On knowing and believing: prenatal genetic screening and resistance to ‘risk-medicine’

Abstract

This paper presents the concept of ‘risk-medicine’ through the analysis of the rejection of prenatal screening among ultra Orthodox Jews in Israel. The foundations of this phenomenon are examined, defining ‘risk’ as a major socio-cultural feature of late modern Western society. The authors describe eight possible components of resistance to biomedicine, some being specifically applicable to risk-medicine: cultural discrepancy, lack of information, religious prohibitions, risk-aversion, incompatible health and illness cosmologies, fear and mistrust, governmental control, and irreconcilable epistemological differences. The analysis identifies two fundamental dimensions associated with risk-medicine: its epistemological basis, and the governmental surveillance that it involves. While the former stems from diverging conceptions on the values of different forms of ‘gnosis’ (probabilities vs. certainty) the latter draws upon the relationship between the state and risk-medicine, portraying ultra Orthodox women's rejection of prenatal screening as a form of resistance to nationalist, secular forces. The paper advances new concepts (namely ‘risk-medicine’ and ‘gnosis’ as related to ‘pro-gnosis’ and ‘dia-gnosis’) that may constitute a ground for further research on forms of medical epistemologies and practices and their related forms of resistance, namely in the context of religious and ideological incompatibilities.

Keywords:

• risk
• risk-medicine
• screening
• genetic screening
• ultra Orthodox Jews

Acknowledgements

This research was supported (partly) by the HWZOA Research Fund for Women Health.

Notes

1. In Israel, a hospital-based committee must approve all artificial terminations of pregnancy. The approval is almost invariably accorded (ICBS 2003).