Global Gametes: Reproductive Tourism and Islamic Bioethics in the High-tech Middle East

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1 Global Gametes: Reproductive Tourism and Islamic Bioethics in the High-tech Middle East Marcia C. Inhorn William K. Lanman, Jr. Professor Anthropology and International Affairs Council on Middle East Studies Yale University

2 Globalization of ARTs to the Islamic World My Fieldwork

3 Emergence Assisted reproductive technologies Islamic bioethical discourses ART industry and market demand for donor gametes Local moral worlds Reproductive tourism Emergent masculinities

4 The New Arab Man

5 Dominant, Residual, and Emergent Raymond Williams New meanings and values, new practices, new relationships and kinds of relationship, which are continually being created

6 Assisted Reproductive Technologies (ARTs) Intracytoplasmic sperm injection (ICSI) Third-party reproductive assistance Gestational surrogacy Cryopreservation Ooplasm transfer Preimplantation genetic diagnosis (PGD) Human embryonic stem cell research Human reproductive cloning

7 In Vitro Fertilization (IVF) Procedure

8 Prof. Robert G. Edwards with Louise Brown, Her Mother and Son

9 The Emergence of Islamic Bioethical Discourses

10 IVF Clinics in Egypt, Israel, and Lebanon, 2003 Egypt (pop. 70 million): 50 Israel (pop. 6 million): 24 Lebanon (pop. 3-5 million): 15

11 Al Azhar University

12 Sunni Islam Permits: Artificial insemination In vitro fertilization Intracytoplasmic sperm injection Cryopreservation Post-menopausal pregnancy with own eggs Preimplantation genetic diagnosis Multifetal pregnancy reduction Embryo research Uterine transplantation

13 Sunni Islam Prohibits: Third party donors Surrogacy Donor or surrogate children as legitimate Assisted reproduction after divorce or death Sperm banks PGD or sperm sorting for sex selection Human reproductive cloning Genetic alteration of embryos

14 Ebrahim Moosa: In terms of ethics, Muslim authorities consider the transmission of reproductive material between persons who are not legally married to be a major violation of Islamic law. This sensitivity stems from the fact that Islamic law has a strict taboo on sexual relations outside wedlock (zina). The taboo is designed to protect paternity (i.e., family), which is designated as one of the five goals of Islamic law, the others being the protection of religion, life, property, and reason.

15 Marriage

16 Potential Half-Sibling Incest

17 Kinship, Descent, and Inheritance

18 Mixture of (Genealogical) Relations Dangerous, forbidden, against nature, against God, haram Stranger to enter the family Purity of lineage through known fathers Patrilineality

19 Islamic Organization for Medical Sciences Ban on donation of reproductive material No Sunni Muslim-majority country allows gamete donation or surrogacy

20 The Emergence of Egg Donation

21 Ayatollah Ali Husayn al-khamene i

22 Iranian Shia Clerics

23 The Iranian ART Revolution

24 Egg Donation in Lebanon

25 The Emergence of Reproductive Tourism Fertility tourism, procreative tourism, or cross-border reproductive care (CBRC) the travelling by candidate service recipients from one institution, jurisdiction or country where treatment is not available to another institution, jurisdiction or country where they can obtain the kind of medically assisted reproduction they desire. As such, it is part of the more general medical tourism.

26 Eight Major Restrictions Religious, ethical, or legal reasons Lack of expertise and equipment Supply problems: shortages and waiting lists Safety risks Categories of individuals may not receive a service Medical privacy and confidentiality Poor quality care and lower success rates Cost

27 The Idea of an Anthropology of Islam Talal Asad A practice is Islamic because it is authorized by the discursive traditions of Islam, and is so taught to Muslims. The resistances they encounter (from Muslims and non-muslims) are equally the concern of an anthropology of Islam.

28 Emergent Local Moral Worlds Arthur Kleinman the moral accounts, [which] are the commitments of social participants in a local world about what is at stake in everyday experience ethnography of experience

29 The Modern Middle East James Gelvin The doctrines and institutions associated with Islam or any other religion are not frozen in time. They exist within history, not outside history. And while there are continuities of religious doctrines and institutions, the meaning those doctrines and institutions hold for society, and the function they play in society, evolve through time.

30 Emergent Masculinities: The Story of Eyad and His Unlikely Egg Donor

31 The Baby Bulletin Board (With My Study Advertisement in Green)

32 Conclusion

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