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Infertility and assisted reproductive technology in a pluralistic world: A development and application of a Hindu ethic
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Content
INFERTILITY AND ASSISTED REPRODUCTIVE TECHNOLOGY
IN A PLURALISTIC WORLD:
A DEVELOPMENT AND APPLICATION OF A HINDU ETHIC
by
Swasti Bhattacharyya
A Dissertation Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements of the Degree
DOCTOR OF PHILOSOPHY
(RELIGION)
December 2002
Copyright 2002 Swasti Bhattacharyya
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UMI Number: 3093736
Copyright 2002 by
Bhattacharyya, Swasti
All rights reserved.
®
UMI
UMI Microform 3093736
Copyright 2003 by ProQuest Information and Learning Company.
All rights reserved. This microform edition is protected against
unauthorized copying under Title 17, United States Code.
ProQuest Information and Learning Company
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P.O. Box 1346
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UNIVERSITY OF SOUTHERN CALIFORNIA
THE GRADUATE SCHOOL
UNIVERSITY PARK
LOS ANGELES, CALIFORNIA 90089-1695
This dissertation, written by
Swasti Bhattacharyya
under the direction of he X dissertation committee, and
approved by all its members, has been presented to and
accepted by the Director of Graduate and Professional
Programs, in partial fulfillment of the requirements for the
degree of
DOCTOR OF PHILOSOPHY
Director
Date Decem ber 1 8 . 2 0 0 2
Dissertation Committee
Ci AU
{ am ( Pmd f i
if C o
Chair
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DEDICATION
11
This work is dedicated to my parents, brother, very close friends,
and professors whose prayers and thoughts sustained me through this
process. It is with you all that I have walked this path.
Thank you.
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iii
ACKNOWLEDGEMENTS
This work would not have been written without the support and
assistance of a number of people. First, I would like to thank my
dissertation committee: Professors William May, Christopher Key
Chappie, John Crossley, and Elize Sanasarian. All of your comments and
suggestions were most helpful. I also appreciate that all of you were
willing to meet for a July defense! I must also express my gratitude to
both Professors May and Chappie. As co-chairs of my committee, your
combined expertise in bioethics and South Asian studies allowed me to
pursue this project; your helpful comments and assistance empowered me
to complete it! Though a Professor and acting chair of Theological
Studies at Loyola Marymount University, Professor Chappie somehow
found the time and energy to invest in my project. Thank you for
believing in me and for allowing my defense to interrupt your summer
vacation. Second, I want to thank the professors of the Department of
Religion and Social Ethics, past and present, for providing a positive
environment in which I could pursue my goal. I appreciate the freedom
I felt for unannounced visits to your offices when I had a question or
two, or three!! (Thank you Bill, Bob, Jack, Jane, Ted and Roberto). I
also want to thank Linda Wootton for her assistance and support. Third,
I am thankful for the financial assistance I received from the department
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and university. The teaching assistantship and dissertation fellowships
helped immensely. I also want to thank Sarah Novak for editing the
entire document. Your work allowed me to finish this project and to
turn my attention to the future. Finally, I am blessed with a supportive
family and a group of close friends. My parents laid the foundations
from which this work springs; thank you for encouraging me through
your questions and for supporting me every step of the way. My friends
are irreplaceable; thank you for walking with me!
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TABLE OF CONTENTS
DEDICATION
ACKNOWLEDGEMENTS
1 INTRODUCTION
Religious Diversity in the United States
of America
2 MEDICINE, BIOETHICS AND RELIGIOUS VOICES
Relationship Between Religion, Medicine
and Bioethics
Marginalization of Religion in the Academy
Religious Voices and the Clinical Arena
Reemergence of Religious Voices in the
Academy and Public Policy Forums
Religious Diversity
Cultural Competency
Complexity of Hindu Voices
3 VOICES FROM HINDUISM’S PAST
What is the Mahabharata}
Brief Synopsis of the Mahabharata
Why the Mahabharata?
The Birth Narratives
KuntI and Pandu
Gandharl and Dhrtarastra
Points of Contact
Paternal Surrogacy
Sperm Donation and Gene Selection
Post-mortem Sperm Donation
Adoption
In vitro Gestation and Artificial Wombs
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4 NARRATIVE AS A SOURCE OF ETHICS
Applicable Topics Addressed in the
Mahabharata Narratives
Brief Comparative Analysis with the
Hebrew Scriptures and New Testament:
God’s Control Over Procreation
Women’s Roles in the Process of Procreation
Roman Catholicism and Control Regarding
Procreation
5 CHARACTERISTICS OF HINDU THOUGHT
Centrality of Society
Underlying Unity of All Life
Requirements of Dharma
Multivalent Nature of Hindu Traditions
Theory of Karma
6 APPLICATION OF HINDU THOUGHT
Jaycee’s Case
Practical Application: A Hindu Analysis
of Jaycee Buzzanca’s Case
Utilization of Assisted Reproductive
Technology
Individual vs. Societal Rights and Interests
Assisted Reproductive Technology and
the Family
7 CONCLUSION
Religion and Bioethics
The Hermeneutics of Cross-cultural and
Inter-disciplinary Studies
Bioethics, Casuistry, and Cultural Competency
Implications and Additional Applications
of Hindu Bioethics
BIBLIOGRAPHY
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1
Swasti Bhattacharyya William May
Christopher Key Chappie
ABSTRACT
INFERTILITY AND REPRODUCTIVE TECHNOLOGY
IN A PLURALISTIC WORLD:
A DEVELOPMENT AND APPLICATION OF A HINDU ETHIC
Reproductive technology is in the forefront of medical research and
contemporary bioethical debates. In the United States, ethical issues
involved are often framed by conflicts among legal, scientific, and religious
perspectives. The primary religious voices influencing these North
American discussions are those grounded in various Jewish and Christian
traditions. However, this country is known for its religious and cultural
diversity. This diversity of worldviews presents challenges that the field
of bioethics needs to address. My goal is to inform and contribute to the
ongoing bioethical dialogues and to increase the cultural/religious awareness
and sensitivity of health care professionals.
This is an interdisciplinary project that weaves elements from the
fields of South Asian Studies, religion, literature, the practice of medicine,
and bioethics. From the Mahabharata birth narratives of the five Pandava
brothers and their 101 Kaurava cousins, points of contact between
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2
antiquity and modern reproductive technology are discussed. Then, four
relevant topics are discussed: (i) the priority society places on having
children; (ii) the acceptance of a variety of creative means for producing
children: (iii) the active role women play in determining reproductive
choices; and (iv) an interrelationship between gods and humans in the
process of procreation. Finally, five characteristics that are important to
Hinduism are extracted, namely: (i) the focus on societal good; (ii) the
underlying unity of all life; (iii) the requirements of dharma, (iv) the
multivalent nature of Hinduism; and (v) a theory of karma. Utilizing the
above insights, I then examine the case of Jaycee Buzzanca, a baby
conceived with donor gametes, through in vitro fertilization, and carried
by a surrogate.
Jaycee’s case not only challenges the limits of the U.S. legal system;
it also highlights complexities of the ethical issues that can accompany the
use of assisted reproductive technologies. By examining Jaycee’s
predicament in light of Hindu thought, I analyze Hindu responses.
Though the above principles preclude the formulation of the definitive
Hindu ethic, they do provide a beneficial set of lenses through which one
can examine the ethical issues associated with assisted reproductive
technology.
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CHAPTER 1
INTRODUCTION
People throughout history have struggled with the challenges of
infertility and with the issues that naturally arise when considering the
implementation of means to circumvent it. New and sophisticated
techniques designed to overcome human infertility are at the cutting edge
of modern medical science, bringing with them a host of controversial
bioethical issues. North American debates concerning such issues have,
until quite recently, been primarily shaped by concepts and values that are
grounded in traditional Jewish and Christian perspectives. More recently,
however, other voices have begun to be heard. Cultural, religious, and
philosophical pluralism is no longer an abstract, academic notion, but is
rather being increasingly recognized as a social and political reality.1
The diversity of alternative worldviews presents distinctive
challenges for the field of bioethics. While the general principle of
inclusiveness may be regarded as a noble ideal, attempts to consider
variant religious traditions within the scope of specific bioethical dialogues
often lead to one of two ultimately unsatisfactory outcomes. Some
'Charles Taylor, Jurgen Habermas, Susan Wolf, and Jeffrey Stout are examples of
scholars whose work has focused on the issues and challenges of multiculturalism. See
Amy Gutmann ed., Multiculturalism (Princeton: Princeton University Press, 1994); Jeffery
Stout, Ethics A fter Babel: The Languages o f Morals and Their Discontents (Boston:
Beacon Press, 1988).
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conclude that religious traditions are so dissimilar that there exists no
common ground on which to base a discussion. Others present these
diverse traditions in such simplistic terms that a rather superficial unity is
espoused--a unity which subsequently collapses under closer scrutiny.
This present study steers a middle path between these two
extremes. While acknowledging that there are differences within and
between “Asian” and “Western” perspectives that cannot and should not
be superficially glossed over or explained away, it is my firm conviction
that cross-cultural dialogues concerning bioethical issues can and should be
mounted. Differences in axiomatic assumptions and distinctive modes of
discourse can certainly present dialogical challenges and difficulties.
However, this very contrast has the potential to bring many of the core
issues involved into clear focus and to provide a basis for developing more
creative and innovative solutions to complex bioethical issues. Armed
with this conviction, this study examines how key elements of Hindu
thought can contribute to contemporary society’s viewing, reframing and
dealing with the complex issues relating to infertility and assisted
reproductive technology.
The purpose of this work is both to inform and to enrich the
ongoing bioethical dialogue concerning assisted reproductive technology and
to increase the cultural/religious awareness and sensitivity of the health
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3
care delivery team. Pursuant to this goal, an example of an applied
Hindu bioethics will emerge from this discussion and application of Hindu
thought. The significance of this study is practical. Whether living in
Los Angeles, Atlanta, or Ames, one need not travel the world to
encounter global perspectives; they exist and thrive within nearly every
North American geographical setting. People ascribing to Hindu ideology
are not simply an “exotic other;” they are individuals and families that
live and work under the same roof, next door, down the street and across
town.
As modern society increases its familiarity with different
worldviews, there are significant challenges as well as benefits.2 Individuals
exposed to different cultural and religious perspectives have the
opportunity to broaden their own perspectives, thus enriching their stock
of conceptual and axiological resources from which to draw when making
decisions for themselves. Also, having examined other worldviews, these
individuals may become better equipped to assist, understand, and interact
with family members, neighbors, colleagues, patients, healthcare
2 This is a time of reflection for many Los Angeles residents: it was ten years ago
that the city burned for four days following the not guilty verdicts of four Los Angeles
Police Department officers in the Rodney King beating trials. Though many issues
contributed to the unrest, some attribute the conflicts to a lack of understanding between
groups and individuals. Reflecting on the past and looking to the future, Reverend Cecil
Murray councils, “move to make room and we’ll fly; fail to make room and we’ll
crash.” Scott Simon, National Public Radio’s Weekend Edition, KPCC 4 May 2002.
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4
professionals and fellow citizens when dealing with complex bioethical
issues.
By its very nature the field of bioethics3 is interdisciplinary,
drawing inquires from any number of disciplines: Anthropology, Law,
Medicine, Philosophy, Religion and Sociology to name several. There are
a variety of approaches and methods utilized by those engaged in
bioethical discussions. As Shannon says, “Bioethics is teaching us the
necessity of genuine interdisciplinary thinking and working [. . .]. Reality
--which is interdisciplinary--has taught us to be interdisciplinary in our
thinking.”4 Theologians, lawyers, historians, and medical professionals all
share a common interest in the normative, meta-ethical, and descriptive
questions posed by various aspects of healthcare, and each discipline
utilizes different methods in examining bioethics and approaches the field
from different perspectives.5
3 While “medical ethics” refers to the study of ethics within the discipline of
medicine and medical care, “bioethics” is a more inclusive term. The latter term focuses
on the worlds of medicine, life sciences, psychology, biotechnology, genetics, and on the
serious challenges and questions that arise from within these worlds. The specific field
of Bioethics began to take shape in the 1960s. Thomas A. Shannon, Introduction to
Bioethics, 3r d ed. revised and updated (New York: Paulist Press, 1997), 4-5; Helga Kuhse
and Peter Singer, “What is Bioethics? A Historical Introduction,” in A Companion to
Bioethics, ed. Helga Kuhse and Peter Singer (Malden: Blackwell Publishers Inc., 2001), 3.
4 Shannon, Introduction to Bioethics, 5.
5 Daniel Sulmasy and Jeremy Sugarman, “The Many Methods in Medical Ethics
(Or, Thirteen Ways of Looking at a Blackbird,” in Methods in Medical Ethics, ed.
Jeremy Sugarman and Daniel P. Sulmasy (Washington: Georgetown University Press,
2001), 5-6; Kuhse and Singer, “What is Bioethics?” 3. Allen Verhey, “Introduction,” in
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In keeping with the nature of the field of bioethics, the
methodology employed in this present inquiry is necessarily
interdisciplinary and “organic.” It is interdisciplinary in that it draws
together elements from the diverse fields of South Asian studies, literature,
religion, bioethics, and some insights offered by a few contemporary
voices from a Hindu community in Southern California.6 Owing to its
inherent internal complexities, several different ethical models are utilized
in the construction of a Hindu ethics. The very mercurial nature of
Hinduism demands the utilization of narrative ethics7 in order to be able
to locate the discussion and to actually say anything of substance. The
multivalent nature of these traditions also necessitates a casuistic approach8
Religion and Medical Ethics: Looking Back, Looking Forward, ed. Allen Verhey, (Grand
Rapids: Eerdmans Publishing Company, 1996), 2. David H. Smith, “Religion and the
Roots of the Bioethics Revival,” in Religion and Medical Ethics: Looking Back, Looking
Forward, 9.
6 After obtaining the appropriate approval from USC’s Institutional Review Board
(IRB), I interviewed a total of six adults: two women and four men from June through
December 2001. All of these individuals are in some degree associated with a Hindu
temple in Southern California. Of the six Hindus interviewed, all of them were born in
India and have lived in the area for a minimum of 14 years, some having been here as
long as 24 years. They are all married and have children. To retain their anonymity, I
refer to them as follows: Mr. A; Ms. B; Mr. C; Dr. D; Dr. E; and Mr. F.
7 See Stanley Hauerwas, A Community o f Character: Toward a Constructive
Christian Social Ethic (Notre Dame: University of Notre Dame Press, 1981).
8 Albert R. Jonsen and Stephen Toulmin, The Abuse o f Casuistry: A H istory o f
Moral Reasoning (Berkeley: University of California Press, 1988).
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6
to applied ethics. The influence of Beauchamp and Childress’ principlism
is evident in the extraction and application of key elements of Hindu
thought. From these varied, select strands, this study weaves a tapestry of
a Hindu ethic that, while not being exhaustive, incorporates many of the
relevant ethical elements drawn from Hindu philosophy, religion, culture,
history and experience.
In addition to its interdisciplinary scope, the methodology employed
in this work may also be regarded as organic in character. Rather than
construct a “Hindu ethic” out of abstract principles, in isolation or
without context, I weave an ethic from strands of Hindu philosophy,
religion, and culture, preserved within the narratives of the Mahabharata, a
formative Hindu epic. A pervasive feature of Hinduism is its oral mode
of transmission. This orality9 implies a reliance on myths and narrative,
and these forms of communication favor open-ended modes of
conceptualization. In these traditions narratives are not utilized to find
“the answer,” or to eliminate options. Rather, myths are used because of
their very pliability, of their tendency to invite alternative options and
9 Lipner’s term, “ A Hindu View of Life,” in The Meaning o f Life in the World
Religions, ed. Joseph Runzo and Nancy M. Martin (Oxford: Oneworld Publications,
2000), 118.
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7
applications. Furthermore, Hindu sacred teachings tend “to work in and
through the oral textual mode.”1 0
By utilizing this ancient epic as a source for ethics and exploring
how it deals with issues relating to the challenges of having children, I
obtain a unique and relevant entry point into the central sacred teachings
of the Hindu traditions. By cultivating a dynamic conversation among
many voices, I both demonstrate and emphasize some of the defining
elements of these traditions, most noticeably, plurality and open-endedness.
Finally, by working from within this epic narrative, I participate in, and
contribute to, an ever evolving, dynamic “Hindu” dialogue.
Religious Diversity in The United States of America
Ethnic and religious diversity is an ever-expanding
Angeles and throughout the United States of America.1 1
1 0 Lipner, “A Hindu View of Life,” 118.
“Because of the high premium placed on the separation of church and state, the
United States government does not collect religious information from its citizens.
However, in recent years The Graduate Center of the City University of New York has
conducted two nation-wide surveys. The first, National Survey of Religious Identification
(NSR1) was taken in 1990 and the second, American Religious Identification Survey
(ARIS) was taken between February and April, 2001. While the NSRI questioned
113,723 individuals regarding their religious preferences, it did not ask the respondents
questions regarding their religious beliefs, involvement and religious composition of their
families. Taking the results of the 1990 survey into account, the ARIS interviewed fewer
people, 50,281; however additional, more detailed questions were asked. For the sake of
analytical depth, the ARIS also interviewed a sub-sample of approximately 17,000
households asking them additional questions regarding religious beliefs, affiliation, etc.
The Graduate Center of the University of New York, American Religious Identification
Survey http://www.gc.cuny.edu/studies/innovations.htm. 4/23/2002. The results and
reality in Los
In her book A
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8
N e w Religious America: H o w a “ Christian Country” Has Become the
W orld’ s M ost Religiously Diverse Nation, Diana Eck records an image of
what she calls a “New America.” Though religious pluralism may have
been a part of this land from the beginning,1 2 Eck argues that the
immigrants of the past thirty years have dramatically and exponentially
expanded the religious diversity of this country. “We the people of the
United States of America” now include Buddhists originating from all over
Asia; Hindus from India, South Africa, and Trinidad; Muslims from
Indonesia, the Middle East, and Africa. Contemporary communities in
the United States are comprised not only of individuals espousing religious
traditions indigenous to the countries from which they came, these
communities also contain various ethnic and cultural expressions of the
long established traditions such as Catholicism and those within
analysis of the NSRI study is written up in: Barry A. Kosmin and Seymour P. Lachman,
One Nation Under God: Religion in Con temporary American Society (New York:
Crown Trade Paperbacks, 1993).
California, and Los Angeles in particular, is one of the first states in the United
States where its Caucasian population is no longer a majority. Some say, “As goes LA
today, so go our communities tomorrow.” Scott Simon, National Public Radio’s
Weekend Edition, KPCC. 4 May 2002.
1 2 Eck points out how the religious diversity of America began with the variety
of peoples indigenous to this land. The Wampanoags of the Northeast, Seminole of the
South, Blackfeet of the plains, and Apache of the Southeast all had their own cultural
and religious traditions. Diana L. Eck, A N ew Religious America: H ow a “ Christian
Country” Has Become the World’ s M ost Religiously Diverse Nation (New York: Harper
San Francisco, 2001), 36. See also, Roger Finke and Rodney Stark, The Churching o f
America 1776-1990: Winners and Losers in Our Religious Economy (New Brunswick:
Rutgers University Press, 1992).
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9
Protestantism. “We the people” include the Filipino Catholic, Korean
Presbyterian, Shiite Pakistani, Japanese Rinzai Buddhist, Sri Lankan and
North American Theravadan Buddhist, South Asian Vedanta Hindu and
second-generation American-born Hara Krishna.1 3
The diversity of voices comes not only from the variety of
different religious traditions, but also from the different generations
speaking from within and between these religious traditions. Religions
indigenous to India such as Buddhism, Hinduism, and Jainism have been
in North America long enough to have established their own American
expression. Second and third generation American-born Hindus, Buddhists
and others may speak in voices different from their parents and
grandparents, who may have immigrated to the United States decades ago.
Intermarriage between religious and ethnic groups, such as American-born
Japanese-Indians and Pakistani-Latinas, produce yet other voices. Scholars
are beginning to hear these diverse voices and realize their importance.
1 3 Eck, 1-5. One of the first questions in the ARIS was an open-ended question,
“What is your religion, if any?” This question generated over one hundred different
answers, which the surveyors classified into sixty-five different categories. Beyond
membership in organized religious traditions, the ARIS asked a question regarding
whether the interviewees considered their outlook on life to be essentially religious or
secular. To the question: “ When it comes to your outlook, do you regard yours as 1)
Secular, 2) Somewhat Secular, 3) Somewhat Religious, or 4) Religious.” Respondents
were able to indicate if they were unsure or a little of both. While Seventy-five percent
described their outlook as religious or somewhat religious, only sixteen percent indicated
their outlook was secular or somewhat secular, http://www.gc.cunv.edu/studies/key
fmdings.htm. 4/23/2002.
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10
Religions, as eloquently described by Eck, “are not like stones passed from
hand to hand through the ages. They are dynamic movements, more like
rivers-flowing, raging, creative, splitting, converging.”1 4 As religions once
foreign to the United States flow through this country they continue to
create new, American expressions of themselves. Eck’s Pluralism Project
is an example of a study that examines the flow of these new voices of
religion in the United States.
Diversity alone, according to Eck, “does not constitute pluralism
[. . .]. Whether we are able to work together across the lines of religious
difference to create a society in which we actually know one another
remains to be seen.”1 5 Eck laments that though “We the people of the
United States of America” now stands for the most religiously diverse
nation on earth, “We,” the people, are quite uninformed and operate out
of sketchy and stereotypical views of one another. In order to create a
truly pluralistic society in the United States, a society where our great
diversity is not just tolerated but is the very source of our strength, Eck
instructs that “we will all need to know more than we do about one
another and to listen for the new ways in which new Americans
1 4 Eck, 22.
K Ibid
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articulate the ‘We’ and contribute to the sound and spirit of America.”1 6
This work seeks to articulate yet another voice, one that combines the
antiquity of traditional Hinduism with the contemporary context in North
America, and engage in, and contribute to, the specific bioethical dialogues
regarding assisted reproductive technology.
I begin Chapter 2, “Medicine, Bioethics, and Religious Voices,” with
an exploration of the role of religion in the practice of medicine and
bioethics as it is discussed in the academy, the clinical setting, and in the
public sphere. After establishing the importance of religion within these
realms, I turn to a discussion on “Cultural Competency.” This is a term
utilized by healthcare professionals that acknowledges the need to be
understanding as well as sensitive to the different cultures, socio-economic
backgrounds, and belief systems of their patients. Religious beliefs often
play a major role in how people make decisions regarding medical care
and how they think about bioethical issues.1 7 To be truly culturally
competent, health care providers need to guard against assumptions that all
Asian, Latina, Hindu, or Jewish patients fall into particular categories. A
competent care provider examines her patients with great skill and care,
i b Ibid., 6.
1 7 Rozzano Locsin, “ Building Bridges: Affirming Culture in Health and Nursing,”
Holistic Nursing Practice 15:1 (October 2000), 1. Downloaded from http://gateway2.ovid.
com: 80/ovid web .cgi. 5/31/2001.
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12
observes the family dynamics, and listens. Ultimately, one should not
distinguish between culturally competency care and competent care.1 8 In
order to provide optimal care, it is imperative for those working within
the medical field to be informed of, and sensitive to, their own religious
and cultural perspectives, as well as those of their patients.
Though cultural competency does not require full knowledge of
every world religion and culture, being exposed to other worldviews may
provide avenues through which clinicians can broaden their own
perspectives. To this end, I focus on Hinduism. The term “Hindu” is in
many ways artificial and superficial. Although it gives the impression of
referring to a single entity, it is a foreign label for a rough collection of
related, yet quite diverse, social, religious, cultural, and philosophical
traditions originating from within India. Just as great diversity exists
within Jewish and Christian traditions, such that one cannot speak of “the
Jewish” or “the Christian” perspective on any topic, it is even more so
the case when attempting to discuss “the Hindu” perspective on specific
issues. This conglomeration of Hinduism has no Pope or Magisterium, no
central, over-arching authority figure or governing body. Nevertheless, out
of the many important systems of thought available within Hinduism, this
1 8 Mary K. Canales and Barbara Bowers, “Expanding Conceptualizations of
Culturally Competent Care,” Journal o f Advanced Nursing 36:1 (October 2001), 102-111.
Downloaded from httpaZ/gatewayl.ovid.cQm:.8J3Zovidw£b.cig. 3/18/02.
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13
study is strongly influenced by the Advaita- Vedanta school, a dominant
and fairly pervasive school of thought. This focus, in no way,
underestimated the plurality inherent within the Hindu traditions. It is
not my aim to construct the definitive Hindu ethic, for this is obviously
an impossible task. It is rather my goal to emphasize selected strands
within Hinduism’s multivalent traditions to discuss various ethical issues
regarding assisted reproductive technology. Its acceptance of differing
beliefs, practices, and truths provides a good model for how clinicians,
patients, theologians, and philosophers might communicate within this
pluralistic, contemporary world.
The third chapter, “Voices from Hinduism’s Past,” provides a brief
synopsis of the Mahabharata and establishes its role and importance in
Indian and Hindu society and culture. Then I recount the stories of how
three queens, KuntI, MadrI, and Gandharl, overcome challenges of
infertility and not only provide heirs for their husbands, but also the
descendants upon which this ancient epic revolves. Finally, I extrapolate
elements within the paradigmatic narratives that are relevant to modern
discussions on assisted reproductive technology. These points of contact
do not make one-to-one correlations between antiquity and modernity;
rather they are designed to indicate similarities in struggles, principles and
ideas.
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14
In these epic narratives, KuntI, and MadrI circumvent a curse placed
upon their husband Pandu by utilizing a mantra that allows them to call
upon the gods of their choice to impregnate them. They overcome
Pandu’s impotency and together bear five sons by implementing techniques
that find some resonance with modern assisted reproductive technology.
While KuntI and MadrI access a “divine sperm bank” to get pregnant,
women living in this century have access to donor artificial insemination
(DAI), i n vitro fertilization (IYF), and surrogacy.
One could argue that the situation of Gandharl and Dhrtarastra,
Pandu’s elder brother, is even more contemporary than that of KuntI and
MadrI. After being pregnant for over twenty-four months, Gandharl
forcefully expels her product of conception— a round fleshy mass
resembling an iron ball. She enlists the aid of Vyasa, sage and legendary
author of the Mahabharata. Together they sprinkle her product of
conception with water and it falls apart into 100 thumb size pieces.
They place each embryo in a clay pot full of ghee (clarified butter) and
incubate them in a warm dark place. Again, correlations can be made
between Gandhari’s actions and modern fertility technology. While she
relied on the powers of an ascetic sage, women living today may utilize
fertility medications, embryonic transfer, gamete intrafallopian transfers
(GIFT), zygote intrafallopian transfers (ZIFT), and other forms of assisted
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15
reproductive technologies. These, and other “points of contact” provide
fertile ground upon which to discuss the ethical issues regarding infertility
and assisted reproductive technology.
Working from the Mahabharata narratives, the fourth chapter,
“Narrative as a Source of Ethics,” begins with an exploration of three
topics extrapolated from the above stories: 1) the priority placed on
having children; 2) an acceptance of a variety of creative means to
produce children; however, this procreative “technology” is to be utilized
within particular limits; and 3) the active role some women take in
controlling their reproductive choices. The implications of these ancient
narratives are intriguing and insightful when brought into contemporary,
comparative discussions. To demonstrate points of comparison, a few of
these Hindu perspectives are juxtaposed with those present in the Hebrew
Scriptures, New Testament, and Roman Catholic teachings.
Prior to analyzing particular Hindu bioethical perspectives on
assisted reproductive technology, it is important to have an underlying
understanding of the traditions within Hinduism. Therefore, Chapter 5,
“Characteristics of Hindu Thought,” presents a careful exploration of the
selected Mahabharata narratives discussed in the second chapter of this
work. I draw out five key characteristics that are primary elements
within Hindu worldviews. The stories of KuntI, Gandharl, and others
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16
within this epic demonstrate a commitment to a variety of beliefs and
presuppositions. Dominant and central to most are the following: 1) the
centrality of society; 2) the belief in an underlying unity of all life; 3) the
responsibilities and flexibility of dharma\ 4) the multivalent nature of
Hinduism; and 5) a theory of karma.
Chapter 6 is an “Application of Hindu Thought.” Most, if not all,
the writing on Hindu ethics in general, and bioethics in particular, is
based in interpretations of primary texts and remains very theoretical:
Sources regarding applied Hindu ethics are scarce. My task in this
chapter begins by directly applying the five elements of Hindu thought to
a particular case, namely that of Jaycee Buzzanca. Unable to have
children through conventional means, her intended parents, John and
Luann Buzzanca, obtained donor gametes and through IVF had a willing
surrogate, Pamela Snell, gestate and carry Jaycee to term. A month prior
to Jaycee’s birth John filed for divorce and denied Luann’s request for
child support. At one point in the legal proceedings of Jaycee’s case, she
was referred to as “a reproductive technology created orphan.”1 9 Her case
highlights many of the legal and ethical challenges associated with assisted
reproductive technology. I examine the ethical complexities through the
1 9 Howard Jones W. Jr. and Susan Cockin, “On Assisted Reproduction, Religion
and Civil Law” Fertility and Sterility 73:3 (March 2000). Downloaded from
http://gateway.ovid. com/re!410/server 1 / ovidweb. cgi. 8/1/00.
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lenses of the above key elements of Hindu thought and other relevant
Mahabharata narratives.
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CHAPTER 2
MEDICINE, BIOETHICS AND RELIGIOUS VOICES
In recent years, the demographics of the population of the United
States have been changing throughout the entire country. Populations in
the U.S. that previously had little to no exposure to people from cultures
and faiths other than their own, now have thriving communities of
individuals from various parts of the world.2 0 The increase in diversity
comes from immigrants who establish themselves in this country and then
bring their families. Additional factors that exponentially increase the
cultural, religious, and ethnic diversity comes from the fact that people
from Africa, Asia, Latin America, and other areas have been established in
the U.S. long enough to have the second and third generations of their
families being born and reared in this country. As these American-born
generations mature, they often develop their own expression of their
religious and cultural backgrounds. Furthermore, as individuals from these
various groups interact, form relationships, and marry, there is a blending
of perspectives leading to the development of yet other worldviews. This
diversity of religions and cultures, and their multiple expressions, has had
2 0 Susan Salimbene, “Cultural Competence: A Priority for Performance
Improvement Action,” Journal o f Nursing Care Quality 13:3 (February 1999):
unpaginated. Downloaded from http://gatewav2.ovid.com:80/ovidweb.cgi. 5/31/01.
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19
profound impacts on healthcare, on the concept and delivery of quality
care, and on how bioethical issues are understood.
Bioethical discussions have been occurring in three different arenas:
the academy; the clinical setting; and in public policy forums. At its
genesis in the early 1960s, theologians played formative roles in the field
of bioethics. However, as time passed, these primarily biblically based
religious perspectives have been dominated by secular, universal, more
philosophical voices in leading textbooks and at leading bioethics centers.
This marginalization of primarily Christian voices dominated the academic
discussions, and in turn, this development influenced the clinical and
public policy settings. Although religion may have been down played to
some extent in the academy, in the clinical settings and public policy
arenas, religion indirectly and explicitly continues to permeate the
experiences of those actually engaged in bioethical struggles at the bedside.
Although the de-emphasis of religion in the academy has had some
influence in the clinical and policy realms, the significance and reality of
religious belief for both patients and practitioners as they face difficult,
wrenching decisions, is evident. The power and influence of these clinical
experiences in turn affect the position of religious voices within the
academy and public policy arena.
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After presenting a brief historical account of the relationships
between religion and the practice of medicine, medical ethics, and
bioethics, I present a discussion on the academy regarding whether, and to
what extent, religious voices have been marginalized. I then turn to the
clinical setting and demonstrate how and why religious voices have
continued to sustain those living in the bioethical struggles. As one who
is in both the academy and the clinical realm, I am well aware of the
various ethical theories, and I know and have experienced the struggles in
the clinical arena as well. Because the academy is dealing with
hypothetical situations or case studies, it often has the luxury of
demanding helpful, consistent, and universally applicable theories.
However, when facing practical, complicated, and disturbing circumstances,
the clinicians and patients often expend their energy on simply surviving
or making it through to the next shift. Repeatedly, it is the religious
convictions of both clinicians and patients that enable them to struggle
through the actual ethical ordeal.
Though calls for consistency, rationality, and universal applicability
influence and are important for the clinical setting, they are usually not
its primary focus. I propose that the questions and experiences of those
in the clinical environment became a powerful influence, and perhaps
played a role in a shift that occurred within both the academic field of
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21
bioethics and the realm of public policy. In the 1990s, the same scholars
who argued for the marginalization of religion within bioethics, began
acknowledging the cost of excluding religious voices, and they began
reevaluating the contributions of religion. When struggling with the issues
of birth, life, and death, many turn to some form of religious or spiritual
counsel and support.
Having demonstrated the influential role of religion in the clinical
setting, and its subsequent influence in the academy and public policy, I
will argue that bioethical discussions need to be broadened to include
religious traditions beyond those grounded in Christianity and Judaism. If
doctors, nurses, and other healthcare professionals desire to administer
quality, culturally competent care, they must take both their own, and
their patients’, religious perspectives and commitments into serious
consideration. In this pluralistic world, where countless ideas and
worldviews are continually coming into contact, Hinduism, with its
multitude of traditions and 333,000,000 gods, provides an exemplary model
for how individuals can function, communicate, and make difficult moral
decisions in and amongst the chaos of life.
Relationship Between Religion, Medicine and Bioethics
There is a well-established relationship between the practice of
medicine, medical ethics, and religion. In their essay “What is Bioethics?
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2 2
A Historical Introduction,” Kuhse and Singer indicate that for many
cultures the religious leader and healer was one and the same individual.
For example, often the shaman was both the doctor and priest,
simultaneously utilizing herbs, exorcisms, and prayers to heal the members
of the community.2 1 The ancient Indian A yurvedic tradition provides
another excellent example of an inextricable connection between the
medicine of the Vedic Indians and their religion. According to Prakash
N. Desai, this Hindu medicine never became divorced from the rest of
life’s pursuits, especially not from the religious life.2 2 According to the
father of medicine in China, Sun Ssu-miao, medicine “is an art which is
difficult to master. If one does not receive a divine guidance from God,
he will not be able to understand the mysterious points [. . .].”2 3 Martin
Marty reminds us that Judaism, Christianity, and most of the world’s
religions began, developed, and continue as healing cults.2 4 Relationships
2 ‘Kuhse and Singer, 4.
2 2 Prakash N. Desai, Health and Medicine in the Hindu Tradition: Continuity and
Cohesion (New York: Crossroad, 1989), 12; See also: Kenneth G. Zysk’s book, Medicine
in the Veda: Religious Healing in the Veda (Delhi: Mondial Banarsidass Publishers, 1998).
2 3 Tao Lee, “ Medical Ethics in Ancient China,” in Cross Cultural Perspectives in
Medical Ethics: Readings, ed. Robert M. Veatch (Boston: Jones and Bartlett Publishers,
1989), 132. For more on medicine in China see, Charlotte Furth, A Flourishing Yin:
Gender in China’ s Medical History, 960-1665 (Berkeley: University of California Press,
1999).
2 4 Marin E. Marty, “ Religion, Theology, Church and Bioethics,” Journal o f
Medicine and Philosophy 17:3 (June 1992): 280-281.
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23
between the practice of medicine and various Western religious
perspectives, primarily Protestant, Catholic, and one Jewish tradition, are
the focus of the book Caring and Curing: Health and M edicine in the
Western Religious Traditionslb
The association between religion and medical ethics also extends
into antiquity. Kuhse and Singer trace a connection that includes eras
that pre-date the Oath of Hippocrates. In the sanctuary of Asclepias
there is a monument that instructs doctors to be like God; to treat, heal
and be a savior of slaves, of paupers, of rich men, and of princes.2 6 In
the same vein, Sun Ssu-maio calls on a physician to have mercy on all
those who suffer and are sick. Being guided by God, the doctor should
“pledge himself to relieve suffering among all classes. Aristocrat or
commoner, poor or rich, aged or young, beautiful or ugly, enemy or
friend, native or foreigner, and educated or uneducated, all are to be
“Ronald L. Numbers and Darrel W. Amundsen, Caring and Curing: Health and
Medicine in the Western Religious Traditions (New York: Macmillan Publishing
Company, 1986).
2 6 They also cite various texts from antiquity and discuss connections between the
Hippocratic Oath and Christianity. Kuhse and Singer, “ What is Bioethics?, 4-5. Isabel
de la Fuente Fonnest and others argue that there’ s a strong relationship between
individual attitudes toward assisted reproductive technologies, professions, and religious
convictions. “Attitudes Among Health Care Professionals on the Ethics of Assisted
Reproductive Technologies and Legal Abortion” ACTA Obstetricia et Gynecologica
Scandinavica 79 (January 2000). Downloaded from
2/ 21/01
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2 4
treated equally.”2 7 According to the Indian Caraka Samhita, a physician-in-
training first devotes himself to the guru. After he is instructed in the
sacred fire ceremonies, then he is taught the healing arts and charged to
serve and heal everyone equally “without arrogance, with care and
attention and with undistracted mind, [and] humility [. . .].”2 8 These
ancient texts contain fluidity between the practice of medicine, religion
and a code of ethics as to how the physicians are to conduct themselves.
Ethical discussions regarding the practice of medicine underwent
major developments in the 1960s. Many ethical issues arose as a result of
social, cultural, and political changes of the time. Significant advances in
biomedical science, and their clinical applications, such as heart
transplantation and dialysis, became a driving force that brought about a
revival in medical ethics. Advancements in such fields as recombinant
DNA and gene therapy contributed to the development of what is now
called “bioethics.” By the end of the 1960s and 1970s, medical technology
extended the possibilities of human life in both directions. On the one
hand, dialysis machines, mechanical ventilators, and organ transplant
technology prolonged the lives of those who would have otherwise died.
2 7 Tao Lee, 133.
2 8 Caraka Samhita as cited by K.R. Srikanta Murthy, “ Professional Ethics in
Ancient Indian Medicine,” in Cross Cultural Perspectives in Medical Ethics: Readings, ed.
Robert M. Veatch (Boston: Jones and Bartlett Publishers, 1989), 131.
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On the other hand, assisted reproductive technologies enabled women to
give birth to children in ways never before imagined.2 9
Developments in assisted reproductive technologies raise challenging
new issues surrounding the beginning of human life. For example, 15
July 1978 marks the birth of Louise Brown, the first baby born as a
result of in vitro fertilization (IVF). This in vitro technology allowed one
woman to donate her oocytes and embryos to another. The development
of embryo cryopreservation and thawing techniques led to the first live
birth from these techniques in 1984. Further developments in gamete
intrafallopian transfers (GIFT) and zygote intrafallopian transfers (ZIFT)
became available in 1985 and 1986 respectively.3 0 These technologies lead
to questions, ethical issues, and choices between options that were
previously known only within the imagination, but unknown in the
realities of daily life.
Questions and issues raised by the challenges of, and advances in,
biomedical technology, are not simply medical; they are moral as well.
For example, a majority of the debates regarding the utilization of human
embryonic stem cells revolves around the question, what is the moral
2 9 Kuhse and Singer, 7-10.
3 0 Inmaculada De Melo-Martin, Making Babies: Biomedical Technologies,
Reproductive Ethics and Public Policy (Boston: Kluwer Academic Publishers, 1998), 52-54.
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2 6
status of the embryo or fetus? Debates over human cloning are often
contentious because they highlight issues regarding what it means to be a
unique individual. What is the definition of human? Abortion raises the
moral question of when human life begins. When is the fetus considered
a human person, entitled to rights and protection afforded other human
beings? Other examples of how these medical advances can be moral
issues become evident when one considers questions of justice: How just is
it to spend close to one million dollars to save one 25-week premature
baby, while the health of children in the same city, in the same
neighborhood, is threatened by malnutrition and lack of immunization?
These questions and moral dilemmas inevitably involve the significance of
life, suffering and death, and are addressed by religious traditions.3 1
Throughout history, birth, life, and death are draped and cradled in the
garments of religious rituals and religious beliefs.
Just as religion has played a role in the practice of medicine and in
the development of medical ethics, so too religion was present and played
a formative role at the genesis of the bioethics revival. According to
David H. Smith, “religious thought was important to the revival, not just
accidental.” Protestants such as Joseph Fletcher, Paul Ramsey, and James
3 'Lynda Beck Fenwick, Private Choices, Public Consequences: Reproductive
Technology and the N ew Ethics o f Conception, Pregnancy, and Family (New York:
Dutton, 1998), 300.
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27
M. Gustafson, Roman Catholic moral theologians Richard McCormick,
Charles Curran, and Germain Grisez, along with David Feldman and
Immanuel Jakobovits, Jewish theologians, were all participants in this
revival. Callahan describes a situation where, through the mid-1960s the
on ly resources for bioethics were in some way or other based in
religion.3 2
Along with being founders in the field of bioethics, these religious
thinkers served as members of formative committees such as The National
Commission of the Protection of Human Subjects of Biomedical and
Behavior Research (1974), and The President’s Commission for Study of
Ethical Problems in Medicine and Biomedical and Behavior Research
(1979).3 3 The Institute of Religion, founded in 1954 at the Texas Medical
3 2 Kuhse and Singer, “What is Bioethics?, 3; Verhey, “ Introduction,” 2; Smith,
“Religion and the Roots of the Bioethics Revival,” 9; Baruch Brody, “Religion and
Bioethics,” in A Companion to Bioethics; Kuhse and Singer, “What is Bioethics?” 4-6;
Lisa Sowel Cahill, “Religion and Theology,” in Methods in Medical Ethics, ed. Jeremy
Sugarman and Daniel P. Sulmasy (Washington: Georgetown University Press, 2001);
Daniel Callahan, “Religion and the Secularization of Bioethics,” Hastings Center Report
20:4 (July/August 1990), 2.
“Unethical experiments conducted on human subjects, such as those conduced at
the Tuskegee Institute, impelled the U.S. Congress to establish the National Commission
for the Protection of Human Subjects of Biomedical and Behavioral Research. Along
with publishing the Belmont Report that articulated the ethical principles that the
Commission felt should govern research on human subjects, the Commission also
instituted the establishment of Institutional Review Boards (Kuhse and Singer, 10). While
Cahill and Lammers emphasizes that various Christian and Jewish theologians and
philosophers were members of these committees, Callahan argues that the reports
generated by these committees, specifically the 1978 Belmont R eport issued by the
National Commission, did not have a trace of religious influence in their wording.
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2 8
Center, sponsored one of the first major bioethics conferences in the
United States in the late 1960s. Joseph Fletcher, Paul Ramsey, and other
Christian thinkers presented major addresses at this conference.
Additionally, Christian theologians and philosophers played a role in the
formation of the field by helping to create various bioethics institutes such
as the Kennedy Institute of Ethics at Georgetown University and the
Institute for the Study of Society, Ethics, and the Life Sciences, now
known as the Hastings Center in New York. Many Christian theologians
and philosophers were also the primary contributors to the first edition of
the Encyclopedia o f Bioethics?*
These religiously informed thinkers were so influential at the
formation of the field of bioethics because, as Smith concludes, “The
religious traditions, or communities of discourse, or spokespersons were
listened to precisely because it was obvious that they had something
important to say.”3 5 Cahill argues that these individuals “were particularly
well equipped to advance medical ethics because religious communities had
cultivated long-standing traditions of reflection on life, death, and suffering,
and had given more guidance on the specifics of moral conduct than had
3 4 Baruch Brody, “Religion and Bioethics,” 4-6; Cahill, “Religion and Theology;”
Verhey, “ Introduction;” Smith, “Religion and the Roots of the Bioethics Revival.”
3 5 Smith, “Religion and the Roots of the Bioethics Revival,” 15.
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29
moral philosophy at the time.”3 6 Citing Weber, Campbell remarks that
the religious perspectives provide an interpretation of reality that responds
to the ‘ “metaphysical needs of the human mind’ to seek order, coherence,
and meaning in our lives, to understand ultimate questions about our
nature, purpose, and destiny.”3 7
Marginalization of Religion in the Academy
Despite the contributions of religion to the origins of modern
bioethics, there are those who argue that the field, as it developed in the
public sphere in the United States, effectively excluded religious voices.
As the field of bioethics came of age in the 1960s, secularism reached its
peak as a social movement in this country.3 8 In his essay “Religion,
Theology, Church, and Bioethics,” Marty argues that this marginalization
is grounded in “liberal culture” and “late Enlightenment rationality.”3 9
This intellectual movement set up a dichotomy between reason and
faith, secular and religious realms of existence. The secular, scientific,
3 6 Cahill, “Religion and Theology,” 50.
3 7 Courtney S. Campbell, “Religion and Moral Meaning in Bioethics,” Hastings
Center Report 20:4 0uly/August 1990): 5.
3 8 Jampes P. Wind, “What Can Religion Offer Bioethics,” Hastings Center R eport
20:4 0uly/August 1990): 18.
3 9 Marty, 273-274; David DeGrazia and Tom Beauchamp, “ Philosophy” in Methods
in Medical Ethics, ed. Jeremy Sugarman and Daniel P. Sulmasy (Washington: Georgetown
University Press, 2001), 32-33; Callahan, “Religion and Secularization of Bioethics,” 4.
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30
public realm was understood as being grounded in the rational and
universal. Good academic judgments were said to be grounded in
empirical evidence and confirmable by any person who has the ability to
reason. On the other hand, religion and the private realm were based on
faith, on the emotional, and the irrational. Lammers argued that the
marginalization of religion occurred within bioethics. He named three
specific realms of discourse where bioethics strove to overcome various
fractious and lethal religious divisions: the academy, public policy, and
clinical setting.4 0
In this environment, there was neither room nor a perceived need
for the particular voice of religion in academic bioethical discussions. An
examination of the table of contents of standard bioethics textbooks, such
as Beauchamp and Childress’ Principles o f Biomedical Ethics, Shannon’s
Introduction to Bioethics and Mappes and DeGrazia’s Biom edical Ethics,
seems to support this notion. Although some of the writers in these
texts may be theologians, one finds no direct mention of religion.
Another example of this shift away from religion is evident in
Callahan’s portrayal of his own adjustment in orientation. Throughout
4 0 Stephen E. Lammers, “The Marginalization of religious Voices in Bioethics,” in
Religion and Medical Ethics: Looking Back, Looking Forward, ed. Allen Verhey (Grand
Rapids: Eerdmans Publishing Company, 1996), 19-43. See also: Marty, “Religion,
Theology, Church, and Bioethics.” These authors agree that marginalization does not
mean total absence of religious voices.
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much of the 1960s, he describes himself as a “religious person” who “had
no trouble bringing that [religious] perspective to bear on the newly
emergent issues of bioethics.” By the end of the 1960s his religiosity had
declined and all but disappeared. His academic training as an analytic
philosopher convinced him that “moral philosophy, with its historical
dedication to finding a rational foundation for ethics, was well suited to
biomedical ethics.” Since religion had become unnecessary in his personal
life, Callahan questioned its relevance to bioethics and the “collective
moral life.”4 1
With the emphasis on secularism and the rise of religious pluralism,
many reflected Callahan’s attitude and argued that ethical and moral
discussions in the academic public square ought not to include God or
religion. According to this argument, pluralism precludes the possibility
of there being “any infallible way” of concluding debates where a single
religious system is the clear winner. According to Richard Holloway,
morality must be based on observed consequences, not beliefs or
superstitions; if an action is wrong, it is wrong because it harms someone,
or violates their rights. He maintains that:
This is why the use of God in moral debate is so
problematic as to be almost worthless. We can debate
with one another as to whether this or that alleged claim
genuinely emanated from God [. . .]. That is why it is
4 1 Callahan “Religion and the Secularization of Bioethics,” 2.
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3 2
better to leave God out of the moral debate and find good
human reasons for supporting the system or approach we
advocate, without having recourse to divinely clinching
4)
arguments.
Holloway obviously believes that one can construct a rational, neutral and
universally acceptable morality. He and other scholars acknowledge that
while, at the beginning of the modern revival of bioethics, religion may
have played a formative role, its influence has rapidly declined and
philosophical categories “more acceptable to the majority of persons,”
became prominent.
There are various analyses that support the argument that religious
voices have been marginalized in the public sphere and particularly in
bioethical discussions. A standard work discussing the notion that religion
was marginalized in the public arena is Stephen L. Carter’s, The Culture
o f Disbelief: H o w American Law and Politics Trivialize Religious
D evotion. Carter does not specifically address the issue of marginalization
in bioethics; nonetheless, his comments are applicable to our discussion.
According to Carter, though millions of individual North Americans in
the United States take their religious commitments very seriously, the
culture in which they live does not. He describes the many ways
4 2 Richard Holloway, Godless Morality: Keeping Religion O ut o f Ethics
(Edinburgh: Canongate, 2000), 14, 19-20.
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33
modern culture in this country trivializes religious devotion and often
discourages religion as a serious activity.4 3
Cahill and others demonstrate how, as a result of the secularization
of this society, even when religious communities choose to enter academic
and public policy discussions, the conditions under which they participate
in effect marginalizes them. They argue that religious discourse in
bioethics is limited because, when in the public square, religions are
required to utilize a “public language,” as opposed to the religious
language of their particular communities. Religious scholars started
operating more like philosophers, attempting to rely more on moral
principles that they felt could plausibly claim to be universal, rational and
“secular.” Additionally, they worked toward developing policy and
decision-making resolutions that would coincide with legal traditions of the
United States and command public support. This hindered and distorted
the religious message, thereby marginalizing it.4 4
In addition to the milieu of secularism and pluralism, Callahan and
others argue that there are issues internal to the religious traditions that
contributed to their being marginalized in the academy, public policy, and
4 3 Stephen L. Carter, The Culture o f Disbelief: H ow American Law and Politics
Trivialize Religious Devotion (New York: Anchor Books, 1993), specifically chapters 2-5.
4 4 Cahill, “Religion and Theology,” 50-51; Campbell, “Religion and Moral Meaning
in Bioethics,” 5-6; Lammers, 37-39.
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3 4
clinical settings. Callahan suggests that during the 1970s, the theological
seminaries and university departments of religion were drawn more to
issues of urban poverty and race, and to questions of world peace in the
nuclear age, not bioethics. Consequently, since these traditions were
focused on other issues, religious voices faded in bioethics. Another
internal contributing factor was attributed to confusion as to the role of
religion. According to this argument, leaders in some religious traditions
could not decide if it was their responsibility to stand over against
culture, transform it, or speak for it.
Thus, because of religion’s own uncertainty, the influence of the
secular movement, the pluralistic character of the day, and the way in
which the field itself was moving, scholars have argued that religious
voices were marginalized in academic bioethics.4 5 Furthermore, as
bioethical arguments entered more into public awareness, interests
commanding the attention of the courts, legal system, medical professions,
and other professional societies, there was increased pressure to utilize
secular language and models to frame and discuss the issues. Callahan
points to the 1975 case of Karen Ann Quinlan as an indication that the
secular legal system would take the lead in bioethics. Henceforth, the
4 5 Callalian, “Religion and Secularization of Bioethics,” 3; Lammers, 37-39;
Campbell, “Religion and Moral Meaning in Bioethics,” 5.
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35
cases in this field would be providing the courts with challenging legal
cases for which no precedents had been set.4 6
Religious Voices and the Clinical Arena
Marty, Callahan and others present convincing arguments indicating
that religious voices have, at least to some extent, been marginalized
within the academy and public policy arenas. Lammers acknowledged that
this marginalization of religion in these realms has influenced the clinical
setting. On the one hand, the emphasis on secularism influenced the
dialogues within the practice of medicine. As a result, the language of
the consumer market dominated, leading to an emphasis on autonomy and
a market model of medicine. This new model addressed neither the limits
of what medicine could do nor issues of human finitude. Furthermore,
Lammers commented on how there seemed to be a decrease in the service
orientation of the medical profession. On the other hand, he indicated
how clinicians he worked with took the religious beliefs of their patients
seriously. They also saw it as part of their job, as healers, to address
their patients’ religious commitments and concerns. According to him,
“insofar as religious voices have been muted or marginalized, the
profession has lost a resource for self-correction that once was available to
4 6 Callahan, “Religion and Secularization of Bioethics,” 3.
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36
it.” Changes were occurring within the practice of medicine during this
time, however, even Lammers admits they could have been unrelated to
the fields relationship with religion.
However accurate the argument for the marginalization of religion
may be in the academy, this is not the case for the clinical setting.
Ultimately, in the midst of actual hospital experiences, where individuals
are struggling with life and death issues, patients and clinicians alike find
it difficult, if not impossible, to discuss these situations without references
to religious beliefs. While working as a registered nurse in labor and
delivery, I had a patient who became pregnant after a third GIFT (gamete
intra-fallopian transfer) attempt. After three zygotes implanted in her
uterus, the doctors offered to “selectively reduce” one of the developing
embryos, thereby increasing the chances for a healthier birth of the
remaining two babies and somewhat decreasing some of the risk associated
with multiple gestational pregnancies. Even months later, as she retells
her story to me, she is shaking her head in disbelief saying, “I couldn’t
do that. I couldn’t let them kill one of my babies. God gave me these
three precious gifts and I have to take care of them.” She named each
fetus, and as they developed one was diagnosed with anencephaly. She
cried. Though she was well aware that “ Joey,” the anencephalic baby,
“didn’t have a brain” and would not live long after birth, she again
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refused the offer of selective reduction. She argued that God gave this
baby life, however short, and she could not end it. She continued to
nurture and talk about, and to, all three of her babies as equals. When
the triplets were born, she and her husband held Joey until he died.
For this patient and her family, constructing rational, universally
acceptable responses to the issues and questions of assisted reproductive
technology, abortion, and personhood were not foremost in their minds.
On the one hand, she seemed to have no problem utilizing medical
technology in order to conceive; moreover, she attributed its success to
God. On the other hand, she refused to utilize this technology, even if
it might enhance her health and the health of the remaining fetuses,
arguing that it would be going against God’s plan. She was not
concerned about this apparent inconsistency. Neither was she concerned
about questions and definitions of personhood. Joey, as a developing
fetus, did not even have the potential to become an adult human being.
He most likely was not self-aware and would never know her, yet she
treated him and referred to him in the same manner as she did her other
“babies.” Her religious beliefs not only guided her actions, they brought
her comfort in the end.
Cahill eloquently identifies how and why religion is so inextricably
related to bioethics and the clinical setting. She says:
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Because they deal in the elemental human experiences of
birth, life, death, and suffering, the biomedical arts provide
an opening for larger questions of meaning and even of
transcendence. Religious themes and imagery can be
helpful in articulating these concerns and addressing them
in an imaginative, provocative, and perhaps ultimately
transformative way. Religious symbolism may be grounded
in particular communities and their experiences of God and
community, but perhaps it can also mediate a sensibility of
transcendence and ultimacy that is achingly latent in the
ethical conflicts, tragedies and triumphs that are unavoidable
in biomedicine.
She continues, “[• . .] ethics opens onto the transcendence that human
persons and communities encounter most fulfilling in the limit experiences
of life, suffering, and death, and that compassionate and just solidarity in
these experiences defines personal and social virtue in the medical
context.”4 7 Though modern medical technology can assist us in healing, in
bringing forth new life, and in extending life, it does not enable us to
answer challenging questions such as: What does it mean to be human?
When, if at all, does ensoulment occur? What is personhood? What
happens when, or after, I die? The practice of medicine often intersects
with our definitions and our understanding of what it means to be
human. It brings to the forefront questions of mortality and meaning.
These questions and issues are raised and are the focus of many religious
discussions.
4 7 Cahill, “Religion and Theology,” 63-64.
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For many clinicians, arguing that religious voices are marginalized is
odd. Such attitudes not coincide with the practical experiences of many
patients and health care professionals who are living the bioethical
dilemmas. Lammers writes:
[. . .] the reality of finitude takes on an immediacy that
can be hidden from us in other settings. Academicians and
public policy persons can operate as if finitude were an
illusion or a bother; nurses and physicians do not have that
luxury.4 8
The practice of medicine often engages human experiences at moments of
intense fear, joy, and unspeakable sorrow. In these moments, for many,
religion is not some theoretical, abstract, academic concept. Religion is
the space in which these individuals can both express their joys and
struggle with the realities of suffering and death. It is the place people
often turn to for meaning and sustenance. Religion is also a thread of
connection, to tradition, to the past, to others, and to the future; it is
often the thread of hope, and the thread that binds individuals together
and helps them move forward in joy or sorrow.4 9
^Lammers, 27-28.
4 9 Though every patient, family member, and healthcare provider may not turn to
organized religion in these times, most of them, in some way, interpret, and engage their
experience on both a conventional and ultimate level. In this work, “religion” is not
necessarily a separate entity. Along with referring to the actuality of living life, it refers
to the space in which individuals struggle with the realities of life, seek for meaning, and
relate to ultimate and unconditioned reality. Though organized, official religious
traditions are included in this space, it is not exclusive to them. This broad
understanding of religion is reflective of a Hindu influence.
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Reemergence of Religious Voices in the Academy and Public Policy
Forums
The influence of religion has remained a compelling force within
the clinical setting, in part because patients and clinicians alike, engaged in
the struggle of bioethical situations, call upon, address their concerns to,
and find comfort in their various religious convictions. The continuance
of religious voices in the clinical setting, has perhaps in some way affected
the academy. In the early 1990s, many of the same scholars, who once
argued for the marginalization of religion began acknowledging the cost of
excluding religious voices and began reevaluating its contributions.
Campbell states it well when he writes: “If it was premature to pronounce
‘the death of God’ in the 1960s, it seems equally mistaken to begin doing
post-mortems on the demise of theological and religious perspectives in
bioethics.”5 0
Callahan, a philosopher who claims to have shed his unnecessary
Christian identity, acknowledges that “whatever the ultimate truth status
of religious perspectives, they have provided a way of looking at the
world and understanding one’s own life that has a fecundity and
uniqueness not matched by philosophy, law, or political theory.” He goes
on to question:
5 0 Campbell, “Religion and Moral Meaning in Bioethics,” 5.
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Can those of us who share my lack of belief still make
sure of at least some of the insights and perspectives of
religion, even as we reject its roots? [. . .]. Is it wrong,
or a form of illogical sentimentality, to continue feeding off
of religious traditions and ways of life that one has, in fact,
rejected at their core? Does intellectual honesty demand
that we have the courage of our convictions (or lack
thereof) and construct our view of the world out of the
whole cloth of unbelief, not borrowing to suit our own
purposes those valuable bits, pieces, and parts of a garment
we have thrown off?5 1
Callahan’s statements and questions most likely reflect influences from
both enlightenment ideology and Christianity. They also reflect some
remorse at his inability, or at least hesitancy, to utilize the resources of
his religious tradition.
He and others identify a number of problems and limitations when
religion is not included in bioethical discussions. First, in rejecting
religion, one is closing one’s eyes to and making unavailable all the
accumulated wisdom and knowledge of long-established religious traditions.
One need not be a Hindu, Jew, or Christian to benefit from the wisdom
and experiences of the past and others. Another result of eliminating
religion leads to an unwarranted dependence upon law as a source of
morality. Laws dictate what is forbidden or accepted. However, legality
is not equivalent to morality; something may be legal but not necessarily
moral or right. Additionally, an emphasis on secularism can also be
5 1 Callahan, “Religion and Secularization of Bioethics,” 2.
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oppressive, in that it can require individuals to pretend their private lives
and beliefs do not spill over into the public realm. Catherine Myser
insightfully points out a problem with the academic search for a universal,
neutral, and environmental influence free solutions. According to her:
A radical universalist approach risks a reductio ad
absurdum, because it does not make sense to proceed from
the premise of cultural pluralism to the conclusion that
bioethics should be taught as a means of recognizing and
managing value differences, and at the same time holds that
all elements of the bioethics curriculum can or should be
universal in definition and/or application.5 2
Rather than providing satisfying, purely rational, universal answers,
secularism forces individuals to pretend they are not simultaneously
members of both particular moral communities and a general society at
large. Wind correctly argues that individuals, be they policymakers,
healthcare professionals, or patients, “do not park their beliefs at the
bioethical door. Instead they smuggle them in--in plain wrappers— beneath
the surface of much of our technical secular discourse.”5 3 Reich concurs
when he argues that it is better and more beneficial if bioethics “were to
acknowledge fully and integrate into its dialogues the voices of
“Catherine Myser, “How Bioethics is Being Taught,” in A Companion to
Bioethics, ed. Helga Kuhse and Peter Singer (Malden: Blackwell Publishers Inc., 2001),
486.
“Wind, “What Can Religion Offer Bioethics,” 18.
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the people answering the questions, experiencing the suffering, living and
dying.”5 4 The trend toward attempting to converse in universal, religious
free language leads to an unnatural and unrepresentative situation that
widens the gap between the academic ivory towers of the philosophers
and the patient and healthcare professional in the “trenches.”5 5 Here
Reich and others are directly calling attention to the events occurring
within the clinical setting and arguing that the voices heard there ought to
be included within the discussion. These voices of the patients and
clinicians are interlaced with their religious convictions.
While academic emphasis on marginalizing religious voices may have
been influential in the public arena for a time, it appears that time has
passed. Again, perhaps in part because of the influence of the experiences
of those in the clinical setting, religious voices are present and are very
influential in public discussions on bioethical issues. Of the many
religious voices heard in the public sphere, I focus on those of the Roman
Catholic Church. The first and foremost reason for choosing the
Catholic Church is that its position of power and influence is unmatched,
5 4 Warren Thomas Reich, “ A New Era for Bioethics: The Search for Meaning in
Moral Experience,” in Religion and Medical Ethics, ed. Allen Verhey (Grand Rapids:
Eerdmans Publishing Company, 1996), 112.
5 5 Callahan, “Religion and Secularization of Bioethics,” 2; Wind, “What Can
Religion Offer Bioethics,” 18; Marty, “Religion, Theology, Church, and Bioethics,” 283.
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both in this country and internationally. Its authority and control
extends far beyond its own members. The teachings of the Magisterium
are heard and shape discussions in the halls of Congress, the White
House, around the country, and around the world. Second, though the
Church is not monolithic, the Vatican does set forth an official,
authoritative teaching, particularly concerning reproductive issues. This
provides good points of comparison, particularly when we examine
elements of Hindu traditions.
The Vatican is the only religious group that has an observer status
at the United Nations. Because of its independent state status conceded
by the Lateran Pacts of 1929, it is granted this privilege, and thus has a
voice in the U.N. Examples of the Church’s international influence are
evident in many ways. From the first international meetings regarding
world population, beginning in the 1950s, the Vatican’s firm opposition to
contraception and abortion put it at odds with a majority of international
development and population organizations. The voice of the Vatican was
heard louder than ever before at the 1994 International Conference on
Population and Development held in Cairo. The Church’s objections to
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4 5
the wording in the conference documents delayed the entire conference for
over four days.5 5
A domestic example of the influence of the Catholic Church is
evident in how the American Fertility Society, a professional medical
organization, went about developing its perspectives on the new
reproductive technologies. In 1986, in its professional journal, F ertility
and Sterility, the 1984-85 Ethics Committee of the American Fertility
Society published, “Ethical Considerations of New Reproductive
Technologies.” This document set forth the Society’s then-held ethical
positions on a variety of new assisted reproductive technologies.5 7 Soon
after the publication of this Committee’s deliberations, the Vatican’s
Congregation for the Doctrine of the Faith published the Instruction on
Respect for Human Life in Its Origin and on the D ign ity o f Procreation
(hitherto referred to as the Instruction) P The Instruction did more than
“Thomas Fox captures the tensions in his description of the conference
proceedings in the eighth chapter of his book, Sexuality and Catholicism (New York:
George Braziller, 1995).
5 7 Ethics Committee of the American Fertility Society, “Ethical Considerations of
The New Reproductive Technologies,” F ertility and Sterility 53 (Apr-June, 1990), SI.
“Though the Roman Catholic Church presents official, authoritative teachings,
there is discussion, debate, even dissent within and between her leaders. For example
three years prior to the publication of the Instruction, the Pontifical Academy of
Sciences, a group consisting of moral theologians who advise the Pope, held a conference
regarding IVF. After three days of presentations on the various aspects of IVF, all the
moral theologians, save one, indicated they would not consider IVF a sin and they had
no moral objection to it. The lone dissenter, Monsignor Carlos Cafarra, objected on the
grounds that IVF allowed for procreation outside the bonds of marriage and that sexual
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4 6
articulate the Roman Catholic Church’s opposition to the utilization of
assisted reproductive technologies. In its final section, under the title
“The Values and Moral Obligations That Civil Legislation Must Respect
and Sanction in this Matter,” the Church calls for legislative intervention:
When the state does not place its power at the service of
the rights of each citizen, and in particular of the more
vulnerable, the very foundations of a state based on law are
undermined. The political authority consequently cannot
give approval to the calling of human beings into existence
through procedures which would expose them to those very
grave risks [. . .]. Civil law cannot grant approval to
techniques of artificial procreation, [. . .]. Legislation m ust
also proh ibit [. . .] embryo banks, post mortem
insemination and “surrogate motherhood.”5 9
The Vatican’s call for the public, legislative prohibition of these
technologies went beyond providing moral instructions for its congregants.
The Church urged political leaders to take legislative action that
disallowed the availability of various assisted reproductive technologies.
intercourse, within marriage is the only legitimate way to procreate. Jones and Cockin,
“On Assisted Reproduction, Religion and Civil Law.” Obviously the voices of the other
moral theologians at this conference did not prevail. As is discussed in Chapter 5, the
Instruction clearly objects to IVF and other forms of assisted reproductive technology.
Though extremely interesting, discovering the reasons for, and reasoning behind, the
positions of the Roman Catholic Church are beyond the scope of this study.
5 9 Congregation for the Doctrine of the Faith, “Instruction on Respect for Human
Life in Its Origin and on the Dignity of Procreation,” in Ethical Issues in the N ew
Reproductive Technologies, ed. Richard T. Hull (Belmont: Wadsworth Publishing
Company, 1990), 35-36. (Emphasis added) This document can also be found at:
hppt:// www.Vatican.va. Henceforth this work, Instruction on Respect for Human Life
in Its Origin and on the D ignity o f Procreation is referred to as Instruction and it is
cited as it appears in Hull.
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The Vatican’s Instruction prompted the 1986-87 American Fertility
Society’s Ethics Committee to reconvene. After reviewing the Instruction,
the Committee located a number of differences and reevaluated and
reasserted their positions on a variety of issues. Following the Society’s
Board of Directors approval, these proceedings resulted in a publication of
a second report in 1988.6 0 The foreword to this document acknowledges
the publication of the Instruction and reads as follows: “Because of the
conflicting conclusion of the two documents, the present Ethics
Committee (1986-87) of The American Fertility Society was convened and
considered the Fertility Society guidelines in the light of the Instruction.”^
Though the Committee did not actually change its position regarding the
utilization of assisted reproductive technologies, the Committee did restate
its positions in light of the issues raised by the Vatican. The Committee
also responded to the arguments and reasoning of the Church.
This influence has not diminished in the late 1990s and early 2000s.
The ethical discussions over stem cell research and cloning demonstrate the
continuing importance of religion in the public debate. In mid July 2001,
6 0 The document resulting from these second meetings is included as Appendix E
in a third report published in 1990. Due to significant developments in the field of
assisted reproductive technology, the Ethics Committee convened for a third time in
1989. The Ethics Committee of the American Fertility Society, “Ethical Considerations
of the New Reproductive Technologies,” 95S-104S.
6 1 Ethics Committee of The American Fertility Society, “Ethical Considerations of
New Reproductive Technologies,” F ertility and Sterility, 95S.
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Los Angeles Times headline’s read: “Pope Urges Bush to Reject Human
Embryo Cell Research,”6 2 “Bible Guides Senate on Stem Cell Studies,”6 3
“Religion Divided on Stem Cell Issue.”6 4 Newsweek ran a story titled,
“Battle for Bush’s Soul.” The lead line states: “The president is trapped
between religion and science over stem cells. Lives--and votes-are at
stake.”6 5 In a meeting between Pope John Paul II and President Bush, the
Pope declared that the utilization of “human embryos for medical research
is an ‘evil’ akin to abortion and infanticide.” Bush responded by
promising to “take that point of view into consideration” as he deliberated
over the issue of federal funding for embryonic stem cell research.6 6 The
role and influence of religion in the development and continuation of the
field of bioethics is well established. With increased globalization and
multiculturalism, the challenge facing contemporary discussions within
bioethics is how to productively include the multitude of religious voices.
6 2 Los Angeles Times, 2 4 July 2001.
6 3 Los Angeles Times, 2 1 July 2001.
M Los Angeles Times, 1 9 July 2001.
6 5 Evan Thomas and Eleanor Clift, “ Battle for Bush’s Soul,” Newsweek, 9 July
2001 p28-30.
0 6 Los Angeles Times, 24 July 2001.
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Religious Diversity
According to Margaret Farley, individual experience “plays an
important role in moral discernment. It [individual experience] is a source
of moral insight, a factor in moral judgment, a test of the rightness,
goodness, and wisdom of a moral decision.” Regarding the significance of
the role of experience she continues by saying: “It is central for finding
and establishing an overall framework for moral discernment; it is
important for formulating and applying general ethical principles and
specific ethical rules; and it plays a key role in developing theories of
moral disposition.”6 7 Globalization, pluralism, and multiculturalism all
increase, not negate, the need for bioethics to pay attention to the cultural
and religious perspectives and experiences of the patients, families, and
healthcare providers.
Over the past decade, religious voices other than Christian and
Jewish have been introduced into the discussions. Prominent bioethical
textbooks are containing the undercurrents of religious influences, and now
there are entire texts that take up the issues of religion and bioethics.
Wolfe and Gudorf’s Ethics & World Religions: Cross-Cultural Case Studies
(Orbis, 1999), focuses on various religious perspectives on a variety of
6 7 Margaret Farley, “The Role of Experience in Moral Discernment,” in Christian
Ethics: Problems and Prospects, ed. Lisa Sowle Cahill & James F. Childress (Cleveland:
Pilgrim Press, 1996), 135-36.
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50
ethical issues. Part V of this book is on “Religion, Medicine, and Public
Health.” Each chapter of this book begins with a particular case study
and is then followed by essays providing various world religions’ views on
the case and the issues that arise.6 8
Hindu Ethics (SUNY, 1989) by Coward, Lipner, and Young
contains three chapters presenting Hindu views on purity, abortion and
euthanasia. Crawford’s D ilemmas o f Life and Death (SUNY, 1995)
discusses Hindu ethics regarding abortion, suicide and euthanasia. Keown
commits an entire book to Buddhism and Bioethics (Palgrave, 2001).
Dorff and Newman’s Contem porary Jewish Ethics and M orality: A Reader
(1995), contains two chapters specifically related to bioethics. Sacred
Choices by Daniel C. Maguire (Fortress Press, 2001), focuses on
contraception and abortion in ten world religions. Though this list is far
from exhaustive, it is sufficient to indicate how current books are
explicitly focusing on religious voices in the field of bioethics. These
books provide examples of religious voices in the public sphere and in the
academy.
6 8 In many respects, this is the methodology employed in this study. Chapters 3
through 6 of this work are centered around two situations. The first “cases” come from
paradigmatic narratives of ancient India. Then, once the foundation is laid through an
examination of these stories, a modem case study is examined in light of what was
extracted from antiquity.
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As a result of the increase in globalization, multiculturalism, and
pluralism, the once dominant religious voices, particularly ones influenced
by Christianity, are no longer the only religious voices present.6 9 By
expanding bioethical discussions to include non-western religions in the
United States, we enhance the significance of religious voices. More
importantly, we engage, not leave behind, the ivory towers of theory and
philosophy with the actual struggles, questions, and concerns of those
confronting genuine bioethical situations. For patients and healthcare
providers, discussions and answers regarding bioethical issues are the
grounds upon which concrete actions are taken. These discussions lead to
decisions regarding birth, the quality of life, and death.
Cultural Competency
Cultural, religious, and social traditions reveal and celebrate the
uniqueness of each individual person, her family and community. As
indicated, the practice of medicine engages human beings in the ordinary
events of giving birth, living, suffering, dying and of caring for those
6 9 According to The Graduate Center of the City University of New York’s ARIS
Study, the Christian population United States has declined from 86% in 1990 to 77% in
2001. The following provides three examples of the change in populations from 1990 to
2001: number of those identifying with Islam rose from 527,000 to 1,104,000, Buddhist
rose from 401,000 to 1,082,00, and the number of Hindus rose from 227,000 to 766,000.
http://www.gc.cunv.edu/studies/kev findings.htm.
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5 2
giving birth, living, suffering, or dying.7 0 It is in the midst of these
ordinary events that worldviews and religious beliefs surface and have a
strong hold. Consequently, the growing multicultural, multireligious
aspects of society have not gone unnoticed by U.S. governmental agencies
responsible for health concerns.
In the 1980s, the U.S. Department of Health and Human Services
established the Office of Minority Health (OMH). This office operated
under the conviction that the administration of quality healthcare was
dependent upon the abilities of medical personal to understand how their
own, and their patients’ religious, socio-cultural backgrounds, affect beliefs
and behaviors regarding health. Recognizing the increasing diversity of
the patient populations and the necessities of addressing the resulting
cultural, religious and social issues, the OMH, along with other medical
associations such as American Nurses’ Association (ANA), American
Medical Association (AMA), and Association of American Medical Colleges
called for national standards of “Cultural Competency.”7 1
7 0 Verhey, “Introduction,” 1 .
7 1 Cheryl A. Howard, Sally Andrade, and Theresa Byrd, “The Ethical Dimensions
of Cultural Competence in Border Health Care Settings,” Family and Com m unity Health
23:4 (January 2001): 36-49. Downloaded: http:// gatewayAovidxomuSQ/Ovidwed.cgi.
5/31/2001; Emilio J Carrillo, Alexander R. Green, and Joseph R. Betancourt, “Cross-
Cultural Primary Care: A Patient-Based Approach,” Annals o f Internal Medicine 130:10
(18 May 1999): 829-834; Giselle Corbie-Smith, “The Role of Cultural Competence in
Addressing Health Disparities,” SGIM Forum 24:10 (October 2001), 1 ; Canales and
Bowers, 102.
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According to the OMH, cultural competency is defined as
follows:
Cultural and linguistic competence is a set of congruent
behaviors, attitudes, and policies that come together in a
system, agency, or among professionals that enables effective
work in cross-cultural situations. ‘Culture’ refers to
integrated patters of human behavior that include the
language, thoughts, communications, actions, customs,
beliefs, values, and institutions of racial, ethnic, religious, or
social groups. ‘Competence’ implies having the capacity to
function effectively as an individual and an organization
within the context of the cultural beliefs, behaviors, and
needs presented by consumers and their communities.7 2
A briefer definition indicates that competent care is “providing care to
patients and their families that is compatible with their values and the
traditions of their faiths. This requires awareness of one’s own values and
those of the healthcare system.”7 3 In her article “Cultural Competence: A
Priority for Performance Improvement Action,” Salimbene discusses ten
basic components of cultural competency. They are:
7 2 Howard, Andrade, and Byrd, 2.
7 3 Barbara Leonard, and Gregory A. Plotnikoff, “ Awareness: The Heart of Cultural
Competence,” American Association o f Critical-Care Nurses 11:1 (February 2000): 51-59.
Downloaded from http:// pageway2.obid.com:80 ovidwetncgi. 5/31/01. A similar
definition for cultural competency, developed by a subgroup within the California
Department of Health Services, is as follows: “learning, accepting and respecting the
values, norms and traditions of cultural groups [and] appreciating the differences and
similarities within, among, and between groups.” California Department of Health
Services, Cultural and Linguistic Requirements Subgroup: Recommended Standards for the
Medi-Cal Managed Care Program (California Department of Heath Services, 1993), as
cited in Salimbene.
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1. An awareness of, sensitivity to, and tolerance of differences in culture
and language;
2. An ability to refrain from making assumptions (or judgments) about
the beliefs, behaviors, needs, and expectations of patients of colleagues
of a different cultural background from oneself;
3. An understanding of the role culture plays in formatting the
health/illness prevention beliefs and practices of patients;
4. The ability to recognize the role that one’s own culture and
background plays in determining one’s attitudes and beliefs not only
about heath and wellness but also beliefs about such things as what
constitutes acceptable behavior, cleanliness, a healthy lifestyle, the roles
of family and friends, and so forth;
5. Enough knowledge about the cultures that one serves to avoid
breaching the patient’s taboos, health care beliefs, or rules of
interaction;
6. Enough knowledge about the cultures that one serves to anticipate
possible barriers to access to or compliance with care;
7. The skill to deliver culturally and linguistically appropriate patient
advice and education;
8. The skill to utilize interpreters effectively so that language barriers do
not impact the extent or quality of care;
9. The knowledge and flexibility to modify both one’s mode of
interaction and one’s manner of delivering care so that it is culturally
and linguistically appropriate to the patient while it meets the
hospital’s or clinic’s standards of quality patient care; and
10. Confidence in one’s ability to offer quality care to patients of others
cultures.7 4
7 4 Salimbene, 23-25. In their article, Leonard and Plotnikoff discuss Starn’s Five
Components of Cultural Competency: 1) An awareness and acceptance of the fact that
there are cultural differences; 2) Self-awareness; 3) Understanding the dynamics of cultural
differences; 4) Knowledge of the client’s family culture; and 5) adaptation of services to
support the client’s culture. Leonard and Plotnikoff, 2.
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This is a recognition that patients’ worldviews as well as their religious
and cultural beliefs, influence, and are tightly interwoven with their
attitudes towards health and medical care. Thus, to ensure delivery of the
best healthcare possible, those engaged in the medical professions need not
only be well trained in order to provide safe and effective care, they also
need to be aware of and sensitive to the various populations their
institutions serve.7 5
Having the knowledge and understanding of various cultural and
religious influences, a healthcare provider can be sensitive to the particular
needs of a patient; she may avert conflicts and be prepared to facilitate
the delivery of timely quality care. Conversely, if ignored in the context
of health and medicine, religious and cultural issues can be barriers to the
promotion and implementation of good competent healthcare.
Unfortunate and even horrific events have occurred because healthcare
providers have failed to hear the concerns of their patients and have failed
to consider the impact of their culture and religion on their
interpretations of what is occurring. Anne Fadiman’s book, The Spirit
Catches You and You Fall Down, documents the story of Lia Lee, an
epileptic Hmong infant, and the unfortunate events that occurred between
7 5 Joseph Fins, “Encountering Diversity: Medical Ethics and Pluralism,” Journal o f
Religion and Health 33:1 (Spring 1994): 23-27; Canales and Bowers, 102-111.
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the medically competent but culturally incompetent healthcare providers
and the Lee family.7 6
At three months, Lia experienced her first seizure after someone
entered the room allowing the door to slam. Her parents recognize her
symptoms and diagnose their youngest child with quag dab peg, “Spirit
catches you and you fall down.” In Hmong-English dictionaries quag dab
p eg is translated as “epilepsy.” According to her parents, the noise of the
slamming door disturbed her soul, caused it to flee from her body and
become lost. In the above phrase, the dab is a soul stealing spirit. They
understood both the seriousness of her condition for her health, and at
the same time they recognized it as a sign of one who is particularly fit
for divine office: many epileptics become shamans. Lia’s parents were
simultaneously proud and concerned; without a physician’s diagnosis, they
knew she had epilepsy. The problem was that they were not aware of
the English term epilepsy, and their healthcare providers did not know
that “Spirit catches you and you fall down” was the Hmong way of
describing epilepsy.
By not hearing and understanding the Lee family’s cultural and
religious interpretations of Lia’s condition, the emergency room doctors
7 6 Anne Fadiman, The Spirit Catches You and You Fall Down: A Hmong Child,
H er American Doctors, and the Collision o f Two Cultures (New York: Farrar, Straus,
and Giroux, 1997).
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did not have the full picture of her illness. Consequently, on two
consecutive emergency room visits they misdiagnosed her and subjected
her to a variety of invasive tests. Six months later, during her third
emergency room visit, Dr. Murphy correctly diagnosed Lia and began the
necessary treatments. Unfortunately the healthcare professionals involved
in the first two visits were unable to provide competent care because they
were lacking in an ability to communicate adequately, and in
understanding the religious and cultural explanations of Lia’s symptoms.7 7
The emergency room doctors and nurses were frustrated when her
parents were not compliant with their prescribed treatments. However,
these medical personnel sent the parents home with written instructions
that they could not read. Competent care includes ensuring one is
communicating with the patient and family members. It is disingenuous
to accuse a patient of noncompliance when little effort is made to ensure
that the patient actually understands the instructions. Unfortunately, these
types of misunderstandings are not unique to immigrant communities.
7 7 In her article “Cultural Competence: a Priority for Performance Improvement
Action,” Salimbene describe other examples of where sensitivity to particular cultural and
religious beliefs can make a difference in the quality of medical care. She uses eye
contact and patting children on the head as two such examples. Though in mainstream
North American culture, a lack of eye contact could be interpreted as “holding
something back” or not telling the truth; in many traditional Asian cultures, it is a sign
of disrespect to look directly at a person in positions of authority. Often, a nurse or
doctor will pat a child on the head as a sign of affection and reassurance. This gesture,
in some Korean families could be very disquieting because touching someone’s head can
be interpreted as an attempt to steal the child’s soul.
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There are countless examples where communication, or lack thereof,
determines the competence or incompetence of care. A young six- or
seven-year old patient of mine had to be rescheduled for a head MRI
because of his inability to lie still enough during the procedure. The plan
was to conduct the procedure under conscious sedation, a light anesthetic,
so the patient would be able to relax and sleep through the claustrophobic
experience. While I was out of the room, the neurosurgery resident
explained the plan to the patient and his mother. When it came time to
take my young patient to his procedure, he began uncharacteristically to
cry and resist. His mother and I tried to console him, but he was
literally beside himself and would not allow himself to be removed from
his bed. The resident requested assistance and at one point the boy was
fighting off four male adults. I stopped everything, went to the head of
the bed, looked at the boy, and quietly asked him what the problem was.
With eyes full of fear and disbelief, he look at his mother and said,
“How can you let them take me; he said they were going to put me to
sleep.” He knew dogs and cats were put to sleep and did not return
home.
Communication and misunderstandings can also be at the root of
issues causing “noncompliance” on the part of the patient. While working
as a homecare nurse in rural Virginia, I was assigned to an elderly
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“noncompliant” patient; one who refuses to take his medications. Upon
arrival at his home, I sat down with the patient, and reviewed the various
medications he was taking. I carefully explained how I was going to fill
a large pillbox, one with four time slots for each day of the week, with
the appropriate medications for the appropriate time of day. As we
discussed what each medication was for, i.e., the time and dose he was to
take each day, he continued to express concern and resistance to taking
his medications. After reviewing his medications with him for a second
and third time, two and a half hours later, the patient’s underlying
concerns became apparent as he blurted out: “I don’t wanna die!” He
had been hospitalized because he had taken the wrong dose of a
medication. His fear of repeating the same mistake was preventing him
from realizing the method we were employing would help him avoid the
same mistake. I looked at him and in my best southern accent, I
responded: “Honey, you ain’t gonna die, you only gotta remember about
what time of day it is.” The familiar accent and my words finally put
his fears at ease and he expressed understanding for the first time.
All three of these examples, Lia, the young boy, and the elderly
gentleman, highlight the importance of hearing and understanding the
particular previous situation. Since misunderstandings are not exclusive to
cross-cultural, cross-religious situations, many argue that “culturally
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competent care” is somewhat of a misnomer. Canales and Bowers, in
their study of Latina nursing faculty, found that “culturally competent
care” was not a salient element for their participants. However, what was
“salient for these participants was the perception that competent care
includes cultural competence.” According to this study, competent care
requires that:
the healthcare professional care for those perceived as
different from self; that they learn to care as connected
members of a community and the larger society.; and that
[. . .] [they] care with a commitment towards changing
existing social, health and economic structures that are
exclusionary.”7 8
Competent care indeed encompasses culturally competent care. Healthcare
providers need to have the ability to hear, understand, and address the
variety of patients that come before them. Particular religious or cultural
traditions will be heard, if the doctor, nurse, or other medical personal
are adept at hearing the voices of their patients.
Providing quality medical care necessitates cultural competency.
Though actual knowledge regarding various cultures is an important
element, comprehensive knowledge of all of the religious and cultural
forces influencing individuals is impractical and ought to be neither the
primary goal nor focus of cultural competency. Rather, the ultimate goal
7 8 Canales and Bowers, 102-111. Emphasis added.
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is to encourage already clinically competent physicians, nurses and other
healthcare providers to be open and willing to learn about, respect, and
work with persons from different backgrounds. Being able to recognize
and work within and between different cultural and religious perspectives
is imperative for clinical care to be competent in this century.7 9 To this
end, Canales, Bowers, Carrillo, Green, Betancourt and others caution
against categorizing and stereotyping patients.8 0 Rather than developing
“recipes” for healthcare professionals to follow when treating patients of
various ethnic backgrounds, they propose an individual patient approach.
Appearing “different” does not necessarily imply one is different.
Conversely, similarities in appearance, does not necessarily reveal
similarities in perspectives or worldviews. One cannot know, simply by
looking at an individual, where he was born or raised. After meeting me,
people have remarked on how well I speak English. They took note of
me, assumed I was “foreign,” and were surprised to hear me speak in
unaccented, comprehendible English. The patient may look Asian, but
having been raised in Iowa, he may have more in common with
Caucasian Iowans than Asians from Laos or Los Angeles. The nurse,
7 9 Marie Ngetiko Fongwa, “ Advancing Healthcare Practices: Linking Quality with
Culture,” Journal o f Nursing Administration 30:6 (June 2000): 291. Downloaded from
http:Z/gat£3ffay2.£!vid.com:80Zovidw_eh.cgi. 5/31/2001; Locsin, 2; Leonard and Plotnikoff,
2 .
8 0 Canales and Bowers; Carrillo, Green, Betancourt.
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physician, and others need to engage the patient and “learn-through-
connecting” with them. Each patient’s situation is unique, influenced by
personal background, culture, and religion. Thus, by interacting directly
and discovering the core issues for that particular patient, healthcare
providers can avoid cultural pitfalls and competently treat the individual.
Competent healthcare professionals will acknowledge that religious
ideology may play a role in how patients interpret their illness and
treatment. In the multicultural pluralistic context of the United States,
giving heed to religious voices demands an ability to hear a myriad of
tones. This country is not only home to many of the religions that exist
in the world, it is also home to the diverse expressions of these religious
traditions.8 1 Therefore, when one desires to hear the voices of religion in
the United States, this requires an ability to hear a myriad of voices.
Not only are there individuals who were raised in Catholic and Protestant
homes, or Orthodox and Reform Jewish families, there are those form
Buddhist, Hindu, Jain, and Muslim families. Each of these groups, have
different denominations and different generations speaking from within
them. Furthermore, there are the voices of those who come from a
combination of any one or more of the above.
8 1 Eck writes, ‘ “We the people of the United States’ now form the most profusely
religious nation on earth” (5).
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Again, Canales and others argue that ultimately there is no
distinction between competent care and culturally competent care.
Competence necessarily includes cultural competence. Beyond sensitivity
and cultural knowledge, the healthcare providers need practical strategies
for communicating with patients and individualizing care so that it is
appropriate for each patient.8 2 The focus here lies with the individual
patient’s worldviews; his or her hopes, fears, and understanding of life,
suffering, and death. The process of actually engaging worldviews other
than one’s own has the potential to be both threatening and therapeutic.
It can be threatening, because the healthcare professional’s original
presuppositions may be challenged; therapeutic, because once the individual
gains a better understanding of how the patient is viewing and
experiencing the situation, the healthcare provider may be better able to
address the fears and concerns of the patient. This understanding can lead
to a dialogue and competent care. Thus, successful cross-cultural care,
competent care, involves a triad of attributes: empathy, curiosity and
respect.
8 2 Canales and Bowers; Salimbene. Working in Neurosurgery Intensive-Care and
in Labor and Delivery, I understand first hand how cultural competence is not dependent
upon actual knowledge of an individual’s culture. This is not to say that actual cultural
knowledge is not helpful, it is. However, being culturally competent is not dependant
up knowledge, but rather on empathy, respect, and a desire to hear and understand the
patient.
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Complexity of Hindu Voices
Having discussed the influence of religion in the practice of
medicine and bioethics, and having just emphasized the need and
importance for cultural competency, we now focus our attention on one
particular world religion, namely Hinduism. Hindus constitute a
population in the U.S. of nearly one million people, in addition to the
over 800 million Hindus who live in India and elsewhere. The editors of
the Journal o f the American Academ y o f Religion dedicated the December
2000 issue to the question, “who speaks for Hinduism?” This is
inherently a difficult and controversial question to answer, though not
unique to Hinduism. The articles in this J A A R present an array of
arguments representing various voices from within and from without the
tradition, from “confessional” and “objective” perspectives, from both
Indian and North American scholars, and from different “native” voices.
Together the essays emphasize the importance of listening to and engaging
in the wide variety of voices present within Hinduism.
In his essay “On Hindu, Hindustan, Hinduism and Hindutva,”
Arvind Sharma discusses the origin and complexity associated with the
term itself. In antiquity, “Hindu” was both a geographical and religious
indicator. The term is derived from the Sanskrit term for river, sindhu,
and gets applied to the Indus river; a river that served as a natural
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65
northwest boundary for the subcontinent. Sharma concludes that
“Hindu,” and derivatives of it, “contain a series of semantic bivalences
characterized by unresolved tensions, and further that these tensions help
account for the complexities generated by the induction of the world.”
The word, like the traditions, reveals fluid boundaries between various
categories and internal diversity among official, unofficial, orthodox, and
popular expressions of Hinduism, such that it defies simple, unequivocal
characterization.8 3
Lipner likens Hinduism to a huge “banyan tree that has lost every
trace of the original trunk.” From the branches of this tree cascade huge
aerial roots, they burrow into the earth below and appear as if each were
a separate banyan trunk. Lipner continues:
Hinduism resembles a widespread thicket of trees [. . .]
interlinked by a continuous tracery of leaves and branches.
Here, however, instead of a uniform whole, we must
imagine an interrelated complex of botanic diversity. One
yet many! A polycentric rather than monocentric unity,
wonderfully rich in the variety of its fruits, flowers, foliage,
and arboreal forms.8 4
8 3 Arvind Sharma, “Oh Hindu, Hindustan, Hinduism and Hindutva,” N VM EN
49:1 (2002): 1, 8. The Persians utilized the term “ Al-Hind” to designate places where
non-Muslim lived, thus also providing it with an obvious religious connotation. It was
not until around the sixteenth century that particular people, who wanted to distinguish
themselves from their Muslim neighbors, appropriated the term “Hindu” as a self
description. Hindu now became a specific “religious” description, referring to a way of
life ultimately grounded in or derived from the Vedas.
8 4 Julius J. Lipner, “A Hindu View of Life,” 112.
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Lipner’s metaphor captures the diversity and multifaceted nature of Hindu
traditions. The tree of Hinduism encompasses tribal people, with vastly
different belief systems, and orthodox brahminical traditions, preserved in
the Laws o f Manu, the Mahabharata, and other texts.8 5 As there is not
one trunk, source, or foundation for these traditions, so there is not one
voice. The complex, polycentric center allows for a multitude of voices
to emerge from within the traditions.
According to Radhakrishnan, Hinduism is a conglomeration of
movements, not a position; processes, not a result; growing traditions, not
a fixed revelation.8 6 The traditions themselves do not acknowledge a
single authoritative body or voice; they celebrate diversity. According to
a passage in the Mahabharata, “The Vedas are varied and the traditions are
varied: one is not a sage if his view is not varied.”8 7 According to these
traditions, having the ability to hold a variety of perspectives is a sign of
a sage! Consequently, when examining a particular Hindu view, one
should always bear in mind that another legitimate, even conflicting,
“Hindu” perspective is around the corner. It is true that many Hindus
are not bothered by this pluralism. Rather, for them “it was no less
8 5 Desai, Health and Medicine in the Hindu Tradition, 7.
8 6 Radhakrishnan, The Hindu View o f Life (New Delhi: Indus, 1993), 91.
8 7 As cited in Lipner, A Hindu View o f life, 117.
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provocative of anxiety to be asked to choose between two incompatible
alternatives than it is for us [“Westerners”] to tolerate our own
o « kttOQ
inconsistency.
A defining characteristic of traditions within Hinduism is their
multivalent natures. By and large,
Hindusim does not distinguish ideas of God as true and
false, adopting one particular idea as the standard for the
whole human race. It accepts the obvious fact that
mankind seeks its goal of God at various levels and in
various directions, and feels sympathy with every stage of
the search.8 9
Inevitably, when Hinduism, or Hindu views, are being discussed, one
often encounters expressions such as: “Some Hindus believe [. . .],” “the
common people describe these things [. . .], the educated Hindus do
not share these opinions,” “some Hindus say [. . .], others have told
me [. . .].”9 0 When asked how Hindus might respond to a particular
question or issue, my responses usually begin with, “It depends [. . .].”
In conjunction with not having clear “doctrinal” boundaries and
definitions, Hindu daily life is not separated from religious life. While
this may lead some, such as John Stratton Hawley, to argue that
8 8 As cited in Doniger O’Flaherty, Women, Androgynes, and Other M ythical
Beasts (Chicago: University of Chicago Press, 1980), 6.
8 9 Radhakrishnan, 24.
9 0 Sharma, “Oh Hindu, Hindustan, Hinduism and Hindutva,” 8.
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“Hinduism is not a religion; it is a way of life,”9 1 it leads others, such as
Radhakrishnan, to say: “Religion is not the acceptance of academic
abstractions or the celebration of ceremonies, but a kind of life or
experience. It is insight into the nature of reality [. . .], or experience of
reality.”9 2 The daily practice of eating provides a perfect example of this.
For many within Hinduism, eating is an activity highly regulated by the
religion. The food actually eaten, who cooks it, when and with whom it
is eaten is all a part of Hindu ritual activity. Desai also points out how
many activities that fall under the category of “hygiene,” are often
religious for many Hindus.9 3
For Hindus, religion, philosophy, and the conduct of daily life are
all tightly interwoven. There is no formal discipline that presents “an
internally consistent rational system in which patterns of human conduct
are justified with reference to ultimate norms and values.”9 4 Nevertheless,
9 1 John Stratton Hawley, “Who Speaks for Hinduism and Who Against?” JAAR
68:4 (December 2000): 712.
9 2 Radhakrishnan, 13. The British used the term “Hindu” to “characterize all
things in India (specially elements and features found in the cultures and religions of
India) which were n ot Muslim, n ot Christian, n ot Jewish, or, hence, n ot Western.”
Utilizing the term “Hindu” to refer to “all things in India” is indicative of the all-
encompassing nature of Hindu traditions (Frykenberg 1989:31, as cited in Sharma, 17).
9 3 Desai, Health and Medicine in the Hindu Tradition, 6-12.
9 4 Barbara A. Holdrege, “Hindu Ethics, ” in A Bibliographic Guide to the
Comparative Study o f Ethics, ed., John Carman and Mark Juergensmeyer (New York:
Cambridge University Press, 1991), 12.
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Vasudha Narayanan emphasizes that this does not mean that Hindus do
not know about ethics or that they are immoral. It simply indicates that
there is neither a discipline within Indian thought that separates ethics
from the activities of daily life nor that focuses exclusively on it.9 5 It is
within these mercurial, pluralistic, symbiotic9 6 Hindu traditions that we
find strands of thought that will benefit contemporary North American
conversations regarding assisted reproductive technology. This study
engages in an examination of how key elements of Hindu thought might
relate, frame, and deal with aspects of bioethics, particularly assisted
reproductive medical care.
9 5 Vasudha Narayanan, “Hindu Ethics and Dharma,” in Ethics in the World
Religions, ed., Joseph Runzo and Nancy M. Martin (Oxford: Oneworld, 2001), 177.
% Lipner describes how there is a constant conversation between official and
unofficial Hindu traditions. On the one hand, characteristics of the orthodox traditions
find expression in the popular forms of Hinduism, while on the other hand, the popular
traditions take on formalized characteristics (117).
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CHAPTER 3
VOICES FROM HINDUISM’S PAST
Setting a context for a dialogue on infertility and assisted
reproductive technology, the previous chapter demonstrated the relevance,
benefits, and necessity of examining diverse religious positions concerning
bioethical issues. We now turn our attention to voices from Hinduism’s
past by focusing on two narratives within the Mahabharata. First, I
provide a brief synopsis of the epic as a whole and establish the
significance of this text. Second, to ensure that all readers are familiar
with the specific narratives being examined, or simply to refresh the
reader’s memory, I retell the accounts of how three queens, KuntI, MadrI,
and Gandharl, overcome challenges of infertility. In providing heirs for
their husbands, they also gave birth to the principal characters of the
ensuing drama. The accounts of these women provide excellent examples
of how a classical Indian text presents issues regarding infertility and
methods for overcoming it. Finally, I present various “p°ints contact”
between this ancient text and modernity. I am arguing that though the
Mahabharata may not have direct references to modern forms of assisted
reproductive technology, it does contain points of contact. These points
constitute analogous, though not identical, circumstances that link the
stories in this ancient text with issues and circumstances encountered in
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71
modern times. Once these thematic associations are identified, we can
begin to see how questions and issues within the Mahabharata can make
relevant contributions to contemporary discussions regarding the ethical
dilemmas related to assisted reproductive technology.
W hat is the Mahabharata?
There are two primary categories of Hindu sacred literature:
revealed (Sruti) and traditional [Smrti). “Revelation,” according to ancient,
orthodox brahmins was sruti, literally “that which is heard,” “knowledge
by hearing.” Included in this knowledge, orally passed on from guru to
student, are works such as Rg-veda, Sama-veda, Yajur-veda, Atharva-veda,
and the various Upanisads. Through the hearing of this literature,
Brahman, the essence of the universe, was heard. The words of these
texts are:
without beginning, for it stretched backward through the
uninterrupted succession of teachers and students to the
beginning [. . .]. It was without an author, human or
divine, since it was part of creation; moreover, were it
authored it would of necessity be flawed by the author’s
imperfections, and its authority diminished. It thus
validated itself insofar as it was the sole source of
knowledge about matters lying beyond the senses.9 7
9 7 J.A.B. van Buitenen, The Bhagavad Gita in the Mahabharata (Chicago:
University of Chicago Press, 1981), 6-7.
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Sruti literature has no beginning or authored, and self validating; it is
knowledge that enables one who desires heaven to obtain it.
Of secondary authority is sm rti literature. Smrti literally means
“recollection,” but is used practically to signify “tradition.” This
traditional literature “is the set of rules for acts of dharma that are not
explicitly declared by sruti, but are implicitly derivable from it.” Being
grounded in sruti, sm rti is authoritative as long as it does not conflict
with the authority of the former.9 8 Smrti literature includes such works
as the Law Book o f Manu, Puranas, and the epic literature of the
Mahabharata, including its most famous eighth book containing the
Bhagavad Gita, and Ramayana.
Though the Mahabharata itself is not technically considered revealed
scripture {sruti}, it is nonetheless one of the most popular and influential
texts originating from India.9 9 This epic is regarded as, and indeed the
text itself claims to be, India’s Fifth {Pa&cama) Vedai0 0 Historically, the
9 8 van Buitenen, The Bhagavad Gita in the Mahabharata, 8-9.
"In his discussion on the Mahabharata, Krishna Chaitanya acknowledges that the
text is “ not scripture by strict orthodox canons;” however, he adds, “it has been treated
as such by long tradition.” Chaitanya, Krishna, The Mahabharata: A Literary Study
(New Delhi: Clarion Books, 1985). Julian F. Woods, D estiny and Human Initiative in
the Mahabharata (New York: State University of New York Press, 2001), viii.
l°°MBh. 1.57.74 & XH.327.18; Shalini Shah, The Making o f Womanhood: Gender
Relations in the Mahabharata (New Delhi: Manohar Publishers, 1995), 2; Bruce M.
Sullivan, “The Religious Authority of the Mahabharata:. Vyasa and Brahma in the Hindu
Scriptural Tradition,” Journal o f the American Academy o f Religion 62:2 (Summer 1994):
378.
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text is situated between the ancient scriptures of the Vedas and
Upanishads and the Dharmasastras. The Mahabharata stands in a liminal
space: embracing its Vedic heritage, all the while evolving and anticipating
new socio-religious realities.1 0 1 Occupying such a special place within
Hindu traditions, this text both preserves the past, records events and
situations of its own time, and provides guidance for the future.
Brief Synopsis of the Mahabharata
The central plot of the Mahabharata revolves around the sons of
two brothers, Dhrtarastra and Pandu. The relationship among
Dhrtarastra’s one hundred sons, known as the Kaurava brothers, and their
five Pandava cousins is defined by an intense rivalry. Duryodhana, the
eldest of the Kauravas, is consumed with jealousy over the successes of his
half divine cousins and a desire for a throne he believes is rightfully his.
Yudhisthira, eldest of the Pandavas and heir to the throne, is often caught
between a desire to follow righteousness and renounce the world and the
prodding of his brothers, mother, and wife to take his stand and claim
what is legitimately his.
1 0 1 Arti Dhand, “Women, Smelly Ascetics, and Reproductive Method: Reflections
on a Theme in the Mahabharata,” 7. Unpublished paper cited with permission of
author.
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7 4
As the cousins grow into men, the conflicts escalate. Duryodhana
conspires to eliminate his Pandava cousins. His hatred intensifies as
various schemes to thwart his cousins fail and Yudhisthira and his
brothers prosper. Yudhisthira accepts worthless swamplands as their
portion of the kingdom and the brothers transform it into a splendid
realm with a spectacular crystal palace. In spite of losing everything in a
rigged dice match and being exiled for thirteen years, the Pandavas return
to claim their place in society, offering to take only five small villages in
exchange for peace. Duryodhana refuses to abide by this simple request.
After all efforts for a peaceful resolution are exhausted, the cousins, each
with their array of allies, converge on the battlefield.
Just prior to the commencement of this war, Krsna and Arjuna
engage in their famous discussion that is captured in the Bhagavad Gita.
After struggling with what his proper course of action ought to be,
Arjuna and his brothers engaged in this devastating battle. Though the
Pandavas win the war in the end, everyone on both sides dies— everyone,
save one embryo, a grandson of the third eldest Pandava, Arjuna. In the
concluding book of the epic, Yudhisthira, is surprised to find Duryodhana
in heaven while his own brothers and their wife, Draupadl, end up in
hell. It is explained that the one hundred Kaurava brothers fought
according to the rules of war, whereas the five Pandavas, under Krsna’s
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advice, fought treacherously. After a period of purification in hell, the
Pandava brothers also attained salvation.
The complex plots of the Mahabharata weave together stories of
gods, goddesses, animals and humans, kings and low-class women, men
with multiple wives and a wife with five husbands. Van Buitenen has
“little doubt that the story was in part designed as a riddle.” This riddle
has captured the heart of India and Hinduism. In doing so, this text
continues to be a source of intrigue and insight. The birth narratives of
the Pandavas and Kaurava, found in the first book, “ The Book o f
Beginning? (Adi Parvan), are the parts of the riddle that are of particular
interest for this present study.
Why the Mahabharata?
The story of the Mahabharata is known from circa 500 B.C.E.
Unlike the Vedas, which once written down required “letter-perfect”
transmission, the Mahabharata is a very fluid, dynamic and popular text
that attained its current form sometime around 200-400 G.E. Van
Buitenen describes it as a “library of opera” where one can “say that 400
B.C. was the founding date of that library, and that A.D. 400 was the
approximate date after which no more substantial additions were made to
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the text.”1 0 2 Through its eighteen books {parvans) and traditional 100,000
couplets, this epic unveils the stories of the Bharata descendants, namely
the five Pandava brothers and their 100 Kaurava cousins. This current
inquiry focuses on two narratives found within the first book, “B ook o f
Beginning;?. In Sanskrit, “M a h f means “great/complete” and “Bharata’ is
the name of the central clan upon which the story line is based.
1 0 2 J.A.B. van Buitenen, The Mahabharata: I. The Book o f the Beginning
[Chicago: The University of Chicago Press, 1975], xxv. James Fitzgerald, “India’s 5t h
Veda: The Mahabharata’s Presentation of Itself,” in Essays on the Mahabharata, ed. by
Arvind Sharma (Netherlands: E.J. Brill, 1991), 154; Elizabeth Seeger, The Five Brothers:
The Story o f the Mahabharata (New York: The John Day Company, 1948).
According to scholars, there never has been nor will there probably ever be, a
census of Mahabharata manuscripts. There are two major traditions of the text, northern
and southern. The most extensive search to produce a critical edition in Sanskrit was
conducted by the Bhandarkar Oriental Research Institute. The project began in 1917 and
was completed in 1966 under the editorialship of V.S. Sukthankar. John Dunham,
“Manuscripts Used in the Critical Edition of the Mahabharata:. A Survey and Discussion,”
in Essays on the Mahabharata, 1-2; Alf Hiltebeitel, The Cult o f Draupadl Vol. 1
(Chicago: University of Chicago Press, 1988), xx; Indira V. Peterson, “ Arjuna’s combat
with the Kirata: Rasa and Bhakti in Bharavi’s Kiratarjuniya,” in Essays on the
Mahabharata, 213.
In his introductory chapter, Norbert Klaes presents a brief yet comprehensive
summary of critical studies regarding the Mahabharata {Conscience and Consciousness:
Ethical Problems o f Mahabharata (Bangalore: Dharmaram Publications, 1975). The
historical development of this text is interesting and informative. However, for the
purposes of this work, it is inconsequential as to when the particular narratives being
examined were incorporated into the text. Whether they were part of the original core
of the story or redacted at a later date (sometime between 200-400 CE), they nonetheless
provide fertile ground for an exploration of issues relating to infertility and human
reproduction.
This study utilizes J.A.B. van Buitenen English translation of the Mahabharata.
This is an annotated and critical English translation based on the Sanskrit edition edited
by Sukthankar. Occasionally stories and details important to this work are taken from
another translation, that of Kisari Mohan Ganguli, The Mahabharata vol. I-XII (New
Delhi: Munshiram Manoharlal Publishers Pvt. Ltd., 1993). Unless otherwise stated, all
direct quotations of the text are taken from J.A.B. van Buitenen’s translation. MBh. is
the abbreviation used to indicate the Mahabharata.
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“Bharata” can also mean “Hindu,” or more generally “man,” therefore; in
many ways the paradigmatic narratives are telling a story of “The Great
History of [Hu]mankind. ”1 0 3
The Mahabharata encapsulates the whole of Indian life and enjoys a
formative role within it. The text itself claims to be all encompassing,
“whatever is here, on Law, on Profit, on Pleasure, and on Salvation, that
is found elsewhere. But what is not here is nowhere else.”1 0 4 Elsewhere
the text says of itself:
A man who knows it and makes others listen to it, and
also folk who listen to it, attain to the realm of Brahma
and become the equals of the Gods. For it is a supreme
means of sanctification equal to the Vedas, this ancient
Lore, praised by the seers, the greatest of the stories that
are worth hearing. In it the Law is set forth in its
entirety, and so is Profit; and in this most sacred History
lies the spirit of salvation.1 0 5
According to this text and tradition, reading the narratives of the
Mahabharata can ultimately bring one to salvation. Radhakrishnan, India’s
former President and well-known modern philosopher, includes the
studying of this epic, along with meditation, fasting, and worshipping
1 0 3 Katz, Ruth Cecily, Arjuna and the Mahabharata: Where Krishna Is, There Is
Victory (Columbia: University of South Carolina Press, 1989), 7-9. Jean-Claude Carriere,
The Mahabharata translated by Peter Brook (New York: Harper & Row, 1985), viii.
mMBh. 1.56.35.
mMBh. 1.56.14-16.
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God, in his discussion regarding ways to “attain the Supreme.”1 0 6 In his
book Dilemmas o f Life and Death: Hindu Ethics in a North American
Context, Crawford states that the great works of Indian epic literature,
Mahabharata and Ramayana, “are not just works of antiquity but embody
the social sinew which connects past with present and makes the epics
dateless, deathless treasuries of true dilemmas.”1 0 7 There is a universal
quality to the dilemmas faced by the heroes and heroines of the
Mahabharata. Through their actions they have become role models for
how individuals ought to live and how society ought to function.1 0 8
Harold Coward regards the Mahabharata as representative of
authoritative classical texts on dharmaN According to Vishnu
Sukthankar, the pre-eminent importance of this text is universally
acknowledged. Regarding the epic he writes:
Next to the Vedas, it is the most valuable product of the
entire literature of ancient India, so rich in notable works.
Venerable for its very antiquity, it is one of the most
inspiring monuments of the world, and an inexhaustible
1 0 6 Radhakrishnan, 87.
1 0 7 S. Cromwell Crawford, Dilemmas o f Life and Death: Hindu Ethics in a N orth
American Context (New York: SUNY, 1995), 6.
1 0 8 Bimal Krishna Matilal, Moral Dilemmas in the Mahabharata (New Delhi: Shri
Jainendra Press, 1989), vii.
1 0 9 Harold G. Coward, Julius J. Lipner, and Katherine K. Young, Hindu Ethics:
Purity, Abortion, and Euthanasia (New York: State University of New York Press,
1989), 46.
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mine for the investigation of the religion, mythology,
legend, philosophy, law, custom, and political and social
institutions of ancient India.1 1 0
Elsewhere, Vinoba Bhave says the following:
Mahabharata is a comprehensive treatise on the science of
society. Vyasa has in his hundred thousand slokas given us
innumerable portraits, customs and heroic actions that are
as beautiful as they are real. The Mahabharata tells us
clearly that none but God is wholly free from blemish;
that none too is an embodiment of absolute evil. On the
one hand, faults are pointed out even in Bhishma and
Yudhishthira, and, on the other, light outsheds on the good
points of Karna and, Duryodhana. The Mahabharata
describes human life as a fabric woven out of both black
and white threads. Himself standing aloof, Bhagavan Vyasa
projects on the screen of the world a picture, made up of
both light and shade of the universal movement. Because
of this perfect detachment and the big literary skill of
Vyasa, the Mahabharata has turned out to be a huge mine
containing pure gold.1 1 1
The paradigmatic narratives within the Mahabharata are indeed mines that
upon excavation will reveal the jewels that reflect India’s past, its present,
and Hinduism’s ethical ideology.
Hindu tradition ascribes at least a superficial unity to the text by
claiming that it is the product of a single author— the sage Krsna
1 1 0 Vishnu S. Sukthankar, “ The Adiparvan: Being the First Book o f the
Mahabharata the Great Epic o f India” (Poona: Bhandarkar Oriental Research Institute,
1933), iii.
mVinoba, Talks on the Gita, (Varanasi: Sarva Seva Sangh Prakashan, 1995), 1-2.
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Dvaipayana Vyasa.1 1 2 Sullivan and others have argued that when Hindus
attribute authorship to Vyasa, they are implying that the status and
authority of the Mahabharata, as religious text is to some extent
dependent on the status and authority of Vyasa. According to this
traditional view, religious authority is personal and embodied in the guru.
Thus, the claim that the epic is the Fifth Veda, endowed with religious
authority, is validated by the conventional belief that its author is Vyasa,
one who not only stands at the head of a chain of great teachers, but is
also the progenitor of the Bharata family.1 1 3
This epic occupies a place of great importance in the collective
psyche of the Indian people. According to Shalini Shah, it sustains their
beliefs and governs their conduct to this day.1 1 4 James Fitzgerald and
Joseph Dahlmann both argue that the epic is a conscious “tutor of the
people for higher religious and moral ideas,”1 1 5 playing a major role in
educating Indian peoples by “structuring and informing their imagination
U 2 Gary A. Tubb, “Santarasa in the Mahabharata,” in Essays on the Mahabharata,
ed. by Arvind Sharma (Netherlands: E.J. Brill, 1991), 171. Vyasa is also traditionally
credited with arranging the Vedas into the four books, composing other texts and,
according to the narrative, he himself fathers the primary patriarchs of the narrative,
Dhrtarastra, and Pandu. He also fathers a third half-brother, Vidura-a minor figure in
the story (MBh. 1.1.50-65).
1 1 3 Sullivan, 377.
U 4 Shah, 2.
U 5 Fitzgerald, 152.
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and sensibilities in fundamental ways for over the past 1500 years.”1 1 6
From generation to generation, Indian and Hindu parents utilize the
Mahabharata’ s colorful narratives to teach and reinforce the feelings of
continuity and cohesions of the traditions to their children.1 1 7
A contemporary impact of this epic on the people of India is
evident in the country’s reaction to the early 1990s release and broadcast
of B.R. Chopra’s and Ravi Chopra’s television production of this great
epic. These eminent Indian filmmakers produced and directed ninety-four
45-minute episodes of the Mahabharata. During its Sunday morning
broadcasts, a good portion of the nation of India would come to a halt.
Individuals prayed to the television screens because of the display of Lord
Krsna’s image. Face-to-face conversations were put on hold and people
refused to answer the telephone or doorbell. Out on the streets, it was
next to impossible to hail a rickshaw or taxi because most of the
population sat mesmerized in front of televisions across the country.1 1 8
n b Ibid. 151.
U 7 Desai, Health and Medicine in Hindu Tradition, 5. Personal experience of
being raised by a Hindu father has demonstrated to me the power of these mythical
narratives.
nspriyate conversations. When I asked how people, who did not own
televisions, were able to watch the production, the person responded: “There are
restaurants, coffee houses, hotels-all that have public televisions.” So, throughout India,
rich and poor alike, participated in watching the Mahabharata unfold each week.
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The impact of this epic is enormous, not only throughout Indian
and Hindu societies, but in the international arena as well. Scholars
analyze and utilize the Mahabharata as a primary source for establishing
and examining Hindu perspectives on a variety of topics, both of
antiquity and modernity. In May 2001, Concordia University hosted The
Second International Conference on the Mahabharata. This conference
attracted scholars from Australia, Canada, England, India, Israel, Mexico,
United States of America and other countries. The papers presented
covered a variety of topics ranging from textual and character analysis to
applications regarding weapons of mass destruction and assisted
reproductive technologies. Presenters were South Asian specialists,
linguists, ethicists and scientists.
The Mahabharata is the primary source for contemporary scholars
exploring various aspects of Hindu thought. In D estiny and Human
Initiative in the Mahabharata, Julian Woods utilizes this text as the focus
of his discussion on Hindu concepts of human destiny and free will.
Norbert Klaes, in his book Conscience and Consciousness: Ethical
Problems o f Mahabharata, examines the character of Yudhisthira, the
oldest son of Pandu. Through his presentation, he demonstrates how the
text presents and works through various ethical dilemmas. While Nicholas
Sutton utilizes this ancient epic in his discussion of religious doctrines of
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Hindu traditions, Bimal Krishna Matilal uses it as the foundation for his
presentation of the moral dilemmas in life. The utilization of this text
throughout Indian history, particularly, its most renounced section, the
Bhagavad-Glta, is evidence of the timeless, applicable nature of the
Mahabharata™
The Bhagavad Gita, literally the “Song of God,” records a
conversation between the warrior Arjuna and Krsna, an avatar of the god
Vishnu, on the eve of the great battle. Encapsulated within their
colloquy are three primary paths for living on this earth and finding
salvation: (i) the path of knowledge (jnana-yoga); (ii) the path of action
{karma-yoga); and (iii) the path of devotion {bhakti-yoga).1 2 0 Opinions
differ regarding the Bhagavad Gita’ s place within Mahabharata. While
some argue that it is an integral part of the great epic,1 2 1 others see it as
a later insertion into the climax of the epic.1 2 2 Regardless of its original
position within the narrative, great philosophers of India for centuries
have treated the Bhagavad Gita as not just smrti, but near -sruti, sacred
scripture. It has been, and continues to be, a primary source of
1 1 9 See bibliography for other texts that focus on or utilize the Mahabharata.
1 2 0 van Buitenen, The Bhagavad Gita In the Mahabharata, 17-18.
mIbid.
1 2 2 Ainslie T. Embree, 227; Hopkins, 89.
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inspiration for Hindu philosophers. Sankaracharya, or Sankara, the great
eighth century CE Vedanta philosopher, argued that the Gita contains the
very quintessence of the Vedas and that knowledge of this story leads one
to freedom.1 2 3 The eleventh century CE Bhakti theologian, Ramanuja,
interpreted the Gita as a basis for the salvific relationship between an
individual and loving God.1 2 4 On a political front, both Bal Gangadhar
Tilak, an important national leader of the modern Hindu resistance, and
M.K. Gandhi, utilized this text as a revolutionary manifesto, calling
Indians to contest British rule.1 2 5 Additionally, contemporary scholars
throughout the world refer to the Mahabharata, and the Bhagavad-Glta, as
exemplary Hindu texts.
In a multi-volume work, Alf Hiltebeitel provides a comprehensive
exploration of the cult of Draupadl.1 2 6 He examines the “continuities and
discontinuities in the cult of the goddess and the transmission of the
1 2 3 van Buitenen, The Bhagavad Gita in the Mahabharata, 9-10.
1 2 4 In his essay “The Life-Ethics of the Bhagavad Gita as Interpreted by
Ramanuja,” Klostermaier argues that Ramanuja “ sees in bhakti the highest calling of a
human persona and reads the Gita as a text that inculcates love to God as the first and
foremost duty.” In Life Ethics in World Religions, ed. Dawne C. McCance (Atlanta:
Scholars Press, 1998), 57.
1 2 5 Gandhi’s call was one advocating non-violence, while Tilak’s call involved the
taking up of arms to fight the British.
1 2 6 Draupadl is one of the main heroines of the Mahabharata. She is princess and
wife to the five Pandava brothers.
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Mahabharata as they relate to each other, and as they work together to
sustain the fundamental values and vitality of Hinduism.”1 2 7 Hiltebeitel’s
work is a testament to the degree to which the characters in this text
permeate Indian religion, society and culture. These cults of Draupadl
and the Mahabharata itself have also been the inspiration behind many
temples throughout Southeast Asia.
Beyond the world of academia, innumerable artists capture the
narratives of the Mahabharata in paintings, marionette theatre, dance,
sculptures1 2 8 comic books1 2 9 and plays.1 3 0 Artists in Indonesia reenact the
adventures of Arjuna and Krsna in their wayang puppet tradition.1 3 1 In
1 2 7 Hiltebeitel, vol. 1, xix.
1 2 8 Hiltebeitel discusses the various forms in which the Mahabharata is depicted.
His text includes photographs of various statutes, plays, paintings, temples and ceremonies
that either depict particular scenes from this epic or are inspired by it (262). Jean-
Claude Carriere, vii, xv.
1 2 9 Americans have Superman, Wonderwoman, Batman and Robin, as well as
biblical figures such as Abraham, Sarah, Samson, and Esther. Indians and Hindus have
Bhlsma, Draupadl, Arjuna and his younger twin brothers, as well as exemplary figures
like Yudhisthira, Gandharl and Kuntl. In keeping up with available technology, a comic
book version of the Mahabharata may be found in cyber space simply by conducting a
search using “ Mahabharata” as a key word.
1 3 0 The Mahabharata is the source of a number of one act plays that reshape and
emphasize the characters from the epic. “ Karnabhara” is an example of a such a play
based on the character of Kama. Translated by Barbara Stoler Miller, “ Karnabhara: The
Trial of Kama,” in Essays on the Mahabharata ed. by Arvind Sharma (Netherlands: E. J.
Brill, 1991).
1 3 I A wayang is a flat or rounded puppet utilized in the presentation of a play.
For a discussion on the making and symbolism of the wayang puppets, see: R.L.
Mellema, Wayang Puppets: Carving, Colouring and Symbolism (Amsterdam: Koninklijk
Instituut voor de Tropen, 1954).
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1975, French playwright Jean-Claude Carriere and filmmaker Peter Brook
began a collaboration that resulted in a play, then a three-hour movie,
and finally a six-hour video series that trace the central plot line of this
great epic. Los Angeles Times staff writer Kevin Thomas makes the
following comment on Peter Brook’s production of the Mahabharata:
Brook and his collaborators have brought to life one of the
world civilization’s literary cornerstones, an awe-inspiring
expression of mankind’s attempt to make sense of the often
baffling and terrifying human experience and to illuminate
the faith, values and conduct essential for human survival
and fulfillment.1 3 2
Through their carefully chosen international cast, Brook and Carriere
emphasize the universal appeal and relevance of this ancient epic.
Another contemporary utilization of the Bhagavad Gita portion of
the Mahabharata is found in Steven Pressfield’s novel, The Legend o f
Bagger Vance: A novel o f G olf and the Game o f Life— now a major
motion picture produced by Robert Redford.1 3 3 Pressfield begins his book
with a citation from the Bhagavad Gita. Then, through the relationship
of his characters, Rannulph Junah and Bagger Vance, he creates a narrative
that mirrors the discussion between Arjuna and Krsna. Steven J. Rosen
in his book Gita on the Green: The M ystical Tradition Behind Bagger
mLos Angeles Times (Los Angeles), 29 June 1990.
1 3 3 Steven Pressfield, The Legend o f Bagger Vance: G olf and the Game o f Life
(New York: Avon Books, Inc., 1995).
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Vance, explicitly points out the connections between Pressfield’s novel and
the Bhagavad Gita.1 3 4 These popular works, along with the timeless
writings of influential authors such as Ralph Waldo Emerson and Henry
David Thoreau,1 3 5 is evidence of how this epic inspired those within and
beyond the Asian continent.
The Mahabharata has had a profound impact on Indian and Hindu
culture, philosophy, religion and society. Along with preserving the
teachings of the past, it continues to provide entertainment and guidance
for those living in the present. Hindu ethics, along with its principles,
morals and values is present within the traditions and is tightly
interwoven with the practical aspects of life. The narratives within the
Mahabharata provide more than thrilling stories, profound crises, and
discussions on cosmology, philosophy, theology and ethics; they also
legitimize and inculcate ethical and political patterns fundamentally
important to Hindu civilization.1 3 6 Thus, through a careful examination of
selected stories from this formative text, it is possible to lay the
1 3 4 Steven J. Rosen, Gita on the Green: The M ystical Tradition Behind Bagger
Vance (New York: Continuum, 2000). In the Foreword to Rosen’s book, Pressfield
acknowledges that the structure of his book, Legend o f Bagger Vance, is modeled on the
Bhagavad-Glta. (11)
1 3 5 Eck, 94-96. Some of Ralph Waldo Emerson’s works reflect an influence the
Bhagavad Gita had on him. It was after reading and digesting this text that he wrote
“Ethnical Scriptures.” Likewise, Henry David Thoreau was influenced by this text.
1 3 6 Fitzgerald, 151.
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foundation for an ethical discussion that identifies key Hindu principles
and applies them to a discussion of assisted reproductive technology.
This work makes no attempt to demythologize the narratives of
the Mahabharata. When characters within the text call upon and interact
with gods/goddesses, the characters are interpreted as interacting with the
realm of the divine. The purpose of this study is to examine these
ancient narratives, and to discover and to apply the principles and
questions that are applicable to modernity. Of the Mahabharata, M.K.
Gandhi says, “I do not regard the Mahabharata as a historical work in the
accepted sense [. . .]. The persons therein described may be historical,
but the author of the Mahabharata has used them merely to drive home
his religious theme.”1 3 7 In a similar attitude, this study focuses on the
religious, ethical and moral teachings of the text as they relate to the
issues regarding assisted reproductive technology.
The Birth Narratives
The multifaceted stories of two related royal families, the Pandavas
and Kauravas, form the warp upon which the tapestry of the Mahabharata
is woven. With a text such as the Mahabharata, where layers of themes
and story lines are intricately interwoven, it is difficult to decide where to
1 3 7 M.K. Gandhi, The Gospel o f Selfless Action or The Gita According to Gandhi
(Ahmedabad: Navajivan Publishing House, 1946), 127-128.
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begin one’s retelling of the particular narratives being examined. Though
this chapter focuses on the accounts of how KuntI, MadrI and Gandharl
produce heirs, their particular stories are preceded by events that lead up
to, and influence, their situations and the decisions they make. Thus, to
highlight a few crucial issues, as well as to provide a larger context for
them, a brief summary of the main, relevant events to these specific
stories follow.
According to van Buitenen, the original narrative most likely begins
with King Samtanu.1 3 8 Through his first wife, the goddess Ganga,
Samtanu has one son who survives into adulthood. His name is Bhisma
and he is the undisputed heir apparent.1 3 9 Years after Ganga returns to
heaven leaving behind the grown prince Bhisma, king Samtanu falls in
love with a fisherman’s daughter, Satyavatl. In order to marry Satyavatl,
Samtanu is required to promise her father that the succession of kingship
will pass through her sons. In order to fulfill the demands of Satyavatl’s
father and to ensure his own father’s future happiness, Bhisma not only
renounces all claims to the throne, he also takes a vow of celibacy to
insure his promise.1 4 0 King Samtanu and Satyavatl marry and have two
1 3 8 van Buitenen, MBh, xvi.
™MBh. 1.92.45-55.
w MBh. 1.94.45-95.
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sons: Citrangada, who dies unmarried and childless, and Yicitravlrya, who
dies leaving two childless widows, Ambika and Ambalika.1 4 1
Long before meeting King Samtanu, Satyavatl had a mysterious
sexual encounter with a brahmin that resulted in the birth of a son,
Vyasa. He was born on an island, remained there, and set his mind on
asceticism. Vyasa tells his mother that whenever she thinks of him, he
will appear and do her bidding.1 4 2 Thus, upon the death of Vicitravlrya,
and due to Bhlshma’s vow of celibacy, Satyavatl calls upon her hermit
son. She asks him to provide heirs for her and her husband through
niyoga, a traditional practice that allows a woman to have sexual
intercourse with a man other than her husband for this express purpose.1 4 3
Responding to his mother’s call, Vyasa appears and agrees to comply with
her request. When Vyasa shows up to have sexual intercourse with the
Ambika, she averts her eyes because of his homely, wild appearance— he
has matted orange hair, fiery eyes, reddish beard. Out of fear she cannot
bring herself even to look at him. Because of her reaction, her son
Dhrtarastra is born blind. Though aware of what happened with her co
w MBh. 1.96.1-60.
mMBh. 1.57.65-75.
x n Niyoga is an ancient Indian custom. P.V. Kane defines niyoga as an
“appointment of a wife or widow to procreate a son from intercourse with an appointed
male” (Kane 1974, 11,1:399). This practice of niyoga, and its disputed history, is
discussed in more depth below.
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wife, the second widow, Ambalika, turns pale at the sight of Vyasa: the
result is that Pandu is born pale but is nonetheless endowed with marks
of excellence.1 4 4 A third son, Vidura, is born to Ambika’s maid, Amba.
Though without physical defect, wise, and far-sighted as his name
indicates, Vidura is not eligible to rule as he is the son of a servant.
After the birth of the two princes, Dhrtarastra and Pandu the land of the
Kurus and its people prosper.
KuntI and Gandharl are married to these two brothers:1 4 5 Pandu,
head of the Pandavas, and Dhrtarastra, patriarch of the Kauravas. Each of
these matriarchs experiences difficulties in producing sons. Obviously, the
challenge of providing heirs for the throne did not begin with these
queens.1 4 6 Through this complicated and tenuous line of succession,
1 4 4 MBA. 1.99.1-100.20.
1 4 5 Vyasa, having ensured the continuation of the royal line, returns to his life of
asceticism, while Bhlsma stays on to protect and rule the land while the sons are
growing up. At the appropriate time, Dhrtarastra and Pandu get married. Gandharl,
known for her devotion and beauty, becomes Dhrtarastra’s bride. When she hears of
Dhrtarastra’s blindness and that both her father and mother desire that she marry him,
she covers her eyes with a blindfold resolving that she will not experience more than
her husband (MBA. 1.103.1-20). Kunti, “one wise in the Law and exceedingly beautiful,”
chooses Pandu to be her husband. Later, MadrI, the daughter of the king of Madras, is
brought to Pandu as his second wife (MBA. 1.105.1-9).
1 4 6 As is evident from the brief summary just provided, the problem of sustaining
suitable heirs for the throne goes back several generations. This issue feeds into an
important theme that runs throughout the entire text, that is, the question of who is the
legitimate ruler. Samtanu is the established king. Bhlsma would be his unquestioned
heir; however, because of his vow to renounce all claims to the throne and his vow of
celibacy, he removes himself from the line of succession. Though Satyavatl and
Samtanu’s sons, Citrangada and Vicitravlrya, both die prior to producing heirs, Vyasa
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Pandu, though the younger of the two brothers, rules over the land of
the Kurus, an area that is located near the upper Ganges River, just
below the foothills of the Himalayan range.
Kunti and Pandu
Sometime soon after Kunti and MadrI marry Pandu,1 4 7 the king
goes on a hunting expedition and kills a buck mating with its doe.
Unknown to him, the buck is a powerful ascetic, who, along with his
wife, had taken on the forms of these animals. As the ascetic lies dying,
he places a curse on king Pandu: Since Pandu thoughtlessly aimed to kill
the buck while it was engaged in the most sacred of activities, Pandu will
suffer a similar fate. If ever Pandu is engulfed by love and has sexual
relations, he will die instantly. After cursing him the ascetic dies and
Pandu is overwhelmed with grief.1 4 8
agrees to provide sons for Vicitravlrya through his two widows. Even though he is the
first-born, the kingship is not passed on to Dhrtarastra, due to his blindness. Thus, the
next in line for succession is Pandu. Pandu rules for some time and increases the
kingdom, both in land and reputation (MBh. 1.105.10-30). Though peace prevails in the
land, questions concerning the legitimacy of Pandu’s reign do not come to an end.
Sutherland, 95-98. For those interested in the larger context of these narratives consult
van Buitenen’s translation or for a shorter version see Elizabeth Seeger’s The Five
Brothers: The Story o f the Mahabharata (New York: The John Day Company, 1948).
w MBh. 1.105.1-8.
1 4 S MBh. 1.109.5-30.
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Prior to this curse, Pandu and his two wives had no children, thus
the curse obviously hangs heavy over them. Though he is married to
two wise and beautiful women, now he cannot produce children and
therefore has no heirs for the throne. After consulting together, the three
decide that Pandu should forfeit his rule to Dhrtarastra. Thenceforth,
Pandu and his two wives renounce the world and wander in the forests
and mountains. The mountain siddhas, great seers and other ascetics
watch over Pandu. After years of living like hermits and practicing
austerity, he becomes like a brother and friend to some of these
renunciants while others watch over him like a son. At some point,
Pandu is troubled by the idea that for him, a childless man, there is no
door to heaven.1 4 9 The group of ascetics with whom he is associated
foresees that he will indeed have sons and they encourage him not to
despair.1 5 0 He discusses his concerns with Kunti and implores her to have
children for him through the traditional practice of niyoga.
Kunti, unable to bear the thought of being with any other man,
yet wanting to please her husband, chooses this time to inform Pandu of
a boon she had received many years before. As a child she was charged
with the responsibility of honoring the guests that came to her home.
1 4 9 The importance of children, particularly sons, is discussed in Chapter 4.
1 5 0 MBh. 1.111.10-20.
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On one occasion, she greatly pleased Durvasas, a powerfully divine sage.
He chose to reward her efforts by granting her a boon: he bestowed
upon her a special mantra that, when used, would result in a son
engendered by whichever god she chose to call upon.1 5 1 Now, for the
first time, Kunti tells Pandu about this boon.1 5 2
Pandu is thrilled by this news that Kunti has the ability to provide
him with sons and together they carefully decide which god she should
call upon first. They desire a son who will be righteous and good, so
after much deliberation they select Dharma, the god of justice and
order.1 5 3 Kunti invokes Dharma and in time she gives birth to a son,
Yudhisthira.1 5 4 Following the birth of their first son, they again consider
which attributes they desire for a second and third son. After much
deliberation, Kunti summons Vayu, the god of wind, and then Indra, the
mMBh. 1.110.25-113.35.
1 5 2 Though Kunti reveals the fact that she has this mantra, she does not disclose
to Pandu that she utilized it shortly after receiving it. Being overwhelmed with
curiosity, she decides to call upon the Sun God to see if the mantra actually works.
The Sun God appears and impregnates her with a son. However, since Kunti is as yet
an unmarried maiden, the birth of her first son, Karna, is deeply problematic. So, in
order to “ hide her misconduct and out of fear of her relations,” she fashions a small raft
and floats Karna down the river. He is discovered and saved by a peasant couple who
raised him as their own (MBh. 1.04.9-15). Kunti hides this secret in her heart.
1 5 3 Reasons for their selections will be discussed below.
™MBh. 1.114.1-5.
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king of gods. These divine unions result in the births of Bhlma and
Arjuna respectively.1 5 5
When Pandu approaches Kunti for a fourth time, she chastises him
for his greediness and reminds him that the law of niyoga does not
provide for a fourth son: “They do not speak of a fourth son, even in
times of distress. After three she is loose, after four she is a harlot.
Here you stand, knowing this Law, which stands to reason: then why do
you transgress it [. . .]?”1 5 6 According to the Mahabharata, this law
permits a woman to sleep with up to two males to provide heirs. It
identifies a woman as “loose” if she sleeps with a third male and “a
harlot” if she has sexual intercourse with a fourth.1 5 7 N ot willing to take
on the label of “harlot,” she refuses to call upon a fourth god.1 5 8 It is at
1 5 5 MBA. 1.114.5-35.
l 5 6 MBh. 1.114.65.
1 5 7 MBh. 1.114.65. This MBA passage is reflecting the limitations of the law when
after a third partner, the woman is considered “ loose” and after a fourth she is called a
“ harlot.” This limit to the number of partners a woman may have in her attempts to
produce children for her infertile (or dead) husband, holds true even in times of distress.
This practice is discussed in the Dharmasutras, specifically Gautama 18.4-8. Along with
limiting the number of partners, this practice also insists that there be no ‘love’ between
the woman and man fulfilling his obligations (M.B. Emeneau and B.A. van Nooten, “The
Young Wife and her Husband’s Brother: Rg Veda 10.40.2 and 10.85.44 Journal o f the
American Oriental Society 111.3 [1991], 484-486).
1 5 8 As just mentioned above, Kuntl’s first use of her mantra resulted in the birth
of Karna. Now in this situation with Pandu, Kunti willingly calls upon three different
gods to provide him with three sons. She refuses to call upon a fourth, declaring that
the law does not permit such actions, even in times of distress. Apparently she is
discounting her first use of the mantra, which resulted in the birth of Karna. If Kuntl’s
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this point that Pandu’s second wife, MadrI, implores him to speak to
Kunti on her behalf, so that she too may have children.1 5 9 Upon his
request, Kunti agrees to allow MadrI a one-time use of her boon.
Thinking carefully and cunningly, MadrI calls upon the twin gods, the
Asvins. From them she gives birth to her twin sons, Nakula and
Sahadeva. Kunti, furious and feeling deceived by MadrI, refuses Pandu’s
second request on behalf of MadrI.1 6 0 Thus, through Kuntl’s boon, she
and MadrI are able to circumvent the curse put upon Pandu and provide
him with five sons, henceforth known as the Pandava brothers— the heroes
of the Mahabharata.
Gandharl and Dhrtarastra
Prior to marrying Dhrtarastra, the elder blind brother of Pandu,
Gandharl comforts and attends to Vyasa, legendary author of the
Mahabharata and her future father-in-law. Vyasa had been traveling and
first use of the mantra is counted, then Indra is the fourth god she calls upon, and she
is, in fact, a “harlot.” However, Kunti has kept Kama’s existence a secret (a secret that
will bring her great heartache in the end, as she watches her sons from Pandu fight and,
unbeknown to them, kill their half-brother). Therefore, as far as Pandu is aware, her
objections are legitimate. Beyond Kuntl’s desire to hide her earlier “indiscretion,” she has
grounds upon which she may discount her first encounter with the Sun God. The text
indicates that following the birth of Karna, the Sun God “restored her virginity to her,”
thus making it as if she had never utilized the boon in the first place (MBh. 1.104.10-14).
mMBh. 1.115.1.
mMBh. 1.115.15-24.
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arrived exhausted with hunger and fatigue. She cares for him, and due to
her kindness, he grants her a boon: She will have one hundred sons that
will be of equal station to her husband and herself.1 6 1 After some time,
Gandharl marries Dhrtarastra and becomes pregnant. By the time her
sister-in-law, Kunti, calls upon the god Dharma, Gandharl has already been
pregnant for about a year. For two long years she carries the pregnancy
without giving birth. Not surprisingly, she is beset with misery. Upon
hearing of the birth of Yudhisthira, she feels the hardness of her belly
and becomes exceedingly frustrated, terribly miserable and inconsolably
worried.
Up until this point, she has patiently endured the physical and
mental challenges of her extended pregnancy. But she has now lost the
opportunity of giving birth to the first son of the next generation of her
husband’s clan, and now more than ever she desires the birth of her
baby. Chaitanya describes her as entertaining a hope that if she had had
her son before Kunti, then perhaps the line of succession would revert to
Dhrtarastra’s progeny, as opposed to Pandu’s.1 6 2 With great effort and the
help of her maid, she successfully expels the product of conception. She
mMBh. 1.107.5-9.
'“Krishna Chaitanya, 160.
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delivers a dark, solid mass of flesh— a dense ball of clotted blood. She is
totally distraught. After two years of being pregnant, how is it that all
she has produced is a clotted mass? What has happened to the promise
of her one hundred sons? She can think of nothing else to do but to
dispose of the fleshy mess she has delivered.1 6 3
With his divine sight, Vyasa, sees what has just taken place and
comes swiftly to her aid. Upon his questioning, Gandharl admits she was
about to throw out the mass of flesh. She reminds him of his promise
of one hundred sons and questions the veracity of his boon. Vyasa
reassures her that his words are never for naught. From the issue of her
womb she can have her desired children.1 6 4 However, he foresees the
death and destruction that will come about through these sons, and
encourages her to allow this pregnancy to be fruitless. But Gandharl
refuses. She has endured pregnancy for two years and Kunti has already
given birth to a son. Now Gandharl wants the one hundred sons that
were promised to her.1 6 5
mMBh. 1.107.10-15.
mMBh. .107.15-16.
1 6 5 The record of Vyasa’s warning to Gandharl is in Ganguli’s translation of the
Mahabharata. Kisari Mohan Ganguli, The Mahabharata vol. 1 (New Delhi: Munshiram
Manoharlal Publishers Pvt. Ltd., 1993), 241-242. This warning is not found in van
Buitenen’s translation.
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Vyasa dictates various orders and Gandharl follows his instructions.
She collects one hundred clay pots and fills them with ghee (clarified
butter). Then she sprinkles the ball with cold water. Upon doing this,
the ball of flesh falls apart into one hundred pieces— each an embryo the
size of a thumb joint.1 6 6 Realizing her desire for her sons will come to
pass, Gandharl now allows herself to express her wish also to have one
daughter. She thinks of all the ascetic austerities she has practiced, all the
charitable donations she has made, all the other actions that she has
performed to gratify her superiors, and argues that she ought to be
granted a daughter as well. As Vyasa finishes placing the embryos in
their clay pots, he informs her that there is one extra piece— the piece that
will become her daughter.1 6 7 After each embryo is placed in the ghee
filled pots, they are incubated in a warm, well-guarded place. After some
time, the first of Gandharl’s sons, Duryodhana, is born. His birth is
soon followed by the births of ninety-nine other sons and of one
daughter, Duhsala. Thus, through extraordinary means, the 101 Kaurava
children, the future rivals of the Pandava brothers, are born to Gandharl
and Dhrtarastra.1 6 8
mMBh. 1.107.16-25.
1 6 7 Ganguli 1993, 243-244. Again, van Buitenen’s translation records neither the
desire for nor the birth of Gandhari’s daughter.
mMBh. I.107.34f.
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Points of Contact
What is to be gained by examining this ancient Indian text when
discussing modern assisted reproductive technology? What benefits and
insights might the situations of Kunti, MadrI and Gandharl bring to
bioethical debates on these new technologies? Though speaking from
antiquity, these rich narratives are worthy of close examination, specifically
in light of modern medical advances. As mentioned above, though actual
current medical procedures may be new, the ideas underlying them are
not. Trying to fulfill their desires to have children, these three queens
overcome major obstacles by utilizing their version of what today is
accomplished through various forms of reproductive technology. While
these matriarchs from antiquity sought aid from the gods, contemporary
couples seek aid from fertility specialists. While the queens succeed
through hierogamy, couples today can succeed through assisted
reproductive technology. What the Mahabharata depicts as occurring
through divine agency is today brought about through the agency of
modern medicine. By highlighting specific aspects of the stories of Kunti,
MadrI and Gandharl, several points of contact between antiquity and
modernity are revealed. As previously noted, “points of contact” refer to
the overlapping of analogous, though not identical, circumstances between
the stories in this ancient text and related circumstances encountered in
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modern times. These points of contact provide the basis for applying
relevant themes found in the Mahabharata to the issues being raised in the
context of contemporary bioethical discussions.
Paternal Surrogacy
The first point of contact between this ancient text and modernity
is the issue of surrogacy. In the initial discussion between Kunti and
Pandu regarding his desire to have children, the two discuss the legality
and appropriateness of “acquiring” children for themselves that are not
biologically related to both parents. Pandu reminds his wife that there
are many legal and acceptable ways through which one may obtain sons
and heirs. He says: “In the eyes of the Law there are these six sons who
are of the blood and heirs. They are the son fathered by oneself, the
son presented, the son purchased, the son born by one’s widow, the son
born by one’s wife before her marriage, and the son born by a loose
woman.” Additionally, Pandu lists other means of acquiring sons;
however, these are neither heirs nor of the blood. They are as follows:
“the son gifted, the son bartered, the son by artifice, the son who comes
by himself, the son come with marriage, the son of unknown seed, and
the son fathered on a lowly womb.”1 6 9 Though one may obtain a son
mMBh, 1.111.25-30. The text reads, “six sons who are of the blood and heirs
[. . .] six who are neither heirs nor of the blood.” Though the former list contains six
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through one of the means included in the second list, that son is not
qualified to be an heir. This was the fate of Vidura, Pandu and
Dhrtarastra’s younger half-brother. Unlike his brothers, Vidura had no
physical defects and the text speaks clearly of his wisdom and far
sightedness. However, since his mother was Ambika’s servant, he was
ineligible to take the throne. The first list presents a variety of options
for one desiring an heir. Though the “son fathered by oneself” assumes a
genetic relationship between the father and son, this genetic connection is,
of itself, neither a necessary nor a sufficient condition for producing a
legitimate heir.
One of the traditionally sanctioned means of producing a legitimate
heir that is particularly relevant to the present narrative is the
controversial practice of niyoga. This practice, a form of paternal
surrogacy, allows for a woman to become pregnant by a man other than
options for obtaining a son, the latter list actually has seven options. Similar, though
not identical, lists appear in The Laws o f Manu, 9.158-160. Again there is mention of
twelve options for obtaining a son, “six are both relatives and heirs, and six are relatives
but not heirs.” The six sons that are both relatives and heirs are listed as being the
“Natural, bom in the (husband’s) field, adopted, made, secretly begotten, and rejected.”
The following six (again, there are actually seven options), are relatives but not heirs,
“Born of an unmarried girl, born of a pregnant bride, bought, born of a remarried
woman, self-given, and born of a servant woman.” Wendy Doniger O’Flaherty and
Brian Smith, eds. and trans., The Laws o f Manu, (New York: Penguin Books, 1991)
[9.158-160]. The Laws o f Manu {Mania) is a Hindu law text, “an encompassing
representation of life in the world-how it is, and how it should be lived” (xvii). All
citations of the Laws o f Manu are taken from the Doniger O ’Flaherty and Smith
translation.
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her husband. The Laws o f Manu 9.33-55 utilizes a metaphor likening the
woman’s womb to a field. The husband is the owner of the field and
the “sperm donor” merely the sower of seed. According to this passage,
the husband, “owner of the field,” is the rightful owner of the child, the
“fruit of the field.”1 7 0 Also in Manu 9.145, “the son born in an appointed
woman should take (his share) in the estate just like a natural son, for
according to the law, that seed and the offspring belong to the owner of
the field.” A child, specifically a son, born through niyoga belongs to the
woman’s legal husband.1 7 1
N iyoga is clearly not a license for illicit sex. Manu places limits
on the number of partners a woman may have:
When the line of descendants dies out, a woman who has
been properly appointed should get the desired children
from a brother-in-law or co-feeding relative. The appointed
man, silent and smeared with clarified butter, should beget
one son upon the widow in the night, but never a second.
Some people who know about this approve of a second
begetting on (such) a woman, for they consider the purpose
1 7 0 Manu 9.33-55. The editors of the Laws o f Manu indicate that Manu is
ambivalent regarding this practice. According to them, though Manu acknowledges that
niyoga is a legal emergency measure to provide heirs for a dead husband, he dislikes the
practice and tends to liken it to unofficial adultery. In 9.181, Manu points out that the
natural father has a serious claim to the child bom through niyoga (Doniger O’Flaherty
and Smith, footnote to 9.58, p.203). There are many rules and regulations regarding this
practice. See Gail H. Sutherland’s article, “ Blja (seed) and Ksetra (Field): Male Surrogacy
or Niyoga in the Mahabharata.” Contributions to Indian Sociology (n.s.) 24:1 (1990): 77-
103.
1 7 1 Prakash N. Desai, Health and Medicine in the Hindu Tradition: Continuity
and Cohesion, 67.
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of the appointment of that couple incomplete in terms of
duty [. . ,].1 7 2
Though the text reflects some debate as to whether it is acceptable for a
woman to have one or two sons via niyoga, there is clearly a limit. It is
to be used only as a means of providing heirs for a family.
N iyoga is intended to be a practice devoid of lust-one that is
solely intended to fulfill the practical function of producing a necessary
heir for a woman and/or her husband. According to Manu, a son
fathered by a woman’s brother-in-law, when she already has a son, does
not deserve a share in the inheritance because this second son is a “child
of lust.”1 7 3 Again the text reads, “If a woman who is appointed gets a
son born of lust from some other man, or indeed from her brother-in-
law, they say that that son is not fit to inherit the estate, and begotten
in vain.”1 7 4 This same child, resulting from “lust” is also unqualified to
perform the funeral rites for the husband.1 7 5
Several generations of the Bharata clan participated in this
traditional, though clearly disputed, practice of niyoga. Satyavatl is the
first to advocate its use when she requested that Vyasa serve as a
mManu, 9.59-63.
mManu, 9.143, 147.
mManu, 9.147.
1 7 5 Emeneau and B.A. van Nooten, 484-486.
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surrogate, to father her grandsons, Pandu and Dhrtarastra. Sutherland
notes interesting moral and legal parallels between niyoga and
contemporary surrogate motherhood. “The question which exercised the
ancient Indian lawmakers, namely, who the real father was, is being asked
with respect to mothers in our society. In both contexts, it is a complex
consideration.”1 7 6 Manu records the dilemma of trying to determine
paternity. “They say that a son belongs to the husband, but the revealed
canon is divided in two about who the ‘husband’ is: some say that he is
the begetter, others that he is the one who owns the field.”1 7 7 As will be
discussed in Chapter 6, the debates regarding paternity, and now
maternity, continue with increasing complexity.
Outside of niyoga, the text records other forms of paternal
surrogacy. While Vyasa was the genetic father to Pandu and Dhrtarastra,
Bhlsma, Samtanu’s eldest surviving son, was for a time the clan’s
functional parent, acting as surrogate father and leader. Upon Samtanu’s
death, Bhlsma becomes the patriarch of the family and guides it through
several generations. Out of necessity, he acts as a regent, ruling the
country until his half-brother, Vicitravlrya, and other heirs to the throne
grow to maturity. Though true to his vow of celibacy, Bhlsma is the
1 7 6 Sutherland, 100.
1 1 7 Manu 9.32.
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surrogate father and grandfather to both the Pandavas and Kauravas.
Additionally, until his death, Pandu is the surrogate father to the five
half-divine sons of Kunti and MadrI. The issues and complexities involved
with surrogacy will be discussed in Chapter 6. From these strategies of
paternal surrogacy, we find an acceptance of a variety of means to obtain
offspring.
Sperm Donation and Gene Selection
Pandu’s request that Kunti conceive a son for him through niyoga
is not unique to his family. Kunti, however, rejects Pandu’s suggestion
that she participate in niyoga, a pre-IVF {in vitro fertilization) form of
sperm donation, and instead informs him of her secret boon. By utilizing
Kuntl’s mantra to call upon the various gods, she and MadrI are able to
overcome Pandu’s infertility by accessing a “divine sperm bank,” so to
speak. While Kunti and MadrI obtained their sperm samples from gods,
today individuals visit medical doctors specializing in infertility, fertility
clinics and sperm banks.
In their utilization of this heavenly sperm bank, these queens
participate in a form of genetic selection. Consider Pandu’s wishes for his
first-born. He wants a son who “shall become the standard of Law for
the Kurus,” thus he implores Kunti first to summon Dharma for “having
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been given by Dharma, his mind will not rejoice in lawlessness [. . ,]-”1 7 8
Dharma is not only the one who personifies cosmic order and keeps it
going, he represents the principle of cognition of this order.1 7 9 Thus,
Pandu assumes a son fathered by Dharma will be one who will set the
“standard of Law” for the clan and who will “not rejoice in lawlessness.”
Indeed, at the birth of Yudhisthira, a disembodied voice declares: “He
shall of a certainty be the greatest of the upholders of the Law, Pandu’s
firstborn son [. . .]. He shall be a celebrated king, widely renowned in
all three worlds, [. . .].”1 8 0 As the Mahabharata unfolds, Yudhisthira does
indeed set the legal standard; furthermore, friend and foe alike respect him
for his truthfulness and lawfulness.1 8 1 According to the citizens of the
mMBh. 1.113.40.
1 7 9 Klaes, 19.
mMBh. 1.113.40.
1 8 1 Yudhisthira’s reputation for honesty is held in such high regard that Krsna
utilizes it to defeat Drona. Under Drona’s leadership the Kauravas are gaining ground
and the five sons of Pandu are weary. Krsna informs Yudhisthira and his brothers that
Drona’s commitment to fight will evaporate if they tell him his son, Asvatthaman, is
dead. Thus, they implement the following plan: Bhlma kills an elephant by the name of
Asvatthaman in the presence of Yudhisthira. He then sends a message to Drona
informing him that his son is dead. Disbelieving the messenger, Drona boils with rage
against the Pandavas. Krsna, edging Yudhisthira on, tells him that Drona will
exterminate everyone if he, someone whose truthfulness Drona trusts, does not confirm
the story. With much hesitation and doubt, Yudhisthira goes before Drona. When
Drona asks if Asvatthaman is indeed dead, Yudhisthira admits he saw Bhlma kill
Asvatthaman. As Drona lays down his weapon and Bhlma falls upon him as
Yudhisthira mumbles under his breath, “ whether he is an elephant or a man I did not
say.” Immediately after deceiving Drona, Yudhisthira’s chariot, which used to hover a
few inches above the ground, sank to the surface of the earth (MBh. VII.164.68ff).
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land, Yudhisthira “is a truthful man who knows the value of compassion.
For he, as he knows the Laws, will surely honor Bhlsma Samtanava and
Dhrtarastra and his sons, and provide them with various privileges.”1 8 2 It
is due to this reputation, not necessarily to an objective right to rule, that
a young Yudhisthira is installed on the throne as king following the death
of his father. Thus, Pandu’s selection of Dharma to father his first child
is based on a calculated decision. He desires particular attributes in his
son; consequently, he chooses the god most likely to bestow those
attributes.
The same careful selection process is utilized for choosing the gods
who will father Kuntl’s second and third sons. Having obtained a son
who is law-minded, Pandu then says to Kunti: “They declare that the
baronage (k sa triy a or warrior class) triumphs through strength; thus, for a
second son, choose one of triumphant strength!”1 8 3 Thus, upon his
urging, Kunti summons Vayu and through this union gives birth to
Bhlma— the strong-armed one whose powers are terrifying to all. At his
birth a voice states, “He is born to be strong over all that is strong!” 1 8 4
mMBh. 1.129.5-10. Klaes, comments on how the tendency of this passage to
moralize the crowning of Yudhisthira as king is particularly striking.
mMBh. 1.114.8-9. Parenthesis added.
mMBh. 1.114.5-11. The text records an amazing occurrence that happened
shortly after Bhima’s birth. Kunti is frightened by a tiger and stands up suddenly,
forgetting that Bhlma is sleeping in her lap. Even as a baby, his strength is so
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For his third son, Pandu wonders how he can “obtain a superior
son who will be supreme in the world.” He then thinks of Indra, the
king and ruler of the gods. Indra’s power and enterprise are boundless;
from him Pandu is sure to secure the most powerful son possible.1 8 5 To
ensure success with the one who is sovereign over all other gods, Pandu
does more than simply ask Kunti to call upon Indra. The two of them
undertake a yearlong vow of practicing various austerities. Only after
receiving the following promise from Indra does Kunti call upon him to
impregnate her: “I shall give you a son to be famous in the three worlds,
who shall accomplish the goals of the gods, the brahmins, and his friends.
I shall give you a superb son who shall destroy all his enemies.”1 8 6 Indra
responds to Kuntl’s summons and their union results in the birth of
Arjuna— the greatest warrior and hero of the Mahabharata.1 * 7 It is through
incredible, his little body as hard as diamonds, that when he falls from his mother’s lap
he shatters the mountain upon which he lands, but he himself is unharmed. Seeing the
pulverized mountain, Pandu marvels in amazement {MBh. 1.114.11-15). Elsewhere, stories
record Bhlma’s unmatched physical strength and character: As a child, he overpowers his
cousins, brothers and others {MBh. 1.119.15-40). His unmatched strength is demonstrated
as he literally carries his family to safety: “Then Bhlmasena, whose speed and power
were terrific, took his brothers and his mother and carried them all. He put his mother
on his shoulder, the twins on his hips [. . .]. He shattered the trees with his impact
and rended the earth with his feet [. . .]” {MBh. 1.136.15f).
mMBh. 1.114.15.
mMBh. 1.114.20-25.
1 8 7 At Arjuna’s birth a disembodied voice declares his greatness by saying: “The
mighty leader of his people shall vanquish the barons, and with his brothers the hero
shall offer up the three sacrifices.” MBh. 1.114.34-35. It is said of Arjuna, “in battle he
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this “most superior” son of Indra that, in the end of the Mahabharata, the
Pandava line survives.1 8 8
MadrI also selects her divine “donors” with great care. She is well
aware that Kuntl’s generosity has limits because Kunti had said: “Think,
for this once, of a deity, and of a certainty you shall have a child by
him.”1 8 9 Desiring to maximize her one-time opportunity, MadrI
deliberately calls upon the Asvins, who are twin gods. Consequently, her
use of the mantra results in her having twins— Nakula and Sahadeva.1 9 0
Although Madrl’s choice of deities is not necessarily related to particular
attributes she desires in her sons, it is directly related to her wishes of
increasing her chances of having more than one son. Neither MadrI nor
Kunti make random choices when calling upon specific gods to father
became no less hard to face than the sun” {MBh. 1.1.84). MBh. 1.123.1-40 records the
story of how Arjuna became the greatest archer of his time.
1 8 8 By the end of the Great War, Bhlsma, Drona, the five Pandava brothers,
Duryodhana, his clan, Karna and all the others who fought, die and traverse heaven and
hell (which are interesting stories to explore in and of themselves). The lone survivor of
either clan is a descendent of Arjuna and Krsna. Through his second wife, Subbadra
who is Krsna’s sister, Arjuna has a son Abhimanyu. Abhimanyu marries Uttara and
while she is pregnant with his son, Pariksit, Abhimanyu dies on the battlefield. Thus,
the Pandava family line continues through Arjuna’s grand-son.
mMBh 1.115.15.
mMBh. 1.115.15-20. Nakula and Sahadeva are endowed with “beauty, courage,
and virtue beyond all other men, they shall shine with surpassing luster, with comeliness
and opulence.”
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their sons. Each deity is carefully selected because of the particular
attribute, or result, he will bestow upon the promised sons.
Whereas the narratives in the Mahabharata counter infertility with
the magic and power from the realm of the divine, modern medicine
combats infertility with scientific technology. Kunti and Madrl’s process
of meticulously choosing a donor for one’s potential baby is analogous to
what occurs in modern sperm donation situations. When choosing a
sperm donor, individuals and couples consider the attributes they desire in
their potential child. They seek answers to all sorts of questions: What
race is the sperm donor?; Where is he from?; What are his physical
characteristics?; What is his IQ; Grade Point Average?; How much
schooling has he completed?; and What is his current profession?.1 9 1
These same questions and others are asked of women willing to donate
their eggs.1 9 2 When going beyond conventional methods of childbearing,
individuals in antiquity, as well as today, prefer not to simply go with
mIn her book Private Choices, Public Consequences, Lynda Beck Fenwick,
mentions the Repository for Germinal Choice in Escondido, California. This is a sperm
bank, founded in 1963, that specifically provides sperm for donor insemination from men
of recognized intellectual achievement (268).
mD aily Trojan, the University of Southern California student newspaper,
consistently runs adds soliciting women to “donate” their eggs. One heading reads as
follows: “ Pay your tuition with eggs.” It continues, “If you’re a woman between 18 and
32, you can earn money easily, anonymously. Donate your eggs to an infertile couple.”
The add then goes on to indicate that a woman willing to participate will receive
“$5,000 and up, depending on your education and other qualifications.” D aily Trojan
April 12, 2002.
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the “luck of the draw.” Rather, they attempt to manipulate as many
factors as possible, so as to control the type of child that will eventually
be born. Just as Kunti and Pandu carefully select their divine sperm
donors, modern individuals meticulously review the charts of potential
sperm and egg donors.
Post-mortem Sperm Donation
Another “point of contact” between the Mahabharata and
modernity is the concept of utilizing a dead man’s sperm for
impregnation. Recall Pandu’s attempt to convince Kunti to produce a
child for him by participating in niyoga. As previously noted, Kunti has
eyes only for Pandu. She says: “For not even in my thoughts shall I go
to any man but you. What man on earth is greater than you?”1 9 3 Kunti
has no desire to be with any other man. It is in the context of this
discussion that she reminds him of the following story.1 9 4 King Vyusitasva
is a law-abiding man whose reputation is respected by men and gods alike.
When he conducted sacrifices, the great seers of the land and all the gods,
including Indra, attended. This king loves his wife, Bhadra Kakslvatl, a
woman of great esteem and unmatched beauty. Tragically, one night
mMBh. 1.112.5.
1 9 4 Interestingly, in this narrative, both Kunti and Paridu ground their arguments
in traditional stories.
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while engaging in sexual intercourse with his wife, the king dies. Bhadra
is overcome with grief: not only has she lost her beloved husband, she is
left without any sons. Clinging to his corpse, she continually laments her
loss and wishes for her own death. Then a hidden voice speaks: “Rise up
[. . .]. I shall father children on you, my sweet-smiling wife. On your
own bed, on the eighth or fourteenth day of the moon, when you have
bathed after your season, you shall lie with me.”1 9 5 The queen follows
these instructions and through her husband’s ascetic powers that reach
beyond the grave, she is impregnated by the king’s corpse and eventually
gives birth to seven sons.1 9 6 Kunti utilizes this story to remind Pandu
that there are other options: They can have children without her having
to have sexual relations with another man. For the purposes of this
study, this account is interesting because it provides yet another example
of how this ancient text contains precursors to contemporary ideas—
namely, the utilization of postmortem sperm.
The first modern postmortem sperm procurement was reported in
1980. The family of a 30-year-old man requested his sperm be preserved
following a deadly motorcycle accident. Dr. Rothman utilized a method
by which he extracted and cryopreserved viable sperm from the deceased.
1 9 5 MBh. 1.112.30.
mM Bk 1.112.34.
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1 1 4
Over a decade later, due to press coverage, the general public became
more aware of such procedures when a newlywed wife requested the
sperm of her deceased husband be preserved so that she would have the
opportunity to bear his children in the future.1 9 7 This newlywed was in a
similar position to that of queen Bhadra. Their husbands had died
leaving them both childless. Whereas Bhadra was able to conceive
through the ascetic powers of her husband, the North American woman
in 1994 secured similar capabilities through the advances in medical
technology.1 9 8
1 9 7 Susan M. Kerr, Arthur Caplan, Glenn Polin, et al., “Postmortem Sperm
Procurement,” The Journal o f Urology 157:6 (June 1997), 2154-2158.
1 9 8 Fenwick discusses issues that arise from utilizing sperm postmortem. She
presents the case of Ed and Nancy Hart. After four years of marriage and unsuccessful
attempts to have children, Ed was diagnosed with esophageal cancer. Prior to receiving
treatment for his cancer, Ed deposited sperm samples in a fertility clinic, to be utilized
at a later time by his wife Nancy. Following Ed’s death in June 1990, Nancy became
pregnant with his sperm and Judith was born a year after her father’s death. The state
of Louisiana refused to recognize the baby as Ed’s child because Ed was not alive when
child was conceived. This began years of legal battles between Nancy and state and
federal governments. When Judith was five years old her entitlement to social security
benefits was finally recognized. Fenwick asks the probing question, “Should society be
willing to underwrite survivors’ benefits for children who did not actually survive their
father’s death but rather came into existence after death?” (195-198).
A more recent example of the difficulties that can arise from utilizing
postmortem sperm was presented on NBC. On August 5, 2001, NBC’ s 11:00pm Nightly
News ran a story of five-year-old twin girls bom two years after their father’s death.
Their mother was suing the Social Security Office for benefits that were denied. This
governmental office ruled that the girls were illegitimate, thus not eligible for benefits,
because their father’s death ended his marriage to their mother.
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Adoption
Acquiring children through adoption is another point of contact
between Kunti and Madrl’s story and modernity. From the list discussing
the means through which an heir may be obtained, some process of
adoption may be assumed. In Kunti and Madrl’s situation, there is a
clear transfer of parental responsibilities. According to the story, one
spring day MadrI and Pandu walked alone in the forest. Pandu “could
not control his lust, and lust overpowered him [. . .]. He forgot the
curse and forced himself upon MadrI.” She struggled and with all her
might tried to stop him, but was unsuccessful. In his moment of passion,
the great king died in the arms of MadrI.
Upon Pandu’s death,1 9 9 Kunti and MadrI both present arguments
supporting their desires to follow Pandu in death through sad. Kunti
says: “I am the elder wife by the Law, and the great fruit of the Law is
due to me [. . .]. I shall follow my husband here who has succumbed to
the dead. Stand up and let go of him! Look after the children.” MadrI
counters by arguing that she is the one with whom Pandu was having
sex, therefore she ought to be the one to follow him to “Yama’s seat.”
Additionally she says:
Nor will I go on living, treating your children the same as
mine, noble lady, for evil would touch me that way!
mMBh. 1.116.1-9.
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Therefore, you, KuntI, must treat my twins as your own
sons [. . .]. Watch over our children and think kindly of
me [. . .].2 °°
This in effect is a form of adoption. MadrI “gifts” or “presents” her sons,
to KuntI and commits herself to sad. From this time on, KuntI raises
the five sons of Pandu as her own.
In vitro Gestation and Artificial Wombs
Gandharl’s situation is every bit as intriguing as that of KuntI and
MadrI. Though the manner in which Gandharl brings forth her children
is interesting and brings to mind some controversial issues regarding
reproductive technology, our discussion needs to begin with an
examination of the context in which she delivers her children. There is a
common assumption that Gandharl is attempting to abort her fetus
through the act of an abortion.
In his chapter “On Abortion and the Moral Status of the Unborn,”
Julius Lipner utilizes Gandharl’s situation as an example of abortion.
Defining abortion in the “causative sense, that is, as the deliberate
effecting of a miscarriage, a deliberate termination of pregnancy”— which
usually results in the “morally reprehensible killing (hatya)” of the fetus,
2 0 °MBJi. 1.116.20-30.
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Lipner demonstrates how abortion is clearly condemned in classical Indian
texts.2 0 1 From his study he concludes that:
[. . .] from the earliest times, especially in the formative
classical period described, both in canonical and
collaborative orthodox Hindu literature, abortion (viz.,
deliberately caused miscarriage as opposed to involuntary
miscarriage) at any stage of pregnancy, has been morally
condemned as violating the personal integrity of the
unborn, save when it was a question of preserving the
mother’s life. No other consideration, social or otherwise,
seems to have been allowed to override this viewpoint.2 0 2
Lipner argues, “Gandharl aborts ‘fainting with grief’” because “she is
aware that she is transgressing the ethical code by her deed.”2 0 3 Lipner
assumes that Gandharl’s actions are motivated by the desire to terminate
her pregnancy, an act that will bring about the death of her fetus. True
enough, she wants to end her two yearlong pregnancy. However, are her
actions motivated by the desire to bring about the “reprehensible killing”
of her fetus? A close examination of her story will reveal that this may
not be an accurate assessment of her motives. She is not necessarily
trying to bring about the death of her baby, but rather she is trying to
2 0 1 Julius J. Lipner, “The Classical Hindu View on Abortion and the Moral Status
of the Unborn,” in Hindu Ethics: Purity, Abortion, and Euthanasia (New York: State
University of New York Press, 1989), 42-43. Crawford’s reading of the Mahabharata and
Ramayana lead him to conclude that in this literature life begins at conception and
preserving this life is of utmost importance (Crawford, 1995, 25).
2 0 2 Lipner, 60. Crawford and Young express similar understandings (Crawford,
1995,25; Young, 19-20).
2 0 3 Lipner, 47-48.
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discover what is going on in her body and perhaps to even bring about
the birth of her fetus. If a simple abortion were her intention, then it is
highly unlikely that she would have waited two years before terminating
her pregnancy.
It is important to pay attention to the particular circumstances
surrounding Gandharl’s actions. Recall that by the time KuntI calls upon
Dharma, the first god she summons with her mantra to father a child for
Pandu, Gandharl has already been pregnant for over a year. By the time
of Yudhisthira’s birth, Gandharl has endured pregnancy for two
excruciatingly long years. The story reads: “When she heard that KuntI
had born a son, splendid like the morning sun; and when she felt the
hardness of her own belly she began to worry.”2 0 4 Her worry,
frustrations and anger should not be underestimated. Because of her
unusually prolonged pregnancy, Gandharl has not only endured the
psychological and physical discomforts associated with pregnancy, she has
also forfeited the claim of giving birth to the first-born son of the two
brothers. This is not an issue to be taken lightly in this narrative; as
indicated above, questions regarding the legitimacy of rule are an
underlying issue in the text as a whole. She takes action only after she
hears that KuntI has given birth to a son. According to the text, her
2 0 4 MBA 1.107.10.
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actions do not appear to be motivated by a disregard for fetal life, but
rather by the concern of a mother who is eager to discover the life of
the unborn within her belly.
Additionally, the argument that Gandharl’s actions do not display a
disregard for fetal life are supported by her insistence that Vyasa act to
ensure that this pregnancy result in the birth of her children. Upon the
delivery of the ball of flesh, Gandharl is understandably distraught. At
first she is about to dispose of the “iron” ball of “clotted blood”;
however, when given an opportunity to do otherwise, she takes it. She
even disregards Vyasa’s warning of the destruction that will be brought
about by the birth of her first son. She wants her prolonged pregnancy
to result in the birth of children, not in their death. The motivations
behind her actions are rooted in her desire to have and to see her long-
awaited children.
Lipner makes it quite clear that abortions are prohibited except
when the mother’s life is in danger. He argues that Gandharl is well
aware that she has transgressed the ethical code and that this is, in fact,
why Vyasa rebukes her upon his arrival. In this event, “the abortion
does not have its natural consequence but is redeemed by Vyasa’s
prescribing a surrogate gestation. All’s well in the end.”2 0 5 According to
2 0 5 Lipner, 48.
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Lipner, Vyasa graciously redeems Gandharl’s wrongful deed. However,
viewed from an alternate perspective, exactly how long would Gandharl be
expected to endure this seemingly endless state of pregnancy before her
actions would not be interpreted as “transgressing the ethical code”?
Granted, the Mahabharata gives no indication that this pregnancy is in
any way actually endangering Gandharl’s life. Nevertheless, the average
human gestation is approximately forty weeks. Gandharl has already
surpassed this norm by sixty-four weeks. Pregnancy places great demands,
both physical and psychological, on the expectant mother. Surely
Gandharl ought to be praised, not criticized, for patiently enduring this
pregnancy for approximately 104 weeks!
The manner in which Gandharl obtains her 101 children is
remarkable and brings to mind some very controversial issues regarding
reproductive technology. Recall how Gandharl’s product of conception is
divided into 101 thumb-sized embryos.2 0 6 These embryos all originate
from the same substance— the same genetic material. Gandharl and Vyasa’s
actions could be considered crude analogies to modern attempts at
“cloning,” or at least at “embryonic manipulation.” Their actions differ
from the actual procedures of cloning; they did not retrieve human eggs
from Gandharl or some other women and extract the nucleus from the
2 0 i MBh. 1.107.15-25.
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eggs. Nor did they gather cells from her or her husband and
electronically fuse them with the harvested, DNA free eggs. However,
they did take the same genetic material, as it were, and divide it up to
produce 101 embryos.
Following Vyasa’s instructions, Gandharl does more than participate
in something akin to “embryonic manipulation.” Although the
fertilization of Gandharl and Dhrtarastra’s gametes occurred in utero, the
final gestation was in vitro,2 0 7 so to speak. Gandharl and Vyasa took each
zygote (fertilized human egg) and “implanted” it into the ghee-filled clay
pots. These pots become more then glass “test-tubes.” They become
“artificial wombs” (ectogenesis) that gestate the developing embryos until
they are brought to term— a feat yet to be accomplished by modern
medicine.
Although contemporary forms of assisted reproductive technology
are becoming increasingly sophisticated and utilized, such procedures are
not without risks and concerns. Gandharl goes beyond the conventional
methods of producing offspring and takes action that results in her having
101 children. The problem of multiple-gestational pregnancies is presently
2 0 7 Lipner also makes reference to this being a possible early substitute for in vitro
gestation (47).
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considered to be a major area of concern.2 0 8 The complications associated
with it are all too familiar to contemporary users of assisted reproductive
technology. The use of Clomid (clomiphene citrate), IVF, GIFT, ZIFT,
and other procedures often result in the development of multiple embryos
and, subsequently, multiple births.2 0 9 This situation leads to increased
physical risks to the mother and to the developing fetuses. It also raises
questions regarding the physical, psychological, and financial abilities of
parents to care for the children who issue from multiple birth situations.2 1 0
2 0 8 New York State Task Force on Life and the Law, Assisted Reproductive
Technologies: Analysis and Recommendations for Public Policy (New York: New York
State Task Force on Life and the Law, 1998), 149.
2 0 9 According to statistics cited in the New York State Task Force’s report,
“Infertility treatment is the major factor that has been implicated in the nationwide surge
in the number of multiple births. Between 1974 and 1994, the rate of triplet and higher
order multiple births increased fourfold.” Nationally and internationally, multiple births
attributed to assisted reproductive technologies are as high as 67 percent {Ibid., 149-150).
2 1 0 The McCaughey and Chukwu families received international media attention
(and subsequent commercial sponsorships) following the successful delivery of septuplets
and octuplets, respectively. Following the birth of the McCaughey’s thirty-one-week
septuplets, ranging in birth weight from two pounds five ounces to three pounds four
ounces, the Governor of Iowa came through with his promise to build Bobbie and
Kenny McCaughey a new, bigger home. Other gifts included university scholarships for
all seven of the children, ten years of portrait photographs, a lifetime supply of Pampers,
and seven years of cable TV. Not every individual can count on family and communal
support in raising up to eight children all at once. Additionally, few receive television
coverage and the resulting financial sponsorship support [Arlene Judith Klotzok, “Medical
Miracle or Medical Mischief?: The Saga of the McCaughey Septuplets,” Hastings Center
http://www.medicalpost.com/mdlink/english /members /medpost/data/3 519/13A. HTM. 5/2/01],
Critics make an astute observation when they comment on how the public
welcomes the situations of these multiple births, despite the medical complications and
the emotional and financial burdens that accompany them. Multiple gestational
pregnancies expose both mother and babies to a great deal of risk. Ovarian
overstimulation, a complication associated with various fertility medications, can cause
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The above assessment of these points of contact clearly
demonstrates the significance of this ancient Hindu text to contemporary
bioethical discussions, specifically regarding assisted reproductive technology.
We have examined only a few examples of how the birth narratives of
the children of KuntI and Gandharl contain elements that are somewhat
analogous, even precursors, to modern day medical practices. Beyond
recording how individuals in the remote past struggled with infertility and
employed various creative methods to overcome reproductive limitations,
the Mahabharata contains voices that have relevant contributions to make
in the on-going dialogues concerning specific issues in contemporary
reproductive bioethics.
swelling and bleeding of the ovaries and severe fluid retention, and in rare situations this
can lead to heart failure. These women are at higher risk for fatal blood clots during
pregnancy and delivery. The babies of multiple gestational pregnancies often suffer from
chronic lung disease, strokes, mental retardation, and blindness. (Klotzok, 6) In her
article “ Access to Justice: ‘Planned Parenthood’: Adoption, Assisted Reproduction, and the
New Ideal Family,” Susan Appleton juxtaposes the public’s outpouring of awe,
excitement, and support in situations of multiple births, with circumstances where families
have more children than they can handle without outside assistance. The same public
that applauds the family with multiple gestational births condemns the latter family as
being “irresponsible.” According to Appleton, the only thing that distinguishes the
babies born as a result of assisted reproductive technology is that their parents went to
considerable trouble to have them. Susan Appleton, “ Access to Justice: ‘Planned
Parenthood’: Adoption, Assisted Reproduction, and the New Ideal Family,” Washington
University Journal o f Law and Policy 1:85 (1999).
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CHAPTER 4
NARRATIVE AS A SOURCE OF ETHICS
The previous chapter has presented the stories of how KuntI,
MadrI, and Gandharl deal with the challenges of becoming pregnant and
how these stories constitute points of contact between the narratives of
the Mahabharata and some specific issues faced in modernity. These
connections exemplify the status of this ancient text as being the
“strongest link between India old and new.”2 1 1 This epic contains more
than simply fascinating or entertaining stories; it preserves key elements of
Hindu thought that informed the past and that may yet provide guidance
for the present and the future.
This chapter begins with an exploration of four topics extracted
from the Mahabharata that remain relevant in contemporary discussions
regarding assisted reproductive technology. The first topic relates to how
the examined narratives place a priority on having children. Building
upon this established value, the second topic demonstrates how these
stories reflect an acceptance of a variety of creative means for producing
children. Though the texts may approve of various “technologies” for
procreation, they would do so within a spirit of restraint. The third
2 1 1 Matilal, 3.
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topic of examination concerns the role of women. These narratives
portray women actively participating in their reproductive choices.
Finally, textual depictions of the interrelationship between gods and
humans in the process of procreation are examined. After examining the
relevance of these topics with respect to the general issues of assisted
reproductive technology, it will become possible to compare and contrast
Hindu perspectives with the attitudes present in the Hebrew Scriptures
and Roman Catholic teachings.
As discussed in Chapter 2, Hinduism is a religion overflowing with
options, alternatives and divergent beliefs. Its traditions neither owe their
origin to a single religious leader or prophet nor do they have a single
determinate creed or centralized hierarchical structure. This, combined
with the fact that Hindu traditions tend not to establish clear categories
of, and distinctions between, philosophy, religion, and the living of
practical life itself, leads to the development of multifaceted traditions that
embrace a variety of voices. It is said that many Hindus welcome
pluralism and are bothered by attempts to eliminate alternative views.
Arvind Sharma asserts that Hinduism is a “religion of options rather than
prescriptions, of propositions rather than dogmas; a religion which prefers
the article a (a truth) to the (the truth); a religion of guidelines rather
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1 2 6
than rules, and a religion which allows for more variations of the basic
positions than its own Kama Sutra.”2 1 2
Hindu traditions are pluralistic, syncretistic and do not have a
monolithic perspective on any topic. Though one will not find the
Hindu perspective on assisted reproductive technology, this does not mean
that Hindu ideas, attitudes, and insights relevant to the subject do not
exist. Though the ancient Indian seers may have constructed systematic,
all encompassing philosophical arguments, no one system was accepted as
absolute or as exclusively expressing truth. The Mahabharata preserves
this moral philosophical thinking of the Indian traditions. Matilal argues
that the “moral dilemmas presented in the Mahabharata were in some
sense universal, for most of them can be effectively used even today to
illustrate arguments in moral philosophy.”2 1 3 This chapter utilizes this text
to examine specific issues as they relate to assisted reproductive
technology.
2 1 2 Arvind Sharma, “When it Comes to Karma” in Ethical Issues in Human
Cloning: Cross-Disciplinary Perspectives, ed. Michael C. Brannigan (New York: Seven
Bridges Press, 2001), 98.
2 1 3 Matilal, 5.
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Applicable Topics Addressed in the Mahabharata Narratives
1. Desirability of Progeny
Through an examination of the situations faced by KuntI, MadrI,
and Gandharl it is evident that for many within traditional Hindu culture,
having children, specifically sons, is of utmost importance.2 1 4 According to
Manu, women are the “goddesses of good fortune” and “worthy of
reverence and greatly blessed because of their progeny.”2 1 5 In The D ivine
Hierarchy, Lawrence Babb suggests, that to “be a mother is to be a
complete woman, and only with the birth of children is a woman’s
position in her husband’s family fully secure.”2 1 6 Prompted by this
cultural edict, many women, including three queens, have engaged in
extraordinary means in order to procreate. Recall how, after renouncing
his throne and practicing austerities for a number of years, Pandu becomes
despondent. He says to his community of ascetics,
For a childless man they say, my lords, there is no door
to heaven. Therefore I who am childless am much
troubled [. . .]. The sons of man are born on earth with
four debts, which are to be paid to the ancestors, Gods,
2 1 4 Obviously the strong desire to have one’s own children is not unique to those
within Hindu traditions. The same can be said for many within our contemporary
North American traditions. Carson Strong, Ethics in Reproductive and Perinatal
Medicine: A N ew Framework (New Haven: Yale University Press, 1997), 14.
ll5Manu IX.26.
2 1 6 Lawrence Babb, The Divine Hierarchy: Popular Hinduism in Central India
(New York: Columbia University Press, 1975), 76.
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seers, and men [. . .]• With sacrifices he pleases the Gods,
with study and austerities the seers, with sons and sraddhas
the ancestors, with benevolence men. I am acquitted by
Law of my debts to seers, Gods and men; but not of my
debt to the ancestors, and therefore I am troubled, ascetics.
This is certain, that when my body perishes, so will the
ancestors. It is to beget children that the best of men are
born in this world. Should I have offspring in my field,
just as I myself was begotten by the great-spirited seer in
my father’s field?2 1 7
Pandu has four moral/religious debts-one to the sages, one to the gods,
one to men, and one to his forefathers. The last debt is fulfilled only
through the birth of a son.2 1 8 According to Sutherland, sons save their
forefathers from hell by performing the sraddha, funeral ceremonies in
which ancestors are ritually remembered and sustained through the
presentation of offerings.2 1 9
Similar sentiments are reflected in the Laws o f Manu: “As soon as
his eldest son is born a man becomes a man with a son, and no longer
2 1 7 MBh. 1.111.10-17. Pandu’s reference to having offspring in his “ field” is
reminiscent of the metaphor in Manu. He is also referring to Vyasa’s participation in
niyoga, when he sowed seeds in Pandu’s dead father’s “field,” that is, in the wombs of
Vicitravlrya’s widows, Ambika and Ambalika.
2 1 8 Manu does make provisions for those who have daughters but no sons. “ A
man with no son may make his female child an appointed daughter [. . .]. Whatever
children are born in her will offer the refreshment for the dead for me.” According to
the text, “A son is just like one’s self, and a daughter is equal to a son” Manu IX. 127-
130. Elsewhere in the same chapter, “There is no distinction between a son’s son and a
daughter’s son in worldly matters, for a daughter’s son also saves him in the world
beyond, just like a son’s son” Manu IX. 139.
2 1 9 Sutherland, 80.
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owes a debt to his ancestors; that is why (the eldest) deserves to have the
whole (estate).”2 2 0 Elsewhere Manu is recorded as saying:
A man wins worlds through a son, and he gains eternity
through a grandson, but he reaches the summit of the
chestnut horse through the grandson of his son. Because
the male child saves (trayate) his father from the hell called
put, therefore he was called a son (putra) by the Self-
existent one himself.2 2 1
Though a great king, accomplished in many ways, Pandu laments the fact
that without children he will neither fulfill his obligations to his ancestors
nor reach the summit of the sun (moksa), spiritual liberation.
In a discussion on the various qualities of marriages, Manu explains
what sons from these marriages can accomplish. From one marriage a
son can “free from guilt ten of the ancestors who came before him, ten
later descendants, and himself as the twenty-first.” From other marriages
a son frees “seven ancestors and seven descendants,” or “three of each.”2 2 2
W ithout sons, one’s ancestors suffer. This is evident in the story of the
ascetic Jaratkaru. Upon seeing the suffering of his forefathers, and hearing
them rebuke him for his vows of asceticism and celibacy, Jaratkaru
2 2 0 Manu IX. 106-107.
2 2 1 Manu IX. 137-138. The “chestnut horse” is the highest world of the sun. (see
IV.231). This importance of having children is also discussed in Baudhayana Dharmasutra
16.1-14.
2 1 1 Manu 111.37-38.
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repents. He agrees to find a wife, get married, and have a son for the
express purpose of relieving his ancestors of their suffering.2 2 3
Crawford comments on the significance of male children within
traditional Hindu families. According to him:
the procreation of sons is especially coveted, partly for
economic and social reasons, but mostly for religious
reasons. The sraddha ceremony is a religious rite
performed for deceased ancestors. It is believed to have the
power to avert the sins of omission and commission of the
parents that are visited upon their family. The rite also
assists the admission of the deceased father into the
company of the forefathers. It follows that a father not
having a son to effectuate his passage into the assembly of
the pitr, through sraddha offerings, is indeed cursed.2 2 4
The narrative within the Mahabharata reflects this emphasis on the need
to have children. Not only will they assist the family in economic and
social success, sons ensure success after death as well.
Arti Dhand asserts that this desire for children is given such a
priority that it “functions as an extenuating condition that overrides the
usual conventions of society. It is a value that supercedes the value of
tidy sexual relations; it acknowledges a need more basic to humanity.”2 2 5
Though this priority of bearing children, in particular sons, is not unique
mMBh. 1.13.20-21.
2 2 4 Crawford, 1995, 26-27.
2 2 5 Dhand, 19.
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to Indian religions, traditional Hinduism establishes childbearing as a duty
for those in the householder stage.2 2 6 The Laws o f Manu provide explicit
instructions regarding when to engage in sexual intercourse so as to
optimize the chances of conception.2 2 7 Furthermore, prior to taking up a
life of renunciation (the fourth stage of life) and focusing on liberation
(moksa),m individuals must not only have provided for their family, they
must also have children (sons) and grandchildren (grandsons). The
Mahabharata clearly reflects this traditional Hindu ideology— that having
children is an important priority, even definitive, for humans. According
to Narayanan, this emphasis on having children opens the doors for
contemporary couples to seek the use of assisted reproductive
technology.2 2 9
^Traditional Hinduism (Brahmanical synthesis) speaks of four stages of life
(asramas) that an individual (particularly men) progress through. These stages are
discussed below in chapter four of this work.
2 2 7 Manu IH.45-50.
2 2 8 Along with the four stages of life, Hindu traditions acknowledge four legitimate
goals, or ends, of life: wealth (artha), pleasure/artistic and cultural life (Lama),
duty/righteousness (dharma) and liberation (moksa). According to Radhakrishnan, human
beings are whole, thus all of their activities have an overarching unity (Radhakrishnan
1993, 56). The individual in the house holder stage usually focuses on the first three of
these goals. Both the stages and goals of life will be further elaborated upon in a later
discussion on dharma.
2 2 9 Narayanan, “Hindu Ethics and Dharma,” 192.
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2. Utilization of “Technology”
Beyond extolling the important role of sons, the examined
narratives, and the Mahabharata as a whole, appear to have few if any
limitations on the utilization of creative means in one’s attempts to
produce sons. One can clearly argue that the Mahabharata would not
only permit the use of surrogacy, sperm donation, participation in gene
selection, and embryonic manipulation, it would condone such practices.
According to the text, none of the gods hesitates when he is called upon
to respond to KuntI’s mantra. The text records no approbation of KuntI,
Pandu or MadrI for utilizing the mantra.2 3 0 The text records no hint of
disapproval over how queen Bhadra obtains her children from her
deceased husband; rather it praises her for her devotion and faithfulness.
Gandharl is not criticized for her actions, even though she was warned
that her eldest son would become a driving force behind the Great War
that would bring devastation to the clan and nation as a whole. Desai
states that myths “like this could be advanced to show the ethical
acceptability of test-tube babies for Hindus.” He goes on to include
ovum donation and implantation of zygotes.2 3 1 These Mahabharata
2 3 0 RecalI that KuntI is not even criticized when, out of curiosity, as a young,
unmarried, teenager, she calls upon the sun god to ascertain if the mantra actually works
MBh. 1.04.9-15.
2 3 1 Prakash N. Desai, Health and Medicine in the Hindu Tradition: Continuity
and Cohesion, 68.
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narratives imply that the methods or “technology” utilized to bring about
the birth of children are, in and of themselves, acceptable within the
scope of Hindu ethics. According to Desai, their use is quite arguably
within ethically acceptable bounds for those who embrace Hinduism.2 3 2
Though sexual intercourse did precede procreation in the narratives
examined in the Mahabharata, according to other stories within the text,
procreation is not necessarily dependent upon sexual intercourse. Consider
the circumstances surrounding the conception of Satyavatl, grandmother of
Pandu and Dhrtarastra. Thinking upon the loveliness of his wife, King
Vasu inadvertently ejaculates. Eventually his sperm ends up in the river
Yamuna, where a fish swallows it. One day, fishermen catch this fish
and, upon cutting its belly, they find Satyavatl and her twin brother.2 3 3
A story such as this demonstrates that this epic is open to and accepting
of a variety of means to bring about the birth of children.
Though the Mahabharata encourages creativity and displays openness
to the process of procreation, it does not argue that “anything goes.”
KuntI’s case highlights a particularly relevant and important issue to
modern reproductive technology--that of designating appropriate limits of
2 3 2 This discussion regarding the appropriate use of reproductive technology is
further developed in Chapter 6 of this work.
mMBh. 1.57.35-55.
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use. Recall how KuntI willingly calls upon three different gods to
provide Pandu with three sons. Upon his request for a fourth son, she
refuses. According to the passage, the law places limits on the number of
children a man may legitimately obtain through niyoga™ Even in times
of distress, when children may be more vulnerable and more likely to die,
the law does not even mention the option of producing a fourth son
through this controversial practice. The purpose of niyoga was to provide
progeny, not opportunities for illicit sex. Therefore, this practice placed
limits on the number of partners a woman may have through its
utilization.
KuntI willingly applies the limitations placed on the practice of
niyoga to her use of the mantra. There is no indication that the power
of the mantra itself is limited. Theoretically, KuntI could provide Pandu
with an endless number of sons, while not being labeled a harlot, by
simply calling upon the same gods again and again. This, however, is not
her chosen course of action. Kuntl’s objection to using her mantra a
fourth time is related to her desire to stay within the limits of the law of
niyoga, as well as not to be branded a harlot.2 3 5 Kuntl’s willingness to
limit the use of her mantra provides a good example of restraint that
mM B h. 1.114.65.
niM B h. 1.104.10-14.
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should perhaps be a lesson for our present times. Like Kuntl’s mantra,
assisted reproductive technologies appear to have no limits within
themselves. Therefore, similar to KuntI, we ought to take the
responsibility of limiting our own utilization of modern technology.
Upon Pandu’s request, KuntI allows MadrI to utilize the mantra.
Here again she limits its use by refusing her husband’s second request on
behalf of MadrI. Admittedly, Kuntl’s refusal of this second request is
probably more related to the fact that she feels deceived and she believes
MadrI is trying to get the better of her,2 3 6 than it is related to her desire
to stay within the law. Regardless, though the power in the mantra is
apparently unbridled and limitless, KuntI is careful not to misuse or abuse
it. She carefully controls its use and distribution. Drawing on this story,
one can draw the conclusion that though the Mahabharata encourages
creativity and would support the utilization of reproductive technologies, it
2 3 6 The text clearly indicates that KuntI is annoyed, even feeling threatened by
Madrl’s cunning choice of calling on the A wins. Kuntl’s response to Pandu’s second
request on behalf of MadrI is as follows: “I said to her, ‘For this once,’ and she got
two! I was deceived! I fear that she will best me. That is the way of women! I had
not known, the more fool I, that by invoking two Gods the fruit would be doubled.”
(MBh. 1.115.23-24) This passage captures Kuntl’s distrust of MadrI and it reveals a sense
of competition between the two wives. KuntI is the first and elder wife, and beautiful
in her own right, but MadrI is younger and exceedingly beautiful. As the story
continues in the Mahabharata, it is, in fact, Madrl’s irresistible beauty that brings about
the death of Pandu.
Additionally, this dialogue between KuntI and Pandu implies that KuntI would
desire to have more children. She is angry and calls herself a “fool” for not realizing
that by calling on twin gods her “fruit would be doubled.”
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also strongly advocates restraint. Though the text may not exclude
creative means through which one overcomes infertility, it definitely limits
the extent to which one ought to utilize such technology.
3. Women and the Control of Procreation
When discussing procreation and the challenges that are associated
with it, it is interesting to note the active role women play in the
process. The Mahabharata’ s depiction of women, their roles in society,
and their influence in reproductive issues reflects a complexity that exists
even today. While there is no denying that this epic is infused with and
upholds a dominating patriarchal social system, it nevertheless preserves
stories of women who possess a wide range of power and influence.
Recalling the circumstances surrounding the conception of Pandu
and Dhrtarastra,2 3 7 Dhand argues that there is a general lack of enthusiasm
on the part of women to participate in the traditional practice of niyoga.
She maintains that women are at the mercy of their husbands,
grandparents or whoever is the family leader. Most of the time.
the women themselves apparently have very little to say in
the process-either in choosing their partners, or in
determining the recourse in the first place. In these
instances, the women are passive instruments for the will of
their husbands and their affinal kin [. . .]. The emotional
2 3 7 Satyavati, acting to ensure the continuation of the family line through the
wives of her son, Vicitravlrya, summons Vyasa from a life of renunciation to engage in
niyoga with her two childless, widowed daughters-in-law, Ambika and Ambalika. MBh.
1.99. Iff.
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1 3 7
maternal fulfillment of the women is a distant second
concern, if it is a concern at all. N iyoga performed under
these circumstances, under which the women do no[t] share
in the decision-making, and are given no choice, appears to
excite terror and misery in the women involved.2 3 8
The reactions of Satyavati’s two widowed daughters-in-law, Ambika and
Ambalika, to the thought of coupling with Vyasa, lend support to
Dhand’s claim that most women did not welcome niyoga. Ambika was
so repulsed by Vyasa’s presence that when faced with the prospect of
having to sleep with him again, she avoids the situation by secretly
disguising her servant Amba and sending her in to Vyasa.2 3 9 This story
reveals how the experiences, thoughts and feelings of many women are
neither considered nor consulted, even in circumstances where their lives
are most affected. This instance supports Sutherland’s description of
niyoga as being a practice that supports the idea that women/wives were
property belonging to their husbands.2 4 0 If a family is in need of heirs,
then the women are expected to do as they are told in order to satisfy
the clan’s needs.
While portions of the Mahabharata depict women as being
powerless, passive characters, there are other situations where this is not
B 8 Dhand, 11.
mMBh. 1.100.20-25.
2 4 0 Sutherland, 98-100.
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the case. Though many women may have found niyoga distasteful, there
are instances in this text where women, both widowed and even single,
initiate the implementation of this ancient tradition. For example, when
Pandu is attempting to convince KuntI to participate in niyoga, he refers
to the story of Saradandayinl. SaradandayinI was a childless widow of a
great hero. After preparing herself ritually, she “stood in the night at a
crossroads and with a flower chose an accomplished Brahmin” to beget
sons with her.2 4 1 In this situation and others, women utilized niyoga for
their own ends. Women are depicted as neither helpless victims nor as
passive pawns in some of these classical narratives. Note, for example,
that in the story of Ambika and Ambalika, it is Satyavatl, not Bhlsma,
who develops the plan to save the family line through niyoga with
Vyasa.2 4 2 On the other hand, Vyasa so repulsed Ambika that, when
instructed to produce a second child by him, she takes actions to
circumvent Satyavati’s plan. She avoids a second encounter with Vyasa by
sending in her disguised maid, Amba.
mMBh. 1.111.32-36. Dhand discusses situations where even unmarried women can
act out of a desire to have children, see MBh. 1.78.32.
2 4 2 A similar type of action is evident in the stories of the women in the Hebrew
Scriptures. They too, though living within patriarchal societies, find ways to meet their
own needs.
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Kuntl’s story provides yet another example of a woman taking
control and determining her own reproductive destiny. Pandu urges her
to participate in niyoga. It is very likely that she is aware of the story
surrounding the birth of her husband and brothers-in-law, Dhrtarastra and
Vidura. Furthermore, she is probably well acquainted with negative
experiences of other women. Thus, it comes as no surprise that she flatly
refuses Pandu’s request. However, Kuntl’s mantra enables her both to
respond to Pandu’s pleading, and to spare herself the horrifying
experiences of niyoga that repulsed her mother-in-law. KuntI is more
than a passive participant in a difficult situation; she takes control. She
refuses her husband’s initial request and devises another plan. Sutherland
argues that Kuntl’s refusal to utilize niyoga a fourth time reflects “a faint
but discernible legal and moral quandary which has begun to emerge in
the lawmakers’ discussions of the conflict between the demand for a
kinder and more ethical treatment of women as human beings and the
need to command them for breeding purposes.”2 4 3
The Mahabharata also preserves a traditional practice wherein the
woman, not the man, determines her future marital partner {svayamvara).
As alluded to above, KuntI participated in svayamvara when she selected
2 4 3 Sutherland, 100.
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Pandu to be her husband.2 4 4 Draupadl devises a competition whereby her
future groom must string a bow and shoot arrows through a contraption
hitting a particular target. This contest brings Draupadl her husband of
choice in the form of Arjuna.2 4 5 While Yudhisthira is chosen by Devika,
Sahadeva is chosen by Vijaya.2 4 6 Upon seeing Bhlma, RaksasI, a giant,
human-eating demon, falls in love with him. Even after Bhlma kills her
brother, RaksasI addresses KuntI and argues that she and Yudhisthira
should allow her to fulfill her desire to marry Bhlma.2 4 7 These are but a
few examples of situations where female characters are choosing their
husbands. Through such narratives, the Mahabharata preserves images of
how some women retain a manner of power and agency. While the
traditional implementation of niyoga seems to preserve established
patriarchal systems, matriarchal systems can be seen in the practice of
svayamvara.
wM B h. 1.105.1-4.
mM B h. 1.174.5ff. During these bridegroom festivities, Arjuna’s skills as an archer
put Duryodhana to shame and crystallizes the latter’s hatred of the former. This event
serves as a focal point of the growing animosity between the sons of Pandu and the sons
of Dhrtarastra.
mM B h. 1.9282-89.
lvM B h. 1.139. lOff. It is interesting to note that while RaksasI saluted both
Yudhisthira and KuntI, her words were actually addressed to KuntI. Yudhisthira
consented to the marriage and agrees that RaksasI could take Bhlma wherever she chose
during the day, however, she was to return him to his brothers every night.
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4. Gods, Humans and Procreation
The Mahabharata preserves tensions between men and women as
they struggle to control the process of procreation. The birth narratives
examined above, along with many others, reflect an attitude toward
procreation wherein gods and humans actively share in the procreative
process. Though gods may participate in the process of procreation, they
are neither in complete control nor are they always dictating the terms.
KuntI is dependent upon the power invested within her mantra.
However, KuntI and Pandu select which god they will call upon. The
chosen god is then obligated to impregnate her. Though Gandhari is
dependent upon the higher knowledge of Vyasa, she is the one who
determines that they should act.2 4 8 These stories, and others, within the
Mahabharata reflect a co-operative relationship between gods and humans
in the process of procreation.
From the above discussions on the birth stories of KuntI and
Gandharl’s children, the Mahabharata clearly depicts the importance of
having children for fulfilling one’s obligations to other human beings,
sages, ancestors, and gods. In this text, humans are free to implement
various technologies in service of the goal of having children. This epic
2 4 8 Recall how, being able to foresee the future destruction brought about by
Gandharl’s first born, Vyasa attempts to dissuade her from proceeding with their plan.
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portrays women as playing a variety of roles when it comes to
procreation. Often, they take the initiative and set plans into motion
that result in their giving birth. Additionally, these narratives suggest that
humans and gods are often co-equals in the process of creating children.
Having examined some implications from this ancient Hindu text, it
is appropriate, as a point of comparison, to turn our attention to specific
texts that have significantly influenced modern, “Western American”
thinking on these issues, namely, the Hebrew Scriptures and the New
Testament. Though the Mahabharata does not share the canonical status
of the Hebrew Scriptures and the New Testament, as indicated earlier, it
is a formative text for India and Hinduism. The point of comparison
between these texts falls within the context that they are all formative for
their respective religious traditions, and they narrate epic stories.
Brief Comparative Analysis with the Hebrew Scriptures and New
Testament:2 4 9 God’s Control Over Procreation
The narratives in the Hebrew Scriptures approach the issues of
human procreation in a very different manner. In this text, God is
unquestionably in ultimate control of the process of producing offspring.
This text records countless stories of people praying to God for children
2 4 9 All citations from the Hebrew Scriptures and New Testament are taken from
the N ew Revised Standard Version (New York: Oxford University Press, 1991).
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and God opening or closing women’s wombs. Take for example the
story of Abraham and Abimelech, the king of Gerar. Responding to
God’s call, Abraham is traveling toward the region of the Negeb. Sarah,
his wife, is very beautiful. As an alien traveling through foreign lands,
Abraham fears that the godless inhabitants might kill him on account of
Sarah. Thus, he instructs Sarah to identify herself as his sister, not as his
wife. Abimelech sees Sarah while she and Abraham are residing in his
city. Upon hearing that Sarah is Abraham’s sister, Abimelech sends for
her. That night God comes to Abimelech in a dream, threatens his life,
and closes “fast all the wombs of the house of Abimelech” because the
king had taken Sarah into his palace. Abimelech pleads his innocence
before God; he had no idea that Sarah was Abraham’s wife. The next
day Abimelech returns Sarah, untouched, and confronts Abraham.
Abraham confesses and then prays to God. God responds and heals the
wombs of the women of Abimelech’s household.2 5 0
Further on in the story, the power of God is seen again. “Now
Abraham and Sarah were old, advanced in age; it had ceased to be with
Sarah after the manner of women.” Sarah laughs and scoffs at an angelic
promise that she and Abraham will have a son, saying: “After I have
grown old, and my husband is old, shall I have the pleasure?” Even the
2 5 0 Genesis 20.
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patriarch expresses his doubts: “Can a child be born to a man who is a
hundred years old? Can Sarah, who is ninety years old, bear a child?”2 5 1
According to this story, and others, old age and menopause are not a
hindrance to God.
Genesis 25 records the prayers of Isaac and Rebekah: “Isaac prayed
to the LORD for his wife, because she was barren; and the LORD
granted his prayer, and his wife Rebekah conceived.” In another story,
Rachel, Jacob’s beloved wife, cries out: “Give me children, or I shall die!”
Jacob angrily retorts: “Am I in the place of God, who has withheld from
you the fruit of the womb?” Jacob is at a loss. Clearly, he feels there
is nothing he can physically do to bring about the birth of a child. He
is not God, granting or withholding the “fruit of the womb.” He and
Rachel engage in the one option they see open to them. They pray, and
eventually God hears their cries and opens Rachel’s womb.2 5 2
The same spirit of divine control over procreation is reflected in
the New Testament. The first chapter of Luke records the story of the
elderly priest Zechariah and his wife, Elizabeth. Both of them were
righteous individuals but they were childless because Elizabeth was barren.
While Zechariah is working in the temple, an angel approaches him
2 5 1 Genesis 17:17.
2 5 2 Genesis 30:1-2, 22-23.
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declaring: “Your prayer has been heard. Your wife Elizabeth will bear
you a son, and you will name him John.” Zechariah, knowing that his
wife is beyond childbearing years, questions the words of the angel.
Shortly thereafter, Elizabeth conceives. Though Elizabeth and Zechariah
had prayed for children, they had been unsuccessful and apparently had
accepted the fact that they would remain childless. However, according
to Elizabeth, God had “looked favorably on me and took away the
disgrace I have endured among my people.”2 5 3 The story of Zechariah
and Elizabeth, and that of Abraham and Sarah, reveals how God can
provide for childbirth for parents who are far beyond the normal age of
human procreation.
In the sixth month of Elizabeth’s pregnancy, God sends the angel
Gabriel to visit Mary, a virgin betrothed to Joseph. Gabriel announces to
Mary: “You will conceive in your womb and bear a son, and you will
name him Jesus.” When Mary objects and questions the angel’s words, he
responds: “The Holy Spirit will come upon you, and the power of the
Most High will overshadow you; therefore the child to be born will be
holy; he will be called Son of God.”2 5 4 In this case, Mary, still
unmarried, has not even prayed for a child; nonetheless, God is indicating
2 5 3 Luke 1:8-24.
2 5 4 Luke 1:30-35.
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that she will have one. This text records the stories of both Mary and
Elizabeth as extraordinary events. The conceptions and births of John
and Jesus are unique and special. However, these stories maintain the
concept that God is in control. In the Hebrew Scriptures and New
Testament, though humans are involved, God is ultimately in control of
human procreation.
Women’s Roles in the Process of Procreation
Though God is ultimately in control of everything, and the
Hebrew Scriptures and New Testament do not record instances where
people are manipulating the products of conception to produce offspring,
there are instances where women take particular actions in attempts to
influence their situations. First, as already discussed, within the Hebrew
Scriptures, one finds narratives depicting people beseeching God to enable
them to have children. Hannah, the barren but most favored wife of
Elkanah, bitterly cries and prays to God for a son at the Shiloh temple.
In due time, the Lord remembers her, and she conceives and bears
Samuel.2 5 5
Beyond praying, there are examples of women taking more of an
initiative to move the procreation process along— especially when it comes
2 5 5 I Samuel 1:17-20.
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to producing a proper heir. After God chose Abraham2 5 6 and promised
to make his descendants as countless as the stars in the sky, Sarah takes
action that is akin to a form of maternal surrogacy. Knowing she is
beyond childbearing years, she pro-actively presents her slave-girl, Hagar,
to Abraham in order that she may obtain a child through her servant.2 5 7
Hagar gives birth to Ishmael and until the birth of Sarah’s own son Isaac,
Ishmael is considered Abraham’s heir apparent. Both of Jacob’s wives,
Rachel and Leah, also participate in a similar surrogacy situation. After
being unable to conceive, Rachel gives her maid Bilhah to Jacob, so “she
[Bilhah] may bear upon my knees and that I too may have children
through her.” Leah, though she already has four sons, but not wanting
to be outdone, follows suit by presenting Jacob with her maid Zilpah.2 5 8
Another example of a woman taking control of her situation
regarding childbearing is found in the story of Tamar and Judah. Tamar
marries the eldest son of Judah, Er. Because of his wickedness, Er dies
prior to having any children. Judah instructs his second son, Onan: “Go
in to your brother’s wife and perform the duty of a brother-in-law to
2 5 6 At this point in the story, Abraham’s name is still Abram, and Sarah’s is Sarai.
However, to avoid confusion, I utilize the new names given to them by God as recorded
in Genesis 17:5,19.
“''Genesis 16:1-4.
2 5 8 Genesis 30:3-13.
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her; raise up offspring for your brother.”2 5 9 However, Onan, knowing
that the children born of Tamar would not be his, ‘spilled his semen on
the ground whenever he went in to his brother’s wife, so that he would
not give offspring to his brother’. Onan also dies, so Judah promises
Tamar his third and youngest son, Shelah. Judah sends Tamar back to
her home while they wait for his son, Shelah, to come of age.
Tamar follows Judah’s instructions and goes home. However, even
when Shelah has grown up, Tamar is not given to him in marriage. So,
Tamar disguises herself as a prostitute. She sets up a tent near a road she
knows her father-in-law, Judah, would be traveling. Upon seeing Tamar,
but not recognizing her, Judah enters her tent thinking she is a prostitute.
As payment for her services, he promises her a kid from his flock. Prior
to having sexual intercourse with Judah, Tamar obtains several of his
belongings as pledge from him to ensure payment. She conceives. Three
months later, when Judah is informed of Tamar’s pregnancy, he is furious
and says: “Bring her out, and let her be burned.” As she is being
brought out of her home, she retrieves Judah’s belongings and informs
him that their owner is the father of the child. Recognizing that the
2 5 9 The biblical idea of levirate marriage (from the Latin leviratus, brother-in-law)
is somewhat related to the practice of niyoga. The difference is that the biblical practice
involves an actual marriage whereas the Hindu practice of niyoga does not. In both
cases, however, the goal of the tradition is to provide heirs.
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items belonged to him, Judah acknowledges that Tamar “is more in the
right than I, since I did not give her my son Shelah.”2 6 0 According to
this story, Tamar knew that Judah was not going to make good on his
promise, so she took matters into her own hands to ensure that she
would not remain childless.
The book of Ruth provides yet another example of both the
implementation of levirate marriage and of a woman taking action
regarding her desires to have children. The story begins with Naomi, her
husband, Elimelech, and her two sons moving from Bethlehem to Moab.
Once established in Moab, Elimelech dies leaving Naomi alone with her
two sons. Soon after, each of her sons marry Moabite women, Orpah
and Ruth. They all live together for a period of about ten years, and
then Naomi’s sons die as well, each leaving their wives childless. While
Orpah returns to her family, Ruth faithfully follows her mother-in-law
back to Bethlehem. To provide for their food, Ruth works in the fields
of Boaz, a wealthy kinsman of Naomi’s husband. Once Naomi realizes
that Ruth has met Boaz, she orchestrates events, providing Ruth the
opportunity to request that Boaz redeem the rights of her dead husband.
Boaz agrees to marry Ruth after determining that a closer next-of-kin is
not willing to take on the responsibility. Upon the birth of Ruth’s first
2 6 0 Genesis chapter 38.
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child, the women in the village say to Naomi: “Blessed be the LORD,
who has not left you this day without next-of-kin.”2 6 1 In this biblical
story, both Naomi and Ruth play an active role in securing their familial
line.2 6 2
Prayer, surrogacy and levirate marriage are the extent of human-
initiated activities regarding procreation to be found in the Hebrew
Scriptures and New Testament. Although there are examples of people
manipulating familial and societal relationships in order to have heirs,
there are no biblical stories— neither in the Hebrew Scriptures nor in the
New Testament— where the product of conception is divided up into pieces
and fetuses develop ex-utero. Individuals pray to God for children, but
none has the power to actually manipulate God into giving them children.
Unlike the narratives in the Mahabharata, these biblical texts suggest an
ultimate divine control over human procreation.
The Hebrew Scriptures provide the grounds for Jewish perspectives
regarding assisted reproductive technology. These Scriptures, in
conjunction with the New Testament, provide the foundation for views
within Christian traditions. Though both of these texts depict a clear
2 6 1 Ruth 4:14.
2 6 2 According to the Gospel of Matthew, this familial line is of great importance.
Boaz and Ruth’s son, Obed, is the father of Jesse. Jesse is the father of King David.
As the family lineage is traced through the generations, it eventually leads to Joseph,
husband of Mary, mother of Jesus.
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image that God is in control of procreation, there are a variety of
interpretations as to how the God-human relationship and power over
procreation function within modern expressions of Judaism and
Christianity. N o single perspective expresses the entire range of
viewpoints that have developed within either religion.
A prominent, though not all encompassing, voice within
Christianity is that of the Roman Catholic Church. As previously
established in Chapter 2, this Church has had, and continues to have,
significant influence on national and international discussions regarding
infertility and procreation. For this reason, I have chosen to focus
exclusively on the teachings of Catholicism as a point of comparison with
perspectives discussed within Hinduism.
Roman Catholicism and Control Regarding Procreation
While Hinduism does not have a fixed and formal doctrine
concerning practically any matter, generally there is neither an insistence
that procreation and sexual intercourse necessarily go hand in hand, nor a
categorical objection to the use of various forms of assisted reproductive
technology. The structure of the Roman Catholic Church and the basic
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teachings of the M agisteriunfa regarding God, humans, and procreation
stand in stark contrast to their correlates within Hinduism.
The Church clearly affirms the biblical concept of divine control.
The position of the Roman Catholic Church, as expressed through various
theologians, asserts the dominion of a divine Ruler who cares about, and
is in ultimate control of, this world and the events occurring in it; sex
and procreation are no exception. Regarding the creation of human
beings, Irenaeus states: “[. . .] each one of us receives his body through
the skillful working of God.”2 6 4 Augustine affirms divine control over the
creation of human beings in his C ity o f God, Aquinas concurs in his
Summa Theologica and in other writings. The Vatican clearly declares
that in “the task of transmitting life, they [humans] are not free,
therefore, to proceed at will, as if they could determine with complete
autonomy the right paths to follow; but they m ust conform their actions
to the creative intention o f G od [. . .].”2 6 5 Again,
to make use of the gift of conjugal love while respecting
the laws of the generative process means to acknowledge
oneself not to be the arbiter of the sources of human life,
but rather the minister of the design established by the
2 6 3 For a discussion on the meaning of the Magisterium, see John Mahoney, SJ.,
The Making o f Moral Theology: A Study o f the Roman Catholic Tradition (New York:
Oxford University Press, 1987), 116-121.
2 6 4 Irenaeus, Against Heresies; 2.33.5.
2 6 5 Pope Paul VI, Humanae Vitae (San Francisco: Ignatius Press, 1978), 11.10.
Emphasis added.
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Creator. In fact, just as man does not have unlimited
dominion over his body in general, so also, with particular
reason, he has no such dominion over his generative
faculties as such, because of their intrinsic ordination
towards raising up life, of which God is the principle.
“Human life is sacred,” Pope John XXIII recalled; “from its
inception it reveals the creating hand of God.”2 6 6
When acts of marital sex are not followed by conception, this same text
reads: “God has wisely arranged natural laws and rhythms of fertility,
which already of themselves bring about a separation in the succession of
births.” 2 6 7 The Church utilizes biblical narratives to establish a solid
concept of divine control. God is unquestionably in control of human
procreation, “transmitting life,” and individuals are not free to “proceed at
will;” rather, they are obligated to conform their actions to God’s
intentions.
Concerning the proper role to be played by human participants,
Pope Paul VI argues that God intends that procreation be inextricably
linked to sexual intercourse and that these sexual relations are to occur
only within the context of a marriage relationship. According to this
Pope, marriage, “a teaching founded on the natural law, illuminated and
enriched by divine Revelation [. . .], is not, then, the effect of chance or
the product of the evolution of blind natural forces; it is a wise
l b b Humanae Vitae, 11.13.
2 b 7 Humanae Vitae, 11.11.
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institution of the Creator to realize in mankind his design of love.”2 6 8
Regarding the inseparable aspects of sex and procreation he goes on to
remark that:
This teaching, set forth by the Magisterium on numerous
occasions, is founded upon the inseparable connection,
willed by God and which man may not break on his own
initiative, between the two-fold significance of the conjugal
act: the unitive significance and the procreative significance
[. • - ] . 2 6 9
Officially the Vatican places procreation in a context wherein individuals
are called upon to follow the path of God, to “conform their actions to
the creative intention of God.” Elsewhere, Humanae Vitae quotes the
Second Vatican Council as saying: “Marriage and conjugal love are by
their nature ordained to the begetting and rearing of children [. . .].5 ,2 7 0
According to the Magisterium, sex, marriage, and procreation are
inextricably linked.2 7 1
The Magisterium teaches that, though God may regulate conception
through “natural laws and rhythms of fertility,” humans are not free to
mHumanae Vitae, 1.4, II. 8.
2 6 9 Humanae Vitae, 11.12.
mHumanae Vitae, II.9.
2 7 1 Though the Humanae Vitae reaffirmed positions of previous pontiffs regarding
the procreative function of sex within marriage, according to Fox, the encyclical is
somewhat reformative in its affirmation, and blessing, of the unitive function of sex
(Fox, 74-76).
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intervene. To do so would fail to consider the “vision of man and of his
vocation, not only his natural and earthy vocation, but also his
supernatural and eternal one.”2 7 2 In these teachings, “each and every
marriage act must remain open to the transmission of life.”2 7 3 The
Church teaches that it is a grave sin to separate intercourse and
conception. This argument provides the grounds upon which the Roman
Catholic Church builds its doctrinal objections to such activities as sperm
donation, IW and other forms of assisted reproductive technology. Sperm
donation is prohibited because sperm is usually obtained through
masturbation and thus apart from the sexual intercourse of the married
couple. IVF also separates the act of sexual intercourse from fertilization;
consequently, it is also prohibited.2 7 4
Immediate hominization, the belief that a soul immediately enters a
zygote at the “moment of conception,”2 7 5 is another reason these
2 7 1 Humanae Vitae, II. 7
2 7 3 Humanae Vitae, 11.11
2 7 A Instruction, 25-28. Some married couples creatively attempt to stay within the
boundaries of the Church’s teachings by having sexual intercourse with a pierced
condom. This maintains the connection between the act of intercourse with the
possibility of procreation, while simultaneously allows for the collection of semen.
^The Magisterium acknowledges the scientific understanding that conception is a
process occurring over time, as opposed to a “moment.” It also recognizes that the
actual “moment” of ensoulment is unknown. According to the Declaration on Abortion
(3.13), “ From a moral point of view this is certain; even if a doubt existed concerning
whether the fruit of conception is already a human person, it is objectively a grave sin
to dare to risk murder” (Washington: Office of Publishing and Promotion Services
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procedures and technology are problematic. While the Church
acknowledges that the biblical texts themselves do not make a
philosophical statement as to when human life begins, it highlights texts
that speak of intrauterine human life. Luke 1:40-41 provides a prime
example of such a passage. After the annunciation, Mary travels to visit
her cousin Elizabeth, who is six months pregnant. Upon hearing Mary’s
greeting, Elizabeth’s fetus, soon to become known as John the Baptist,
leaps for joy within her womb. This text, along with others, is utilized
by the Church to indicate that prior to birth, a fetus is a human being.
According to Noonan, this position reflects and enhances the values of a
community sensitive to the living character of the embryo.2 7 6
United States Catholic Conference, 1974). Nevertheless, the Vatican’s rulings regarding
hominization are grounded in the “theological concept protecting the embryo from the
moment of conception, whether the life is human or not, ensouled or not” (Fox 1995,
99). Emphasis added). According to the Church, this position protects the embryo’s
right to life because it has the potential of human life throughout the process of
conception. Through this argument the Vatican continues in its commitment to
safeguard the dignity of human life.
^John T. Noonan, “The Catholic Church and Abortion,” The Dublin Review
514 (Winter 1967/68): 305. In Evangelium Vitae, Pope John Paul II elaborates on the
“incomparable worth of the human person,” wherein humans are called to a “fullness of
life [. . .]. The loftiness of this supernatural vocation reveals the greatness and the
inestimable value of human life even in its temporal phase.” (Intro. 2.)
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In spite of the fact that there is no agreement as to when
ensoulment occurs,2 7 7 the Magisterium argues for immediate hominization
in the following:
In reality, respect for human life is called for from the
time that the process o f generation begins. From the time
that the ovum is fertilized, a life is begun which is neither
that of the father nor of the mother; it is rather the life o f
a n ew human being with his or her own growth [. . .].2 7 8
As this excerpt intimates, the soul is infused into the embryo at the
“moment” of conception. Through IVF, ZIFT and other such
technologies, a greater number of zygotes are produced and frozen than
are actually implanted. Thus, the Church argues that in essence these
procedures are imprisoning a number of human souls. Additionally, in
the process of cryopreservation and implantation, embryos are destroyed,
resulting in the death of the destroyed ensouled zygotes. Finally, after
individuals utilize these reproductive technologies, oftentimes there are
“left-over" embryos. If one believes in immediate hominization, one is
left with a dilemma as to how to dispose of these extra ensouled
embryos. Such official and unequivocal teachings as found in the Roman
Catholic Church do not find their equivalent within Hinduism.
2 7 7 If one examines the writings of the Church Fathers through the ages, one finds
a variety of different perspectives as to when ensoulment occurs. This is discussed
further in the sixth chapter of this work.
2 7 8 Declaration on Abortion, 3.12. Emphasis added.
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In this chapter, we have utilized the Mahabharata narratives of the
births of KuntI and Gandharl’s children as a source for examining how an
ethic from within Hinduism might respond to issues relating to assisted
reproductive technology. Extrapolating from these paradigmatic stories, we
see the importance that Hinduism places on having children and find an
acceptance of human creativity in attempts to bring about the birth of
children. The god-human relationships portrayed in this text demonstrate
a somewhat co-equal existence. As a point of comparison, these issues
were compared and contrasted with those found within the Hebrew
Scriptures, New Testament and Roman Catholic teachings. Again,
utilizing the Mahabharata narratives, and keeping the above issues in mind,
the following chapter explores five key elements of Hindu thought that
underlie the construction of a Hindu ethic regarding assisted reproductive
technology.
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CHAPTER 5
CHARACTERISTICS OF HINDU THOUGHT
From our discussion of attitudes regarding assisted reproductive
technology preserved within the Mahabharata, we can uncover some
underlying characteristics of Hinduism. Prior to constructing a Hindu
ethic regarding assisted reproductive technology, it is necessary to ensure a
basic understanding of some of the underlying themes and key principles
operating within this religious tradition. As already emphasized, the
Mahabharata is a storehouse of the principles and characteristics that
define Hinduism. Five important elements of Hindu thought relevant to
the present discussion may be extracted from this text, namely: 1) the
centrality of an emphasis on societal good; 2) a firm belief in the
underlying unity of all life; 3) the expectations and requirements of
dharmar, 4) the multivalent nature of Hindu traditions; and 5) a theory of
karma. These five characteristics of Hindu thought can profoundly
influence the way individuals think about ethical issues, and the way in
which they make decisions.
Centrality of Society
A defining characteristic of Hindu traditions is evident in how
KuntI and Pandu utilize their mantra. Rather than acting immediately to
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satisfy their own desires, they carefully consider the needs and the greater
good of the society in which they live. Through this mantra, KuntI has
the means by which she can circumvent Pandu’s curse and produce
heirs.2 7 9 Through it, she, and later MadrI, have access to the entire
pantheon of gods, each of whom could potentially be compelled to
become her sperm donor should she choose to call upon one. However,
KuntI and Pandu are cognizant of the fact that this mantra provides them
with a somewhat unique opportunity that society may or may not accept.
They could easily argue that utilizing the boon is similar to the socially
accepted practice of niyoga and proceed to exploit the mantra’s promised
benefits without impunity. However, this is not their chosen course of
action. Their hesitation indicates that they appreciate the difference
between a “human sperm donor” and a “divine sperm donor.” Only after
devising a plan that ensures them of the social acceptability of their
actions, do they implement her boon.
Pandu selects the god Dharma because “he, among the Gods,
partakes of merit. For Dharma would not join yoke with us if it were
2 7 9 As previously discussed, the need for heirs goes beyond simple desires of
having a son-even beyond fulfilling the necessities of having a male child to replace the
King after his death. Recall that Pandu’s discussion with KuntI takes place after he
laments the fact that “for childless men there is no door to heaven.” According to the
text, the motivating factor behind his desire for children is heaven.
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not lawful, and people will now think that this is the Law.”2 8 0 Dharma
is chosen because he is a god of merit and, more importantly, if what
they want to do is unlawful, Pandu is convinced that Dharma would
refuse to participate. The god Dharma is the cosmic judge and discloser
of truth. He “not only mythically personified the cosmic order or kept
it going,” he “also represented the principle of cognition of this order.”2 8 1
It is through Dharma’s power that order is perceived and distinguished
from chaos.
Consequently, if Dharma obliges KuntI and Pandu’s request, then
they can be assured that the rest of society will look upon their actions
as lawful. Klaes confirms the idea that KuntI and Pandu’s choice of
Dharma is related to their realization that they are participating in a risky
adventure that can be accompanied by uncertain consequences. By
choosing Dharma, “the most virtuous among the Gods,” they can be
assured that he will not allow them to do something that would
contradict the order of the universe or go against society. Additionally,
the son they would obtain from Dharma would certainly be a righteous
and just ruler of the clan.2 8 2 As the story reports, Yudhisthira is born
n0MBh. 1.113.40.
2 8 1 Norbert Klaes, 19.
2 8 2 Klaes, 20.
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under auspicious signs and is indeed a king who works to restore dharma
in the world. KuntI and Pandu’s careful deliberation regarding the
implementation of her boon highlights the priority they place on the
importance of acting within the needs and concerns of society.
Hindu society is often described with the term, varnasrama-dharma.
Varna, meaning “color,” refers to the classes or castes and describes a
stratified nature of society. There are the four traditional castes into
which individuals are born, namely: 1) brahmin, the caste comprised of
priests and scholars;2 8 3 2) ksatriya, the caste of warriors and rulers; 3)
Merchants, artisans, and craftspeople make up the third caste, vaisyar, and
4) the sudra caste, comprised of peasants.2 8 4 Additionally, traditional
Hinduism speaks of four asramas, or stages of life. One begins in the
first stage as a brahmacarin, or student. The second stage involves
establishing one’s economic stability, getting married and having children;
this is the grhastha, or householder stage. Third, after having
grandchildren, particularly grandsons, one may enter the vanaprastha, or
“forest-dweller,” stage. This is a stage of life where one’s thoughts turn
2 8 3 The name of this caste reflects the close proximity in which this group was
identified with Brahman, the all-encompassing essence of the universe. To avoid
confusion, brahmin refers to the caste or priests, while Brahman refers to the essence of
the universe.
2 8 4 Thomas J. Hopkins, The Religious Life o f Man: The Hindu Religious
Tradition (Belmont: Wadsworth Publishing Company, 1971), 84.
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inward and to spiritual matters. The final stage, reached by few, is that
of the sannyasin, or renouncer. This is an individual who completely
renounces family, society, and work in search of moksa, spiritual
liberation. The vamasrama-dharmi8 5 system is well established within
Indian/Hindu society. It became one of the unifying elements, allowing
for absorption of heterogeneous social and religious groups in the early
development of what became known as Hinduism2 8 6
Being married, in the childbearing stage of life, and fulfilling their
duties as royalty, KuntI and Pandu are participating in the second of four
stages of life-the grhastha stage. Manu commends this householder stage
of life as being the best.
Just as all living creatures depend on air in order to live,
so do members of the other stages of life subsist by
depending on householders. Since people in the other
three stages of life are supported every day by the
knowledge and the food of the householder, the
householder stage of life is the best.2 8 7
According to Manu, the grhastha stage is the most important because all
the other elements of society are dependent upon it. As individuals
engage in this stage of life, they are to do so with zeal and happiness
2 8 5 The concept of dharma is discussed below.
2 8 6 Hopkins, 74-84.
1 X 1 Manu, 3.77-78.
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because of the important supportive role this stage plays within society.
One could argue that the principal goal of the Dharmasutra and
Dharmasastra texts2 8 8 is the arrangement of life within a social system, so
as to bring about a smooth functioning, well-ordered society.2 8 9
So central is the concept of society that David Kinsley associates
being a Hindu, in part, with being a member of the Indian/Hindu
society 2 9 0 Radhakrishnan expresses this well when he writes:
Human society is an organic whole, the parts of which are
naturally dependent in such a way that each part in
fulfilling its distinctive function conditions the fulfillment
of function by the rest, and is in turn conditioned by the
fulfillment of its function by the rest. In this sense the
whole is present in each part, while each part is
indispensable to the whole.2 9 1
This underlying assumption that all of society is interdependent leads to
an ideal where individuals are encouraged to act in a manner that
supports and works toward the greater good of society. According to the
Bhagavad Gita, preserving order within society is one of the primary
motivating factors calling upon Arjuna to take up his arms and fight.2 9 2
2 8 8 These are texts that establish Brahmanical rules for society.
2 8 9 Hopkins, 74-75.
2 9 0 Kinsley, 152-175.
2 9 1 Radhakrishnan, 76.
mBhagavad Gita, 1.39-40.
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This focus on the centrality of society is an important characteristic
within a majority of Hindu traditions.2 9 3
Underlying Unity of All Life
The centrality of society in turn reflects a foundational
metaphysical belief evident within many Hindu traditions; namely, that
there is an underlying unity of all life, the world, and all that exists.
The Vedas, Upanisads, Bhagavad Gita, Vedanta philosophy, and other
literature and schools of thought within Hinduism teach this
interconnectedness amongst all life and all things.
R g Veda 10.90 describes how the world, humans, gods, animals,
plants, and everything else comes forth from a cosmic primeval being,
Purusa. The text reads as follows:
His mouth became the Brahmin; his arms were made into
the Warrior, his thighs the People, and from his feet the
Servants were born. The moon was born from his mind;
from his eye the sun was born. Indra and Agni came
from his mouth, and from his vital breath the Wind was
born. From his navel the middle realm of space arose;
from his head the sky evolved. From his two feet came
the earth, and the quarters of the sky from his ear. Thus
they set the worlds in order [. . .].2 9 4
2 9 3 The focus on ensuring the good of society does not exclude the needs and
desires of individuals. See the discussions below regarding the choices of Gandharl and
Dhrtarastra and the multivalent nature of Hinduism.
2 9 4 Rg Veda 10.90.12-14. The Rg Veda is the earliest “Hindu” texts containing
hymns of praise to various Vedic goes. All translations of the R g Veda are taken from:
Wendy Doniger O’Flaherty, The Rig Veda: An A nthology (New York: Penguin Books,
1981).
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From out of Purusa’s mouth come the brahmin caste, and the gods Indra
and Agni. The earth and sudras, the servile class of society, originate
from the feet of this cosmic being. Hopkins clearly articulates the
significance of these connections. Just as the feet are the base for Purusa,
so the sudras are the base of society, and the earth is the base of the
cosmos.2 9 5 This late Vedic hymn establishes an ultimate connection
between the Vedic fire sacrifices, gods, humans, the world and the
cosmos.2 9 6 Eck comments on how the Vedic “affirmation of oneness is
not sociological or political but theological.” According to her, “it is an
affirmation about the very nature of ultimate reality. God or truth or
Ultimate Reality is one, though people speak of that One in many ways
and try to realize it in their lives through many paths.”2 9 7
This Vedic worldview becomes the foundation from which the
Upanisads teach that ultimately everything shares an underlying reality, a
2 9 5 Hopkins’ complete discussion of Rg Veda 10.90 is found on pp. 22-25
2 9 6 According to Hopkins, this late Vedic worldview understood that the
“ phenomenal world, the world of thought and action, was neither permanent nor self-
existent; it was a manifestation of names and forms brought forth by the creative powers
of brahman and tapaP (Hopkins, 36). However, early Vedic hymns expressed a different
worldview; one in which there was a clear distinction between humans and gods. Early
Vedic hymns depict a world where the gods are in control and humans aimed at
improving their lives on this earth through praising and appeasing these gods. An
example of this attitude is found in Rg Veda 1.32. For a discussion on these various
strands of Vedic thought, see the first two chapters of Hopkins.
2 9 7 Eck, 80.
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spiritual essence called Brahman. Ultimately Brahman encompasses
everything. The Mundaka Upanisad says of Brahman-.
In Him alone, as he shines, do all things reflect; this whole
world radiates with his light. Brahman alone here extends
to the east; brahman, to the west; it alone, to the south to
the north, it alone extends above and below; it is brahman
alone that extends over this whole universe, up to its
widest extent.2 9 8
Elsewhere the Katha Upanisad states: “Its roots above, its branches below,
this is the eternal banyan tree. That alone is the Bright! That is
brahmanl That alone is called the Immortal! On it all the worlds rest;
beyond it no one can ever pass.”2 9 9 The monistic upanisadic worldview is
one of ultimate unity.3 0 0
2 9 8 Mundaka Upanisad 2.2.10-11. The Upanisads are primarily philosophical
dialogues between gurus and their students. All translations of the Upanisads are taken
from: Patrick Olivelle, Upanisads (New York: Oxford University Press, 1996).
mKatha Upanisad 6.1. Brhadaranyaka Upanisad 1.4.10 reads: “In the beginning
this world was only brahman, and it knew only itself (atmaiij, thinking: ‘I am brahman.’
As a result, it became the Whole [. . .].” Chandogya Upanisad 8.3.3-4 provides yet
another example of where the text is clearly linking the atman (one’s true self/”soul” )
with brahman and then arguing that brahman is the real, totality of all.
3 0 0 Hopkins utilizes the following metaphor in his description of this Upanishadic
worldview, “Since all things are ultimately the Existent, individual differences are no
more significant than are the individual rivers that in the end all flow together to make
the single ocean” (Hopkins, 44). As Klaes clearly states, ultimately there is “no essential
difference; but only a difference of degree, between the lokas [worlds] of the Gods and
the life on earth.” (Klaes, 55) Radhakrishnan recalls how when Yajnavalkya, an
Upanishadic sage, “was called upon to state the number of gods, he started with the
popular number of 3306, and ended by reducing them all to one Brahman. ‘This
indestructible enduring reality is to be looked upon as one only’” (Radhakrishnan, 22).
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Emphasizing this interconnectedness of all, Krsna, representing the
supreme personality of Brahman in this passage, proclaims the following:
He who truly knows My manifested lordship and power is
united with Me by unwavering devotion, of this there is
no doubt. I am the source o f everything, from Me
everything evolves. Knowing this, the wise worship Me,
endowed with faith.3 0 1
O.P. Dwivedi, in his article “Dharmic Ecology,” comments on how this
belief that the Divine permeates everything radically connects all of life,
human and otherwise. Thus, God and nature, the individual and others
are all one and the same.3 0 2
Regarding the connection between individuals and Brahman, the
Bhaga vad-Glta builds on the upanisadic teaching and affirms they are
indeed the same. Human beings have within them an atman, or soul3 0 3
that is Brahman. Therefore, Krsna assures Arjuna that “The Self [atman]
neither slays nor is slain [. . .]. Just as a person discards worn-out
clothes and puts on new ones, so too the embodied Self casts off old and
Xl Bhaga vad-Glta X.7-8. Emphasis added.
3 0 2 O.P. Dwivedi, “ Dharmic Ecology,” in Hinduism and Ecology: The Intersection
o f Earth, Sky, and Water, ed., Christopher Key Chappie and Mary Evelyn Tucker
(Cambridge: Harvard University Press, 2000), 4-6.
3 0 3 The common word for “self” in the Sanskrit language is the reflexive pronoun,
atman. Within the upanisadic literature, atman had a more specific meaning: the essential
part of a human being, a person’s most fundamental reality. Generally atman refers to
the “inner self,” and is distinguished from the physical body (Hopkins, 37).
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worn-out bodies and enters into other new ones.”3 0 4 Krsna continues:
“The Self, which dwells in the body of everyone, O Bharata [Arjuna], is
eternal and can never be slain.”3 0 5 In this text, Krsna affirms that the
atman, being ultimately identical with Brahman, is immortal and is
indestructible.3 0 6
Sankara, the famous eighth century Hindu Vedanta philosopher, is
attributed with proclaiming:
I am verily that Supreme Brahman, which is eternal,
stainless, and free; which is One, indivisible and nondual;
and which is of the nature of Bliss, Truth, Knowledge, and
Infinity. The impression of “I am Brahman” thus created
by uninterrupted reflection, destroys ignorance and its
distractions, as rasayana medicine destroys disease. Sitting
in a solitary place, freeing the mind from desires, and
controlling the senses, meditate with unswerving attention
on Infinite Atman, which is One without a second [. . .].
He who has attained the Supreme Goal discards all such
objects as name and form, and dwells as the embodiment
of Infinite Consciousness and Bliss.3 0 7
^Bhagavad Gita 11.19, 22.
i0 b Bhagavad Gita 11.30.
3 0 6 Crawford describes Brahman as “the ultimate source of the external world” and
atman as “the inner self of man.” “ Brahman of the macrocosm is none other than the
atman of the microcosm.” S. Cromwell Crawford, The Evolution o f Hindu Ethical Ideas
(Hawaii: University Press of Hawaii, 1984), 37.
3 0 7 Atmabodha 36-38, 40. Translation obtained from: Atambodha (Self-knowledge)
trans. by Swami Nikhilananda (New York: Ramakrishna-Vivekananda Center, 1970).
Authorship of this text is somewhat unclear, although Indians traditionally attribute it to
Sankara.
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Sankara argues for more than the nondual nature of the world and
existence. According to him, the real, Brahman, is the indivisible Reality;
an integration of the individual and the whole, of knowledge and of
consciousness. Brahman “is life, human life, as lived.”3 0 8 This underlying
belief in ultimate unity is one of many threads making up the fabric of
Hinduism. This thread is present in the ancient foundational texts of the
Vedas, and Upanisads, is seen throughout the Mahabharata, is present in
the works of philosophers such as Sankara, and is affirmed in the Hindu
law codes.
The Laws o f Manu seek to ground societal divisions and order in
this idea of the Vedic cosmic person and the upanisadic teaching of
ultimate unity:
Then, so that the worlds and people would prosper and
increase, from his mouth he created the priest, from his
arms the ruler, from his thighs the commoner, and from
his feet the servant. He divided his own body into two
and became a man with one half, a woman with the other
half [. . .]. You, who are the best of the twice-born,
should know that the one whom he emitted was me, the
creator of this whole (universe). Thus this whole
(universe), stationary and moving, was created by those
great-souled ones at my command through the use of inner
heat-each according to its own innate activity [. . .].3 0 9
3 0 8 Antonio T. de Nicolas, “The Unity and Indivisibility of the Self (Brahman),”
Main Currents in Modern Thought 29:4 (1973): 134.
mManu, 1.31-32, 41.
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171
All of society is part of a cosmic body. In order for it to operate
smoothly and to ensure cosmic order, each portion of society needs to
fulfill its function; each individual needs to perform his or her duty.
This principle of underlying unity is a primary belief within most, if not
all, Hindu traditions.
Requirements of Dharma
Within Hindu traditions this thread of ultimate unity is tightly
interwoven with the teachings on dharma, as is the concept of
varnasrama-dharma. According to these traditions, just as all of society,
the world, and the cosmos make up one “body,” so also does each part
have a particular role to play within the whole. This role, along with a
number of other elements, is encompassed within the term dharma.
Regarding dharma Patrick Olivelle remarks that:
It is undoubtedly the most central and ubiquitous concept
in the whole of Indian civilization [. . .]. This very
centrality, however, also made it possible for the concept to
be given new twists and meanings at different times and by
different groups, creating a dauntingly broad semantic
range.3 1 0
Whenever the topic of Hindu ethics is broached in academic circles it
inevitably includes a discussion of dharma. Though dharma intersects
3 1 0 Patrick Olivelle, Dharmasutras: The Law Codes o f Apastamba, Gautama,
Baudhayana, and Vasistha, (Varanasi: Motilal Banarsidaas, 2000), 14.
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with ethics, it is not equivalent to it. It has no direct English equivalent
and its meaning is context specific.
The Sanskrit-English D ictionary of Sir Monier Monier-Williams
provides the following definition of dharma: “that which is established or
firm, steadfast decree, statute, ordinance, law; usage, practice, customary
observance or prescribed conduct, duty; right, justice (often as a synonym
of punishment); virtue, morality, religion, religious merit, good works.”3 1 1
Dharma is utilized in such a variety of ways so as to elude concise
definition. It has both a universal and individual level. Holdrege argues
that it constitutes a principal Hindu equivalent of an “ethical category” on
both a naturalistic and a normative level. According to her, dharma is a
cosmic ordering principle that upholds the universe as a whole;
simultaneously, on an individual/human level, it is infused with normative
312
meaning.
When discussing dharma, Hopkins refers to the large body of
Brahmanical social and ritual responsibilities. According to him, dharma
is “that which is established,” or “what men ought to do.”3 1 3 Though in
3 1 1 Sir Monier Monier-Williams, Sanskrit-English Dictionary (New York: Oxford
University Press, 1995), 510. Though in their translation of the Laws o f Manu, Doniger
and Smith usually translate dharma as ‘duty,’ they also render it to mean ‘religion,’
‘ justice,’ ‘law,’ and ‘right.’ (Doniger and Smith, 3)
3 1 2 Holdrege, 12-14.
3 1 3 Hopkins, 73.
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early times what people ought to do was related to sacrificial rituals, even
as early as R g Veda 10.90, the concept of dharma has a broader context
of societal and cosmic order. Later texts on dharma, such as the
Dharmasastras, focus on the particulars of social duty of all actions.3 1 4
Dharma refers to the privileges, duties and obligations of individuals, and
their standard of conduct in relation to their stage of life, their caste, and
society.3 1 5 According to Desai, dharma sustains individuals and connects
them to one another.3 1 6
In all of its multiple meanings, dharma is a term that ultimately
relates in some manner to some sort of action or prescribed behavior. In
the context of this study in comparative religious bioethics, the focus is
on how dharma relates to the roles, decisions, and behaviors of individuals
and groups. As discussed above, according to Hindu traditions, individuals
do not live independently of one another or of the society that surrounds
them. As members of society, individuals have particular dharmas, roles
and responsibilities.3 1 7
3 1 4 HopkIns, 73-75.
3 1 5 Pandurang Vaman Kame, H istory o f Dharmasastra (Poona: Bhandarkar Oriental
Research Institute, 1974) vol. 2, part I, 1-3; Hopkins, 72-75.
3 1 6 Desai, Health and Medicine, 18-19.
il7Manu 1.88-91 prescribes various tasks for the four castes. Brahmins, priests, are
ordained for teaching and learning, sacrificing for themselves and for others, and giving
and receiving. The ksatriya is responsible for protecting his subjects, having sacrifices
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The narratives of KuntI and Pandu reflect the focus on the needs
of society, the belief that all are ultimately interconnected, and that all
individuals have a role, a dharma, to fulfill. Even Pandu’s desire for an
assurance of heaven is not outweighed by the constraints of society and
his sense of dharma. Recall how Pandu’s quest for children began when
he laments that “for a childless man [. . .] there is no door to heaven.”3 1 8
Though Pandu desires children and heaven, he and KuntI proceed with
their plan only after they are assured that their actions are lawful and
considered legitimate by society. For KuntI and Pandu, acting according
to dharma, both in terms of the god and in terms of their duties within
society, is of utmost importance. Before they even begin to act, they
want assurances that what they do is done in accordance with their
dharmar-m accordance with their privileges, duties and obligations to
society.
One of the main themes in the Bhagavad Gita is Krsna and
Arjuna’s discussion regarding the latter’s dharma. Just prior to the
commencement of the war, Arjuna beseeches Krsna for advice, “my mind
is puzzled about my duty [dharma], I appeal to You to tell me which is
performed, studying, giving and being ruler. Protecting livestock, farming, having
sacrifices performed, studying, trading and lending money is the focus for the vaisya.
mMBh. I.111.11. Recall discussion in Chapter 3 regarding the importance of
progeny.
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better.”3 1 9 Arjuna is weighing his role in the impending battle; should he
fight and conquer his uncle’s family or ought he allow them to conquer
him? Krsna responds by saying:
After considering your own duty, you should not waiver.
There is no greater good for a Kshatriya than a battle
fought for a just cause [. . .]. Now, if you refuse to fight
this righteous battle, then, by failing in your own duty and
honor, you will incur sin. People will recount forever
your lasting dishonor. And for one who has been
honored, dishonor is much worse than death.3 2 0
Toward the end of their discussion Krsna says:
Man attains true perfection by devoting himself to his own
duty [. . .]. He from whom all beings have their origin,
by whom all this universe is pervaded, by worshipping
Him, a man finds perfection through the performance of
his own action. Better is one’s own duty though
imperfectly done than the duty of another carried out
perfectly. By performing actions in accordance with one’s
own nature, one does not incur sin. One should not
abandon the work suited to his nature, even though it may
be deficient, for all undertakings are subject to defects just
as fire is subject to smoke.3 2 1
The Gita clearly indicates that Arjuna has a particular dharma and it is
better for him and all involved if he fulfills his dharma. This text and
the Mahabharata as a whole clearly argue that fulfilling one’s dharma is a
priority; it is important for both the individual and society as a whole.
3 1 9 Bha.ga.vad Gita II.7.
i 2 0 Bhagavad Gita 11.31, 33-34.
mBhagavad Gita XVIII.45-48.
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While dharma provides guidelines for how the individual and
society are to function, these guidelines are not abstract universal
principles. Rather, according to Manu, to be a moral individual is to
particularize--to ask who did what, to whom and when? Each caste has
its particular duties and each stage of life has its particular dharma. What
might be “right” for one individual at a particular stage of life might not
be right in a different stage of life. Ramanujan emphasizes this context-
sensitive nature of dharma, when he compares it to a “Western” ideal of
virtue. He highlights Hegel’s observation, “While we say, ‘Bravery is a
virtue’ the Hindus say, on the contrary, ‘Bravery is a virtue of the
Kshatryas.’”3 2 2
Multivalent Nature of Hindu Traditions
When the concern for society and acting according to one’s
dharma, as seen in Kuntl’s story, is juxtaposed with the narrative of
Gandhari and Dhrtarastra, another key characteristic within Hindu
traditions comes to light— that of its multivalent nature. While KuntI and
Pandu allow the needs of society to influence their decisions, Gandhari
and Dhrtarastra choose to act in their own interests. The latter couple is
warned of the coming doom and destruction if their first born,
3 2 2 A.K. Ramanujan, 46.
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1 7 7
Duryodhana, is allowed to develop and live. At Duryodhana’s birth,
Dhrtarastra calls a council of his advisors and they tell him: “Clearly, this
son of yours will spell the death of the dynasty! In abandoning him
there is appeasement, great disaster in fostering him!”3 2 3 They remind the
king that he will still have ninety-nine sons and a daughter, and that he
will secure the world and his dynasty if this baby is not allowed to
develop. The counselors cite the law “For the family, abandon one son;
for the village, abandon a family; for the country, abandon a village; for
the soul, abandon the earth!”3 2 4 In spite of their warnings and utilitarian
justifications for abandoning the infant, the parents love for their son
trumps the future of their dynasty and even society as a whole.
Since many of the narratives within the Mahabharata underscore
the importance of society and argue that individuals ought to act in a
manner consistent with dharma, one might assume that the text would
condemn Gandhari and Dhrtarastra for doing just the opposite. However,
this is not the case. The narratives record no criticism of this royal
couple. Often individuals find themselves in arduous situations where
difficult decisions have to be made. Bruce Long comments on the
multivalent nature of Hinduism when he writes:
W M B A . 1.107.30ff.
mM Bh. 1.107.30-35.
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1 7 8
One conclusion that we might draw from this
diversification of philosophical perspectives and the
inclination to intermingle ideas drawn from a variety of
schools of thought evidenced throughout the MBh. is that
the sages and scholars failed to discover any single principle
of causation that could account for all exigenecies of human
life. Or, to state the matter affirmatively, like their Vedic
forebears, the epic writers were prepared to embrace (or, at
least, to tolerate) a diverse array of doctrines in the
conviction that while reality is one, it can be designated by
many names (Rg Veda 1.164.46).3 2 5
In its silence regarding Gandhari and Dhrtarastra’s actions, and the actions
of others, the Mahabharata acknowledges the complexity of life and
demonstrates an understanding of the challenges posed by the ethical
struggles in life. This commitment to multivalent thinking stands in stark
contrast to Kantian philosophy, a system that presents clearly delineated
categories through which human action is evaluated.
The stories of KuntI, MadrI and Gandhari all acknowledge the
complexities involved in actual life. According to Radhakrishnan:
A Hindu thinker readily admits other points of view than
his own and considers them to be just as worthy of
attention. After all, if the whole race of man, in every
land, of every colour, and every stage of culture, is the
offspring of God, then we must admit that, in the vast
compass of his providence, all are being trained by his
wisdom and supported by his love to reach within the
limits of their powers a knowledge of the Supreme.3 2 6
3 2 5 Bruce J. Long, “The Concepts of Human Action and Rebirth in the
Mahabharata,” in Karma and Rebirth in Classical Indian Traditions, ed. Wendy Doniger
O’Flaherty (Berkeley: University of California Press, 1980), 42.
3 2 6 Radhakrishnan, 16.
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Rather than holding blindly to a strait jacket of philosophical ideals, the
Mahabharata acknowledges the various roles and responsibilities individuals
hold at various times. There is flexibility in dharma that reflects and
embraces the flexible character of reality. In his book Dharma in Hindu
Ethics, Creel discusses the complexities of dharma. Though on one hand
the essence of dharma is “law, order, fixed pattern,” when there is a
conflict between varnasrama-dharma and sadharana dharma, the case of
particular duties wins out over universal principles.3 2 7 The holistic
underpinnings of Hindu traditions and the complex nature of the
situations described in the Mahabharata and other texts highlight
Hinduism’s flexible and mercurial nature. These narratives take into
account extraordinary and difficult circumstances and acknowledge that
what might be good for one may not necessarily be good for others.3 2 8
Though the Mahabharata may not establish a clear, consistent, all
encompassing, philosophical treatise categorizing proper ethical behavior, it
is nonetheless concerned with how individuals act and that they act
3 2 7 A.B. Creel, Dharma in Hindu Ethics (Calcutta: M.K. Mukerjee Temple Press),
6.
3 2 8 M.C. Joshi, Hindu Religion and Ethics (New Delhi: Aryan Books
International), 257; Jhingran, ix.
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180
appropriately. As discussed, dharma implies movement toward a higher
order and sense of purpose. Each individual has duties to perform within
society and each is called to perform that duty to one’s utmost ability.
According to the Bhagavad Gita, it is better “to perform one’s own duty
(dharma) imperfectly than to perform the duty of another perfectly.
Better to carry out one’s own duty, even unto death, for to follow
another’s duty is perilous.”3 2 9 This focus on behavior and dharma is
accompanied with a general guideline-one should act with the intention of
guiding individuals in the right direction. However, specific prescriptions
regarding what behaviors are proper or inappropriate and definitions of
“right direction” are not listed. Rather those judgments are to be
determined by the circumstances surrounding the situation.
Taking individual situations into account results in an inherently
flexible system of beliefs. This might lead some to conclude that there
are no boundaries or limitations to human behavior within Hindu
traditions. Additionally, these traditions are sometimes viewed as being
indifferent and supportive of a general attitude that “anything goes.” This
is not necessarily true. As Radhakrishnan expresses it, “Hinduism does
not mistake tolerance for indifference. It affirms that while all revelations
^Bhagavad Gita 111.35.
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181
refer to reality, they are not equally true to it.”3 3 0 Though the
Mahabharata does not criticize Gandhari and Dhrtarastra for choosing
their son over the needs of society, and though it makes no apologies for
their actions, it is neither indifferent nor, more importantly, does it “let
them off the hook.” Throughout its verses, this text clearly demonstrates
that individuals always reap the consequences, and benefits, of their
actions.3 3 1 The entire text records not only the decisions and actions of
individuals and groups, it painstakingly records the consequences of those
decisions and actions. This highlights yet another primary element within
Hinduism: namely that of karma.
Theory of Karma
The multivalent nature of Hinduism also demonstrates a respect for
the law of karma, which ensures that Gandhari and Dhrtarastra cannot
avoid the consequences of their decision not to kill Duryodhana.
3 3 0 Radhakrishnan, 36.
3 3 ‘As Duryodhana matures, he envies the five sons of Pandu and is never
dissuaded from his desire to take over as the ruling king. Though the actual
responsibility for the Great War falls on many shoulders, Madeleine Biardeau places
responsibility as far back as on king Samtanu himself (See discussion in Woods 2001, 10-
14). Duryodhana’s persistent hatred for his cousins and his desires for the throne
eventually lead to the actual engagement of war. At the conclusion of this war,
practically everyone from both sides of the clans— family, friends, leaders, and teachers
die.
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Contrary to popular understandings of karma, it is, in and of itself,
neither fatalistic nor negative.3 3 2 Linguistically, karma simply means
“action.”3 3 3 As a theory or concept, it is complex and not surprisingly
has a variety of interpretations even within the Mahabharata itself.3 3 4 The
concept of karma evokes the debate between destiny and human
freedom.3 3 5 In his essay “Human Action and Rebirth in the
Mahabharata, ” Bruce Long demonstrates how passages in this epic reflect
both the idea that human destinies are predetermined and the belief that
humans, through their actions, determine their own destinies.3 3 6 Regardless
of whether one is living a life committed to acting in the world [pravrtti)
or to a life of asceticism ( .nivrtti), karma is action. Action, whether past,
present, or future, is inextricably tied to consequences, be they negative or
positive, that will come to fruition either in this life or another.
3 3 2 Christopher Chappie, Karma and Creativity (New York: State University of
New York Press, 1986), 2-3; Desai, 32; Radhakrishnan, 52.
3 3 3 The word karma derives from the Sanskrit verbal root k r (do, make, perform,
accomplish). It is the nominative singular neuter form of the word karman meaning
“act, action, performance, deed” (Chappie, 2).
3 3 4 See the collection of essays published in Wendy Doniger O’Flaherty’s Karma
and Rebirth in Classical Indian Traditions (Berkeley: University of California Press, 1980).
The concept of karma evokes the debate between destiny and human freedom.
3 3 5 In an essay “ Life Ethics of the Bhagavad Gita as Interpreted by Ramanuja,”
Klaus Klostermaier argues that a concept of predeterminism is intrinsically linked with a
theory of karma and rebirth (55).
3 3 6 Long, 38-60.
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According to the Mahabharata, everyone, regardless of gender, social status,
or philosophical commitment, is subject to the constraints of karma; all
will reap the fruits of the seeds planted by their actions.3 3 7
The Bhagavad Gita declares that human beings cannot help but act.
“ Indeed, no one can exist, even for a moment, w ithout doing some
action. Everyone is forced to work, helplessly driven by the forces born
of nature.”3 3 8 According to this passage, to be human and alive is to act.
All action, all karma, is followed by results.3 3 9 Consequently, Krsna
implores Arjuna:
to do his allotted work, for action is indeed better than
inaction and even the mere maintenance of your body is
not possible without action. This world is bound by
action (karma), except for work done as a sacrifice.
3 3 7 In the introduction to his translation of the Bhagavad Gita, Murthy describes
the doctrine of karma as being “fundamentally the application of the scientific law of
causation to the spiritual plan. Every act performed by an individual has its inexorable
consequences” (Murthy, 11). Klaes understands the law of karma to be underlying all
expectations and doubts in life. According to him, this law applies to both the
usefulness of the effects/fruits of action in balancing the order of human society and its
fruitfulness for the actual individual who is producing its cause (Klaes, 54). Hopkins
relates the doctrine of karma to the belief of rebirth and argues that both are important
because “all actions had continuing effects and all were important in determining the
future conditions of the embodied self [. . .]. The totality of men’s actions determined
the conditions of their rebirth and their progress toward release” (73-74).
^Bhagavad Gita III.5. Emphasis added.
3 3 9 Holdrege likens the “ law o f Karma” to a cosmic law of retribution that
dispenses justice to all living beings in accordance with their deeds. Karma is “an
inexorable law of cause and effect that extends the principle of natural causality to the
realm of human morality (Holdrege, 14).
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1 8 4
Therefore, O son of KuntI, do your work as a sacrifice
and become free from the bonds of desire.3 4 0
Here the passage combines the principle of duty, one’s allotted dharma,
with that of karma. Again, though this text does not provide a specific
handbook detailing exactly what one ought, and ought not, to do, it is
pointing its readers in a particular direction.
Though various influences of karma may determine one’s current
state of being, karma “never determines one’s mode of action. Karma is,
therefore, more positive than normative and more descriptive than
deterministic.”3 4 1 In discussing the principle of karma, Radhakrishnan
writes:
The cards in the game of life are given to us. We do not
select them. They are traced to our past karma, but we
can call as we please, lead what suit we will, and as we
play, we gain or lose. And there is freedom.3 4 2
According to this metaphor, there is freedom because all individuals are
free to play their hands as they see fit. Thus, rather than being
deterministic, this theory of karma calls individuals to take responsibility
for their actions and to act!
iKBhagavad Gita, III.8-9.
3 4 ,Murthy, 11.
3 4 2 Radhakrislman, 54.
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This theory of karma condemns inactivity as the bane of all
existence. According to Chappie:
Without activity, nothing can be accomplished. Even if
one encounters an unexpected occurrence due to past
action, it is not disturbing if one is firmly anchored in
present action. However, if one is not active, then one is
at the mercy of the situation and unable to fend off the
unexpected or to accomplish much of anything.3 4 3
Though karma from past actions may influence an individual’s current
situation, it does not deem one powerless over the present or future. In
his discussion regarding human effort in the Mahabharata, Chappie recalls
Yudhisthira’s question to Bhlsma, “Is the course of a person’s life already
cast, or can human effort shape one’s life?” Bhlsma responds by relating
a story of a conversation between Brahma, the Lord of creation, and the
sage Vasistha. According to Brahma:
Nothing is born without seed;
Without seed there can be no fruit [. . .].
Just as a farmer plants
A certain type of seed
And gets a certain crop,
So it is with good and bad deeds.
Just as a field sown without seed is barren,
So without human effort there is no fate.3 4 4
3 4 3 Chapple, Karma and Creativity, 62.
3 4 4 Chapple, Karma and Creativity, 59-60. MBh. XIII.6.5-7, Chappie’s translation.
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186
Here the Mahabharata denies the idea of unexplainable fate and
instead argues that human action, karma, is the cause of current
situations and the determinate for the future.3 4 5
Acting in the present can transform the current and future course
of karma. KuntI, Madri and Gandhari all took decisive actions that
altered the course of their situations regarding having children. They
obviously did not hold to the view that their course, their fate, was set
and that any action on their part was futile. To the contrary, they
initiated actions that set their lives on an entirely different course. This
theory of karma connects human actions with their consequences, thus
making humans directly responsible for both the positive and negative
fruits of their actions. According to Gandhi, “All action will have its
consequences; the consequences in one case, as we’ll see, will be the
bondage of samsara, in the other case it will be freedom from it.”3 4 6
The Mahabharata and Gita may not provide an explicit course to
follow, such as is found in the ethical code of the Ten Commandments.
However, they do supply general guidelines for shaping one’s behavior.
Krsna instructs Arjuna to, “always perform without attachment the work
3 4 5 Again, as Long reminds us, the text also preserves the idea that the gods are
puppeteers and human beings their wooden puppets (46-47).
3 4 6 Gandhi, 173.
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that should be done. By doing work without attachment, man attains the
Supreme [. . .]. You should perform action also with the intention of
guiding the people in the right direction.”3 4 7 Vinoba clearly argues against
the notion that these texts do not provide specific instructions as to how
one is to act. According to him, acting without attachment is a guiding
principle that provides specific instructions as to how one should act:
Some people complain, “The Gita merely teaches us to
perform actions renouncing the fruit, but it does not tell us
what actions to perform.” But it only appears so; it is not
really so. Because, once it is said, “Perform action after
renouncing the fruit,” it becomes clear what actions we
should perform and what not. Violent actions, actions filled
with falsehood, actions like theft--it is quite impossible to
perform them after renouncing the fruit. The moment such
actions are tested on the touchstone of renunciation of
fruit, they simply disappear. When the light of the sun
spreads, all objects begin to look bright, but does the
darkness too appear bright? No, it disappears altogether.
This is the condition of forbidden and interested actions.
We must test all our actions on the touchstone of
renunciation of fruit. Renunciation of fruit is the test for
performing any action.3 4 8
According to Vinobha, acting without attachment clearly means one’s
actions will neither be violent nor false. In the tradition of M.K.
Gandhi, Vinobha interprets the Gita as presenting a very clear path for
individuals to follow; a path of ahimsa, “not killing” or “non-violence.”
M 7 Bhagavad Gita, 111.19-20.
3 4 8 Vinobha, 218.
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More than non-violence, Young asserts that ahimsa suggests the
principles of nonmaleficence and beneficence.3 4 9 Though the examined
narratives do not directly address this concept of ahimsa, it is an
important principle that directly relates to all five of the characteristics of
Hindu thought discussed above. Krsna says, the “gateway to hell which
destroys the soul is threefold: lust, anger and greed. Therefore, one
should renounce these three.”3 5 0 Actions grounded in ahimsa are free of
lust, anger, and greed; they are actions of “protection, benevolence,
friendship and compassion.”3 5 1
If one believes that all of life is interconnected and interdependent,
then a logical expression of that belief is ahimsa. According to Gandhi:
Attacking an individual, even an enemy, is tantamount to
resisting and attacking oneself. For we are all tarred with
the same brush, and are children of one and the same
Creator, and as such the divine powers within us are
infinite. To slight a single human being is to slight those
divine powers, and thus to harm not only that being but
with him the whole world.3 5 2
3 4 9 Young, “Hindu Bioethics,” 12.
™Bhagavad Gita, XVI.21.
3 5 Young, “Hindu Bioethics,” 12.
3 5 2 Gandhi, 206.
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Gandhi’s belief in the underlying unity of all life, fueled his commitment
to ahimsa?^ By acting in a spirit of ahimsa, one is acting in a manner
that would most likely support the good of society, and positively affect
one’s dharma and karma. According to Gandhi, ahimsa is more than the
basis for action, it is the basis for truth.3 5 4
Traditions within Hinduism recognize that norms and values differ
for those from diverse geographical areas and castes, from different genders
and ages. There is also recognition that life itself is ever changing and
dynamic, and that no text, law, or philosophy can ever capture life in its
entirety.3 5 5 Ahimsa and the other five characteristics of Hindu thought
3 5 3 Young makes an interesting observation. According to her, while many
Hindus ground their commitment to the value of life in the belief that there is an
underlying unity to all life, many Christians ground their argument regarding the sanctity
of life ultimately in God. Since God created each individual, each life is valued. While
the Hindu concept emphasizes the collectivity of humanity, and all of life, this Christian
perspective focuses on the individual, wholly other from the rest of creation (Young, 16).
3 5 4 For more on ahimsa, and its importance in Indian religious traditions, see:
Christopher Key Chappie, Nonviolence to Animals, Earth, and Self in Asian Traditions
(New York: State University of New York Press, 1993).
3 5 5 Narayanan provides a modern example of how the classical dharmic texts are
superseded by local practice. In a legal case, Krishna Singh v. Mathura Ahir (AIR 1980
SC 707; 1980 All LJ 299), the Supreme Court of India debated the question: May a
sudra become a sarmyasith According to the classical texts, only men from the top
three castes are allowed to go through all four stages of life. Sudras and women are
excluded from participating in the final stage, that of renunciation. Thus according to
the texts, a sudra may NOT become a sannyasin. However, traditions associated with
Ramanuja and many Saiva orders have a number of sudra ascetics, sannyasins. The
Supreme Court of India ruled, “though the orthodox view does not allow shudras to
become sannyasis, the existing practice in India is contrary to such a view and [. . .] at
the present time a Hindu of any caste can adopt the life of a sannyasi.” Additionally
the Court abrogated, by virtue of mandates embodied in Part III of the Constitution of
India, the ban on sudras becoming sannyasins. According to Narayanan, this ruling
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are malleable in their application. These five key concepts are in
Hinduism’s foundational and formative texts such as the Vedas, Upanisads,
and Mahabharata. However, Young and Narayanan indicate that though
foundational, the Hindu texts are flexible and interpreted in various ways
depending upon the time and situation.3 5 6
Devotees within Hindu traditions tend to develop their ethics from
the specific contexts and instances presented to them. This focus on the
actualities of life accentuates the mercurial nature of these religious
traditions. According to Desai, the interpreters of these Hindu traditions
demonstrate a passion for inclusiveness. They steer away from absolutes,
are sensitive to context, and allow for qualification of each situation.3 5 7
These traditions are pluralistic and welcome a plethora of options.
Doniger O ’Flaherty observes that, “what makes Indian thought so
fascinating is the constant rapprochement between opposed worldviews,
hardly a true synthesis, but a cross-fertilization that seems to have no end,
one mediation giving rise to another, each result becoming a new cause
[. . ,].”3 5 8 This ability to hold a great amount of ambiguity— neither to
indicates that though dharma and classical legal texts are important, local customs and
living traditions are even more important (186-188).
3 5 6 Young, “Hindu Bioethics,” 5.
3 5 7 Desai, 19.
3 5 8 Doniger O’Flaherty, Karma and Rebirth in Classical Indian Traditions” xxv.
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feel compelled to arrive at a single conclusive answer nor to encapsulate
the entirety of human experience into categories—provides fertile ground
in which the complexities of life, rather than being problems, glitches, or
inconsistencies that need to be overcome, are allowed to determine what is
considered ethical and non-ethical behavior.
The Hindu traditions reflected in the Mahabharata are neither
interested in establishing consistent philosophical theories or ethical
principles nor are they committed to arriving at a single conclusion or
answer. Perhaps this is in part because these traditions acknowledge that
abstract philosophical theories cannot always assist those engaged in the
process of living-those facing the emergencies of life. There seems to be
an implied positive regard and confidence in an individual’s ability to
reason ethically. Murthy talks about how there is an emphasis on created
faith and a confidence in human efforts.3 5 9 Ideally this process of human
reasoning is given some structure through the principles of karma and
ahimsa.
By focusing on human action and the consequences of those
actions, the Mahabharata highlights the particularities and complexities of
people’s lives. This epic text makes no effort to clean up reality so as to
satisfy the limitations of particular categories. By approaching each
3 5 9 K.R. Srikanta Murthy, Professional Ethics in Ancient Indian Medicine, 127.
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situation with a wide range of options, preconceived ideas of what ought
or ought not be, are minimized. Each situation is assessed on its own
merits and allowed to define the issues and direct one’s course of action.
Each situation places one in the center of a circle, with spokes like a
wagon wheel going out in different directions, each presenting an array of
choices. As Carstaires and Sharma indicate, these types of options and
choices do not necessarily provoke anxiety for those living within the
traditions reflected in the Mahabharata.™ Rather, these options provide
opportunities for action; opportunities for individuals to fulfill their
dharma and influence the course of karma for themselves and others.
Having discussed five key characteristics of Hindu thought and a
few of their implications, we are now prepared to turn our attention to a
particular case that highlights issues relating to assisted reproductive
technology. In the following chapter, I apply these Hindu elements to an
examination of the case of Jaycee Buzzanca. Through this process a
Hindu ethic regarding assisted reproductive technology is constructed.
3 6 0 Doniger O’Flaherty, Women, Androgynes, and O ther M ythical Beasts, 66;
Sharma, “ When it Comes to Karma,” 98.
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CHAPTER 6
APPLICATION OF HINDU THOUGHT
Thus far, this study of the Mahabharata has demonstrated the
ancient epic’s relevance to contemporary discussions regarding assisted
reproductive technology. Although principles and characteristics extracted
from the narratives are foundational for many Hindu traditions, it should
be reemphasized that Hinduism, like other religious traditions, is not
monolithic. Differences and nuances in perspectives exist among the
various world traditions. Therefore, it is difficult to speak of major
world religious perspectives and ethics in universal terms. This is all the
more true for Hinduism, a conglomeration of traditions that cherish their
multivalent nature. Sharma remarks that these Hindu traditions “consist
of a frame of mind rather than fixed ideas;” their “answers are
exploratory, rather than catechetical in nature.”3 6 1 Thus, when discussing
ethics and how individuals ought to act, many speaking from within
Hindu traditions tend to focus on the particular situation being examined
rather than putting forth various generally applicable principles. Bearing
this attitude in mind, we now examine a particular case— namely that of
Jaycee Buzzanca— in light of Hindu ethics. Jaycee’s situation not only
3 6 1 Sharma, When It Comes to Karma, 98.
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challenges the legal limits of particular laws in the United States,3 6 2 it
highlights many of the central ethical complexities that can accompany the
use of assisted reproductive technologies.
Following a brief summary, I examine Jaycee Buzzanca’s case in
light of the five key elements of Hindu thought that have been previously
identified, namely: (i) emphasis on societal good; (ii) the underlying unity
of all life; (iii) the responsibilities of dharmar, (iv) the multivalent nature of
Hindu traditions; and (v) a theory of karma. Though these Hindu
elements— specifically, the context-specific nature of dharma— preclude the
formulation of an exclusive or definitive Hindu ethic, they do provide a
beneficial set of lenses through which one can examine the ethical issues
associated with particular medical technology. Through this practical
application of these characteristics of Hindu thought, Hindu responses to
assisted reproductive technologies may be theoretically adduced. As a
point of comparison, these Hindu concepts will be juxtaposed with those
of the Roman Catholic Church, one of the most influential voices in the
United States and the world, specifically regarding reproductive issues.
3 6 2 Though fascinating and important, the legal aspects of this case are beyond the
scope of this paper.
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Jaycee’s Case3 6 3
The story of Jaycee Buzzanca begins in May 1989 with the
marriage of John and Luanne Buzzanca. After years of unsuccessfully
utilizing fertility treatments, Luanne meets and convinces Pamela Snell to
be a gestational surrogate mother for her and John’s baby. Due to their
own sterility, the Buzzancas obtain an embryo conceived through IVF
with the sperm and ova from anonymous donors.3 6 4 On 13 August 1994,
3 6 3 The case as it is presented here draws on the following sources: Jaycee B. v
Superior Court 42 Cal. App. 4th 781; 1996 Cal App. LEXIS 101; In re Marriage o f John
A. and Luanne Buzzanca 61 Cal. App. 4t h 1410; 1998 Cal. App. LEXIS 180; Laura A.
Brill, “When will the Law Catch up with Technology? Jaycee B. v. Superior Court of
Orange County: An Urgent Cry for Legislation on Gestational Surrogacy,” The Catholic
Lawyer 39:241 (Summer/Fall 1999); Jerald V. Hale, “From Baby M to Jaycee B.:
Fathers, Mothers, and Children in the Brave New World,” Journal o f Contemporary Law
and Family Studies 24:335 (1998); liana Hurwitz, “Collaborative Reproduction: Finding
the Child in the Maze of Legal Motherhood,” Connecticut Law Review 33:127 (Fall,
2000).
^Currently there are two types of maternal surrogacy. First, traditional
surrogacy is when a woman agrees to be artificially inseminated with the sperm of a
married man and, if all goes as planned, upon the birth of the child, she relinquishes it
to the father and his wife. In this circumstance, the surrogate and father are both
genetically related to the resulting child. The famous case of Baby M is an example of
traditional surrogacy. In this case, however, the surrogate mother, Mary Beth Whitehead,
reneged on the agreement and sued for parental rights of the baby she carried. Second,
gestational surrogacy refers to a situation where the surrogate has no genetic link to the
embryo she has agreed to carry and allow to develop to term. In this case, through the
process of IVF, a couple’s egg and sperm, or donor gametes, are united and the resulting
zygote is implanted into the surrogate’s womb. (Hale 1998. 336-339) The Buzzancas
and Ms. Snell are participating in the latter form of surrogacy. While Johnson v.
Calvert was the first surrogacy case to come before the courts, Jaycee’s situation is the
first case where all of the parties involved (the surrogate, her husband, and
contracting/intended parents - the Buzzancas), did NOT have any genetic relationship to
Jaycee. Additionally, this case is unique in that, unlike Johnson and Moschett, Ms. Snell
is neither reneging on her agreement nor seeking to establish parental rights regarding
Jaycee.
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this embryo is implanted into Ms. Snell’s uterus. She, her husband
Randy, and both the Buzzancas sign a surrogacy contract stipulating that
neither the surrogate (Ms. Snell) nor her husband will interfere, retain, or
assert any parental rights. Additionally, the contract provides that in the
event that the “intended mother” (Luanne) dies prior to the child’s birth,
the child will be placed with the “intended father” (John), and if the
“intended father” dies, then the child will be placed with the “intended
mother.” If both Luanne and John were to die before the birth of the
child, then the surrogate and her husband agreed to place the child into
the custody of guardians, as stipulated in the Buzzancas’ will.3 6 5 This
surrogacy contract clearly indicates that John and Luanne Buzzanca are the
intended parents who will both care and provide for the resulting baby.
The contract also unmistakably stipulates that Pamela and Randy Snell
will neither make claims to parenthood nor bear any parenting
responsibilities.
On 30 March 1995, John Buzzanca files for “dissolution of
marriage,” alleging that he and Luanne have been separated since
September of 1994. In his claim, he indicates that there are “no minor
children of the marriage.” Less than a month later, Luanne files a
response alleging that though there are no minor children at present, she
% 5 Jaycee B. v Superior Court, 722.
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and John are expecting a baby by way of a surrogate contract. Six days
later, on 26 April 1995, Jaycee Louise Buzzanca is born. According to
the conditions of the surrogate contract, and without any objections or
hesitation, Ms. Snell willingly gives the baby, and custody of her, to
Luanne, who subsequently takes her home. Several months later, Luanne
files for sole custody of Jaycee, and requests pendente Ike child support
payments from John.
N ot disputing the fact that he signed the surrogacy contract, John
argues that the California Family Court lacks the jurisdiction to force him
to pay child support because, according to its own definitions, it cannot
establish that Jaycee is indeed a “child of the marriage.” According to
section 7610 of the Uniform Parentage Act,
The parent and child relationship may be established as
follows: (a) Between a child and the natural mother, it
may be established by proof of her having given birth to
the child, or under this part; (b) Between a child and the
natural father, it may be established under this part;
(c) Between a child and an adoptive parent, it may be
established by proof of adoption.3 6 6
Johnson v. Calvert clarify “under this part” to mean “genetic
consanguinity.” According to this Act, there are three ways in which
3 6 6 7610 of the Uniform Parentage Act, quoted in Andrew W. Vorzimer, Milena
D. O’Hara, and Lori D. Shafton, “ Buzzanca v. Buzzanca: The Ruling and Ramifications.
Journal o f Assisted Reproductive Law. Downloaded from
huzzancazca&editml. 4/10/02.
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individuals may establish legal familial relationships: 1) having a genetic
connection with the child; 2) actually giving birth to the child; and
3) through the legal process of adoption.
Basing his ruling on the facts of the case, and a close interpretation
of the above Act, the trial court judge, Robert D. Monarch, came to the
extraordinary conclusion that “ Jaycee had no lawful parents.” First, the
judge accepted a stipulation that neither Pamela Snell, the surrogate, nor
her husband were the “biological” parents.3 6 7 Second, he concluded that
the facts clearly indicate that Luanne could not be Jaycee’s mother because
she did not contribute the egg, or give birth to her, or legally adopt her.
Additionally, John could not be Jaycee’s father because he neither had a
biological relationship with her, nor had he adopted her. Thus, Judge
Monarch concurred with John’s argument that the California Family
Court lacked jurisdiction.
Jaycee’s case is not a dispute over facts, but rather a dispute over
the legal significance of the facts. John acknowledges that he willingly
signed the surrogacy contract; however, he claims this contract is not
sufficient evidence to indicate that he is Jaycee’s father. The California
3 S 7 Though John’s attorney was present at the hearing that accepted this
stipulation, he made no objection. Yet on appeal, he did argue that the surrogate is the
lawful mother of Jaycee by virtue of having given birth to her. Additionally, he argued
that if Pamela and her husband chose not to subsume the responsibilities of Jaycee, then
the burden ought to revert to the state.
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Court of Appeals disagreed and reversed the lower court’s decision
declaring:
We disagree. Let us get right to the point: Jaycee never
would have been bom had not Luanne and John both
agreed to have a fertilized egg implanted in a surrogate.
The trial judge erred because he assumed that legal
motherhood, under the relevant California statutes, could
only be established in one of two ways, either by giving
birth or by contributing an egg. He failed to consider the
substantial and well-settled body of law holding that there
are times when fatherhood can be established by conduct
apart from giving birth or being genetically related to a
child. The typical example is when an infertile husband
consents to allowing his wife to be artificially inseminated.
As our Supreme Court noted in such a situation over 30
years ago, the husband is the "lawful father" because he
consented to the procreation of the child. (See People v.
Sorensen (1968) 68 Cal. 2d 280, 284-286 [66 Cal. Rptr. 7,
437 P.2d 495, 25 A.L.R.3d 1093].)
The same rule which makes a husband the lawful father of
a child born because of his consent to artificial
insemination should be applied here, by the same parity of
reasoning that guided our Supreme Court in the first
surrogacy case, Johnson v. Calvert (1993) 5 Cal. 4th 84 [19
Cal. Rptr. 2d 494, 851 P.2d 776], to both husband and
wife. Just as a husband is deemed to be the lawful father
of a child unrelated to him when his wife gives birth after
artificial insemination, so should a husband and wife be
deemed the lawful parents of a child after a surrogate bears
a biologically unrelated child on their behalf. In each
instance, a child is procreated because a medical procedure
was initiated and consented to by intended parents. The
only difference is that in this case, unlike artificial
insemination, there is no reason to distinguish between
husband and wife. We therefore must reverse the trial
court's judgment and direct that a new judgment be
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entered, declaring that both Luanne and John are the lawful
parents of Jaycee.3 6 8
Through this ruling, the California Court of Appeals put an end to
Jaycee’s status as a “legal orphan.”3 6 9 In doing so, the Court ruled that
even in the absence of a genetic or biological relationship, parental
relationships may be established when the intended parents initiate and
consent to reproductive medical procedures.3 7 0 This court, like that of the
Johnson court, arrived at its conclusion through examining the importance
of an individual’s intentions. The court did not focus on the question,
“Is the surrogacy contract enforceable?” Rather it focused on the question
of “What was John’s intent when he signed the contract?” Jaycee would
not exist had John and Luanne not intended for a child to be born. The
California Court of Appeals, extrapolating from previous cases, utilized a
degree of common sense to equitably resolve Jaycee’s predicament.
mIn re Marriage o f Buzzanca, 1412-13.
3 6 9 From birth and throughout the years of legal proceedings, Jaycee was in the
custody of her mother Luanne. The final court rulings simply made their mother-
daughter relationship legal and required John to provide child support. Presumably, this
continues on into the present day. Though I have searched for updated information on
Jaycee, for her privacy reasons, I am not surprised that my searches have been
unsuccessful.
3 7 0 Vorzimer, O’Hara, and Lori D. Shafton. Under the Act, paternity may be
established in a variety of ways. In addition to blood tests, one may establish paternity
by being married to a Child’s mother when she gives birth, or through consenting to
adopt the child of one’s wife. Also, if a man’s wife undergoes artificial insemination
(AI) with the husband’s consent, the law will treat the husband as if he were the natural
father of the child (In re Marriage o f Buzzanca, 1417).
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Though there is general agreement that the Court arrived at the best
decision for Jaycee’s situation, there is concern and debate over its
conclusions for, and application to, future cases.3 7 1 Though the legal
questions are beyond the scope of this paper, the ethical issues are not.
Practical Application: A Hindu Analysis of Jaycee Buzzanca’s Case
In the context of assisted reproductive technology, Jaycee’s case
involves the utilization of donor gametes, IVF, and surrogacy. Of the
many areas of concern regarding these technologies, this discussion focuses
on three. First, there is the question of whether these technologies ought
to be used or not. Second, Jaycee’s case underscores concerns relating to
the tensions between individual rights and self-interest versus the rights
and interests of others and of society as a whole. Third, opponents of
assisted reproductive technologies often argue that these technologies
threaten the existence of the marriage, the traditional family, and
understandings of parenthood. Jaycee’s case brings all these challenges to
the forefront. Hull states the obvious when he indicates that fair-minded
individuals can disagree over moral issues related to assisted reproductive
3 7 1 George J. Annas, “Assisted Reproduction: Who is the Mother?” N ew England
Journal o f Medicine 340:8 (25 February 1999) [Downloaded from Ovid file:// /D | /Journal
Art30 Aug/Buzzanca & other art/Who is mother.htm. 8/30/01]; Brill, 39; Hale, 24:335;
Jonathan B. Pitt, “ Fragmenting Procreation,” Yale Law Journal 108:1893 (May, 1999)
[Downloaded from LEXIS-NEXIS file:// /D |Journal Art30 Aug/Buzzanca & .../PittNote
on Fragnenting Procreation.htm. 8/30/01].
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technology. The disagreements involved in Jaycee’s case may provide
opportunities for reexamination and expansion of previously held ideas.3 7 2
Through an application of the five elements of Hindu thought, and the
utilization of several other selected narratives from within the
Mahabharata, Hindu perspectives regarding these questions and concerns
are addressed.
Utilization of Assisted Reproductive Technology
One of the initial questions raised by assisted reproductive
technologies— specifically, donor gametes, IVF, and surrogacy— is the ethical
permissibility of their utilization.3 7 3 Responses to this question vary.
Some argue that these technologies perpetuate a society that devalues
women, by viewing them simply as baby making machines, and therefore,
they ought not to be utilized. Others view these technologies as
increasing the options for women and providing them with additional,
welcomed choices. While Roman Catholicism morally objects to all these
reproductive technologies on the grounds that they go against God’s
creative design, by separating procreation from the act of sexual
3 7 2 Hull, 3.
3 7 3 Thomas Reich, ed., 2233.
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intercourse, some Protestant traditions may object to a few of the
technologies, while finding others morally acceptable.3 7 4
As discussed in Chapter 4 of this study, the attitudes expressed in
the examined narratives of the Mahabharata would presumably support
John and Luanne’s use of donor gametes, IVF, and surrogacy. Hindu
perspectives are neither simple nor monolithic. Gupta and Lingam both
object to various forms of assisted reproductive technologies on the
grounds that their utilization “abuse, disrespect, manipulate, and exploit
women as objects.” According to them these technologies reinforce the
idea that fertility is a primary indicator of a woman’s status, and other
“anti-women” ideals of society. Of critical importance to them is for the
world to take note of and “support a woman’s struggles to resist control
by others and to achieve and maintain their integrity and autonomy over
their bodies.”3 7 5 It appears that the primary area of concern for them is
not necessarily the particular technology, but rather the society within
which it is being utilized. Presumably, if a woman, freely exercising her
3 7 4 Reich, 2223, 2227; See also discussion in previous chapters.
3 7 5 Jyotsna Agnihotri Gupta, “Women’s Bodies: The Site for the Ongoing
Conquest by Reproductive Technologies,” Issues in Reproductive and Genetic Engineering:
Journal o f International Feminist Analysis 4:2 (1991), 93-107; Lakshmi Lingam, “ New
Reproductive Technologies in India: A Print Media Analysis” Issues in Reproductive and
Genetic Engineering 3:1 (1990), 13-21. Both Gupta and Lingam express their concerns
regarding the utilization of assisted reproductive technologies.
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autonomy, chooses to utilize any number of assisted reproductive
technologies, they would not object.
Other than the above, the majority of contemporary sources
presenting Hindu views on assisted reproductive technology, indicate that
Hinduism argues for its permissibility. For example, the New York State
Task Force on Life and the Law has a paragraph on Hindu perspectives.
After acknowledging the lack of a central authority within Hinduism, the
Task Force states the following:
Most Hindu authorities, however, view the production of
male offspring as a religious duty. Assisted reproduction is
acceptable, therefore not only to address fertility problems
but also the lack of male children. When all other
infertility treatments have failed, assisted insemination with
donor semen is permitted [. . .]. IVF using egg or embryo
donors is also acceptable.3 7 6
Concurring with the Task Force’s conclusions regarding Hindu
perspectives, the Encyclopedia o f Bioethics states, “the mythologies of
ancestors appear to allow IVF, oocyte donation, embryo implantation, and
surrogacy.”3 7 7
A majority of contemporary Hindus argue for the ethical
acceptability of gamete donation, IVF, and surrogacy. For example, Desai,
3 7 6 New York State Task Force on Life and the Law, Assisted Reproductive
Technologies: Analysis and Recommendations for Public Policy (1998), 114-115.
3 7 7 Reich, ed., “Reproductive Technologies,” 2233.
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relying on the Mahabharata as a source, argues that gamete donation, IVF,
implantation of fertilized ova, and surrogacy are all ethically acceptable for
Hindus. Narayanan comes to the same conclusion in her essay, Hindu
Ethics and DharmaH Similar attitudes are present in the views of lay
Hindus living in the United States. Of the six individuals I interviewed
for this study, all of them saw the utilization of assisted reproductive
technology as acceptable. Mr. C and Mr. F, both with grown adult
children, indicated that though they have no ethical objections to the
implementation of these technologies, they themselves would choose not to
utilize them. Ms. B and Dr. D are married to each other. They
underwent two cycles of IVF, the first failed, and the second, where they
utilized intracytoplasmic sperm insertion (ICSI), resulted in the birth of
twins.3 7 9 From these examples from antiquity, the academy, and from lay
Hindus, one finds a general acceptance of the use of various forms of
assisted reproductive technologies. Within these Hindu perspectives, there
is no presumption that procreation and sexual intercourse are inseparable
3 7 8 Desai, Health and Medicine in the Hindu Tradition, 68; Narayanan, “Hindu
Ethics and Dharma,” 192. There is discussion regarding to the acceptability of
anonymous sperm donors. While Desai makes no distinction, Narayanan indicates that
the husband’s sperm, or sperm from one of his family members, is preferred by “higher
caste” Hindus. This same sentiment was expressed by a few of the individuals I
interviewed for this study. This issue of biological connections is discussed below.
3 7 9 Mr. C, interview by author, tape recording, Loma Linda, CA., 30 July 2001;
Mr. F, interview by author, tape recording, San Bernardino, CA., 1 December 2001; Ms.
B and Dr. D, interview by author, tape recording, Riverside, CA., 30 July 2001.
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activities. Neither is there any evident concern that utilizing creative
means to procreate will defy the will of the gods or disturb the
normative order of life.
Key arguments for or against the use of IVF, and other procedures
that involve the extracorporeal creation and transfer of human zygotes or
embryos, are based upon one’s understanding of the moral status of an
embryo. This moral status is an important focus of many, if not all,
world religions for it concerns the question of ensoulment. Religious
traditions share in their attempts to answer the question: “At what point
is the zygote, embryo, or fetus infused with a soul?” Though they share
in an attempt to answer this question, there is great disagreement within
and between religious traditions, regarding when ensoulment occurs and
what that means in terms of our obligations to it.3 8 0
There are three primary ethical positions regarding the ethical and
moral status of a pre-embryo, or embryo. At one extreme, the pre
3 8 0 The status of the embryo is of primary concern when considering the
implementation of some assisted reproductive technologies, particularly IVF. “ Bioethics
for Clinicians: Assisted Reproductive Technologies.” Canadian Medical Association
Journal 164:11 (29 May 2001), 1589-1594. Downloaded from http:ZZgatewayljovid.CQmZ
ovidweh.cgi. 7Z12Z2001; F. Shenfield, “Current Ethical Dilemmas in Assisted
Reproduction ” International Journal o f Andrology 20: Suppl.3 (1997), 74-78; While Paul
Ramsey expresses his opposition to IVF in Fabricated Man: The Ethics o f Genetic, Kass
presents his objections to IVF in the essay, “Babies by Means of In Vitro Fertilization:
Unethical Experiments on the Unborn?” N ew England Journal o f Medicine 285 (1971),
1174-1179. Joseph Fletcher, in “The Ethics of Genetic Control: Ending Reproductive
Roulette,” argues for the ethical acceptability of utilizing IVF.
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embryo is viewed as being a full human being immediately after
fertilization. This requires that it be accorded the rights of a person. At
the other extreme is the idea that the pre-embryo, embryo, or even fetus
is simply tissue, no different from any other human tissue, and not
having any rights or requiring protection.3 8 1 A third, intermediate
position views the pre-embryo as deserving of respect greater than that
accorded to human tissue, but not the same degree of respect given to an
actual person. Because of the potential to become a full person, and
because of its symbolic meaning for many, the pre-embryo, embryo and
fetus are afforded this middle ground of an ethical and moral status that
is more then that accorded to tissue, but less than that of a person, a
human being living ex utero?n
To begin this discussion regarding ensoulment with familiar ideas to
many, let us pick up the discussion within the teachings of the Roman
Catholic Church. Despite the diverse opinions expressed by its
3 8 ‘While working in a large teaching Hospital on the East Coast, I once had to
prepare the body of a 26-week fetus that had been aborted. She had multiple
deformities, and may not have survived in utero, much less through the birthing process.
The entire body of the fetus fit within my hands together, but not overlapping.
Another nurse entered the room in which I was preparing the body. She shook her
head sideways and said, “that’s just tissue.” Looking up at her, I couldn’t help but
respond, “Well if you and I are ‘just tissue,’ then OK.” At 26 weeks, a fetus is not
“just tissue.”
3 8 2 Ethics Committee of American Fertility Society, 34S-35S.
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theologians throughout history,3 8 3 today, the Catholic Church teaches
immediate hominization and makes the following argument regarding a
zygote:
3 8 3 Though the Church has always argued for the sanctity of human life, there has
never been a unanimous view as to when ensoulment actually occurs. For example,
while Augustine {C ity o f God, xxi.10) and Ambrose {On Belief in the Resurrection,
2.113) argue for immediate hominization, Tertullian presents conflicting views. In his
support of traducianism, the theory that the soul is transmitted via the sperm, he argues
that both the body and soul are conceived, formed and born simultaneously so that “not
a moment’s interval occurs in their conception [. . .]. Now we allow that life begins
with conception, because we contend that the soul also begins from conception”
(Tertullian, A Treatise on the Soul, xxvii). Here he is clearly arguing for a theory of
immediate hominization. However, elsewhere, in his A Treatise on the Soul, Tertullian
states, “The embryo therefore becomes a human being in the womb from the m oment
that its form is completed’ ( xxxvii). This does not coincide with his comments
regarding traducianism-, here his remarks support delayed hominization.
Thomas Aquinas, espouses hylomorphism, a theory that expresses the Aristotelian
idea that all natural or physical bodies are composed of matter and form as essential
substantial principles (W.A. Wallace, “Hylomorphism,” N ew Catholic Encylopedia).
Aquinas claims “ the soul is in the embryo; the nutritive soul from the beginning, then
the sensitive, and lastly the intellectual soul [. . .] the intellectual soul is created by God
at the end of human generation” (Aquinas, Summa Theologica, 1.76.3). According to
Aquinas, as the embryo matures and grows, so does the soul. Only when the embryo
has developed into a fetus and has human form does it have a human soul. Thus, in
his theological application of hylomorphism, Aquinas concurs with Tertullian’s support
for the theory of delayed hominization.
Anselm also argues against immediate hominization because it is “inadmissible
that the infant should receive a rational soul from the moment of conception. This
would imply that every time an embryo perishes soon after conception, a human soul
would be damned forever, since it cannot be reconciled with Christ” (as cited in
Donceel, 78). Anselm points to one of the staggering implications of the theory of
immediate ensoulment. If the Magisterium’s argument of immediate ensoulment, is
juxtaposed with the widely recognized fact that one-third to one-half of all fertilized ova
never survive to implant in the uterus or differentiate to any advanced degree, then every
day countless human beings are damned for eternity. In light of this theory of
ensoulment and the medical facts, Karl Rahner responds by asking contemporary Catholic
Moral Theologians, if today they still have “the courage to maintain this presupposition?”
Rahner questions if these theologians are able to acknowledge that “50% of the ‘human
beings’ -real human beings with an ‘immortal’ soul and an eternal destiny-do not, from
the very start, get beyond this first stage of a human existence?” (Karl Rahner, Schriften
Zur Theologie 8 (Einsiedeln, 1967), 287 as cited in Donceel, 99-100).
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[T]he fruit of human generation, from the first moment of
its existence, that is to say from the moment the zygote
has formed, demands the unconditional respect that is
morally due to the human being in his bodily and spiritual
totality. The human being is to be respected and treated
as a person from the moment of conception; and therefore
from the same moment his rights as a person must be
recognized [. . .].3 8 4
In their argument regarding ensoulment, the Magisterium makes no moral
distinction between zygotes, pre-embryos, embryos, and fetuses. From the
“moment of conception,” the Church views the zygote as a full person,
possessing a right to life and thus entitled to protection from harm.
Since IVF and other technologies utilizing zygotes inevitably involve the
destruction of at least some of them, the Church rejects the ethical
permissibility of IVF and related technologies.3 8 5
The teachings of the Vatican concern itself with the question:
“When does human life begin?” Utilizing contemporary scientific
knowledge regarding the nature of human in utero development, others
argue the question ought to be: “At what point in the development of
the embryo do we attribute to it the protection afforded a human being?”
Stating the question in this manner acknowledges the profound changes
that begin as a sperm starts to penetrate the wall of the ovum and
mInstruction, 22.
Instruction, 26.
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culminates, approximately forty weeks later, into a much larger and more
complex full term fetus. The Ethics committee of the American Fertility
Society and others argue that the facts of developmental process ought to
be considered as the status of the embryo is being determined. During
the “pre-embryonic stage,” the early events in internal gestation involve
physiological interactions between the multiplying blastocyst and the
mother. At this point an embryonic rudiment is not even present. Each
cell is totipotential, capable of becoming any type of subsequent cell. At
this stage, if the cell mass undergoes twinning, a process whereby the cell
is divided in half and allowed to grow, each half will develop into a full
adult. This is when identical twins are formed. However, at this point
if a divided cell goes through a process of reconjunction, where the halves
are rejoined, the result is one embryo. The argument for immediate
hominization, simply does not coincide with these early biological stages
of development.3 8 6
Once differentiation begins, a process where the embryonic cells
“specialize,” and are designated to become the bones, eyes, heart, or other
3 8 6 Jennifer Gunning and Veronica English, Human In Vitro Fertilization: A Case
Study in the Regulation o f Medical Innovation (Aldershot: Bartmouth, 1993), 29; Ethics
Committee of the American Fertility Society, Ethical Considerations o f N ew
Reproductive Technologies, 3IS. In the eighth chapter, the Ethics Committee report
presents a concise discussion regarding the complexities involved in the process of human
development in utero. James Diamond also discusses the early process of human
development in his essay, “ Abortion, Animation, and Biological Hominization,”
Theological Studies 36 0une 1975): 307-312.
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parts of the fetus, that genetic individuality begins to be established. The
first differentiation occurs slightly less than a week after fertilization.
Implantation begins and the surface cells of the zygote form the placenta.
Once the placenta is formed, the cells increase rapidly for approximately
another week. Then by the end of the second week, a hominal organizer
appears in the blastocyst. Differentiation of specific organ systems will
not occur unless this organizer orders the pluripotential cells to
differentiate into the specific organ systems that will form the human
fetus. It is during this stage of the developmental process, after
differentiation begins, that it makes sense to talk about ensoulment. Prior
to this point, biologically, the multiplying zygote can undergo twinning or
reconjunction any number of times. However, after differentiation, the
cells of the zygote are programmed to develop into particular entities.
Bearing these biological facts in mind, it appears reasonable to allow for
moral distinctions to be made between a zygote, per-embryo, embryo, and
fetus.3 8 7
Classical H indu texts reflect an understanding of the developmental
nature of a zygote, embryo, and fetus. Preserving the Atharvan theory of
fetal development, the Garbha Upanisad reads as follows:
3 8 7 American Fertility Society, Ethical Considerations o f N ew Reproductive
Technologies, 32S; Diamond, 307-312.
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By the second night after the union of semen and blood
the foetus is of the form of a round lump called Kalala, at
the eighth night it is of the form of a vesicle called
Budbuda, after a fortnight it assumes the form of a
spheroid - Pinda, in two months the head appears, in three
months the feet, in four months the abdomen, heels, the
pelvic portion appear, in the fifth month the spine appears,
in the sixth month nose, eyes and ears develop; in the
seventh month the feotus becomes endowed with life
[. . .]; in the eighth month it becomes fully developed. In
the ninth month when the foetus is well-developed with all
of its organs, [. . .].3 8 8
Another account of embryonic development is found in the Caraka
Samhita, a pre-Buddhist, Indian medical work dating from circa eighth
century B.C.E. Once all the necessary elements are combined, the
embryo takes on a form of jelly and “bears no particular form and the
organs of the embryo are both manifested and latent,” during the first
month. During the second month “the embryo takes a compact form in
the shape of a knot, elongated muscle or tumor (round and elevated).
During the third month, all the senses and limbs along with their organs
manifest themselves simultaneously, ” and so forth, the description
389
continues.
3 8 8 V.W. Karambelkar, The Atharva-Veda and Ayur-Veda (Nagpur: Majestic
Printing Press, 1961), 106.
3 S 9 Ram Karan Sharma, and Vaidya Bhagwan Dash, Agnivesa’ s Caraka Samhita,
vol. XCIV (Varanasi: The Chowkhamba, Sanskrit Series, 1976), 391-400.
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Lipner, in his discussion on abortion, lists the various terms used
for abortion. For example, srava, or “emission,” is the term used to
indicate miscarriages until the fourth month of pregnancy. For
miscarriages occurring in the fifth and sixth months, the term pata, fall, is
used. The different terms utilized are related to the developmental stage
of the fetus.3 9 0
Along with presenting different accounts for the development of a
zygote or fetus, these texts also contain differing arguments as to when
ensoulment occurs. Lipner describes a major and a minor tradition in his
brief discussion on Hindu perspectives concerning ensoulment.3 9 1 The
major tradition is found in Caraka Samhita. The developmental process
begins once all the elements necessary to form an embryo are present,
namely, the unimpaired sperm of a man, a healthy fertile woman’s womb
and ovum, sex during a fertile period, a free jlva (Soul) along with the
mind to descend into the zygote.3 9 2 According to this text,
The fetus is produced out of the Soul [. . .]. This is now
as jlva or animated Soul [. . .]. He [the jlva] is without
the beginning and end, and He is unchangeable. By
entering into the uterus, it gets combined with the sperm
and the ovum thereby reproducing Himself in the form of
3 9 0 Lipner, “The Classical Hindu View on Abortion,” 42-43.
3 9 1 Lipner’s designation of “major” and “minor” is related to the apparent weight
of authority and strength of evidence.
mAgm'vesa’ s Caraka Samhita, 366.
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a fetus [. . .]. The state of mere existence of sperm and
ovum prior to be combination \_sic\ of the Soul cannot be
called as fetus. They are entitled to be known as fetus
only when the Soul gets combined with them.3 9 3
In this case ensoulment is simultaneous with the commencement of the
process of conception. A zygote by definition is ensouled. According to
Lipner, this major tradition views human beings as “composites of two
essentially disparate but intimately conjoined principles - spirit (atman,
purusa) and matter (prakrti). Personhood is established once there is a
combination of the two.”3 9 4
While the major tradition supports the idea of immediate
hominization, Lipner describes the minor tradition as arguing that the soul
unites with the embryo sometime after conception. In the Garbha
Upanisad, cited above, it is in “the seventh month the feotus becomes
endowed with life.” Or, as Lipner translates it the fetus “is join ed to the
soul*™ According to this minor tradition, there may be grounds for
distinguishing between an embryo prior to ensoulment and an ensouled
embryo. However, Lipner comments on how the embryo does not
undergo a “quantum leap,” in its development. Rather, “in characteristic
mIbid, 372-373.
3 9 4 Lipner, “The Classical Hindu View on Abortion,” 52.
mIbid, 54.
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Hindu fashion, the language here is in terms of progressive
MANIFESTATION of a personhood previously only latent, rather than
origination of personhood ab initio.i%
Regardless of when the atman is believed to enter the zygote,
Hindu texts reflect a respect for the developing fetal life and argue that it
is deserving of protection from harm.3 9 7 The fetus is conscious and even
has a memory of his or her previous births. The fetus knows the
difference between good and bad, and “repents, that on account of its
previous Karma, it is suffering from the pains of life in a fetus, and
resolves that if it can once come out, it will follow the path of
knowledge.” Unfortunately, as soon as the baby is “born, it comes into
connection with the Vaisnava Vayu and forgets its previous births and
resolutions.”3 9 8
mIbicL, 56.
3 9 7 According to the Gautama Dharmasutra, “A man should disown a father who
assassinates a king; sacrifices for a abortionist.” (20.1); “A woman falls from her caste by
carrying out an abortion.” (21.9) The Rg Samhita, a text containing some of the earliest
canonical Hindu texts, refers to Visnu as the “protector of the child-to-be.” According
to the Atharva Veda, abortions are amongst the most heinous of crimes. Lipner, 41-61;
Narayanan, 193; Desai, 64; Jayapaul Azariah, et ah, Bioethics in India, 54. Regarding the
prohibitions against abortion, Jhingran remarks that of primary concern for these Hindu
authors was the value of property, not necessarily life (89). Even so, this does not
negate the argument that the fetus is an entity of value.
3 9 8 V.W. Karambelkar, The Atharva-Veda and Ayur-Veda (Nagpur: Majestic
Printing Press, 1961), 106-107.
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This story of the fetus forgetting past lives, and other narratives
vividly depicting them as hearing, learning, and remembering, speaks
volumes as to the status of the unborn fetus within Hindu traditions. At
one point in the Mahabharata, Krsna is telling his pregnant sister,
Subhadra, second wife to Arjuna, how a soldier can break into a
particular military formation known as “the disc” called, chakra-vyuba.
According to the story, the fetus, Abhimanyu, is carefully listening to his
uncle’s instructions. Unfortunately, Krsna’s discussion is interrupted and
he does not tell Subhadra how one gets out of the military formation.
At sixteen, Abhimanyu is on the battlefield and successfully penetrates the
chakravyha of his enemies. However, he is ultimately killed because he
lacks the knowledge of how to get out of it. This story clearly
demonstrates that a fetus, in utero, has the ability to hear and
remember.3 9 9
Interestingly, these Hindu texts and traditions preserve both a
commitment to the moral status of an embryo and a support for utilizing
various means, intra utero as well as ex-utero, for producing children.
According to these traditions, it is not an either or situation. One can
have respect for an embryo and still utilize technologies such as IVF.
There is nothing inherently wrong about IVF, gamete donation, and
3 9 9 Jean-Claude Carriere, 174-177.
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surrogacy that would contradict any of the five elements of Hindu
thought previously discussed.
These elements of Hindu thought would not have censured John
and Luanne for taking advantage of the assisted reproductive technologies
made available to them. Gamete donation, IVF, and surrogacy do not in
and of themselves undermine a non-dualist worldview. Ultimately, the
donors, doctors, zygotes, embryos, and intended parents are all part of
Brahman. Similar to the two couples of the epic narratives (Kuntl-Pandu
and Gandharl-Dhrtarastra), John and Luanne Buzzanca were a married
couple in the householder stage of life. At this stage, one of their
primary duties is to have children, thus securing the continuation of
society. The Buzzancas were facing challenges in their attempts to
produce children. KuntI obtained donor gametes, as did the Buzzancas.
The Buzzancas utilized IVF and a surrogate mother, while Gandharl is
said to have utilized “artificial wombs.” This utilization of technology can
be interpreted as enabling John and Luanne to fulfill their debts to their
ancestors and society. In this manner, the good of society is supported.
By having this child, according to traditional Hinduism, the Buzzancas
would also be fulfilling a primary dharma of parenthood, thereby affecting
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their karma in a positive manner.4 0 0 Thus, in view of the five elements
of Hindu thought discussed in chapter four of this work, the utilization
of assisted reproductive technologies is ethically acceptable. One could
argue that even the concerns raised by Gupta and Lingam are addressed in
the theory of karma. When these technologies are used to harm,
undermine, and control women, then those utilizing them in such a
manner ultimately will be held responsible.
Individual vs. Societal Rights and Interests
In the United States, central ethical issues regarding the uses of
assisted reproductive technologies are often couched in terms concerning
individual rights and interests versus those of society at large.4 0 1 On the
one hand there are those, championing autonomy and individual rights,
who argue that procreation and infertility are private matters to be
decided by each individual for himself or herself. According to these
4 0 0 Narayanan argues that contemporary couples seek out the use of these
technologies in order to fulfill their obligations to have children (192). As discussed in
Chapter 3, children are a priority for most Indian and Hindu traditions. Lipner
comments that having children is a public duty for those in the householder stage of
life. According to him it is “unHindu” to see procreation related issues as a private
concern of mother or individual family alone (“The Classical Hindu View on Abortion,”
59).
4 0 1 Reich, 2234. Discussions regarding issues associated with the utilization of
assisted reproductive technologies in contemporary contexts of global overpopulation,
availability of health care, or lack thereof, and costs are immensely important. It is
prudent to question whether or not it is even appropriate to use these technologies in
light of other global issues. The current focus is localized to discussions in the United
States and acknowledges the reality that these technologies are being widely used.
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arguments, individuals have a right to enter into contractual agreements
providing them access to the appropriate technologies and willing third
parties.4 0 2 While the U.S. Constitution may imply that individuals have a
right to procreate, the U.S. Supreme Court does not explicitly consider
procreation a positive right— it is a negative right.4 0 3
On the other hand, there are those who view these matters from a
broader societal perspective. Some of them caution against implementing
these technologies because they go against the greater good of society.4 0 4
4 0 2 Reich, 2234.
4 0 3 In the United States, a constitutional right NOT to procreate is clearly
established (Roe v. Wade, 410 U.S. 113). Meyer v. Nebraska, 262 U.S. 390 (1923)
established that it is a constitutional liberty for an individual to have the right to marry,
set up a home, and bring up children. Skinner v. Oklahoma, 316 U.S. 535 (1942)
established that the state has no right to interfere with an individual’s procreative
capacities through forced sterilization. This ruling explicitly mentions that individuals
have a right to have children. This is considered a fundamental, basic liberty.
Individual rights and the right to privacy regarding contraception and termination
underlie the decisions established by Griswold v. Connecticut, 381 U.S. 479 (1965),
Eisenstadt v Baird, 405 U.S. 438 (1972) and Roe v. Wade, 410 U.S. 113 (1973). These
cases suggest that there exists a right to reproduce. However, it is a negative, not a
positive, right. In the Eisenstadt v. Baird ruling, Justice Brennan stated: “If the right of
privacy means anything, it is the right of the individual, married or single, to be free of
unwarranted governmental intrusion into matters so fundamentally affecting a person as
the decision whether to bear or beget a child” (as cited in Richard T. Hull, Ethical
Issues N ew Repro Tech p.9).
Carson Strong in his book, Ethics in Reproductive and Perinatal Medicine: A
N ew Framework, reflects on the issue of the right to procreate. In his book, Children
o f Choice, J. Robertson attempts to extend the right to reproduce to include the right to
utilize assisted reproductive technologies such as IVF (Princeton: Princeton University
Press, 1994).
4 0 4 Fenwick, 302-306. In his essay “Medical technologies and Ethics,” Gino Papola
argues that contemporary societies are schizophrenic when they allow the killing of over
a million children through abortion, yet at the same time condone the use assisted
reproductive technologies. Issues in Biomedical Ethics: Proceedings from the Festival o f
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In M aking Babies: Biomedical Technologies, Reproductive Ethics and
Public Policy, De Melo-Martin agues that viewing fertility, infertility, and
procreation primarily as an individual issue is inadequate. She is quick to
point out that public policy relating to assisted reproductive technologies
does not only affect the infertile, it affects society in a variety of ways.
By focusing primarily on the individual, one is disregarding or
underestimating social, ethical, and political factors, and this often leads to
policy decisions that may not be in the public’s best interest.4 0 5
Admittedly, the issues of individuals and their relationships to others and
society are very complex.
The paradigmatic narratives of the Mahabharata and the five
elements of Hindu thought extracted from them both preserve and handle
these complexities, however with a slightly different focus. First, three of
the five elements, underlying unity of all life, centrality of society, and
dharma, directly address the above issue being raised by De Melo-Martin.
Infertility, fertility, and having babies are not considered private, individual
Life International Congress, eds. C.J. Vas and E.J. de Souza (Delhi: Macmillian India
Limited, 1990), 249.
4 0 5 De Melo-Martin, 13. De Melo-Martin juxtaposes the risks and high costs of
IVF and other assisted reproductive technologies with their low rate of success and other
societal needs for medical care, and cautions against an uncritical acceptance of these new
technologies. According to her, the common good sometimes ought to override
procreative liberties and the focus ought to be on preventing infertility and improving
the overall health of members of society. (66-68, 90-123) Regarding societal goods, issues
relating to distribution of resources, and over-population are also very important.
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issues. Rather, they emphasize the opposite. The actions of individuals,
particularly regarding procreative issues, affect their family, society, and
ultimately all of life. Additionally, dharma relates an individual’s actions
to her particular situation and her relationship with society at the time.
Take for example Kuntl’s use of her mantra. Her initial use of the
mantra, as an unmarried young woman, caused her to fear the response of
society. However, in the same action, taken once she is married and has
the responsibility of producing an heir, she is fulfilling her dharma.
Second, while the discussions in the United States are dominated by
“rights” language, the language within the Mahabharata and that utilized
by many North American Hindus is one of “duty.” Saral Jhingran points
out that the Dharmasastra literature contains no discussions of individual
human rights, except when speaking of Brahmins. When “rights” are
discussed in these texts, they are the rights of a caste, not of individuals.
Furthermore, these discussions regarding rights are undertaken in the
context of defining the duties incumbent on one class with respect to
another.4 0 6 According to Creel, the Indian social system is comprised of a
synthesis of groups rather than of individuals.4 0 7 This reflects the notion
that there is an underlying unity to all of life. We may be individual
4 0 6 Jhingran, 101.
4 0 7 Creel, 6.
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beings, but we do not stand in isolation, we are members of a family, of
a society. Thus, it is in this context that Hindu traditions tend to focus
on the needs of society as a whole, prompting questions of duty as
opposed to rights. Rather than asking “What are my rights?” or “What
are the rights of my society, vis a vis other societies or individuals?”
These traditions ask such questions as: “What is my duty? What is my
duty to myself, the family, and society?”
A dominant worldview depicted in the Mahabharata narratives
presupposes this centrality of society and an underlying unity of all life -
divine, human, or otherwise.4 0 8 This worldview is ideally “based on the
sanctity of life of every creature, sympathy for sufferer, service without
expectation, contentment and efficiency in all activities. These great
principles become the soul and spirit of all people.”4 0 9 The concept that
one’s atman (soul) is ultimately identifiable with Brahman, the divine
ground of being, implies interdependence among all forms of life. In this
4 0 8 When one examines the familial relationships of the various characters within
the Mahabharata, a clear pattern of interconnectedness emerges. Ultimately everyone is
somehow related to everyone else. Samtanu fathers Bhlsma and the latter becomes the
patriarch of the Bharata clan. Satyavatl, Samtanu’s second wife, is Vyasa’s mother.
Upon her request, Vyasa fathers Dhrtarastra, Pandu, and Vidura. Through blood and
marriage relationships practically every primary character of this paradigmatic epic is
related to one another. These narratives also reflect a fluidity between the realms of
existence of human, divine and animal. For example Bhlsma is the son of a human king
and the goddess Ganga. Kuntl’s and Madrl’s son’s are also half human and half divine.
Their mother-in-law, Satyavatl, is half divine and half fish.
4 0 9 Murthy, “Professional Ethics in Ancient Indian Medicine,” 127.
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worldview, humans are each part of a larger whole, thus individual
concerns extend beyond the individual to include her society and
ultimately all beings.4 1 0
While this particular belief in the underlying unity of all life, and
the subsequent priority of societal good, are commitments of religious
faith within Hindu traditions, the idea that individuals are not radically
insular is a concept shared by many and is not necessarily unique to
Hindu belief systems. Louis Dumont, in H om o Hierarchius: the Caste
System and Its Implications, indicates that the idea of fully developed
individual selves has a relatively modern, even Christian ancestry. He
writes, the “[a]ncient philosophers, up to the Stoics, did not separate the
collective aspects of man from the others; one was a man because one
was a member of a city, as much a social as a political organization.”
Plato, Dumont reminds us, said: “a true man is a man as collective being
not man as a particular being.”4 1 1
4 1 0 Ronald Nakasone, “A Buddhist Response,” in Regina Wentzel Wolfe and
Christine E. Gudorf ed., Ethics and World Religions: Cross-Cultural Case Studies (New
York: Orbis, 1999), 329-330. Though Nakasone is utilizing the metaphor of ice and
water to describe the interconnectedness in Buddhism, it is applicable to a similar concept
within Hinduism. The principle of pratltyasamutpada, or “co-dependent origination,” is
one of the central philosophical paradigms of Buddhism. This is not to say that
Buddhism and Hinduism are very distinct religious traditions. For example, while
Buddhism rejects the existence of a soul (anatman), the upanisadic understanding of atman
argues it is ultimately Brahman.
4 1 1 Louis Dumont, Homo Hierarchius: the Caste System and Its Implications,
trans. Mark Sainsbury (Chicago: The University of Chicago Press, 1970), 6-7.
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Though the dominant contemporary North American worldview
places a priority on individual rights and autonomy, the idea of addressing
and working toward societal good is not foreign to “Western” sensibilities.
Emile Durkheim, the father of the field of Sociology of Religion, discusses
the concept of interdependence in his book, Elementary Forms o f the
Religious Life. According to his model of modern society, individuals are
dependent upon one another because of their particular areas of
specialization. Thus, in order for society to function properly, members
of society need to perform their various jobs. Admittedly, while on a
metaphysical level Durkheim and the Upanisads may be working from
very different views of reality, on a practical level their ideas of
interdependence are quite compatible.
This notion that individuals are ultimately dependent upon one
another, unfortunately, is somewhat obscured when undue emphasis is
placed on individual rights. With freedom and autonomy comes
responsibility. In her book, Private Choices, Public Consequences:
Reproductive Technology and the N ew Ethics o f Conception, Pregnancy,
and Family, Lynda Fenwick comments on the commitment to autonomy
within the United States. She calls upon all North Americans to take
seriously the fact that autonomy goes hand in hand with responsibility.
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We each need to realize the impact that we have on one another, take
responsibility, and make the hard decisions.4 1 2
The idea that societal prerogatives ought to play a central role in
the formation of ethical standards is obviously not unique to Hindu
traditions. Cahill demonstrates how theological ethics, specifically in
certain strains of Christian ethics, also tends to place a priority on
distributive justice and social solidarity over an individual’s rights and
liberty.4 1 3 Thus, individuals do not have to subscribe to an Advaita-
Vedanta belief that one’s atman is identical with Brahman in order to
acknowledge interconnectedness with others, or that the effects of their
decisions and actions extend far beyond the immediate circle of the
individual in the present moment.
In applying the presuppositions of an underlying unity and
centrality of society to Jaycee’s case, the discussion begins in a large arena
that encompasses society, the United States’ court system, and the
individuals directly involved. Rather than beginning from a point of view
that places society in a central position, both John Buzzanca and the
California court system began their discussions from a position that holds
autonomy and individual rights in a position of priority. Both John’s
4 1 2 Feirwick, 306.
4 1 3 Cahill, Christian Ethics: Problems and Prospects, 63.
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attempt to legally relieve himself of any responsibility with respect to
Jaycee, and the California Court of Appeals’ decision that John was
responsible for paying child-support are grounded in a modern, Western,
North American notion that places a premium value on autonomy and
individual rights.4 1 4
The ethical and legal discussions surrounding the California Court’s
ruling on Jaycee’s case reflect a concern for the complex implications of
the ruling, both for society and for the rights and interests of the
individual. While John was looking out for his own self-interest, the
Court based its decision on what was best for Jaycee. Rather than asking
what is best for only John or only Jaycee at any particular time, the
Hindu ethical perspective being examined and analyzed here asks what is
best for both of them within the context of society and the universe.
This Hindu approach calls for us to take a step away from a
preoccupation with our own self-interest and rights, and instead consider
how our actions might affect others, both now and in the future. Acting
in such a manner decreases the hold of selfish and egotistical states of
4 1 4 Nicholas Sutton argues that this emphasis on individuality is supported by free
market capitalism, the dominant system in the USA [. . .]. According to him, free
market capitalism is primarily concerned with the individual and “stresses self
aggrandizement as a primary motivation for human activity and as the natural stimulus
for human achievement” Religious Doctrines in the Mahabharata (Delhi: Motilal
Banarsidass Publishers, 2000), 448.
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mind and allows one to act from a position that is less distorted by an
egocentric worldview.4 1 5
The presupposition of the underlying unity of all life and the
commitment to placing society in a position of priority is complemented
by an acute awareness of how one’s dharma should affect one’s actions.
Like a pebble skipped on the surface of a still lake, actions have an ever-
widening effect. The theory of karma presented in the previous chapter
discusses the far-reaching consequences of actions. The most ethical
expression of action operating from this worldview is grounded in
compassion. By acting from the standpoint of compassion, one reduces
the suffering of others and ultimately of oneself as well.4 1 6 This Hindu
worldview would call John to a position of responsibility and compassion.
According to Sutton, the “ideology preached by the Mahabharata is
concerned specifically with sustaining virtue in opposition to selfish and
hedonistic ways of life. This notion of virtue is a familiar one involving
honesty, being true to one’ s word, generous, forgiving, kind-hearted, and
tolerant.”4 1 7 From this perspective, John ought not to focus solely on his
own self-interest or perceived legalistic rights. Rather he ought to be a
4 1 5 Sutton, 451.
4 1 6 Nakasone, 329.
4 1 7 Nicholas Sutton, 448. Emphasis added.
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man of his word and honor the commitments he made to Jaycee when
he signed the contracts that began the process that brought about her
conception and birth. Callahan, though not speaking from within Hindu
traditions, would agree to this call for responsibility. According to him,
“Humans bear a moral responsibility for voluntary acts that have an
impact on the lives of others; they are morally accountable for such
acts.”4 1 8 Again, the concepts supported by dharma and karma are not
unique to Hinduism, nor entirely new to North Americans. Occasionally
these reminders need to be raised with the focus on autonomy and
individual rights.
Hindu traditions place the needs of society in a position of
priority. This is not to say that an individual’s interests or rights are
unimportant or ignored. Similar to the Buzzancas, the characters of KuntI
and Pandu wanted children, as did Gandharl and Dhrtarastra. Gandharl
even placed her interests in having children over and above Vyasa’s
warnings of catastrophic destruction. Also like the Buzzancas, these kings
and queens employed measures that ensured they would have children.
However, unlike John Buzzanca, once they took action, the characters in
the Mahabharata did not attempt to abandon their responsibilities. They
4 1 8 Daniel Callahan, “ Bioethics and Fatherhood”, 99.
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had willingly taken on the dharma of parenthood and they followed
through by fulfilling their parental responsibilities.
John’s position of wanting to abandon his responsibility to Jaycee
is not without parallel in the Mahabharata. The story surrounding the
birth of Karna, Kuntl’s first-born through her encounter with Surya, the
Sun god, provides a good example. Kuntl’s actions following Kama’s
birth are somewhat similar to John’s legal attempts to relieve himself of
responsibility to Jaycee. Both John and KuntI were abandoning their
parental responsibilities. However, Kuntl’s situation is somewhat different
from John’s. Unlike John, she was an unmarried teenager. Additionally,
while John willingly set into motion a plan that resulted in Jaycee’s birth,
KuntI was simply acting out of curiosity; her intent was not necessarily to
have a baby. Recall that she had just been given this boon and was
curious to see if it would work.
According to the story, once Karna was born, KuntI placed him
“in a basket that was well-packed on all sides. And in that basket,
comfortable, soft, sealed with beeswax, and finely covered, she tearfully set
her child afloat in the River Asva.” KuntI knew that propriety forbade
her to have a child at this stage in her life, and she “lamented piteously
and prayed” as she sent her son down the river: “May you be safe from
the creatures of earth, atmosphere, and heaven, and from those that live
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in the water, little son. May your pathways be auspicious, and not
adverse, and those who approach you, son be without malice [. . .].”4 1 9
She foresees who rescues him, adopts and cares for him, and she prays for
and blesses them. These are not the words and actions of a young
woman recklessly abandoning her parental duties.
While the actions of John and KuntI appear similar, their situations
are quite different. John intended to be a parent; KuntI did not. Upon
his divorce, John, as a competent, presumably gainfully employed adult,
apparently simply did not want parental responsibilities. KuntI was young
and feared the wrath and disapproval of her family. When she did
abandon Karna, it was not without great preparation, prayer and remorse.
The multivalent nature of Hindu traditions allows these differences to
influence how each case is evaluated. The actions of John and KuntI may
be similar; however their intent and circumstances are not. Rather than
focusing on a philosophical principle and attempting to make universal
applications, these traditions tend to examine various elements of the
situation and evaluate each one accordingly.
The narratives of the Mahabharata demonstrate that individuals are
free to act in any manner they choose. However, all individuals, through
the impersonal law of karma, must ultimately bear the responsibility for
mM Bh. III.292.5-25.
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the consequences of their chosen actions. Although KuntI is not explicitly
criticized for her indiscretion, the impersonal law of karma eventually
comes full circle. She suffers deeply when, after she fails to reconcile
with Karna, he dies at the hand of Arjuna, Kuntl’s fourth son and
Kama’s younger brother. Just as the Hindu notions of dharma and
karma proactively and reactively hold individuals responsible for their
actions, so ought our commitment to autonomy be accompanied by a
clear understanding of the natural and social consequences of one’s choices
and actions.
Assisted Reproductive Technology and the Family
The use of these technologies and their effects on the family is
another area of great disagreement. On the one hand, there are those
who argue that these technologies offer options and support for couples
who would otherwise be unable to have their own children. On the
other hand, there are others who object to the utilization of assisted
reproductive technologies on the grounds that they threaten the sanctity of
marriage, the existence of the traditional family, and familial
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relationships.4 2 0 Jaycee’s situation is an excellent case to explore these
various issues.
Regarding the threat to the sanctity of marriage, the Roman
Catholic Church claims that a child “has the right to be conceived,
carried in the womb, brought into the world, and brought up within
marriage.”4 2 1 Elsewhere the text reads: “the act of conjugal love is
considered in the teachings of the Church as the only setting w orthy of
human procreation.”4 2 2 According to this view,
utilizing donor gametes is contrary to the unity of
marriage, to the dignity of the spouses, to the vocation
proper to parents, and to the child’s right to be conceived
and brought into the world in marriage and from marriage
[. . .]. Recourse to the gametes of a third person, in order
to have sperm or ovum available, constitutes a violation of
the reciprocal commitment of the spouses and a grave lack
in regard to that essential property of marriage which is its
unity.
As previously indicated in this work, the Church prohibits anything that
divides the act of sexual intercourse from procreation, and it prohibits
anything that allows for procreation outside the marriage relationship. It
4 2 0 Daniel Callahan, “Bioethics and Fatherhood” in Sex/Machine: Readings in
Culture, Gender, and Technology, ed. Patrick D. Hopkins (Bloomington: Indiana
University Press, 1998), 99. Reich, 2222.
4 2 1 Instruction, p 27.
4 2 2 Instruction, 32. (Emphasis added)
4 2 3 Instruction, 28.
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argues that such activities damage the relationships within the family.
The same argument is applied to the utilization of IVF and surrogacy.
One speaking from within the Church might point to Jaycee’s case and
use it as an example of how these technologies not only threaten but defy
the existence and definitions of family.
According to Article 16.1, the U N Declaration of Human Rights
states: “men and women of full age, without any limitation due to race,
nationality or religion, have the right to marry and found a family.” In
Hull’s exploration of this U N statement, he indicates that the Committee
regards heterosexual marriage as being the “most appropriate context for
having children,” all things being equal. However, the Committee
acknowledges that factors in life are often n o t equal. Consequently, the
U N Committee is unwilling to argue that not being married is grounds
for constraining the liberty of individuals to reproduce. According to this
U N Committee, family structures are important; however, they need not
be the sole environment into which children are born.4 2 4
In his essay “Bioethics and Fatherhood,” Callahan presents an
argument that these technologies threaten familial relationships. He
objects to various assisted reproductive technologies, particularly sperm
donation, on the grounds that it is morally wrong because it
4 2 4 Hull, 17.
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“downgrades” fatherhood. Callahan asserts that it is morally irrelevant
whether a donor does not want to be a father, or if the medical
establishment simply wants his sperm and not a commitment of
fatherhood. It is also morally irrelevant if society and the woman do not
want him to serve as a father. “If there are to be moral duties at all,
the biological bond is as fundamental and unavoidable as can be.” He
continues: “Fatherhood, because it is a biological condition, cannot be
abrogated by personal desires or legal decisions.”4 2 5 According to him,
these technologies allow yet another father to go free and not fulfill his
parental duties. Munson disagrees with Callahan, arguing that while
biological connections are important, they are not sufficient conditions for
being a moral or social father. According to him, the moral or social
father is one who actually invests time and energy in the process of
raising the child.4 2 6
The Catholic Church’s concerns regarding assisted reproductive
technologies extend beyond the preservation of the family. According to
the Magisterium, assisted reproductive technologies such as donor gametes,
IVF, and surrogacy not only cause a “rupture between genetic parenthood,
4 2 5 Callahan, “ Bioethics and Fatherhood,” 100.
4 2 6 Ronald Munson, “Artificial Insemination: Who’s Responsible?” in Sex/Machine:
Readings in Culture, Gender, and Technology, 107-115.
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gestational parenthood and responsibility for upbringing,” they have
negative “repercussions on civil society: what threatens the unity and
stability of the family is a source of dissension, disorder and injustice in
the whole of social life.”4 2 7 Though James Dobson, founder of Focus on
the Family, finds few areas of agreement with Roman Catholicism, they
do share a commitment to the family and a belief in its connection to
the strength of society. According to Dobson: the family
The family is unraveling right in front of our eyes [. . .].
Let me say one more time that if the family and the
Judeo-Christian ethic collapse, the entire culture will
descend into the same black hole that consumed Greece,
Rome and the other great empires of the world. It’s just a
matter of time.4 2 8
Both Dobson and the Catholic Church predict dire consequences for the
United States if society allows for the continual unraveling of the
traditional family. They find assisted reproductive technology as a
potential threat to the family, for these technologies allow for children to
become a part of alternative relationships that in turn threaten the
traditional family. Hindu traditions, and other traditions such as
Confucianism, Neo-Confucianism and Shintoism, agree with Roman
Instruction, 28.
4 2 S James Dobson, “Future of the Family.” Downloaded from
httpr/Zw.ww.iamily.QrgZ^ docstudy/newsktters/ADQ16ZQZJitml. Z/26/01
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Catholicism that the family is the bedrock for society.4 2 9 However, most
traditions within Hinduism would not share the Church’s prohibition
against the utilization of assisted reproductive technologies.
Admittedly, the utilization of assisted reproductive technologies
creates new and even complicated biological, social, and legal relationships.
Jaycee’s case provides a clear example of the complexities that may arise
when technologies are utilized to bring about the birth of a child within
a family. Through the use of IVF, donated gametes, and surrogate
motherhood, potentially four couples, or a total of eight individuals, could
4 2 9 Confucius (551-480 B.C.E.) saw filiality and brotherly respect as the roots of
ren, or moral perfection/virtue. The Analects records: “It is unlikely that one who has
grown up as a filial son and respectful younger brother will then be inclined to defy his
superiors.” Thus, the passage concludes: “there has never been a case of one who is
disinclined to defy his superiors stir up a rebellion” (1.2). Again, according to this text,
a “student should be filial toward his parents when at home and respectful toward his
elders when abroad” (1.6). Confucius believed that families made up the core of society
and if the families were in order, then society would be in order (Edward Gilman
Slingerland, trans. in Readings in Classical Chinese Philosophy).
According to the Neo-Confucians, the Great Learning was a classic Confucian
text. Chu His (1130-1200), drew on it to ground many of his teachings. Regarding the
family visa vi society, the Great Learning reads: “The ancients who wished to manifest
their clear character to the world would first bring order to their states. Those who
wished to bring order to their states would first regulate their families [. . .].” Having
order within ones family, one could then be assured of order within the state. Familial
order ensured societal stability (Wing-Tsit Chan, trans. A Source Book in Chinese
Philosophy, 86).
Ancient Shinto traditions see familial ties as establishing not only the order of
society, but the Japanese Islands and people as well. The Nihongi and K ojiki myths
record the actions of the kamis, Izanami and Izanagi. As a couple, “they stood on the
floating bridge of heaven [. . .] together they create the Japanese Island, descend and
dwell on them. Then, through their daughter Amaterasu comes the imperial line and
the Japanese people (Tsunoda, Ryusaku, Wm Theordore De Bary and Donald Keene,
Sources o f Japanese Traditions, vol. 1 (New York: Columbia University Press,) 15,25.
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have claimed parental rights for Jaycee: 1) the woman who donated her
ovum and her husband; 2) the man who donated his sperm and his wife,
3) Pamela Snell, the gestational mother and her husband; and, finally,
4) Luann and John Buzzanca, the intended parents. This case clearly
challenges the definitions of a traditional family and the legal definitions
of motherhood and fatherhood. Though these technologies may increase
the complexity of familial relationships, they, in and of themselves, are
not necessarily a threat to the family.
Traditional Hinduism, with its belief in the underlying unity of all
life and a focus on the good of society, tends to hold a broad definition
of family. Consider the familial situations within the Mahabharata. Prior
to Pandu renouncing his throne and heading for the mountains with his
wives, they all lived in the same palace with Dhrtarastra and Gandharl,
their grandmother Satyavatl, and probably a multitude of other family
relations. Following Pandu’s death, KuntI gathers his five sons and
returns to live with Gandharl, Dhrtarastra, their 101 children, other
relatives, and a few of the great sages. This is an excellent example of an
extended family, an idea that continues on in contemporary Hindu
society.
Of the six individuals I interviewed, all but one described their
family as being part of an extended family. Mr. A, the one exception
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and a “convert” to Hinduism, defined his family as consisting of himself,
his wife and his children. However, he comments that his definition of
family may differ “from the people in congregation because I grew up in
Western world. From a Hindu perspective, a family includes brother,
sisters, parents, [. . .] grandparents from both sides, cousins, brothers,
sisters, and all of that.” Ms. B describes her family as including herself,
her husband and children, uncle and aunt living locally, her husband’s
three brothers in India, her half-sister’s daughter, and very close friends.
While Mr. C acknowledged that only his immediate family, himself, his
wife and children, were living in the United States, according to him “the
whole village [where he was born and reared] is my family.”4 3 0 After
retiring from government work in India, Mr. F and his wife moved to
the United States to rejoin four of his children, their spouses and
children. There are times when families immigrate to this country leaving
behind all familial ties. It is interesting to observe how, after establishing
themselves within a particular area, they will often construct an “extended
family” that serves as an adopted family structure.4 3 1 The belief in an
underlying unity of life coincides with an extended concept of family.
4 3 0 Mr. A, interviewed by author, 23 July 2001, Riverside, CA.
4 3 1 My father, being one of the oldest Assamese living in Southern California, is
the “grandfarther” of sorts to the Assamese community in the area. Individuals from as
far away as West Virginia and Texas, consider my parents their “grandparents.” My
parents’ home is their home.
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On a metaphysical level, ultimately everyone is family. These situations
may be better equipped to absorb the complications introduced through
the use of assisted reproductive technologies.
The narratives of the Mahabharata demonstrate that even in the
midst of the complex familial relationships the stability of society can
stand.4 3 2 Though technologies such as IVF and artificial insemination are
relatively new, discussions regarding who in society is responsible for
children born of donated sperm are not. According to Manu:
The son born in an appointed woman should take (his
share) in the estate just like a natural son, for according to
law, that seed and the offspring belong to the owner of the
field. A man who maintains the property and the wife of
his dead brother should beget a child for his brother and
give his property to him alone.4 3 3
Though Manu is not specifically referring to a donor gamete, IVF, and
surrogacy situations, his principles can still apply. The daughter, Jaycee,
born in an appointed woman, Ms. Snell, should have her share of the
estate just like a natural son of John and Luanne would. Unlike
Callahan’s argument in “Bioethics and Fatherhood,”4 3 4 this passage does not
4 3 2 Christopher K. Chappie, “Arjuna’s Argument: Family Secrets Unveiled,” Journal
o f Vaishnava Studies 9:2 (Spring 2001): 23-31.
4 1 3 Manu IX. 145-146.
4 3 4 Callahan, “ Bioethics and Fatherhood,” 99-100.
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presume a necessary connection between biological relation and the
responsibilities and duties of fatherhood.4 3 5
While the paradigmatic narratives of the Mahabharata imply that a
genetic connection between a child and his or her parents is significant,
sometimes even preferred, it is not an exclusive requirement for
establishing parental relationships. Consider the specific circumstances
surrounding the “five sons of Pandu.” Of the five sons, three are born
of KuntI and the younger twins are born to Madrl. Upon Madrl’s death,
KuntI fulfills her promise to Madrl and takes as her own the younger
twins. The epic acknowledges Madrl as the mother of the twins.
However, following her death, they are the children of KuntI. Chaitanya
comments on how, even though KuntI scrupulously tries to avoid the
slightest discrimination in the way she treats her five sons, the youngest
Sahadeva, is her favorite.4 3 6 None of the five boys is genetically related to
Pandu, and none of them even shares the same father. Furthermore, the
twins are not even biologically related to KuntI. Nevertheless, they all
recognize KuntI as their mother and Pandu as their father. Both the text
4 3 5 In his chapter “ Artificial Insemination: Who’s Responsible?” Munson argues that
being a biological father is not a sufficient condition for being deemed a moral or social
father. [Sex/Machine: Readings in Culture, Gender, and Technology, ed. Patrick D.
Hopkins (Bloomington: Indiana University Press, 1998), 114]. Gunning and English
indicate that illegitimate children make a clear case that biological and social elements of
fatherhood as separable (77).
4 3 6 Chaitanya, 155-156.
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itself and the multiple generations reading it throughout the centuries
recognize Yudhisthira, Bhlma, Arjuna, Nakula, and Sahadeva as brothers -
as the five sons of KuntI and Pandu.4 3 7 From the story of the Pandava
sons, one may infer that intent plays a role in establishing parenthood.
Similar to John Buzzanca, Pandu participated in the original plan that
brought about the births of the boys, and he was the intended father.
Interestingly, though lacking in actual genetic connection, the fact
that the Pandava’s family lineage and right to rule is secure is somewhat
related to the source of the donated gametes. Recall when Pandu
encourages KuntI to participate in niyoga, his instructions are for her to
find a Brahmin of equal or greater status than he. It is not insignificant
that KuntI and Madri are royal queens in their own right, and that all of
their donors are divine. This secured a high social status for their sons.
Such is not the fate of Vidura, Pandu and Dhrtarastra’s younger brother,
Vidura, the only son of Vyasa free of a physical deformity,4 3 8 is
nevertheless ineligible to rule because his mother is the maidservant to
Ambika. Though the text does not demand a biological connection, it
4 3 7 James L. Fitzgerald, “The Great Epic of India as Religious Rhetoric: A Fresh
Look at the MahabharataJ Journal o f the American Academy o f Religion 51:4 (December
1983), 620.
4 3 8 Recall that Dhrtarastra is bom blind and Pandu pale. Vidura means “ far
sighted.” Throughout the Mahabharata, his advice reflects sound reason and insight.
Unfortunately, his words are continually ignored by Dhrtarastra and his 100 sons.
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does imply that social status is an important factor. According to the
text, these types of constraints are necessary to keep society functioning
properly.
Narayanan points out that some contemporary Hindu couples place
a great deal of importance on having a genetic connection to their
children. Thus, for them, a husband or wife is generally the only
accepted gamete donor.4 3 9 This may imply hesitancy on the part of some
Hindus to utilize anonymous gamete donations. Interestingly, none of the
individuals I interviewed objected to sperm banks and the use of
anonymous gametes. However, all of them indicated they would not
choose to utilize them for themselves. When asked why, Ms. B indicated:
“If the gene pool is going to come from somewhere else, I might as well
get a child that is already here. I don’t have the T have to have baby, or
be pregnant’ feeling.”4 4 0
By virtue of the fact that KuntI and MadrI were Pandu’s wives,
and that he, while alive, fulfilled his parental duties, his dharma, to the
Pandava brothers, he is considered their father. According to this
narrative, while biology and social status is not insignificant, of greater
importance are those who intend to take on the parental dharmic
4 3 9 Narayanan, 192.
4 4 0 Ms. B, interviewed by author, 30 July 2002, Riverside, CA.
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responsibilities. The responsibility of motherhood and fatherhood is
granted to these individuals. Kama’s story provides another example of
how parentage is determined more by intent and by who actually fulfills
the dharmic role of parenthood.
According to the story, after Radha and her charioteer husband,
Adhiratha, adopt Karna, they nurtured him and raised him as their own.
When Karna was presented with the facts, that KuntI, a queen of much
higher status than his adopted parents, is his mother, he was not moved.
Although KuntI gave birth to and is genetically related to Karna, he feels
no obligation to her. Following Krsna’s failed attempts, KuntI tries to
convince Karna to join her other sons and fight side by side with his
Pandava brother.4 4 1 Since he is Kuntl’s eldest son, by joining the
Pandavas, their whole kingdom would be his. However, according to
Chaitanya, Karna is not a son to KuntI in the same way that Yudhisthira
or Arjuna is and he, Karna, is well aware of this fact. He is courteous
and respectfully rejects her offer and her pleas. He acknowledges that
children have a duty to their parents. However, since she never fulfilled
her parental duties as a mother toward him, he feels no obligation to
reciprocate in kind.4 4 2 The relationships in this story imply that not
mMBh. Udyoga. Parvan ch 145-146.
4 4 2 Chaitanya, 130.
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2 4 4
gestational, genetic mothers or biological fathers have precedence over
those who actually take the children into their care and parent them.
Examining Jaycee Buzzanca’s case in light of the prism of Hindu
thought, we find some informative emphases and perspectives regarding the
utilization of gamete donation, IVF, and surrogacy. Traditional as well as
contemporary societies condone and encourage individuals to have children.
Interestingly, even in our current situation, where many claim that
overpopulation is one of the world’s greatest threats to existence,4 4 3 having
children is important and valued by society. According to one
interviewee, having children is of “great importance because your children
have to be better than you. The role of children is to improve society,
and that’s the way it should be.”4 4 4 In light of this societal emphasis, as
well as personal desires of individuals to raise children, the traditions
reflected in the Mahabharata are sympathetic to John and Luanne’s initial
desires to have children. Additionally, this emphasis on the good of
society calls John and Luanne to focus on their duties to Jaycee and
society.
4 4 3 According to Fox, international concern over the threat of overpopulation
began in the 1950s (282-283).
4 4 4 Mr. C, interviewed by author, 30 July 2002, Loma Linda, CA.
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The belief in the underlying unity of all life has many implications
for this discussion. Since everything is part of this underlying unity, an
interconnection among all humans, among all life, is presupposed. Perhaps
this belief underlies the concept of the extended family prevalent within
many Hindu communities. Familial relationships are ultimately not
dependent upon genetics. This implies that there are no moral objections
to John and Luann’s use of donor gametes. The fact that Jaycee is not
genetically related to either of them does not lessen their familial
connection to her. This underlying belief, coupled with the principles of
dharma and karma, bind John and Luann closer to Jaycee than any court
ruling ever could.
Additionally, these principles of dharma and karma call John to
fulfill his responsibilities and at least financially support Jaycee. His
arguments that Luanne is not Jaycee’s legal mother, and that therefore he
is not her father, hold little to no weight in this situation. He
participated in setting events into motion that resulted in the birth of
Jaycee. Presumably, he is an adult, in the householder stage of life, fully
aware of his circumstances, and in control of his actions. Consequently,
he has obligations to Jaycee. Based on the fact that he could afford to
utilize the reproductive technologies made available to him, he presumably
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can afford child support payments. Karma and karmic consequences
ultimately hold every individual responsible for his or her actions.
In Jaycee’s case, under these particular circumstances, the hitherto
mentioned characteristics of Hindu thought support the implementation of
assisted reproductive technology, and establish that John and Luanne are
parents to Jaycee, in spite of their lack of genetic connection.
Additionally, they establish that both John and Luanne are responsible for
Jaycee’s well being. However, the multivalent nature of Hindu traditions
and the context-specific nature of dharma together require an examination
and careful consideration of the particular conditions of each case that is
brought up for questioning. These traditions will not simply impose the
interpretations and conclusions of this case onto others. A majority of
those operating within Hindu worldviews have little desire to attempt to
impose set categories onto reality. Rather, they have an incredible ability
to allow each situation to set and define its own parameters.
While in Luanne and John’s case, utilizing assisted reproductive
technology was considered appropriate; this does not translate to an
uncritical acceptance of assisted reproductive technologies. In this case,
where no one else contested it, Luanne was granted the responsibilities of
motherhood. This in no way implies that gestational motherhood is
secondary. While in Jaycee’s case, genetics was not considered a defining
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factor, this does not negate the importance of genetics in other situations.
While John was being held responsible in this situation, there are
circumstances under which he might not be. The multivalent nature of
Hindu traditions admits that a “right” course of action is often dependent
upon the particulars of the situation. Admittedly, cases and bioethical
issues may appear more complex and difficult when a multivalent attitude
prevails. However, this attitude preserves a commitment to viewing and
honoring the views of life from various perspectives. In this
contemporary, pluralistic world, this emphasis may be an immense, even
Hinduism’s greatest, contribution to the contemporary field of bioethics.
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CHAPTER 7
CONCLUSION
This work has explored four aspects that distinguish Hindu
approaches to reproductive technology: (i) the priority placed by the
tradition on having children; (ii) an acceptance of a variety of means for
having children; (iii) the active participation of women in their
reproductive choices; and (iv) the close interrelationship between gods and
humans in the procreative process. Five characteristics of Hindu thought
that can be abstracted to form touchstones for arriving at ethical decisions
within this complex faith, were also discussed. These characteristics
include an emphasis on societal good as opposed to the pursuit of
individual pleasure, a belief in the underlying unity of all life, the fluid
demands and expectations of following the moral social code {dharmi}, the
multivalent nature of this code, and a theory of karma. I have
demonstrated how these aspects of the Hindu tradition are reflected in
selected birth narratives from the Mahabharata, and I have applied these
ideas to the case of Baby Jaycee. Throughout this process, I have
attempted to demonstrate the central role religious ideals play in the
ethical decision-making process for bioethical matters.
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249
Religion and Bioethics
Albert Jonsen’s article, “American Moralism and the Origin of
Bioethics in the United States,” demonstrates the pivotal role religion plays
in the development of the field of bioethics. Discussing the relationship
between the field of bioethics and religion, Jonsen argues that there is “a
moral tradition that runs wide and deep, although in our days, quite
silently, through American culture.”4 4 5 He calls that tradition “American
moralism.” By this term, he means “the deep source in which a certain
way of thinking and feeling about the moral life is engendered and
nourished.”4 4 6 According to him, the roots of American moralism are
firmly grounded in Christianity, particularly Calvinism. After presenting
his argument regarding the tie between American moralism and Calvinism,
he maintains that the North American interest in bioethical issues grew
out of this “American moralism.”
He points to the 1970 publication of Paul Ramsey’s Patient as
Person as one of the defining events in the development of the field of
bioethics. He describes Ramsey as one steeped in the theology of Calvin
and Edwards, and one who attempted “to bring order to the new chaotic
4 4 5 Albert R. Jonsen, “ American Moralism and the Origin of Bioethics in the
United States,” Journal o f Medicine and Philosophy 17:3 (June 1992): 113.
^Jonsen, “American Moralism and the Origin of Bioethics in the United States,”
114.
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feature of contemporary medical science [. . .]. He [Ramsey] sought
principles to bring clarity into confusion and while admitting room for
exception, made that room as narrow as possible.”4 4 7 According to
Jonsen, Ramsey’s desire to bring order and clarity to the confusion
accompanying the advances in medical science reflects Calvinistic
influences.
As new medical technology developed in the early 1960s and 1970s,
the Federal Government established committees to consider the ethical and
moral implications of the technologies and their use. Jonsen was a
member of one of the first ethical panels established by the Federal
Government in 1972, namely, the Totally Artificial Heart Assessment
Panel. He was also a Commissioner of the National Commission for the
Protection of Human Subjects of Biomedical and Behavioral Research.
Looking back, Jonsen is skeptical of the work of this Commission’s
“status as a serious ethical analysis.” He suspects that the desire of
members of Congress, and the public, “to see the chaotic world of
bioethical research reduced to order by clear and unambiguous principles”
is in part a product of Calvinistic thinking.4 4 8 According to Jonsen,
Calvinist perspectives influenced moral thinking in a variety of religious
w Ibid., 124.
mIbid., 124-125.
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traditions within America, Protestant and Catholic alike, and underlie
American moralism in general.
Jonsen’s thesis provides a particular example of how religious voices
were present at the revival of the field of bioethics in North America.
Though Calvinism represents only one of the many Christian voices, those
perspectives, with a few Jewish voices interspersed, were the primary
contributors to the early discussions in bioethics. Along with the
dominant voice of Ramsey representing a Calvinist tradition, were the
Roman Catholic voices of Curran, McCormick, and others. While the
teachings of the Magisterium regarding sexual and reproductive ethics can
make it appear as if there is unanimity within Roman Catholicism, this is
in fact not the case. There is a variety of perspectives that exist within
Roman Catholicism, both among the laity and theological scholars.
Chapter 2 discussed what scholars refer to as “the marginalization
of religion in bioethics.” The religions that they were referring to are
primarily the Christian perspectives represented by prominent Protestants
and Catholics. Consequently, one could more accurately describe this
argument of marginalization by saying “soon after the genesis of bioethics,
the academy began de-emphasizing Christian voices.” With the exception
of a few Jewish perspectives, other religious traditions were not
represented in the early North American bioethical discussions. It is not
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until the late 1980s and early 1990s that the voices of other world
religions, such as Buddhism, Daoism, Hinduism, and Islam, begin to be
heard on a substantial level in the bioethical debates in this country.
Interestingly, it is around this same time that scholars began re-evaluating
the role of religion and its possible contributions to the field. Perhaps
the struggles, experiences, and diverse religious interpretations of those in
the clinical setting increased the awareness, and importance, of religious
voices.
The Hermeneutics of Cross-cultural and Inter-disciplinary Studies
Sulmasy and Sugarman in their book, The M any M ethods in
M edical Ethics (or Thirteen Ways o f Looking at a Blackbird), emphasized
that a richer understanding of moral questions and better grasps on
answers are gained when bioethical issues are examined from the vantage
point of several different methods. They also suggested that there is a
need for good interdisciplinary discussions in the field.4 4 9 The process
presented in this current study of bioethics and the Mahabharata is
interdisciplinary, drawing on sources from within the practice of modern
medicine, the fields of bioethics, literature, South Asian studies,
comparative religious ethics, and interviews of contemporary Hindus living
4 4 9 Sulmasy and Sugarman, 5.
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in the United States. Through engaging in a few of the paradigmatic
narratives within the Mahabharata, wisdom of the past from South Asian
traditions enters and contributes to our contemporary bioethical discussion
regarding assisted reproductive technology. This interdisciplinary
methodology also allows for the Hindu perspectives to emerge from
within the tradition itself. Having no strict boundaries between religion,
ethics, and the practical aspects of daily life, these Hindu narratives
provide a rich source from which to engage with and capture the essence
of Hindu traditions, teachings, and her people.
In a discussion regarding comparative study, Antonio De Nicolas
comments on how we call the studying of “others” comparative. “Thus,”
he says, “we have not succeeded in encountering the other, but rather we
have pushed through this method the possibilities of other men and ours
to the verge of almost human triviality.”4 5 0 DeNicolas suggests that rather
than seeking authentic understanding, comparative studies often seem to
trivialize other cultures. By conducting this in-depth study regarding
reproductive ethics in the Mahabharata, the author would like to suggest
that we have provided a method for arriving at an authentic cross-cultural
engagement. Narratives such as those within the Mahabharata are
4 5 0 Antonio T. de Nicolas, Avatara: The Humanization o f Philosophy Through the
Bhagavad Gita (New York: Nicolas Hays Ltd., 1976), 20.
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powerful and provide an opportunity for peoples from diverse cultures,
religions, historical periods, and geographical lands to actually engage with
each other. They allow people to truly encounter each other as
embodied, whole individuals, not simply as abstract thoughts.4 5 1
Within this study, we engaged in a limited use and interpretation
of the Mahabharata. As Ricoeur has observed, we are limited by our
own orientation and our interaction with the text itself. Our very
questions and issues reflect our contemporary times and technological
advances, in this instance, pertaining to reproduction. However, we find,
as Ricoeur says, myths, though seemingly disconnected from modernity,
provide a grounding for understanding and “ritual action.”4 5 2 Hence, by
studying these myths, we can gain insight into current Hindu attitudes
toward reproductive technology.
Of the myriad topics, themes, and issues discussed within the
Mahabharata, this study focused on issues relating to assisted reproductive
technology - issues very specific to our times. Our study did not
encompass the entire epic. We limited our examination and interpretation
primarily to the birth narratives of the Pandavas and Kauravas. These
specific narratives were particularly significant for their approach to
K X Ibid, 20-21.
4 5 2 Paul Ricoeur, The Symbolism o f Evil (New York: Beacon Paperbacks, 1969).
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reproductive bioethical issues. Along with demonstrating the applicability
of this ancient text to modernity, these birth narratives contributed yet
another avenue through which bioethical issues might be examined. Our
focus was to discover what the narratives, as they appear and are passed
down now, contribute to contemporary discussions.
The interpretations of these Mahabharata birth narratives were made
in conjunction with foundational Hindu texts, the teachings of established
scholars, and the perspectives of a few contemporary Hindus living in the
United States. A guiding element in our textual interpretations was the
desire to discover the prisms various Hindus might bring to bioethical
material. In order to fully employ a hermeneutic of suspicion, we would
also need to examine the epic’s reflection on such issues as the desire for
male progeny, the dominance of men, and the support of the caste
system. Though important, these issues are beyond the scope of this
current study.4 5 3 This work demonstrates that these narratives capture the
attitudes and worldviews of a multitude of Hindus, and by engaging in
4 5 3 A thorough examination of these issues might include a discussion about how
the Mahabharata reflects differing attitudes toward the caste system and male dominance.
The epic acknowledges the general perception that all lives are caste bound and that by
in large men dominate women. However, the narratives also challenge these stereotypes.
For example, while Arjuna is defending the importance of keeping the castes pure in his
dialogue with Krsna, Arjuna’s own heritage, and that of the Pandava family, contains
representatives from an array of castes.
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this endeavor we are expanding the avenues through which bioethical
issues might be examined.
Bioethics, Casuistry, and Cultural Competency
Bioethical issues are raised in three primary arenas: the academy,
the clinical setting, and in public policy. This study engages the
discussions in the academy and the clinical setting. Combining these two
arenas is more than simply fulfilling a requirement for being
interdisciplinary. According to Reich, truth is related to the experiences
of living and suffering. The harm done by neglecting the experiences of
the individual and the good done by compassionate care of the individual,
“manifested through literature, psychology, autobiographical accounts,
moral-anthropological models, and so on, can, through interpretive dialogue,
give rise to a new (or renewed) ethic of responding to suffering.” Reich
continues by saying: “Since ethics involves the study of all experiences
and/or clusters of experiences that have a bearing on the moral life, ethics
must [. . .] involve the study of the objects of experiences [. . .].”4 5 4
The cross-fertilization between the academic ivory towers and the
experiences occurring at hospital bedsides is immensely important for both
realms. First, philosophers, theologians, and bioethicists may be humbled
4 5 4 Warren Thomas Reich, “A New Era for Bioethics: The Search for Meaning in
Moral Experience,” in Religion and Medical Ethics, 114.
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and grounded in reality if they allow themselves to confront the
complexities of actual life and death situations. In The Abuse o f
Casuistry: A H istory o f M oral Reasoning, Jonsen and Toulmin argue that
the philosophical rule, or principle-based approach to ethics, can
oversimplify the issues. Also, as the academy focuses more on meta
ethics, it often fails to address the complexities present in the actual
clinical situations.4 5 5 While meta-ethical analysis may affirm the importance
of particular principles and even illuminate ethical discussions, it is of
minimal value in the clinical setting if it is unable to address the
particular issues of practical situations.
Second, clinicians may also be humbled and challenged to carefully
consider the implications of their choices and actions on behalf of their
patients. While discussing a plan of care for a particular patient in the
neurosurgery intensive care unit, one neurosurgery resident commented:
“There is no such thing as ethics. We can fix his head.”4 5 6 While some
physicians may agree with this comment, physicians would do well to
remember that they are treating more than “a head injury,” or “a diseased
liver.” Ethics is involved because the clinicians are working with whole
4 5 5 Albert R Jonsen and Stephen Toulmin, The Abuse o f Casuistry: A H istory o f
Moral Reasoning (Berkeley: University of California Press, 1988), 5-11.
4 5 6 This situation records the author’s experience while working in a neurosurgery
Intensive Care Unit at a prominent teaching hospital.
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individuals and their families. They are working with people whose
hopes and fears regarding their reason for hospitalization are tied up with
their beliefs regarding life, suffering, and death.
Finally, patients may also benefit from an interchange between the
academy and the clinical setting. Patients can benefit from the wisdom
preserved and passed on in the various schools of thought and ethical
theories. From them they may also obtain tools for interpreting and
expressing their own experiences. Additionally, they may find some
comfort in the knowledge that they do not struggle in isolation; others
have come before them, asking similar questions, and seeking answers.
Cultural competency emphasizes the importance of healthcare
professionals having the ability to hear, understand, and address the
various questions and concerns of their patients. This is a challenging
task in the contemporary pluralistic, multicultural, and multi-religious
environment of the United States of America. By being open and
exposed to other worldviews, clinicians can increase their ability to
administer competent care to all their patients. To this end, this present
study was utilized to bring in Hindu perspectives on the ethical issues
regarding assisted reproductive technology.
Working from within the Mahabharata, five key Hindu
characteristics were extracted which embrace a diversity of thought and
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experience; they welcome pluralistic, multicultural and multireligious
dialogues and engagement. Together, they provide a variety of avenues
through which bioethical issues and clinical situations may be examined.
The presupposition of an underlying unity of all life, coupled with a
multivalent nature, lead these traditions to genuinely invite and engage in
a diverse variety of perspectives. Eck remarks: “Unity in diversity is a
keynote of Hindu civilization: so many paths, so many gods, so many
sects, and yet the deeply held affirmation of one common humanity
animated by the one reality called Brahman.” As she says, these Hindu
traditions have something unique to offer America, which is “a worldview
based on religious pluralism. It is a worldview in which the various
religious ways, paths, and understandings of God, are not conflicting but
„ 4 S 7
consonant.
When there is an underlying belief that everything is ultimately
one, ultimately Brahman, the attitude of tolerance goes beyond just being
polite. Mr. A describes it well when he says:
The Hindu perspective at least allows the possibility or
gives credence to other religious traditions. When my
father-in-law [who is a Christian] walks in here [the Hindu
temple], he’s polite. But basically, I think he thinks we’re
idolaters; we’re worshipping graven images. So I don’t
‘ t 5 7 Eck, 80-81.
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260
think he really believes we’re worshipping the same God as
he is, and that we’re somehow or other connected with, I
don’t know if he’d say the devil, or anything that bad, but
it’s off. It’s not right.
Mr. A continues:
Whereas, if a Hindu were to go into a Christian church,
or even a mosque for that matter, I don’t think in the
deepest part of their soul they’re seeing that this is off,
they’re seeing it’s a different way, but it’s the same God.4 5 8
While ideologically exclusive, fundamentalist groups exist within Hinduism,
this attitude of genuine acceptance and inclusion of differing perspectives is
pervasive throughout many paths within Hindu traditions.
Mr. F responds with the following to the question, “How would
you define a good Hindu?”
Practicing Hindu is a tolerant man. He believes that God
appears in so many forms. What is required is faith in
God. It may be in a form or formless. We may have an
idol or not. Some Hindus believe only in one God.
Others believe in so many gods [. . .]. He [a Hindu]
believes that God may be worshiped in so many different
ways. You can worship god simply by working and doing
your professional work. You see, God is difficult to
specify. Just like the blind man who feels the elephant.
One man says it is like a trunk, another man says it is
like a broom. The man who feels the ear says it is like a
fan. So each one feels God is omniscient, feels one aspect
of it, and says that is God. Actually you need to integrate
all that.4 5 9
4 5 S Mr. A, interviewed by author, 23 July 2002, Riverside, CA.
4 5 9 Mr. F, interviewed by author, 1 December 2002, San Bernardino, CA.
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This ability to hold and be comfortable with differing accounts and
interpretations of God, of Brahman, translates to differing accounts and
interpretations of particular situations. In our contemporary pluralistic
world, this attitude and ability provides an exemplary model for engaging
in bioethical discussions.
This metaphor of the blind men and the elephant has several
implications regarding Hinduism’s notion of human ability. One could
argue that this story is in fact saying that each of us suffers from some
sort of blindness. Consequently, we are prevented from seeing the whole
picture of reality; we as human beings are limited. To this, Sankara and
others would respond that it is true. The assumption that there are even
qualities and forms is a result of avidya, ignorance. A vidya is itself a
result of maya, or illusion, of not seeing things the way they really are.4 6 0
However, in recognizing human blindness there is strength and wisdom.
This story is often told to elucidate the belief in the underlying
unity of life and the multivalent nature of Hinduism. The point of the
story is not only the recognition of human blindness. Rather, the lesson
emphasizes the importance of genuinely hearing other descriptions of the
elephant, of reality. Implicitly, there is an assumption that we are all
engaging reality; we all have a handle on a part of the truth. There is
4 6 0 Hopkins, 119.
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also a presupposition of trust and faith in the human ability to perceive
reality, reason, and act.
In the contemporary context of bioethics, both interpretations of
this metaphor have implications that may be found to be constructive for
working through difficult bioethical issues and situations. First, there is
an admission that no one, not the patient, the philosopher, the physician,
or the theologian is omniscient. Second, complete knowledge and
certainty is not expected. The admission and acceptance of limited
knowledge can be beneficial in that it potentially can decrease an
individual’s anxiety over always “having to be right.” More importantly,
it may provide opportunities to learn something new or see something
from yet another perspective. Third, there is a call to listen and hear the
perspectives of others. If the blind men were to integrate all their
findings, as Mr. F suggests, they would all have a more complete
understanding of an elephant. Finally, there is an allowance for the actual
circumstances of particular clinical situations, or cases, to frame the issues
and influence one’s decisions and actions.
This case-based approach to decision-making, and to bioethics in
particular, has a long, though somewhat dubious, history. Jonsen and
Toulmin present a history of casuistry, a “method for the practical
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resolution of moral issues,”4 6 1 that directly addresses issues present in actual
situations. Within their discussion, Jonsen and Toulmin point out how
moral philosophers in Great Britain and the United States moved away
from case-based reasoning toward a focus on meta-ethics, on developing
universal, abstract, systematic ethical theories and foundational principles.
They demonstrate how these attempts of designing general, abstract,
philosophical theories are themselves bound to historical and social
backgrounds. These theories, they argue:
need to be understood not as making comprehensive and
m utually exclusive claims but, rather as offering us lim ited
and com plem entary perspective on the whole broad
complex of human conduct and moral experience [. . .],
none of these theories tells us the whole truth [. . .] about
ethical thought and moral conduct. Instead, each of them
gives us part of the larger picture we require, if we are to
recognize the proper place of moral reflection and
discussion [. . .].4 6 2
Though the various philosophical theories claim to ground ethics in
“axiomatic superprinciples,” they are ultimately framed by the historical
and social settings of the time in which they were developed. Rather
than providing us with the elephant in its entirety, these theories provide
us with insights into different parts of the elephant.
4 6 1 Jonsen and Toulmin, 10.
A a Ibid., 293.
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After discussing the zenith and then decline of casuistry, Jonsen and
Toulmin conclude by calling for a revival of a “new casuistry.” This
current study supports this call and the two claims they make regarding
this approach to ethics. First, in ethics, particularly bioethics, they claim
casuistry is unavoidable. Second, Jonsen and Toulmin assert, “ m oral
knowledge is essentially particular, so that sound resolutions of moral
problems must always be rooted in a concrete understanding of specific
cases and circumstances.’,4 6 3 The five characteristics of Hindu thought are
elements that engage the practical aspects of life; they demonstrate the
necessity of a casuistic approach to considering the ethical circumstances of
particular situations. These five Hindu characteristics also encapsulate the
tendency within Hindu traditions to intermingle elements such as
philosophy, religion, knowledge, and experience. For many within these
traditions, experience and knowledge, religion, philosophy, and ethics are
inseparable. Consequently, the particulars of specific situations are
important when evaluating ethical and moral issues.
There is a clear difference between casuistry and “situation ethics.”
While the former has a long, conflicted history within Catholic moral
reasoning, the latter experienced a brief period of popularity during the
4 6 } Ibid, 330.
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1960s. While casuists operate with a number of moral paradigms,
principles, and maxims, situationists do not necessarily acknowledge one
general principle. Situationists may accept a role for maxims; however,
they are only considered guidelines, not determining factors. Casuists pay
attention to circumstances as one feature among many regarding the moral
life; situationists usually reduce the moral life to the circumstances.
Another difference is that casuists will analyze a new case by comparing
and contrasting it with previous or paradigm cases. Situationists will
focus more exclusively on the concrete case before them.4 6 4
Jonsen and Toulmin maintain that this casuistic approach to ethics
falls within the Aristotelian tradition. By heeding “Aristotle’s advice to
take a more substantive and practical approach to ethics, we can broaden
our view and recognize in what multiple ways moral arguments are
rooted in experience.” Moral arguments, according to them, “form
‘networks’ whose multiple roots and inner connections give them— in the
jargon of the electronic engineers— the ‘redundancy’ they need if they are
to be provided with effective strength in practice.”4 6 5 Rather than being
left with different, disconnected philosophical descriptions of an elephant,
mIbid, 272-273. For the seminal work on situation ethics see Joseph Fletcher’s
Situation Ethics: The N ew M orality (Philadelphia: Westminster Press, 1966).
4 6 5 Jonsen and Toulmin, 302.
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the five elements of Hindu thought and this casuistic approach encourage
a blending of a variety of views leading to a fuller understanding of the
elephant, of the circumstances, and the issues at hand.
Jonsen’s description of a good casuist seems quite applicable to one
operating out of the five characteristics of Hindu thought. According to
him, an individual engaged in bioethical struggles “should be cognizant of
particulars,” and “should have a solid, even scientific understanding of
topics.” In addition:
He or she should recognize the obscurity of the situation
and thus depend on other involved parties to illuminate as
best they can. He or she must be able to hear and hold
in mind a variety of arguments about the maxims
appropriate to complex situations. He or she should be
able to tolerate uncertainty about the right course and,
within that uncertainty, find a reasonable course of action;
that is, the course recommended by the most persuasive
argument in the circumstances, with due recognition of
other arguments that are plausible. A good casuist must,
then, have all the intellectual virtues recommended by
Aristotle: science, prudence, intuition, wisdom [. . .].4 6 6
The strength of casuistry, and that of the multivalent nature of Hindu
traditions, are their commitment to engage in the actual struggles
occurring in the clinical setting. These practical experiences are taken
seriously. More importantly they are the focal point from which the
bioethical discussions emerge. Though academic bioethical discussions may
4 6 6 Albert R. Jonsen, “Casuistry,” in M ethods in Medical Ethics, ed. Jeremy
Sugarman and Daniel P. Sulmasy, 121.
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2 6 7
occur in a vacuum, in isolation from actual experiences, the clinical
struggles do not.
DeGrazia and Beauchamp present a critique of casuistry that some
may wish to apply to the Hindu ethics being examined in this study.
They caution that casuists are less independent of principle-based reasoning
then they care to admit. They also argue that casuists have difficulties
when it comes to justifying judgments in particular cases. According to
DeGrazia and Beauchamp, this case-based approach risks not being able to
make progress, especially in controversial issues, and it can potentially
overlook general fundamental issues.4 6 7 However, Hindu ethics, as
discussed in this work, clearly acknowledges its dependence on the five
key characteristics of Hindu thought. The focus on the underlying unity
of all life and the multivalent nature of Hindu traditions, societal good,
the context-sensitive guidelines provided by dharma, and the degree to
which individuals are free to pursue the four goals and four stages of life
as well as the degree to which they are held responsible for their actions
through karma, all combine to create a fairly comprehensive Hindu ethic.
While there is a focus on the particular circumstances in this Hindu
decision-making processes, there is also an eye to the overall good of
4 6 7 David DeGrazia & Tom L. Beauchamp, “Philosophy,” in Methods in Medical
Ethics, ed. Jeremy Sugarman and Daniel P. Sulmasy, 40.
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2 6 8
society. While dharma lays out particular guidelines for how people
should live, these guidelines are not set in stone. As individuals mature
and societies evolve, roles and expectations of dharma change and shift
depending upon one’s circumstances. While some may question the lack
of universal principles and lack of attention to “means-end” and “actor-
action” dichotomies within this Hindu ethic, one need only to examine
the theory of karma. In the theory of karma, these dichotomies dissipate
because the “ends inhere in means and actors are products of actions.”4 6 8
N o one is free from the ultimate consequences of his or her actions.
Implications and Additional Applications of Hindu Bioethics
These five elements of Hindu thought have implications for
bioethics in the academy, the clinical setting, and in the public policy
arena. Hindu presuppositions in the academy may contribute to the
exploration of bioethical issues in at least two ways. First, they broaden
the discussions by the inclusion of perspectives from non-Western, very
pluralistic, South Asian traditions. In this age of globalization and
multiculturalism, this inclusion is an important element for the academy.
These Hindu perspectives can provide ethicists, philosophers, and
theologians additional material from which to draw when considering
4 6 8 McKim Marriott, “Constructing an Indian Ethnosociology,” in India Through
Hindu Categories , ed. McKim Marriott (New Delhi: SAGE Publications, 1990), 3.
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2 6 9
various issues. Second, these characteristics of Hindu thought, grounded
in practical experiences as they are, may be utilized to remind the
academy that the issues being discussed, though perhaps abstract and
theoretical in the classroom, are often actual situations that individuals are
struggling through within the clinical setting and their lives.
W ithin the clinical and public policy setting, these five
characteristics of Hindu thought can be very useful. The current
dominant religious voices influencing the clinical and public policy arenas
are those from within various Roman Catholic and conservative Christian
groups such as the Moral Majority. These conservative voices tend to
hold tightly to principles that they consider absolute, such as the sanctity
of all human life. Their commitment to this principle influences how
they engage the clinical setting and public policy debates and decisions.
In the clinical setting, their influence is often manifested in the medical
services, or lack thereof, that are offered to women.
Grounding their conclusions in the principle of respect for life, the
National Conference of Catholic Bishops issued the “Ethical and Religious
Directives for Catholic Health Care Services.” It is these directives that
prohibit Catholic hospitals from offering many reproductive health services
such as contraception, tubal ligations, vasectomies, abortion, and IVF or
other infertility services. These restrictions are of great concern for the
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2 7 0
public at large because as hospitals, HMOs, and medical facilities struggle
financially, many are bought by, or merge with, Catholic health systems.
According to statistics offered by the Catholic Health Association of the
United States, one out of every ten acute care hospitals in this nation is
now operated by Catholic operated healthcare systems. From 1990
through 1998, there were 127 Catholic/non-Catholic hospital mergers and
affiliations throughout the nation. Forty-three of these occurred in 1998
alone. While some creative efforts are made to preserve at least minimal
reproductive services, in approximately half of these mergers all or most
of the disputed reproductive health care services were discontinued at the
non-Catholic facility. Consequently, women of the communities where
these mergers occur, regardless of their religious convictions, are deprived
of many reproductive health services.
Public policy issues such as third-trimester abortions, fetal stem cell
research, cloning, and even foreign aid are likewise affected by an
unwavering commitment to the principle of the sanctity of human life.
Arguing for the sanctity of human life, these conservative religious
positions demand the prohibition of third-trimester abortions and jail time
for physicians participating in such procedures. They also call for a ban
on fetal stem cell research and cloning, arguing that these technologies fail
to recognize the sanctity of the life of the fetus. Their objections to
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2 7 1
foreign aid are often grounded in their objections to the funding of family
planning services. According to these arguments, society is better served
by eliminating particular reproductive options from which individuals may
choose.
In the United States, where autonomy, freedom of choice, and self-
determination are primary values, issues involving fetuses often become
very polarized. On the one hand, there are those, represented by the
conservative religious voices, who place the principle of the sanctity of
human life over and above autonomy and argue for a “pro-life agenda.”
On the other hand, there are other voices, both religious and secular, that
uphold autonomy and individual freedom, who defend a “pro-choice
agenda.” Within the clinical and public policy arenas, there is a struggle
between balancing the principle of autonomy with other principles and
with what is good for society as a whole.
The Hindu ethic presented within this work also presumes the
sanctity of human life, of all life. However, rather than upholding a
particular principle as universal and monolithic in meaning applicability,
the five characteristics of Hindu thought work together to form an ethic
that may prove to be very helpful for negotiating a path through these
complicated issues. Rather than defending agendas, these characteristics
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2 7 2
highlight the nuances of the situation and the arguments. They invite
thoughtful consideration of the complexities of issues at hand.
For example, in regard to fetal stem cell research and cloning, the
Hindu belief in the underlying unity of all life acknowledges the sanctity
of fetal life, of all life. A human fetus is not simply inconsequential
tissue easily discarded, or is it human life in its entirety. Taking life,
even fetal life, has its karmic consequences; therefore, Hindu principles
would most likely support objections to the creation of fetuses for the
sole purpose of experimentation. However, the acknowledgement of the
sanctity of life applies both to the fetus and to the practical situations
within society and the overall good for society. While it may not be
good for society to indiscriminately kill embryos and fetuses, finding cures
for Alzheimer’s and Parkinson’s disease, organ failure, and other diseases is
a potential good for society. Therefore, one could justify utilizing fetal
tissue from miscarriages, abortions, or remaining frozen embryos from
reproductive technologies. Again, all actions are accompanied with karmic
consequences, thus medical scientists need to carefully consider their
dharma, the harm, and the good that will result for their work.4 6 9 The
4 6 9 In my interview with Dr. E, an obstetrics-gynecology physician, I asked her
when human life begins. Her answer: “ Life begins when two halves meet to form a
whole, which is conception [. . .]. Yes, a zygote is a human being.” I then asked her
if she offers abortions or not. She replied:
I do abortions because I’ve been trained in it. Women have died in
my hands because of septic abortions. So I perform abortions on
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2 7 3
principle of the sanctity of life is not necessarily in jeopardy when it is
considered within the context of what is good for society and the sanctity
of other lives.
The complex issues involved with foreign aid provide another
example of how the five characteristics of Hindu thought work in concert
to preserve the sanctity of life while also considering the concrete
situations occurring in the world. Fox and others draw connections
between particular religious convictions and objections to various forms of
foreign aid. The objections arise from the fact that this aid often includes
family planning services. According to this argument, these services, such
as abortions and various forms of contraception, threaten the life of the
principle. I detest it. But I do it because I’m trained better than
anyone else they could go to, and I feel obligated I should give them
my training. Until the point we have the perfect form of
contraception. We don’t have that now, so as a medical person, I feel
as though I have to perform them [. . .]. Yes, I am ending life,
absolutely [. . .]. Saying “it’s tissue,” is rationalizing. It [a fetus] is
certainly a human being. I do ultra sounds in my office. I’ve seen
the heart beating from week six. And I have performed abortions on
conceptions that I have seen the heart beating in, so I know what I’m
doing. I hate it. But I do it because I’d rather not have the mother
die somewhere else. And if I don’t do it, I can’t refer my patients to
somewhere else.
Dr. E’s words regarding the status of fetuses, her position as a medical doctor, and
abortions, reflect her concept of dharma and the multivalent nature of Hinduism. In
keeping with her tradition, she acknowledges that a zygote is a human being. She
rejects the argument, the rationalization, that fetuses are simply tissue and admits that in
performing abortions she is ending life. However, her decision is grounded in her desire
to preserve the sanctity of the life of a woman who could die of a septic abortion, and
her dharma as a physician (Dr. E, interviewed by author, 2 August 2002, Anaheim Hills,
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2 7 4
fetus, and thereby threaten the sanctity of life.4 7 0 On the topic of foreign
aid, the Hindu ethic developed within this work would take into
consideration a broad range of issues, not the least of which would be the
sanctity of life. However, rather then exclusively upholding the life of
the fetus as sacred, this ethic would also consider the lives of the women
and the multitude of children already on this earth as sacred as well.
Each of these topics, fetal stem cell research, cloning, and foreign aid and
its relationship to family planning services, merit a full examination in
light of various potential Hindu perspectives.
In ethical perspectives within Hinduism, commitments to the
principles of the sanctity of human life, autonomy, and self-determination
are combined when suggesting clinical practice and public policy. Though
we are individuals, we live in societies, are interdependent upon one
another, and are affected by each other’s actions. Rather than focusing
on prohibiting various actions, the Hindu ethic examined in this work
emphasizes the presupposition that all are ultimately interconnected, that
each of us has a particular dharma, and that karm a ultimately holds each
4 7 0 Fox, 281-298; Barbara Crossette, “Darkest Hour at U.N. For Richest Deadbeat,”
The N ew York Times (September 21, 1998); Susan A. Cohen, “Abortion Politics and
U.S. Population Aid: Coping with a Complex New Law, ” International Family Planning
Perspectives 26:3 (September 2000): 137-139, 145; Frances Kissling, “Church and state at
the United Nations,” USA Today 130:2678 (Nov. 2001); John Leo, “Cracking the U.N.
code,” U.S. News & World Report 131:10 (Sept. 17 2001): 70; Steven V. Roberts,
“Unveiling the face of abortion politics,” U.S. N ews & World R eport 117 (Sept. 19
1994): 10-11.
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of us responsible for all of our actions. When applied to academic
bioethical discussions, experiences in the clinical setting, and public policy,
the Hindu focus presented here offers potentially insightful conclusions.
Although these perspectives will most likely not produce a definitive,
difficulty-free conclusion, they can potentially contribute to the process of
decision-making and thereby move the field of bioethics forward in our
contemporary pluralistic world.
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2 7 6
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Creator
Bhattacharyya, Swasti
(author)
Core Title
Infertility and assisted reproductive technology in a pluralistic world: A development and application of a Hindu ethic
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Graduate School
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Doctor of Philosophy
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Religion
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University of Southern California
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anthropology, cultural,health sciences, health care management,health sciences, obstetrics and gynecology,OAI-PMH Harvest,philosophy,religion, general
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English
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Chapple, Christopher Key (
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), May, William W. (
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), Crossley, John (
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), Sanasarian, Elize (
committee member
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Bhattacharyya, Swasti
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Tags
anthropology, cultural
health sciences, health care management
health sciences, obstetrics and gynecology
religion, general