Women, Biomedical Research and Art. A Relationality in Tension
by Ninette Rothmüller
About the book
Applying a phenomenological lens, Ninette Rothmüller investigates intersectional vulnerabilities, socio-geographical and racial injustices, as well as the potential of trauma in reproductive medicine, human trafficking and black-market organ trades in a global context. The interdisciplinary study combines notions of writing back from within Pedagogy and hands-on creative social work tools, which emphasize dignity and integrity, and support self-efficacy and human rights in the everyday lives of affected populations.
Snippet: pp. 159-166
5 Body Gepgraphics. Territories, Trade and Mappings in Inequality
The last chapter concluded by offering an insight into how that which is inner to a body has in various ways been turned inside out, fragmented, and made publicly available, both to vision and to judgement. In this second analysis chapter of my study, I will examine the commodification of the human body and the ways in which modes of commodification relate to fragmenting practices and leave discursive and experiential traces at the level of both the individual and society. I will look at various modes of drawing and activating maps: maps that are concerned with mapping bodies and actors. I understand mapping practices to be one of the prerequisites for a conceptual approach to the body that frames bodily substances as commodities, and thus supports trading with these substances. One of my conversation partners from the UK states:
The reason that I raise aspects of economics and finance, is that generally I find in human genetic research that a lot of the public and media discourse is about ethics and that’s understood in a very individual sense, or is about the morals of it, or is about, yeah, donating, helping other people out, altruism, people dying, all that kind of thing. What is left out of all those discussions and contexts and decisions is that this is also an economic project. It’s not either/or, but it is also an economic project, which should come into the discussions as well, and consequently into the whole range of decisions.
Hence, this chapter takes the lead formulated by this conversation partner to address issues relating to the economics of biomedicine (in her statement, human genetic research), in order to expand the issues that are taken into account in this study, but also in order to respond to concerns raised by conversation partners.
5.1 Body Territories Under Re-construction – an Introduction
Erst Kultur kennt den Körper als Ding, das man besitzen kann, erst in ihr hat er sich vom Geist, dem Inbegriff der Macht und des Kommandos, als der Gegenstand, das tote Ding, ‘corpus’, unterschieden (Adorno and Horkheimer 1994: 247).
What we are witnessing is nothing less than a new gold rush, and the territory is the human body (Dickenson 2004: 109).
The title of this section resonates with language used in geography and state politics. Notions of ownership are inherent to the term “territory” insofar as it (most often) refers to politically dependent geographical units. Territory is a late Middle English term arising from the Latin term territorium, thus referring to terra: soil or land. This reference is interesting in the context of the study in that biomedical practices performed as part of stem cell research aim to manipulate bodily substances to become fertile to grow and reproduce cell lines and ultimately organs. Thus, Dickenson’s notion of the body as territory transports ideas of the body, as a whole including all organs and systems, as rich soil for reproduction.131
Geographically, territories are framed as spatial and (historically speaking) geographically definable through practices of mapping. Hence, mapping is a tool for accessing and marking territories by coding them and suggesting a certain “reading” of them. Maps create visual text. The suggested readings inherent to a map, to the visual text, may exclude specific information, as was the case in colonial mapping practices. Excluded information here may have been the names for regions that were used by the people living in the space being mapped. Hence, just as mapping creates authoritative readings it also excludes possibilities of applying certain readings of that same space, as it oftentimes excludes information that arises from indigenous naming practices (Wainwright and Williams 2008). Maps can thus be understood as never being value free. They are visual renditions of value systems. This leads to an understanding that the term “territory” echoes the power relations between those who do the mapping and those who are limited by the suggested readings of these visual codes as well as the borders that are “mapped” on paper or, ever more increasingly, through computer programs. I’ve laid out these thoughts here in order to apply the thought that mappings of objects, spaces, actors, and bodies echo with power relations in place to my analyses within this chapter. This will include looking at power relations activated in processes of mapping, where appropriate.
Looking at the second term used in the heading, “construction,” the first image that might come to mind is likely to be that of a road under construction. This work optimizes the road system: a system that connects different points on a map in order to facilitate a smooth (networking) flow between them. The term “construction” points to the future, as construction aims toward a better future based on problems that have been created or identified in the past and are being worked on in the present. Every act of construction re-constructs realities, for example, by re-constructing the accessibility of a space, the authority to move within it, and so on. Re-construction is acted out by both passive and active involvement and has the potential to reinforce certain authorities within a space. Re-construction, however, also questions conceptual framings, which were applied before the construction began. Writing about the relationality between body and economics within this study, the resonance of the two terms that are used in the headline with spatial dimensions and qualities is useful for helping us to understand more about how bodies and bodily substances are framed at the beginning of the 21st century, as some of the framings rely heavily on foregrounding spatial relations between bodies, thereby creating certain hierarchies between actors. However, the term re-construction is especially useful, as it can function as a reminder of the fact that some of the currently activated frameworks and concepts regarding bodies and bodily substances connect in certain ways to, or borrow from, concepts that have been around for a longer period of time. These concepts are thus both already part of the cultural memory when it comes to bodies, and part of how challenges are encountered when thinking about what bodies can be understood to be in the future on various levels. One such understanding, for example, is the understanding of the body as being extensional, and thus able to re-produce itself, for example through re-birth. However, as much as traditional notions of ownership still play a crucial role in legal decisions and cultural understandings of what can and cannot be owned, it seems that concrete concepts that can address powerful high-speed activities as part of globalized business relations, dealing with bodily substances, had not been developed at the time of this research. At the same time, globalized business relations dealing with bodily substances give rise to complex new questions, that are hard to address within traditional ownership frameworks. Such questions might arise in conjunction with framing the ownership of a space in which the substance seemingly resides, or is offered to, buyers or bidders when that space is a virtual space. In parallel to challenges in framing ownership, one can witness an interesting development: the remodeling of spatial (in the sense of räumliche) notions as they relate to the body with regard to ownership. As visualizations of bodily substances do play a role in how these are seen to have marketability, the latter development is to a certain degree interrelated to the example regarding the virtual space, as the establishment of spatial understandings and framings in both cases are driven by modes of visualizations, and by the idea that that which my eye can see is under certain circumstances real at least to the eye and can thus be marketed “for real.” In these next pages I will bring together theoretical perspectives on the political economy of the body, practices of body commodification, and discourses of trade and trafficking. The latter being possibly grounded in 1. the discourses of human trafficking, 2. “free trade” market economy science, but, also in 3. the emergence of health care and science “tourism” (which moves beyond legislative boundaries and oftentimes within the seemingly boundary-less organization of the virtual world).
The transformation of spatial notions of body with regard to ownership can be related to developments in the trading of bodily substances. From a global perspective, following Dickenson it can be argued that once “globalization” has harvested the life from less powerful geographical regions, that which remains to be harvested is that which we are, literally (Dickenson 2007). Thus, harvesting the world does include geographic as well as somatic localities; it includes somatic harvesting. This has, of course, to a certain degree always been the case if we include low paid or unpaid labor into the framework of harvesting the body.
Current biomedical activities involving the “harvesting” of the human body, regarding bodily substances, take place across nation state borders within and outside of the European Union including the virtual world, at least as far as advertisement goes. Trading networks, which have been established to enhance a smooth flow of bodily substances across nation-state borders and through different national legal frameworks, take advantage of variations in legal frameworks as well as differences in the economic standards of the countries involved. This brings questions regarding the ways in which nation-states participating in these practices relate to each other and about how inhabitants of various states can be equally protected through law to the attention of both national parliaments as well as the European Parliament. Again, some of the regions that supply certain European countries with labor force might also be the regions in which the “harvesting” of the human body, regarding bodily substances, gets established (with a gendered connotation to it, as the third analysis chapter within this study will show).
5.1.1 Body Territories Under Re-construction – Voices
Bodily substances must to be framed as “units” in order to be subject to trade. Following the statement by the European Parliament in 2005, which prohibits the trading of human egg cells,132 Biggi Bender, the health politics Speaker of the German Parliament at the time, explained: “Menschliche Zellen und Gewebe sind keine Waren – weder für die Fortpflanzungsmedizin noch für die Klonforschung. Für uns steht Artikel 3 der Grundrechtecharta der Europäischen Union nicht zur Disposition. Danach ist es EU-weit verboten, den menschlichen Körper und Teile davon als solche zur Erzielung von Gewinnen zu nutzen. Auch die Gewebe-Richtlinie der Europäischen Union sieht die Unentgeltlichkeit der Spende und den Ausschluss des Handel mit menschlichen Zellen und Geweben vor” (Bündnis 90/DIE GRÜNEN 2005: # 606).
Gernot Böhme’s work introduces the idea that Leibphilosophy might offer a framework for the resistance Bender’s statement calls for. Böhme, referring to the work of Petra Gehring, underlines that resistance to the commercialization of the body (and its parts) is grounded in the European legal tradition in which the human body is not an object (Böhme 2003 and 2010). Böhme argues, however, that this basis is not strong enough to withstand “der versachlichenden Zugangsart zum menschlichen Körper wie er in der Wissenschaft und Technik praktiziert wird […] weil es die Aneignung des Körpers durch das Ich oder die Inkarnation des Ich voraussetzt” (Böhme 2010: 34). Böhme identifies lines of thought within the field of Leibphenomenology in order to strengthen his own argument and to develop a discourse of resistance. He notes: “Demgegenüber ist der Aufweis der Leibphänomenologie, dass der Leib immer notwendig mein Leib ist, stärker, weil er sich auf die pathischen Existenzformen beruft. Dieses Argument verknüpft die Unveräußerlichkeit des Leibes mit anderen rechtsdogmatisch eingeführten Argumenten, die den Umgang mit Lebendigem durch die Empfindungsfähigkeit einschränken. […] Das Argument das sich auf die Jemeinigkeit des Leibes stützt, schützt nun allerdings Teile des menschlichen Körpers nur, insoweit und solange sie in den lebendigen Leib integriert sind” (ibid). Hence, although Böhme points us to the limitations that an argument based on my-own-owness133 brings, this argument (when looking at the commercialization of eggs, retrieved from women) can create an awareness of the inviolability of the Leib as basis of the self. Böhme points out that the dogma of the body not being an object is essential to the European legal tradition. The inviolability of the Leib is, following Böhme, an aspect of human dignity (ibid).
While trading activities, and the material issues that are raised, transcend national borders, discussions about the legal and ethical means and reasons to regulate such activities, seem, however, to be much more “culturally con- tained.” While the majority of my research looked at emerging discourses in the UK and Germany, a significant amount of literature and precedent-setting cases that serve as reference points in the field during the time of my research has been published by US-based scholars. In looking at voices coming from the US, one can acquire an initial idea about just how broad the field is and how widely the theoretical framing of the issues may vary. It is, for example, difficult to imagine, for me at least, that issues that were debated during the formulation of the Human Tissue Act134 in Europe, as well as following its initial implementation, would have been discussed in a similar manner in the US. The Human Tissue Act finds egg cell trade to be incompatible with the maxim of human dignity. Having travelled between academic “homes” in the US and Europe for several years, I personally have never come across a discussion in the field of organ trade in the US which is based on the notion of human dignity. Olga Pierce who reports on the US discussion of legal restrictions regarding embryonic stem cell research confirms my impression that human dignity is not a crucial component of the discussion (Pierce 2006). In the US, more often discussions center on notions that relate closely to themes such as autonomy, yet also competitiveness and Christianity (ibid).
The American Lawyer’s Lori B. Andrews statement, which opposes Bender’s standpoint that was outlined above, exemplifies how the argument in the US centers on the notion of autonomy. Following Ingrid Schneider’s analyses of Andrews’ work, Andrews “Spricht sich für eine Selbstverwirtschaftung des eigenen Körpers aus und will möglichst gute Vermarktungsbedingungen für die Körpersubstanz-VerkäuferInnen realisiert wissen” (Schneider 2003a: 44). For Andrews, activities of trade that are connected to a woman’s reproductive capacity, such as the selling of egg cells or acting as a surrogate mother, are an acceptable means by which the poorer population can make money. They are thus part of activities based on the actor’s autonomy. In Andrews’ words: “to the person who needs money to feed his children or to purchase medical care for her parents, the option of not selling a body part is worse than the option of selling it” (Andrews 1986: 32). Andrews’ position, which she articulates in published writing as early as 1986, points us to a history of trade in bodily substances, an activity in which poorer citizens historically seem more likely to become (and following Andrews’ stream of thought should have a right to be) involved. Yet, a history of “selling one’s body or bodily substances” cannot act per se as a justification of the activity itself. Andrews’ approach foregrounds, in the age of globalization, the idea that individuals should have the right to sell bodily substances. Thus, problems that reside within a society, such as an insufficient health care system, are represented as solvable through the act of a seemingly “responsible self-harvest.”135
Representing a more recent voice from the US and, at the same time, representing a “donor writing back,” Anne Pollock counters the framing of egg “donation” as a juridical issue, stating: “The process of egg donation acts as a normative technology, rather than a juridical one. It is not that the technology impedes the reproduction of undesirables, who are irrelevant to the industry on supply side or consumer side. Rather the technology facilitates the reproduction of desirables by extending the years of reproduction for middle class women” (Pollock 2003: 249). The donors in Pollock’s study are not poor women seeking funds to pay for basic needs as suggested by Andrews’ statement cited above, but rather are seeking to reduce their credit card debt, to pay college tuition, etc. Pollock uses the argument that the egg donors are not vulnerable subjects to then further frame her analysis as one about the reproduction of “desirables” [desirable human beings with appropriate normatively appreciated attributes], leaving the practice of selling eggs intact as just another dimension of capitalist practices and commodification (ibid). Her characterization of the donors as non-vulnerable agents is increasingly common within the discourse of (egg) donation in the US. The revelation of a flourishing egg trade network between Romania and the US, which was made public shortly after the publication of this work by Pollock, is one example that counters representations of the “donors” in the US fertility treatment industry as US women interested in financing a middle-class lifestyle. Furthermore, this example raises the question of which donors are “visible” and which not. I will take a closer look at the egg trade network between Romania and other countries in the following chapter.
Bringing Andrews’ legal perspective together with the work of the German political scientist Ingrid Schneider, it becomes clear that the discursive tension which spans between Andrews’ argument in support of the possibility for “people to transfer and sell own body parts” and Bender’s explanation of the prohibition of trading with human egg cells, as cited above, leaves room to follow this discussion through, by paying specific attention to experience as a formative parameter (Andrews 1986: 37 and Schneider 2002a). I believe that, focusing on experience, within my research allows for the possibility to take into account individual experiences without losing sight of the material and discursive conditions that give rise to these experiences. Schneider states:
Körpersubstanzen sind niemals eine bloße Sache, sondern bleiben in der Regel sozialpsychologisch Teil der Person, von der sie stammen. Verschiedene Körpergewebe haben jeweils einen unterschiedlichen psychischen und sozio-kulturellen Status. Einige können eine hohe Bedeutung für die Identität des Menschen haben, teilweise kommt ihnen symbolische Signifikanz als Teil des ganzen Körpers, als Teil der Person im Sinne eines pars pro toto zu. Diese symbolische Repräsentanz und Signifikanz ist in der westlich-christlichen Kultur besonders hoch bei Keimzellen (Schneider 2006: 244).
In Europe, framing the discussion about human reproduction in terms of the reproduction of products does not function well within transnational discussions of biomedical practices. In 2005, one of my British conversation partners observed that:
The future is not just a knowledge economy, but the future is the biotechnology economy. We have to encourage this for economic reasons for our economy. This is where the British economy is going to be.
This chapter aims to show that this vision of the future has, in part, become reality quite quickly. Positions have been cited above, as a means of pointing to the wide range of standpoints on the issue that scholars and politicians have been taken in various disciplines and geographical contexts. Every position and perspective that is taken, has the potential to hide further aspects that are worth paying attention to in accordance with the aims of this study. For example, while Andrews focuses on the individual, Dickenson’s analyses of current developments reveal an equally concerning notion. Her writing brings yet another component of the discussion to our awareness. This component is concerned with discourses of ownership applied within processes of trafficking bodily substances. To exemplify, I will finish this section with one of her statement. She states,
The notion of allowing ownership of human beings or human bodies – particularly in countries that have been subjected or are still subject to slavery and trafficking in persons – is repellent, even if couched in the language of owning oneself. It may be equally worrying if the developing country claims such an ownership interest ‘on behalf’ of its ‘citizen’ as do India and China – making human tissue property (Dickenson 2004: 117).
131 With reference to Dickenson’s choice of words in the opening quotation and her comparison between biomedical research and gold rushes, it struck me when I came to understand that one of the biggest gold rushes in history started in a stream joining the Klondike River in Canada’s Yukon Territory, thus in a still disadvantaged and ‘dependent’ territory.
132 For further details, please consult the press release relating to the session of the European Parliament in Strasbourg on March 10th, 2005 (vote regarding the trading with egg cells, trading rejected).
133 This translation is used following the Indian philosopher J.L. Mehta’s (1976) translation of Heidegger’s notion of Jemeinigkeit. This term has in other places also been translated with mineness.
134 Information about the human tissue act can be found at: http://eur-lex.europa.eu/legalcontent/EN/TXT/?uri=URISERV%3Ac11573)
135 When looking at US statistics, it is furthermore hard to miss, that those population groups who form the majority of the poorer population have historically also been the ones to provide unpaid or else cheap labor, such as the population of color. A US based analysis of Andrews work, thus should not miss to look at racial and intersectional dimensions of new injustices.
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