Physiognomy, familism and consumerism: preferences among Jewish-Israeli recipients of donor insemination

What can European Principlism Teach about Public Funding of IVF? The Israeli Case

Fertility treatments, which are part of "assisted reproductive technologies" (ART), mainly undertaken through in vitro fertilization (IVF), offer the opportunity to infertile couples to conceive. IVF treatments are undertaken in Israel in significantly higher numbers than in the rest of the world. As such, Israel provides an important case-in-point for examining the validity of the actual claims used to justify the more generous public funding of IVF treatments at the policy level. In this article, we utilize an analytical philosophy approach to conduct this examination. First, we highlight two fundamental concepts that were used at the Israeli public policy level in order to justify the generous public funding of IVF treatments. These concepts are "emotional vulnerability" and the "worthlessness of the childless," where the latter emphasizes the infinite value of children. Then, by applying the perspective of the European model of Bioethical Principlism, and focusing the attention to these two concepts we show that these justifications are invalid. Specifically, it is suggested that these concepts are on the one hand both relying on and expressing the principles of vulnerability, dignity, and integrity; yet on the other hand, these concepts are also undermining the very principles of bioethics they are supposed to express and rely on. Based on this suggested criticism, we offer two "take home" messages informed by our analysis of the Israeli case, but reaching beyond it.

Thirty-five years of assisted reproductive technologies in Israel

Israel is known as a pronatalist country. Whether due to the Biblical commandment to 'be fruitful and multiply' or the traumas of the Holocaust and perennial wars, reproduction is a central life goal for most Israelis. Israeli women bear substantially more children than their counterparts in industrialized countries and view child-rearing as a key life accomplishment. These personal world-view and real-life individual quests take place in a context of equally pronatalist state policies and religious openness to assisted reproductive technologies. In this paper, I outline 35 years of assisted reproductive technologies in Israel by tracing a principal axis in the development of three major technologies of assisted reproduction: the proliferation of IVF-ICSI; the globalization of gamete donation; and the privatization of surrogacy. The paper is based on a policy analysis as well as various studies of assisted reproductive technologies, conducted in Israel over this period.

Resemblance talk: A challenge for parents whose children were conceived with donor gametes in the US

The normative folk model of kinship in the US continues to attach great significance to "blood" relationships. These implicit genetic links are commonly reinforced through observations about a child's physical similarity to parents or other family members, i.e., "resemblance talk". This paper explores the meanings of resemblance and resemblance talk for parents drawing on semi-structured interviews with 148 heterosexual couples who had used a donor gamete to conceive at least one living child. For parents of children conceived with donor eggs or sperm, resemblance talk represents the ongoing threat that comments about physical appearance could stigmatize their children or cast doubt on the legitimacy of their family structure. Furthermore, these concerns were present regardless of whether a sperm or egg donor had been used and irrespective of the parents' disclosure decision, i.e., whether or not their children were told of the true nature of their conception. Parents found that resemblance talk was not only ubiquitous, unavoidable, and uncontrollable, but it also had the capacity to exacerbate ongoing uncertainties about their disclosure decision (or lack of one), worries about establishing their child within the extended family, and apprehension that insensitive remarks could make the child feel different from other family members. As a result, many couples spent considerable energy developing a variety of strategies for managing resemblance talk that included genetic plausibility arguments, "passing", and strategic silence. We conclude that parents of children conceived with a donor address and contest normative definitions of kinship and family, including stigma and otherness, resist challenges to the family they have created, and, to some extent, rework their allegiance to cultural norms to suit their own needs. Because resemblance talk and disclosure decisions are frequently tied to each other, it is likely that if the public were more accepting of difference, parents would likely feel more comfortable with disclosure. Yet resemblance talk may make it more difficult for parents to disclose, not easier, as long as attitudes about the implicit primacy of genetic connectedness prevail.

Parents’ contributions to the narrative identity of offspring of donor-assisted conception

Donated sperm, eggs, and embryos are an increasing feature of assisted reproduction; people conceived in this way have different genetic and social histories. Although most offspring of donor-assisted conception are ignorant of their genetic history, recipient parents must negotiate increasing demand for full disclosure to offspring. This paper illustrates some of the reasons parents give for not telling their children, underlines the experience of many parents of being uncertain of how to go about telling, presents information from some parents who have endeavoured to be open with their children about conception from very early childhood, and discusses implications for the narrative identity of offspring of donor-assisted conception. Recipient parents (n=55) and offspring (12) from Australia; Canada, US, England, and Argentina were interviewed and subsequently consulted about the development of their narrative accounts and the way in which these have been interpreted. Parental narratives were found to be located along a continuum, broadly encompassing: (1). Parents who intend to exclude donor-assisted conception from the narratives they construct for their children, (2). parents who are uncertain about what they want to do, or confused about the best way to disclose and discuss donor conception with their children and (3). those have incorporated the donor in their children's narratives from the beginning. From interviews with offspring and on the basis of human rights issues and the increasing salience of genetic knowledge, it is concluded that disclosure to offspring before adolescence should be encouraged.