The Social Worlds of the Unborn

D. Lupton

• Publisher: Palgrave Pivot
• Year: 2013
• Print ISBN: 9781137310712
• eBook ISBN: 9781137310729
• Topic: Sciences sociales
• Subtopic: Biologie

Human embryos and foetuses are highly public and contested figures. Their visual images appear across a wide range of forums. They have become commercial commodities as part of the IVF industry and are the focus of intense debates regarding concepts of personhood. This book discusses these issues, drawing on social and cultural theory and research.

1

Contingencies of the Unborn

Abstract: Should the unborn be viewed as fully ‘persons’ in moral and ethical terms? Should they be considered indeed fully ‘human’? What are the implications for how they are treated in medical and scientific procedures, and for the pregnant women in whose bodies many, but not all, unborn entities are located? As this chapter will demonstrate, the answers to all of these questions are arbitrary, located within specific social, cultural and historical contexts. It includes discussion of concepts of the unborn in previous eras in developed societies as well as in contemporary developing societies to highlight the contingency of meanings around embryos and foetuses. The role of definitions in shaping concepts of and practices around the unborn is also covered.

Key words: sociology; anthropology; history; embryos; foetuses; personhood; ethics

Lupton, Deborah. The Social Worlds of the Unborn. Basingstoke: Palgrave Macmillan, 2013. DOI: 10.1057/9781137310729.

Personhood, humanness and the unborn

The contested nature of defining the unborn came to the fore when a highly controversial article published in 2012 in the prestigious international Journal of Medical Ethics put the case for the logic of ‘after-birth abortion’ (Giubilini and Minerva 2012). The authors, two bioethicists, Italian Alberto Giubilini and Francesca Minerva from Australia, assert in the article that the killing of a newborn infant, regardless of its state of health or normality, should be viewed as ethically acceptable if its birth were seen to disadvantage its parents or siblings in some way, including imposing a psychological or economic burden upon them.

Giubilini and Minerva use the terms ‘pre-birth abortion’ and ‘after-birth’ abortion to suggest that there is little difference between the foetus and the newborn infant. To support their argument, Giubilini and Minerva claim that neither the foetus nor the newborn infant ‘can be considered a “person” in a morally relevant sense’ (2012: 2) because they lack the properties that justify the attribution of a moral right to life. They argue that both should be considered ‘potential persons’ rather than fully developed persons. Because of their undeveloped nervous system and lack of awareness, neither foetus nor neonate can be said to possess values or beliefs. Neither is capable of attributing value to life, a perspective on its own interests or forming long-term aims, as they have not achieved the requisite mental development. Foetuses and newborn infants are therefore not capable of recognising any harm to themselves from being killed. Based on this reasoning, Giubilini and Minerva claim if ‘pre-birth’ abortion were considered morally and legally allowable, as it is in many jurisdictions (albeit usually with restrictions concerning gestational age – see Chapter 4), then so should ‘after-birth abortion’.

Such logical and pragmatic utilitarian arguments fail to acknowledge the sociocultural and emotional meanings that gather around and constitute the unborn. These meanings came to the fore, however, when Giubilini and Minerva’s article attracted public attention immediately following its publication, when it received a high level of coverage in newspapers and websites. The authors’ arguments aroused major debates over their article’s moral worth. They were subjected to death threats and the journal’s editors were also sent abusive and threatening messages. The journal’s website was deluged with responses. Comments on various websites commenting on the article, including the journal’s own, referred to the ‘evil’, ‘vile’ and ‘scary’ nature of the arguments posited in the article and described the act the authors were advocating as ‘murder’ and an ‘atrocity’. Giubilini and Minerva were even described as ‘soulless monsters’ in one comment on the journal’s website.

In response to the criticism, the editor, the well-known Australian applied ethicist Julian Savulescu, was forced to publish a blog entry on the journal’s website defending his decision to publish the article (2012). Savulescu is himself known for his utilitarian approach to prenatal genetic diagnosis and screening and his support of hESC research. In his defence of Giubilini and Minerva, Savulescu pointed out that infanticide has been the subject of many scholarly ethical discussions, including in his own journal, and that there has been an active debate over the moral status of the unborn and neonates in philosophy for many years. Savulescu contended that Giubilini and Minerva were simply the latest in a long line of philosophers raising questions about the extent to which the unborn and the newborn should be considered fully ‘persons’.

One commentary published on the journal’s website in response to Giubilini and Minerva’s article was penned by Charles Carmosy, a Roman Catholic theologian. The title of his piece referred to ‘Our vulnerable prenatal and antenatal children’ (2012). This terminology of the ‘prenatal’ and ‘antenatal’ child flags the orthodox Catholic view, promulgated by the Vatican, that unborn humans are already children. As a catechism of the Catholic Church puts it, ‘From the first moment of his [sic] existence, a human being must be recognized as having the rights of a person – among which is the inviolable right of every innocent being to life’ (Catechism of the Catholic Church: Part Three – Life in Christ 2013). Carmosy points to the relational nature of the unborn human and argues that simply because the potential of that human is immature or frustrated (as in the case of adults with mental disabilities, for example), this is not a just reason to consider them less than fully persons. He also highlights the difficulty of deciding exactly when a newborn might be considered to have developed the attributes of what Giubilini and Minerva consider ‘actual personhood’. For Carmosy, the very vulnerability of the unborn is what gives them the ‘special’ status of requiring greater rather than less protection, underpinned, he argues, by the Christian ethic of protecting the vulnerable.

What the arguments both of bioethicists such as Giubilini and Minerva and of theologians such as Carmosy attempt to do is to conflate the unborn and the already born so that they are seen as morally and ethically the same. For Giubilini and Minerva both foetuses and neonates are lacking in full personhood; for Carmosy, both are fully human children deserving of the kind of protection and rights offered to any other human.

As this debate and the public response to it highlights, agreement concerning at which point in human development the unborn organism is considered to be a ‘human’ or fully a ‘person’ has long been subject to contestation and has varied across western history and across cultures (Casper 1994a, 1994b, Conklin and Morgan 1996, Duden 1993, Featherstone 2008, James 2000, Kaufman and Morgan 2005, Morgan 1996, 1997, 2009). Definitions of personhood, and by extension, notions of individual embodiment, are constructed via social and cultural understandings. They are dynamic and shifting, open to change and contestation. What is considered ‘human’, and in contrast, ‘non-human’, are themselves contested and constructed subject positions rather than fixed or natural, subject to claim and counter-claim. ‘Doing human’ is performative and recurring, based on practices and interactions (Casper 1994a, 1994b). As Conklin and Morgan argue, ‘[t]he beginning of life – the time when new flesh must be interpreted, shaped and transformed into socially meaningful forms – is especially revealing of how competing views of personhood are “worked through the body” ’ (1996: 663). Personhood, therefore, is both biological and social, both natural and cultural, phrased in different ways according to the specific context in which it is debated and understood (Cesarino and Luna 2011, Marsland and Prince 2012).

Indeed discussion of the contingencies of the unborn go directly to the heart of contemporary scholarship on ‘vitality’ and how we define it, including concepts of when life begins or ends (Kaufman and Morgan 2005, Marsland and Prince 2012). Building on the work of Foucault on biopower and biopolitics, several writers (Rose 2007a, 2007b, 2009, Waldby 2002a, 2002b, 2008, Waldby and Squier 2003) have explored the question of human ‘life itself’: how vitality is understood, how it is valued, the strategies, discourses and practices that configure it and how boundaries are constantly blurred between ‘human’ and ‘non-human’, ‘living’ and ‘inanimate’, ‘material object’ and ‘flesh’ and so on. Such inquiries have highlighted the role played by the concepts, discourses and practices of scientific medicine and other forms of biotechnologies in defining the human body and its capabilities and ills. Medicine and biotechnologies have played an increasingly important role in the configuration of the unborn, including producing new forms of life, such as ex vivo embryos and the stem cell lines that are generated from them. Whether or not an unborn entity is created in vivo or ex vivo, its trajectory of development is observed, monitored and regulated by medical and other scientific practices, including the forming of decisions about how valuable, viable, normal and capable (or worthy) of life it is.

There is something unearthly, strange and Other about the unborn entity. Given its early stages of development, its temporal distance and morphological difference from the newborn infant, the embryo is a particularly ambiguous, complex, hard-to-pin-down entity. At the embryonic stages of development in particular, the unborn body appears like another creature gradually morphing into a human-like body. It is not until about the tenth week of gestation (eight weeks following fertilisation), at which point in development the embryo technically becomes a foetus, that it begins to look human. Even at the foetal stage of development, the unborn body still has a certain strangeness to it, a liminality that may challenge accepted concepts of humanness and of living creatures. As McGinn asserts:

The fetus is not yet an autonomous living being, more like a bloated internal organ than a fully functioning creature, quite unable to survive outside the mother’s body. It is an almost-life, at risk of extinction, poised between nothingness and existence, an intermediate identity: in it we see a precarious quasi-life, a fragile upsurge from the emptiness that precedes it. (2011: 100)

This quotation comes from a book-length analysis of disgust, in which the author puts forward the proposition that entities that are not easy to categorise, that inhabit the border between life and death, human and non-human, provoke disquiet and even feelings of disgust because of their liminal status. While the corpse is the apotheosis of a bodily object of disgust, unborn entities (and even newborn infants) may similarly arouse feelings of unease and revulsion because they do not easily fit into these cultural categories. McGinn goes so far as to suggest that ‘As the corpse is a repulsive token of life’s ambiguous end, so the foetus and the new-born are semi-repulsive tokens of life’s fraught beginning’ (2011: 101).

In direct contrast to this notion of unborn entities as somewhat repellent and unsettling and not quite (or yet) human, however, is the increasingly common portrayal of them as already loveable and cute ‘babies’. This ontological extension backwards of infancy in the human developmental time-frame has major implications for how we think about and treat the unborn. The growing emphasis in wealthy developed societies on the value of children and the accompanying discourses of intensive parenting (Beck and Beck-Gernsheim 1995, Hays 1996) has resulted in children being considered infinitely important (Ruddick 2007, Zelizer 1985). This is particularly the case for infants, considered the most vulnerable and precious of all children (Lupton 2013a, 2013b). I have commented elsewhere (Lupton 2013b) on the four dominant discourses that frame notions of the infant body in the popular media: as precious, pure, vulnerable and uncivilised. These discourses are also all relevant to concepts of the unborn. Both the unborn and infants are considered highly valuable, the most important of all humans in terms of their potentiality, their closeness to nature and their purity, uncontaminated as they are by the excesses of culture. Their bodies are viewed as highly fragile and open to contamination by polluting outside influences, and therefore as requiring high levels of protection. Indeed the unborn have increasingly become positioned as even more vulnerable to such threats than are infants, given that they are viewed as at the mercy of their mothers’ actions, unable to escape the confines of the womb (see more on this in Chapter 5). As I will go on demonstrate in Chapter 3, the unborn may also be conceptualised as ‘uncivilised’ by the pregnant women in whose bodies they are developing if they are viewed as antagonists, creating discomfort or illness for women.

The ex vivo embryos that have become such a focal point of public discourse and policy-making in the past 15 years or so in relation to their disposal and their use in hESC research and regenerative medicine are at the blastocyst stage of development, and thus are only about five days past fertilisation. They have no human appearance at all: they are simply a round-shaped collection of dividing and multiplying cells. Yet for those couples who have undergone IVF, the opportunity to view their embryos at this very early developmental stage through an electron microscope can be an important way in which they come to visualise and think about these products of conception. For some people this process of viewing the blastocysts, even though at this stage they have no human form, serves to reinforce the notion of these entities as the beginning of life, the precursor to their ‘baby’ (Haimes et al. 2008, Kato and Sleeboom-Faulkner 2011). As one Japanese woman who was undergoing IVF commented, ‘When I saw my embryo through the microscope, I thought that I had finally met my child’ (Kato and Sleeboom-Faulkner 2011: 439). However this is not a universal reaction. For other people undergoing IVF, viewing their embryos supports their concept of these organisms as ‘just cells’ that have not attained personhood (Haimes et al. 2008: 121). In an Australian study, for example, one man described the appearance of the blastocyst he had viewed as ‘just a little blob’, likening its appearance to ‘bubbly eggwhite’, while a woman commented that her embryos ‘don’t look real’ (as foetuses or infants do) (de Lacey 2007).

As this suggests, uncertainties about whether the unborn are fully human and fully persons, and at what point in their development they achieve these statuses, begins at the very earliest stage of embryonic development. The sociocultural, historical and political contexts in which the unborn are encountered shape concepts of their personhood and which stage they are viewed as reaching in the journey to full human subjectivity. The unborn, particularly in the earliest days and weeks of their development, are portrayed differently across various lay, medical and scientific texts and practices, as human and non-human, alive or not yet alive according to the context. They are placed on the margins of the boundaries between human and non-human or in the spaces between these categories. They are thus located on a continuum rather than a binary definition of humanness (Casper 1994a, 1994b, 1998, Cesarino and Luna 2011, Christoffersen-Deb 2012, Conklin and Morgan 1996, Haimes et al. 2008, Morgan 2009).

Anthropologists have demonstrated that different cultures have differing ways of deciding when unborn and even post-born entities are deemed to become ‘infants’ or even designated as ‘human’ (Conklin and Morgan 1996, Gottleib 2000, James 2000, Kaufman and Morgan 2005, Littlewood 1999, Morgan 1997, 2006a, 2009). There are ‘processes of coming-into-social being’ (Kaufman and Morgan 2005: 321) which are related not to biological attributes but rather to accepted understandings within a social group or culture. James (2000) draws on the writings of the early anthropologist Marcel Mauss to argue that that these processes involve a ‘recognition’ or pragmatic acceptance of an entity as a separate being from the maternal subject and at least provisionally a ‘person’. This is not universal or automatic for unborn or even already born entities. As James notes, these processes of recognition are expressed with wide variation between cultures, but they centre on the concept of individuation from the mother and identification of a social being that can respond to others and demonstrate a potential to engage in reciprocal social relations.

Some cultures locate the beginning of infancy while the unborn body is still in utero. As I argued earlier and will throughout this book, this extension of infancy back into gestation has become increasingly apparent in some countries and cultures. In many other cultures, however, even newborn infants are considered to be not fully human until they have demonstrated certain behaviours or lived for a defined time period (Conklin and Morgan 1996). In one Australian Aboriginal culture, for example, the newborn is still called a foetus for some weeks until it has started to smile, and only then is it called a child (Gottleib 2000). In Ecuador the foetus remains a liminal organism, a creature rather than a human until birth and beyond, with infants not being accorded full personhood until some months after birth. As this research demonstrates, some cultures do not make a definite, clear-cut distinction between ‘person’ and ‘non-person’ when thinking about the unborn: they incorporate the category of ‘quasi-person’ to describe humans who are considered to occupy an ambiguous status. In the case of the Ecuadorians, this status of quasi-person is attributed to humans who have not been baptised according to their religious faith, such as infants who have not yet undergone the ceremony and the unborn (as well as adults who have not been baptised) (Morgan 1997, 2009). The unborn arouse even more uncertainty about personhood and individuated embodiment than do newborns, given that they still are encased within the maternal body.

Histories of the unborn

It is important to emphasise that concepts of the unborn in many societies have changed considerably in recent times. Historical analyses, like cross-cultural comparisons, are able to demonstrate the contingent nature of the unborn. They have shown that in previous historical eras in western societies very different notions of the unborn circulated. Despite their potent contemporary position as cultural icons, the unborn as they are represented and conceptualised today are relatively recent figures.

The concepts and representations of the unborn produced through medical and scientific knowledge emerging in the early modern period in Europe, for example, portrayed these entities in very different ways from previous representations. Before the invention of medical and scientific technologies that could conduct anatomical dissection or autopsies on unborn corpses, test for pregnancy hormones, visualise the unborn body or hear its heart-beat, the unborn, particularly in their earlier stages of development, were enigmatic, hidden creatures. One major difference between the contemporary era and earlier times – as recently as a generation ago – is that embryos and foetuses were never referred to using these medical words (Duden 1993). While medical drawings and anatomical wax figures from the early modern period represented the foetal body as individuated from that of the maternal body, lay people were not exposed to these representations and did not think of the foetus in these terms (Duden 1993, Erikson 2007, Hanson 2004, Newman 1996). Indeed the unborn body was not routinely treated legally or clinically as if it were a separate entity until the 1960s (Featherstone 2008, Weir 1998). The unborn–maternal assemblage was inextricably interbound and considered as a unitary organism until the moment that the unborn passed out of the maternal body, at which point they became viewed and treated as separate entities.

Duden (1993) argues that in the pre-modern era people described to physicians the haptic sensations, or feelings derived from the senses of touch, sme...

Table of contents

• Cover
• Title
• Introduction
• 1  Contingencies of the Unborn
• 2  Imaging the Unborn
• 3  The Unborn within the Self: Womens Experiences of Pregnancy
• 4  Death, Disposal and the Unborn
• 5  The Endangered Unborn
• Final Thoughts
• Glossary of Key Terms
• Web Resources
• Bibliography
• Index