Extra embryos: The ethics of cryopreservation in Ecuador and elsewhere

Through ethnographic comparison with Ecuador, I localize North American and European ethical debates about embryos. In Ecuador, some in vitro fertilization (IVF) practitioners and patients do whatever they can to preserve the life of embryos through donation or cryopreservation. For this group, embryos are embroiled in debates about life, as they commonly are in North America. However, other Ecuadorians do not view embryos through debates about life. Instead, these IVF practitioners and patients let embryos die rather than freeze them, to regulate the legitimate bounds of kin relations. These contrasting models of life ethics and kin ethics illuminate ideologies of religion, kinship, and personhood in Ecuador. In addition, this comparison demonstrates that the location of embryos in a framework of kinship prevents their circulation and exchange, whereas the North American and European debates about the human life of embryos allow for their continued circulation in the globalized reproductive marketplace. [biotechnology, life, ethics, kinship, personhood, comparison, Latin America, North America] O n May 25, 2005, the front page of the New York Times carried a picture of U.S. President George W. Bush at a press conference, holding a baby born “as a result of one couple’s donation of frozen embryos to another” (Stolberg 2005:1). The donation was arranged by a Christian “adoption” agency.1 At the conference, surrounded by many other children born from frozen embryo adoption, Bush stated that “the children here today remind us that there is no such thing as a spare embryo” (Stolberg 2005:1). Bush held the press conference as a preemptive strike against a congressional push to expand federal financing of embryonic stem cell research, research that Bush, along with many other conservative Christians, claims destroys the human lives of embryos. Despite Bush’s efforts, the bill passed, although without enough votes to prevent a presidential veto. The reporting on this event, which posed “life” as contested, assembles the elements of one half of this article. In this scenario the ethical debate about the proper use of embryos boils down to the status of embryos. Are they human life or not? In this article, I am concerned both with these debates over the life of embryos as well as a very different approach to embryos that I observed in my research on Ecuadorian in vitro fertilization (IVF). This other approach situates embryos within a framework of kinship, not life. These are ethical frames, ethical because they involve issues of “why and how to think” about “what is good in life” (Rabinow 2003:3). By juxtaposing these two ethical approaches, which I call “life ethics” and “kin ethics,” an unexpected story emerges about what the discourse of life ethics makes possible. Posing embryos as kin, which many IVF patients and practitioners in Ecuador do, constricts the possibility of embryo circulation, while debating their life makes their circulation possible. At the same press conference Bush declared that “every embryo is unique and genetically complete . . . these lives are not raw material to be exploited, but gifts” (Stolberg 2005:1, emphasis added). I argue that, on the contrary, it is precisely contemporary discourses of life that contribute to the transformation of entities like embryos into valuable, AMERICAN ETHNOLOGIST, Vol. 34, No. 1, pp. 181–199, ISSN 0094-0496, online ISSN 1548-1425. C © 2007 by the American Anthropological Association. All rights reserved. Please direct all requests for permission to photocopy or reproduce article content through the University of California Press’s Rights and Permissions website, http://www.ucpressjournals.com/reprintInfo.asp. DOI: 10.1525/ae.2007.34.1.181. American Ethnologist Volume 34 Number 1 February 2007 and anonymous, raw materials, some of the essential building blocks in the global biotechnology industry. In the last 20 years the development of new reproductive technologies and practices, such as IVF, has prompted an avalanche of philosophical and ethical debates in North America and Europe, debates that often center on the issue of life itself. Anthropologists have also turned their attentions to the effects of these technologies and the social arrangements they entail (Becker 2000; Franklin 1997; Kahn 2000; Modell 1989; Ragoné 1996; Thompson 2005).2 For the most part, however, these studies have focused on Europe and the United States, reinscribing the notion of the “West and the rest.” For example, in the introduction to their seminal anthology, Conceiving the New World Order, Faye D. Ginsburg and Rayna Rapp wrote that although “women in Europe, the United States and Australia can get IVF treatments” to alleviate their infertility, Third World women “may turn instead to religion, popular remedies, and fostering or adoption” (1995:7). More recently, anthropologists and other social scientists of science and technology have come to recognize that this characterization of a stark technological divide between North and South, East and West is not accurate, even for those on the economic margins (see Anderson and Hecht 2002; Arnold 2000; Choudhuri 1985; Cueto 1988; Das and Dasgupta 2000; Hayden 2003; Lock 2002).3 This newer scholarship reflects the growing awareness of how central science and technology are (esp. biomedical technologies) to the lives of people throughout the globe (Bharadwaj 2002; Georges 1996; Handwerker 1995; Inhorn 2003; Pashigian 2002; Paxson 2004).4 We still know very little, however, about the ethical stakes involved in assisted conception outside of Europe and North America. Although some institutions, such as the Catholic Church, claim they have resolved the question of the beginnings of life within the human embryo, a long line of comparative anthropological writings has shown that preoccupations with the beginnings and ends of life are more variable cross-culturally than the mostly Eurocentric field of bioethics supposes (Franklin and Lock 2003; Kaufman and Morgan 2005; Morgan 1989). Do reproductive technologies like IVF universally put life in question, or might they prompt other sorts of quandaries not solely driven by concerns with the preservation of life? To map the distinctions between some of the ethical discourses surrounding embryos, for this article I focus on the technique of embryo cryopreservation. What I am proposing is that the specificity of Ecuadorian approaches to freezing embryos demonstrates that embryos are not universally embroiled in the politics of life. The cryopreservation of embryos is not “automatic” in Ecuador, as it appears to be in the United States and Europe, and prompts the question: Why is it that for those in certain Euro-American locales the creation of frozen embryos is natural and their death is contentious whereas the inverse is true for some Ecuadorians, for whom it is their creation, not their death, that makes frozen embryos so problematic? IVF, life, and dignity This article is based on an ongoing engagement with Ecuadorian IVF since 2000. In 2002–03 I carried out a year of ethnographic research in seven of Ecuador’s nine private IVF clinics, all located in either Quito or Guayaquil.5 Although the mechanics of IVF are roughly the same country by country, there are key differences in the practice of IVF between nations.6 For instance, the optimal number of eggs retrieved from a woman undergoing an IVF cycle varies with policies of country and clinic, depending on costs, drug protocols, the local health care system, and the existence, or not, of regulatory institutions. IVF, which might be seen by some as an “immutable mobile,” an entity that can be moved without a change of meaning (Latour 1988), is very mutable, indeed. Comparing the problems, debates, and anxieties that surface (or do not) over new technological practices and assemblages in different sites “provincializes” (Chakrabarty 2000) scientific and ethical norms, although of course some of these norms are more dominant globally. It was through observation in Ecuadorian IVF in which I examined how preexisting cultural forms impact clinical practice that the specificity of North American embryo debates emerged. In regards to IVF in Ecuador, one cultural form involved the Catholic Church and local Ecuadorian Catholicism. Church condemnation of IVF derives primarily from the fact that the research, development, and practice of IVF involved, and can still involve, the destruction of human embryos, which, like abortion, is construed as the destruction of human life (Ratzinger 1987). In Ecuador, most people say they are against abortion, in line with their identity as Catholics. But when one looks at the way patients and doctors characterize their actions around the technology of cryopreservation, a more complicated story about the status of embryos becomes apparent. In Ecuador, some practitioners and patients would rather discard extra embryos than freeze them. These anxieties about freezing have less to do with the status of embryos as human life as most commonly framed within Euro-American life debates. For these patients, what mattered most was that embryos stayed within the family’s purview and were not abandoned while the family moved on in time without them or abandoned to someone unknown, who might be of a different race or class. Thus, for some Ecuadorians, throwing out embryos did not necessarily constitute abortion. Embryos were conceptualized as “family members” who required protection from temporal discontinuity and uncontrolled circulation beyond family boundaries, not as “life” that must be preserved. As I shall demonstrate, kin ethics are not limited to Ecuador but can be found in the ethnographic record of IVF throughout the world, especially in sites in which non-Christian religious