explores how a variety of screening techniques are framed as promissory strategies in the context of egg donation. It considers how screening tools and the knowledges they produce, materialise a particular construction of the idealised, healthy donor.
Paper long abstract:
Media reporting of a small number of high profile cases in which serious genetic conditions have been inadvertently passed from donor to offspring serve to generate ideas about the potential for genetic risk in donor conception. Current guidance in the European context suggests that egg donors should have no known serious genetic conditions in their family history and additional screening should only be offered where additional risk factors, such as those associated with particular ethnicities, exist. More recently, expanded carrier screening tools are being used routinely in some contexts to identify carriers of recessive conditions amongst all prospective donors. These changes appear to mark a move towards the expansion of genetic testing for donors.
Our paper explores how a variety of techniques, which offer to screen for risk of genetic disease, are framed as promissory strategies in the use of egg donation. Drawing on data from an ESRC-funded study on egg donation in the UK, Belgium and Spain, it considers how professional and policy rationalities, screening tools and the knowledges they produce, materialise a particular construction of the idealised, healthy donor who is free from genetic illness and risk. We consider whether these tools may be part of a set of increasingly commercialised choreographies within egg donation in Europe.
Paper short abstract:
Building on a series of discussion groups on genome editing (CRISPR) in Austria, this paper aims to show how people use "moral geographies" in making sense of these new technological promises. This practice (re)produces hierarchical differences of us/them, here/there and closeness/distance.
Paper long abstract:
"… but for people it's very simple, they just drive to Slovakia or one
of the neighboring foreign countries and get it done there". This is one
quote from discussion groups organised by the STS Department in Vienna
(Felt, Metzler & Bieszczad) in late 2017 addressing genome editing with
CRISPR.
Due to the relative affordability and speed of gene editing with CRISPR,
promises arise to democratise genetic research whilst potentially
eliminating heritable diseases. While ethics boards, researchers in
different fields as well as leading journals have voiced concerns about
these promises, this project investigates both the attempts of
participants to make sense of this highly contested emerging technology
and the narratives (re)produced surrounding reproductive technologies in
the genetic age.
Feminist scholars of technoscience have long been pointing out
problematic entanglements of reproductive technologies, with questions
of local/global inequalities and the hierarchization of societies both
within and amongst each other. Although CRISPR does raise new questions
of regulation and governance, it reanimates a long-standing discourses
that moralizes reproduction and polices bodies.
By conducting a narrative analysis of discussions on reproductive
technologies using gene editing, this paper examines how participants
draw distinctions along axes of race, ethnicity, gender, age, and
ability, utilising "moral geographies" to make sense of the distributed
nature of gene editing technologies. Considering the uneven legislation
across national boundaries, participants are acutely aware that national
legal frameworks are often insufficient to encounter the complexity of
contemporary reproductive possibilities.
Paper short abstract:
This paper explores the bio-objectification of mitochondria in the field of reproduction. It asks how a feminist technoscience approach helps us to address the implications of their objectification in promissory bioeconomies, while accounting for the way they blur the boundaries of reproduction.
Paper long abstract:
Largely unknown only a few years ago, mitochondria, these organelles providing the cell with energy, have recently gained greater public visibility in the field of reproduction through the introduction of two technologies involving their manipulation and transferability. The first, so-called 'three-parents IVF' aims at avoiding the maternal transmission of serious health disorders, while the second, so-called AUGMENT, promises to improve egg quality and increase fertilisation chances. Both are invested with promissory capital and gain biovalue in a reproductive bioeconomy driven by hope and technological innovation. At the intersection of reproduction and genetics, these 'mito-technologies' contribute to a reconfiguration of reproductive and hereditary processes.
Our paper questions the implications of rendering mitochondria both manipulable and manipulating by examining three key characteristics of the bio-objectivation processes of mitochondria: 1) their transferability; 2) their enhancement potential; and 3) their biovalue. It asks how a feminist technoscience approach helps us to address the articulation between mitochondria as a biological resource on the one hand and as a promissory one on the other. We argue that if mitochondria's life is objectified in biological and economic terms, it also resists any attempts to stabilize a fixed notion of life and contributes in contrast to blur the boundaries of reproduction.
Paper short abstract:
Since 2011 sperm from a Danish Sperm bank was sold and delivered to private customers for home insemination. In 2017 this practice was questioned in the Danish Parliament, leading to a regulative ban. In this presentation it will be questioned how donor sperm for home insemination became unsafe.
Paper long abstract:
During an ethnographic fieldwork at a Danish sperm bank, cryopreserved sperm was increasingly sold and shipped directly to private customers, and no longer only to medical professionals. The sale and delivery to private customers enabled the sperm bank and their customers to by-pass legislations in Europe that otherwise would have excluded single women and lesbians to become inseminated with donor sperm. The practice was possible because sperm sold and delivered to a private customer within the EU made the sperm change from being perceived as human cells regulated by the EU tissue and cell directive, to being a commercial product moving freely a cross borders. The bypassing of the medical community and national legislations, has however not taken place unnoticed. In Denmark the practice was recently questioned in relation to traceability and safety, leading to a regulative ban. In this presentation, I am interested to understand how the ethical and legal negotiations regarding the mobility and use of donor sperm takes place in practice. Therefore, I make an inquiry in to how donor sperm becomes unsafe as it is delivered to a private customer, in order to carry out a home insemination. Methodologically and theoretically I draw on Clarke et al.´s (2017) developments of situational analysis in order to analyze the existing controversy. Empirical material analyzed includes an ethnographic fieldwork at a Danish sperm bank, combined with newspaper articles, legal documents and parliamentary debates.
Paper short abstract:
The paper analyses how pronatalist strategies and IVF service provision are articulated within German policies, and is based on an interpretative analysis of policy consultancy papers. On this basis, a comprehensive intersectional analysis of reproductive technologies is suggested.
Paper long abstract:
The development of assisted reproductive technologies (ART) is embedded in diverse relations of power and discrimination: it is articulated with genetic diagnostics searching for specific "medical" conditions of the embryo perceived as problematic or even avoidable, and with heteronormative legal and institutional frameworks which in many countries exclude unmarried, single, lesbian or transsexual people from access or health insurance coverage. Moreover, ART services generally exclude low income persons from expensive treatments. The paper will add another problematic biopolitical context of ART by addressing the link with demographic policies as they have become important within Germany, and connect this biopolitical dimension within an intersectional approach to ART.
In 2012, the German government established a tax-financed fund to subsidize IVF treatment within its new "demographic strategy". The background are (selective) pronatalist policies with the aim of increasing fertility, especially within the academic and middle classes, as they had become central for German family policies since the early 2000s. Referring to results from the research project "demographization of the political", the paper analyses how the link between demographic knowledge production and knowledge production on ART is articulated by various think tank and consultancy bodies, and discusses how the dimension of population policies could be integrated into an intersectional analysis of current ART developments. Methodologically, the author refers to interpretative policy analysis and shows - within the STS tradition - how scientific knowledge production about demography and fertility develops within a context of hegemonic policy discourses on the nation, the family and class relations.