Abstract
In the previous chapters I described a variety of mechanisms which have contribued to the emergence of fetuses and couples as patients and which have in part facilitated the development of IVF and fetal surgery. Arguments were presented to show that medical interventions n-define and relocate the problems addressed in ways that simultaneously transform the patients suffering from these medical problems. Precisely in doing all the medical work necessary to arrive at the particular diagnoses involved in fetal surgery and IVF for infertile men, new problem-definitions as well as new patients have been construed. Prior to artificial fertilization and modern prenatal technology, couples nor fetuses were considered to be patients as such.
“Of course, who controls the interpretation of bodily boundaries in medical hermeneutics is a major feminist issue.”256
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Notes
Haraway (1991) p.169.
In the following quotes from feminist literature on the nature of modern medicine the theme of transparency of bodies is linked to visualization technologies, specifically ultrasound: “Since the seventeenth century, science has ”owned“ the study of the body and its disorders. This proprietorship has required that the body’s meanings be utterly transparent and accessible to the qualified specialist (aided by the appropriate methodology and technology) and utterly opaque to the patient herself.” Bordo (1993) p. 66;
Among the many transformations of reproductive situations is the medical one, where women’s bodies have boundaries newly permeable to both ‘visualization’ and ’intervention“’ Haraway (1991) p.169.; ”…take as an example the technique of echography, which allows you to externalize and see on a screen the inside of the womb and its foetal content. Offering “everything” for show, representing even the unrepresentable, i.e. the “origin”, means finding images that replace and dis-place the boundaries of space (inside/outside the mother’s body) and of time (before/after birth).“ Braidotti (1989) p.153.
See, for instance, Haraway (1985) p.169: “Such images [of fetuses] blur the boundary between foetus and baby; they reinforce the idea that the foetus’ identity as separate and autonomous from the mother (the ‘living, separate child’) exists from the start. Obstetrical technologies of visualization and electronic/surgical intervention thus disrupt the very definition, as traditionally understood, of ’inside’ and outside’ a woman’s body, of pregnancy as an ’interior’ experience. Increasingly, ’who controls the interpretation of bodily boundaries in medical hermeutics [becomes] a major feminist issue”; Petchesky writes that: “Like penetrating Cuban territory with reconnaissance satellites and Radio Marti, treating a foetus as if it were outside a woman’s body, because it can be viewed, is a political act.” (1987) p.65. For similar views see Duden (1993) and Franklin (1991).
Harrison (1982a) p.19. Quoted in Hubbard (1990) pp.175–76; in Bordo (1993) p.85; in Petchesky (1987) p.69.
This is, therefore, also an instance where Petchesky’s warning that we should not “confuse masculine rhetorics and fantasies with actual power relations, thereby submerging women’s own responses to reproductive situations in the dominant (and victimizing) masculine text” seems very much to the point (1987, p.71).
Harrison et al. (1993b) p.815.
Estes et al. (1992) p.951.
Estes et al. (1992) p.953.
Foucault (1979).
It is hardly trivial that the boundaries crossed are heavily laden with symbolical, cultural, and psychological meaning; these medical practices exist in cultures that simultaneously refer to genitals and wombs as “private parts” and “sanctuaries”. This inevitably creates tensions that women, quite unlike men, are expected to be able to deal with without complaint. Although such emotional and psychological acrobatics is in considerable measure required of all women in cultures that structurally medicalize the female reproductive body, it is hardly possible to imagine cases more extreme in this respect than the two technological practices of this study.
Hughes (1987) p.73.
Hughes (1987) p.53.
This also makes clear where I would depart from a systems approach in this case: unlike Hughes’s depiction of reverse salients, I would not take them to be empirically given, merely presenting themselves to the problem solver. Instead, their ‘identification’ is an active way of framing and locating a problem that is anything but neutral. It involves a specific attribution of technological failure, that always could have been different - one, moreover, that contains beforehand a legitimization of subsequent efforts to clear away this “barrier” to technical efficiency and success. It systematically leaves certain alternatives unexplored and assumptions unquestioned. It is, for instance, always in favor of continuation of experimentation and tends toward inclusion of whatever is designated as ’environment’ into the domain to be controlled and manipulated.
Adzick et al. (1993) p.810.
Harrison et al. (1993a) p.1415.
Harrison et al. (1993a) p.1413. Note how the military metaphor of ‘maneuvers’ in this quote affirms the appropriateness of ’reverse salients’ as analytical concept here.
Harrison et al. (1993a) p.1411.
Harrison et al. (1981), p.942.
Turner (1967).
The image of doctors as pioneers is often invoked to justify continued experimentation in the face of discouraging results. See for instance Michejda et al. (1986) p.881: ‘Thus the recent expression of disillusion with the long term benefits of antenatal treatment are premature. The concept is sound and justifiable, and the current problems are those common to pioneering efforts.“
Harrison’et al. (1993a) p.1414.
H. arrison et al. (1993a) p.1416.
H. arrison et al. (1993a) p.1414.
H. arrison et al. (1993a) p.1414.
Jennings et al. (1992) p.1332.
Jennings et al. (1992) p.1332.
Generally in this discourse, the whole range of medical care during pregnancy, and the specific forms of care in individual cases are commonly referred to as “fetal management”. Such care may involve, for example, having a woman travel to a clinic equipped with a neonatal intensive care unit, just before she gives birth to a child that is anticipated to need immediate surgery. In the context of ‘fetal management’, however, there is no woman making any trip, but a fetus being transported “in situ” (Harrison et al., 1981a).
See Casper (1995) p.73 for a similar observation about the role of the female body in the ‘fetal intensive care unit’ as planned, under this very name, in San Francisco.
The last three comparisons were made by a fetal surgeon of Guy’s Hospital, London, as quoted in a Dutch newspaper article. Van Zweeden (1990).
Harrison et al. (1993a) p.1411.
Harrison et al. (1981) p.939.
Touraine (1992) p.47.
H. allock (1985) p.787.
S. abik et al. (1993) p.547.
Sabik et al. (1993) p.547.
Haraway (1991) first introduced the metaphor of the “cyborg” in 1985 to capture the necessity of rethinking what can constitute embodied subjectivity in a way that takes the loss of the distinction mentioned into account.
The term ‘recognition’ does not necessarily imply that body boundaries exist prior to such recognition. Analogous to the recognition of new, self-declared independent states, and in the manner of speech acts, the act of recognition creates the reality of boundaries.
Rosoff (1981) p.3.
Rosoff (1981) p.1.
Rosoff (1981) p.1, quoting Justice Cardozo in Schloendorff v. Society of New York Hospital, 211 N.Y. 125, 105 N.E. 92, 93 (1914).
Palermo et al. (1992a) p.248.
Ng et al. (1991) p.1118.
Bals-Pratsch et al. (1992) p.101.
Two quotes from each paper cited, in which it can be seen that “patient” does not unequivocally refer to an individual at all: “There were two groups of patients: (1) Patients with very low sperm density on the day of oocyte retrieval, and (2) patients with 1-day-old oocytes that failed to fertilize.” “Seventeen couples completed the whole study. One couple (patient no.2) discontinued the study after three placebo cycles (…).”
Here we find the same hermaphrodite patients described in detail in chapter 2: the first quote has patients posessing both male and female gametes; the second shows a couple counting as one patient.
Robichaux et al. (1991) p.12
See chapter 2, section 3.2.
H. arrison et al. (1993a) p.1413.
C. rombleholme et al. (1988) p.1115.
A. ppelman and Golbus (1986) p.487.
T. ouraine (1992) p.45.
B. als-Pratsch et al. (1992) p.103.
R. obertson (1986) p.603.
G. oldstein et al. (1990) p.89.
K. older et al. (1988).
See for such opposition, for example, Annas (1986), (1987); Nelson and Milliken (1988); Fletcher (1986); Pringle (1986), and Purdy (1999).
Engelhardt (1985) p. 315.
E. ngelhardt (1985) p.315.
Robertson (1986) p.608.
A. merican Academy of Pediatrics (1988) p.899.
American Academy of Pediatrics (1988) p.899.
American Academy of Pediatrics (1988) p.899.
And, ironically, so is the number of women willing to act as guinee pigs so that ‘experimental’ procedures may eventually become ‘established’.
Smith (1985) p.380.
Spielman (1984) p.759.
Engelhardt (1985) p.313.
Engelhardt (1985) p.316. The ‘cases’ referred to in this quote are court-cases, which renders the choice of words (’tolerating’ when the woman’s basic rights were not overruled; ’inviting’ for court-ordered surgical intervention) particularly inappropriate.
Goldstein et al. (1990) p.87.
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van der Ploeg, I. (2001). Elusive Body Boundaries and Individuality. In: Prosthetic Bodies. Springer, Dordrecht. https://doi.org/10.1007/978-94-015-9847-7_5
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