A Feminist Views New Reproductive Technologies

Against the Current, No. 37, March/April 1992

an interview with Varda Burstyn

VARDA BURSTYN, A writer and activist in Toronto, is co-chair (with Sunera Thobani) of the Health and Reproductive Technologies Subcommittee of the National Action Committee on the Status of Women (NAC). She spoke with Dianne Feeley and David Finkel of the ATC editorial board regarding the issue of reproductive and genetic technologies.

ATC: Please tell us about the background of the reproductive technologies debate and the brief that NAC submitted to the Royal Commission (government-appointed investigatory committee) on this issue.

Varda Burstyn: Since the late 1970s when Louise Brown, the first “test-tube baby” was conceived in a petri dish, feminists have been looking at the new reproductive, especially “procreative” technologies, with some concern. With the increasing development of genetic technology and proliferation of procreative technology – procedures such as in vitro fertilization, ova stimulation, sperm manipulation and genetic embryo experimentation – feminists in many countries have raised a series of concerns.

In Canada these have been expressed in the women’s health networks, by feminist scholars, health researchers, and social and natural scientists. NAC was part of a coalition that in 1988 called for a Royal Commission to look into the many technologies (over thirty!) under consideration. It required great original research to find out what the implications of these would be. When the Royal Commission on New Reproductive Technologies was established in 1990, it therefore made sense for us to make a submission raising our concerns.

A note on terminology: We should be saying, in my view, “reproductive and genetic technologies” because we’re looking at two interlinked and mutually potentiating clusters of technology: one having to do with making babies, the other with the quality of babies.

The term “reproductive technology” tends to obscure the genetic component, which is at least as serious as the procreative one. Most people aren’t aware that there now exist a series of technologies, which, taken together, move us much further toward the artificial fabrication of life. So in our brief we used the term “New Reproductive and Genetic Technologies,” or “NRGTs.”

ATC: Did you make demands about how the commission would be constituted?

VB: Two things were part of the coalition’s demands. First, that the commission look not only at the health and safety implications of the NRGTs, but equally importantly at the social, legal, moral, philosophical and commercial aspects of these technologies. We must make social as well as physical evaluations of these technologies. Second, we demanded special attention to the implications for women: their physical and social status.

Indeed, the formal mandate of the commission included both clauses. When the commission was originally formed its composition also reflected those concerns. This is no longer the case—and the integrity of the commission has now been thoroughly compromised, as a result of high-handed antidemocratic behavior on the part of the chair Just last week, NAC finally called for a boycott of further commission consultations and other work, though we did this with great aner and trepidation about the future of these technologies.

ATC: What is the National Action Committee?

VB: NAC, the National Action Committee on the Status of Women, is the national unitary women’s organization in Canada. It contains some 500 groups, including everything from service organizations to women’s caucuses in the unions—a tremendous range of different organizations, which taken together represent a membership of several million women.

NAC plays a role in Canada comparable to that of NOW in the United States, although it is constituted differently. It includes educational, mobilizing and lobbying functions, and addresses issues in global ways while individual organizations take them up by sector.

ATC: What approach did your brief take toward the new technologies?

VB: Let me begin to answer that question by saying that I’ve been active in the women’s movement since around 1967, and I’ve never encountered an area so complex as this and so fraught with nuances, contradiction and complications, with so many levels at which women need to understand the implications. So it’s tough to summarize briefly, but I’ll give it a shot.

First: We feel these new technologies that purport to address infertility and infant disability in fact advance ineffective technological solutions for social problems. That is, the causes are social and medical, and preventing the problems—infertility and infant disability—we need to address those causes. These technologies direct public attention and resources away from the causes of infertility, providing extremely ineffective “solutions.”

The same holds true with infant disability, which is socially correlated and of course, as with all other health indicators, the main negative correlation is with wealth. Less than ten percent of infant disability is genetically determined, and most people become disabled after the age of thirteen. So prenatal testing and genetic abortion doesn’t touch the vast majority of disability.

In terms of amniocentesis, alfafetalprotein testing and chorionic villus sampling (all prenatal screening technologies that look at genetic components), there’s a view now generalized throughout the medical profession, almost a hallucination that we are taking care of disability by looking at genetic components rather than low birth weight, maternal stresses and medical accident The expansion of the technology actually deflects attention away from social and medical causes of disability.

Second: We are very concerned with a variety of social implications entering this new period of human history, where conscious human fabrication can take place.

We are leaving behind the era when spontaneous biological generation could occur only in the woman’s body, where women have always attempted to have some kind of control. What happens when the site of procreation takes place outside the woman’s body, in a petri dish, when it’s possible to retrieve ova from female cadavers and fetuses, possible in effect to create embryos and maintain fetuses outside women’s bodies for a considerable period of time, possible to freeze and store”surplu? embryos? It’s not yet possible to carry a fetus to term outside the woman’s body, but we are in fact moving toward that.

Women are the childbearing sex. Feminists have struggled to separate sexual pleasure from necessary childbearing. But with the usurpation of women’s bodies as the site of procreation, we have possibilities for social control and marginalization of women that are serious—not inevitable or automatic, but serious These technologies are complex, specialized, high-tech procedures dependent on an industry women do not control, and embedded in profoundly masculinist institutions and systems.

Furthermore, for women, children and men, the potential for eugenic social control opened up by the genetic technologies is very worrying. We have seen eugenics on a national scale in a militarized society—I’m referring of course to Nazi Germany—and while no one is suggesting that the mechanism exists for state enforcement of eugenic policy today, there are serious dynamics that can affect the disabled, people of color, anybody who is “different,” that are exacerbated by the institutionalization and banalization of genetic technologies. This is in addition to physical risk. These aren’t issues simply for women—and of course for children—but potentially have consequences for everyone.

Third: A number of feminist critics have talked about the potential damage to women and to children in what they term the “dismemberment of motherhood.” It’s now possible, as most people know, to have a genetic mother, a gestational (so-called surrogate) mother and a social mother—potentially three different women—whereas those functions used to be more or less unified. Genetic and gestational motherhood, fused in the physical makeup of human females, were always unified.

This dismemberment, which violates the symbiotic relationship between women and fetuses, has potential consequences at both the physical and social levels for women and children. In addition, it contributes to the larger problem of the “commodification of body parts and capacities” in medicine today. Thus there exists ale-gal, as well as “gray” and “black” (illegal) markets in organs, tissues and gestational capacities. The commodification of human, in particular women’s, fetuses’ and babies’ bodies, raises tremendously disturbing issues.

For example, fetal tissue is now being hailed as the fountain of relief for diseases from diabetes to Alzheimers and Parkinsons. According to feminist researcher and medical ethicist Janice Raymond, it won’t be possible to retrieve the necessary amount from abortions performed in the United States in order to meet the needs for fetal tissue. She claims the proliferation of fetal tissue therapy creates a market in fetuses which will inevitably be supplied by Third World, desperately poor women who are being organized and exploited by unscrupulous entrepreneurs.

We have along with the miracle of technology; the nightmare of the potential creation of an industry, in the breeding of fetuses for purposes of medical technology; Is the benefit to the Alzheimers patient worth the loss to the mother? Or what dowe think when a mother decides to have another child, because her child has bone marrow disease and she needs access to the tissue of a fetus or another baby to save that child?

This opens up new problems because it confronts us with possibilities based on changes in phenomena we thought were immutable in nature. In the name of helping women, many of these technologies actually divide women from one another, along economic lines. Because we live in a highly hierarchical society; the donors of services and body parts are and will be poor women.

Fourth: There’s a whole problem, not only with the reproductive technologies but with all technology; not just for women but for all of us. It’s the fundamental question of the control of technology; This is a fundamental problem in democracy; Are we going to be in control or are the manufacturers and practitioners of technology going to control us? With respect to the NRGTs, this raises the question of controlling the pharmaceutical sector and the medical-industrial sector.

It isn’t just a question of profits or working conditions, as meaningful as those things are, but of who decides what these industries produce, and how we can stop the displacement of crucial social and political decisions by the unregulated economics of de facto technological proliferation.

Finally, we are raising our concerns about the fact that the discourse of reproductive “choice” developed by the women’s movement in the 1970s to deal with the issue of abortion, important as it has been, isn’t sufficient to deal with the new technologies.

That discourse was developed within the terms of the fundamental premise of liberal democracy—that individual rights are primary; Because for a long time access to abortion was the kind of issue that united women across economic lines, individual rights were congruent enough with gender-class line, so this held up pretty well. Yet even in the 1970s, in Canada there were Native women, women on welfare, Quebecois women pointing out the dangers of involuntary steriliztion, and for the economic wherewithal to support children. But still on the whole, the individual rights argument got us throuh in the fight for abortion rights.

But it won’t get us through the next ten years, because there are real contradictions, in some cases, between the benefits to one woman and the losses to another, and between the individual and the collective levels. It may be beneficial to one woman to partake of one particular technology because it expands her “choice,” certified pristine by standards of feminist correctness and individual self-determination; yet the generalization of that technology may still undermine the position of women as a group in the long run.

ATC: U.S. socialist-feminists argued that the women’s movement had to support abortion rights and to oppose sterilization abuse. When several cases of abuse were exposed in the mid-70s, there was a proposal to extend the three-day waiting period to thirty days. NOW President Eleanor Smeal opposed the extension. There was a debate in NOW—we argued that protection for poor and oppressed woinen was more important than possible inconvenience to middle-class women.

VB: In your example we can see the whole dynamic of contraceptive and proceptive technologies, as they have been applied to different sectors of the population. Contraceptive technologies are generally developed and tested on working-class, Third World and poor women. The trend is to stop women who are economically disadvantaged from having babies. This holds not only with sterilization abuse, but dreadful forms of birth control. So it’s been very difficult for disadvantaged women to get access to the social conditions and the technologies for having children.

On the other hand, there are proceptive technologies for economically advantaged women, and pressures on them to reproduce. So we have the most eloquent testimony to how women are differently valued along class and race lines, and it’s one of the things women have to come to terms with.

In Canada we had the same debate (over the linkage of these issues) within the women’s movement, and at a certain point those who had problems with “choice” just backed off, because it was better to proceed into an effective fight for abortion rights united rather than with a weakened, divided movement But that doesn’t mean the women’s movement took the right position. It didn’t.

So today we must look at those issues again and take the needs of the most oppressed and disadvantaged women as our bottom line, and take a position of uniting on the basis of addressing those needs.

ATC: Another question that is bound to arise in resisting or questioning the new technologies is the fear that the women’s movement will find itself in a bloc with the anti-choice right wing. How do you address this?

VB: Right now, in terms of the actual relation of forces on the ground, abortion rights at least in the abstract sense aren’t under all-out attack in Canada. The situation you face in the United States is different in that respect In Canada abortions aren’t available to everyone, but they are no longer in the criminal code.

Second, by and large the tactics of the so-called Right to Life in Canada haven’t been as militant and dangerous as in the States. And the Catholic and fundamentalist churches aren’t as powerful here, so we don’t have the same siege situation.

Nevertheless, after NAC submitted its brief to the Royal Commission we received numerous phone calls from people in the Right-to-Life movement, saying they were very confused about how we could take a “pro-abortion” position and then raise these questions about the reproductive and genetic technologies.

I’ve been invited on several occasions to address Catholic groups on the reproductive and genetic technologies, conditional on my soft-peddling abortion rights—which I’ve never agreed to do, so I’ve never actually made it to one of those church basements! There maybe some tactical convergence in objecting to the new technologies, but no alliance in action or in theory.

In Germany the Protestant church, which isn’t happy about abortion but is not mobilized against it, has become active in struggling against these technologies; and there is an alliance with the women’s movement That hasn’t been possible in North America, so far, though it may be possible with some of the nonfundanientalist Protestant churches.

ATC: Were other feminist briefs besides yours put forward to the Royal Commission?

VB: The positions we submitted were adopted by the executive of NAC, and then by an annual meeting, by a very large majority. At those meetings there was little organized opposition. Many other feminist briefs also shared similar concerns. Nonetheless there are differences among women who consider themselves feminists.

One brief came from CARAL, the Canadian Abortion Rights Action League, which has been very important to the struggle for the right to choose for the last twenty years. They raised concerns about a possible contradiction between saying a woman has a right to terminate a pregnancy and supporting her right to do so, versus questioning the validity of abortion for genetic indication (because of spina bifida, for instance).

I should say that NAC has not in fact taken a position against genetic prenatal diagnosis—and we probably won’t—but we are definitely opposed to embryo research. That has been banned in Germany and there are debates in many countries over whether to allow it We say no, for reasons having to do with the health of the baby and future generations, and from a social-feminist point of view objecting to the instrumentalization and commodification of humans involved in this procedure.

We have tremendous fears about ignorant intervention into the gene pool, the breeding of embryos, the generalization of in vitro fertilization (IVF), preimplantation diagnosis which is a biopsy of an eight-cell embryo to screen for genetic “defects.” The doctors who developed this technology have advocated that every embryo should be screened for genetic difficulties as a basic eugenic measure for public health. That would happen if they had their way.

Quite apart from the serious human rights violations that arise from a eugenic view of the universe, pre-implantation diagnosis necessarily requires IVF—you can’t do it unless the embryo is available outside the woman’s body. To do this procedure women must go through dangerous drug programs, and there are many difficulties with IVF children. So the notion of full-scale genetic testing is a gold mine for the companies, necessarily involving a whole series of other technologies.

A number of women have said embryo research can improve women’s reproductive lives, and opposing it coincides with the Right-to-Life attack. We are prepared to take that risk. We don’t agree with this argument; we feel we’ve been successful in defending abortion rights.

ATC: We understand there are three positions on these issues?

VB: The NAC position combined some of the issues raised by feminist scholars who look at gender issues as such, with a socialist emphasis on understanding the power of the pharmaceutical industries in the medical and health systems, and concluded the losses outweigh the benefits.

Some feminists say that to put in question any form of women s right to choose the kind of pregnancy she wants will put abortion rights in jeopardy. A related position says that if doctors can know what’s going on in a pregnancy a woman’s body, then she has the right to know too, even if we disapprove of what she may do with that knowledge.

You know the prenatal genetic technologies were developed to detect a genetic predisposition to various disabilities. But in a number of Asian countries and in some communities in Europe and North America, they are used for sec selection per Se, in actual fact to select for boys against girls, since ninety-eight percent of abortion (for this purpose) is of female fetuses. So you have a series of perverse effects, a technology developed for one purpose being used for another.

Should the sex of the fetus be revealed to the mother? The Danes have said no, except when sex-linked genetic characteristics are present, because they found that female fetuses were being aborted. There are feminists who argue that’s unacceptable. There’s a concrete example in which the principles and the discourse we’ve developed don’t meet the new problems.

The third feminist position, also different from ours because it has a different assessment of what is possible, says the technologies m themselves are neutral, and that harm can be avoided if women control them. I personally think this is naive with respect to any techno1ogy.

There’s nothing neutral about the difference between a machine gun and a bow and arrow, for example. And some technologies are so problematic that they are completely uncontrollable—I would cite nuclear energy, because there is no known way to deal with its by-products, whereas other energy technologies, whatever their problems, are more amenable to reform or control.

So it is with many reproductive technologies. The old turkey-baster many women have used for artificial insemination, after personal, face-to-face negotiation with a man, is controllable by women. It is low-tech, inexpensive, noninvasive, voluntary, drug-free and so forth. Preimplantation diagnosis is completely uncontrollable, at the other end of the spectrum. So we don’t want to tar all technology with the same brush. But human fabrication outside woman’s body is not an innocuous or low-tech process, and not controllable by women either individually or collectively.

ATC: Can we go back to the point you made about these doctors advocating universal embryo testing—meaning universal IVF? Surely this isn’t to be taken seriously except as some Nazi fringe thing?

VB: Since the 1970s, particularly since the birth of Louise Brown and the direction taken by reproductive technology, a number of people—dissident scientists as well as feminists in Europe and North America—have said we are moving toward the Brave New World scenario.

We are putting in place the valuation of some forms of human life over others, not just in terms of choosing and discarding through prenatal and preimplantation diagnosis—but in the selection and manipulation of so-called germ-line genetic material in order to create the custom-made, quality-controlled baby, the making of the “super-baby.”

Critics have been raising this fear for a long time. And if you think about Aldous Huxley’s scenario, well, its arrival became something that such people could visualize concretely from the mid-1970s on. Mainstream geneticists and WF practitioners never stopped decrying these fears as paranoid fantasy. I heard this old refrain all over again this past summer, at the Sixth World Congress of In Vitro Fertilization and Infertility Specialists in Paris.

There I spoke with Dr. Robert Winston, of Hammersmith Hospital in Britain, the main man in preimplantation diagnosis, who gave me the same line denouncing scare tactics, Luddism and the like. Now in August in New Scientist magazine, a very small item appeared in a news column: Mary Warnock, head of the first commission in Britain to investigate the new technologies, said that now that preimplantation diagnosis has been developed to this stage, it will be primarily used for screening, but it’s “impossible to exclude” that “at some point” it would be used for genetic modification.

That message, qualified as it was, really leaped off the page at me. Warnock is the leading medical ethicist in this field internationally, and if she gives her OK, it’s going to be done. Last October, at the American Society of Geneticists, they held a discussion on genetic modification of ova—of gametes—an issue so controversial that most of the discussion was about how to discuss it.

After all the denunciations and denials of these fears, the project of modifying the genetic makeup of human beings is now here. It’s neither our paranoia, nor only the dream of a Nazi fringe. It will take a long time to generalize, or rather for its consequences to generalize. But Robert Oppenheimer said that when something is technically sweet, scientists don’t ask whether it’s ethically correct to do it—they just go ahead until they achieve their goal. Now, you put all the separate pieces in place for genetic manipulation, and sooner or later, in the absence of regulation, you are going to have it.

There are some geneticists who find this prospect appalling. But this is what we will see in the 1990s, and this is precisely what is hidden from public view. That’s what is at stake in the process legitimized by the completely understandable search for “healthy babies.”

ATC: That arises because some people can only afford to have one baby and are seeking perfection in it.

VB: Frederick Osborne, a eugenicist who worked with leading geneticists from the 1930s to the ’50s, including American, British, Soviet and Nazi scientists, said the way to bring about a eugenic society is, first, to reduce the number of children per family to two or less—because then people would worry about the quality of their children. And second, make everything available as a commodity—including health, and then through the marketplace you will have a eugenic society in which people behave eugenically without knowing it Something to think about.

I think another thing that’s happened with these new technologies is that we’ve stopped thinking about the symbiotic relationship between mother and baby as the most important determinant in health. If the mother is healthy and conditions of birth are good, chances are excellent that the baby will be healthy. If we pay attention to maternal and fetal health as an indissoluble unity, we will have healthy babies, maybe not all male, six-feet-two with blue eyes and capable of quantum physics and basketball, but healthy, various and wonderful. There will be genetic difficulties with varying degrees of severity, but those can be dealt with socially.

But because we aren’t prepared to look at the social and economic conditions women and children face, we move toward technological solutions which have inherent fascistic tendencies. The answer is maternal wellbeing and social support for the disabled, whatever the cause of their disability—answers that are consistently obscured by the proliferation of these technologies.

ATC: Any comments on the pharmaceutical industry and medical training in relation to these issues?

VB: In the United States and increasingly in Canada and Europe, there is almost no “disinterested” scientific research, I mean economically disinterested. In the early 1980s, according to dissident American doctors, close to eighty percent of university scientific medical research was financed by private sources, primarily the drug companies. And that figure must be higher now. When I was in Germany last year, scientists pointed out the trend there as well.

What that means is that the research agenda for health is being determined by the needs and interests of the pharmaceutical companies. In the pharmaceutical field there are twelve to fifteen major corporations with a determining influence over the whole sectot Their interests are in profit and marketing—and the medical system, the doctors and hospitals, act as least as much as their distribution systems as systems that assist people.

Thus the companies control not just the research agenda for drugs and medical devices; but the entire research agenda is framed by their paradigm. They aren’t going to look at how to prevent transmission of sexual diseases, for example, through counselling or meeting emotional and physical needs. No profits there. The entire health agenda is forged in the image of the interests of drug companies, so our ability to think about health becomes completely skewed and distorted.

ATC: Finally, do you have any thoughts on RU486, the “abortion pill,” an issue where certain contradictions are developing among women in the United States?

VB: I will only speak about that as an individual, because I need to make it clear that NAC has taken no position. On the one hand, it’s important for women to have experiences that are minimally traumatic as far as abortion is concerned—the less difficult it is, the better.

Insofar as this drug apparently holds out improvements in that respect—what it’s been touted to do—it’s worth investigating. But on the other hand, from my own experience as well as research, the more! see the effects of intense endocrinological (hormone) intervention the more worried! get RU486 entails massive bombardment of the endocrine system, and that is worrying.

I do have to recall, with respect to the birth control pill, we were told for twenty years that it was safe. I personally don’t accept that anymore. Although the trauma of abortion can be very bad, if! had to have oneI would go the surgical rather than the drug route. The endocrine system is such a delicate balance and the effects can be so far-reaching thatI really worry—especially about the women who would be research subjects.

March-April 1992, ATC 37