Last Thursday, Yale professor Marcia Inhorn gave a seminar at McGill addressing the bioethics of reproductive tourism, highlighting the paradox in Islamic countries regarding assistive reproductive technology, or ART.
Assistive reproductive practices began in the United Kingdom in 1978 with the birth of Louise Brown, the first "test-tube baby." Other assistive reproductive practices include multi-fetal pregnancy reduction, intracytoplasmic sperm injection (ICSI), ooplasmic transfer, and cryopreservation of unused embryos.
Inhorn said that several Western nations - including Italy, Norway, Canada, and Great Britain - have enacted strict legislation prohibiting some, or all, forms of gamete donation, especially anonymous gamete donation and gestational surrogacy. Such restrictions have led citizens of these countries to travel elsewhere for these services, a practice known as reproductive tourism.
"Young women in these countries may comprise a vulnerable population of egg donors compelled out of economic necessity to sell their ova in the local marketplace. There is a newly recognized category that is being described now as one of the traveling foreign egg donors, a woman who receives economic mobility through the sale of her body parts," said Inhorn.
"In the world of sperm donation, the world's major supply of sperm is Denmark. I always think that the world is going to be overtaken by blonde, Viking men because their sperm is being sent around the world," said Inhorn.
Inhorn also said that the constraints faced by infertile couples on their quest for ARTs are still widely unknown. However, in the Middle East the Islamic faith has proven to be the biggest deterrent in certain aspects of these technologies. Yet the ART industry is growing rapidly in the Middle East, which is apparent in the hundreds of IVF (in vitro fertilization) clinics.
"This fluorescence of mostly private Middle Eastern ART industry is not surprising because Islam encourages the use of science and medicine as solutions to human suffering. Yet relatively little is known about Islam in technoscience," said Inhorn.
Looking to answer this last question, Inhorn began a multi-sited study among poor, urban women in Egypt in the late 1980s. After several disputes with the Egyptian secret police, Inhorn continued her study in Lebanon. This was followed by a study of an "Arab" community in United States near Detroit, Michigan, composed of mostly Shi'ia Muslims, as well as a project in Iran. Inhorn will conclude the study in the United Arab Emirates this January.
"[Professor Inhorn] spends months and years developing relationships. She manages to get access to people and can hear and learn their stories," said Wilson Will, a PhD. candidate at McGill.
These relationships and stories allow other researchers to understand the influence of religion on scientific and technological practices, particularly in the Middle East.
"Understanding the rapidly evolving moral, religious reasons surrounding ART in the Muslim world, in my view and the view of my colleagues, is very imperative. To do so requires examining fatwas, or non-legally binding, yet nonetheless, very authoritative religious decrees which are issued by important leading clerics," said Inhorn.
The overlap of religion and politics is evident in IVF practices. While IVF is permitted, Islamic authorities prohibit third party donations. This means that no donor eggs, sperm, embryos, or gestational surrogacy is permitted, according to Inhorn.
"In terms of Islamic ethics, Muslim authorities consider the transmission of reproductive material between persons who are not legally married to be a major violation of Islamic law," said Inhorn. "This sensitivity stems from the fact that Islamic law has a strict taboo on sexual relations outside wedlock."
In effect, one cannot receive third party donation anywhere in the Sunni world.
"Artificial insemination by donor is considered adultery and leads to confusion regarding the lines of genealogy," said Inhorn.