Book Review: Birth Control and Controlling Birth & The Custom-Made Child

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Book Review: Birth Control and Controlling Birth & The Custom-Made Child

by Marian Lowe

‘Science for the People’ Vol. 13, No. 5, September-October 1981, p. 23

Marian Lowe teaches chemistry and women’s studies at Boston University. She has been involved in Science for the People. 

Birth Control and Controlling Birth & The Custom-Made Child 

Edited by H.B. Holmes, B.B. Hoskins and M. Gross. The Humana Press, Inc., Crescent Manor, P.O. Box 2148, Clifton, N.J. 07015. $7.95 (paperback) $14.95 (hardcover).

These two volumes are the proceedings of a conference titled “Ethical Issues in Human Reproduction Technology: Analysis by Women” held at Hampshire College in Amherst, Massachusetts in June, 1979. These books make an important contribution to the growing dialogue around issues of science and science policy. 

The nine sessions of the conference were each devoted to one topic. Following the format of the conference, the two volumes are divided into nine sections, each of which consists of short formal papers, responses to those papers and discussions. The first volume, Birth Control and Controlling Birth, covers the following issues: the ethics of contraception development and deployment, sterilization abuse, technology and childbirth, policy making for cesaerian births and abortions. The Custom-Made Child includes the topics Diethystilbesterol, prenatal diagnosis, the handicapped neonate, sex preselection and manipulative reproductive technologies. 

Although one can learn a great deal about current issues in reproductive technology from these books, they are not meant to be a place to seek specific information on various technologies. The aims of the conference (and presumably also of the published material) are set out in the preface as: 

    1. To identify the ethical issues involved in setting priorities in research on human reproduction and in the application of such research. 
    2. To determine which values have heretofore been considered in resolution of conflicts. 
    3. To discover any alternative applicable social values that are now being offered by women. 
    4. To recommend new approaches for assessing values and determining policy. 

These goals are extremely important and ambitious. Although the conference did not provide clear cut answers, it did succeed in the crucial task of raising new and compelling questions about the political and ethical implications of current and future technologies. These books are important as learning tools; by allowing us to assess the strengths and limitations of this conference, they suggest future paths of analysis and debate. 

In reading these volumes, it is apparent that the conference suffered from two shortcomings. First, the participants, although representing a wide range of political views, were predominantly health care professionals. Academics were heavily represented as were individuals working in alternative health care organizations. The lack of health care consumers involved resulted in discussions which tended to focus on the problems of other people. Although this issue was raised, there was no serious exploration of how consumers could have been incorporated into the conference. 

The second major weakness of the conference was the lack of explicit discussion of political issues or of political differences. We do find the statement in the introduction that “the political is ethical,” and there are hints throughout the books that the ethical is also political. Nonetheless, there is little recognition of the connections between values and power. Too much of the political analysis of values in science and technology policy stops with the idea of “male-controlled.” In the future, we need to develop further the emerging analysis of the nature of masculine values in science and to assess how those values are related to science done in a capitalist society. 

In the session on sex preselection political differences were most clearly articulated resulting in the most exciting discussions of the conference. The issue of sex preselection more than any other reveals the failure of classical liberal solutions of individual choice. All of the studies to date reveal that male children are preferred to female children, and even for those couples that prefer a sexually balanced family, there is a desire for a male first child. With the availability of technologies that allow selection of the sex of a chld, the social, political and biological implications of individual rights and individual choice become extremely complex and traditional liberal solutions begin to breakdown. It is around such issues that feminists will have to develop new analyses and these books will help to initiate that process. 

As one might expect, the material in these books is uneven. Some of the formal papers are quite conventional. Others such as those by Punnett on women-controlled research or by Ruzek on ethical issues in childbirth technology, raise new insights and propose values from a woman’s perspective. 

Overall, the books are well edited and enjoyable to read. Much of the most interesting material appears in the discussions, and because of this, issues raised in one section are sometimes not followed up or connected to other issues until later discussions. Because of the importance of the discussions, this is a work in which it is best to read each section as a whole. I found the sections on contraception, depo-provera, sterilization abuse, prenatal diagnosis and sex preselection to be particularly valuable. These are important books, and they should be read by anyone interested in ideas relating to the development and use of new health care technologies. 


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