Discretionary Birth: Assisted Reproductive Technologies and the Rationalization of Decision Making Around the Beginning of Life

This study applies Machado’s (2005) theoretical concept of “discretionary death” in order to generalize the notion of rational discrete decisions from the domain of end-of-life studies to ethical questions concerning the beginning of life. Birth “as deed” (ibid.: 792) reflects a “new in-between class of situations” for medical personnel and (future) parents where natural birth is complemented by a range of prenatal (and postnatal) medical techniques including among other interventions prenatal diagnosis and – in the context of assisted reproductive technologies – preimplementation genetic diagnosis. This is neither birth “without human intervention nor an unnatural” birth (ibid.). Just on the contrary these medical interventions and ART are intended to provide new opportunities for having children. As in the case of assisted dying this “is a realm of high social professional responsibility calling for normative regulation” (ibid.). The medical contexts of firms offering IVF and genetic analysis as well as hospitals and birth clinics make up a professional sphere where the beginning of life is partialized in discrete choices and reflects rationalization and optimization of formerly “intimate” matters and “natural” processes. Together with the increased application and knowledge about ART and discretionary birth technologies (DBT) the social sciences gain importance besides medical and bio ethics: While morality politics analyses the processes of gaining influence on public opinion by political leaders and interest groups, sociological and survey research focus on tendencies in attitudes as well as the use of ART/DBT and how birth becomes negotiable. This paper presents empirical evidence from a pilot survey in Germany (2013, n=900) on the semantic framing of the beginning of life and contextualizes these results in the light of a rising biotechnology industry and the implications for the meaning of the beginning of life in the process of discrete subsequent choices that become available.