Acting ethically, responding culturally: framing the new reproductive and genetic technologies in Sri Lanka

Abstract

The spread of new reproductive and genetic technologies to the developing world stimulates reflection on the ethical issues they generate. The ‘built-in-ness’ of assumptions about personhood and relationality within these technologies means that local professionals must, perforce, engage with attempts to make sense of new technology with reference to local meanings and traditions or take positions which reject them. This paper explores such attempts to indigenise bioethics in contemporary Sri Lanka with reference to ethical/ cultural conflicts surrounding two practices: donor insemination and consanguinity counselling. The former is discussed in relation to the now defunct practice of polyandry and the latter in relation to matrilateral cross-cousin marriage. The final discussion takes up the consequences of this detailed parsing of local relationality for the larger project of rendering bioethics in some sense comparative.

Keywords:

• Sri Lanka
• Bioethics
• Polyandry
• Cross-Cousin Marriage
• Donor Insemination
• Genetic Counselling

Acknowledgments

The research on which this paper is based was carried out with the aid of a Wellcome Trust Fellowship under the Medicine in Society Programme (Biomedical Ethics GR067110AIA) for the year 2002–3. This work was preceded by a pilot study conducted in the summer of 2000 funded by the Nuffield Foundation (Social Science Small Grants Scheme).

I should like to express thanks to Dr P. Phillimore, Professor S. Arseculeratne and Dr D. Da Silva for their comments on earlier drafts of this paper; to Professor Rohan Jayasekera and Dr Vajira Dissanayake of the Human Genetics Unit (University of Colombo, Medical Faculty) for their invaluable assistance; and to the anonymous readers for their most helpful comments. I should also like to thank Marilyn Strathern who helped with this paper in more ways than one.

The final version of the paper has also benefited from comments made on earlier versions by participants at seminars given at York (Science and Technologies Studies Unit), Oxford (Institute of Social and Cultural Anthropology) and Newcastle (Policy Ethics and Life Sciences Research Institute Forum on Ethics, Medicine and the Law).

Notes

Bob Simpson is Senior Lecturer in the Department of Anthropology at the University of Durham.

• The notion of ‘discussion’ used here comes from Kenneth Burke by way of Machin and Carrithers:

  • • Imagine that you enter a parlor. You come late. When you arrive, others have long preceded you and they are engaged in a heated discussion, a discussion too heated for them to pause and tell you exactly what it is about. In fact the discussion had already begun long before any of them got there, so that no one present is qualified to retrace for you all the steps that had gone before. You listen for a while until you decide you have caught the tenor of the argument; then you put in your oar. Someone answers, you answer him; another comes to your defence; another aligns himself against you …. The discussion is interminable. The hour grows late, you must depart, with discussion still vigorously in progress. (Burke cited in Machin & Carrithers 1996, p. 343)

I should like to thank Aditya Bharadwaj for making this point very eloquently in a paper ‘Sacred conceptions: science, religion and technologies of procreation in India’. The paper was presented at the American Anthropological Association Conference in Chicago in 2003 and he was kind enough to share the unpublished manuscript with me.

For a more comprehensive and critical discussion of comparative bioethics, see Marshall (1992), Muller (1994), Kleinman (1995), Callahan (1999), Das (1999), Rabinow (2002) and Simpson (2004).

The Democratic Socialist Republic of Sri Lanka has nearly 19 million inhabitants. The majority of the population are Buddhist (69 per cent) and are drawn from the Sinhala ethnic group (74 per cent). Hindus (15 per cent), Roman Catholics (7 per cent) and Muslims (8 per cent) make up the remainder of the population. The second main ethnic group are Tamils who constitute approximately 19 per cent of the population.

For example, in genetics the code of life/book of life metaphor is deeply ingrained (see Kay 2000) but, as the base metaphor for genomics, it is nonetheless one that is read rather differently across cultures (see Árnasson & Simpson 2003). For a discussion of the issue of metaphors in the context of science in Asia, see Goonatileke (1998, pp. 247–53).

A working group has recently drawn up guidelines for Genetic and Reproductive Technologies at the request of the National Science and Technology Commission (NASTEC 2003). One of its main recommendations was for the creation of a National Assisted Reproductive Technologies Commission, the development of which is currently being expedited by the Sri Lanka Medical Council.

Examples include guidelines issued by the UK Human Fertilisation and Embryology Authority, the American Fertility Society, the Indian Council of Medical Research and the Australian Government to name but a few.

Although this is currently the position in most countries there is much debate about whether it is right that it should be the case, with calls for a different approach to secrecy in gamete donation being put forward (see Widdows (2002) for a discussion of these).

Comparative data on such requests are scarce. However, an embryologist acquaintance in the UK recently pointed out to me that in seven years of practice she had only ever come across one request for donor insemination (DI) using a brother's sperm.

It is beyond the scope of this paper to go into how communities with other kinds of cousin marriage react to injunctions against kin marriage. For example, the Borah are a community of Muslim traders mostly found in Colombo but originating in Pakistan/Afghanistan. They are strictly endogamous and practice patrilateral cross-cousin marriage.

Strictly speaking, Sri Lanka is an exception in this regard as the majority of the population speak an Indo-Aryan language (sinhala) but share the Dravidian kinship system (Trautmann 1981, p. 320; Guneratne 2002, p. 30; Stirrat 1977).

Such views may be linked to the debate that has emerged in the West regarding health, culture and consanguinity. One of the perspectives put forward in this debate sees the social functions of consanguinity as ignored and the genetic consequences as overplayed in dealing with migrant groups from South Asia and particularly Pakistan (see Ahmed 1993, 2000; The Lancet 1991).

My own earlier work on the transmission of ritual tradition among a caste of ritual specialists contains several examples of cross-cousin marriage contracted precisely to control resources. In that instance, however, the resources were not property as such but access to ritual knowledge (Simpson 1984).

Similar debates have gone on around ‘Asian values’ (Bauer & Bell 1998), ‘Asian capitalism’ (Dirlik 1996) and ‘Asian psychotherapy and counselling’ (Laungani 1999). In each of these there is an attempt to take Western constructs and appropriate them in a variety of ‘Asian’ idioms.

For an extreme argument in favour of this view in relation to South Asia in general and Sri Lanka in particular, see Goonatileke (1982) who goes so far as to castigate compatriot scientists as having ‘crippled minds’ for the way they have imbibed Western values.

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Notes on contributors

Bob Simpson

Bob Simpson is Senior Lecturer in the Department of Anthropology at the University of Durham.