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Born and Made

Born and Made: An Ethnography of Preimplantation Genetic Diagnosis

Sarah Franklin
Celia Roberts
Series: In-Formation
Copyright Date: 2006
Edition: STU - Student edition
Pages: 288
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  • Book Info
    Born and Made
    Book Description:

    Are new reproductive and genetic technologies racing ahead of a society that is unable to establish limits to their use? Have the "new genetics" outpaced our ability to control their future applications? This book examines the case of preimplantation genetic diagnosis (PGD), the procedure used to prevent serious genetic disease by embryo selection, and the so-called "designer baby" method. Using detailed empirical evidence, the authors show that far from being a runaway technology, the regulation of PGD over the past fifteen years provides an example of precaution and restraint, as well as continual adaptation to changing social circumstances. Through interviews, media and policy analysis, and participant observation at two PGD centers in the United Kingdom, Born and Made provides an in-depth sociological examination of the competing moral obligations that define the experience of PGD.

    Among the many novel findings of this pathbreaking ethnography of reproductive biomedicine is the prominence of uncertainty and ambivalence among PGD patients and professionals--a finding characteristic of the emerging "biosociety," in which scientific progress is inherently paradoxical and contradictory. In contrast to much of the speculative futurology that defines this field, Born and Made provides a timely and revealing case study of the on-the-ground decision-making that shapes technological assistance to human heredity.

    eISBN: 978-1-4008-3542-3
    Subjects: Sociology, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. List of Figures
    (pp. ix-x)
  4. Acknowledgments
    (pp. xi-xiv)
  5. Preface
    (pp. xv-xxiv)
  6. Introduction Babies by Design?
    (pp. 1-24)

    One of the late twentieth century’s most infamous offspring, the “designer baby” has become, alongside the clone, a familiar figure in debates about new reproductive and genetic technologies in what has come to be known as the “postgenomic” era. Like the iconic image of the “test-tube baby” that preceded it, the “designer baby” signifies a disturbing mixture of newfound biogenetic control, consumer demand, and parental desire. An ambivalent figure, the designer baby is at once celebrated as a medical-scientific breakthrough and decried as an example of “science gone too far.” Alongside media celebrations of joyful parents enabled to have a...

  7. Chapter 1 What Is PGD?
    (pp. 25-74)

    3 May 2003. The glossy cover of the Guardian Weekend magazine features a provocative image of a sonogram of a fetus reading a volume of Proust to accompany an article by Bill McKibben warning of the dangers of the designer baby era.¹ The reconstructed scientific image challenges the viewer with the issue of genetic enhancement, by depicting a superintelligent baby in the womb. In provocative visual language it conveys the idea of a new era of genetic manipulation and made-to-order, “superior” offspring.

    The image was created by artist David Newton, who altered the familiar scientific imagery of ultrasound by providing...

  8. Chapter 2 Studying PGD
    (pp. 75-93)

    Analyzing the social life of PGD requires moving across widely disparate sites and materials, from media representations and scientific articles to interviews with policy makers and medical practitioners. It also requires a range of methodologies, from semistructured interviews to policy analysis and social history. Providing a methodological justification for using such a wide range of sources and methods, in what is intentionally a very open-ended and exploratory fashion, is not straightforward, and runs the risk of appearing rudderless, haphazard, journalistic, dilettantish, and unscholarly. On the other hand, it could be argued that the social science of biomedicine must be inventive...

  9. Chapter 3 Getting to PGD
    (pp. 94-131)

    In the same way there is no single definition of PGD, so too there are several different ways of “getting to PGD”—for scientists, clinicians, genetic counselors, patients, and researchers. Each of these involves a different path of approach, and consequently a different sense of arrival. Paths to PGD clearly depend on where one is located to begin with, and the first section of this chapter presents a brief account of the picture that has emerged after PGD’s first decade of clinical practice, in which access to it was both widened and heavily restricted. This overview also helps to situate...

  10. Chapter 4 Going Through PGD
    (pp. 132-162)

    Once a couple have decided to explore the possibility of PGD, and have made an appointment at the clinic, they attend what is known as their initial consultation session to meet with several different members of the PGD team. This session is designed both to provide more detailed information to the couple about what is involved in PGD and to enable the clinical staff to evaluate a couple’s suitability for treatment. As Jenny Caller described the purposes of the initial consultation session in an interview: “I suppose in a way I like to say, you know, it’s a case of...

  11. Chapter 5 Moving On from PGD
    (pp. 163-195)

    Everyone who undergoes PGD will eventually have to end active engagement with treatment. For a minority, this will come as a logical progression following the birth of one or more unaffected children. For the majority of couples, however, “reaching the end of the road” turns out, like most aspects of PGD, to be more complicated than first imagined. Coming to terms with ending treatment means, for most couples, coming to terms with its failure, and facing the challenge of how to make sense of experiences that will remain with them for the rest of their lives. However, failure is also...

  12. Chapter 6 Accounting for PGD
    (pp. 196-217)

    The preceding chapters have introduced a range of divergent perspectives on PGD—from patients, clinicians, scientists, policy makers, journalists, bioethicists, philosophers, and other commentators as well as from the media, government agencies, and the voluntary sector. Together, these accounts of PGD comprise an ethnographic archive, through which a collection of disparate and conflicting understandings becomes a sociology-of-PGD database. The contrasts, alignments, and comparisons between and among these versions of “what PGD is all about” evoke Meg Stacey’s (see introduction) mandate to describe and apprehend the “manifold and complex” nature of social life, its complexity, and in particular the “interrelatedness of...

  13. Conclusion PGD Futures?
    (pp. 218-230)

    As noted at the outset of this account of PGD, there are several reasons why it has become not only a focal point of contestation over the future of reproductive biomedicine, but itself a condensed signifier of broader anxieties symbolized by the figure of the “designer baby.” Situated at the intersection of reproductive and genetic technology, PGD inevitably poses difficult questions about the increasing role of genetic choice in the context of reproductive intervention and the ability to “assist” both conception and heredity. It would be worrying if such technology did not elicit concerns. Nor are many of these concerns...

  14. Appendix
    (pp. 231-232)
  15. References
    (pp. 233-248)
  16. Index
    (pp. 249-256)
  17. Back Matter
    (pp. 257-258)