Wednesday, September 16, 2009

Donor Insemination Offspring Literature

1) Consumer/Mom Literature: Written mostly for and by women concerning the options available for DI as well as first-hand accounts from women who have experienced it. This is, by far, the largest sub-genre and the easiest material to come by, readily available at your local Barnes and Noble. As you might imagine these books are almost 100% in favor of all RTs and their area of concern is not so much whether or not these practices are ethical but rather focus on what the best methods, techniques and approaches for getting pregnant, and how best to manage the future child in the absence of a father and how to break the news to the future child that they are donor offspring. Much to this sub-genre's credit, the authors seem to be almost unanimously against keeping the DI procedure secret from the child. While many of these books do give ample historical context to DI (some even go so far as to discuss the eugenic implications of the procedure) these books are, for the most part, like any other consumer literature – they are buyer's guides that treat the mother-to-be like a consumer and the child-to-be like a product to be appropriately priced and researched before purchased. Frankly, I found many of these books to be quite alienating. But there are a few that I thought were fairly comprehensive in their perspective:

On Our Own, Melissa Ludtke

Single Mothers By Choice, Jane Mattes

Having Your Baby By Donor Insemination, Elizabeth Noble

2) Medical/Bioethical Literature: Mostly written by and for doctors and/or academics concerning the ethical decisions and ramifications of DI within the larger context of RTs. Besides the fact that these books are harder to come by, more expensive and more difficult to understand than the aforementioned Consumer-Mom literature[1] these books are concerned with the way DI and other RTs contrast with what we as a culture have long considered to be normal and how best to deal with the schism between the new normal and old normal.[2]

For instance, Brent Waters, in his book Reproductive Technologies asks the million dollar question: If medicine is now displacing marriage as the principle institution ordering procreation – how do we begin to understand the ethical framework from which modern medicine arose? To answer this very difficult, very relevant question, Waters says:

contemporary medicine is practiced against the backdrop of a Western philosophical crisis. With the collapse of Christendom and the Enlightenment’s failure to fill the void, Western societies lack consensus on a normative practice of medicine. Thus an ‘anonymous perspective of reason’ is needed in which no religious or moral orthodoxy is imposed or privileged. A secular framework of moral deliberation encompassing a pluralistic world is required, necessitating a neutral mode of public moral discourse. The role of the moral philosopher in general, and the bioethicist in particular, is not to judge the truth of conflicting claims but to develop credible options among a diverse population. They map the terrain of contending values, identifying procedures for resolving conflict…Although a secular bioethic must acknowledge a wide spectrum of moral convictions, freedom is the dominant value….

Freedom. Never has the word flapped so lonely in the wind. Freedom of choice. Freedom to be oneself. Freedom from the other. But if everyone is free in their own realm of biotechnological decision-making what happens to community, neighborhood, belonging, togetherness? Now that men and women no longer need each other for reproduction what does a man see when he looks at a woman? What does a woman see when she looks at a man? What do we think about when we think about ourselves?

I got really into this subgenre. I couldn’t stop. These books are academic, slow going and, really, kind of far out. I found that reading several of these books in a row is like huffing glue: brief high-highs interspersed with fat black patches of nothing. Let me just say: these books are interesting (theoretically) but I wouldn’t want to live in a world ruled by scientists or bioethicists. Remember the technocratic dystopia described in Aldous Huxley’s Brave New World? Well, you know where I’m going with this.

Good stuff:

Ethics of New Reproductive Technologies, Jonathan Glover

The Future of Human Reproduction, ed. John Harris and Soren Holm

The Artificial Family, donors R. Snowden and G.D. Mitchell[3]

A Question of Life: The Warnock Report, Mary Warnock

Reproductive Technology: Towards a theology of Procreative Stewardship, Ethics of New Reproductive Technologies, Brent Waters

3) Philosophical Literature: Most of the philosophical literature here does not refer to DI by name but rather to the nature of human reproduction in the age of science and, in particular, how this effects being, conciousness, one's existential perspective and whether or not such an existential perspective even still exists. This is yet an even smaller sub-genre than the previous two, depending on what philosophical texts you want to drag into the conversation. One book from thus sub-genre stood out from all the rest: Jurgen Habermas's The Future of Human Nature, published in 2003, in which he examines the difference between the “grown” and the “made.” He asks, “…whether the instrumentalization of human nature [the made][4] changes the ethical self-understanding of the species in such a way that we may no longer see ourselves as ethically free and morally equal beings guided by norms and reasons.”

In other words, by “making” new human beings via technology we are essentially giving birth to a new existential or extra-existential or even non-existential perspective, a people for whom we "naturally" conceived humans can't possibly apply our "normative" ethical framework. It would be like critiquing a film based on television standards.

By the way, whenever the subject comes up in conversation, I tell people I am a “product” of donor insemination. Several of my friends have commented that this is a rather cold or unfeeling self-description but I do believe it’s apt.

Useful references:

The Human Condition, Hannah Artendt

Secrets, Sissela Bok

The Future of Human Nature, Jurgen Habermas

The Question Concerning Technology, Martin Heidegger

The Republic, Plato

4) The Literature of Eugenics: It turns out that Francis Galton and the history of Eugenics is the story within the story, as it were, concerning DI.[5] I believe this story gives adequate context to the questions and practical applications facing DI today. Needless to say, I was surprised by what I found and I’m guessing you will be too.

Did you know, in the early 20th Century, the United States had a comprehensive sterilization program in 26 states in which the “ lower tenth” - those determined to be stupid, poor, ugly - were legally forced into sterilization in an effort to improve the race? Did you know, in the early 20th Century, the U.S. and U.K. eugenics programs were far more advanced than their Nazi counterparts and were in fact the models upon which Nazi Germany based their eugenics program? Did you know that American, British and Nazi German scientists worked hand-in-hand in cooperative eugenics programs, both here and in Germany, and were forced to separate only after the United States entered the war in 1941? Did you know that it was only at the end of World War II, when word of the Nazi concentration camps (a direct result of their eugenics program) spread around the world, that all the western nations closed the doors on their own eugenics programs, afraid of being associated with the Holocaust? And did you know that, at the end of World War II, the West's eugenics programs were not, in fact, "closed" but were merely transformed into what we now call genetics?[6]

Yeah, I didn’t either. It might be the great untold story of the 20th century.

War Against the Weak, Edwin Black

Better For All the World, Harry Bruinius

The Unfit: A History of a Bad Idea, Elof Axel Carlson

Essays in Eugenics, Francis Galton

5) DI Offspring Literature: Besides a handful of articles and blog posts[7], would you believe there’s almost nothing whatsoever written from the perspective of a man or woman created by DI? Nothing. I'm sure the secrecy and shame that has long surrounded the practice has something to do with it. I heard about a young woman, a product of DI, who, several years ago, supposedly wrote a memoir in the ‘90s condemning the practice. She was taken on Larry King Live and hailed by Pat Robertson and other Religious Righters as evidence that donor insemination and all other RTs are unholy, unnatural, etc. But, after much research, I was unable to find this young woman’s name, her book, or her supposed appearance on Larry King.

[1] Think of the difference between Variety and People magazine: one caters to the industry insider and one caters to the consumer.

[2] When they say normal they typically mean Christian; many of these books inevitably (and understandably) talk about Man’s relationship to God and whether or not Man is supplanting God’s infinite wisdom and procreative decisions with Science.

[3] Incidentally, the only book I came across written by a donor.

[4] The brackets are mine.

[5] For my dollar anyway.

[6] All of this and much much more can be found at Edwin Black’s mind-boggling War Against the Weak.

[7] The most comprehensive blog is PCVAI (People Conceived Via Artificial Insemination) at yahoo, but you have to be a donor offspring to gain access.

Monday, September 14, 2009

The Walking Dead

The Walking Dead is a really great comic book that's about to be made into an ongoing serial on AMC.

I haven't read comic books in years. When I was a kid I used to collect them religiously. There are currently boxes upon boxes of comic books stacked in my mother's garage, each comic book individually wrapped in plastic with cardboard backing. Most of the Marvel and DC comics from my childhood are essentially worthless. When my friends and I were collecting we thought that our comics would someday be worth as much as the comics from the '40s, '50s and '60s, which is to say, a lot. But, thanks to mass-mass production that will probably never be the case.

Anyway, The Walking Dead is a lot of fun. Conceptually, it's great. The dialogue is often tedious and the characterizations are sometimes one-dimensional (classic traits of comic book writing) but after a while you really get into the post-apocalyptic suffering of the characters; the pace with which the characters come and go is...strangely refreshing. Most serials seem loathe to kill off characters here or there - but to see a story line in which even the most central characters are (or could be) killed off, I find somehow entirely cathartic.

You've probably noticed that there's been a huge vampire resurgence going on for the past few years - Joss Whedon's Buffy and Alan Ball's True Blood are the most notable - but I'll take a good zombie movie/show/story any day of the week. The thing about zombie movies is that they're movies about us. I know I'm not the first to say this but zombie movies are the perfect contemporary social satire, you know, what with our mass consumer liberal democracy and all. The herd mentality. I think you know where I'm going with this. The horror of a good zombie movie is the horror of ourselves. It's a beautiful (and very funny) thing when done well.

And so to celebrate zombies, an impromptu top 4 zombie movie list (in reverse!):

4) Dawn of the Dead (original), George Romero: His best film.

3) Mean Girls, Mark Waters: This is the best zombie-movie-that's-not-a-zombie-movie I've ever seen. Brilliant!

2) 28 Days Later, Danny Boyle: Overall, this might be the best zombie movie (even though technically I think you could make the case this is a virus film and not a zombie film at all but...)'s certainly the best movie movie of
any of them...

1) Dawn of the Dead (remake), Zack Snyder: The
first five minutes of this film are outrageously scary and
phenomenal...the most authentic representation of what the first few minutes of a zombie outbreak would really be like.

Tuesday, September 8, 2009

The Archimedean Point

A definition lifted straight from Wikipedia:

"A hypothetical vantage point from which an observer can objectively perceive the subject of inquiry, with a view of totality. The ideal of 'removing oneself' from the object of study so that one can see it in relation to all other things, but remain independent of them."

From the Greek mathematician, Archimedes.

Monday, September 7, 2009

The Birth of American Donor Insemination: A Modern Techno-Myth

In 1884, a merchant and his Quaker wife, unable to become pregnant, visited the Jefferson Medical College in Philadelphia where they met with Dr. William Pancoast. After a series of tests, Dr. Pancoast discovered the husband to be azoospermic, or sterile, while the wife was found to be perfectly fertile. Uncertain of how to treat the couple, the doctor consulted with his class of six medical students, one of whom suggested that they use the semen from the “best looking” man among them to inseminate the woman. Dr. Pancoast agreed and called the wife in once more for a final examination. He anesthetized the woman with chloroform and, with a rubber syringe, injected his student’s semen into her while his six students observed.

It was only after the birth of her son nine months later - the first ever reported human DI pregnancy in the United States - that Dr. Pancoast confessed to the merchant what he and his students had done. The husband, by most accounts, responded positively but asked that the doctor and his students keep the secret from his wife. They agreed, and she was never told.

Without realizing it Dr. Pancoast and his six anonymous medical students set a precedent that day in 1884 for the practice of DI that has continued until this day.[1] But what right do semen donors have to anonymity? In this case, does the donor’s right to anonymity outweigh the mother’s right to know with whose semen she has been inseminated? Does the donor’s right to anonymity also outweigh the unborn child’s right to know who his true father is?

I suspect the identity of the “true” biological father was kept secret for three reasons: 1) It was initially kept secret from both the husband and wife to protect Dr. Pancoast and his students from recriminations in case the merchant and/or his wife found their decision to inseminate her to be dishonorable or criminal; 2) The husband wanted to protect his wife from the potential shame of knowing she’d been inseminated, unknowingly, while passed out, by an anonymous man and; 3) Not wishing to lose face in his wife’s eyes the husband did not want his wife to know that he was incapable of impregnating her. In any case, the chief motivating factor in maintaining donor anonymity in this first ever use of human DI in the U.S. was - unambiguously – fear; each actor in the scenario was afraid that what they had done might be perceived as wrong and sought to protect themselves from wrongdoing by cloaking themselves in secrecy.

It is an important story and one of the most frequently told in the literature of DI. It’s almost become a kind of origination myth. Each author tells the story in a slightly different way, from a slightly different perspective, like the many apostles each representing Christ[2] in their own subjective voice. In the absence of any federal or state legislation since 1884, the decisions made by Dr. Pancoast and his six anonymous students have, remarkably, set the standards for a medical practice that has become increasingly common and even, in the past few decades, highly commodified.

What was the husband’s special relationship with the doctor that he was let in on the secret and his wife was not? And what about the six anonymous medical students? Who are they in this modern techno-myth? They are like the Council of Anonymous Masturbators standing in the background, bearing witness to this unique form of medicalized rape. They know whose semen it is. It is the “best looking” man’s semen and they are hiding his identity to prevent him from having to take any responsibility for the creation of new life, thus setting the stage for the practice of contemporary DI. The commemorative coin would show the bust of a featureless man and would read:

Celebrating 125 years of Donor Insemination!

Creating Life and Avoiding Responsibility!

Had the Quaker woman been told, on her way to the doctor’s office, that she was going to be drugged and impregnated with an unknown man’s semen with a rubber tube would she have consented? What right did Dr. Pancoast have to experiment on his patient?

As if to assuage its own guilt over grossly misusing that Quaker woman, the American Medical establishment convinced itself (and nearly everyone else) that donor insemination is a boon for women’s freedom. Thanks to Dr. William Pancoast and his six brilliant (and handsome) medical students (who shall remain dignified in their anonymity) women now enjoy a liberation and freedom of choice never before known in the history of the world. They are so free that they don’t even need men any more.

Dr. Pancoast, his six students and the Quaker woman’s husband kept their secret to themselves for the next 25 years. But, in 1909, the cat was, as they say, let out of the bag. Addison Davis Hard, one of Dr. Pancoast’s medical students (often speculated to be the “best looking”[3]) visited the donor offspring, then a twenty-five year old businessman living in Philadelphia, and revealed to that young man the story of his true conception.[4] Soon after, Hard published a letter in the American journal Medical World, in which he unveiled their collective secret to the world. An excerpt from Hard’s letter:[5]

From a nature point of view, the idea of artificial impregnation offers valuable advantages. The mating of human beings must, from the nature of things, be a matter of sentiment alone. Persons of the worst possible promise of good and healthy offspring are being lawfully united in marriage every day. Marriage is a proposition which is not submitted to good judgment or even common sense, as a rule…Artificial impregnation by carefully selected seed, alone will solve the problem. It may at first shock the sensibilities of the sentimental who consider that the source of the seed indicates the true father, but when the scientific fact becomes known that the origin of the spermatozoa which generates the ovum is of no more importance than the personality of the finger which pulls the trigger of a gun, then objections will lose their forcefulness and artificial impregnation become recognized as a race-uplifting procedure.

In the massive controversy that followed, the Jefferson Medical College, and all parties involved, took a considerable PR hit. Some claimed Addison Davis Hard was playing a joke. Some defended him, claiming that this procedure would in fact help limit unwanted pregnancy while others argued against AI as grotesque and absurd. But, most importantly, “The eugenicists were quickly on the scene and in the process divided the medical profession by their claims that the improvement of the genetic stock of America was now possible.”[6]

[1] The main difference today, of course, is that women know they’re being inseminated when they go to the doctor - but donor anonymity is still the norm.

[2] Of course, it’s worth mentioning that Jesus was the product of The Immaculate Conception. If a woman never has intercourse with a man but becomes pregnant via DI would she still be considered a virgin?

[3] Ladies and gentleman, America’s first semen donor!

[4] If Hard was, in fact, the donor father it’s interesting to note in this origination myth that it was the anonymous father who sought out the donor child – not the other way around. Clearly, no matter what anyone says, this is a two-way relationship. How many sperm donors are there who, having jerked off for money in college, found themselves, later in life, wondering - really wondering - where their children are, who their children are?

[5] Courtesy of Elizabeth Noble’s Having Your Baby By Donor Insemination.

[6] From R. Snowden and G.D. Mitchell’s The Artificial Family.

Saturday, September 5, 2009

A Brief History of Donor Insemination

1677 - Antonie van Leeuwenhoek, a Dutch scientist from Delft, considered to be the father of microbiology, discovers sperm, along with his pupil Johan Hamm, with the use of a magnifying lens. They refer to the sperm as animalcules.

1779 – Italian biologist and physiologist Lazzaro Spallanzani is the first to perform artificial insemination, using a dog. He kept the two animals in separate rooms to avoid natural mating and when the female dog showed signs of being in heat he collected semen from the male dog next door injecting the semen into the female dog’s womb. She became pregnant, and sixty-two days later, three healthy puppies were born. Spallanzani also observed the effects of cooling and freezing human sperm, now a common storage technique.

1790 - John Hunter, British physiologist and surgeon, is the first to record a pregnancy and delivery of a child conceived by artificial insemination with a husband’s semen.

1838 - A Frenchman named Girault used a hollow tube to blow sperm into a vagina.

1865 - De Haut published a pamphlet on Artificial Insemination in France but discontinued his experimentation due to public disapproval.

1866 - American gynecologist J. Marion Sims reported fifty-five intrauterine injections performed on six women enjoying only a four per cent success rate. Sims, a controversial doctor, said to have performed unethical and sometimes brutal surgery on slave women, was later elected as President of the American Medical Association in 1875.

1866 - First reported successful artificial insemination (with husband’s semen) in the United States.

1883 – Francis Galton, first cousin of Charles Darwin, coins term eugenics, meaning good breeding.

1884World’s first case of human donor insemination, performed by Dr. William Pancoast Jefferson Medical College, Philadelphia. The procedure is kept secret until 1909.

1886 – Paolo Mantegazza, a well known Italian neurologist, physiologist and anthropologist makes world’s first proposal for a sperm bank.

1909 – Addison Davis Hard, one of Dr. William Pancoast’s students, publishes a letter in American Journal Medical World, disclosing the details of the 1884 DI procedure, setting off a debate among lawyers, philosophers, theologians and medical practitioners.

1914 - Giuseppe Amantea, an Italian physician and physiologist, devised first artificial vagina thought to have greatly advanced artificial insemination technology.

1938 – Twenty-four articles on human artificial insemination are written and published in the United States.

1938 - First cattle breeding organization in the United States to use artificial insemination begins operations in New Jersey.

1941 - It is estimated that 3700 human donor inseminations occur in the U.S.

1945 - A string of medical committees are established in the U.K. concerning the ethical and moral dimensions of human donor insemination. The first report in the British Medical Journal condemned Donor Insemination calling it a “criminal offense.”

1949 – Pope Pius the XII rejects donor insemination on moral grounds.

1960 - The Feversham Committee deems the practice of donor insemination undesirable.

1970 - The Peel Report comes out in favor of Donor Insemination.

1985 - The Warnock Report states: “The protection of the public, which we see as the primary objective of regulation, demands the existence of an authority independent of Government, heath authorities, or research institutions. The authority should be specifically charged with the responsibility to regulate and monitor practice in relation to those sensitive areas which raise fundamental ethical questions. We therefore recommend the establishment of a new statutory licensing authority to regulate both research and those infertility services which we have recommended should be subject to control.”

1980’s - In the United States it is estimated that up to 100,000 children are the product of D.I. each year, 20,000 a year in California alone.

1987 - It is estimated one million DI children are living in United States.

1988A study done by the Congressional Office of Technology - commissioned by then Senator Al Gore - reveals a surprising lack of testing among semen donors for sexually transmitted diseases. According to the study, as reported by The New York Times, “…more than half of the 1,558 physicians surveyed said they did not check prospective donors for the AIDS virus; nearly three-quarters did not test for syphilis, gonorrhea or hepatitis, and about half did not perform any tests for genetic defects.” Then what are they screening for? “What many doctors do instead of testing is require prospective donors to answer questions about their life style, such as ‘Are you homosexual?’ and ‘Are you sexually promiscuous?’ These doctors say that since a majority of donors are university or medical students, who are presumably knowledgeable about health matters, their answers can be trusted.” Do you get the feeling that there’s a lot of winking and nudging going on in the DI world? It is the most comprehensive U.S. survey of procreative industry to date.