Tübinger Studien zur Ethik · Tübingen Studies in Ethics 7 TSE 7 Tübinger Studien zur Ethik · Tübingen Studies in Ethics 7 Since the first IVF birth in 1990, the Iranian medical community has not only given full support to the use and development of assisted reproductive technology but has aided the emergence of a pow ful, locally-trained body of medical practitioners and biomedical researchers. At the same time, from a religious point of view, most Shia legal authorities - differences of opinion notwithstanding - have taken a relatively permissive view and generally support assisted reproductive technology, including procedures that involve egg, sperm and embryo donation as well as surrogacy arrangements under certain conditions. An examination of the social, legal and ethical aspects of the development and implementation of these technologies in Iran is the subject of this book. It is based on a combination of extensive ethnographic research and textual analysis of important academic and religious seminary publications in Iran, from Shia jurisprudence (fiqh) and Persian histories to the analysis of laws and verdicts. ISBN 978-3-7720-8616-8 Naef Kinship, law and religion Shirin Naef Kinship, law and religion An anthropological study of assisted reproductive technologies in Iran er Kinship, law and religion Tübinger Studien zur Ethik Tübingen Studies in Ethics 7 Herausgegeben vom Internationalen Zentrum für Ethik in den Wissenschaften (IZEW) Schriftleitung: Prof. Dr. Regina Ammicht Quinn Dr. Cordula Brand Dr. Birgit Kröber Prof. Dr. Thomas Potthast Prof. Dr. Dr. Urban Wiesing Shirin Naef Kinship, law and religion An anthropological study of assisted reproductive technologies in Iran Bibliografische Information der Deutschen Nationalbibliothek Die Deutsche Nationalbibliothek verzeichnet diese Publikation in der Deutschen Nationalbibliografie; detaillierte bibliografische Daten sind im Internet über http: / / dnb.dnb.de abrufbar. © 2017 · Narr Francke Attempto Verlag GmbH + Co. KG Dischingerweg 5 · D-72070 Tübingen Internet: www.francke.de E-Mail: info@francke.de Das Werk einschließlich aller seiner Teile ist urheberrechtlich geschützt. Jede Verwertung außerhalb der engen Grenzen des Urheberrechtsgesetzes ist ohne Zustimmung des Verlages unzulässig und strafbar. Das gilt insbesondere für Vervielfältigungen, Übersetzungen, Mikroverfilmungen und die Einspeicherung und Verarbeitung in elektronischen Systemen. Gedruckt auf chlorfrei gebleichtem und säurefreiem Werkdruckpapier. Printed in Germany ISBN 978-3-7720-8616-8 To Maurice Godelier Acknowledgments This book is a slightly revised version of my doctoral dissertation. Its defence, in the Department of Social Anthropology and Cultural Studies at the University of Zurich, took place in February 2016. I would like to thank my doctoral supervisors, Willemijn de Jong and Thomas Eich, without whom none of my dissertation would have been possible. I would also like to thank Roland Hardenberg and Johannes Quack, the examiners of my doctoral dissertation, for the time they spent reading the manuscript and providing me with valuable comments. The research for this study was funded by the German Research Foundation (DFG) as part of the Research Training Group “Bioethics” at the International Centre for Ethics in the Sciences and Humanities (IZEW) at the University of Tübingen. I am very grateful for their generous and intellectual support for both the research and the development of this book. I particularly thank Eve-Marie Engels, Thomas Potthast and Ralf Lutz for their crucial comments and suggestions. The help, comments, criticisms and collegiality of Sebastian Schuol, Robert Ranisch, Daniel Henrich, Ilona Szleza´k, Lea Schumacher, Jon Leefmann, Simon Ledder and Mone Spindler were important to me throughout my dissertation project. I wish to thank them for our intellectual discussions and unforgettable time in Tübingen. In 2011, I was awarded a visiting PhD fellowship at the University of Manchester, Department of Social Anthropology, supervised by Jeanette Edwards, to whom I am very grateful for the enjoyable time I had in Manchester. My thanks also go to Peter Wade, Katherine Smith, Petra Tjitske Kalshoven, Soumhya Venkatesan, Tony Simpson, Karen Sykes and Keir Martin for their intellectual feedback and discussions. I am also grateful to the Brocher Foundation for their generous support in funding my stay in Geneva, Switzerland in the spring of 2015, enabling me to work on the final stages of my dissertation. In Iran, I am deeply grateful to many individuals and friends at various infertility and IVF clinics, biomedical, religious and legal institutes and research centres, in the cities of Tehran, Yazd and Qom: - far too many to thank individually here. My thanks also go to the many men and women who spoke to me and shared the intimate details of their reproductive lives with me. Apart from the people mentioned above, over the years I have benefited from the critical reading, advice and encouragement of many others. I particularly thank Morgan Clarke, Chris Gregory, Simon Teuscher, Enric Porqueres i Gene´, Shahnaz Nadjmabadi, Nasser Fakouhi, Jenny Schreiber, Anke von Ku¨ gelgen, Raoul Motika, 8 Acknowledgments John Harris and Jonathan H. Marks. Last but not least, I would like especially to thank my husband Michele Naef for his understanding, support, patience and love. I am also grateful to Azadeh Torabi for her friendship and her help in translating many of my writings from Persian to English. I also thank Richard Crabtree for the English editing. All errors remain my own responsibility Note on transliteration For the transliteration of Persian words and phrases in this book, I have tried to follow the system of transliteration used by the new edition of the Encyclopaedia of Islam (EI3) , with some exceptions. The Persian id ˙ a¯fa is written as -e after consonants, and -ye after vowels; thus I use h ˙ oqu¯q-e dı ¯nı ¯ rather than h ˙ oqu¯q-i dı ¯nı ¯ . Personal names as well as Arabic and Persian terms common in English are not transliterated (e.g. Ayatollah, halal, haram, Quran, Shia, Hazrat, etc.). Non-English terms are italicized. Table of content Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Note on transliteration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 1. Framing the issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 2. Ideas about Iranian kinship . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 3. Shia approaches to assisted reproductive technologies . . . . . . . . . . . . . 63 4. Embryo donation law and surrogacy regulation: the intersection of religion, law and ethics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 5. Surrogacy as doing a good deed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 6. A priceless gift: a short story of surrogacy . . . . . . . . . . . . . . . . . . . . . . . 120 7. “M as in Mother”: medical perspectives, clinical environments and social dynamics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 8. Cousin marriage, siblingship and reproductive technologies . . . . . . . . . 161 9. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174 Appendix 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180 Appendix 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184 Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186 Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189 1. Framing the issues Introduction It is a warm autumn day in October 2005, and I am sitting in the courtyard of one of the well-known infertility clinics in the northern part of Tehran. There are lots of men and women, old and young, waiting and going in and out. Mashyana 1 - a non-religious, middle-class woman from Tehran - is standing in a small group of people, talking. She gives an impression of exuberance. So I move closer to her and ask her if she is here because of an infertility problem, to which she replies that she is not: I am here because of my kha¯har-za¯deh 2 [niece, the sister’s daughter]. Her husband has a problem. Today, they are trying IVF [ in vitro fertilisation] 3 for the second time; I am waiting for them. His sperm is very weak; the doctors believe that the possibility of insemination is very small. We will see how it turns out. My niece does not have [an infertility] problem herself. They have tried an IVF treatment with her husband’s sperm. Their first IVF was not successful. If this [the second IVF] does not work, we will go to another hospital [with an infertility and IVF section] in the centre of Tehran. She continues: “A friend of mine is now three months pregnant. She was at that hospital. There, she received the embryos of a married couple. Now she is very 1 I have changed the names of my interlocutors when I felt it necessary to protect their privacy. 2 Kha¯har-za¯deh is a combination of two words. One is kha¯har, meaning “sister”. The other is za¯deh, which derives from the verb za¯ı ¯ı ¯dan, meaning “giving birth”. 3 In vitro (“in glass”) fertilisation (IVF) is a procedure that was first pioneered in England in 1978 with the birth of Louise Brown, known as the world’s first “test-tube baby”. In this procedure, which is designed to help infertile couples to conceive a child, fertilisation takes place outside the woman’s body. The multiple egg cells are removed from the woman’s ovaries and fertilised by sperm in a laboratory culture dish and placed in an incubator. Three to five days later, the fertilised eggs or embryos are transferred to the woman’s uterus using a catheter through the cervix. I have observed this procedure many times during my fieldwork in IVF clinics in Iran. The remaining embryos are frozen in case the couple needs to try again. If unused, the spare embryos are donated to another infertile couple or eventually destroyed. 12 Framing the issues glad about it. They have met the donor couple.” They are very happy. She continues to talk to me about her brother: My brother is also waiting for an embryo donation; he does not produce any sperm. We have decided that my husband and I will give them an embryo. It is a good idea; his wife has agreed to it too. Afterwards, we came here and the doctors told us that due to my age, it would not work. The maximum age for a donor is 38; I am 40 years old. We told them that we were both healthy and have agreed to it, but the clinic did not allow it. It did not work out at that hospital either. She laughs and says, “I would love to be a few years younger.” Mashyana continues energetically with her narrative: Finally they [the clinics] told us that using another couple’s donated embryo could be an alternative. My brother’s wife did not agree to it at first. I talked to her for a long time and eventually persuaded her. I told her: “After all, your belly grows and you can say that you are pregnant. The baby will grow in your belly [ … ] there, it will become alive [ … ] it will be your own child. It will stay in your belly for nine months and you will give birth to it.” On the same day, in an interview with the head of the Embryo Transfer Commission of the clinic, I asked about embryo donation, and whether it is possible between close relatives. He explained: We have just recently received the permit for embryo donation. The law does not indicate whether embryo donation is allowed or not when a degree of kinship exists. There is also nothing mentioned in this regard in the bylaw. From the fuqaha¯ ’s [religious legal experts] 4 point of view, there is no constraint on embryo donation to relatives. Since we are not prohibited from the shar ı ¯ [religious] point of view, the donor can be any individual from the infertile couple’s close family. Currently, those who come to us for embryo donation are the embryo recipient’s sisters, brothers, cousins or other close relatives. Other people who are eligible to donate are the ones who have their frozen embryos kept here. They are once-infertile couples who successfully conceived a child through IVF and they do not need their extra embryos 4 Plural of faqı ¯h, a religious scholar and an expert in Islamic jurisprudence (fiqh). 13 Introduction anymore. Another form of donation, which is still in its infancy, is that volunteer couples can come to us and donate their embryo. 5 One year later, in October 2006, I called Mashyana. She told me that her brother and his wife had become parents through embryo donation (from an anonymous married couple). Her niece had tried IVF with her husband’s sperm several times with no success; she had now chosen to give embryo donation a try and was receiving an embryo from her husband’s married sister. An examination of the social, legal and religious aspects of such reproductive practices in Iran is the subject of this book. The above account is an example taken from my early fieldwork in an IVF clinic in Tehran in 2005, the same year the Iranian embryo donation law - passed in 2003 in the Iranian parliament ( majles ) - became fully operative. 6 Embryo donation is a procedure in which embryos created by IVF from another couple’s egg and sperm are donated and transferred to infertile couples so that the wife can become pregnant and give birth to a child. Different countries have adopted different approaches to regulating embryo donation and transfer in accordance with their respective national, historical, cultural, religious and ethical traditions. A few countries like the United Kingdom, the Netherlands, France and Finland have established laws and regulations permitting embryo donation, while in countries like Norway, Sweden, Germany, Switzerland, Denmark, and Iceland it is prohibited by law. 7 Iran is one of the few countries in West Asia 8 where the legislative work has been done by the state to facilitate embryo donation and transfer as a means of helping infertile married couples to conceive children. Similarly, surrogacy arrangements in which a woman agrees to carry another couple’s embryos to term are permitted in Iran, and in many respects they are treated in the same way as embryo donation agreements. 9 At the same 5 Author’s interview, Tehran, October 2005 . 6 I will examine this law in chapter 4 . 7 In recent decades, the debates on embryo transfer and research have been the subject of many political, ethical and theological controversies both within and across nations. For instance, in Embryo Politics: Ethics and Policy in Atlantic Democracies Thomas Banchoff ( 2011 ) offers a comparative analysis of these controversies in the United States, United Kingdom, Germany and France. He demonstrates how national historical and institutional legacies has shaped the ethical and policy controversies of embryo politics in these countries. 8 The research for this project was conducted in Iran, a Persian-speaking country located in West Asia, often called “the Middle East” in Eurocentric discourse. I prefer to use the geographically (or even historically) more appropriate term “West Asia” rather than “Middle East”. Iran borders on Armenia, Azerbaijan and Turkmenistan to the north, Pakistan and Afghanistan to the east, and Turkey and Iraq to the west. 9 Israel is another country that has also adopted a permissive approach to the regulation of assisted reproductive technology. For instance, in 1996 , the Israeli government legalised 14 Framing the issues time, from a religious point of view, most Shia legal authorities - differences of opinion notwithstanding - have taken a relatively permissive view and generally support assisted reproductive technology (ART), including procedures that involve gamete and embryo donation and surrogacy arrangements under certain conditions. This Shia juridical-theological viewpoint has provided an important background for regulations pertaining to ART in Iran. Of course, as we will see later in this study, the role of lawyers, legal experts ( h ˙ oqu¯qda¯na¯n ) and intellectuals in Iran - whether from secular or religious backgrounds - and their legal and philosophical interpretations of this normative legal reasoning and these religious opinions is too important to neglect. The courtyard of the clinic in the above account was where I had one of my first encounters with the issue of assisted reproductive technologies in Iran. 10 As a student of the French anthropologist E´ douard Conte, whose anthropological scholarship on kinship studies was one of the initial inspirations for this research, I decided to focus on issues relating to the development and use of assisted reproductive technologies in Iran as a way to deepen our anthropological understanding of contemporary Iranian society and as way to contribute to and comment on kinship studies more generally. The beginning of my interest in kinship studies, however, goes back to the 1990s, when I was studying and practising theatre in Tehran, and became much inspired by Iranian playwright and filmmaker Bahram Beyzai’s allegorical approach to Iranian myths and social reality, 11 and Claude Le´vi-Strauss’s structural approach to the analysis and interpretation of myths. 12 surrogacy arrangements under a law titled the “Embryo Carrying Agreements Law”. This law makes surrogacy permissible for heterosexual Israeli married couples. Single women, single men, and homosexual couples are not allowed to contract a surrogate, and only single, divorced, or widowed women are allowed to become surrogates (see e.g. Teman 2010 ). 10 Based on the data I collected in 2005 and 2006 I wrote my master thesis Sibling Intimacy in the Age of Assisted Reproduction: An Ethnography of New Reproductive Technologies in Iran, submitted in 2008 at the University of Bern, supervised by E´ douard Conte. 11 Beyzai’s works embody historical and social events while dramatizing Iranian myths, and in so doing they conceptualise Iranian identity, particularly in terms of culture, language and the gendered dynamics of kinship relations. Female characters in Beyzai’s works are actively present and multidimensional and make up the lead personas in his literary and visual depictions of social reality. Evidently, this dynamic and powerful presence is not fabricated or even an imitation of male characteristics; it stems from their “womanhood” identity. In fact, they are a reflecting mirror of the ancient mother-goddess figures in Persian mythical culture that manifest fertility, blessing, earth, water, light and wisdom. Beyzai’s works, one could say, ironically challenge the stereotypical understanding of Iranian society (and kinship system) as patriarchal. See Dabashi ( 2015 : 313 ) for a more detailed discussion of this point. 12 Prominent Iranian directors and theatre scholars Hamid Samandarian and Parsi Saberi 15 Introduction Nevertheless, the two above examples in Mashyana’s account show the use of embryo donation as an option in the treatment of male infertility in Iran. In one example, Mashyana’s infertile brother and his wife received an embryo donated by an (anonymous) married couple; her brother’s wife became pregnant and gave birth to a healthy child. In the second example, Mashyana’s sister’s daughter had tried IVF with her husband’s sperm several times with no success; she then chose to receive an embryo from her husband’s married sister. Now, if Mashyana’s sister’s daughter gets pregnant and gives birth to a new member of the family, will the infertile father of the child also be the uncle (mother’s brother) of the child, and from the child’s perspective will the father’s sister be the mother? To whom should the maternity be ascribed? The woman who gives birth? The contributor of the eggs? Or both? Is there any incestuous element in this embryo transfer? Who is the father of the child? The infertile husband’s brother or the sister’s husband? What is the filiation of the child? How are these issues regulated in the Iranian Civil Code? What do the religious authorities say about it? Why, in the case of male infertility, do these couples resort to embryo donation and not sperm donation? What are the rules and mechanisms in Iranian society with regard to the treatment of infertility? As Le´vi-Strauss in his lecture on “Sperm Donors, Surrogate Mothers, and Social Filiation” 13 states: The first imperative of a human society is to reproduce itself, in other words, to maintain itself over time. Every society therefore possesses a rule of filiation defining how each new member belongs to the group; a kinship system determining the way that relations will be classified, as kin by blood or by marriage; and finally rules that define the modalities of matrimonial alliance by stipulating whom a person can and cannot marry. Every society must also possess mechanisms to remedy sterility (Le´vi- Strauss 2013: 47). Generally speaking, a great deal of attention has been paid in Iran to the discussion of bioethical issues - especially in the areas concerning infertility treatment and assisted reproductive technology. Since the first IVF birth in 1990, the Iranian medical community has not only given full support to the use and development of such technologies but has aided the emergence of a powerful, locallytrained body of medical practitioners and biomedical researchers. In addition, in the light of positive public attitudes towards reproductive technology as a means to assist procreation, Iranian legislators have drafted regulations and guidelines were also among those whose scholarship, teaching and knowledge of Iranian history, culture and myths inspired me most along the way. 13 This title is part of a series of lectures Le´vi-Strauss delivered at the invitation of the Ishizaka Foundation in Tokyo in spring 1986 , under the title Anthropology Confronts the Problems of the Modern World. 16 Framing the issues to provide appropriate solutions to facilitate accessibility to this technology and tackle the challenges involved in their application. In 2003, the first Iranian law on assisted reproduction was passed in the Iranian parliament, permitting embryo donation. At the same time, from a religious point of view, as mentioned above, most Shia legal authorities have taken a relatively permissive view and generally support assisted reproductive technology, including procedures that involve egg, sperm and embryo donation as well as surrogacy arrangements under certain conditions. Iranian scholars have chosen the term “ akhla¯q-e zı ¯stı ¯ ” as an appropriate equivalent in Persian to “bioethics”. In general, the term “ akhla¯q ”, which literally means “character” or “one’s nature” in Arabic, is used to refer to both “ethics” and “morality” in Islamic thought. The term “ zı ¯st ” derives from the Persian verb “ zı ¯stan ”, meaning “to live”. I would argue that bioethics has gradually taken on an institutionalised form in Iran. Educational and research centres have been established in major universities and seminaries, and a number of Masters and PhD programmes have been introduced in the areas of Public Health and Medical Ethics. In the curricula developed for these Master and PhD programmes, in addition to contemporary western medical ethics ( akhla¯q-e pezeshkı ¯ ), subjects like fiqh (Islamic jurisprudence), h ˙ oqu¯q (law), philosophy (with an emphasis on the Islamic tradition) and the history of Islamic and Iranian medical ethics have been added to the training programmes. 14 The teaching staff include physicians who are also experts in medical ethics, religious scholars and professors of law and philosophy invited from non-medical universities and Islamic seminaries. Indeed, as I will argue, the bioethical discussions now taking place in Iran are not only framed in terms of traditional Islamic jurisprudence and theology, but also with reference to the philosophy of law, hermeneutics, ethical theories and social sciences more generally (Naef 2017). Thus, another important issue in the context of this study is Islamic jurisprudence. There are two major branches of Islam, Sunni and Shia, each with their own historical, political, theological, legal and even anthropological characteristics. Shias are the minority group within Islam and number between 130 and 195 million people, having broken with the majority Sunnis (approximately 1 billion people) in a disagreement over the Prophet Mohammed’s successors and the role that his successors were to play. According to Shias (the “party”, “followers” or “supporters” of Ali), Mohammed’s paternal cousin and son-in-law, Imam Ali, rather than the three first Caliphs (political leaders) of the Sunnis, was the 14 In September 2010 , for instance, I attended the journal club meeting of the first postgraduate doctoral programme in medical ethics at the Medical Ethics and History of Medicine Research Centre at Tehran University of Medical Sciences, where a paper on “Medical Ethics Committees in Hospitals” was presented and discussed. 17 Introduction rightful first successor to the Prophet. However, while there are subdivisions within these two major branches, most Shias belong to “Twelver” or “Imami” Shia Islam, so called because they believe that the spiritual and political leadership (Imamate) of the Muslim community passed down through Fatima (Mohammed’s only child and Ali’s wife), via her son Husayn, down to the twelfth Imam. In other words, in “Twelver” or “Imami” Shia Islam, the branch to which most Iranians belong, the Imams (spiritual and political leaders) are male descendants of the Prophet Mohammed, through his daughter Fatima. 15 According to some accounts (e.g. Amir-Moezzi 2011: 45-100), Husayn, Fatima’s son and the third Shia Imam, married Shahrbanu (“Lady of the Land”), the daughter of the last Sassanid king of Persia (now Iran), who gave birth to the fourth Shia Imam, Imam Sajjad. For Iranians and in the Shia tradition, this royal marriage seems particularly important in the connections that link Imami Shia Islam to pre-Islamic Persian ideas about social order, class structure and sacral kingship, in which religion and kingship were unified. Thus, Shahrbanu, “the Mother of Nine Imams”, is “the main link in the relationship which unites pre-Islamic Iran and Imamism (Amir-Moezzi 2011: 99). Consequently, the line of Imams descended not only through the male lines but also through female lines. There is a shrine named after Shahrbanu in the city Ray (the “royal city”), a settlement of ancient Media, south of Tehran, which can be visited only by women. A nearby mountain is also named after her. According to some sources (e.g. Boyce 1967, Babayan 2002), the shrine of Bibi Shahrbanu is a transformed temple of Anahiat (“Lady of the Waters”), the Iranian goddess of fertility, birth and motherhood as well as the goddess of wisdom, purity and celestial waters. Anahita ( aredui sura banu ), the virgin mother of Mithra, the Iranian god of the sun, justice, contract and war, was widely worshipped in ancient Iran and gained greater importance as the giver of royal power in the Sassanid Empire (224-650 AD), the last Iranian empire before the Arab conquest and the adoption of Islam. The integration of “Magian priestly” [Mazdean religious elite] and bureaucratic classes into the administration of this empire “played a significant role in the definition of religious and social identities” (Kosso and Scott 2009: 268; see also Amir-Moezzi 2011: 45-100). 16 In this book, we will see the cultural continuity, or rather, in the words of Radcliffe- 15 See, for example, Nasr ( 2006 ) and Halm ( 1994 ) for a short introduction to the historical and intellectual development of Imami Shia Islam. For a detailed recent discussion of the roots of the differences between Sunnis and Shias from both a theological and a historical viewpoint, see Newman ( 2013 ) and the lectures by Norman O. Brown ( 2009 : 60 - 75 and 107 - 127 ) on the challenges of Islam. On the historical evolution of Shia Islamic political thought, see (Ayatollah) Mohaghegh Damad ( 2010 ). And, in general, on the religions of Iran, see Foltz ( 2004 and 2013 ). 16 For Iranian religions in the Sassanid Empire, see Daryaee ( 2013 ). 18 Framing the issues Brown (1952: 10) the “structural continuity” of the cult of Anahita through to the present time. I will return to uterine kinship (kinship traced through females) in Shia and Iranian culture in chapters 2 and 3, where I argue that Shia (and to a large extent Iranian) representations of lineage ( nasab , relations of filiation) and legitimacy take a more gender-balanced structure and recognize a bilateral filiation, under which maternal and paternal filiation are clearly distinguished and in many regards symmetrical, whereas Sunni (and to a large extent Arab) notions of nasab place more importance on the male line (agnatic lineage). According to the Shia doctrine, the twelfth Imam, Imam Mahdi (“the Hidden Imam”, “the Lord of the Age” or “the Imam of the Time”) went into occultation by divine command soon after his father’s martyrdom in 874 AD. He is still alive and will return alongside Jesus as a messianic figure at the End of Time to establish justice and peace in all the earth. 17 Imami Shia Islam is found mainly in Iran, with substantial communities in Iraq, Lebanon and the Arab states of the Persian Gulf, as well as Afghanistan, Pakistan and India. In this book, however, by “Shia”, I do not refer to the Shia communities and populations around the world. I refer to the specific conceptual and objective characteristics which have been formed through the influence of Imami Shia Islam in Iran. In this introductory chapter, I will comment further on anthropological studies of reproductive technologies, and introduce the outline of the book, but let me first present an ethnographic vignette taken from my time in Qom, which should serve to give an idea of the issues we will be faced with. Sacred IVF It is a hot sunny day in September 2010. My plan is to visit the first subspecialty clinic for infertility treatment in Qom, Iran’s second most sacred city after Mashhad and a major centre of Shia theology and scholarship. The clinic, affiliated with the Academic Centre for Education, Culture and Research (ACECR) 18 , commenced its activities in August 2008 on the birth date of Imam Ali, the first Imam (spiritual and political leader) of Shia Muslims and the Prophet Muhammad’s 17 The doctrine of occultation (gheybat) and return of the Mahdi is central to Shia theology and practice. 18 The Academic Centre for Education, Culture and Research (ACECR), known in Persian as jaha¯d-e da¯neshga¯hı ¯, is an Iranian research institution established in 1980 , shortly after the Iranian Revolution of 1979 , with the goal of presenting native [Islamic] models for the production of knowledge and technology (see ACECR website http: / / www.acecr.ir, last accessed 27 June 2015 ). The Royan Institute and the Avicenna Research Institute - two of the leading and best-known reproductive biotechnology research centres in Iran - are also affiliated to this centre. 19 Sacred IVF paternal cousin and son-in-law - from whom the other eleven Shia Imams were descended. The clinic contains three departments (Embryology, Urology and Gynaecology) where treatment and research on infertility is conducted, and a wide range of biomedical techniques such IVF, freezing embryos, eggs or sperm and PGD (preimplantation genetic diagnosis) are practised. Ebrahim, the director of the Academic Centre for Education, Culture and Research (ACECR) in Qom is the first person I have a chance to visit. Our meeting is held in his office in the central building of the institute in Qom and one of his assistants joins our conversation. Medical tourism ( tu¯rı ¯sm-e darma¯nı ¯ ) is the first subject that comes up in our talks. He highlights the attraction of Qom as a site of pilgrimage and the presence of the holy shrine of Hazrat-e Masoumeh (“the Pure Saint”), 19 the sister of the eighth Shia Imam, Ali Ibn Musa al-Reza (765-818 AD) in the city and explains that many infertile couples choose this destination because of its holiness. 20 Emphasizing that the treatments and techniques offered by the clinic are ethical [from an Islamic viewpoint], appropriate and in accordance with religious criteria ( mava¯zı ¯n-e shar ı ¯ ), he mentions the interest that foreign [Muslim] patients have taken in the clinic and says: Receiving infertility treatment in Iran can be of utmost importance to other Islamic and Persian Gulf countries, Central Asian countries as well as our neighbouring countries like Afghanistan, Iraq, Pakistan and Turkey, since we share the same religious beliefs [ … ] As you know, we are among the pioneering countries where sophisticated medical treatments are offered and we are doing so while asking the lowest costs. Many Muslims prefer to undergo the process [of infertility treatment] in a specialized centre run and administered by Muslim staff. 19 The term Hazrat (“presence”, “His [or Her] Holiness”, “His [or Her] Highness”) is an honorific title used before the names of prophets, imams and saints. 20 For Iranians, Imam Reza, the eighth Shia Imam, is especially important because he is the only one of the eleven Shia Imams who is buried on Iranian ground, in the city of Mashhad, the holiest city in Iran and the second largest after Tehran. The shrine of Imam Reza attracts millions of pilgrims annually from all over the world and many come hoping for a miracle, particularly (but not only) in relation to health problems. The shrine is also very famous as a destination favoured by honeymooning Iranian couples. The shrine of Hazrat-e Masoumeh, Imam Reza’s sister, is the next most important shrine in Iran. It is located in Qom, the most important centre of contemporary Shia scholarship and jurisprudence. 20 Framing the issues He further adds: People used to seek infertility treatment in countries like Germany, England, etc. But today, not only has that need been removed, but we frequently come across foreign couples who come to Iran for treatment. While staying here to complete their treatment period, they can also enjoy the tourist attractions and historical sites in Iran. As the conversation continues, we explore the effects of relaxation, hopefulness and prayer on infertility treatment. Affirming that the age parameter is not an important factor in accepting patients in the clinic, he says: There are many infertility clinics where patients over forty years old are turned down. They reason that such patients will lower the success rate of their facilities [ … ] well, who will take care of these disappointed people? Where should they go? Many of these women and couples who have not been successful in their treatments in other clinics have retreated to a emeh-e ma su¯mı ¯n [infallible imams; Shia saints and religious figures] and travelled to holy cities like Mashhad, Shah Cheragh 21 in Shiraz and Qom [ … ] They come specifically to Qom and ask God to give them a child while visiting Hazrat-e Masoumeh’s shrine. The patients experiencing such spiritual and relaxing fulfilment in the shrine - be it before or after their IVF procedure - have proven to increase our success rate by a factor of ten and it is quite tangible in our studies. He then proudly tells me of the clinic’s 30-35 percent or in some cases 55 percent success rate and adds: “this is a significant achievement for a clinic with only two years of activity, and this much success may be attributed to the presence of the holy shrine of Hazrat-e Masoumeh nearby.” After concluding the interview, we set out towards the clinic. It is located six kilometres outside the centre of Qom in the foothills of a mountain that is called khed ˙ r-e nabı ¯ (known in English as the Prophet Khidr). 22 Whilst on the road, 21 The Shrine of Shah Cheragh (“King of the Light”) is another famous shrine in Iran located in Shiraz. The shrine is the resting place of two brothers of Imam Reza. 22 Khidr (“the Green One”) is the name of an enigmatic and theosophical figure in many ancient Oriental legends, myths, histories and religious texts, who is particularly associated with immortality, fertility and esoteric knowledge, including mystical insights. Many scholars consider that the figure of Khidr has its equivalent in the Mesopotamian Epic of 21 Sacred IVF Ebrahim and his assistant speak of the holiness of the location and the reasons that led to the IVF clinic being built there. It is believed that three thousand years ago, there was a cave at the top of the mountain where Khidr the Prophet used to retreat to pray - a cave which has now been transformed into a small mosque with a capacity of ten to fifty people. Even years before today, it was regarded as a sacred place for mystics to worship. One of the miracles ascribed to Khidr the Prophet is that he brought greenery to every barren land he walked on and that is the meaning of his name Khidr, which means green and symbolises immortality and fertility. Furthermore, about Khidr, they add: According to our religious accounts and texts, there are two prophets who are still alive - one being Jesus and the other Khidr the Prophet [ … ] He was also considered to have been a master to Moses and there are Quranic verses referring to Moses accompanying Khidr on a journey [ … ]; and there are other accounts indicating that at the time of the reappearance of Hazrat-e Mahdi [the twelfth Shia Imam], these two prophets [Khidr and Jesus] will also emerge to fulfil their mission of bringing peace and justice to the world. Another reason that has added to the sacredness of this place is the burial of fourteen anonymous martyrs of the Iran-Iraq war (1980-1988) 23 who have been put to rest in the foothills of the mountain. The burial site has become a pilgrimage destination. As we are passing by the site, we see a woman wrapped in her black chador sitting in a corner and reciting verses. Across from her, there is a young man doing daily prayers. Ebrahim’s assistant states: “we Iranians believe in a special sacredness for our martyrs and they are very dear to us; but if they are Gilgamesh, in the Alexander romance and in the Jewish legend of Elias; others, depending on the cultural landscape, tend to identify him with the Zoroastrian angel Sraosha (equivalent to the Archangel Gabriel) in Iran, Vishnu in India, Saint George and John the Baptist. According to Babayan ( 2002 : 368 ), “Khidr is related to the Zoroastrian water goddess Anahita, and some of her former sanctuaries in Iran were rededicated to him (Pir-e Sabz)”. The shrine of Pir-e Sabz (“the old woman [master] in the mountain”, “the green saint”) is a major Zoroastrian pilgrimage site located in Yazd, in the centre of Iran. In the Islamic tradition, on the basis of the Quranic narrative concerning the meeting between Moses and God’s servants (Sura 18 : 65 - 82 ), Khidr is widely known as Moses’ guide, who initiated Moses through a journey to the “meeting place of the two seas” into “the science of predestination”. Khidr, according to Corbin ( 1998 : 55 ), “reveals to Moses precisely the secret, mystic truth (h ˙ aqı ¯qa) that transcends the sharı ¯ a [religious law], and this explains why the spirituality inaugurated by Khid˙ r is free from the servitude of the literal religion”. Thus, Khidr reveals himself as “the repository of an inspired divine science, superior to the [religious] law (sharı ¯ a)”. For more on Khidr, see the detailed study by Franke ( 2000 ). 23 Which is known in Iran as the Sacred Defence (defa¯ -e moqadas). 22 Framing the issues anonymous, the endearment will only increase due to their anonymity.” Ebrahim explains: “In addition to these [sites], the road here leads to Jamkaran. 24 This makes it possible for people who come here to go to Jamkaran and do the special prayer for Imam Mahdi.” While we are on the road to the clinic, I hear of three more accounts, which I have named in accordance with the context, and they are as follows: First account: fertility and faith It is stated in this account that believers who desire to have a child will be granted their wish due to Khidr’s prayers for them if they cleanse their living environment for forty days and appeal ( tavassul ) 25 to Khidr the Prophet and ask him to mediate between them and God to give them a righteous child. Second account: fertility and gemology The second account is a quote from one of the religious scholars in Qom that elaborates on the therapeutic quality of precious stones and their effect on fertility. An infertile couple visits the scholar and asks him for help. He advises them to wear a silver ring with a turquoise gemstone on it. A Quranic verse is recommended to be engraved on the turquoise. Each of them must wear this ring for about a month. After a while, the couple visits the scholar again and this time, they inform him of their established pregnancy. Third account: fertility and astrology The third account focuses on the relation between IVF and cosmic circumstances. I recite it here as a direct quote. Ebrahim explains: About 95 percent of IVFs result in embryo formation; however, the number drops to 30 percent after the embryos are transferred. What can explain this? One of the reasons is linked to the PH levels in the uterus - being either too acid or too alkali. It is one of the issues that must be taken into account. But 24 Jamkaran, the Hidden Imam’s Mosque, is another popular pilgrimage and sacred site in Iran, renowned for healing and miracles and a place of hope. Unlike other shrines in Iran, where a historical connection (through kinship by birth or by marriage) with the family of the Prophet and the twelve Imams of Shia or with the Persian nobility and often women of the royal family is very important, Jamkaran follows a different tradition. It is believed that Jamkaran is the place where Imam Mahdi, the messianic figure in Shia Islam, appeared to believers and will reappear (z ˙ ohu¯r) from his occultation at the End of Time to rid the world of evil (see e.g. Amir-Moezzi 2011 : 403 - 485 ). The Jamkaran site was long a sacred place and its popularity has grown in recent years, especially among young people (both religious and non-religious groups). 25 Tavasssul refers to the intention of seeking nearness to God, and in Shia theology, by resorting to a saint and religious figures. 23 Sacred IVF our [religious] accounts advise us not to underestimate the cosmic influences in such conditions. The grand masters call it esoteric astrology. According to esoteric astrology, the condition of stars and their constellations can affect many phenomena taking place on earth. In some Jalali calendars 26 it is indicated that when the moon is in Scorpio, it is not an appropriate time to undertake certain tasks. He then adds: “currently we have the issue under study to see if celestial conditions can have an effect on fertility and embryo transfer.” We arrive at the Qom Infertility Treatment Clinic - a three-story building and a new development in a quiet residential area. The neighbourhood is considered one of Qom’s distinguished districts populated mostly by well-off families. The ground floor consists of a large waiting hall with white marble flooring encircled by almost ten rooms that include the director’s office, midwifery room, reception, counselling, and genetic sections. The operation rooms, ultrasound, examination room, recovery, laboratory, cord blood banking and seminar rooms are located on the upper levels. I meet with the clinic’s director and some of the personnel. The majority of staff in the clinic are female. An appointment is made to interview the director. She is a gynaecologist and a certified ART specialist. She is from Tehran but according to her account, she calls Qom home now. A friendly talk ensues. I ask her about the efficiency of their practice. According to her, almost forty women and thirty men visit the clinic on a daily basis. She says: It has solved many problems in the city. Two or three years ago, before the centre opened, a lot of patients had to go back and forth between here and Tehran. Now it’s become much easier for patients [ … ] although the burden has lifted, there is still a long way to go. I ask her whether there are patients from other countries. She replies: 26 The Jalali calendar, which is considered by some to be the most accurate solar calendar in the world, was used in Persia (Iran) and, following a modification in 1925 , is the basis of the modern Persian solar calendar used today in Iran. The Persian solar calendar has a year of twelve months named after Zoroastrian angels and divine entities (Amesha Spentas and Yazatas). The official calendar of Iran is the Persian solar calendar (shamsı ¯), which begins on the vernal (spring) equinox around March 21 (the Iranian New Year, Nowruz), while the lunar calendar is used for religious (Islamic) purposes. For a general history of the Persian calendar (among other ancient calendars), see Stern ( 2012 ). 24 Framing the issues Yes, almost 9 percent of people referring to our clinic are non-Iranian patients from neighbouring countries and particularly from Iraq, but we have had a few visitors from Europe too [ … ] we even have patients from Tehran. Religious concerns are big among those who come to Qom. As you know, donated sperm is used sometimes in Tehran. Those who are more religious prefer to come here. We have had patients who have tried the procedure in Tehran a few times, but they believe in here more. On the other hand, Qom is a holy city [ … ] they resort to Holy Lady Masoumeh. My next question is about the latest techniques employed by the clinic and she informs me of the egg freezing option: Since commencing our work at the clinic, we have practiced embryo freezing and we have recently been able to perform egg freezing by innovating a new technique in egg culture [ … ] we have had a couple of egg freezing cases so far where the husband and wife were both present. The husband had to go through the TESE procedure 27 and the wife had high quality eggs, but it was not possible to extract the husband’s sperm at the same time. I mean we were faced with an emergency situation. These were the cases when we had to freeze the eggs and after removing them from freezing, they were still of outstanding quality and the fertilization took place successfully and we were satisfied with the results. Our conversation continues. She has to visit a woman who is to benefit from egg donation. I manage to get to know the midwifery ward staff better. They are on their break and have gathered in one of the rooms. In the coming days, I will spend more time with them in this very room. A man who has recently become a father has brought sweets and pastries and everyone is busy helping themselves to tea and sweets 28 . I become acquainted with Zahra, a microbiology graduate who works in the laboratory and is currently conducting research on the correlation between the Jalali calendar and IVF - a subject which Ebrahim had discussed with me previously. Zahra explains: 27 Testicular sperm extraction. 28 Offering sweets and pastries on happy occasions such as the birth of a child, passing entrance exams to college, etc. is very customary in Iran. 25 Sacred IVF There are tasks that are perceived as having an ill-fated outcome if they are done during certain times in the Jalali calendar; for instance, first marital intercourse is said to be inauspicious if it is done during the period when the moon is in Scorpio, therefore, it is better to let the moon come out of the sign [ … ] there are a few days in each month when the moon positions itself in Scorpio and then comes out of it. For now, I am studying the cases to see whether there is a relation between IVF and embryo transfers we do here and these specific times in the Jalali calendar. In the evening of the same day, there is an internal seminar on sex selection at the clinic. I am also invited to take part in the seminar. The participants are all female professionals and the seminar speaker is a female physician from the laboratory department. Commencing her lecture, she addresses the reasons behind sex selection propensity in various countries. Family balancing and medical reasons are highlighted as two dominant reasons in Iran. She explains: There are families who have had four or five children in the hope of having a boy or a girl. With sex selection, we can help these families [to achieve what they want] as well as reducing their financial costs economy-wise [ … ] however, the most important factor in sex selection is to prevent sex-linked diseases as well as preventing repetitive miscarriages. However, the other subject that the speaker touches upon at the end of her talk is related to the ethical aspects of sex selection. She refers to a renowned infertility treatment clinic in Iran where sex selection is not part of its practice. The clinic considers the act morally wrong and reasons that it will lead to a gender imbalance in the population. She then adds: “However, there are clinics where sex selection is practiced only for families who have got one or more boys or girls and who wish to have a child of the opposite sex.” That evening I find my way into the courtyard of the Hazrat-e Masoumeh Shrine. As always, it is overcrowded. I am sitting on a platform out in the courtyard, deeply engaged in taking down my notes on today’s observations. A family next to me has spread their evening meal there. There are three women - grandmother, mother and daughter. The eldest woman makes me a sandwich, which tastes awesome after leaving a busy afternoon behind. They offer me a cup of tea as well. As I was sitting in the courtyard, I noticed a few groups of people carrying a couple of coffins on their shoulders while chanting “ la ilaha illa Allah ” (there is no god but God). It is part of the funeral ritual in Qom to bring the body of the deceased in the coffin and perform t ˙ ava¯f (circumambulation) 29 around the 29 The act of moving around a sacred object. 26 Framing the issues Holy Shrine of Masoumeh before taking it to the cemetery for burial. As I am standing there as an onlooker, the elderly woman turns to me and says: “Whenever you see a funeral procession, you should say: inna lillahi wa inna ilayhi raji’un , a Quranic verse meaning “truly we belong to God and to Him we shall return.” 30 The term sacred IVF occurred to me that evening. On that particular day, I had spent my whole time at the clinic where most of staff were female. While the clinic offered the most state-of-the-art ART - from embryo donation to egg freezing, etc. - and scientific studies, there were many sacred, divine and cosmological values in (re)production as well; the clinic was built in a sacred location - a place which not only derived sanctity from [the tombs of] historical figures like Khidr (the prophet), but was doubly respected due to its proximity to the memorial park of anonymous war martyrs. Even the research subject of one of the laboratory personnel was about the effect of cosmology and astrology on IVF pregnancy. Before and after the procedure, infertile couples visited Hazrat-e Masoumeh’s shrine, where the bodies of the deceased had to be sanctified before burial. This was where I stumbled upon the fact that assisted reproductive technology does not necessarily displace the cosmological phenomena and moral logics that structure kinship and reproduction. Instead, they create new sites and moments for reproducing and redefining these principles; they renew and emphasize the connection between the human and the divine in the ongoing process of creation. This is understandable if one considers reproduction as a cultural achievement through which the foundational structures and perceptions of a society and its dynamics are reproduced and contested rather than simply the combination or encounter of male and female reproductive substances (of course, necessary but not sufficient condition). Indeed, as Annette Weiner put it, we need to think of reproduction “not as a biological construct, but as a cultural concept in which the basic processes for reproducing human beings, social relations, cosmological phenomena, and material resources are culturally defined and structurally interconnected” (Weiner 1978: 183). And in Godelier’s terms, “in all socities, a man and a women do not suffice to make a child, and that other agents, ones more powerful that the men and women who unite sexuality and than the group that contract alliances, intervene to transform the foetus made by humans into a child that will take its place in the cosmos and in its society” 30 This verse (in Arabic or Persian translation ma¯ hame az khoda¯-iı ¯m wa be soy-e khoda¯ baz mı ¯gardı ¯m) is one of the most commonly-cited Quranic verses among both religious and non-religious people in Iran; it is also often used in announcing the death and funeral of a person and in sending messages of condolence. 27 New kinship and assisted reproductive technology (ART) (Godelier 2011: 415). These definitions give room for a multitude of actors who all play a part in making a human being with a cultural identity and turning him or her into a relational being and a member of society. It is this understanding of reproduction that I follow more closely in this book. New kinship and assisted reproductive technology (ART) In his critique of traditional anthropological studies of kinship, defined in terms of genealogical reasoning - American anthropologist David Schneider (1984) argues that the true foundation of kinship is primarily a matter of culture, as a system of symbols and meanings, not a matter of biology. In his view, the biological framework in traditional kinship studies - from Morgan to Le´vi- Strauss - is a cultural construct based on Eurocentric or Western assumptions about kinship and reproduction and is not shared by other people around the world - in particular, assumptions about biogenetic relationships and common bodily substances (e. g. blood and semen). British anthropologists such as Needham (1971) and Leach (2004) made similar critiques of the genealogical foundation and evolutionary origins of human kinship at about the same time. 31 But it was Schneider who destabilized the debate about kinship by postulating that kinship is a “non-subject” and, as a field based on genealogical relations, does not exist. 32 But, as Sabean and Teuscher (2013: 1-2) argue, “Schneider failed to notice that kinship in Europe has been anything but a stable entity, that it has gone through numerous reconfigurations over the centuries, that is has been the topic of controversies, and that it has always been the subject of comment in one way or another by theologians, lawyers, physicians, philosophers, and scientists”. However, Schneider’s culturalist approach to kinship has been broadly taken up by a number of scholars, especially in the field of feminist anthropology and gender studies, under the name of “new kinship studies” (transposed from “kinship” to “relatedness”). 33 Many of the anthropological studies of assisted reproductive technologies have followed this approach, exploring the effects of these 31 Although, as mentioned by Godelier, Needham’s and Leach’s criticism of kinship studies (formalist approach) does not mean that the study of kinship should be halted but that is should be “conducted on different bases, not stopping at terminologies but going on to the link between kinship and economy, power, religion, etc”. (Godelier 2011 : 19 , italics in the original). 32 For more on Schneider’s relativistic approach, see Ottenheimer ( 2001 ). For another critical review, see De´chaux ( 2008 ), and for an extensive and complete review on the earlier tradition of kinship research, see Godelier ( 2011 ). 33 See Carsten ( 2004 ) for references and a detailed discussion. 28 Framing the issues technologies and medical developments on forms of relatedness and knowledge practices in Euro-American culture. 34 More specifically, these studies have documented how reproductive technologies have challenged not just the traditional family structures and kinship, but knowledge about kinship relations itself. As Carsten (2004: 167) clearly states: “if both kinship and knowledge had previously been seen as a ‘direct reflection of nature’, as Schneider has observed, then it followed that these developments had destabilized not just kinship or nature, but knowledge itself.” Schneider’s influence is also evident in the feminist approaches to the study of reproduction and gender relations in Islamic societies (also transposed from “sex” to “gender”). For example, in her ethnography of a Turkish village, Delaney (1991) argues that the “folk theory of procreation” is fundamentally “monogenetic”, “it is men [‘the seed’] who give life; women [‘the field’] merely give birth”. 35 Furthermore, describing a rural Turkish village, Delaney (ibid.: 30-42) notes the symbolic and structural association between men and God in the entire system of beliefs about procreation, and considers this association to be part of the power behind the “Middle Eastern” patriarchal system(s). The “monogenetic theory of procreation” has been also documented by Inhorn (e.g., 1994, 1996, 2006) in her study of infertility among lower-class Egyptian women. Inhorn’s ethnography and analysis highlight some of Delaney’s findings. She (Inhorn 1996: 22) claims that in these “monogenetic reproductive scenarios” only males - as “procreators” and “makers of foetuses” - are seen as contributing to the genetic substance of the offspring. Furthermore, according to her, “in Egypt and other parts of the Muslim word, the creative power of Allah, the one God, who is gendered male, is symbolically associated with the procreative powers of earthly males, whose ties to the divine are apparent in the realm of religion practice” (1994: 6). 36 In another example, King and Stone (2010), based on such ethnographic observations - including their own fieldwork 37 - offer an approach for addressing the issues of kinship, gender and reproduction by developing the concept of “lineal masculinity”, as “an ontological essence that flows exclusively to and through men over the generations”. Following Delaney 34 For example, to cite but a few, the works of Strathern ( 1992 ), Ragone´ ( 1994 ), Franklin ( 1995 , 1997 ), Edwards et al. ( 1999 ), Edwards ( 2000 ), Franklin and McKinnon ( 2001 ), Finkler ( 2000 ) and Thompson ( 2005 ). Again, the majority adopt an explicitly feminist stance. 35 She even argues ( 1991 : 48 , footnote 22 ) that Islam has promoted a monogenetic theory of procreation, and states: “nowhere have I seen any ancient, medieval, or early modern argument that would qualify as saying that both men and women contribute equally and the same kind of thing.” (Italics in the original). 36 In a recent study she goes even further and offers an oversimplified and decontextualized representation of “Middle Eastern men” (Inhorn 2012 ). 37 Diane E. King among Iraqi Kurdish communities and Linda Stone in Nepal. 29 New kinship and assisted reproductive technology (ART) and Inhorn, they assert that this concept especially helps them to discuss male reproductive roles, “patriliny” 38 and masculinity in the region “from Morocco to Pakistan”. 39 Soraya Tremayne has also conducted comparative research on IVF in Iran and England within infertile Iranian couples. In a similar vein, and using Inhorn’s arguments, she postulates that the use of third-party donation provides scope for a reinforcement of the patriarchal values in relation to reproduction (e.g., Tremayne 2012). In addition, according to her, the application of reproductive technologies leads to profound transformations in the structure of the family and in gender relations (Tremayne 2015: 143). 40 In another example, Inhorn (2003), in her ethnographic study of IVF in Egypt, describes how IVF leads to the establishment of nasab between the married infertile parents and the in-vitro children who might otherwise never have existed. 41 She argues that the use of reproductive technologies leads “to a further entrenchment of deeply-held local cultural beliefs about the nature of kinship, family life, and parenthood” (Inhorn 2003: 120). 42 However, Inhorn proposes to “globalize” an argument first made by anthropologist Marilyn Strathern: Strathern has argued that the new technological interventions in reproduction have led a main effect of privileging ‘biogenetics relatedness’ as the ultimate and determinative form of kinship in Euro-America. Basically, because these technologies promise to bring biological children to those couples who might otherwise have them, these technologies powerfully solidify extant cultural notions of what a ‘natural’ family is: that is, one in which children are connected to their biological parents through ‘blood ties’ (Inhorn 2003: 120). 38 According to King and Stone ( 2010 : 327 ), in their model, “a patriline is not only a line of fathers and sons through time but it is also a ‘mascu-line’ that enhances and gives form to masculinity. Again, fatherhood and masculinity will be identified with biogenetic contributions. 39 They interchangeably use “MENA region (Middle East and North Africa region)” and “Middle East” without any clear definition of what they mean. In so doing, people’s religious, historical, political, cultural and linguistic diversity and experiences have been essentialized to specific and constructed entities, which serves the American political agenda more than the discipline of anthropology. 40 However, she does not give any clear example or explanation of “structure” and “transformations”. 41 IVF and ICSI are only allowed in Egypt for married couples; sperm must come from the husband and eggs from the wife. 42 I agree with her on this point, but not with her understanding of kinship and family structures. She - like Schneider and other scholars in new kinship studies - reduces genealogical ties to biological ones. See also Godelier ( 2011 : 19 - 22 ) and his critique of Schneider on this point. 30 Framing the issues This is “despite anthropologist Susan Kahn’s claim [see below] that Strathern’s argument is inherently Eurocentric - given that it does not seem to fit well with the unique Israeli assisted conception scene, where kinship itself is truly being refashioned by these technologies” (ibid.: 120). Inhorn, who has produced a considerable body of work on IVF and infertility, argues that Strathern’s argument about the biologically essentializing potential of these technologies may, in fact, apply to many other global sites. Inhorn continues: Certainly in the Sunni Muslim world, Strathern’s argument takes on perhaps its strongest form. There, the pre-existing Islamic imperatives regarding ‘pure’ lineage, coupled with Islamic prohibitions against adoption, not only privilege but, in fact, mandate biological as opposed to social construction of families. In summary, in the Sunni Muslim Middle East including Egypt, biogenetic relatedness - glossed as nasab , or blood relations [misleading and false translation] 43 - is an absolute imperative. (Italics in the original) But, one should note that nasab - as we will see throughout this book is legal filiation and not “biogenetic relatedness” or “blood relations” as Inhorn considers as a definition for nasab and therefore the affirmation of Strathern’s argument about the biologically essentializing potential of reproductive technologies. Nevertheless, in my study, I consider new kinship studies and their focus on the issues of “gender”, “substance”, and “personhood” (Carsten 2004) to be inappropriate for the study of assisted reproduction and kinship in the Iranian and Islamic context (see also Clarke 2009: 26-38), where kinship ( khı ¯sha¯vandı ¯ in Persian as equivalent to the Arabic term qara¯bah ) is, and has been, for instance, the dominant subject of many legal and theological discussions, associated with practice and knowledge. By ‘knowledge’ I do not mean here only biological (or genetic) facts and information, in the new kinship sense, but knowledge in its entirety. In this context, as we will see throughout this study, it is not only biology that produces new knowledge about kinship (e.g., Franklin 1997 and 2013); it is rather the legal and theological meanings ascribed to the biological fact that take on the nature of kinship knowledge. Indeed, according to Clarke (2009: 206), legitimacy in Western countries has faded from relevance, which might, as he puts in, “in itself help explain the prominence of biogenetics”. In this study, I agree with Schneider’s insight that culture plays an important role in human behaviour - but as a system of knowledge. However, I cannot accept his conclusions about the nature of kinship, and I argue that kinship can be cross-culturally defined in terms of sexuality and the reproduction of human life. In my view, sexuality and reproduction are at the heart of kinship and 43 On nasab see also Clarke ( 2009 ) and Eich ( 2012 ). Chapters 2 and 3 of this book address the concept of nasab in Iranian religious and civil law. 31 New kinship and assisted reproductive technology (ART) structured by the ontological, legal and moral orders and values, language and logic of the culture in which they are practised. So, I support Porqueres i Gene´ and Wilgaus’s criticism of current anthropological kinship theory, that “Western cultural understandings of kinship are radically different from non-Western ones ” (Porqueres i Gene´ and Wilgaus 2009: 112). In so doing, my approach to kinship in this study focuses principally on formal legal aspects of the Iranian kinship system, 44 which also influence and shape people’s perception of the ordering of society and may in turn be shaped themselves. As the eminent Iranian sociologist Taghi Azadarmaki (2012) argues, Iran is a society in which family ( kha¯neva¯deh ), religion ( dı ¯n ) and state ( dolat ) are three dominant social institutions that shape the social and political structure and relations. Historically, these three institutions have been formed and developed together in Iran. When discussing kinship, religion and law in this book, I refer to these three independent but closely related units. By law, I refer to the Iranian legal system in general, both religious law (associated with Shia jurisprudence and Islamic law) 45 and civil law (associated with the national state in particular). 46 However, as we will see later, the representatives of all these entities have come together to form an Iranian coalition model in support of assisted reproductive technologies. This study aims to explore the interrelations between civil and religious legal thinking and social and institutional practices in the interpretation, application and on-going redefinition of ART in the complex field in which religious authorities, jurists (whether from secular or religious backgrounds), medical practitioners, clinical staff, would-be parents and donors all directly or indirectly interact. Thus, the research questions posed in this book deal with the interaction between the new forms of reproductive practices, religious and legal deliberations, state regulations and social dynamics that represent different sources of knowledge and power through which the social uses of assisted reproductive techno- 44 As we will see in chapters 2 and 3 , issues pertaining to kinship are addressed in two ways in Iranian legal writings: firstly in legal texts (motu¯n-e hoqu¯qı ¯) that are mostly associated with civil law and national state and enjoy a more homogenous pattern, and secondly in legal texts (motu¯n-e fiqhı ¯) written by Shia religious scholars that are more inclusive in subject. Chapter 4 discusses the relationship between fiqh and hoqu¯q in the Iranian legal system. 45 There are two concepts commonly translated as “Islamic law”: “sharia” - literally meaning “the way” - refers to revelation. “Fiqh” - literally meaning “deep understanding” or “insight” - is the Islamic science of jurisprudence, and like any other system of jurisprudence it is local, contextual and subject to change in its premises. When I refer to “Islamic law” in this book, I mean the broader theoretical legal discourse and not divine law (or God’s law), normally associated with the concept of sharia. 46 This book also illustrates how civil language and religious language do cooperate in the context of IVF. 32 Framing the issues logies in Iran are interrelated. In particular, it addresses: 1) an analysis of the moral reasoning embedded in the Shia theological legal discourse on reproductive technologies and how this tradition interprets assisted reproduction, with a particular focus on underlying concepts, structure and principles of kinship; 2) the emergence and development of the relevant legislation and administrative policies and how they might shape the relationship between civil and religious law in Iran, and 3) the ways in which reproductive technologies are used and understood, with particular focus on underlying values, local narratives and the resulting societal dynamics. This study also examines what happens when cosmological phenomena, economic values, conflicting moralities and kinship principles meet clinical practices, legislation and regulations pertaining to reproductive technologies, including gamete and embryo donation and surrogacy arrangements. I should add here that I do not focus on any particular techniques of ART. The most important issue is assisted reproduction and reproduction in general and how it is contested and negotiated in the religious and legal arena and in the process of social interaction. A number of related studies have focused on a specific technique of ART such as egg donation (e.g. Konrad 2005), surrogacy (e.g. Teman 2010), PGD (Franklin and Roberts 2006), etc. In this study, I have explored and covered most of these techniques to give a general picture of the practice and discussion of ART in Iran, although I do not view them solely as “techniques of ART”. As I have observed many times in IVF clinics, what makes all these techniques ultimately similar are the common acts of releasing egg, obtaining sperm sample, fertilizing the eggs outside of woman’s body in a lab setting, developing an embryo, and finally embryo transfer or freezing. Meanwhile, the legal relationship between the egg, sperm and embryo contributors and recipients define such in vitro fertilization. 47 Are the egg, sperm and embryo donated? What is the marital status of the donors and recipients? Will the resulting embryo be carried by the gamete owners or will another woman be involved as gestational carrier? Thus, in this study, I am concerned with the social, rather than considering the emergence of technology as causal in relation to the social process. My emphasis will be on social relations, individual experiences, law and legislative processes and institutional structures. In this respect, my perspective differs from approaches that draw on science and technology studies (STS) and their focus on technology and biological sciences, such as Franklin (2013), Jasanoff (2007), Thompson (2005, 2013) and Inhorn (2012) among others. 47 As we will see, according to most clinic regulations, the consent and agreement of all parties are recorded in written form and include their signatures and fingerprints on the documents. By legal relationship, I refer to this contractual relationship between two parties. 33 New kinship and assisted reproductive technology (ART) This book is inspired by aspects of the works of Susan Martha Kahn (2000) and Morgan Clarke (2009) and their reflections on the issues of kinship and reproductive technologies in Israel and Lebanon. I do not deny that I have greatly benefited and learned from their analytical approach. In her pioneering ethnographic study, Reproducing Jews: A Cultural Account of Assisted Conception in Israel , Kahn examines IVF practices in Israel, focusing mainly on state discourses and rabbinic (Jewish religious) attitudes towards kinship and reproduction. Her study also includes observations at IVF clinics and interviews with medical professionals, religious figures and unmarried Israeli women who have chosen to become mothers through artificial insemination. She opens her book with the description of a birth scene at a fertility clinic on the outskirts of Jerusalem. “The baby is healthy, the mother is happy, guests bring gifts, and the child is welcomed into the world. The birth is remarkable because the women conceived the child without having sexual intercourse and the baby has no identifiable father” (Kahn 2000: 1). The mother in this account is a single Israeli woman, who used an anonymous Jewish sperm donor to conceive. Kahn vividly shows how a confluence of social, legal and rabbinic forces has enabled such a birth in a strongly pronatalist society where there is a direct interrelationship between kinship, religion and nationality. As a social worker in a Jerusalem fertility clinic told Kahn: “If you’re not a mother, you don’t exist in Israeli society.” On the basis of her research findings, Kahn problematizes Strathern’s model for theorizing reproductive technologies and their consequences for thinking about kinship. According to Strathern (e.g., 1992 and 1995), assisted reproductive technologies tend to challenge previously-held normative assumptions about kinship, family and human origins, and bring about radical cultural transformations and structural changes in society. A central goal of Kahn’s study is to show how the social uses of assisted reproductive technologies in Israel “reinforce and entrench the foundational assumptions of Jewish kinship thinking”. She argues that changes in reproductive medicine and the choices afforded by reproductive technologies do not necessarily displace “a culture’s foundational assumption about kinship”. In this book, I support Kahn’s claim that Strathern’s argument is inherently Eurocentric, and I do not see the applicability of Strathern’s argument to the Iranian cultural context and Shia tradition. In the Iranian case, as we will see, this is a kinship system whose morality and norms are deeply rooted in history, but one where the social uses of these technologies gives these ancient terms and values a modern twist. In so doing, I also support Porqueres i Gene´ and Wilgaus’s criticism of current anthropological kinship theory, that “new forms of relatedness represent a radical break from ‘traditional kinship’” (Porqueres i Gene´ and Wilgaus 2009: 112). 34 Framing the issues Turning to the second work, Morgan Clarke’s research was conducted in Lebanon. His work mainly focuses on interviews with Shia and Sunni religious authorities in Lebanon while analysing Islamic legal texts. His work includes some interviews with physicians; however, his research on [infertile] couples, donors and infertility clinics is limited, which is understandable since it is comparatively difficult for a man to carry out research in this area. My work includes the analysis of Shia legal texts in Iran. In many cases, I have reached the same conclusions as Clarke. The way he views and values the analysis of legal texts is very important to me, and to some extent, I consider my work as an extension and completion of Clarke’s work. I agree with his reflections on kinship and assisted reproductive technologies, and particularly with his critique of new kinship studies and their applicability in the study of kinship and (assisted) reproduction in Islamic societies. However, there are issues where I do not agree with his viewpoint. For instance, Clarke conducted his research in Lebanon but he refers to the Middle East, Islam and Shia as a whole in his analysis. Every country in the so-called “Middle East” has its own political, economic, cultural, religious and linguistic history. The social changes and evolution in these countries depend on many factors, which need to be examined separately. How could it ever be possible to talk about one Middle East? Although countries in this part of the world share geographical or even cultural and religious proximity, each of them represents a different social order due to their different colonial and war experiences. Therefore, in my opinion, it is impossible to speak of one Middle East - at least in anthropological terms. Finally, this book is also about Iran, or, more precisely about certain aspects that shed light on the dynamics and complexity of contemporary Iranian society. Some see Iran as the “brave new world” of assisted reproduction. Others have called the Iranian approach to reproductive technologies “revolutionary”. But for me this study is more about the personal and human face of assisted reproduction for the men and women who spoke to me about the intimate details of their reproductive lives, and the children born through assisted reproduction. 35 Methodology: doing ethnography in the fields of theology and medicine Methodology: doing ethnography in the fields of theology and medicine One of the things we need to recognize is the strength of the empirical bias which Malinowski introduced into social anthropology and which has stayed with us ever since. The essential core of social anthropology is fieldwork [ … ]. E. R. Leach (2004 [1961]: 1), Rethinking Anthropology As mentioned above, my research on infertility goes back to 2005 when I was an MA student in Anthropology. My interest in kinship and reproduction and in cultural forms and changes in social organizations stems from years of studying and practising theatre and drama in Tehran. I have always viewed these issues from the perspective of drama and literature, which also led me to the initial reports, news, and topics about family and reproduction published in Iran. One of these reports contained information that opened my eyes to the latest developments in infertility treatment and embryo donation and the positive viewpoints of religious scholars about them. In autumn 2005, I had two interviews with the head of the embryo transfer commission of a pioneering IVF clinic and biomedical research centre in Tehran. This motivated me to choose the topic as my MA thesis subject in anthropology. This topic has challenged me for more than a decade and the following book is its fruit. I started my research with participant observation in Tehran IVF clinics, which included five IVF clinics and one infertility centre in a private hospital. The waiting areas of these clinics were usually overcrowded places where people were usually exchanging information. They would share their stories, experiences, and information about the newest infertility treatment techniques, IVF clinics, costs, etc. Listening to them allowed me to gain general information about all the aspects involved. Later on, I had the chance to interview the directors of these clinics and I obtained permission from three of them to conduct my research in their clinics. Their positive outlook and generous cooperation resulted in excellent research results. In particular, knowing the staff at the reception and our friendly encounters helped me tremendously in getting to know many infertile couples and donors, thus deepening my understanding of the issues. I kept in contact with many of them. In one private clinic I was not allowed to conduct any interviews as a researcher. The clinic director suggested that I should sit in the reception area to make my observations and try to establish contact with the patients somehow without introducing myself as an outside researcher. Another clinic allowed me to stay in the reception room as an anthropologist and conduct my research freely in their institution. In the third I was 36 Framing the issues not allowed to interview the donors or infertile couples, but I was allowed to do fieldwork in the laboratory and operating room and interview the clinic staff. Thus, I was able to undertake different forms of research activities in these clinics. In 2006, furthermore, I had three productive months of fieldwork in Qom - the centre of Shia scholarship in Iran - where I was able to meet and interview prominent Islamic religious scholars who have published articles and books on subjects related to assisted reproduction and biomedical issues. My discussions with these scholars in Qom gave me a new way of understanding not only assisted conception, but also Shia jurisprudence ( fiqh ) itself. Although I had a background in Islamic studies as the minor subject in my MA, it took me a great deal of time to figure out fiqhı ¯ methodology and to become acquainted with textual analysis and knowledge production in the Islamic legal context. After all these years, I feel like I am still taking my first steps there. Following my participation and talk at a two-day interdisciplinary seminar on surrogacy in Tehran in October 2007, my first article on surrogacy was published in Farsi in Iran (Garmaroudi 2008b). Participating in this seminar paved the way for me to meet more medical specialists, legal experts and scholars in Islamic studies in Iran. Subsequently, this was to have a great impact on my understanding of how the relevant knowledge was generated and produced in Iran. In the following years, invitations to other seminars and conferences in Iran followed this first publication. The connections I made created a trust that later enabled me to conduct further research in the IVF clinics in Yazd - a city in central Iran - and Qom in 2010. It was an outstanding opportunity to learn about assisted reproductive technologies in two other cities in Iran with different cultural settings to Tehran. In this study, I have had the advantage of talking to many men and women, fertile and infertile, to civil and religious lawmakers, physicians and nurses alike without any trouble and I do hope that the present work reflects that. I can honestly say that I have collected, if not all, then most of the religious and civil legal texts published in Iran and I have applied them to my work as much as possible. Thus, as George Marcus notes: “Multi-sited ethnographies define their objects of study through several different modes or techniques. These techniques might be understood as practices of construction through (preplanned or opportunistic) movement and of tracing within different settings of a complex cultural phenomenon given an initial, baseline conceptual identity that turns out to be contingent and malleable as one traces it” (Marcus 1995: 106). In sum, the methodological approach for this study is a combination of extensive ethnography conducted between 2005 and 2011 and subsequently in 2015 in the cities of Tehran, Yazd and Qom, and the textual analysis of important contem- 37 Plan of the book porary academic and religious seminary publications in Iran, from Shia jurisprudence and Persian histories to the analysis of laws and verdicts. The study includes more than 200 interviews and discussions with Iran’s infertility and IVF specialists, medical and clinical staff, religious authorities, legal experts, infertile couples undergoing infertility treatment using donated gametes and surrogacy, gamete donors and surrogate mothers. I personally interviewed, transcribed and took notes in Persian, and then translated them into English, where necessary. 48 I started my research on this subject as an unmarried Iranian woman studying Anthropology at the University of Bern in Switzerland. During those years, I met my Swiss husband who is now an attorney working in Bern. At the end of my graduate studies, we got married. The fact that I have spent half of my adult life in Iran and the other half in Europe is a unique opportunity that has helped me to gain a profound understanding, which I hope resonates both in my field studies and in the research itself. During these years, Iran experienced many political and economic changes and upheavals. Although I cannot deny an emotional involvement in the flow of events, the profound understanding I mentioned above helped me to focus resolutely on the task at hand and follow the issues pertaining to reproduction, kinship and family formation in Iran without siding with any particular parties or political activities. It was like walking on a tightrope and I think I have been a successful tightrope walker. Plan of the book After this introductory chapter, which has presented my approach and the historical and theoretical context of the study, chapter 2 explores some ideas about the Iranian kinship system, setting the scene for my subsequent arguments. Through analysis of the formal legal kinship structures in Iran, I will argue that the Iranian kinship system is a flexible and integrated bilateral kindred system, which reckons descent through both male and female lines and affines, and which embraces bilateral filiation (filiation through either parent), siblingship and affinity. My concern in the next two chapters is to address some aspects of religious legal hermeneutic strategies that have shaped the Iranian approach towards reproductive technologies. I explore some fundamental issues in contemporary Iranian society, politics and culture facing the regulation of biotechnology in Iran. 48 Here I would like to thank again a special friend, Azadeh Torabi, my high school friend in Tehran for her help with the English translation. Without her help, it would have been impossible to convey in English all the meanings and nuances I had described in Farsi. 38 Framing the issues Chapter 3 presents an analysis of the moral reasoning embedded in the Shia theological legal discourse on reproductive technologies, and how this traditional knowledge interprets assisted reproduction. A discussion of these normative statements will serve to introduce concepts of kinship and parenthood in Shia fiqh (religious legal discourse, Shia jurisprudence) that will also be important when we turn to the implications they have for the regulation and practice of assisted reproduction in Iran. I have dealt with various aspects of this issue in previous publications (Garmaroudi Naef 2012, 2015a). Chapter 4 describes and examines the Iranian approach to the regulation of reproductive technologies, through which medical, Shia legal and civil legal authorities come together in producing bioethical legislation and regulations in the national context. It focuses in particular on the legislation and regulations for embryo donation and surrogacy, which are both morally permissible according to the majority of Shia religious authorities. It traces the development of this legislation and identifies the institutions and figures involved, and examines in particular the dynamics of religion, law and medicine in the formation of these bioethical regulations. I argue that the Iranian approach towards bioethical issues involves all stakeholders - religious and secular, state and private - and reflects a combination of elements drawn from both secular and religious principles. I focus on the relationship between religious and civil law in Iran, and go on to discuss some of the most recent work published in Iran on this subject. The understanding of this relationship is crucial to understanding the formation of laws and regulations on the use of assisted reproductive technologies in Iran. Much of the content of this chapter has been previously published in the special issue in Die Welt des Islams, International Journal for the Study of Modern Islam (Garmaroudi Naef 2015b). In the next chapters I present an account of the practice of assisted reproduction in Iran. Chapters 5 and 6 are devoted to the issue of surrogacy and explore how Iranian surrogates and intended couples react to the surrogacy procedure. In chapter 5, I explore the ways in which gestational surrogates and intended parents attempt to transform surrogacy from a controversial issue into a normative concept in infertility treatment. Again, I have discussed some aspects of this issue in a previous publication (Garmaroudi Naef 2012). Chapter 6 describes the personal experiences of an intended mother and her surrogate; their experiences both individually and through their close and intimate relationship over the course of their surrogacy procedure. Reproductive technologies, as I argued above, do not necessarily displace existing Iranian kinship structures and cultural assumptions about kinship. Rather, many of these structures and assumptions are truly being reinforced and refashioned by these technologies. Chapters 7 and 8 address and discuss some of 39 Plan of the book these structures and assumptions. My main concern in these two chapters is with the “native point of view”: the voices of infertile couples, gametes donors, their doctors and clinical staff. In chapter 7, I present some vignettes from my fieldwork in clinics, mainly on gamete and embryo donation, as well as the regulatory framework. Chapter 8 shows how IVF is reshaping the practice of cousin marriages. I argue that the social use of assisted reproductive technologies seems to strengthen the already privileged sibling relationship that cousin marriage implies. The final chapter ties this material together and offers summary and conclusions. On the one hand, I argue that the social uses of assisted reproductive technology in Iran tend to reveal and reinforce existing foundational assumptions about kinship and reproduction. On the other hand, while its implementation has come about through the participation of all relevant stakeholders - whether from secular or religious backgrounds - it has also opened up a space for discussion and critical insights that may have a significant impact on the development and production of both religious and non-religious knowledge. 2. Ideas about Iranian kinship A kinship system implies an intellectual construction, something like a “model”, in which all the parts or traits can be understood in relation to the whole, while neglecting everything left outside the system. Dumont (2006 [1971]: 14), Introduction to Two Theories of Social Anthropology: Descent Groups and Marriage Alliance My father [ pedar ] had three brothers [ bara¯dar ] and two sisters [ kha¯har ], and my mother [ ma¯dar ] more or less the same. Then there were all of us brothers and sisters. My mother gave birth thirteen times, and eight out of those survived, including me. Of these eight, one was devoured by cancer, my sister, who also did not have children [ bacheh ]. A stroke got another one, my older brother, who, even though he had a child from his first wife [ zan ], took two more wives and divorced them, but in the end when he died, he only had that one child. But the rest, each one of them has children and grandchildren [ naveh ]. And [it is] only her [great] great-grandchildren [ nadı ¯deh ] [that] my mother has not seen. Then there are paternal [ parallel ] cousins [ amu¯ -za¯deh ] and maternal [ parallel ] cousins [ kha¯leh-za¯deh ] 1 and grandchildren and great-grandchildren [ natı ¯jeh ] and a whole line of offspring [ za¯d o ru¯d ], a tribe [ ı ¯l ] in the full sense of the word. And in [this] frenzied and chaotic world filled with children [ tokhm o tarakeh , “progeny”], destiny prevailed and chose only me, so that - because of anemia, and because of God only knows what defect is in my body, and my scarce and lazy sperm [ esperm ] - now I must become the individual at the end of the line with respect to all those currently behind me, and enviously look at others passing me by. And the reality is that no one will follow me. A road to the edge of a precipice, and then cut off. Barren [ abtar ] in the full sense of the word. After all, is it [at all] possible for one to imagine that a line has come from the very beginning of time to the sparse forest of thinly scattered civilization at the end of Ferdowsi Alley in Tajrish 2 to bring you this trust from hand to hand [ dast be dast ] - that is, from generation to generation [ nasl be nasl ] - and 1 Cross-cousins have also the same bilateral position in the Iranian kinship system and terminology. Da¯yı ¯-za¯deh refers to matrilateral cross-cousins and ameh -za¯deh refers to patrilateral cross-cousins. 2 The end of Ferdowsi Alley in Tajrish is a neighbourhood in the north side of Tehran that houses two important and historical buildings. One is the house of Nima Youshij ( 1895 - 1960 ), a contemporary Iranian poet and the father of modern Persian poetry; the other belonged to Jalal Al-e Ahmad ( 1923 - 1969 ) - the narrator of this passage - and his wife Simin Daneshvar ( 1921 - 2012 ), who are known as a prominent Iranian literary couple. The area is a part of the literary, artistic, and intellectual history of Iran that has been the meeting place for many Iranian poets, artists and writers. 41 Ideas of kinship in Islamic societies that you will not have anyone to follow you to pass on the burden? Scientific explanation and resignation and reality all have their own place. But what do I do with this burden, with this cut-off path? Am I the end point of creation [ khelqat ], the end of the road? Jalal Al-e Ahmad, A Stone upon a Grave ( Sangı ¯ bar gu¯rı ¯ ) 3 Ideas of kinship in Islamic societies Unilineal descent and FBD marriage The literature on Iranian kinship is sparse and often suffers from a lack of theoretical grounding and comparative analysis. The reflection on ideas about kinship and family relations in Iran usually takes place within a wider framework of anthropological studies of kinship in the “Middle East” - particularly in Arab Muslim communities. 4 Generally speaking, these studies, largely conducted from the perspective of classical descent and alliance theories, 5 have highlighted either the principle of unilineal descent 6 in the male line or the preference for endogamy and close-kin marriages 7 as the main characteristics of social organization in “Middle Eastern societies”. Some later studies (notably Conte 2003 and Clarke 3 A Stone upon a Grave (Sangı ¯ bar gu¯rı ¯) is a short autobiographical account written by Jalal Al-e Ahmad about his struggle to cope with his inability to conceive a child. It is the most intimate autobiography in contemporary Iranian literature, exploring issues of male infertility, kinship, fertility, sexuality, body and male identity. Al-Ahmad wrote the book in 1963 ; however, it was first published in 1981 , 12 years after his death. The book has been republished several times by various publishers since then. 4 Starting with Smith ( 1885 ), Eickelman ( 1976 ), Bourdieu ( 1966 ), Holy ( 1989 ) etc. and subsequent writers, including a group of French scholars centred on Pierre Bonte and E´ douard Conte (see Clarke 2009 for references). One should note that the focus of all these studies is on Sunni Arab-Islamic societies. Kinship in Islamic legal texts and Arabic literature has been also discussed by scholars of Islamic studies and Arabic language (see, for example, Kohlberg 1985 , van Gelder 2005 , and Eich 2012 ). These latter studies, however, give a more differentiated picture of “the Islamic way” of constructing kinship. See also Eich ( 2012 : 49 ). 5 For an excellent introduction to these two theories of social anthropology, see Dumont ( 2006 ). 6 In unilineal systems, descent is traced through either the male or female line, but not both, See, for example, Barnard and Spencer ( 2002 : 151 - 154 ) and Barnard and Good ( 1984 : 66 - 87 ) on descent and systems of descent; see also Dumont ( 2006 ). 7 The prevalence of patrilateral parallel cousin marriage with father’s brother’s daughter (FBD, and FBS, father’s brother’s son of course) has been particularly emphasized in these studies; FBD marriage reflects both the agnatic and endogamous aspect of social structure and relation. It (re)produces the patrilineal structure and its continuity (See also Clarke 2009 : 38 - 55 ). 42 Ideas about Iranian kinship 2009) have also found that the Islamic notion of kinship is cognatic, 8 characterised by the asymmetry of gender relations. However, a key insight derived from all these studies is the hierarchical superiority of man over woman, and thus the precedence of agnatic over uterine relations in the constitution of kinship and social relationships; that is, a person’s lineage and affiliation is determined through the male line of descent, as well as one’s dignity, honour and position. 9 Logics of substance Yet, another approach that has occupied anthropologists in the study of the “Middle Eastern” kinship system brings together “gender” and “corporeal substance” - also popular in the “new kinship” (see e.g. Carsten 2004) - as a way of thinking about kinship, reproduction and social organization in Muslim societies. It is associated in particular with the works of the French anthropologist Franc ¸oise He´ritier (1999), who succeeded Le´vi-Strauss at the Colle`ge de France. By placing the emphasis on the transfer, combination and encounter of bodily fluids (e.g. blood, mother’s milk, semen) at the heart of her wider project, which tackles kinship on a universal level and argues for a secondary type of incest, He´ritier claims to have found the “underlying logic” (ibid.: 15) of all prohibitions on sexual relations between kin in different societies; that is “the contact between identical bodily fluids” (ibid.: 11), incest of the second type. Inspired by Le´vi-Strauss, 10 this theory, which has won wide approval and been highly influential among He´ritier’s colleagues in France, further maintains that “the idea 8 By “cognatic”, Conte (e.g. 2003 ) refers to a kinship system that allows for a choice to be made in affiliation between paternal and maternal kin. His emphasis is, thus, on the element of “choice” and the establishment of an elective bond of relatedness. 9 See Clarke (2009: 38-55) for full references and further discussion on “ideas of kinship in the Middle East”. 10 I see in the Le´vi-Strauss theory of incest a societal reasoning, whereas He´ritier’s theory of incest is mainly based on sexual differentiation and gender identity, even if it may be in a symbolic and conceptual way. For Le´vi-Strauss ( 1969 ), incest is “at once social, in that it is a rule, and pre-social in its universality” (ibid.: 12 ); and thus it is a point of transition between “nature” and “culture”. As such, incest prohibition “is instituted only in order to guarantee and establish, directly or indirectly, immediately or mediately, an exchange” (ibid.: 51 ). For Le´vi-Strauss, all systems of kinship are ultimately to be seen as accommodating the universal principle that kin groups exchange women. However, in Godelier’s terms, “I do not deny that male domination exists; but unlike Claude Le´vi-Strauss and Franc ¸oise He´ritier, I do not think that it is a constituent principle of kinship. What is constituent, owing to the incest taboo, is the obligation to exchange” (Godelier 2011: 125), and, of course, “the obligation to keep and transmit” (ibid.: 470). 43 Ideas of kinship in Islamic societies that incest might have been the rule somewhere (rather than universally forbidden) is groundless” (1999: 16). 11 In short, in a general re-theorization of incest in her monograph Two Sisters and Their Mother: The Anthropology of Incest , He´ritier argues that the prohibition of marriage and sexual contact between kin and affines in fact derives from the taboo on identical bodily fluids being mixed. Thus, the worst part of Oedipus’s crime, He´ritier seeks to demonstrate, is not that he married his mother Jocasta (incest of the first type), but that he had sexual relations with a woman with whom his father has already had sexual relations (contact of son’s sperm with the father’s sperm, incest of the second type). Hamlet, too, according to He´ritier, is a story of incest of the second type that ends in blood. Thus, the vital part of Hamlet’s tragedy is not a question of the father’s murder by his brother, but the contact of the two brothers’ identical fluids (sperm) in the same womb through the intermediary of the same woman, Queen Gertrude. He´ritier analyses ancient law codes from Hittite to Greek and Roman law as well as Islamic, Christian and Jewish legal texts on the one hand, and ethnographies of African societies on the other. Inspired by Altorki’s (1980) article on milk kinship created through suckling ( rida ) in urban Saudi Arabia, He´ritier expands upon her thesis to elucidate the logic underlying marriage prohibitions based on suckling, as stated in Islamic law. Suckling constitutes a basis for kinship relations other than those created through ties of marriage and descent. Islamic rules forbid marriage not only between the child and the milk mother but further, with all the other members of the milk mother’s kin, including the milk mother’s husband and his kin (see below; see also Clarke 2007 and Nazari Tavakkoli 2006 for full references). According to He´ritier, such marriage prohibitions can only be understood in terms of “incest of the second type”, which implies the contact and combination of identical bodily fluids (e.g., two sisters’ vaginal fluids). From an Arab folk and legal saying that “the milk is from the man”, she argues that in the Islamic rules of milk kinship, the male substance transmitted by lactation ultimately appears to be decisive in establishing kinship ties: “The breast-feeding relationship reinforces the agnatic relationship and extends it” (He´ritier 1999: 276), and the women’s milk itself is not considered as something that comes from women. Thus, we can see that, in Godelier’s terms, “the modern problematic of ‘gender’ has become a key to [He´ritier’s] reading of present and past social and historical facts” (2011: 355). However, He´ritier’s theory has been endorsed by several like-minded French anthropologists working in Muslim Societies (e.g., Conte 2000 and Fortier 2007), 11 See Godelier ( 2011 ) for a detailed explanation and critique of He´ritier’s idea of incest of the second type. 44 Ideas about Iranian kinship but has also attracted criticism by other scholars (e.g., Parkers 2005, Van Gelder 2005, Frandsen 2009 and Clarke 2009). 12 For example, Fortier’s article (2007) on the subject of milk kinship, descent, and medically assisted procreation is another affirmation of He´ritier’s theory. Inspired by He´ritier’s idea of “identical substance”, Fortier repeatedly maintains that agnatic forms of Arab kinship are biologically based, arguing that in Sunni Islam, “sperm appears as an essential biological determinant of patrilineal descent” (ibid.: 16). She argues that in all the stages of the physical creation of the child (conception, gestation, and lactation), it is the male agnatic substance that plays a primary role. Thus: “in these representations, woman plays no substantial role in either conception or pregnancy” (ibid.: 26). Furthermore, “they are dispossessed of the substance visibly flowing from their breast” (ibid.). Based on Marcia Inhorn’s (2003) IVF and infertility studies in Egypt, Fortier adopts this approach to demonstrate and clarify why Sunni Islam forbids sperm donation and allows artificial insemination only with the husband’s sperm, and why it forbids sperm banks but allows blood banks. Nevertheless, in disagreement with such interpretations (based on gender differences rather than relations of consanguinity), I would suggest instead that these legal statements, as Thomas Eich (2012: 49) in his article “Constructing Kinship in Sunni Islamic Legal Text” has argued, have to be contextualized historically and “they must be put into perspective in terms of the way in which broader legal concepts are linked to specific issues”. In addition, I would argue, we must also pay attention to the traditions that regulate the production of legal knowledge and to the social processes and dynamics through which these legal statements emerge and take shape (see particularly chapters 3 and 4). 13 Now let us return to Iran. In this chapter and throughout this book we will see that the Iranian kinship system does not fit into the framework of defined theories on kinship in the “Middle East”. On the contrary, through analysis of the 12 Myself included, see Garmaroudi Naef ( 2012 ). 13 Let me give you an example from my own experience of fieldwork in Qom among religious legal authorities (fuqaha¯). “Embryo donation” and “gestational surrogacy” are viewed and discussed as two different types of assisted reproductive technologies. During the interviews and discussions I had with fuqaha¯, I gradually learned that they did not respond to my questions by differentiating between this two terms. Their focus was primarily on the same subject matter involved in both. In both procedures, “a woman (married or not) is carrying the embryo of a married couple that was fertilised outside her body”. This was, for example, the point of departure for further discussions, questions and concerns. In the former case (“embryo donation”), there is an infertile couple of which the woman is carrying the donated embryo of another married couple for themselves; in the latter case (surrogacy), a woman (surrogate) is carrying the embryo of an infertile married couple where the wife is not capable of carrying their own embryo. It was here that I learned not to focus solely on these legal statements as such but also on the way they are produced, argued and shaped. 45 The Iranian kinship system formal legal kinship structures in Iran, I will argue that the Iranian legal kinship system is a flexible and integrated bilateral kindred system, which reckons descent through both male and female lines and affines, and which embraces bilateral filiation (filiation through either parent), siblingship and affinity. By filiation I mean the legal relation that links the children to their paternal and maternal sides, while descent refers to the transgenerational continuity established through other principles, such as rules of inheritance, citizenship, marriage, patrilineality and matrilineality. Furthermore, on the basis of my analysis of Shia Islamic legal discourse on the appropriateness of assisted reproduction, which will be the major concern of chapter 3, I argue that whereas Sunni legal notions of filiation ( nasab ) follow the agnatic line of descent, Shia notions take on a more gender-balanced structure under which maternal and paternal filiation ( nasab-e ma¯darı ¯ va pedarı ¯ ) are clearly distinguished and in many regards complementary and symmetrical. I argue that the concept of incest from the Shia perspective does not depend on the contact and transfer of bodily sexual fluids. It depends (rather) on the illegitimate physical act that happens through illicit sexual intercourse and not on the act of conception itself, that is, on physical contact rather than the mixing of reproductive substances. I problematize He´ritier’s thesis of contact and transfer of bodily substances for the study of incest and its implications for kinship thinking and practice. In doing so, I hope to show that the rhetoric of incest does not follow a “universal grammar”: incest, has been, and still is, a rule , somewhere. The Iranian kinship system Law provides a model for how society can be. Fernanda Pirie (2013: 53), The Anthropology of Law In my opinion, the best equivalent term for kinship in the Persian language is khı ¯sha¯vandı ¯ , of which the most important elements are filial ties ( nasabı ¯ ) and affinial ties ( sababı ¯ ). The Iranian legal experts (see e.g. Safai and Emami 2007: 267) consider khı ¯sha¯vandı ¯ as equal to the Arabic term qara¯bah , the rot meaning of which is “closeness” (Clarke 2009: 39-40). The Iranian Civil Code, based on Shia Islamic jurisprudence, acknowledges three types of khı ¯sha¯vandı ¯ (or qara¯bah ) which will be discussed later on in this chapter (see below). Khı ¯sha¯vandı ¯ derives from the root khı ¯sh or khod , meaning either “oneself” and “one’s own” or “kindred” and “relative”. The plural form of khı ¯sh is khı ¯sha¯n or khı ¯sha¯vanda¯n , meaning “relatives”; khı ¯sha¯vand-e nazdı ¯k 14 refers to “close relative”. The plural form of the 14 Like sister, brother, mother, father, son, daughter, aunts, uncles, grandparents and others like cousins. 46 Ideas about Iranian kinship Persian term nazdı ¯k (“close”) is nazdı ¯ka¯n , meaning “close relatives” and synonymous with khı ¯sha¯vand-e nazdı ¯k . Another term deriving from nazdı ¯k is nazdı ¯kı ¯ , meaning “closeness”; it also refers to “sexual intercourse” in everyday use. Khı ¯sha¯n-e ma¯darı ¯ and khı ¯sha¯n-e pedarı ¯ are further terms, which respectively stand for maternal relatives and paternal relatives. 15 In this sense, I would argue that the “concept of kinship” in the Persian language is primarily related to the “concept of self”, to the cognitive awareness of the self or of one’s own identity, and then to the consanguinal and affinal structures and the formation of relations between “categories of individuals” (Godelier 2011: 20). In the Middle Persian language, khı ¯sha¯vandı ¯ (written khw ˙ e´tu¯da¯s ) is normally translated as “next-of-kin marriage”, and in the Pahlavi texts it is specially defined as marriage with one’s sister, mother or daughter (Spooner 1966). We can see that most of these terms stem from the root khı ¯sh , mean “one’s own”, and are related to the concepts of “marriage”, “closeness” and “sexual intercourse”. The Persian word for sister is kha¯har and comes from the same root. One can therefore argue that the conception of kinship in Persian is primarily based on siblingship (same-sex or opposite-sex sibling relations) and affinity: it seems to me that kinship in this system is more a theory about marriage. However, the centrality of marriage, siblingship and the bilateral structure of the filiation in the Iranian kinship system can also be traced in the various versions of the Iranian creation myth. For example, as described in Bundahishn 16 (Bahar 2006, 81-83), the sibling set Mashya and Mashyana - male and female respectively - were the first two humans in ancient Iranian mythology whose children then populated the world. It is said that Ahura Mazda (the supreme Iranian God), created the first human, Keyumars (“the first human”) who was neither male nor female. Keyumars was the result of the sacred union of Ahura Mazda (the father, the god of the sky) with his daughter Spenta (the goddess of the earth). The spirit of evil, Ahriman sought to destroy all of Ahura Mazda’s creations and sent a demon to kill Keyumars. Keyumars was killed, but from his seed grew a plant ( riva¯s ), and from this plant grew the sibling set Mashya and Mashyana, whose marriage created the human race. Mashyana is also a Persian female name, mean, “the first woman”. 17 15 arh ˙ a¯m, meaning “uterine kindred” or “maternals” (Varasteh 2011 : 555 ), is another term for maternal relatives; it derives from the Arabic and Hebrew verbal root “r-h-m”, meaning “womb” or “caring”. 16 One of the principal sources of ancient Iranian cosmology and traditions. 17 The story of Mashya and Mashyana was written as a novel by the contemporary Iranian novelist Mohammad Mohammad-Ali in 2009 . The story is narrated by Mashyana who talks about Iranian cosmology and their viewpoints on the universe while retelling the creation myth as well as the story of Ahriman (Devil), Keyumars (the first human being) and her love and life. 47 The Iranian kinship system Nevertheless, kha¯neva¯deh (family) is another word close to the root khı ¯sh in meaning. It stems from the word “ kha¯neh ” (house) and includes such members as father, mother, children, brother and sister. Khı ¯sha¯vandı ¯ and kha¯neva¯deh are two major terms in modern Persian used to refer to kinship and family (see e.g. Safai and Emami 2007). The word khı ¯sh is also used in the colloquial term “ qom-okhı ¯sh “ which refers to the extended family, and include people who are related by birth or through marriage, and social, economic and emotional relations that affect their lives (Azadarmaki 2012). This colloquial term by itself happens to reveal another characteristic of Iranian kinship which, I would argue, is (mostly) based on the interaction and interweaving of Persian culture - with its special emphasis on “affinity” - and Islamic legal tradition - with its special emphasis on “descents”. Khı ¯sh , as noted, is a Persian term meaning “oneself” or “kin”. The word “ qom ” is an Arabic term that implies the relationship of a group of people with a person; it also means people, nation and ethnic group. As mentioned above, the Iranian civil code, based on Shia Islamic jurisprudence, 18 acknowledges three types of kinship. We will now look at each of these three ways of reckoning kinship or khı ¯sha¯vandı ¯ in the Iranian legal system: firstly in terms of filiation; secondly in terms of affinity, and third in terms of suckling. We should note that the discussion of all three types of kinship in the Iranian legal literature often appears in a section concerning qara¯bah or khı ¯sha¯vandı ¯. Legal issues relating to adoption, illegitimate children and assisted reproductive technologies come in this section. Khı ¯sha¯vandı ¯ nasabı ¯: filiation The analysis of kinship relations in the Islamic legal tradition is associated with the notion of nasab , an Arabic term variously translated as “consanguinity”, “genealogy”, “lineage”, “descent”, “kinship relations” or “relations of filiation”. When it comes to assisted reproductive technologies, as we shall see in the next chapters, nasab is a key concept of fundamental importance. The primary definition of nasab in the Iranian legal literature 19 is that of the natural ( t ˙ abı ¯ ı ¯ ) relationship of a child ( t ˙ efl or farzand ) to its parents ( va¯ledeyn or pedar va ma¯dar ) through procreation ( tavallod , za¯yesh ). 20 Iranian legal experts - both in religious 18 I will discuss the relationship between religious and civil law in Iran in chapter 4 . 19 See, for example, mafhu¯m-e nasab (concept of nasab) by Hamdollahi and Roshan ( 2009 : 160 - 165 ) and by Safai and Emami ( 2007 : 288 - 292 ). 20 Some texts refer to this natural relationship through procreation as “takavvone yek ensa¯n az sperm-e mard va tokhmak-e zan”, meaning the formation of a human being from the male’s sperm and the female’s egg (see, for example, Hamdollahi and Roshan 2009 : 162 ). 48 Ideas about Iranian kinship and civil matters - consider this definition as the most commonly understood conception of nasab ( mafhu¯m-e orfı ¯-ye nasab ). However, this natural relation ( ra¯bet ˙ eh-ye t ˙ abı ¯ ı ¯ ) 21 is not a sufficient condition for the establishment of legal filiation ( nasab-e shar ı ¯ ) 22 . The Iranian Civil Code (ICC), in accordance with Shia law, acknowledges nasab as legitimate ( mashru ) 23 and lawful ( qa¯nu¯nı ¯ ) 24 only if the father ( pedar ) and the mother ( ma¯dar ) of the child ( farzand ) are within a valid marriage contract at the time of conception ( en eqa¯d-e nut ˙ fah ). As such, the primary concept of nasab in the Iranian legal discourse is that of relations of bilateral filiation based on a married union, both de facto and de jure. 25 Hence, if conception takes places as a result of zina¯ (illicit sexual intercourse), 26 it is not possible to acknowledge the child’s nasab as legitimate. According to article 1167 of the ICC, a child born as a result of the act of zina¯ is not attached to the za¯nı ¯ (fornicator, both man and woman in Shia fiqh ), 27 is not recognized as legitimate, and is the subject of an illegitimate nasab ( nasab-e na¯mashru ). According to article 884 of the ICC, a child who is the result of illicit sexual intercourse does not inherit from the father, the mother, or their relatives (see e.g. Safai and Emami 2007). In other words, the establishment of legal filiation ( nasab-mashru ) and the right of inheritance is based on legal paternity and maternity, and not just a natural bond between parents and children. It should be noted that the law treats legitimate and illegitimate children equally except when it comes to inheritance; therefore, the rights and obligations remain the same in matters of custody, guardianship, and alimony (Safai and Emami 2007: 342). 28 Also, in order to protect illegitimate children, the uniformity vote of the National Supreme Court in 1997 requires the birth of the child to be reported to the National Organization for Civil Registration and the birth certificate to be issued under the name of the father. According to Ayatollah Khomeini, the fornicator is recognized as the 21 Some texts refer to this as blood relation (ra¯bet ˙ eh-ye khu¯nı ¯); - blood not as “substance” but as “concept”. 22 But it does create a marriage prohibition. 23 That is to say religious legitimation. 24 That is to say civil legitimation. 25 This understanding of nasab is very important in the context of our discussions on assisted reproduction, as we will see in the next chapters. Again, “blood relations” or “biological relations”, translations frequently used in Inhorn’s work, are, in my view, highly misleading and false. See also Clarke ( 2009 : 52 ) and Eich ( 2012 : 29 ) for the same challenge to this view. 26 See below for further explanation of the term zina¯. 27 Whereas in Shia legal discourse the construction of maternity is an legal act, in Sunni law maternity is determined primarily on the basis of the natural connection between a mother and her child (see e.g. Shabana 2015 ). I will discuss this issue further in the next chapter. 28 As we will see, the regulation of adoption and embryo donation shows the same legal pattern. 49 The Iranian kinship system child’s [social father] pedar-e ’orfi 29 . In cases where the mother of the child is known but not the father, it is approved to issue the birth certificate under the mother’s name and to put “ambiguous” in the space provided for father’s details (Safai and Emami 2007: 342). However, the use of the term nasab in Islamic legal texts is not restricted to the concept of filiation, and differs from one context to another. It also refers to “origin”, “descent” and agnatic lineage. Let us now turn to the issue of affinity. Khı ¯sha¯vandı ¯ sabab-ı ¯: affinity Islamic law defines mus ˙ a¯hara as one of the three components of kinship. Mus ˙ a¯hara is an Arabic term derived from the root s ˙ ı ¯hr (“affinity”) and refers to kinship relations created through marriage. An Arabic-Persian Dictionary (Ghayyem 2002: 997) translates mus ˙ a¯hara as khı ¯sha¯vandı ¯ sabab-ı ¯ or Khı ¯sha¯vandı ¯ da¯ma¯d-ı ¯ . Sabab is an Arabic term used in Persian as “a cause of something”. The Persian term da¯ma¯d denotes one’s son-in-law. Da¯ma¯d , meaning related by marriage, is one of the less numerous Persian kinship terms that are still used today. Let me now refer to some issues that are important to our subject in the context of assisted reproduction related to the marriage. Mut a marriage is a form of temporary marriage ( ezdeva¯j-e movaqat in Persian) which is only recognized by Shia Islam and is practiced in Iran and other parts of the Shia world. Mut a is a legal personal contract. It refers to a union between an unmarried woman and a married or unmarried man for a limited period of time and for a set amount of money by the man. The time agreed could be from one hour to several years (see Haeri 1989). The mut a marriage was practiced in the pre-Islamic and early Islamic eras. However, Sunni law does not recognize it, considering it as illicit sexual intercourse and therefore forbidden (ibid.: 30). The mut’a marriage is not subject to dissolution by divorce. At the end of the contract period, both parties may decide to terminate the relationship or transfer their temporary union to a permanent one. Furthermore, the mut’a marriage does not entail the mutual right of inheritance between the temporary spouses, although children born as a result of temporary marriage are recognised as legitimate offspring (ibid.). In the context of egg donation, temporary marriage of the husband of the woman who is going to receive the egg to the egg donor has been proposed by some Shia scholars as a solution to legitimize egg donation. In this case, at the time of insemination both the egg donor and the egg recipient are in the marriage bond - temporary or permanent - with the producer of the sperm 29 It is interesting to see how this legal reasoning considers the fornicator (the biological father in anthropological terms) as the social father. 50 Ideas about Iranian kinship (the father). Many other scholars, in contrast, argue that temporary marriage is not required for donation. 30 However, infertility is said to be one of the grounds for divorce in Iran. 31 According to the Iranian Civil Code, if a man or woman is barren, either of them is eligible to file for divorce. It is worth noting that a man can also seek a second wife, since polygamy is permitted in Islam. Of course, a man cannot establish a second marriage without permission from the [family] court and the consent of his first wife. This is why the traditions of Iranian society, in my opinion, do not support polygamy and view it as an unpleasant and frowned-upon phenomenon. It is still hard for a man or woman to remarry after divorce or the death of a spouse, although the conditions vary greatly when various factors such as family background, financial status, and social status come into play in different cities. Meanwhile, taking a temporary wife - in order to avoid polygamy and divorce - has become an accepted way of resolving the issue of infertility in Iranian society. In this particular situation, the first wife or his [close] relatives find a woman - usually from a lower class family or a remote village - prepared to marry him temporarily for an agreed amount of compensation, to bring him a child. The temporary wife must then leave the child in the care of the man and renounce all rights over the baby. Consequently, the man and his first wife will have offspring. 32 The acceptance of surrogacy and egg donation, I would argue, has emerged in this cultural groundwork. In other words, the definition of assisted reproduction already existed in the culture, in a way, and has not come into existence through technology alone. Khı ¯sha¯vandı ¯ rida -ı ¯: suckling Suckling ( rida in Arabic or shı ¯r khordan in Persian), 33 like filiation and affinity, is another type of kinship defined in Islamic law and jurisprudence, and is also culturally recognized as a legitimate means of creating ties of relations. In general, the issue of breastfeeding ( shı ¯r-dehı ¯ ) holds a special position. Besides the constant importance attached to the mother’s milk as the best and most perfect food for an infant, 34 the breastfeeding of another woman’s child or wet-nursing, 30 We return to this issue in the next chapter. 31 In the past ten years that I have focused my research on reproduction in Iran, I have also come across women who have divorced their husbands due to his sterility and married [another person] afterwards. 32 The movie “Leila” by the renowned Iranian filmmaker Dariush Mehrjouie is a great example of this genre. 33 Also in the Persian term the emphasis is on the “act of suckling” and not on the substance of “milk”. 34 Attention has also been given to the methods and the length of breastfeeding, the breast- 51 The Iranian kinship system either in charity or for payment, has also been given much attention by jurists and religious scholars. 35 Islamic legal sources recognize children who have suckled from the same woman as milk sibling and prohibit their marriage to one another for reasons of incest. In other words, the milk bond created between the infant and the wet nurse constitutes the basis for kinship relations other than those created through ties of affinity ( sabab-ı ¯ ) and filiation ( nasab-ı ¯ ). Although the foster relationship was a pre-Islamic custom, Islam accepted it and laid down rules ( ah ˙ ka¯m ), conditions ( shara¯yet ), and even ethical codes ( a¯da¯b ) to regulate it. The milk bond or suckling constitutes a marriage prohibition and establishes permanent legal relations between the child and the milk mother - who suckles the child - and subsequently between all the other members of the milk mother’s kin, including her husband and his kin, with no inheritance rights. Marriage prohibition with the milk mother and the milk sister is laid down in the Qur’an (4: 23). However, following the hadı ¯th (saying) ascribed to the Prophet Mohammad that “whatever is forbidden by nasab is forbidden by rida [suckling],” the marriage prohibition was also extended to other milk relations. The Shia position, which is codified in Book 7 of the Iranian Civil Code (Article 1046), deals with the issue of milk kinship and stipulates that kinship relations created by the act of suckling ( khı ¯sha¯vandı ¯-ye rida -ı ¯ ), not by the milk as substance, are equivalent to kinship relations created by nasab ( khı ¯sha¯vandı ¯-ye nasabı ¯ ) as far as impediments to marriage are concerned. Furthermore, Shia scholars add many more conditions and rules, which are very detailed and complex arguments in their own right. For example, two of the prevalent opinions among Shia scholars, which are also part of the above-mentioned Article 1046, are that the milk of the woman must be generated by a haml-e mashru’ (legitimate conception), and that the milk must be received directly from the breast and should not be taken, in particular, from a bottle. This implies that what is important is the physical act of suckling (the physical connection between the milk mother’s nipple and the child) in the constitution of kinship ties, rather than simply the transmission of bodily substances or the “reinforcement of the agnatic relationship” that He´ritier argues for (1999: 276). What is perhaps more important is the implication of the matrimonial union and the legitimacy of sexual relations in the constitution of such an elective kinship. feeding wage (mozd), the weaning of the child from the breast and both father’s and mother’s duties during the breastfeeding period. See Nazari Tavakkoli ( 2006 : 17 - 148 ) for a detailed discussion of these aspects in Shia jurisprudence. 35 Attention has also been given to the selection of the wet nurse. Besides the ability to breastfeed, other factors such as mental and physical health, chastity and even beauty have also been taken into consideration (see Nazari Tavakkoli 2006 ). 52 Ideas about Iranian kinship Nevertheless, although suckling as a type of kinship system may have lost its socio-cultural importance in today’s Iranian society, its transformative mechanism to establish other types of kinship relations (both in legal and moral terms) is still apparent, as we will see in the context of assisted reproduction. 36 In fact, as Godelier (2011: 80), following Fortes (ibid.: 120) writes: All of the transformations that occur in a kinship system always (if the society continues to exist) lead to the establishment of another type of kinship relations, to the appearance of another kinship system. Changes in kinship never produce anything but more kinship [ … ]. (italics in the original) However, suckling as a legal and moral institution has always been a debatable issue among religious authorities and legal experts in Iran. With the introduction of surrogacy as a form of assisted reproduction, the issue of milk kinship has once again gained prominence and many religious legal and civil legal articles have been published in this regard (see chapter 3). The issue of suckling comes into consideration in much of this literature, and scholars refer to it in constructing their arguments regarding surrogacy. At the same time, the Shia religious authorities have different viewpoints about it, as we shall see in the next chapter. But, I would argue, making the comparison between surrogate mother and milk mother may be one of the reasons that has made surrogacy a more acceptable type of assisted reproduction in Iran. For instance, the website of Royan Institute and Infertility Clinic includes the following information on surrogacy ( rah ˙ em-e ja¯ygozı ¯n ): 37 The procedure does not imply any shar ı ¯ [religious] and qa¯nu¯nı ¯ [legal] 38 restrictions, and it is being administered in Iran. The [infertile] couple can either introduce a volunteer to the infertility treatment centre to perform the surrogacy or they can seek help from the centre. In the Royan Institute, there is a list of volunteer women for surrogacy, who will be available to assist if the couple require it. Considering the fact that the gestational carrier will endure the hardships of pregnancy, it is customary ( orfı ¯ ) and acceptable for the infertile couple to compensate her financially. From the religious viewpoint [ shar ı ¯ ], the surrogate is considered like a milk mother ( ma¯dar rida ı ¯ ) since she has a blood relation [ erteba¯t-e khu¯nı ¯ ] with the 36 One should note that the idea of support and assistance existed in the act of breastfeeding of another woman’s child in the case where the mother had difficulty in breastfeeding her own child. This aspect has not been the subject of attention in studies of milk kinship. This idea of woman-to-woman support, as we will see, appear also in the context of surrogacy. 37 See Royan’s website http: / / www.royaninstitute.org/ cmsfa (accessed on 14 October 2015 ). 38 Chapter 3 considers the relationship between religious jurisprudence and civil law in the formation of such regulations in Iran. 53 The Iranian kinship system baby; hence, issues such as inheritance and mother-child rights do not apply to them [the surrogate and the child] according to law. In short, breastfeeding is the dominant form of infant feeding in Iranian culture. During the ten years that I have spent researching in Iran, there were instances I came across or accounts that I heard through other people about mothers who did indeed have difficulty breastfeeding; either the supply was not sufficient or they were not able to breastfeed at all. The majority of them had tried bottlefeeding with infant formula. A few of them resorted to a wet-nurse through friends, neighbours, or even charity centres to breastfeed their babies for a certain period of time, while paying compensation for the service. 39 There were also two cases of surrogacy where the baby was given to another woman (not the surrogate) after delivery to be breastfed. Adoption in normative and pragmatic perspective Informal adoption of a sibling’s child, in which the child’s parents allow their infertile sibling to take parental responsibility for their child without obtaining legal guardianship or custody, has been long practised in Iran, and my findings show the transformation of this kind of kinship arrangement - a domestic arrangement without creating any legal relation - into the formal practice of embryo donation between close relatives, particularly siblings, as we shall see in the story of Shokoofeh and Azar in this chapter (see below). The Iranian Civil Code, in accordance with Islamic law, does not acknowledge adoption, as we know it today. But, in 1974, a law was ratified in Iran that created some of the legal effects and social functions of adoption ( farzand-kha¯ndegı ¯ ). According to this law, entitled the ‘Act of Protection of Children Without Guardians’, infertile Iranian couples residing in Iran can adopt children without any guardian ( sarparast ) under certain conditions, whereby the child is given the name of the adoptive parents (forbidden in other Islamic normative settings). According to this law, the responsibilities of the adopting couple and the adopted child are the same as those of ‘real parents’ ( pedar va ma¯dar-e va¯qe ı ¯ ) and their child in terms of custody, education, alimony and respect; but this adoption does not include inheritance rights and does not affect the legal consequences of the natural relationship between the child and its real parents (Safai and Emami 2007: 277-285). 40 As we will see, the legal regulation of embryo donation is very similar to regulations concerning adoption in Iran (see chapter 3). 39 Paying compensation to nannies (da¯yeh) and wet-nurses or milk mothers has always been discussed in religious legal and civil legal texts, and it is recommended. The same is true for surrogacy. Many religious authorities reiterate the idea of paying compensation to the surrogate mother for the service provided, as we will see in the chapters on surrogacy. 40 For the content of the law, see the Iranian National Organization for Civil Registration’s 54 Ideas about Iranian kinship However, almost all the infertile couples I met during my research preferred embryo donation and surrogacy to adoption; adoption was less favoured and in some cases it was not even considered as an appropriate option. This, I would argue, is mostly due to uncertainty about the parental background of adoptive children and the problem of illegitimacy. However, many infertile couples I interviewed pointed to the complexity of legal procedures and the strict conditions for adoption in Iran as the main reasons for their lack of enthusiasm about this remedy for childlessness (as in Bokaie et al., 2012: 429-434). 41 More recently, in 2013, the new adoption law, entitled the ‘Act of Protection of Children and Adolescents Without Guardians or With Irresponsible Guardians’, was approved to facilitate the conditions of adoption in Iran, giving, for instance, Iranian couples living abroad and single Iranian women over thirty the right to adopt a child (in the latter case only a female child, to whom is given the name of the adoptive mother). Conditions are included in this law for the protection of adoptive children and covering issues pertaining to inheritance and marriage in Islamic law. 42 A note on mah ˙ ram, na¯mah ˙ ram: a socio-legal view on incest In Islamic legal tradition, social and sexual interactions between the two genders are defined by the division of men and women into two reciprocal categories of mah ˙ ram and na¯mah ˙ ram. A Persian-English law dictionary (Varasteh 2011: 1006) translates mah ˙ ram as “of close relationship” and “with whom marriage is prohibited”, and mah ˙ a¯rem , the plural of mah ˙ ram , as “very near relatives” and “nonmarriageable persons” (ibid.: 1006). For the term na¯mah ˙ ram , it gives “not intimate” (ibid.: 1076), which in a normative perspective refers to someone before whom a Moslem woman is supposed to veil herself. A Persian-English dictionary of (religious) knowledge ( farhang-e ma a¯ref ) 43 translates mah ˙ ram as used in Islamic mysticism ( erfa¯n ), as “intimate”; and as used in Islamic jurisprudence ( fiqh ) as “close relative” and “congenial person” (Khodaparasti 2005: 673). Thus, na¯mah ˙ ram are potential marriage partners (marriageable) with whom sexual rewebsite: https: / / www.sabteahval.ir/ Default.aspx? tabid=174 (accessed on 10 June 2015 ); for more on the religious legal and civil legal aspects of child adoption in Iran, see Shariati Nasab ( 2011 ). See also, Sardoueinasab ( 2013 : 29 - 38 ). 41 Some couples in my study were also cautious because adoption, according to Islamic law, does not constitute a ‘natural’ relationship and thus mah ˙ ramı ¯yat (marriage prohibition). See below on mah ˙ ramı ¯yat. 42 For the content of the law, see http: / / rooznamehrasmi.ir/ Laws/ ShowLaw.aspx? Code=1344 (accessed on 10 June 2015 ). 43 In Chapter 4 I will give an overview of the relationship between fiqh (Islamic jurisprudence) and h ˙ oqu¯q (civil law) in the Iranian legal tradition. 55 The Iranian kinship system lations without having a marriage contract - permanent or temporary - is forbidden. Na¯mah ˙ ram could be either a close relative like a cousin or a stranger ( gharı ¯beh ). The rules on marriage and its prohibition, incest and adultery, veil and dress code result from such reciprocal categories. Mah ˙ ram is an unmarriageable member of kin with whom having sexual intercourse is taboo and would be equated with zina¯-ye ba¯ mah ˙ a¯rem or “incest”. As in Arabic, there are no Persian terms to indicate incest and incestuous, but, as stressed by van Gelder (2005: 4), this does not mean that these concepts are unknown or do not exist. In general, in Islamic family law, zina¯ refers to all varieties of illegitimate sexual intercourse between a man and a woman, applicable to married and unmarried persons. It is also analogous to “adultery”, “fornication”, “incest” and “incestuous adultery” as well as “rape” (see table 1; see also Kohlberg 1985). Table 1: Comparison of some definitions and translations of zina¯ zina¯ kardan to commit adultery, to fornicate zina¯-ye ba¯ mah ˙ a¯rem incest, incestuous adultery zina¯-ye be o nf rape (o nf means “force”) zina¯-ye moh ˙ saneh / zina¯-ye moh ˙ san adultery , sexual intercourse with a married woman / married man (moh ˙ saneh means “married woman”; moh ˙ san “married man”) zina¯-ye gheyr-e moh ˙ saneh/ zina¯-ye gheyr-e moh ˙ san fornication, sexual intercourse with an unmarried woman/ unmarried man zina¯za¯deh illegitimate child born out of wedlock, bastard In this context, the key term relating to the concept of incest is mah ˙ ram (unmarriageable member of kin). Mah ˙ ram entails the notions of prohibition, social proximity and intimacy. 44 When applied to people, mah ˙ ram is a relative, either male or female, with whom marriage is forbidden, but close social contact is allowed; for example, veiling is not required for a woman. In Iranian family law (see e.g. Safai and Emami 2004: 22ff), a mah ˙ ram relationship is established through consan- 44 Mah ˙ ra¯ma¯negı ¯ (“confidentiality”) is another concept derived from the term mah ˙ ram. One of the important concerns in the context of third-party reproduction is the principle of confidentiality (mah ˙ ra¯ma¯negı ¯). In chapter 4 I will address the implications of this principle in the Iranian context. 56 Ideas about Iranian kinship guinity, marriage and suckling (again, not the substance of “milk”): In other words, mah ˙ arem (unmarriageable members of kin) are divided into three groups: mah ˙ arem-e nasabı ¯, mah ˙ arem-e sababı ¯ and mah ˙ arem-e rida ı ¯. Firstly, mah ˙ arem-e nasabı ¯ (those based on consanguinity even created by zina¯ ) include one’s father / mother, children, brother / sister, paternal / maternal ancestors, paternal / maternal siblings and siblings’ children but not cousins (either parallel or cross). 45 Secondly, mah ˙ arem-e sababı ¯ (those based on affinity) include one’s husband / wife, parents and maternal / paternal ancestors of spouses, spouses of children and their children but not wife’s sister and husband’s brother. Finally, mah ˙ arem-e rida ı ¯ (through the act of suckling) include milk siblings, one’s milk mother / father and their direct kin. Thus, one could argue that incest prohibition here functions in two ways: on the one hand it creates the possibility for marriage outside the family (Le`vi-Strauss’ theory); on the other hand it ensures and regulates gathering and cooperation within the family (Malinowski’s theory). 46 We can therefore see that the concept of incest is related to the concepts of prohibition, taboo, adultery, marriage and to other juridical-theological and sociocultural regulations. 47 On the contrary, this concept of incest is not related to the concept of “inbreeding”. Iranian practitioners and scientists refer to the Persian term “ daru¯n-za¯ı ¯ı ¯ ” (literally “to produce within”) as equivalent to “inbreeding” and “endogeny”. Thus, in my view, from the analysis of these definitions, concepts and marriage rules, we can develop a socio-legal understanding of incest beyond the biological or psychological explanation of it. In the next chapters, this socio-legal understanding of incest and adultery will be discussed in more detail around the religious legal permissibility of assisted reproduction. 45 Both cross and parallel cousin marriages are allowed and practised in Iran. I discuss this issue in chapter 8 . 46 Godelier ( 2011 : 327 - 376 ) refers to similar functions in the Na society. 47 Schneider, for example, does not tie the concept of incest to prohibitions, taboos or any other sociocultural regulations, whereas Tylor, Mead and Malinowski do relate incest to sociocultural regulations (Shepher 1983 : 25 - 43 ). The literature on incest is extensive. A good summary and bibliography of the main theories can be found in Robin Fox’s critical account, The Red Lamp of Incest: An Enquiry into the Origins of Mind and Society (Fox 1983 ). Joseph Shepher’s Incest: A Biosocial View ( 1983 ) also provides a comprehensive survey of the theoretical literature on incest. His study is a contribution to the development of the sociobiological theory of incest. See also Kuper ( 2002 ) for a theological and legal explanation of incest in Victorian England. In addition, for an excellent recent contribution to the issue of incest and marriage prohibition, see David Warren Sabean’s works on Germany (Sabean 2002 a and 2002 b). 57 Kinship as a grammar of social proximity Kinship as a grammar of social proximity The Iranian kinship system is bilateral and flexible and includes horizontal much more than vertical relations. They consist of relations between father, mother, and women and men who enter the family structure by way of marriage as the daughter-in-law and son-in-law. In extended relations, the system includes both paternal and maternal grandparents on the one hand, and aunts (mother’s sister, and father’s sister), uncles (mother’s brother, and father’s brother), cousins and their spouses on the other. In some families, it is normal for two cousins to marry each other. However, it is, generally speaking, a flexible system where ultimately each individual determines the extent of closeness or otherwise in the relationship. In some families, maternal relatives are regarded as more important, whereas other families may regard paternal relatives as closer. Some families exhibit matriarchal values while patriarchal values are more dominant in other families. But they cannot be identified as a fixed structure; they are constantly changing due to fluctuations in the values of Iranian society. To develop an analytical concept, I define kinship in this context as a grammar of social proximity, and by grammar I mean certain legal and ethical norms and values that form the social proximity and regulate it in the dynamic framework of the society. These norms and values have roots in two cultural systems; Iranian culture where these norms and values stem from the moral system of the ancient world, with significant emphasis on purity and impurity, and Islamic culture where this norm and these values are mostly defined in the form of rights and obligations. In such a context, it could be argued that Schneider’s culturalism and Sahlins’ definition of kinship as “the mutuality of being” (Sahlins 2013) are of no help to us in defining what kinship is all about. Hence, as Hamberger (2013: 306) rightly notes in his comment on Sahlins, “what turns paternal and maternal, consanguineal and affinal, horizontal and vertical relations into kinship relations is not some mysterious intrinsic quality they have in common, but the fact that they from part of a common logic which differentiates them from each other and frequently opposes them to each other”. It seems to me that the approaches discussed in this chapter emphasize this common logic. So far in this chapter, I have provided a brief overview of some key points concerning the characteristics of the Iranian kinship system that we need to keep in mind when analysing contemporary Shia legal debates on technologies of assisted conception and the regulations and implementation of these technologies in Iran. In the next chapter, I concentrate on the Shia theological legal approach to assisted reproductive technologies. In chapter 4, I first introduce some ideas concerning the nature of the Iranian legal system, in order to under- 58 Ideas about Iranian kinship stand the formation of laws and regulations on reproductive technologies, and then focus on the Iranian embryo donation law. But let me first, in the remainder of this chapter, draw on another ethnographic case study concerning the use of embryo donation in the treatment of infertility to outline some religious and cultural factors that are of particular importance in understanding the regulatory framework for assisted reproduction in Iran and the relevant legislation and administrative policies. This case involves a familial embryo donation between the wives of two brothers. The Case of Shokoofeh and Azar Shokoofeh, a twenty-nine year-old housewife, has lived comfortably with her husband for eight years in Tehran. Her husband was diagnosed with infertility and they have gone through different treatments since the first year of their marriage. Shokoofeh’s twenty-three-year-old sister-in-law, Azar, has been married to Shokoofeh’s husband’s brother for nine years, and they live in Tehran with their six-year-old daughter and their two-year-old son. Shokoofeh and Azar live in a three-flat apartment complex, with one flat occupied by their motherin-law. Azar and her husband are willing to donate embryos made from their own gametes to Shokoofeh and her husband. I interviewed Shokoofeh and Azar separately in an IVF clinic located in a private hospital in Tehran in December 2006. Azar and her husband had accompanied Shokoofeh to the clinic. Later, Shokoofeh told me that her husband was too occupied with work in their family-run office to join her. His younger brother was off to Dubai for business, so her husband had to stay and run the office. In addition, he was assured that she would be in good company with his brother (i.e., Azar’s husband) and Azar. Shokoofeh and Azar - members of a comfortable and non-conservative but religious upper-middle class family - were both meticulously dressed in neat chadors and high heels and looked very happy and hopeful. In response to my question as to how she regarded an embryo donated by her ja¯rı ¯ (sister-in-law, husband’s brother’s wife), Shokoofeh told me of the time Azar was pregnant with her second child: Azar suggested to us that we have the baby she was pregnant with, but I said no. At that time, Azar had a daughter and I asked her, “What if you give birth to a boy? ” She replied: “So what? I will get pregnant again and have another boy for myself.” But I was thinking what would happen later if she could not bear another boy for herself. My mother-in-law did not disagree with her 59 Kinship as a grammar of social proximity suggestion either. But my mother did not seem too happy about it. She was very upset and she thought if I waited a bit more, I would get pregnant myself. As I have mentioned above, informal adoption of a sibling’s child has long been practised in Iran, and my findings show the transformation of this kind of domestic kinship arrangement into the formal practice of embryo donation between close relatives, particularly siblings, as we shall see in the story of Shokoofeh and Azar. Azar’s suggestion, however, was rejected and she gave birth to a healthy boy. But Shokoofeh’s childlessness was still a subject of discussion, as she explained: One day, while the three of us [Shokoofeh, Azar and their mother-in-law] were sitting and talking, the embryo donation option was brought up. I had heard about it before in an infertility clinic. I told them that there was such a thing as embryo donation and it could be a possible choice for us. Azar enthusiastically welcomed the idea. She was initially intending to get pregnant for me, but I told her that I did not want her to go through pregnancy and delivery for me, but I would accept her offer if she could donate an embryo to me instead. She agreed and said that in fact it was a better solution since she would not have the same maternal feelings for a baby she was not carrying and delivering. After they reached an agreement between themselves, Shokoofeh and Azar decided to consult a religious authority to discover whether embryo donation was religiously permissible or not. Shokoofeh continued: Finally we all agreed on embryo donation and in order to get things straightened out, we called our marja -e taqlı ¯d [religious authority]. We asked him about embryo donation and whether it was not in contradiction with shar ı ¯ [religious] principles. He said there was no problem with embryo donation but using donor sperm was questionable. I would have never looked into sperm donation myself [ … ] but the way he explained embryo donation was that since the embryo was from a married couple’s egg and sperm it didn’t raise any contradictions [ … ] my body is like a medium and the embryo continues to grow inside it. This interpretation made us really happy. We saw our doctor and he referred us to this clinic. 60 Ideas about Iranian kinship It was after the religious and medical consultation that Shokoofeh and Azar got ready for embryo donation. At the time Azar was still breastfeeding her eighteen month-old son. In order to get better ovulation, the egg donor should stop breastfeeding before the procedure begins. Shokoofeh explained: “It was not fair to take his mother’s milk away from him but Azar stopped breastfeeding her son quite early [ … ] she told me she wanted me to get pregnant as early as possible.” Similarly, and as in Mashyana’s narrative with which I began, many of the women and men I interviewed, particularly in the case of egg and embryo donation, referred to the physical experiences of pregnancy, childbirth and breastfeeding in their narratives. The ability of the woman using a donated egg or embryo to carry, bear and breastfeed the child makes it easier to “normalize” the use of donor gametes in the treatment of infertility. This gestational conception of motherhood, however, is in contrast to the majority of fiqhı ¯ conceptions of motherhood that lie at the heart of the embryo donation law and consider the contributor of the egg and sperm as the legal mother and father; whereas in the case of surrogacy, this conception, as my findings show, is widely considered to be in conformity with the fuqaha¯ ’s conceptual model of maternity that ascribes maternity to the originator of the egg and not to the woman who gives birth. 48 In all cases, however, “motherhood itself remains understood as a deeply natural desire and goal, despite the extraordinary technological measures necessary to achieve it” (Kahn 2000: 62), as evident in Azar’s words: I wanted her to become a mother and experience motherhood. We live in the same building. Every time she came to my house and saw my children, I felt bad for her. I thought I should do something for her. I even offered to give birth to a baby for her but that was not a good idea. But embryo donation is different [ … ] she will give birth to a baby, breastfeed [ … ] we are really glad to donate an embryo to her [ … ] It doesn’t matter that the embryo is from us [ … ] when she goes through the pregnancy, she will be the mother of the child. In the case of Shokoofeh and Azar, the closeness of the marriage relations also means that issues over filiation are more manageable. I asked Shokoofeh what her husband’s opinion of embryo donation had been. As well as being a couple, Shokoofeh and her husband are close kin. Shokoofeh explained: “We had family ties even before getting married. Our grandfathers were brothers and they married two sisters who became our grandmothers. My brother-in-law [Azar’s husband] is my close relative anyway.” She continued: 48 See the next chapter for further discussion. 61 Kinship as a grammar of social proximity My husband and his brother are very close to each other and they work together as well. My husband did not come to the clinic today but he feels confident since his brother is with us [ … ]; he had no problem agreeing with embryo donation. He tells me “it is from my brother but since you will give birth to and breastfeed the baby, it is ours” [ … ]. My mother-in-law says the same thing [ … ]; anyway, it is her son’s [infertility] problem. I met Azar in the clinic one more time when Shokoofeh was in the operation room for embryo transfer. This time, their mother-in-law was also with them. Azar pulled me aside: The doctors say not all of the embryos are complete and they can only transfer two of the embryos and there is a chance that it won’t work. I told Shokoofeh: “Don’t worry! I will donate as many embryos as I can until one of them makes you pregnant” [ … ]. I do not care how long it takes [ … ]; it is God’s will to make it happen. The story of Azar and Shokoofeh is not exceptional. My studies show that embryo donation and surrogacy, as well as egg donation, have enjoyed relatively rapid growth in Iran. For instance, in a study that took place in Qom in 2008, more than half of infertile women expressed a positive viewpoint about surrogacy. 49 In my study, despite immediate acceptance of surrogacy by some infertile couples, the majority I interviewed only gradually came to accept the use of surrogacy and embryo donation as the only hope for becoming parents after losing complete faith in other available infertility treatments. However, there were a few couples in my study who did not accept the idea of embryo donation and surrogacy. As the director of an infertility and IVF clinic in Tehran put it: There are issues in Islam which mean that, despite them being legal, people will not take them into consideration due to the fact that they follow a particular marja . This is true in embryo donation. We even have people who are against blood donation … they are very rigid in such subjects. There was a case in which we recommended embryo donation to a couple. However, they said that they followed such-and such a marja and he had advised them not to 49 See Ahmari Tehran et al., 2010 and 2014 for more attitudes towards surrogacy in Iran. 62 Ideas about Iranian kinship pursue it, as eh ˙ tı ¯ya¯t ˙ -e va¯jeb [a precautionary measure]. This is while there is a law with regard to embryo donation, which has been ratified by the parliament and the guardian council. 50 Nevertheless, to understand the legal regulation of assisted reproduction in Iran, it is important to stress that, in accordance with the religious, cultural and legal background described above, the use of assisted reproductive technologies is socially and religiously acceptable and considered legitimate. This and many of the concerns and challenges mentioned in the above cases have clearly influenced the formation and development of regulations and legislation concerning embryo donation and surrogacy in Iran, alongside practical and ethical considerations. The next chapter is an analysis of the moral reasoning embedded in the Shia theological legal discourse on reproductive technologies, and how this tradition interprets assisted reproduction. 50 Author’s interview, Tehran, September 2010 . 3. Shia approaches to assisted reproductive technologies Sexual intercourse [ ham bastar shodan , literally “sharing the same bed” in Persian] between husband and wife is one of the regular ways to make children. Artificial insemination is another new way, and cloning [ shabı ¯h-sa¯zı ¯ ] could be another way. Thus, the act of fertilizing the wife’s ovum outside the body with the husband’s sperm and then transferring the fertilized egg into the wife’s or another woman’s uterus or even into an artificial uterus in order to conceive a child have the same legal implication as sharing the same bed in which legal intercourse takes place between a woman and her husband. Author’s Interview with Ayatollah Mohammad Mo’men, 13 October 2006, Qom The fact that culture may negate even the most basic procreative bond supports particularly well the claim that human affairs are freed from the influence of genealogical kinship. But whether the mother’s role in procreation is recognized or neglected - whether in any particular society the “genealogical grid” applies to motherhood or does not - the fact remains that motherhood creates genealogical kinship. Whatever the ideology of procreation, the biological facts of pregnancy, parturition, lactation, and maternal care translate into matrifilial links. And regardless of cultural beliefs in the procreative role of mothers, matrifiliation generates preferential bonds between maternally related kin. Bernard Chapais (2008: 55), Primeval kinship: How Pair-Bonding Gave Birth to Human Society This chapter proposes an analysis of the legal reasoning embedded in Shia theological discourse on reproductive technologies, and how this tradition interprets assisted reproduction. 1 I will examine the normative positions of Shia authorities on a range of issues related to reproductive technologies from artificial insemination and sperm donation to surrogacy arrangements. My aim is to explore some aspects of religious legal hermeneutic strategies that have shaped the Shia approach towards assisted conception. I will describe some prevalent Shia juridical moral values and reasoning surrounding conception, kinship relations, marriage, procreation and sexuality that are influential in the context of the Iranian regulations, legislation and application. 1 Again, by “Shia” I do not refer to the Shia communities and populations around the world. The term embodies the specific conceptual and objective characteristics that have been formed by Shia Islam in Iran. 64 Shia approaches to assisted reproductive technologies In Islamic normative debates, applications of science and technology that can maintain and improve the health and wellbeing of individuals and families are generally accepted. However, with regard to assisted reproductive technologies and donor procedures in particular, the major religious concerns (besides their permissibility) are the offspring’s legitimacy and the determination of nasab (legal filiation, relation between parent and child). From this standpoint, most contemporary Shia scholars - differences of opinion notwithstanding - adopt a pragmatic and permissive approach to assisted reproductive technologies and, as I argue in this chapter, tend to consider them as supportive of the preservation of nasab (filiation, relations of kinship). In contrast, Sunni Muslim scholars tend to emphasise the danger these practices introduce into filiation and the family order, and thus reject the use of donor gametes and surrogacy arrangements in the reproductive process. 2 I argue that this is because of the different representations of lineage and legitimacy in the two traditions: whereas Sunni notions of nasab place more importance on the male line (agnatic filiation), Shia notions take on a more gender-balanced structure under which maternal and paternal filiation are clearly distinguished and in many regards complementary and symmetrical. 3 As such, when it comes to assisted reproductive technologies, nasab is a key concept of fundamental importance. Shia scholars justify assisted reproduction on the basis of the need to determine relations of filiation ( nasab , both paternal and maternal) resulting from the use of reproductive technologies. The issue of assisted reproduction has raised many questions, and religious scholars have divergent opinions regarding it. However, the following questions are primarily addressed in the arguments of Shia scholars regarding assisted reproduction. Is artificial insemination ( leqa¯h-e masnu¯ ı ¯ ) religiously allowed? Are procedures such as the use of donor sperm, eggs, or embryos and surrogacy arrangements permitted? Does artificial insemination with donor sperm constitute zina¯? Is it allowed to fertilize the woman’s egg with the sperm of a man other than her husband? And if so, what is the legal status of the child conceived with donor gametes? Should a child conceived in this way be considered an illegitimate child? Who should be the father and the mother of the child: the owner of gametes and uterus or the recipients of the gametes? How should the rules of inheritance ( ah ˙ ka¯m-e erth ) and marriage ( ah ˙ kaa¯m-e ezdeva¯j ) be applied? 4 In sum, the most important question is the issue of the nasab of the child, both paternal 2 On this issue, see for example, Houot ( 2012 : 53 - 69 ). On the consensus against surrogacy in Sunni Islamic law see Shabana ( 2015 ). 3 For more on the question of kinship and filiation in Sunni Islam, see Eich ( 2012 ). 4 For a detailed study of Shia legal debate about filiation and inheritance in the context of third-party reproduction, see (Ayatollah) Gheblei Khoei ( 2008 ). 65 Establishing paternity: artificial insemination and donor sperm and maternal ( pedariı ¯ and madarı ¯ ), and how paternity and maternity should be established. We will now examine how these issues are addressed in Shia fiqh . Establishing paternity: artificial insemination and donor sperm With regard to male-factor infertility, most Islamic scholars approve of artificial insemination if the husband’s sperm is used. The idea of using donor sperm has been controversial. Most Shia authorities raise moral objections against the insertion of the semen of a “stranger” ( bı ¯ga¯neh or ajnabı ¯ ) into the woman’s uterus. Particularly, following a hadı ¯th attributed to the sixth Imam Ja’far Sadeq (702-765 AD), “He who will receive the worst tortures on the day of judgement is the man who placed his seed in a womb forbidden to him”, artificial insemination using the sperm of a donor other than the husband is considered by most Shia authorities to be prohibited. 5 However, without a sexual act involved, most scholars consider the offspring to be legitimate, 6 and the originator of the sperm is considered the father of the child. Yet Shia authorities recognize other possibilities for the treatment of male-factor infertility: most authorities prefer IVF, ICSI (intracytoplasmic sperm injection) and the use of embryo donation; 7 a minority permit the insemination of the woman’s egg with the donor’s sperm under laboratory conditions, and then the implantation of the fertilized egg into the wife’s uterus, as long as no forbidden act, such as gazing or touching, has taken place. 8 For instance, according to the fatwas of Ayatollah Khamenei, the supreme religious leader of Iran (Samadi Ahari 2004: 33) and some senior Shia clerics like Ayatollahs Mohammad Shirazi (Samadi Ahari 2004: 39), Mosawi Ardebili (Samadi Ahari 2004: 46), Qomi (Rezaniya Mo’allem 2005: 196), and Ayatollah Seyyed Mohammad Musavi Bojnurdi (Rezaniya Mo’allem 2005: 197), in the case where the husband’s infertility leads to difficulties in the marriage, fertilization 5 There are two verses in the Quran that are used by many religious authorities, both Sunni and Shia, to argue that artificial insemination by donor sperm (not that of the husband) is not allowed. The first is: [ … ] and guard their private parts save from their wives and what their right hands own then being not blameworthy (but whosoever seeks after more than that, those are the transgressors) [ … ] (Sura 23 : 5 - 7 , trans. Arberry) The second is: Say to the believers, that they cast down their eyes and guard their private parts; that is purer for them [ … ]. And say to the believing women, that they cast down their eyes and guard their private parts, and reveal not their adornment save such as is outward. (Sura 24 : 31 , trans. Arberry). 6 Many rabbinic scholars follow the same legal reasoning (see, for example, Kahn 2000 ). 7 As in the examples of Mashyana, Shokoofeh and Azar in the previous chapters. 8 As a result of this permissibility, sperm donation is practiced in some clinics in Iran. 66 Shia approaches to assisted reproductive technologies of the woman’s egg with the sperm of a man other than her husband outside of the woman’s body and then the implantation of the fertilized egg ( janı ¯n ) in the woman’s uterus is allowed as long as no forbidden act ( fe el-e haram ), such as gazing or touching, has taken place. Thus, in response to the question concerning the artificial insemination by a man’s sperm other than the husband’s, some above-mentioned scholars give the following explanations: Question: “Is it allowed to fertilize the wife with the sperm of a stranger [ biganeh , here ‘a man other than the husband’], by placing the sperm in her womb? ” (Samadi Ahari 2004). Ayatollah Khamenei: “There is no problem as long as no forbidden act [ fe el-e haram ] such as touching and gazing has taken place” (Samadi Ahari 2004: 33). Ayatollah Mohammad Shirazi: “It is permissible with the consent of the husband and as long as no forbidden act [ fe el-e haram ] has taken place” (Samadi Ahari 2004: 39). Ayatollah Mosawi Ardebili: “There is a problem to the placing of a stranger’s sperm ( biganeh , ‘donor’s sperm’) directly into a woman’s uterus, but there is no problem to the fertilization of an egg outside of the womb and then implanting the embryo ( janı ¯n ) in the woman’s uterus” (Samadi Ahari 2004: 46). Clearly, a distinction can be made, in the context of the Shia debates, between the act of placing sperm directly into the woman’s uterus, which is not allowed according to the majority of religious scholars, and the act of implanting an embryo into the uterus of a woman - whether a surrogate or intended mother - for which there is religious moral permissibility. The in vitro embryo in this context is the result of a legal union and not the result of an illicit or impure ( na¯pak ) sexual act. 9 Legitimacy ( mashru¯ ı ¯yat , an Arabic concept) and purity ( pa¯kı ¯, a Persian concept) appear as the two important juridical moral values at the centre of these debates. 9 Many infertile couples - both religious and non-religious - that I interviewed referred to this distinction and preferred the use of embryo donation to sperm donation. Yet this opinion is not held by all authorities and individuals, which in effect leaves great latitude to medical practitioners and would-be parents, as one doctor who performed the entire range of donor procedures (including egg, sperm and embryo) at a private IVF clinic told me: “We offer all appropriate procedures for patients; it depends on the infertile couples which procedure they prefer.” 67 Establishing maternity: egg donation, surrogacy Establishing maternity: egg donation, surrogacy Traditional surrogacy, which also involves the insertion of sperm from a man other than the husband into the woman’s uterus, is not allowed according to the majority of scholars. In contrast, the practice of (gestational) surrogacy, in which the surrogate woman carries the embryo of a married couple, is, among the majority of Shia authorities, an accepted form of assisted reproduction. There is no consensus against surrogacy arrangements among Shia authorities; rather, according to the majority opinion, it is permissible to employ a surrogate and to serve as a surrogate from the viewpoint of Islamic law. 10 Again, a clear Shia distinction can be made here between the act of placing sperm directly into the female’s uterus, which is not allowed according to the majority of religious scholars, and the act of implanting an embryo into the womb of a woman, a new technological procedure in which the sperm and egg 11 of a married couple are combined outside the woman’s body and the resulting embryo is placed in a surrogate woman’s womb, for which there is clear religious permissibility. In other words, the prohibition is against putting the seed into the womb, which is forbidden to a man, and not against introducing an embryo. Thus, the use of gestational surrogacy and embryo transfer for married couples unable to produce a child is permissible, according to the abovementioned scholars (see e.g., Musavi Bojnurdi 2007: 102-24). The use of donated eggs raises the same concern as the use of donor sperm. As a shar ı ¯ solution, the temporary marriage ( mut a ) of the donor egg recipient’s husband and the egg donor has been proposed by some Shia scholars as a solution to legitimize egg donation. In this way, at the time of insemination, both the egg donor and the egg recipient are in the marriage bond - temporary or permanent - with the producer of the sperm (the father). However, as noted, there is no uniform viewpoint among religious scholars, especially when it comes to issues involving the third-party donation of eggs and sperm. For example following the same principle - the absence of sexual act - those scholars (see above) who permit sperm donation also permit the insemination of the donor’s egg in petri dish, no matter if the egg donor is married or single at the time of insemination. Ayatollah Khamenei and Merghati-Khoei, 12 for example, hold this opin- 10 Almost all Iranian lawmakers (h ˙ oqu¯qda¯na¯n) support this position and agree on the permissibility of surrogacy. On the legal issues relating to children born through surrogacy, see (Ayatollah) Mousavi Bojnordi ( 2007 : 102 - 124 ); for more on legal and fiqhı ¯ arguments in Iran concerning surrogacy arrangements, see Hamdollahi and Roshan ( 2009 ) and various authors ( 2007 : 35 - 168 ). 11 And in some cases donated eggs. 12 Mehr Khaneh - News Analytical Database Family And Women, 6 January 2014 . Available in Persian at: http: / / mehrkhane.com/ fa/ print/ 9690) (accessed on 3 December 2015 ). 68 Shia approaches to assisted reproductive technologies ion. In this case, the use of temporary marriage to religiously legitimate egg donation is not required. Of course, there are other authorities who have responded in a different and particular way to this issue. For example, Ayatollah Ma’refat (correspondence by letter and interview, 13 October 2006, Qom) compares egg donation with organ donation and states that transferring one woman’s egg to another woman’s uterus is allowed, and that the act of transferring the egg from one woman’s body and implanting it in another woman’s uterus reassigns the acknowledgment of maternity from the woman who contributed the egg to the woman who gestates and gives birth to the child. Likewise, Ayatolla Yousef Sane’i suggests that the donor’s relinquishment of his / her gamete and anonymous donation of it to a sperm, egg and embryo bank is an indication of obliterating the ties of nasab from the gamete owners. These interpretations permit egg donation even among close kin, for example between two sisters. Furthermore, temporary marriage is not required for donation. Nevertheless, in the cases of egg donation and surrogacy, which involve one woman’s egg and another woman’s uterus, the question arises of who should be considered the mother. Is it the woman who carries the child in her uterus, the producer of the egg, or both? Most Shia authorities (though not all) argue that the woman who contributed the egg should be regarded as the mother of the child. However, this view is not universally held. While a wide range of opinions exists, others ascribe maternity to the woman who gives birth to the child, and, some suggest that the child should be considered to have two real mothers. 13 In what follows, I examine some of these legal arguments. Firstly: the majority of Shia scholars (Rezaniya Mo’allem 2003: 355) hold the opinion that the producer of the ovum should be considered the mother. They argue that maternity, similar to paternity, is established at conception. This is the opinion of many leading Shia Ayatollahs like the late Khomeini, Yousef Sane’i, Mohammad Mo’men Qomi, Musavi Bojnurdi (Musavi Bojnurdi 2007: 113), Safi Golpayegani (correspondence by letter, 9 October 2006, Qom), Naser Makarem Shirazi (correspondence by letter, 11 October 2006, Qom), Montazeri, Sistani, and Khamenei. They give equal emphasis to both the maternal and paternal seed in the procreation of a child. Ovum and sperm therefore play an equivalent role in the conception. They argue that the principle whereby paternity is ascribed to the contributor of the sperm is also applicable to ascribe maternity to the con- 13 In this respect, rabbinic thinking about who is considered the mother is strikingly similar to Shia thinking. The majority rabbinic opinion holds that the woman who gives birth should be considered the legal mother, as described by Kahn ( 2000 ). But over the last few years there has been a change in thinking and the genetic mother is now considered the legal mother (see Jotkowitz 2011 ). However, a systematic comparison of Shia and rabbinic juridical thinking and structures is lacking. 69 Establishing maternity: egg donation, surrogacy tributor of egg. According to this argument, the definition of maternity is identical to the legal father-child relationship, which considers the father is the owner of the sperm; thus, the owner of the egg should be considered the mother (Rezaniya Mo’allem 2003: 317-62). They support this view with the Quranic verses that indicate the constitution of nasab (both agnatic and uterine) and the origin of the human being: And it is He who created of water [ al-ma¯’ ] a mortal, and made him kindred [by nasab ], and marriage [ sı ¯hr ] [ … ] 14 We created man of a [ nutfah ], a mingling. 15 In their discussion of these verses, they refer to the definition of khalaga men ma¯ (created from water) and men nutfah emsha¯j (from mixed semen) to explain the Quranic description of the creation of human life by God by mixing male and female fluids, the sperm and the ovum respectively. In their interpretation, the term ma¯ (water in Arabic) refers to the male and female fluids and it is from their mixing that the foetus is formed. In this interpretation, the male’s sperm and the female’s ovum have a symmetrical role in the formation of the foetus and the creation of the child and subsequently the constitution of nasab . Furthermore, in reference to emsha¯j , meaning “mixed” in Arabic, they argue that the phrase “ men nutfah emsha¯j means “from mixed nutfah ” and indicates the fertilized ovum resulting from the ovum of the woman and the sperm of the man. According to these Shia scholars (Rezaniya Mo’allem 2003: 327), the Quran does indeed make it clear that the formation of the human being starts with a single cell called nutfah emsha¯j , which is a mix of an ovum from a female and a sperm from a male (two ma¯ ). Thus, in the case of egg donation and surrogacy, the majority of Shia opinion ascribes maternity to the originator of the egg ( s ˙ a¯h ˙ eb-e tokhmak ). Among scholars, Ayatollah Yousef Sane’i, a Shia marja’ widely renowned as a theologian, Islamic philosopher and reformist scholar, is one of the most distinguished holders of this opinion. I collected his views regarding assisted reproduction published in different sources (e.g., Rezaniya Mo’allem 2005: 449-55; Various Authors 2003: 396; and Sane’i 2006), which can be summarized as follows: - Ayatolla Yousef Sane’i argues that the implantation of the fertilized egg ( nutfah-e emsha¯j shodeh ) of a married couple into another woman’s uterus to grow in it is allowed. According to him, in this case, the father and mother of the child are the originators of the embryo ( s ˙ a¯h ˙ eba¯n-e nutfah-e emsha¯j ). This permissibility facilitates gestational surrogacy arrangements. In this situation, the re- 14 Sura 25 : 54 , Arberry’s translation with the modification of “by nasab” for his “blood.” 15 Sura 76 : 2 , Arberry’s translation with the modification of “nutfah” for his “sperm-drop.” 70 Shia approaches to assisted reproductive technologies sulting child would be assigned to the couple providing the embryo (the intended parents for whom pregnancy is impossible) and not to the woman who carries it and gives birth to the child (gestational surrogate). - According to Ayatollah Sane’i, the child conceived through gestational surrogacy is not mah ˙ ram (unmarriageable member of kin) to the woman who carries the child in her uterus or to that woman’s husband, since the surrogate woman only carries the child in her uterus and is not the contributor of the egg, and her husband is not the contributor of the sperm. In fact, in the case of gestational surrogacy, the child should be considered to be related to the married couple who produced the sperm and egg for his or her conception, and not to the woman who carries and delivers the child. - According to Sane’i, a gestational surrogate can be either a married or an unmarried woman; she can be either mah ˙ ram (unmarriageable) or na¯mah ˙ ram (marriageable); even the wife’s sister ( kha¯har-e zan ) and the husband’s sister ( kha¯har-e shohar ) can act as a gestational surrogate. In other words, gestational surrogacy between siblings is permissible: a woman is allowed to deliver the child of her sister or carry the child of her brother in her womb and give birth to it. To give another example, Ayatollah Mo’men, 16 like the majority of Shia authorities, ascribes maternity to the producer of the egg. According to him, being the gestational carrier and giving birth does not established maternity. The Quranic verse (58: 2), “Their mothers are only those who gave them birth,” is used by many Islamic legal authorities, particularly among Sunni scholars, to argue that it is the gestational carrier and deliverer of the child who should be considered the mother (see e.g., Clarke 2009, Houot 2012). In disagreement with these authorities, Ayatollah Mo’men uses the same Quranic verse (58: 2) to argue that maternity should not be established by birth. The reason for disagreement is that this verse of the Quran (58: 2), according to him, was revealed for those men who compared their wives with their mothers by saying to them, “You are to me as the back ( z ˙ ı ¯ha¯r ) of my mother,” implying that they are as untouchable to them as their mothers (Mo’men 2006: 95-96). It should be noted here that z ˙ ı ¯ha¯r (literally 16 Ayatollah Mo’men is a learned and much respected high-ranking seminary cleric, one of the six faqı ¯h members of the Council of Guardians and a member of the Assembly of Experts. He is considered to be one of the preeminent and notable scholars of the Quranic sciences ( u¯lu¯m-e qora¯anı ¯) and fiqh. He has contributed to a number of articles on assisted reproduction and related topics in both Arabic and Persian (see chapter 4 ), and is frequently cited in academic publications on assisted reproductive technologies in Iran. I interviewed him on 13 October 2006 in Qom. 71 Establishing maternity: egg donation, surrogacy “back” in Arabic) was a pre-Islamic custom of repudiation or divorce, in which a husband could divorce his wife by verbally declaring to his wife “You are to me as the back of my mother.” Zı ¯ha¯r is rejected by Islam, but sexual intercourse with the wife is prohibited to the man who makes this pronouncement, until he makes expiation ( kaffara ) for his deed (see e.g., van Gelder 2005: 118-19). However, according to Ayatollah Mo’men, the Quranic verse (58: 2) “Their mothers are only those who gave them birth” refers to men who pronounce z ˙ ı ¯ha¯r and therefore it does not stipulate the criteria for maternity ( me ya¯ar-e ma¯darı ¯ ) in Shia fiqh ; “Thus, maternity should be assigned to the originator of the egg” (Mo’men 2006: 87). What are used in this interpretation are juridical arguments; maternity is established by reasoning and not by referring to biological facts alone. Furthermore, in the cases of egg donation and surrogacy, Ayatollah Mo’men argues that the child has natural relations with both women, but only the woman who is the provider of the egg is the legal mother of the child. He compares rah ˙ em (the uterus) with z ˙ arf (a container) and makes it clear that the gestational carrier just provides a place for the fertilized egg to grow in. Second - another opinion held by a group of Shia scholars is that the maternity of the child should be assigned to the woman who carries the pregnancy and gives birth to the child. This was the opinion of late Grand Ayatollah Khu’i, the late Ayatollahs Ma’refat (correspondence by letter dated 20 October 2006, Qom) and Tabrizi (correspondence by letter dated 9 October 2006, Qom), Ayatollah Araki, and the majority of Sunni authorities (Rezaniya Mo’allem 2003: 317-62). Those who hold this opinion argue that the Quranic verse “Their mothers are only those who gave them birth” relates directly to the point that the gestational carrier and deliverer of a child should be considered as the mother, which has been rejected by many Shia scholars, like Ayatollah Mo’men, as we saw above. Third - finally, another opinion held by a minority of Shia legal scholars is that maternity is established by two principles: one through formation ( takvı ¯nı ¯ ) and the other gestational ( h ˙ amlı ¯ or vela¯datı ¯ ). These Shia scholars argue that the child born as a result of gamete donation and gestational surrogacy should be considered to have two real mothers: one is the “contributor of the egg” ( s ˙ a¯h ˙ eb-e tokhmak ) and the other is the “gestational carrier” ( s ˙ a¯h ˙ eb-e rah ˙ em ). This is the opinion of Ayatollah Mosavi Ardebili (Rezaniya Mo’allem 2003: 355) and Ayatollah Sadeqi Tehrani (interview with Ayatollah Sadeqi Tehrani, 19 December 2006, Qom). According to these scholars, the establishment of two maternal relations at the same time does not cause any problem (in the establishment of filiation) since in parental relations, fatherhood and motherhood are also two relations that coexist at the same time. Hence, in the case of egg donation and surrogacy, the child has two maternal relations because they are both nominal ( e teba¯rı ¯ ) relations and from the legal standpoint, the simultaneous existence of both is possible (see also Hamdollahi / Roshan 2009: 170-171). 72 Shia approaches to assisted reproductive technologies Discussion In the Shia tradition, as in Islam more generally, there is no centrally organized clergy, but numerous independent religious authorities ( fuqaha¯ ; sing. faqı ¯h ) at any one time. According to the normative Shia model, a believer can choose one of these authorities as his religious reference to obtain legal guidance specific to his individual actions and situations. As a result of this decentralization, a practice that is allowed by some authorities may be forbidden for another group of believers who have chosen another religious authority as their marja -e taqlı ¯d (‘source of emulation’). Moreover, a faqı ¯h ’s ruling on a particular case, given its individual circumstances, might be different from the view he holds as a matter of general principle. In this respect, due to the potentially multi-centric nature of religious authority or marja’iya in Shia Islam, there is no monolithic and centralized Shia approach to new reproductive technologies. 17 Rather, as noted, Shia scholars’ responses to the appropriate uses of these technologies have been very complex and divergent. What is remarkable is the extreme conceptual and pragmatic flexibility of the majority of Shia religious authorities in issuing fatwas allowing the use of these technologies, while preserving traditional structures and principles of kinship at the same time. They range from the juridical permissibility and acceptability of artificial insemination by the husband’s sperm to the permissibility of embryo donation and surrogacy - forbidden in many Western and Sunni Muslim countries. However, a minority of Shia scholars, comprising the most high-ranking authorities, permit artificial insemination by third-party donor (sperm donation) in the case of the husband’s infertility, as long as no forbidden act ( fe el-e haram ), such as gazing or touching, has taken place. 18 This flexibility goes even further, to the point that some Shia scholars (like Ayatollah Sane’i) believe that the donor’s relinquishment ( e ra¯z ) and anonymous donation of his / her gamete to a sperm, egg and embryo bank obliterates the ties of nasab (legal filiation) from the gamete owners. Others, such as Ayatollah Ma’refat, compare egg donation with organ donation and affirm that transferring one woman’s egg to another woman’s uterus is allowed, and that the act of transferring the egg from one woman’s body to another woman’s uterus reassigns the acknowledgment of maternity from the woman who contributed the egg to the woman who gestates and gives birth to the child. However, this Shia flexibility is based on some fundamental principles: the endeavour is based 17 On the institution of the marja -e taqlı ¯d, see e.g. (Walbridge 2001 : 3 - 17 ); see also Dahle´n ( 2003 : 77 - 103 ). 18 As a result of this permissibility, sperm donation is practiced in some clinics in Iran. Many clinics also offer infertility treatment using donated eggs; only the regulation of each clinic is different. 73 Discussion on the need to define kinship relations resulting from the use of reproductive technologies, to ensure the sanctity of kinship - as a grammar of social proximity (my italics, see previous chapter) - and, at the same time, to guarantee social continuity. One might say that Shia jurisprudence - differences of opinion notwithstanding - tends to consider assisted reproductive technologies as supporting the preservation of kinship ties in both agnatic and uterine terms, and reinforcing traditional moral values and ideas. In fact, as Shai Lavi (2010: 93) in his article, on the case of reproductive technologies in Jewish Bioethics argues, “as long as reproductive technologies can be put in use without altering traditional life-world structures and traditionalist worldviews there is no source of tension between progress and tradition.” Let us now look at some of these traditional principles and structures. Matrimonial union and physical touch At the core of the debate surrounding assisted reproduction, as we have seen, is the question of zina¯ (here meaning adultery). 19 Generally, in Sunni Islam, the use of donor gametes and surrogacy is unacceptable and is regarded as analogous to zina¯ (e.g. Inhorn 2003, Clarke 2009). In contrast, the Shia view differs from the Sunni consensus regarding assisted reproduction. Many Shia authorities follow the reasoning that assisted reproduction does not involve the physical act of sexual intercourse, and they do not regard assisted reproduction involving a third party as analogous to zina¯ . For instance, embryo transfer in IVF and assisted reproduction do not entail physical contact between the two parties; therefore, no illicit and impure sexual act takes place in reproduction using such procedures 20 . In legal and theoretical terms, the essential principle that emerges is that from a Shia perspective, the definition of the act of adultery and incest does not depend on the contact and transfer of bodily sexual fluids. It depends (rather) on the illegitimate physical act that happens through illicit sexual intercourse and not on the act of conception itself, that is, on physical contact rather than the mixing of reproductive substances. Hence, many leading Shia authorities have given permissibility ( ja¯yez bodan ) to embryo donation and surrogacy. 21 A minority of Shia authorities, however, regard it as impermissible. 19 As mentioned in chapter 2 , in Islamic law, zina¯ refers to all varieties of illegitimate sexual intercourse between a man and a woman, applicable to married and unmarried persons. It is also analogous to “adultery”, “fornication”, “incest” and “incestuous adultery” as well as “rape”. 20 This distinction between the “physical” and the “biological” act of adultery has also been addressed in rabbinic arguments concerning assisted reproduction in Israel (Kahn 2000, 96-97). 21 Both procedures involve embryo transfer and carrying. 74 Shia approaches to assisted reproductive technologies It should be noted that most of these legal opinions (fatwas) for or against permissibility have been issued in response to questions posed by IVF physicians, infertile couples, donors, legal and medical institutions, policy-makers and others who are dealing with bioethical issues. This traditional question-and-answer form of discourse - the istifta¯’-fatwa discourse 22 - plays an important role in the development of legal and practical responses to bioethical questions in Iran, which, one might argue, may have a significant impact on the development and production of both religious and non-religious knowledge . The significant role of istifta¯’ - particularly in the questions posed by medical scholars - in such development and knowledge production cannot be denied. As mentioned above, such legal opinions are then often used as the basis for regulations in IVF clinics and legislative actions by the Iranian parliament. These questions and answers have usually appeared either as a separate section or included in the appendix section of the books that address the legal, juridical and ethical concerns surrounding assisted reproductive technologies. Indeed, this form of discourse continues to reflect the underlying Shia ethical principles and legal reasoning on a case-by-case basis. For instance, in 1999, the Avicenna Research Institute and Infertility Clinic in cooperation with the Faculty of Law and Political Sciences of Tehran University organized a conference called “Jurisprudential and Legal Issues Concerning Embryo Donation”. One outcome of the conference was the publication of the book “Modern Human Reproductive Techniques from the View of Jurisprudence and Law” (Various authors 2003). The last section of the book (appendix) embodies a collection of istifta¯’a¯t (plural of istifta¯’ ) and fatwas (legal opinions) of some leading Shia authorities as well as the opinions of Sunni Islamic scholars and representatives of other monotheistic religions. The following is a summary of an example of istifta¯’-fatwa discourse concerning embryo donation to infertile couples (ibid, 392-398). Question, submitted by the Avicenna Research Institute: In vitro fertilization (IVF) is one of several techniques available to help infertile couples to conceive a child. The procedure starts by taking the eggs from the wife and fertilizing them with her husband’s sperm. The resulting embryo will be transferred to the woman’s uterus in order to start her pregnancy and eventually give birth. It should be noted that embryos get transferred within 24-48 hours of fertilization, at the 4- to 8-cell stage of development. Sometimes the number of embryos conceived exceeds the desired amount. In such cases, the extra embryos are frozen. Later, after the pregnancy and delivery, the embryos are thrown away with the consent of the married couple. On the other hand, there are married couples who, due to their medical condition, cannot 22 In the Islamic legal tradition istifta¯’ - literally “to inquire” - means to submit a request in order to obtain a legal opinion (see Masud 2009 ). 75 Discussion conceive at all. For some of these couples, there is a possibility of receiving one of these extra embryos. What is the stance of sharia [Islamic law] on transferring those extra embryos to the uterus of another woman, in order for her to get pregnant, deliver the child, breastfeed and raise the child? Responses from some leading Shia authorities and scholars: Ayatollah Tabrizi (ibid, 393): “The transfer of this embryo to another woman’s uterus is not permissible.” Aytollah Mosawi Ardebili (ibid, 395), founder of the Mofid University in Qom - an academic centre for humanities studies and research with a new academic-Islamic seminary ( hawzavi-da¯neshga¯hi ) approach: “There is no problem if it is carried out with the permission or request of the third woman, and with the consent and request of her husband if she is married.” Ayatollah Yusef Sane’i (ibid, 396), known for his moderate religious views in favour of reform: “Implanting the Petri-dish-fertilized egg (from a man and his wife) in another woman’s uterus as indicated in the question is not prohibited in itself and is permissible.” Ayatollah Naser Makarem Shirazi (ibid, 397), known as a conservative cleric: “The act in itself is not prohibited by sharia ; however, there are [possible] haram (prohibited) lateral issues involved such as touch and gaze. It is not considered haram if it is done by the husband; for instance, he can get his sperm and the egg of one of his two wives, mix them together and have it implanted in the uterus of his other wife (even if they have agreed on a temporary marriage 23 for the act); otherwise, in order to make haram lateral issues [such as touch and gaze] legitimate, it should be determined whether the act [embryo transfer] is of necessity or not.” Ayatollah Khamenei (ibid, 397): “The act of transferring this embryo to the uterus of another woman is not forbidden by sharia ; however, any act of touch or gaze is prohibited.” In all these deliberations, however, the focus is on the juridical moral meaning ascribed to bodily substances and physical contact and not on the biogenetic principles of descent. Moreover, a clear Shia distinction can be made between the act of placing sperm directly into the female’s uterus, which according to the majority of religious scholars is not allowed, and the act of implanting an embryo into the womb of a woman - whether a surrogate or intended mother - for which there is religious moral permissibility. Embryo transfer does not entail physical contact between the two parties; therefore, no illicit and impure sexual act takes place in reproduction using such procedures. Thus, following this line of reasoning, the transfer and donation of embryos and surrogacy arrangements for the purposes of infertility treatment for married couples unable to produce a child 23 See chapter 2 for more details on temporary marriage. 76 Shia approaches to assisted reproductive technologies are, according to the majority of Shia scholars, permissible. The in vitro embryo in this context is the result of a legal union, and not the result of an illicit or impure (na¯pa¯k) sexual act. Filiation and dual seed Another relevant subject for this discussion, as I have argued above and in the previous chapter, is the less male-biased Shia (and to a larger extent Iranian) representations of lineage and legitimacy. I have argued that Shia notions of nasab take a more gender-balanced structure and recognize a bilateral filiation, under which maternal and paternal filiation are clearly distinguished and in many regards symmetrical. As we have seen, the majority of Shia authorities give equal emphasis to maternal and paternal seed in the procreation of a child, so a male’s sperm and a female’s egg, in this model, play equivalent roles in the conception and subsequently in establishing both maternal and paternal filiations. These authorities (though not all of them) argue that legal maternity, like paternity, is solely determined on the basis of the genetic potential embedded in the female’s seed from which the foetus comes into existence ( takavvon , meaning “coming into existence” and “formation”) and not through gestation and birth. 24 In other words, the mother of the child is considered to be the woman whose egg has generated life ( motevakken ) in the embryo (Hamdollahi/ Roshan 2009, 398). Thus, the emphasis in this model is on the condition that involves bringing into existence ( erteba¯t-e takvı ¯nı ¯ ) and not on the cause that manifests itself as gestation and birth ( erteba¯t-e h ˙ amlı ¯ va vela¯datı ¯ ). This line of reasoning leaves room in Shia thought for the legal permissibility of third-party donation and surrogacy, and for ascribing maternity (according to the majority opinion) to the producer of the egg and not the woman who gives birth. 25 The normative implications of this view, which is the majority view of Iranian jurists, are that in a surrogacy arrangement, the legal mother is the contributor of the egg and not the surrogate woman; that in cases of embryo donation, legal parenthood is ascribed to the providers of the gametes, and that in cases of sperm donation the sperm donor is considered the legal father. 26 24 This is not only because a woman’s egg is viewed solely as a biological factor in reproduction. Rather it (the egg) is given a legal definition; hence the woman, just like the man, plays a legal role in reproduction and establishing ties of filiation. 25 Also for the legal permissibility of adoption by conferral of the name of the adoptive parents, forbidden in Sunni Islamic law (see chapter 2 ). 26 However, as we shall see in the next chapter, the question of parenthood remains a debated one and constitutes the main challenge facing the regulation of reproductive technologies in Iran. 77 Discussion These underlying principles also explain why many Shia scholars consider the clone as offspring and not a sibling, in both legal and theoretical terms (see Moeinifar/ Azimzadeh 2012), and define a legal filiation - either parental or maternal - for the clone. For instance, in his article on cloning, Ayatollah Mo’men (2006: 111), a prominent Shia religious authority, who views cloning as a new form of reproduction, 27 provides the following explanation: A cell is extracted from the body of a woman and is then implanted in the removed nucleus egg [either her own egg or a donated egg]; the cell substitutes the nucleus and starts to grow. Under this particular circumstance where the cell is extracted from the woman and no man, whether her husband or someone else, has been involved in the procedure, the resulting child is considered the woman’s child and she is recognized as the child’s mother. This is because the child has originated from her body; therefore, she has been completely involved in bringing the child into existence and the child does not have a father, and as stated in our previous discussions, if a child lacks a father, as long as it has a mother or vice versa, this will not raise any problem [in establishing a filiation]. As such, this epistemology takes place within a historical legal framework and it is based on the phenomenological experience of human life rather than recognition of scientific discoveries in genetics to define maternal or paternal identity. It is important to add here that in ancient Iranian thinking, wherever the seed is discussed, it refers to both the male and female seed - not only for humans but also for animals and plants. For instance, in the Middle Persian (Pahlavi) Book of Primal Creation, the Bundahishn, one of the principal sources of ancient Iranian cosmology and traditions, there are several references to the biological and morphological characteristics of both sperm and egg (as cited by Bahar 2006, 84): 28 The female seed is cold and humid, is flowing from the loins, and the color is red and yellow; the male seed is hot and dry, is flowing from the brain of the head, and the color is white and clayish. The female seed is always emitted first, and goes into the uterus [ zehda¯n ], and the male seed settles above it, and fills the uterus [ … ]. Ibn Sina (Avicenna, 980-1037) regarded the fluid of both man and woman as substances ( gohar - meaning “gem”, “essence” or “nature”). He believed that the nature of male substance was of fire and the nature of female substance of earth; hence, the mixture of the two was responsible for the creation of human beings (cited in various authors 1988). The close similarities of these contemporary Shia 27 I have incorporated his views regarding assisted reproduction elsewhere (see Garmaroudi Naef 2012 : 170 - 175 ). 28 In my study of the Bundahishn, I have used the Persian translation by Mehrdad Bahar ( 2006 ), Iran’s prominent Iranologist. The English translation is adopted from Anklesaria ( 1956 , chapter 15 ) and West ( 1880 , chapter 16 ). 78 Shia approaches to assisted reproductive technologies approaches (like the one of Ayatollah Mo’men’s) to the Galenic (see Boylan 1986) and ancient Iranian view of conception are evident here. Formation of the foetus and its ontological status Another key factor in understanding the internal logic of the Shia approach is related to the issue of the status of the embryo. The Iranian view regarding the moral status of the embryo is also grounded in the Shia idea of gradual respect which does not view the human embryo as a fully developed person from the beginning, acknowledging it as a full person at birth and not at the time of conception. In this tradition, the newly-formed foetus does not have the same moral status as a person, and gradually increases in moral status according to its physical maturation during the pregnancy. According to the legal opinions of many Shia religious authorities, if the mother’s life is at stake, or the foetus is diagnosed with birth defects such that caring for it will burden the mother with extreme hardship, abortion is permissible before the ensoulment that is said to happen when the embryo is in its fourth month of age (various authors 2007: 512; Aramesh 2009). 29 According to this position, which stems from theological interpretations of Quranic references to the stages of human embryonic development (see Eich 2008), human life starts with the infusion of the soul ( ruh ) into the foetus in the fourth month of pregnancy. Hence, ensoulment makes a distinction between the biological life that begins at conception and the human life that begins at ensoulment. The Bundahishn (as cited in Bahar 2012: 38) also describes the development of the embryo as a gradual process with different stages, beginning with moistness ( tarı ¯ ), the intermixture ( a¯mı ¯khtegı ¯ ) of semen, blood, and finishing with the embryonic stage ( dashtak ) after the first movement ( chandesh ). However, Shia scholars, in general, do not permit abortion under unnecessary conditions and ascribe a moral juridical status to human embryos from the moment of conception as well. From their legal standpoint, when abortion takes place during any stage of an embryo’s development, a dı ¯yya (the monetary compensation) is determined for it depending on the embryo’s growth and the stage it was at. 30 29 This attitude is reflected in the regulation of abortion in Iran as well. According to the Therapeutic Abortion Act, passed in June 2005 , it is possible to grant authorization for therapeutic abortion under the above circumstances. To complete the process of therapeutic abortion, it is necessary for the mother to submit her request, which will be examined at least by three gynaecological specialists and consequently confirmed by the Legal Medicine Organization, provided that the duration of the pregnancy is less than four months. In this law, the consent of the mother is sufficient to grant her the permit to have a therapeutic abortion (see Atighetchi 2007 : 100 - 121 ). 30 Iran’s current Penal Code (Article 487 ), based on Shia fiqh, considers six stages of devel- 79 Conclusion As such, the sacred meaning ascribed to the embryo takes a central value in the debates around the moral status of a human embryo. Thus, following the same reasoning, the majority of Shia religious authorities consider embryonic stem cell research for therapeutic purposes permissible only in pre-ensoulment stages of foetus development, i.e., before the end of the fourth month of pregnancy. 31 Conclusion This chapter has analysed the moral reasoning embedded in the Shia legal discourse on reproductive technologies, and how this tradition interprets assisted reproduction. I have explored some aspects of religious legal hermeneutic strategies that have shaped the Shia approach towards assisted conception, and described some prevalent Shia juridical moral values and reasoning about conception, filiation, marriage, procreation, sexuality, adultery and incest. I have tried to give some insight into how Shia scholars employ an ancient religious-legal system to address the bioethical dilemmas of the present and future. As we have seen, many Shia scholars approve of the use of third-party donation and surrogacy as a treatment for infertile married couples. However, the opinions are not monolithic and centralized, and Shia scholars respond divergently to the questions posed by assisted reproduction, although certain principles remain the same. We have seen that: (1) achieving conception and creating a child do not always depend on sexual intercourse; (2) establishing paternity and maternity are based on legal reasoning and not just on biological ties and natural facts; (3) Shia scholars tend to consider assisted reproduction as supporting the preservation of nasab (legal filiation, both paternal and maternal); (4) according to many Shia scholars, male and female reproductive substances play a symmetriopment for human embryos, which includes: 1 ) nutfah (mixed semen) residing in the uterus; 2 ) alaqah or clotted blood; 3 ) muzagha or blood clot that has turned into tissue; 4 ) a foetus during the stage of bone formation; 5 ) a foetus whose bone and flesh growth has been completed but still lacks soul; 6 ) an ensouled foetus (various authors 2007 : 478 - 479 ). Although abortion taking place during any of these stages is considered a criminal act calling for punishment, killing the embryo is only considered murder after ensoulment; however, it does not call for qisa¯s (equal retaliation); it requires diyya to be paid in full. In other words, the embryo has a nature sui generis from the current legal viewpoint in Iran and personhood comes into existence at birth, not at the time of conception (ibid.: 479 ). 31 For example, according to the legal opinion (fatwa) of the Ayatollah Khamenei in 2002 , “the destruction of the left-over embryos from an in-vitro fertilization cycle in order to collect stem cells for research” is allowed (Miremadi et al. 2013 : 55 ). Currently, under Iranian regulations - with the full support of the government - all forms of stem cell research are permissible with the exception of human cloning for reproductive purposes (ibid.). 80 Shia approaches to assisted reproductive technologies cal role in the procreation of a child and in producing the legal line of lineage and ties of agnatic and uterine kinship; (5) stress is laid on the juridical meaning ascribed to kinship relations and not on the biogenetic principles; (6) the use of donor gametes and embryo or surrogacy arrangements, whether they are allowed or not, is not considered as a kind of adultery or incest, and the resulting child is not an illegitimate child. In other words, the Shia notion of incest and adultery does not concern the biological act that occurs through the contact and transfer of bodily substances. It depends (rather) on the illegitimate physical act that occurs through illicit sexual intercourse between a man and a woman: again, in Clarke’s terms, “not a question of substance, but rather one of Propriety” (Clarke 2009: 198). The permissibility of donation between siblings is based on the same logic: embryo transfer between siblings is allowed and is not considered to constitute incestuous adultery. How should the incest taboo be understood, taking the aforementioned perspectives into account? Annette Weiner (1992: 70-71) explains Malinowski’s thinking on the question of incest as follows: “For Malinowski, the incest taboo functioned as a sociological regulator that divides ‘persons of the opposite sex into lawful and unlawful’ relationships, which restrains ‘intercourse in virtue of the legal act of marriage and which discriminate[s] between certain unions in respect of their desirability’”. Considering the moral reasoning embedded in Shia legal discourse on assisted conception, it seems that they may approach the concept of incest in a similar way. The contact and transfer of bodily substance is not important in the definition of incest or adultery. What is considered to be incestuous adultery here is the illegitimate physical act of illicit sexual intercourse that occurs between unmarriageable members of kin ( mah ˙ a¯rem ). Once again, one should note the moral juridical considerations of incest prohibition rather than the biological or psychological explanations of it. As such, the content of this chapter should help to explain why the rhetoric of incest does not follow a “universal grammar.” In fact, within this framework, the descriptions of natural entities and phenomena are not separated from descriptions of the symbolic meanings - in moral and legal terms - ascribed to them. In my view, it is on the basis of these traditional interpretations and this phenomenological understanding of natural entities that Shia religion adopts its permissive approach to reproductive. 4. Embryo donation law and surrogacy regulations: intersection of religion, law and ethics In the preceding chapters, we have seen some religious (normative viewpoints) and sociocultural factors that appear to be of particular importance in understanding the regulatory framework for assisted reproductive technologies in Iran and the relevant legislation and administrative policies. Now, in this chapter, we turn to the regulation of these reproductive technologies. I focus on two legislative attempts that have taken place in Iran since the late 1990s to regulate embryo donation and surrogacy arrangements, which are both, as we saw in the last chapter, morally permissible according to the majority of Shia religious authorities. My intention is to examine the emergence and development of this legislation and to identify the institutions and actors involved. As has been argued by Manfred Sing (2008), we might see the process of the legitimisation (my italics) of medical techniques in Islamic contexts as very similar to that which takes place in Western societies, despite the different semantic materials, authorities, languages and juridical frameworks involved. 1 In fact, “in both cases, answers to actual problems must be derived from historical authorities, consensus in society must be organized, and coherence in law must be constructed” (ibid.: 98). In what follows, we shall see that the Iranian approach towards reproductive technologies stems from collaboration between religious authorities, physicians, legal scholars, philosophers, experts in social sciences and policy makers, and reflects an interconnection between religious legal deliberations and secular ethical principles, autonomy and paternalism, and forbidding and allowing. It is this particular arrangement between secular and religious authorities that stands at the centre of my analysis. 2 In the first section of this chapter, I provide an overview of the relationship between fiqh (Islamic legal discourse; jurisprudence) and h ˙ oqu¯q (law) in the Iranian legal tradition. The relationship between these two fields within the changing framework of social, political and economic developments in Iran is of course a vast and complicated topic and would require its own independent study. However, a discussion of this relationship - both conceptual and institutional - 1 Some of these different concerns have been discussed in previous chapters. 2 By ‘secular’ I mean here those principles - both ‘moral’ and ‘institutional’ - that are not the product of religious thinking and codes of conduct (cf. Maclure and Taylor 2011 : 23 - 24 ). 82 Embryo donation law and surrogacy regulations: intersection of religion, law and ethics is crucial to understanding the formation of laws and regulations on a diverse array of bioethical issues in Iran. 3 The second section then explores the legislative process leading to the enactment of the Iranian embryo donation law and the formulation of the surrogacy bill. Finally, the third section offers a closer examination of the embryo donation law and the critical and scholarly responses to the ethical and practical challenges it posed. My argument is that these laws and regulations are in harmony with the cultural, social and religious conditions of Iranian society; they have been born out of practice and developed from the ground up and within the structure of the Iranian society, through bottom-up rather than top-down approaches. In other words, the legislation recognizes what is already being practiced and is deemed socially relevant, acceptable, legitimate and desirable. 4 By bottom-up approach I mean that the legal regulation of reproductive technologies in Iran has emerged within and across a variety of institutions and settings and is not something that has been imposed by state authorities. 5 Its implementation has thus come through the involvement and contributions of all the relevant stakeholders - particularly medical, legal and religious scholars. The relationship between fiqh and h ˙ oqu ¯¯q According to Mohammad Rasekh (2007: 9-26), the Iranian professor of Public Law and Jurisprudence at the University of Shahid Beheshti in Tehran, in the introduction to his translation of A History of Islamic Legal Theories: An Introduction to Sunnı ¯ us ˙ u¯l al-fı ¯qh by Wael B. Hallaq (1997), when speaking of legal understand- 3 And the formation of many other laws, of course. 4 Regulation of reproductive technologies in Iran has not been the subject of public criticism. Critiques have usually been addressed by academics, in particular by scholars of law and ethics. One should also note the absence of feminist concerns from all these debates. Media debates are in general in support of IVF and technological advances. 5 I do not claim that this approach exists in all cases and circumstances. For instance, in an attempt to increase fertility rates, the Iranian parliament has recently voted to pass legislation including the banning of permanent forms of birth control like vasectomies. The proposed bill, which includes punitive fines, has been hastily formed and has attracted much controversy and criticism from both public and academics in the country. It is important to note here that the development of assisted reproductive technologies in Iran started at a time when Iran (in cooperation with Shia religious authorities) had developed a very successful family planning programme and birth control policy that were widely accepted by the majority of Iranians, but not by ethnic and religious minority groups (Tober 2006 ). However, as indicated in the latest news and media discussions, Iranian society is not pronatalist, and the negative population growth of recent years has prompted the Iranian state to encourage population growth. 83 The relationship between “fiqh” and “h˙oqu¯q” ing ( fahm ) and criticism ( naqd ) and the production ( tolı ¯d ) of law ( h ˙ oqu¯q ) in the Iranian legal system in general, it is necessary to pay attention to the theoretical roots and theories dominating the thought and legal system of the country. This thought and system, as he points out, has sprung from different sources, of which Iranian, Islamic and Western ones are the most important. Since at least one hundred fifty years ago, Shia thinkers and religious reformists in Iran have had to face many emergent issues in all aspects of their lives. One concerns modern law (h ˙ oqu¯q-e modern) , its connection to religious law ( h ˙ oqu¯q-e dı ¯nı ¯ ) and the re-reading of theories of Islamic jurisprudence in the light of the theoretical and practical necessities of the modern era (ibid.: 23-24). In fact, by the time of the Constitutional Revolution of 1905-1911 that led to the establishment of the first Iranian Constitution ( qa¯nun-e asa¯sı ¯ ) and the first Iranian National Parliament ( majles-e shora¯-ye mellı ¯ ) in 1906, a modern legal system in Iran had gradually emerged. 6 According to scholars like Kamaladdin Herissinejad (2010), Professor of Law and Social Sciences at the University of Tabriz, the modern Iranian legal system was strongly influenced by the Roman- Germanic legal tradition - and in particular the laws of France - while also drawing on Islamic sources. The first generation of non-clerical lawmakers ( h ˙ oqu¯qda¯na¯n ) in Iran had received their academic training in western countries such as France, Switzerland and Belgium. The appearance of the term “ h ˙ oqu¯q ” in the modern Persian legal language is the result of the translation of the French word “ droit ” (meaning “law”) by these Iranian lawmakers (Forughi 2010). H ˙ oqu¯q is the plural form of “ h ˙ aqq ”, which is indeed the equivalent of the word “ droit ” in the sense of “right”. H ˙ aqq is used in the Quran, hadı ¯th (traditional sayings) and Islamic jurisprudence ( fiqh ) and mysticism ( ’erfa¯n ) with a variety of meanings. It embraces a wide range of implications in ethics, law, philosophy and politics that have recently become the subject of lively intellectual and academic debate in Iran. 7 H ˙ oqu¯q , on the other hand, refers to the wide array of legal regulations and codes in a society, as well as the legal system and legal science. 8 6 A recent contribution that provides a historical-sociological analysis of the development of the modern legal system in Iran is Enayat ( 2013 ). And on the juristic origins of constitutionalism in Iran, see Boozari ( 2011 ). 7 For instance, see Rasekh ( 2014 ). Tabatabayifar ( 2014 ), in his book voju¯h-e fiqhı ¯-ye naqsh-e mardom dar h ˙ oku¯mat [The Jurisprudential Aspect of the People’s Role in Government] devotes a chapter to the interpretation of h ˙ aqq from both the traditionalist and modernist approaches in Shia jurisprudence. 8 The term “h ˙ oqu¯q” includes other definitions; it can refer to compensation and wages paid in work-related situations, for example “h ˙ oqu¯q-e ka¯rmanda¯n” (wages of employees), “h ˙ oqu¯q-e ka¯regarı ¯” (wages of laborers), “h ˙ oqu¯q-e ba¯zneshastegı ¯” (retirement pension), etc. Terms such as “h ˙ oqu¯q-e zana¯n” (women’s rights), “h ˙ oqu¯q-e bashar” (human rights) and “h ˙ oqu¯q-e shahrvandı ¯” (citizens’ rights) have been formed in more recent times. 84 Embryo donation law and surrogacy regulations: intersection of religion, law and ethics Since the Iranian revolution of 1979 and the subsequent referendum on the establishment of the Islamic Republic of Iran, Shia jurisprudence has been considered the most prominent resource for legislation, although it should be noted that the transforming of ah ˙ ka¯m-e fiqhı ¯ (religious juridical rules) into h ˙ oqu¯q-e mod ˙ u¯ eh (positive laws) had already been attempted in some Islamic countries, including Ottoman Turkey and Iran, before the establishment of the Islamic Republic. For instance, the Iranian Civil Code ( qa¯nu¯n-e madanı ¯ ), devised in 1928, was based on Shia jurisprudence, although, despite its Islamic legal content, as many scholars of jurisprudence and law ( fiqh va h ˙ oqu¯q ) have noted, it demonstrates many similarities with the Civil Code of France in terms of structure and subject arrangement (Shafiei Sarvestani 2007). It also evinces significant cooperation and understanding between religious and secular authorities and legislators. For instance, in a discussion with Shafiei Sarvestani (2007) regarding the development of legislation ( qa¯nu¯n-godha¯rı ¯ ) in Iran after the revolution of 1979 and its strengths and weaknesses, Ayatollah Mohaghegh Damad, a prominent professor of jurisprudence (fiqh) , law ( h ˙ oqu¯q ), philosophy ( falsafeh ) and bioethics ( akhla¯q-e zistı ¯ ) in Qom and Tehran, stated that the collaboration of intellectual clerics (fu¯qaha¯-ye roshanfekr) with devout lawyers ( h ˙ oqu¯qda¯na¯n-e motedayen ) in devising the Civil Code of Iran was a turning point in the process and history of lawmaking in Iran. However, he asserted that despite the considerable work done in this field after the Iranian Revolution, “this collaboration has not adopted a proper form yet” (ibid.: 264). In general, as was explained in chapter 3, fiqh - literally meaning “deep understanding” - is the Islamic science of jurisprudence, and like any other system of jurisprudence it is local, contextual and subject to change in its premises. The most important sources used in contemporary Shia jurisprudence include the Quran, the Sunna (traditions and sayings attributed to Prophet Mohammad and the twelve Shia Imams) and ’aql (meaning “intellect” - the process of reasoning to deduce the religious law). As for h ˙ oqu¯q , the Iranian Constitution (qa¯nu¯n-e asa¯sı ¯) , Iranian Civil Code (qa¯nu¯n-e madanı ¯) , laws passed by the majles (Iranian Parliament), custom (’orf) , judicial methods of interpretation of the law, and the viewpoints of Iranian lawmakers are among the available sources. 9 However, apart from the differences in their institutional and ideological settings, during the last decade, the exchange of thoughts and opinions between these two fields has found a new form that has also spread to ethical discussions and led to new dialogues about the conceptual relationship between law ( h ˙ oqu¯q ), jurisprudence ( fiqh ) and ethics ( akhla¯q ). 10 A considerable number of clerics ( fu¯qaha¯ ) in Iran have 9 For further discussion on the relationship between fiqh and h ˙ oqu¯q, see Ziaifar ( 2010 ). See also Shafiei Sarvestani ( 2007 ) and “fiqh va h ˙ oqu¯q” in Mehrnameh 2010 ( 5 ): 146 - 161 . 10 Some recent important publications in this field are Ziaifar ( 2010 ) and Shafiei Sarvestani ( 2007 ). 85 The relationship between “fiqh” and “h˙oqu¯q” completed modern academic training ( tah ˙ s ˙ ı ¯la¯t-e da¯neshga¯hı ¯ ) in legal studies. At the same time, many jurists and legal experts ( h ˙ oqu¯qda¯na¯n ) have followed traditional Islamic seminary ( h ˙ awza ) studies. For instance, Ayatollah Mohaghegh Damad received his traditional religious education in philosophy, theology and jurisprudence in Qom. In addition, he earned a bachelor’s and a master’s degree in Islamic philosophy and jurisprudence from the University of Tehran, and a doctorate in law from the Catholic University of Louvain in Belgium. He has written extensively on the application of Islamic ethical and jurisprudential principles to contemporary bioethical issues and environmental ethics. 11 An example of the latter trend is Mohammad Rasekh, who not only completed his doctorate in law and philosophy at Manchester University but also has ten years of religious seminary studies to his credit. His discussions of philosophical and theoretical subjects in law have left a profound impact on the academic field of law in Iran. He has also compiled and translated a number of key legal texts, among them a translation of A Short History of Western Legal Theory (1992) by Irish legal scholar John Maurice Kelly and The Concept of Law (1961; 1994) by British legal philosopher Herbert Hart. He is a faculty member at the Avicenna Research Institute and has written many articles on bioethical issues. The extent to which fiqh and Islamic rules ( ah ˙ ka¯m ) are involved in the legislation process and the government of society in the Islamic Republic of Iran is unique. Theoretically, according to Article 4 of the Constitution, all civil, penal, financial, economic, administrative, cultural, military, political and other laws and regulations must be based on Islamic criteria (mava¯zı ¯n-e islamı ¯) . 12 But practically, as one might expect, complying with these principles - at every step of the way - has not been an easy task. A look at the development of the process of lawmaking in Iran indicates that the Islamic Republic has constantly been faced with numerous weaknesses and challenges since its formation (Shafiei Sarvestani 2007). For instance, in response to the question of what challenges Iran has faced in the sphere of legislation over the last three decades, Ayatollah Shoushtari (ibid.: 269-274) points to the lack of collaboration and understanding between the clerical and non-clerical jurists and says: One reason that led the regulations to become unsustainable after the revolution is that there was no understanding between fu¯qaha¯ and h ˙ oqu¯qda¯na¯n . After the revolution, when h ˙ oqu¯qda¯na¯n and those who were familiar with fiqh had a chance to sit together to devise a law, each of them used the terminology they were accustomed to; therefore, 11 For instance, fiqh-e pezeshkı ¯ (medical jurisprudence; two volumes). 12 The phrase “bar asa¯s-e mava¯zı ¯n-e islamı ¯” (based on Islamic criteria) and its interpretation, however, is a subject of its own that is being debated with much deliberation in many publications in Iran. See, e.g., Shafiei Sarvestani ( 2007 : 269 - 274 ). 86 Embryo donation law and surrogacy regulations: intersection of religion, law and ethics the laws that came out of such negotiations were so erratic [ qava¯nı ¯n-e na¯monaz ˙ am ] that the h ˙ oquqda¯n would understand one thing from it and the faqı ¯h another. [ … ] Unfortunately, these issues still exist (ibid.: 280-281). Mahmoud Akhondi, a Swiss-trained law professor known for his contributions in the field of criminal procedure, stresses the need for more dynamic jurisprudence ( fiqh-e poya¯ ): The Articles of our Civil Code are based on Islamic jurisprudence; this means that in codifying [ tadvı ¯n ] the law, the people’s customs and traditions that stem from Islamic jurisprudence and are accepted in society have been transformed into law. If the law springs from within the society, its execution is guaranteed. The adoption of the Civil Code is a good example of this kind, which showed that people accepted it with no trouble [because it was familiar to them]. [ … ] But we have some problems with the penal code [ qava¯nı ¯n-e jaza¯yı ¯ ] [ … ]; we have to follow a dynamic jurisprudence [ fiqh-e poya¯ ] and leave behind what the society is not in favour of. Currently, there are different perceptions and understandings of fiqh and we are capable of accepting the one that is most compatible with [the issues] of our time … by taking advantage of scientific data [ da¯deha¯-ye ’elmı ¯ ], we can achieve a more dynamic fiqh (ibid.: 388-389). In what follows, I will explore how, by taking advantage of medical and technological advances, this collaboration and dynamic jurisprudence has provided a means to develop principles and critical insights for dealing with contemporary problems in bioethics. As we have noted before, in 2003, the first Iranian law addressing assisted reproduction was passed in the Iranian parliament permitting embryo donation and (implicitly) 13 surrogacy arrangements. The following section traces the development of this legislation, identifies the institutions and actors involved, and examines in particular the dynamics of religion, law, and medicine in the formation of these bioethical regulations. The legislation In 1966, Mehdi Shahidi (2013: 159-179), a distinguished Iranian jurist trained both in law and in the religious seminary, published an article about human artificial insemination, mainly devoted to the legal determination of filiation ( nasab ) in the context of donor insemination. However, as explained in chapter one, sustained efforts to discuss legal and ethical issues related to assisted reproductive technologies in Iran only started in the late 1980s and were directly 13 As we will see, the law does not explicitly mention the permissibility of surrogacy. It concerns the permissibility of embryo transfer and carrying agreement, which is however a case in the surrogacy arrangements as well. 87 The legislation linked to the establishment of medical institutions such as the Research and Clinical Centre for Infertility at Shahid Sadoughi Medical Sciences and Health Services University in Yazd in 1988, including the first IVF centre in Iran, under the supervision of Dr. Aflatounian - the father of IVF in Iran. In 1990, the first IVF baby in Iran was born at this centre. Three years after the successful delivery of the first intracytoplasmic sperm injection (ICSI) baby in the world, the first baby conceived using ICSI was born there in 1995. In 1991, the Royan Institute affiliated to the Academic Centre for Education, Culture and Research (ACECR) was established in Tehran as a public clinic for infertility treatment. The late Saeid Kazemi Ashtiani, who was the founder and director of the Institute, managed to collaborate closely with Islamic religious authorities from the moment of its establishment. In 1998, the Ministry of Health, Treatment and Medical Education accredited the centre for developing reproductive medicine and stem cell research. In 1998, the Avicenna Research Institute affiliated also to the ACECR was established under the supervision of Mohammad Mehdi Akhondi in Tehran. The rapidly growing number of research centres in Iran and new medical approaches addressing infertility, as well as the increasing number of infertile couples seeking appropriate treatment, created the impetus for debate on the jurisprudential and legal aspects of the social uses of new reproductive technologies to pave the way for the constitution of a proper law. In 1999, the Avicenna Research Institute, in cooperation with the Faculty of Law and Political Sciences of Tehran University, organised a conference called “Jurisprudential and Legal Issues Concerning Embryo Donation.” One outcome of the conference was the publication of the book Modern Human Reproductive Techniques from the View of Jurisprudence and Law ( ravesh-ha¯-ye novı ¯n-e tolı ¯d-e methl-e ensa¯nı ¯ az dı ¯dga¯h-e fiqh va h ˙ oqu¯q ). The book (various authors 2003) consists of three sections. The first introduces assisted reproductive technologies and new methods for treating infertility. The articles included in this section were written by prominent Iranian medical scholars and IVF experts. The second section is divided into two parts: the first provides a comprehensive collection of important articles published to date on artificial insemination and IVF in Iran, some written by seminary clerics and leading Ayatollahs - two of them members of the Guardian Council (see below) 14 - and others by h ˙ oqu¯qda¯na¯n (lawyers and 14 One is Ayatollah Mohammad Mo’men’s article sokhanı ¯ darbare-ye talqı ¯h ˙ (“A Debate on Insemination”), originally written in Arabic under the title kalamat fı ¯-l-talqı ¯h ˙ , translated by Musa Danesh, published in Qom first in 1994 and then in Persian in 1996 . See Garmaroudi Naef ( 2012 ) for his views regarding assisted reproduction. I interviewed him in October 2006 in Qom. The other is Ayatollah Mohammad Yazdi’s article entitled ba¯rvarı ¯-hay-e masunu’i va h ˙ okm-e fiqhi-e an [“Artificial Reproduction and its Jurisprudential Doctrine”], first published in the Fiqh-e ahl-e bayt journal in Qom in 1996 . 88 Embryo donation law and surrogacy regulations: intersection of religion, law and ethics legal experts). These legal-normative contributions deal mostly with the determination and establishment of kinship relations ( nasab , filiation) in the context of assisted reproduction, and stand in an intellectual tradition that provides a set of moral juridical principles and precepts derived from religious codes (see chapter 3). The second part includes the papers presented at the conference, mostly from scholars of Islamic jurisprudence ( fiqh ) and law ( h ˙ oqu¯q ). The last section of the book (the appendix) contains a collection of fatwas (legal opinions) of some leading Shia authorities as well as the opinions of Sunni Muslim institutions and representatives of other monotheistic religions. 15 The fiqhı ¯ articles reveal that there is no uniform viewpoint among religious scholars on issues pertaining to assisted reproduction. They range from the permissibility of IVF and artificial insemination only if the husband’s sperm is used to the permissibility of using the sperm of a third-party or embryo donation and surrogacy - forbidden in many Western and Sunni Muslim countries. 16 In addition to collecting and analysing such fiqhı ¯ reasoning, the legal ( h ˙ oqu¯qı ¯ ) articles stress the importance of further research to pave the way for the establishment of legal resolutions and regulations. One example is the following statement in a legal article written by a member of the Faculty of Law of Shahid Beheshti University, also a member of the scientific committee of the Avicenna Research Institute: To encourage the authorities [to take appropriate measures for legislation] it is recommended that specialists with expertise in ART [assisted reproductive technologies] should try to offer a thorough explanation and clear definition of these techniques, of the scientific nature [ ma¯hı ¯yat-e ’elmı ¯ ] of the sperm, egg, zygote and embryo, and of the role of the uterus in the development of the foetus to the society of religious scholars and legal experts [ maja¯me’-e fiqhı ¯ va h ˙ oqu¯qı ¯ ] in order to gain better understanding of them. Such efforts will gradually fill the gap between the fiqhı ¯ [religious legal] and h ˙ oqu¯qı ¯ [legal] opinions and enable the legislator to adopt an appropriate decision based on the opinions of the experts in fiqh [ faqiha¯n ] (various authors 2003: 236). 15 The Sunni sources include rulings from the Council of the Islamic Fiqh Academy (Jeddah, 1986 ) and the Council of the Islamic Fiqh Academy of the Muslim World League (Mecca, 1990 ). For instance, the statement of the Council of the Islamic Fiqh Academy (Jeddah) of October 1986 viewed both surrogacy and embryo donation as h ˙ ara¯m (religiously forbidden) and completely banned the practice because of consequences such as confused genealogy (a¯mı ¯khtegı ¯-ye nasab) and the anonymity of the mother (majhu¯l ma¯ndan-e ma¯dar). See various authors ( 2003 : 409 - 412 ). 16 For instance, in one of the most controversial legal opinions, Ayatollah Mohammad Yazdi - one of the clerical members of the Guardian Council - in an article first published in 1996 , permitted artificial insemination using donor sperm. Regarding the status of the offspring conceived from donor sperm, he considered the offspring to be pa¯k (pure) and legitimate (various authors 2003 : 73 ). 89 The legislation Such statements are in line with the attempts of Iranian legal actors (including lawyers) to generate “dynamic” legal dialogue in the context of state and society, as I have described above. After the conference in 1999, Iranian legislators, taking advantage of the conference’s achievements to bridge the gap between scholars of fiqh and h ˙ oqu¯q in order to find the appropriate model for a law, proposed a bill to the Parliament ( majles ) concerning embryo donation. Eventually, after years of intense medical, theological and legal debates and both regional and national scientific conferences and workshops, the result was the legal approval of embryo donation, formally entitled the “Act Concerning Embryo Donation to Infertile Couples” (known as “the embryo donation law”), by the Iranian Parliament (the sixth parliament known as the reform parliament) in 2003. As is the case with all regulations approved by the Parliament in Iran, this was sent to the Guardian Council to decide whether it was based on Islamic criteria ( mava¯zı ¯n-i ’esla¯mı ¯ ) and the Iranian Constitution. Shortly after its approval by Parliament on 30 July 2003, the Guardian Council endorsed a legislative Act governing embryo donation, and the law became fully operative in 2005. It should be noted that, the Guardian Council ( shora¯-ye negahba¯n ) is one of the most powerful bodies within the Iranian legal and political system, charged, among other things, with ensuring the compatibility of all parliamentary bills with the Iranian Constitution and Sharia. According to Article 91 of the Constitution, the council is comprised of twelve members, of whom six are fu¯qaha¯ appointed by the Supreme Leader ( maqa¯m-e rahbarı ¯ ), who serves as Iran’s head of state; the other six members, who also have to be Muslim, are non-clerical jurists ( h ˙ oqu¯qda¯na¯n ) proposed by the head of the judiciary and approved by the parliament. 17 However, according to Mohammad Mehdi Akhondi, an embryologist and the director of the Avicenna Research Institute, without the support and legal contributions of Shia religious authorities, the enactment of this law would not have been possible. 18 But it is therefore also of the utmost importance to acknowledge the central role that medical scholars have played in addressing such medical issues and in holding scientific meetings, seminars and workshops. It should be noted that most of these legal opinions ( fatwa s), as explained in chapter 3, have been issued in response to questions posed by infertile couples, donors, IVF physicians, legal and medical institutions, policy-makers and others dealing with bioethical issues. Such legal opinions are then often used as the basis for regulations in IVF clinics and legislative actions by the Iranian parliament. Indeed, the institutional interconnection between law, religion, medicine, state and family 17 As mentioned above, some of the members of the Guardian Council are among those pioneer authors in the field of ART in Iran. 18 Author’s interview, Tehran (November 2006 ). 90 Embryo donation law and surrogacy regulations: intersection of religion, law and ethics resulted in the enactment of the embryo donation law. Since its approval, many publications and conferences have addressed the law from legal (h ˙ oqu¯qı ¯) , ethical ( akhla¯qı ¯ ) and Islamic legal (fiqhı ¯) points of view. This body of literature has played a crucial role in developing and advancing legal and ethical-philosophical discourse on bioethical issues in Iran. For example, three years after passing the law on embryo donation, another important conference on Gamete and Embryo Donation in Infertility Treatment was held in Tehran in 2006, this time in the international arena. The conference was again organised by the Avicenna Research Institute and the Faculty of Law and Political Sciences of Tehran University with the support of the Iranian National Committee for Bioethics and the Ministry of Health and Medical Education (MOHME). At the opening ceremony of the conference, Marefat Ghaffari, the scientific secretary of the conference, an embryologist and faculty member of Shahid Beheshti University of Medical Sciences stated that, “the aim of this conference is to explain different aspects of gamete donation (sperm and eggs) and disambiguate the law pertaining to embryo donation” (Aftab, March 1, 2006). 19 He then adds: “this conference intends to examine gamete donation from different perspectives, including medical, Islamic legal [ fiqhı ¯ ], legal [ hoqu¯qı ¯ ], sociological, ethical ( akhla¯qı ¯ ) and psychological ones, while looking into the regulations of the executive bylaw of the embryo donation law” (ibid.). The conference was attended by a number of prominent Iranian academics and researchers from various disciplines, including religious authorities, as well as several Western academics and social scientists, government representatives, fertility and IVF doctors and students, among others. A collection of the papers presented at the conference was published in a book entitled Essays on Gamete and Embryo Donation in Infertility Treatment from Medical, Theological, Legal, Ethical, Psychological and Sociological Approaches (various authors 2006). In another example, related to the surrogacy regulations, the Avicenna Research Institute in association with several universities in Tehran organized a twoday interdisciplinary conference on surrogacy in 2007, which led to the publication of the book Essays on Medical, Legal, Islamic Jurisprudential, Ethical-Philosophical, Sociological, and Psychological Aspects of Surrogacy (various authors 2008). 20 As with embryo donation, as noted in chapter 3, surrogacy arrangements are permitted by many Shia fuqaha¯ , and most of them consider the contributor of 19 Available in Persian at: http: / / www.aftabir.com/ news/ view/ 2006/ mar/ 01/ c8c1141231017 fair exhibition iran.php 20 I myself presented a paper at this conference, the first ethnographic account of surrogacy arrangements in Iran, which also focused on the Shia conceptual models of motherhood and argued for the legal recognition and regulation of surrogacy contracts. See Garmaroudi ( 2008 b). 91 The legislation the egg and not the surrogate as the child’s legal mother. For instance, a statement was issued by the Majma’-e fiqh-e ahl-ul-bayt - a body comprised of a number of Shia clerics and established by Ayatollah Khamenei in 1992 to address and reflect on modern issues - supporting surrogacy arrangements (Hamdollahi and Roshan 2009: 86-87). The Iranian Research Centre for Ethics and Law in Medicine had sought the standpoint of this assembly on assisted reproduction, in response to which it developed its viewpoint on surrogacy and embryo transfer as follows: “the implantation of an embryo [of a married couple] in another woman’s uterus is permissible; however, the mother of the child is considered to be the woman whose egg has generated life in the embryo” (ibid.: 398). Through the garnering of statements such as these, this conference went on to play an important role in presenting a proposal for a bill on surrogacy to the Iranian parliament. For instance, jurists and lawmakers participating in the conference proposed that the following text should be added to Article 19 of the Iranian Vital Records Law as an amendment ( tabs ˙ areh ): The physician or midwife who, in accordance with Article 19 of the Vital Records Law, is authorized to issue the birth certificate [under the name of the woman who has delivered the child], must issue the birth certificate - subject of Article 19 - under the name of the infertile couple [not the surrogate] referred to by one of the accredited infertility treatment centres, upon receiving the written confirmation from such centres endorsing the surrogacy as the recommended treatment procedure (Milanifar et. al. 2008: 87). However, while the majority of Shia scholars approve of surrogacy arrangements and despite the popularity they have gained among infertile couples, insofar as they have been practiced in Iran for more than a decade, the proposed bill is still in draft form and has not been discussed in parliament. This could be due to disagreements between the politicians and officials of the administrative bodies. In an interview, for instance, the Head of the Health Commission at the Parliament stated that the Parliament has not seen the necessity to devise a law for surrogacy so far (Entekhab, February 6, 2012). 21 On the other hand, Alireza Milanifar, a medical doctor, lawyer and legal expert on medical issues who is also one of the contributing writers of the proposed bill, said that: “we were not looking into making surrogacy into a law because there was no need for it and it was already a legitimate procedure [from the fiqhı ¯ point of view]; however, the proposed bill means to resolve two issues: it is firstly designed to accommodate intending couples with regard to the process of obtaining a birth certificate for the new-born; secondly, it is intended to save physicians from the accusation and 21 Available in Persian at: http: / / www.entekhab.ir/ fa/ news/ 52004/ (accessed on 10 June 2015 ). 92 Embryo donation law and surrogacy regulations: intersection of religion, law and ethics penalty of issuing false birth certificates.” 22 The General Manager of Legal Affairs at The Iranian Vital Records Office also said that: In general, we have to issue the birth certificate under the name of the woman who has given birth to the child; however, despite the lack of codified legal references related to surrogacy, the Vital Record Office issues the birth certificate of such newborns under the name of the true mother [the intended mother who is the contributor of the egg], because according to the istifta¯’a¯t [see above] that we have officially received, the real mother of the child is the one who is the owner of the egg (Qanun, November 26, 2013). 23 However, in practice, the clinics where such treatments are offered have their own internal policies and regulations that include mutual consent between the infertile couple and the surrogate woman and her husband - if she is married (see appendix 1 for an example of a surrogacy contract). These regulations, however, do not prohibit payment of the surrogate; 24 the intended mother is recognized as the child’s mother, and the birth certificate is issued under the name of the intended mother and her husband, not that of the surrogate. According to Alireza Milanifar, in the absence of a codified law, it is possible to seek advice from authentic fatwas and legitimate Islamic resources (Article 167 of the Iranian Constitution) and from the law for embryo donation and other general laws to resolve disputes concerning surrogacy. 25 In the next chapters, we will turn to the issue of surrogacy again. But let me now, in the last section of this chapter, reflect in more detail on the Iranian embryo donation law and look at the critical and scholarly responses to the ethical and practical challenges posed by this law. Challenges and criticisms According to Article 1 of the Iranian embryo donation law, upon receiving the written consent of the embryo owner couple ( zojeyn-e s ˙ a¯h ˙ eb-e janı ¯n ), all special- 22 Author’s interview, Tehran (January 2010 ), see also Khabaronline (September 22 , 2013 ), available in Persian at: http: / / khabaronline.ir/ detail/ 314135/ society/ 4841 (accessed on 10 June 2015 ). 23 Available in Persian at: http: / / ghanoondaily.ir/ 1392/ 09/ 05/ Files/ PDF/ 13920905-301- 10-10.pdf (accessed on 10 June 2015 ). 24 Most Shia authorities who regard surrogacy as permissible allow the surrogate to be compensated monetarily ( ojrat), and the gesture is considered appropriate. Since the human act is respectable, the woman who endures the hardships of pregnancy is entitled to receive money for her pains (see chapter 6 ). 25 Author’s interview, Tehran (January 2010 ). 93 Challenges and criticisms ised and licensed centres for infertility treatment are authorized to transfer embryos resulting from in vitro fertilization of a married couple to the uterus of women whose infertility or whose husband’s infertility (or that of both of them) has been confirmed, in accordance with Sharia. Further, according to this law and its bylaw (approved in 2005), donor couples must be married and be in a proper state of physical and mental health. The donation must be voluntary and free of charge. The recipients must be infertile, married, Iranian couples who have previously submitted their request to the Civil Court. Receiving, preserving and transferring donated embryos should be done under a confidential system; last but not least, the infertility treatment centres must preserve the embryos of Moslem and non-Moslem donors separately to later match the religion of the infertile couples with that of the donated embryo. In this law, embryo ( janı ¯n ) refers to the fertilised egg outside the uterus within five days after retrieval and should be obtained from legally married couples. The donated embryo can be used either fresh or frozen (See Safai and Emami 2007: 330-335). 26 Currently, almost all infertility clinics in Iran provide embryo donation predominantly to overcome male infertility, and embryo donors receive some financial compensation. Once embryo donation has become the only remaining option for an infertile couple to have a child, clinics offer a choice between two methods: either the couple can wait for an anonymous donation from another married couple, which will take place through the clinic and may take anything from six months up to two years, or the infertile couple will be asked if they can find their own embryo donor, which leads them to turn to their own friends or family, especially siblings of the same or opposite sex - as in the examples of Mashyana, Shokoofeh and Azar in the previous chapters, or according to my recent observations in 2015, to commercial agencies ( va¯set ˙ e-ha¯ ) - both official and unofficial sources - to find a donor. There are some clinics, however, that have changed their regulatory policies and offer only anonymous donation. In his article “Shortcomings of the Iranian Law on Gamete and Embryo Donation in Legal Comparative Literature”, Professor Seyyed Hossein Safai, Law Professor at the Faculty of Law and Political Sciences of Tehran University, examines the laws and regulations pertaining to gamete and embryo donation and the filiation of the child resulting from embryo transfer in France, and compares them with the respective laws in Iran to shed light on what he perceives as the shortcomings of the Iranian law. According to him, for instance, in the Iranian law, unlike the French law, the donated embryo must arise from the 26 For the content of the law, see Islamic Parliament Research Center, available in Persian at: http: / / rc.majlis.ir/ fa/ law/ show/ 93943 (accessed on 10 June 2015 ). For the content of the bylaw, see Islamic Parliament Research Center, available in Persian at: http: / / rc.majlis.ir/ fa/ law/ show/ 125235 (accessed on 10 June 2015 ). 94 Embryo donation law and surrogacy regulations: intersection of religion, law and ethics gametes of a legally married couple, and only a legally married couple can ask to receive such an embryo, which is understandable, considering the traditional and religious culture of Iranian society. He believes that the Iranian law has kept quiet on the subject of egg and sperm donation by contrast; since contemporary religious scholars differ on the legitimacy of the issue [gamete donation], the Iranian law needs to be revised. Furthermore, he believes that the Iranian law is insufficient as regards the filiation of the child resulting from embryo donation (Safai 2007: 323-329). As we can see, the legal regulation of embryo donation is very similar to regulations concerning adoption in Iran, as explained in chapter 2. According to Article 3 of the embryo donation law, the duties and responsibilities of the married couple receiving the embryo and the resulting child are the same as those of “real”] parents and children in terms of custody, education, alimony, and respect. Regarding inheritance rights, the article remains silent. As I mentioned earlier, the majority of Shia authorities agree that embryo donation is legitimate from the viewpoint of Islamic law, although, according to most of them, “the true parents of the child” ( pedar va ma¯dar-e h ˙ okmı ¯ ) are the providers of the egg and sperm, no matter who may raise the child. In other words, in the case of embryo donation, the “true parents” of the child are normatively the donors of the embryo, not the recipients of the embryo, and they inherit from each other as other parents and children do. But social practice appears to be different. My ethnography shows that neither embryo donors nor recipient couples describe embryo donation in this way. For instance, a couple who received donated embryos and have three-year-old twins told me: “Before the embryo donation and even during pregnancy we thought about this issue, but after their birth and now that they are growing up we cannot even believe that they are from embryos donated by someone else. The donor couple do not know anything about us [ … ]; they got their money and they are out of the picture now.” And the husband said: “At any rate, they have grown in my wife’s womb [ … ], everyone has seen her pregnancy [ … ]; by talking about embryo donation we will cast a grey shadow over our happiness.” However, this is why a majority of experts currently argue for confidentiality as a principle of infertility treatment in Iran. For example, in a symposium on confidentiality in infertility treatment held in 2009 in Tehran, Seyyed Taha Merghati-Khoei, a cleric and expert in Islamic jurisprudence and member of the ethical department of the Royan Institute, stated: “I am one of the supporters of confidentiality in infertility treatment. In our country, favouring non-confidentiality will present us with numerous problems that arise due to the culture and religious regulations [ farhang va qava¯nı ¯n-e shar ı ¯ ] and we will be unable to find a solution for them” (various authors 2009: 18). He elaborates further: “If we reveal the information, it is possible that the egg and sperm donor may claim 95 Challenges and criticisms inheritance from the child. This will lead to setbacks in issues pertaining to inheritance; therefore, the foundation [ mabna¯ : basis, principle here in reference to the definition of filiation and the genealogical ties] must be altered, which is not an easy task in itself” (various authors 2009: 18). Similarly, at the same symposium, Behzad Ghorbani, a psychologist, stated that: “I was among those who were advocates of honesty and telling the truth to the people involved. Even psychological books state that the child is entitled to know about the process of his/ her formation and birth. But we have to make a distinction here. My one-year experience of working in the Avicenna Infertility Clinic made me inclined toward the fact that our society values confidentiality more” (ibid.: 28). Alireza Milanifar, a medical doctor, lawyer and legal expert in medical issues, emphasizes the importance of creating a culture ( farhang-sazı ¯ ) in this regard to make disclosure in infertility treatment fit into Iranian culture, and believes that it will take time for that to happen. “Currently, confidentiality is of the utmost importance to both donors and recipients for various reasons. That may change in the future. But considering the present conditions, they ask for confidentiality” (ibid.: 30). In the meantime, some people put forward arguments about “the right to know one’s biological parents” (ibid.: 20) or as suggested by Mohammad Rasekh, a leading non-clerical jurist in this field, “the right to know the genetic roots or history” (ibid.: 23). Iranian legislation has shown considerable support for this approach. According to Article 10 of the bylaw of the Law of Embryo Donation, donor and recipient information must be kept confidential and only made accessible to competent authorities under special legal conditions (ibid.: 4). In the final analysis, then, the apparently starkly different positions on effective filiation of the religious authorities - filiation follows genetic lines, 27 even in cases of gamete and embryo donation - and the consumers of these services - the recipients are the effective parents - are in practice, and indeed in law, finessed through the institution of confidentiality: if no one knows who the genetic parents are, on the one hand, or who the recipients of their embryos are, on the other, then no genetic relationship can be identified. However, the question of parenthood remains open to debate and constitutes one of the main challenges facing the regulation of ART in Iran. 28 27 Based, of course, on the “genealogical reasoning” and “biological logic” and not based on the “biogenetic substance«, as discussed at length in chapters 2 and 3 . 28 Another challenging issue has been emerged significantly in recent few years is the formation of a market around gametes and embryo donation as well as surrogacy, and this raises many ethical, social, political and economic issues. I plan to address this topic in more detail in a future publication. 96 Embryo donation law and surrogacy regulations: intersection of religion, law and ethics Conclusion This chapter has addressed major aspects of two legislative efforts in Iran through which medical, Islamic legal and civil legal authorities, and scholars in the humanities and social sciences, have come together in formulating bioethical legislation and regulations in the Iranian national context. It has also illuminated the legal, social and cultural background of these efforts. It argues that the Iranian approach towards bioethical issues involves all stakeholders - religious and secular, state and private - and reflects a combination of values and principles stemming from both secular and religious considerations, whether with regard to the shaping of law or in medical practice. Going further, we might suggest that this interconnection between ‘religious’ and ‘secular’ elements is not specific to this particular domain. In many ways, it mirrors other characteristics and dynamics of contemporary Iranian society in both individual and institutional terms. At the same time, Shia jurisprudence ( fiqh ) is the foundation on which this law and many other regulations on bioethical issues are determined. However, Shia jurisprudence consists of diverse viewpoints, which in some cases might contradict each other. The Iranian Civil Code ( qa¯nu¯n-e madanı ¯ ) has turned a number of these standpoints into laws for the service of society while seeking to remain in harmony with Iranian traditional and religious values. The Iranian embryo donation law is an example of how jurisprudence ( fiqh ) has found its way into the Civil Code. It demonstrates how Iranian lawmakers have devised a law - considering the requirements of time and place ( moqtad ˙ ı ¯ya¯t-e zama¯n va maka¯n ) - that has not only benefited from Shia jurisprudence, but has manifested itself as an effective Islamic legal ( fiqhı ¯ ) verdict with a modern legal framework. To conclude, this type of approach to innovation in legislation, bottom-up rather than top-down, is noteworthy, even if the resulting law is, admittedly, not comprehensive and already faces some challenges. It throws light on the possibilities of forming new capacities in the Iranian legislative system to provide solutions to the current legal demands of the Iranian people and society. The role and social functions of bioethics in this regard are clearly interesting. In the next chapters, I shift the perspective, and present an account of the practice of assisted reproduction in Iran. 5. Surrogacy as doing a good deed Anthropologist: “When you carry the baby inside you for nine months, don’t you think that the baby is yours? ” Surrogate: “No, it is not mine. The egg is someone else’s. The baby is just nurtured by me. Nor is the sperm from my husband. It is from another man. The baby is like a deposit [ ama¯nat ] to me. I safeguard it in my womb for nine months. It is a good deed [ savab da¯reh ].” Excerpt from an interview with a surrogate Savab , literally meaning reward, can be conceived as a system of direct communication between God and human beings, a “divine contract”, as it were, between the supreme deity and his subjects. Good deeds are reciprocated, or expected to be reciprocated, with favorable rewards. Shahla Haeri (1989: 215), Law of Desire: Temporary Marriage in Shi’i Iran Having presented the opinions of the various medical, religious and civil legal authorities with respect to the Iranian laws and regulations, I now provide an account of the practice of assisted reproduction in Iran. The focus of the next two chapters is on surrogacy. I draw on my ethnographic fieldwork conducted among Iranian surrogates and intended couples over a long period of time. As we saw in the previous chapters, according to both civil and religious law in Iran, surrogacy arrangements are permissible and socially accepted. It is only allowed for infertile married couples, the producers of the sperm and egg, and a payment to the surrogate is appropriate. The infertility clinics have their own internal regulations, which include a contract between the intended (infertile) couple and the surrogate woman and her husband if she is married; the intended couple can either introduce a surrogate to the infertility clinic or they can seek help from the clinic itself. The regulations contain different medical examinations for both the surrogate and the intended couple; the intended mother is recognised as the child’s mother, and the birth certificate is issued under the name of the intended mother and her husband, and not delivered to the surrogate, the birth mother, as it should be. Surrogacy demands the involvement of another woman in the process of childbearing and delivery; a woman who is able to carry the baby of another married couple in her womb for nine months and then give birth to it. This chapter explores how Iranian surrogates and intended couples react to this pro- 98 Surrogacy as doing a good deed cedure. It further explores the way in which surrogates and intended mothers attempt to transform surrogacy from a controversial issue into a normative concept in infertility treatments in Iran. What drives a woman to carry another couple’s embryo for nine months, give birth, and surrender the baby to his / her legal parents? What is the reaction of the family members of surrogates when presented with the idea? Does giving birth to a child entitle the surrogate to motherhood? Let me first turn to the way in which Iranian surrogates talk about their experience of surrogacy. I focus on the surrogates’ narratives I have recorded to illustrate how they conceptualize their experience of surrogacy. They address a set of cultural assumptions about reproduction and kinship embedded in the Iranian legal and social context, assumptions that enable them to bear and deliver a child whom they do not consider to be their own. Encounters with surrogates 1 Many surrogates I interviewed had financial motives that explained their act of carrying another couple’s child. Additionally, another reason was one of affection between relatives or friends. Anthropologist Soraya Tremayne (2009) also discussed exactly these two reasons in her study of third-party donation in Iran. Women in both groups emphasized the altruistic aspect of the process, helping a woman to become a mother as well as preventing a marriage from falling apart because of infertility problems. However, all of them, no matter what their personal reasoning, referred to one commonality. The resulting child does not belong to the gestational surrogate, but to the “true parents” ( pedar o ma¯dar-e va¯qe ı ¯ ) 2 of the child, the contributors of the embryo who are joined in legal marriage. Shabnam has volunteered for surrogacy for the first time. She is thirty-five years old and it has been four months since she divorced from her husband, with whom she had been married for sixteen years. She has a fifteen-year-old daughter who lives with her. She explains her motivation following the divorce: 1 My research on surrogacy goes back to the early years when the practice of surrogacy was still fairly new in Iran ( 2005 - 2008 ). I was the first to conduct fieldwork on Iranian surrogacy. I also wrote the first ethnographic article in Farsi on surrogacy arrangements, published in Iran in 2007 and 2008 (see Garmaroudi 2008 b). Most women sharing their surrogacy experiences in this chapter are without doubt the first surrogates in Iran. 2 Va¯qe ı ¯ (“true” or “real”) refers here to the social legal status of (intended) parents/ couples as a married couple. 99 Encounters with surrogates It is almost four months since I started thinking about surrogacy [ … ] pretty much since I got divorced. It is a considerable amount of money. I don’t think any pain can equal the pains of delivery. If I had not divorced, I wouldn’t think about it, but when I think about the money involved [ … ] well, I told myself I could buy a house and pay its mortgage later when I get a job. I want my daughter to feel comfortable in my house. She doesn’t like her father. Although she speaks of her financial need to act as a surrogate, she doesn’t exclude the altruistic aspects of such an arrangement. Furthermore, her belief that the child she carries is not hers is central to her decision to participate in the surrogacy arrangement: Although the financial need is a strong drive in this case, I am certain that I am doing a savab [good deed] 3 . This is not something everyone can do, even if they have severe financial needs. I have met the woman for whom I’ll carry the baby. The egg and sperm had been taken from them but since her womb cannot hold the embryo, I’ll carry it for her [ … ] Every time we talk, it makes me feel good and I am glad of my decision [ … ] Sometimes I ask myself, if I had this problem, would I have had such money to give to another person to carry the baby for me? When I see these things, I thank God for being able to carry my own child. Another gestational surrogate, Farideh, spoke of her financial needs as well as her altruistic motives in helping an infertile couple: It is a savab [ savab da¯reh , “it is good deed”]. I have been a surrogate mother once, you have no idea how happy they were [to have a child], especially the wife; she loved her husband very much and feared he might divorce her. That is why she insisted on having a baby of their own [ … ] Well, being pregnant is not easy for everyone, you go through hell while you are pregnant, I have already given birth to five kids of my own, it is not that hard for me and I need 3 Savab, an Arabic term, literally means “reward”. It refers to any good deeds or kindness to another person for divine reward. Many surrogates (as well as many other individuals I talked to in Iran) described surrogacy as savab, a God-loving deed of carrying and giving birth to another’s couple child. This finding confirms that of Teman ( 2010 ) in her study of surrogates’ motivations in Israel. Many surrogates in her study described their act in term of mitzvah - “a good deed”. Indeed, their interpretation of their role in surrogacy as “doing a mitzvah” also hints at the “presence of the divine” in their understandings (ibid.: 266 ). 100 Surrogacy as doing a good deed the money too. We haven’t paid off our house yet [ … ] This way, we were able to pay it off and they became parents as well. God is pleased with both of us. We haven’t done anything wrong. It is not like I have slept with her husband. I carried her baby just like my own in my belly [ … ] I will do it in a heartbeat. I enjoy childbearing, I don’t feel any pain. I love babies. (Farideh, 32 years old, married for 19 years, 4 mother of 5 boys, housewife) As argued in chapter 3, many Shia authorities follow the reasoning that surrogacy, or assisted reproduction in general, does not involve the physical act of sexual intercourse, and they do not regard surrogacy as analogous to an adulterous act ( zina¯-ye moh ˙ san , illicit intercourse with an married man). The distinction that Farideh makes here between the act of gestation and physical proximity through the (illicit) sexual act is a further demonstration of this Shia moral juridical reasoning - from a pragmatic perspective of course. Almost all the informants I interviewed referred to this distinction. In fact, Farideh is carrying the baby of a total stranger ( gharı ¯beh ) inside her. In Iranian culture, getting pregnant before or without a marriage contract is a morally wrong and disapproved act, from both religious and non-religious standpoints. But, in this case, Farideh (like other surrogates) is carrying another man’s baby without having a marriage contract in place. Here, IVF has removed the stigma (or the “sin”) of getting pregnant - which requires physical intimacy between forbidden partners - from a man other than her husband. Instead of disturbing moral concerns, IVF has redefined these substantial moral values. Sometimes, gestational surrogacy can also be an act of love toward another woman. Afsaneh is a twenty-six-year-old homemaker who has been married for six years. She is content with her marriage and has a four-year-old daughter and a three-year-old son. She has decided to become a gestational surrogate for her friend. Her friend Akram is thirty-seven years old and works as a driving instructor. She has been married for twenty years, and her uterus had been diagnosed as not appropriate for pregnancy; therefore, the physicians have offered her surrogacy as a reproductive option. Afsaneh and Akram’s friendship became closer while Afsaneh took driving lessons with her. During this time, Akram talked about her infertility problem with Afsaneh; after consulting her husband, Afsaneh decided to be a surrogate for Akram. She says of her decision: “I am only doing this ‘for God’s sake’ [ be kha¯ter-e khoda¯ ]; only for Him, my heart and hers [ … ] It is not her fault. I want her to experience motherhood after all these years [ … ] She told me about her complications. I offered to be the gestational 4 When I asked Farideh how old she was when she got married, she smiled and said: “Well, we get married soon in our family (kha¯neva¯deh) [ … ] I was thirteen when I got married.” 101 Encounters with surrogates surrogate to her child. I am really fond of her. I want her to become a mother, just like me.” Like the examples of Mashyana, Shokoofeh and Azar in the previous chapters, some infertile couples in the case of surrogacy also resort to one of their own close relatives, especially siblings of the same or opposite sex. As noted in chapter 3, according to many Shia authorities, embryo donation and surrogacy between siblings are permissible and do not break any rules of adultery or incest, as long as they do not involve the direct transfer of sperm or egg. For example, in an interview I had with the late Ayatollah Sadeqi Tehrani, a distinguished scholar of the Qom seminary and a Shia marja in Qom in 2006, he explained to me that a third-party donation in the form of sperm and egg donation is not permissible. In these forms of third-party donation, according to him, “another man’s sperm” or “another woman’s egg” enters a place in which it does not belong. Such procedures are against the Quranic text (Sura 23: 5-7), which, according to Ayatollah Sadeqi Tehrani, gives strong clarification about the immorality of such actions. His opposition to sperm and egg donation, however, does not include embryo donation involving an embryo from another married couple or gestational surrogacy, which involves the uterus of another woman. In other words, he separates the status of egg and sperm from the status of the embryo and identifies embryo donation as a fully legal religious act. He does this by considering the embryo as the result of a legal marriage between a man and a woman. Following his arguments, both embryo donation and gestational surrogacy are allowed in order to overcome either male or female infertility in another married couple. According to him, it is even necessary ( va¯jeb ) for an infertile married couple, who would like to have a child and do not have another way to attain true parenthood, to take gestational help into account. According to Ayatollah Sadeqi, embryo donation and surrogacy between siblings is permissible: The transfer of sperm or egg alone as nutfah is not allowed. However, the procedures involving the fertilization of a wife’s egg with her husband’s sperm, and then transferring the resulting embryo [ janı ¯n ] into the uterus of another married woman is halal and permissible [ ja ez ast ], whether among siblings or among strangers [ qarı ¯beh ] (interview with Ayatollah Sadeqi Tehrani, 19 December 2006, Qom). Thus, a woman is religiously ( shar ı ¯ ) allowed to deliver the child of her sister or carry the child of her brother. The two cases I present here will illustrate the social implication of this juridical permissibility. These ethnographic examples also show how the power of sibling intimacy reinforces the affinal bond between spouses as the basis for legitimate offspring reproduction; “alliance” and “descent” combine in the dual roles of spouses and siblings and regulate kinship relations. Here the sibling relations appear to be foundational, as the following two examples show. 102 Surrogacy as doing a good deed Taraneh is a forty-year-old woman who wants to act as a surrogate for her brother’s wife. Her brother has been married for eight years; his wife cannot bear a child since her uterus is too small. 5 Taraneh says: Well, he is my brother. What is he supposed to do? He loves his wife. Well, my kids are older now. I have given birth three times, all of them natural births [ … ] When my sister-in-law approached me, I said to myself that I have been pregnant three times, I could do it one more time for my brother. It will be his child! I am forty years old and thank God, my uterus is still healthy; the doctors said they don’t see any problem with it [ … ] It is better not to involve a stranger. My sister-in-law did not want to involve a stranger either. It would have been very expensive [ … ] I ask God to help us. Sara is another gestational surrogate who has given birth to her sister’s baby. She is twenty-nine years old and has a six-year-old son. She has a BA in business management and is currently a housewife. Sara explains: My sister is a few years older than me. She got married before me but it wasn’t in her fate to get pregnant. Her husband is a relative; he is our cousin [ pesar-kha¯leh , mother’s sister’s son]. They did everything they could to get pregnant but it didn’t happen [ … ] The doctors told her that her uterus could not hold the baby and they recommended surrogacy to her. She talked to me first and asked me if my husband agreed whether I could do it for her. I talked to my husband and he said if I could tolerate the pregnancy and not travelling, not going to parties, he had no objection [ … ] After this, I was up for it [ … ] Well, I felt closer to my sister and loved her dearly. I hope God gives her a child this time. She continues: During pregnancy, my mother and sister were around me. My sister didn’t let me do anything at home [ … ] My son is still very young but he understands a lot of things. He used to tell me “Are you bringing me a sister? ” [ … ] I explained to him: “It is auntie’s baby that I am carrying [ … ] Since auntie’s belly is small, mummy is carrying the baby for her. When the baby arrives, we have 5 By the time of finalizing this chapter in 2012 , I was informed that Taraneh had given birth to her brother’s twins. 103 Encounters with surrogates to give it back to auntie.” [ … ] He had gone to my sister and asked her: if his mom’s tummy was small, who was supposed to hold him in her tummy? Let us turn to another point. The conceptual understanding of family members of gestational surrogates - their husbands and children in particular, and their reaction towards the subject - can be understood from different points of view. It is noteworthy that the pattern is the same in all of the cases and none of the families involved considered the surrogacy arrangement as a haram or illegal act. Since the fertilization of the sperm and egg of the infertile couple, in which the wife suffers from problems with her uterus, happens outside of the surrogate’s uterus and the embryo is subsequently transferred to the surrogate’s uterus, no legal (although not made morally appropriate through temporary marriage) or illegal sexual relation can be implied between the legal father (sperm donor) and the surrogate. On the other hand, the embryo carried by the gestational surrogate is a product of the legal union of an infertile couple, the legal union between the contracting husband’s sperm and the contracting wife’s eggs, and not the result of an illicit sexual union. In this regard, Shabnam (the first surrogate in this chapter, see above) speaks of her experience talking to her daughter: My daughter [15 years old] was opposed to it in the beginning. I had to tell her [ … ] There was no way I could hide it from her [ … ] The belly would grow big and show after all [ … ] But she used to tell me not to do it since she felt embarrassed in front of her friends and classmates. I assured her we would not let anybody know about it; instead our life would get better financially. But she said: “What will we say to our family? What are we supposed to do in front of others? Since you and dad are divorced, won’t they ask whose baby this is? ” I sat her down and explained to her that I am only offering my uterus and this is not a sin at all [ … ] I am only gestating the child of an infertile married couple. After that, she didn’t say anything. Shadi, who has donated eggs several times, is Shabnam’s sister. She is thirty years old and has a ten-year-old son and a five-year-old daughter. She talks of her sister’s decision to become a gestational surrogate: It is very difficult. You have to wait nine months. When she told me she was going to be a gestational surrogate, I thought this was not going to be easy but I didn’t give her any negative energy. I supported her [ … ] Well, she has a better situation than I do; her daughter is grown up and she has more free 104 Surrogacy as doing a good deed time. But my situation is different. I have to take my son to school every day, pick him up, and look after my daughter. So I encouraged her to go for it. We’ll see the result of this experience. In response to whether she would like to become a gestational surrogate, she says, “I don’t like pregnancy in general. I get depressed; it will last nine months. They [the social workers in the infertility centre, who know her sister] suggested to me that I could become a gestational surrogate but I didn’t accept. I don’t like pregnancy, it limits you, you have to stay home; my kids are very energetic. There is special care required [ … ] It is hard, I can’t do it.” Mina, a surrogate, has been married for fifteen years. She is thirty years old and had a miscarriage when attempting surrogacy. She wants to become a gestational surrogate for the second time, but this time her husband and ten-yearold daughter are opposed to it. Her husband supports her for egg and embryo donation, but does not want her to become a gestational surrogate again. When asked the reason for her husband’s disapproval, she says: He is not happy with it because I get migraine headaches and I have to take medication for it. If I decide to do surrogacy, I have to stop taking medication and my headaches will come back [ … ] This is one of his reasons for disagreement; on the other hand, my husband and daughter want me to bear another child for us, and I have been giving them excuses about my health condition. But they will be expectant when they see I have been a surrogate for someone else [ … ] I seriously don’t want to have another child to look after. Mina’s husband responded to the same question: She can’t, it is tough for her, and she’ll become ill-tempered. The first time she did it, I didn’t agree with it easily. I was worried for her. I was worried something might happen to her. But she insisted on doing it [ … ] but this time is different, I won’t agree to it [ … ] If she wants to be pregnant again she should give birth to our own child. Farideh (the second surrogate in this chapter, see above), also talks about her family and her neighbours: 105 Encounters with surrogates Everyone knows what I am doing: my husband, children, neighbours [ … ] I am doing something humanistic [ ensa¯nı ¯ ] [ … ] Do you know how gracious it is to carry someone else’s baby for nine months? God, help us! My sister-inlaw couldn’t get pregnant. Her husband stayed with her for eight years but he divorced her because of not having a child. She loved her husband very much. She still looks at his pictures [ … ] Well, in those days such technology was not available. These treatments are new [ … ] Maybe if it had been available at that time, they would have had kids by now [ … ] God knows I would offer to surrogate for her. Farideh gives her opinion about the religious aspects of it: To be assured about surrogacy, I even consulted some Shia scholars [ fu¯qaha¯ ] [ … ] We believe in haram and halal [ … ] They assured me that we are not committing a sin [ … ] They told me that my uterus was like a bowl that the baby grew inside. Sara, who gave birth to her sister’s child, and Taraneh, who has decided to surrogate for her brother, have a similar opinion. They say: We thought not to tell anyone in the beginning but it didn’t work; [in the family] they see you, they will figure it out [ … ] We decided that it was better to tell the truth [ … ] Those who don’t know might think that we are doing something wrong [ … ] so we told everyone that the baby was actually theirs and we were only carrying the baby for them. Afsaneh and Akram (surrogacy between friends, see above), on the contrary, have decided not to tell anyone. However, since the body goes through changes during pregnancy, it is not easy to hide Afsaneh’s pregnancy from others. In this regard, she says: I have told everyone in my family that I couldn’t get pregnant anymore since I had closed my tubes. Now they will be suspicious about how I have got pregnant [ … ] Akram asked who would know if we told them that the tubes had opened on their own [ … ] As for the baby, we won’t say anything until I am five months pregnant. No one will know. In the fifth month, I will say it is 106 Surrogacy as doing a good deed two months and in the ninth month, I will say I am six months pregnant [ … ] Then, by the due date, my husband and I will go to the hospital [ … ] Akram and her husband will come to the hospital too. When I have given birth to the baby, they will take it home. We’ll say to everyone that the baby was born dead or it was premature. I have two kids already. No one will mind. Encounters with intended couples Let me now turn to my encounters with intended couples. 6 Generally speaking, most of the intended couples I interviewed expressed their happiness about the religious ( shar ı ¯ ) permissibility of surrogacy as a solution for their infertility. They had little or no concern about registering the baby after birth. Compared to embryo donation (discussed in length in chapter 4), surrogacy attracts less controversy concerning nasab (legal filiation) because the intended (married) couple are the producers of the embryo that the surrogate is carrying. And from the fiqhı ¯ ’s point of view, the child will be that of the producers of the egg and sperm (the embryo), and the surrogate is simply gestating another couple’s embryo. From the very beginning, the intended couples learn about the circumstances under which the birth certificate is issued. The clinic where the intended couple receives treatment provides them with a [reference] letter to be taken to the hospital where the delivery takes place. The hospital then issues the birth certificate under the name of the intended mother and her husband, the child’s father. 7 Not all hospitals are trained for this particular documentation, so there are sometimes problems and confusions (e.g. in the case of Giti and Mehri, see the next chapter). 8 In contrast, the intended couples were mainly concerned about the high price of the treatment, the failure of the pregnancy, and the possibility of miscarriage. Almost all the intended mothers I interviewed wanted to keep con- 6 Here I use “intended couples” instead of “intended parents”, a term that is also often used in Iran to refer to couples who intend to use surrogacy. Couple (zojeyn) is defined as a man and woman who are bound together by way of marriage, which once more indicates the importance of matrimonial union in the context of our discussion of kinship and reproduction. 7 Therefore, in my opinion the existence of [various] viewpoints on the legislative aspect of surrogacy (e.g. the proposed bill on surrogacy explained in chapter 4 ) is a clear indication of the involvement of different individuals and organizations with a wide range of attitudes and affiliated political parties that exist in the administrative and legislative system in Iran. 8 However, according to my recent observations in 2015 , this has changed. Many hospitals now have an IVF and infertility section and can help intended couples to find a surrogate. 107 Cases from the field tact with the surrogate and accompany her to ultrasound sessions and monthly check-ups. 9 Some of the intended couples found the surrogate themselves, using the traditional method of asking among family and friends, or referred to charity centres. Many of them had resorted to the [infertility and IVF] clinics as well. As will be explained (chapter 7), the clinics had an open, warm atmosphere with a lot of coming and going, which helped to establish a friendly atmosphere among clinic staff (e.g. social workers), intended mothers and surrogates. They had good relations to the extent that they could open up to each other with no trouble, and that contributed to the secure atmosphere of the clinic. The following case studies show some aspects of the way Iranian intended couples experience surrogacy. Cases from the field a) The case of Nasrin, Reza and Homeyra Nasrin and Reza are a couple who have decided to try their chance at parenthood with surrogacy. They come from a traditional, middle-class family; Nasrin is a housewife and Reza is a self-employed bazar trader ( bazarı ¯, businessman). The day I spoke with them, it was less than two months since three embryos had been transferred to the surrogate’s uterus. Nasrin, Reza and the surrogate had come to the clinic where they learned from the ultrasound that one of the embryos had come through and the heart ( qalb-e janiı ¯n ) had formed. 10 The clinic had provided them with the document for the surrogacy contract to be read and signed. 11 Waiting for the surrogate’s husband to come and sign the contract, Reza tells me their story: “my wife gets pregnant but her uterus is too small so her pregnancy ends with miscarriage. We are happy that we can become parents in such a way, after eight years”. However, he is very worried and talks about the shortcomings in the contract form. 12 The following is part of his conversation with the coordination manager at the reception office of the clinic while I was present there: 9 Elly Teman’s ( 2009 ) analysis of Jewish-Israeli surrogates and intended mothers also shown similar results, except that in Israel the surrogate mother must be an unmarried women. 10 This usually means that the surrogate does become pregnant. “Forming the heart” refers to hearing the baby’s heartbeat through ultrasound in the first trimester between the 12 th and 14 th week of pregnancy. For many women and men in my study this was the most beautiful moment in the long process of IVF and embryo formation. 11 Usually when the surrogate becomes pregnant, the clinic asks both the intended parents and surrogate (and her husband if she is married) to meet and sign the surrogacy contract. The important issues relating to the surrogacy agreement are discussed in several meetings before the embryo transfer. 12 Issues that are the subject of many ethical and legal debates and publications in Iran, as I describe in chapter 4 . 108 Surrogacy as doing a good deed The contract doesn’t say, if something happens to this lady while pregnant, say if she gets hospitalized or God forbid, if she dies, who will be responsible. Are we held responsible? [ … ] It is not clear in the contract that if something happens to her because of the pregnancy what shall be done [ … ] it is as if we are renting, then imagine that we rent a house [ … ] if something happens, are we responsible or the landlord? For example, if an electrician comes to fix the electricity and he gets electrocuted and dies, will we be held responsible for it? [ … ] Right now we have to make this clear in the contract that if the pregnancy puts her in jeopardy or something happens to her, who should be held responsible? The coordination manager at the reception office tells him that he has to discuss his concerns with the clinic manager. Reza turns to me saying: “since you are doing research in this field, you have to bring this to their attention and ask them to revise these contracts so there won’t be any shortcomings in them [ … ] It must be more specific.” I detected fewer such worries about the surrogacy contract in Reza’s wife, Nasrin. Her worries, which had been more focused on the personal and marital life of the surrogate mother, were gradually turning into hopefulness and trust. Nasrin states: I care about her [the surrogate] a lot [ … ] since I know she is married I feel more at ease [ … ] in the beginning when they told [me about her] I was wondering who was she? How would she be? But when I met her husband I felt less worried. I saw that they are a family-loving couple [ … ] now I am just hopeful that this will go through completely [ … ]. Although the roots of the worries stirring in Reza and Nasrin’s minds are different, they agree on one thing: there is no doubt that the baby on its way belongs to them: It’s our baby [ … ] it is just like we’ve got the baby a nanny [ parasta¯r ] with the difference that the nanny is taking care of the baby before birth. The same day at the clinic, I spoke with the woman who was pregnant with Reza and Nasrin’s embryo. Like many other surrogate mothers in this chapter, she stated financial need as her biggest motivation in undertaking the role. She tells me that she heard about surrogacy through a friend of hers. Then she discussed it 109 Cases from the field with her husband who encouraged her to see what it was all about. She puts her story this way: One day, I started walking up town (toward the centre and north of the city). I visited a lot of clinics on my way until I found a maternity hospital. I told them that I wanted to do this [surrogacy]. They laughed and then told me that they didn’t do it there. But they gave me the address of this centre. I was happy to see that there is a [specialized] centre that does this and all their work is legalized [ qa¯nu¯nı ¯ ] and it doesn’t contradict with shar ı ¯ issues either. My husband also came to see the place and made sure of its qa¯nu¯nı ¯ [legal] and shar ı ¯ measures and agreed to do it. But he told me that if it was alright with me and I was not scared, he would agree to it. 13 Homeyra lives on the lower level of her mother-in-law’s house in a southern neighbourhood in Tehran. Her husband is a worker and they have two children, 5 and 7 years old. She says: They have agreed to give us 10 million tomans [about US$ 10.000 in 2010]. But honest to God, it is nothing. But I had no choice and accepted it. You know [ … ] not many people will do this. The lady [Nasrin] is very kind to me. We meet most of the time and she cares for me. In return, I want to take care of the baby for her, I try not to be on-the-go too much so I can deliver a healthy baby for them. This way their dream [of becoming parents] will come true and I can get the money to move out of my mother-in-law’s house and be independent. I am so tired of her and I can’t stand living in that dark place anymore [ … ] my husband has also promised to help me out. Homeyra and her husband have decided not to tell anyone about the pregnancy. The only one who knows about their plan is Homeyra’s mother, in case she needs to rush to her for help. Homeira explains: 13 In chapter 4 we saw how the correlation between civil and religious authorities provided a means for developing bioethical knowledge. Here, we can see how the combination of civil and religious legitimation has served the medical practice. 110 Surrogacy as doing a good deed I have decided not to tell anyone because it might not bring a good reputation to my husband. They might think that he is not man enough or devout or even say other nonsense stuff. My mother-in-law might say that I have bamboozled my husband [ … ] so I have to say that I am pregnant and I know, even at that point, they will blame me for not being careful enough and not using protection [ … ] my neighbours will definitely ridicule me for not stopping myself [ … ] I ask Homeyra a question: “Don’t you think of this baby as yours? ”, to which she replies: No! Why should I? If I had wanted another baby, I would have slept with my husband and made it happen [ … ] there was no need to do this [ … ] we already have two kids, but we don’t know how to handle them … my children are very excited about the baby [ … ] but I will tell them that the baby died after birth. No one will know [ … ] Listening to our conversation, the woman at the reception asks Homeyra: “You are not sexually active with your husband, are you? Just remember, if you are active and you become pregnant from your husband and they learn that the baby is yours, you have to keep the baby and refund the money to them”. Homeyra laughs and says: “No! I don’t even like it when my husband passes me by. We don’t have sex. I’ve also told him that we shouldn’t do it especially now [ … ] so he understands [ … ] I swear to God, I just want to get away from that house [her mother-in-law’s].” Later, I learnt from the reception lady that Homeyra’s pregnancy went well and ended with no complications. The two families got along nicely and today, Nasrin and Reza are parents to a baby girl. b) The case of Kobra and Houshang Kobra is the other surrogate mother I spoke with when she was seven months pregnant. Unlike other surrogate mothers I had spoken with, it was Kobra’s husband who had introduced her to surrogacy. Kobra recites her story: My husband once told me that one of his friends had heard about such a thing [surrogacy]. Then he asked me whether I was interested in doing it. He told me I could only do it if it was not hard for me. Well, I gave it some thought, 111 Cases from the field conferred with my mother and mother-in-law [ … ] they agreed only if I really wanted to do it [ … ] after all, we’ll receive some money for it. In contrast to Homeyra in case 2, Kobra has a good relationship with her mother-in-law. She was the only person who was worried about the decision Kobra had to make. Kobra reveals to me that her mother-in-law did not have a happy marriage since her husband had taken another wife after her. This had left her with a pessimistic view about all men, including her own son. “What if something bad happens to you? What if you become disabled and bedridden? Then your husband will take another wife [ … ] but if you think it is not difficult, go with it.” These are the concerns her mother-in-law had voiced before Kobra made her decision. “I did it anyway and it was successful the first time and now I am seven months pregnant,” Kobra says. Having a nine-year-old son and a five-year-old daughter, she is carrying a baby for a 48 year-old couple who live in Europe. According to the ultrasound results, it is a girl. Kobra and her family are working class and live in a neighbourhood near the south side of Tehran. Everyone knows about her work in progress and respect her tremendously for the sacrifice she has made. Only her children are not told the truth of the matter. Just like other surrogate mothers I had met with, Kobra has decided to tell her children that the baby has died after birth. It is obvious that her children have bonded in their own way with the baby she is carrying. Kobra says: “my daughter complains about why I want to bring another baby girl [ … ] she is jealous and wants to kick my belly but my son is happy and says: “Mummy is bringing another sister for us.” I ask how she feels about the baby she is carrying. She says: “of course, I love her [ … ] when she doesn’t kick, I get worried [ … ] I think what if something has gone wrong [ … ] I wasn’t this nervous when I was pregnant with my own children, but for this one [ … ] well, I always think that it has been entrusted to me.” In the meantime, Kobra does not underestimate the financial aspect of her endurance and her husband’s dire need for it: “my husband helps me a lot. He washes the dishes, cooks and does the things around the house. In one word, he does everything in the house. He says “now that you are going through this trouble, make sure to deliver a healthy baby - insha’Allah - this way, they will have their child and we can get the money too.” My mother-in-law keeps quiet then. Kobra has not met with the parents of the child she is carrying. Her only contact is Houshang, who is the brother of the woman she is carrying the baby for. Houshang’s brother-in-law [his sister’s husband] came to Iran once, a year ago, to freeze his sperm. Houshang’s sister cannot conceive due to lack of ovulation and rheumatoid arthritis. Kobra’s eggs, 14 therefore, have been used to make the embryo. She tells me of her feelings towards the baby: 112 Surrogacy as doing a good deed I hear her heartbeat, I feel her [ … ] I am sure I will feel [closer to her] when she is born [ … ] … but she is not mine, she has only been put into my care … I can only pray for her to have a happy life [ … ] it will be great if they can keep me posted on her from time to time. I will be happy for her. Houshang has accepted the responsibility of finding a surrogate mother for his sister in Iran. Forty and single, Houshang is a well-groomed and articulate man who comes from a well-off family. He says: “My sister couldn’t bear any children; they tried their luck there [Europe] too but with no success.” And just like the other recipient couples who insisted on the surrogate coming from a decent family with moral values, he adds: It wasn’t possible to try this [surrogacy] in other countries; not only would it have been more expensive, but they couldn’t trust the women [surrogate mothers]; who they are, what type of activities they are involved in; what they would do during pregnancy [e.g. smoking, drugs, sex], here, they feel more at ease. This lady [Kobra] is a respectable and caring woman; she is married [ … ] she is doing it because of her financial needs [ … ] every time she has to come here, I’ll go pick her up myself. She is very kind. She doesn’t bother us [ … ] I only hope that she delivers a healthy baby [ … ] my sister is extremely happy. She has put me in charge of everything [ … ] here [at the clinic], Ms. X [the reception and coordination assistant at the clinic] has been tremendously generous and kind to us [ … ] Three months later Kobra gave birth to the baby girl and handed her over to Houshang immediately after the birth. The birth certificate was issued under his 14 In some cases (see also the case of Giti in the next chapter), the surrogate’s eggs will be used, although not in terms of traditional surrogacy, which involves the insertion of sperm directly into the surrogate’s uterus. Here, the conception would occur in vitro, outside the surrogate’s body, with the intended father’s sperm, and then the resulting embryo would be transferred into the surrogate’s uterus. The division of surrogacy into the two categories of traditional and gestational is not relevant for my study. This division is only based on using or not using the surrogate’s eggs; an understanding of surrogacy as a medical or technological achievement. It does not cover the social patterns and statuses that are involved in surrogacy. Nevertheless, in my study, in the cases where the surrogate’s egg has been used, intended mothers consider themselves the mother, since they are in a marriage bond with their husband and not the surrogate. Again marriage - in fact legitimacy - takes precedent over all other principles. 113 Cases from the field sister’s name. Houshang hired a nanny for the baby for two months to take care of her in his mother’s house - the baby’s maternal grandmother. After two months, his sister and brother-in-law came to Iran and after spending a week in Iran returned to their home in Europe with their two-month-old daughter. c) The case of Nasim and Parastou Nasim and Parastou both come from lower-middle-class families; a new middle class affected by the religious culture as well as the existing secularism in Iran. Nasim is thirty-eight years old and works at the international desk in a travel agency. Her husband is forty-six years old and they have been married for eight years now. Three years ago, they started trying for a baby and it was then that she was diagnosed with Asherman’s syndrome. 15 The day I spoke with Nasim she had come to the clinic to meet with a couple of surrogate candidates the clinic had found for her. She could possibly come to an agreement with one of them. Parastou was one of the surrogate candidates. I first interview Nasim in the reception room. I ask her whether her husband agrees with surrogacy. She replies: Yes [ … ] but he wanted us to find someone from one of these small villages around the city in the hope that it might cost us less. 16 But I was afraid that she might refuse to give us the baby afterwards. 17 It is safer here [ … ] After all there is a [surrogacy] contract [ … ] there is a centre [to handle the case]. Then she adds: I don’t want my husband to sleep with another woman or take another wife in the name of having a baby. I have also told him if it gets to that point, I will not stay in this marriage. We will peacefully get a divorce. I prefer to get a divorce rather than accept that my husband has a second wife. After all, I have my expectations. 15 Asherman’s syndrome is an acquired uterine disorder characterized by changes in the menstrual cycle, infertility, and pregnancy loss. 16 She is referring to “taking up a temporary wife”. As explained in chapter 2 , this is an accepted way of resolving the issue of infertility but not the best choice for either of the women. 17 Because children born as a result of temporary marriage are recognised as the legitimate offspring of both parents (see chapter 2 ). 114 Surrogacy as doing a good deed Nasim’s sister is married to Nasim’s brother-in-law; in other words, two sisters have married two brothers. Nasim explains: You know, he [her husband] adores children [ … ] but I am also my sister’s sister-in-law [ ja¯rı ¯ ]; these two brothers have taken us, two sisters, as wives [ … ] my sister’s life is really good [ … ] he [Nasim’s husband] won’t divorce me because of my sister [ … ] because if he does, it will affect their marriage too [ … ] my sister will tell her husband “your brother divorced my sister for [not bearing a] child” [ … ] I don’t mean that my husband doesn’t love me but he is a man and he wants to have his own child. In the beginning of our marriage, we didn’t care about having a baby [ … ] I was working and my husband had his own business … not that he makes a lot of money [ … ] no, his income is moderate [ … ] we have to see what will happen anyway. 18 Nasim is even interested in doing a TV interview to speak about surrogacy. She says: I hope it [surrogacy] becomes an acceptable thing to do in the eyes of the ordinary people and in our culture [ … ] I am not hiding what I am doing from anyone [ … ] I don’t want to wear a prosthetic belly, pretending to be pregnant and things like that [ … ] No! I will tell everyone that someone else is getting pregnant for me [ … ] she [the surrogate] isn’t doing anything wrong. I ask Nasim what type of expectations she has about the surrogate mother. She replies: I want her to have faith in God, be a believer [ … ] I want her to know that the task she is accepting to do, she is doing it for a childless family [ … ] I want her to believe in God, to have faith in what she is doing [ … ] we are paying her [ … ] in return, she will do this for us [ … ] I prefer her to be married and have children of her own [ … ] I think it is better this way. I want her to have a family so she will understand what it means to help another family. Anyway it is better this way. I want her to come from a good family [ … ] in any case, it is like babysitting. Instead of hiring a babysitter after birth, you hire a babysitter to carry the baby for nine months. 18 Another example of two ja¯rı ¯s (also two sisters at the same time). Again, note how alliance and descent combine in the dual roles of spouses and siblings and regulate kinship relations. 115 Cases from the field While we are sitting in the reception room, Masoumeh (the reception and coordination assistant) introduces Parastou to Nasim. It is the first time that the 28-year-old Parastou wants to be a surrogate. Her slender figure is draped in the up-to-the-minute fashion of Tehran and it is clear that she has spent a lot of time on her perfectly-applied makeup. She has come to the clinic with her husband and her six-year-old daughter. Pointing out of the window, she shows us her husband. He is almost the same age as her, with a lean figure and freshly shaved face and he is pacing the clinic yard with their daughter. Nasim is glad that Parastou is married. Parastou I learned about surrogacy from TV programs. I should mention that I had donated eggs once and with the money I received from it, I prevented my husband’s cheque from bouncing. We were doing fine financially until he went bankrupt. Now it is my turn to do something for our life. Nasim What does your husband do? Parastou Nothing! He doesn’t have a job right now but we have a lot of bounced cheques. I want to do this to clear his cheques. With this money, I can now buy a car to get me here and with the rest of it, we can pay his debts off. I didn’t work before. I was a housewife. I am glad now that I can do something for my husband [ … ] for my daughter, she is only 6 [ … ] I am only doing this for them. Nasim I can come visit you. Parastou: You can. But I haven’t told anyone. My husband and his mother are the only ones who know about this. My mother and my sisters know nothing about it. We all live together in a house with a shared yard. My sister-in-law [husband’s brother’s wife] is in the unit opposite us. My husband’s sister lives in the unit next to us. They will see us. If you come to visit, you shouldn’t tell them the truth. You have to say that we are friends. Nasim Why don’t you want to tell them? What is the problem with it? You aren’t doing anything wrong. Parastou: No! I don’t want to [ … ] it is not possible [ … ] they are very traditional. If my mother or brothers hear about this, they will think that my husband has lost his pride [ gheirat , “his manhood”]. They would say “see what he is making her do.” This aside, what will others say? No! Only my mother-in-law knows about it. I had to tell her. After all, he is her son [ … ] but no one else knows. I love my husband 116 Surrogacy as doing a good deed dearly. Now that he needs me I am willing to do anything for him [ … ] (her gaze travels through the window towards her husband and daughter walking in the yard). Nasim After you become pregnant, won’t you want to keep the baby for yourself? Parastou Why would I? If I want another baby, I will have it with my husband. No need to do all this work. Why would I need someone else’s baby? Nassim Won’t they ask about the baby? Parastou I’ll tell them that it came as a stillbirth [ … ] they won’t find out the truth. Nasim and Parastou keep on with their talks. When Parastou steps out for a short moment, Nassim turns to Masoumeh and says: “I don’t think she could be the one. She is very high-maintenance. She wants a car too! My husband might want me to check on them every day [ … ] he might even get them a car [ … ] No! I have to wait and see how much she asks for.” Parastou returns to the reception hall. Nasim: Now, how much do you have in mind? Name a price that is reasonable. Masoumeh: We have had different cases ranging from 6 to 7 million tomans to 10 to 11 million tomans. Anyway, it depends on you. Parastou: To be honest with you, I have asked around and I will do it for 12 million tomans [about US$ 12.000 in 2010]. Nasim: 12 million tomans is way out of our budget. I have told my husband it is going to be around 7 to 8 million tomans [ … ] I can bring him around for 8 million tomans but for 12 million tomans [ … ] no, I can’t. Masoumeh: Well, you have to come to terms with each other … we can’t help you on this [ … ]. Nasim and Parastou could not reach an agreement that day. Masoumeh has three more surrogates to meet with Nasim. She agrees that Nasim and Parastou are not a good match for what is ahead of them. She tells me her opinion about Parastou: “she seems to be a fussy person and might cause trouble later on [ … ] 12 million tomans is a lot of money to ask for too.” Nasim has not left a better impression on her either. Masoumeh says: “It is not clear whether she will give the whole 117 Cases from the field money or will be haggling all along the way,” and adds “but it is our responsibility to treat them with respect and patience.” Nevertheless, these cases and experiences I observed through all these years indicate that surrogacy is a practical solution and can help to strengthen the structure of a family. This is in contradiction to most studies on surrogacy (e.g., Ragone 1996, Dalton 2000 and Pande 2014), which maintain that it is to blame for failed marriages, through the “prostitution of motherhood” (Ragone 1996), that it creates confusion in kinships (Strathern, Franklin 2000), or that well-off families exploit and take advantage of the body of another woman (Pande 2014). The examples shown in my study indicate otherwise. In the first case, it is obvious that Nasrin and Reza are both from a middle-class family who have been seeking treatment for eight years. They are happy together and have high hopes that Homeyra will give birth to a baby for them and bring them joy and life. Despite being unhappy about living with her mother-in-law, Homeyra loves her husband and is hoping to provide better living conditions for her family [by undertaking surrogacy]. It will be a whole new life for her to live far from her mother-in-law and gain independence. Homeyra is not concerned about being a surrogate, nor does she care if others criticise her for becoming one. She worries most about whether people will accuse her husband of being so incapable of providing for his family financially that she has had to resort to surrogacy. 19 It increases Nasrin’s trust when she learns that Homeyra is a family woman who is trying to make life better for her family by becoming a surrogate. The fact that Homeyra is married and has a family of her own makes Nasrin feel more confident about her. And Reza’s concerns are more about the contract. Reza thinks about the contract and is worried about who will be responsible in case something happens to Homeyra during the pregnancy. He thinks that the surrogacy contract needs revising. As I explained in the previous chapter, there remain issues that have been the subject of many interdisciplinary ethical and legal seminar discussions in Iran. Furthermore, most intended couples preferred the surrogate to be married. They believed a married surrogate would be more reliable, morally-speaking. As one of the intended mothers put it: When she is married, it is comforting to know that she has a husband, she is a family person, she is watching over her children [ … ] but the playful ones, those who wander around are not reliable [ … ] you don’t know who they hang out with. 19 The point that Parastou also refers to, explaining why she did not want to share her surrogacy with her family. 118 Surrogacy as doing a good deed As in Kobra’s case, she has a good relationship with her husband and her mother-in-law, which helps her to have a peaceful and supportive pregnancy. It was Kobra’s husband who first proposed the surrogacy idea to her, but it was she who made the final decision. As she stated, her neighbours and relatives were aware of her decision and for the same reason, they respected her even more. Kobra was very peaceful; she thought about the babies she was carrying; she thought about the good deed she was doing; even though the babies were from her own donated eggs, she called them trusts in her care. However, she did not hide her affection for them. Houshang, the brother of the infertile mother, respected Kobra tremendously. In his talks, he stressed the fact that Kobra came from a good family. As explained in chapter 2, in the past, it was customary for women who were not able to breastfeed to choose a nanny or wet-nurse from a reputable family. Nannies were highly respected. The same pattern is present in Kobra’s story. In Nasim’s case, she is a middle-class woman who loves her husband. But she has her doubts and is worried that they might get divorced if they do not have any children. In any case, she feels that benefitting from surrogacy is better than allowing her husband to marry another woman or even divorcing him. It is important to her that in surrogacy there is no sexual encounter between her husband and another woman. She, like other infertile mothers, prefers to have a devout surrogate mother; someone who is married and has a family of her own. Although Nasim and Parastou could not reach an agreement, their case is a good example of how an intended mother and a surrogate negotiate about the financial aspect of the task at hand - an example of “a relationship of reciprocal interests” (Godelier 2011: 539) and the fact that they might not reach an agreement. Surrogacy, indeed, is and can be a good deed. However, there have been cases where the relationship was not established properly or they faced a bump in the road - as in all types of social relations. For example, one of the clinic’s staff recalled a case with a surrogate who had given the intended parents a very hard time. Their relationship appeared to start fairly well. In the fifth month of pregnancy, the surrogate lost her husband in a car accident. Two months later, her mother passed away. She became hysterical and did not want to carry on with the pregnancy when she was seven months into it. She bothered the intended mother by asking her to take her to various places for shopping, coffee, etc. The intended mother suffered from a nervous breakdown and was hospitalized. Eight months into the pregnancy, the surrogate started hitting herself in the abdomen to the extent that bruises were visible on her stomach. At that point, the treating physician decided to deliver the baby since it was no longer safe for either the surrogate or the baby to continue that way. The intended parents, who had waited a long time for their own embryo to form, were having a difficult time. In the end, the baby was delivered and kept in an incubator until it was ready to go home. Meanwhile, the surrogate met another man. 119 Conclusion Conclusion In these narratives we have seen how the social actors themselves perceive assisted reproduction. We have seen how surrogates decide to get pregnant and give birth to a child, whom they consider to be the child of the intended couple and not their own. We have seen how surrogates use the grammar of kinship - a grammar of social proximity - to disconnect themselves from the experience of the surrogate pregnancy in order to provide a way for another woman to achieve maternity, and how the intended couples use it to connect. The grammar of kinship is used to maintain social order in dealing with infertility - what I consider as social disorder in this account - which implies a form of regulation, and this regulation does not come from biogenetic substances but from the rules of kinship itself and the social actors who apply these rules. As Le´vi-Strauss wrote: “The rules of kinship and marriage are not made necessary by the social state. They are the social state itself, reshaping biological relationships and natural sentiments, forcing them into structures implying them as well as others, and compelling them to rise above their original characteristics” (1969: 490). The fact that the embryo carried by the gestational surrogate is the result of a legal union between an infertile couple demonstrates the importance of the matrimonial union and the legal meaning ascribed to the reproductive male and female substance in emic thought - in Le´vi-Strauss’s view (1985: 115-120), “the level of perception.” However, in Godelier’s terms (2011: 539-540), “but what a legal act can never establish is the amount of the moral debt the parents feel with respect to the woman who enabled them to have a child.” Likewise, “nothing can measure the moral satisfaction felt by the surrogate mother at the fact of having helped a couple to have a child” (ibid.: 540). We have also seen that surrogates consider their act to be doing something they qualify as savab - a good deed - that will help another woman to become a mother. Some stress their financial need and appreciate the value of payment; others emphasize emotional bonds and enjoy their acts of assistance in creating a child. However, receiving money for what they do does not contradict their understanding of reproduction and their empathic feelings toward an infertile woman, which in itself creates a form of female power and symmetrical reciprocity in favour of creating, keeping, and reinforcing ties of kinship, and, thus, the reproduction of society and social relations. In the next chapter I will explain why I call this form of social relation “uterine intimacy” and a “priceless gift”. 6. A priceless gift: a short story of surrogacy In certain cases, one can study the whole of human behaviour, and social life in its entirety. One can also see how this concrete study can lead not only to a science of customs, to a partial social science but even to moral conclusions, or rather, to adopt one more old word, ‘civility’, or ‘civics’, as it is called nowadays. Studies of this kind indeed allow us to perceive, measure, and weigh up the various aesthetic, moral, religious, and economic motivations, the diverse material and demographic factors, the sum total of which are the basis of society and constitute our common life, the conscious direction of which is the supreme art, Politics , in the Socratic sense of the word. Marcel Mauss (1990 [1950]: 83), The Gift: The Form and Reason for Exchange in Archaic Societies The surrogate who is offering her uterus to carry the baby may be thinking “God has given me the power of childbearing. Perhaps I can help another family to have a child.” Why, then, do we call this [surrogacy] exploiting or taking advantage of someone else’s body? Don’t we have da¯yeh [nannies] in Sharia [here “Islamic culture”]? Don’t we have ma¯dar rida ı ¯ [milk mothers]? These were never associated with exploiting in the past. A woman would have said to another “now that you cannot, I will breastfeed your child”. Seyyed Taha Merghati-Khoei, a cleric and expert in Islamic jurisprudence in an interview with Mehr Khane News, 2014 1 Giti, aged twenty-nine, was an intended mother who could not carry a child herself, because she was born without a uterus. Mehri, twenty-six, was a mother of two who decided both to donate an egg and to be a surrogate mother for Giti and her husband, using Giti’s husband’s sperm and her own donated egg. Mehri gave birth to three healthy baby girls. Their birth certificates were issued under the name of Giti and her husband. With the payment Mehri received, she bought a small apartment. This is a summary of the story of two Iranian women named Giti and Mehri 2 who came to know each other through one’s infertility and the other’s financial 1 Mehr Khaneh - News Analytical Database Family and Women, 6 January 2014 . Available in Persian at: http: / / mehrkhane.com/ fa/ print/ 9690) (accessed on 3 December 2015 ). 2 Giti and Mehri are very common Persian female names: Giti means “universe” or “world”, while Mehri derives from the Persian word “mihr / mehr”, standing for “love”, “friendship”, “sun”, “light”, or “agreement”, “contract” and “the protector of truth and cosmic order”. To me, Mehri in this story embodies all these things. 121 The Story of Giti and Mehri needs, and who experienced surrogacy together along the way. An experience that has been the subject of few studies. For example, in her ethnography of surrogacy in Israel, Teman (2010) focused on the surrogate-intended mother relationship from the perspective of the body and emotional facts. This embodied connection, in Teman’s terms, “can produce an intimacy that can have profound implications for the women involved and for the success of the whole process.” (ibid.: 133). The power of this intimacy, furthermore, can shape “the contractual relationship” into a “gift relationship” (ibid.: 209). Similar patterns can also be observed in my study of Iranian surrogate and intended mothers. We should not forget, however, from a cultural perspective, that the influence of religious ethics made surrogacy a less morally controversial issue in both countries. The personal experiences of Giti and her surrogate Mehri forms the body of this chapter; their experiences both individually and through their close and intimate relationship - what I call uterine intimacy - over the course of their surrogacy arrangement, from meeting each other to the pregnancy and until giving birth and delivering the babies. Focusing on this particular story, I argue that surrogacy is not just a form of “technological assistance to reproduction” (Franklin 2013: 189), but a collection of complicated human relations that come together and can generate other forms and meanings. “Uterine intimacy” and “priceless gift” are two examples of such generated forms and concepts to be drawn from the story. Another important point I seek to convey in this chapter is the importance of ethnography in offering a clear description of these complicated human relations. The Story of Giti and Mehri Giti: born without a uterus 3 My first interview with Giti took place in the reception room of an IVF clinic in Tehran in October 2010. She was twenty-nine years old and had been married for five years - a non-religious, middle class woman with a calm and attractive manner of speaking and a bachelor’s degree in Social Sciences. After introducing myself and talking briefly about my project, our conversation continued with my first question: “How did it all start? ” Giti was born without a uterus (Rokitansky 3 In her study of surrogacy in Israel, Weisberg ( 2005 : 117 - 146 ) describes the story of a famous infertile Israeli couple (Michal and Shlomo Zabaro) who initiated a lawsuit that finally forced the Israeli Parliament (Knesset) to enact the law of surrogacy. Michal was born without a uterus. Four years after she brought her lawsuit to allow surrogacy, the couple received the birth of their son by a surrogate. Weisberg devotes a chapter of her book to Michal’s story. 122 A priceless gift: a short story of surrogacy syndrome, a genetic disorder). “During my puberty, I noticed I did not get my periods. Visiting the doctor, I was told that I did not have a uterus at all,” she said, remembering the hardship of those days and the many times she had wept in her loneliness. But she had always managed to mask her sadness. She added: “My parents were pesar amu¯ dokhtar amu¯ [FBS-FBD; son and daughter of two brothers]. But this [cousin marriage] was not the reason for my condition. We never got an answer, we never understood why. I am the eldest among my siblings. I have three sisters and a brother who are completely healthy. I always thank God that they do not have a problem [ … ] but that was a hard period of time. I thought I would never get married.” Giti’s husband is a distant relative. Before getting married, they had met once in a family occasion and he had fallen in love with her. He has a high school diploma and runs his own business, enjoying reasonably good financial status. When he proposed, Giti rejected his proposal. She explained everything to him, including the fact that she could not bear children. For that reason she did not want to marry him. But he insisted, stating that he would accept her conditions. “He is very good. He told me that we would take medication or something. I told him that my problem was not of a kind to be solved by medication. I did not have a uterus to begin with,” she said, adding “but he said if medication did not work, we would consider adoption” (see chapter 2 on child adoption in Iran). 4 “When he heard of this method [surrogacy], he became very happy. After coming here [IVF clinic] several times and not getting the positive results, he suggested adopting a baby from an orphanage [ parvareshga¯h ]. But I was not up for it.” 5 Giti first heard of IVF in a television program and later read about it in a family magazine and it had raised her hopes over the previous four years. 6 She had been coming to the clinic for almost two years. She told me about the hardships and unsuccessful experiences she had had with surrogacy. Mehri was the third woman Giti had reached an agreement with for surrogacy. The other two women she 4 Giti’s husband is no exception. There were other men in my study who had proposed to resort to child adoption even though it was their wives who were infertile, not them. Nevertheless, as mentioned in chapter 2 , almost all infertile couples I met during my research preferred to resort to assisted reproduction (in general, embryo or sperm donation in the case of male infertility and surrogacy or egg donation in the case of female infertility) rather than child adoption. However, the assumption that all men in “the Middle East, with predominantly patriarchal values in relation to reproduction and fertility” (Tremayne 2012 : 149 ), have a strong desire to have a child who is the result of their own sperm cannot be applied to all men. At least, my study does not support the idea that women’s experience with infertility is a form of “lived patriarchy” (ibid.: 147 , citing Inhorn 2008 ). 5 As she later explained (see below), this is mostly due to uncertainty about the parental background of adoptive children and the problem of illegitimacy (see also chapter 2 ). 6 As I mentioned earlier, media debates in Iran are, in general, in favour of surrogacy and other forms of assisted reproduction. 123 The Story of Giti and Mehri had tried with did not get pregnant after the embryo transfer. “The previous times, embryos would form but after transferring them the women did not get pregnant. This is the fourth time that we have had the embryos transferred and the test results are positive.” Giti spoke of her feelings towards Mehri: “Since we have learned that the result is positive, my feelings are different. I feel differently about her. I do not want her to be away. I want to be near her. I did not have any feelings for the other two. But now I count the days until I see Mehri again. I even asked her to come and stay with us for this nine-month period. Well, you get worried about what she eats, where she goes, if she is having any bad times [ … ]; all of these affect the baby. Whatever I eat, I want to give her,” she added, “you have no idea how hard and stressful it is. Especially the two weeks following the embryo transfer when she had to rest completely and then take a test to see if the transfer had been successful. I was completely stressed during the two weeks. I thought to myself that I would have rested if I were pregnant. I would have done this or that. But it all depends on God’s will [ dast-e khoda¯ ast , my italics]. There are many who rested but did not get pregnant.” Giti went on: “There was a woman with whom we were negotiating for surrogacy but the price she asked was very high. We did not do it but I became friends with her (my italics). She accepted to be a surrogate for another woman and she got pregnant. I thought to myself “if we had accepted her offer, she would have been pregnant with my babies.” Giti continued: “She was placed on full bed rest too but after six months she had a miscarriage. Her water had broken. She went through a lot. I called her later and asked her to become my surrogate but she told me that she did not accept surrogacy offers any more [ … ] this is how I learned that it was not up to her or me. It was God’s will (my italics).” Giti’s eggs are of poor quality and Mehri’s eggs were used to produce the embryos. In other words, Giti’s own genetic material was not part of the conception. But throughout our conversation she constantly referred to her embryos and the fact that they were her husband’s. “Embryo transfer is important to me. It will be from my husband. It would have been better if I had become pregnant and delivered our baby but now that is not possible, I prefer embryo transfer to adopting a baby from an orphanage. I wanted the embryo to be from us.” 7 Giti continued: “Of course I help [the needy children]. I even made a nazr [vow] 8 to support an orphan and now we are giving out a sum of money for him monthly. I don’t know [ … ] I feel like adopting an orphan [ bache-ye parvareshga¯hı ¯ ] is not going to be the same as having my own child. 9 Maybe because I think it was born 7 One should note here the importance of the marriage bond in her understanding of filiation. 8 Nazr (a vow with God] means a promise to do an act of charity or dedicate property in exchange for a divine favour. 9 Again, her own child is the “child of marriage” and not just a “biological child”. 124 A priceless gift: a short story of surrogacy in a different way [i.e., through illicit sexual union] [ … ]. You do not know who the parents are, where it has come from [ … ], that is why I prefer embryo transfer. 10 One of the previous surrogates who did not get pregnant [with our embryos] suggested that she could get pregnant with her own husband and give us the baby afterwards. My husband was okay with it. He said it was not a bad idea. But I did not want it. I wanted the embryo to be ours.” Giti does not belong to the religious class of the society in its orthodox definition; however, she did not neglect the importance of religious [ shar ı ¯ ] permissibility in her talk. “ Shar ı ¯ matters are important to me,” she pointed out, “but I was told that this [surrogacy] is not that complicated and many religious scholars approve of it. I myself called the office of a marja’ 11 (religious scholar) and they told me that it does not pose any problem. But I was advised not to do it this way because the eggs are also from the surrogate woman and it might cause problems in the future, like my child would be mah ˙ ram to that lady. 12 But I said it was not going to be a problem because we did not want to keep contact with that lady.” Giti had met with Mehri a year before our first interview. Giti became close to a woman called Shahla in the clinic who had become pregnant with Mehri’s donated eggs. Then Shahla introduced Mehri to Giti. “Shahla did not have any eggs at all, her uterus was weak too,” Giti said. “When the embryos were ready, they transferred them to both Mehri and Shahla. But the ones transferred to Mehri did not come through and Shahla herself got pregnant. That was when Shahla suggested Mehri as a surrogate possibility to me.” Giti talked about my work to Mehri, who enthusiastically accepted my request for an interview. The first interview took place in the clinic’s reception room. Mehri was twenty-six years old, smart and vibrant. From a working class background, she had moved to Tehran with her family from a small provincial town in Iran. Mehri started her story like this: “When we moved to Tehran, we rented this place. The landlord lady [Shahla] did not have any children. She talked to me 10 Again the importance of marriage and legitimacy. 11 Like many others couples in my study. 12 See the discussion on mah ˙ ram and na¯mah ˙ ram in chapter 2 . It is interesting to note that this religious scholar uses the term mah ˙ ram (non-marriageable members of the kin) to describe the relationship of Merhi to the child she carries and to whose creation she contributed by donating her eggs. However, as noted in chapter 4 , many medical, legal and religious scholars argue that the donation of gamete and embryo (not surrogacy of course) should be anonymous and the identity of donor and recipient should kept confidential. As we saw in a previous chapter, according to the majority of religious legal scholars, the contributor of the egg is considered, normatively, the legal mother of the child. But, as we also see in this story, social practice appears to be different and does not always follow the normative pattern. For more discussion, see the section “challenges and criticism” in chapter 4 . 125 The Story of Giti and Mehri about her problem and told me that she did not have anyone to help her. I spoke to my husband and we agreed to do it for her. We came here, and thanks be to God, it was successful. Now she has a six-month-old baby girl.” She continued: “Well, her baby is somehow from me, I mean the sperm were from her husband but the eggs were mine. They implanted the embryos in both of us. Mine didn’t come through but hers did. They had been married for six or seven years then but she had not become pregnant [ … ]; now she has an angelic baby girl. Then she introduced me to Giti. I talked to her. She sounded kind and nice. She really has a problem. She does not have a uterus. I accepted to do it for her.” Mehri was Shahla’s tenant, living on the floor below her. I asked Mehri whether she had any feelings toward Shahla’s daughter, since they were living in the same building. She replied: “Well, we hang out with each other; she comes to my house, I go to hers … even if I had any feelings, I would not show it because I have two children of my own. I don’t think about her. But when she is sick or having a fever, I get worried … but I have left her in God’s hands [ … ].” She pointed to her belly: “Now this one is in here and I have to take care of it for nine months. This one’s egg is from me too but the sperm is from her husband. I have asked God to help me to deliver the baby, to take its love from my heart and place it in the mother’s heart.” I asked her: “What if they are twins? ” She replied: “I would want that for her [Giti] more than anything else [ … ] My children are twins. It would be good for Giti [ … ] but there are nine months of pregnancy [ … ] then the delivery [ … ] God is great.” The waiting room in the IVF clinic: have the babies’ hearts formed? I was sitting with Mehri and Giti in the waiting room. It had been two months since the embryos were transferred to Mehri. Three embryos were transferred. Today they had an appointment for an ultrasound. It was a very special day. The doctor was going to tell them how many of the embryos had come through and whether their hearts had formed yet. The fact that I could be there on that particular day was an exceptional chance, enabling me to bear witness to one of the most private dialogues between an intended mother and a surrogate. 13 Mehri I can’t bend anymore [ … ] it causes a lot of pressure on me. I can’t take care of shaving and things like that. I have left it to my husband (she lowers her voice) he does a really good job [ … ] my legs, hands [ … ] (she chuckles). 13 They both allowed me to keep my MP 3 recorder and stay with them in the waiting room. I wish to thank them both for letting me have such opportunity. This was a priceless gift for me. 126 A priceless gift: a short story of surrogacy Shirin You mean your husband does everything for you? Mehri He does. Giti (chuckling) Oh my God, I couldn’t bring myself to ask him that. Mehri That’s nothing. He washes the dishes, clothes, cleans the house. He even cooks [ … ] In the beginning he did not know how to make khoresht-e qeymeh . 14 I taught him. I told him that if he added a bit of cinnamon, it would be very aromatic. He then added two tablespoons of cinnamon [ … ] I asked him “were you making cinnamon stew? ” We all laughed at this. Giti said: “I add cinnamon to khoresht-e qeymeh too. It makes it more delicious; (turning to Mehri) it is useful for you too.” Mehri replied (placing her hand on her belly): “Oh God! I hope its heart has formed already.” The three of us said insha¯a’llah [God willing, hopefully], in unison. The reception called out another patient’s name. Mehri Mahshid (her daughter) told me: “Mommy, a boy is no good [ … ] bring me a girl [ … ] I like girls better. I don’t want a boy”. Mohammad (her son) said: “Not a girl, bring me a boy [ … ]” Giti (talking to me) She is right. Her children are adorable. Her daughter wants a girl; her son asks for a boy. Mehri I asked them what to call the baby. My daughter said “Zahra”. I told her “no! That’s your aunt’s name [ kha¯leh , mother’s sister].” My son said “Abulfazl”. Giti laughs. Shirin (asking Giti) What do you like? Giti It does not matter but I think I like a girl better. Mehri Girls are sweet. Giti If it is a girl, I will be more comfortable talking to her. Mehri I ask our Holy Lady Fatima 15 (tapping her belly with her fingers) to let these be. 14 Khoresht-e qeymeh is a Persian stew made with meat, tomatoes, onions, split peas and dried limes. It is usually served with zafaran rice. 15 Fatima, Mohammed’s only child and Ali’s wife (see chapter 1 ). 127 The Story of Giti and Mehri Shirin (asking Mehri) Do you feel it now? Mehri Yes, it’s moving a bit. Giti Did you feel the same when pregnant with your own children? Mehri Yes, it was like this. At forty days, it moved. Giti Her children are strong, masha’llah [what Allah wishes]. Giti (laughs) I will bring you Bruce Lee. We all laugh again. Mehri Niayesh doesn’t look like me. [Niayesh is Shahla’s daughter who was conceived with an egg donated by Mehri]. Giti No, not a bit. Mehri She has taken after Shahla’s husband. Giti Yes, she has. Mehri When Shahla is angry with the little girl and shouts at her, I tell her jokingly “hey, you only have 50 per cent of her [ … ]”. She laughs. Giti’s cell phone rang. It was her husband. He wanted to know what had happened with the ultrasound. Giti told him that the doctor had not come yet and that as soon as he came, she would call him back. Mehri (to Giti) We have to see about the heart [ … ]. If the heart has formed, I will be relieved. Within a blink of an eye, eight months passes by and one night you will see, the baby has arrived. Now the minutes are heavy. The doctor had not come yet. Mehri and Giti were talking about the advantages and disadvantages of other IVF clinics in Tehran. Giti After three months, I will say I am one month pregnant. At nine months, I pretend I am in my seventh month [ … ]. Mehri Later then tell everyone you had made a mistake in keeping track of your periods. You got them mixed up. Nobody will notice. You can fill a damkonı ¯ 16 and put it over here (she points to her belly) [ … ]. You have to act for a while. 16 Damkonı ¯ is a piece of round-layered cloth that is used to steam rice in Persian cooking. 128 A priceless gift: a short story of surrogacy Shirin (surprised) What? damkonı ¯ ? Mehri You heard me right, damkonı ¯ . Giti How should I make it? Mehri First you get one of those wide elastics used for the waistline of a skirt [ … ] you measure four fingers [ … ] one from here, one from the top just like a bra. Giti You should take care of this for me too. Mehri When someone comes to your house, put on a cha¯dor [long veil]. Giti I don’t wear a veil. Instead I wear a ma¯nto [coat]. Shirin No one touches your belly? Your mother-in-law or sister-in-law? Giti No! I will not let them. Mehri As I was saying, a damkonı ¯ is a good idea. It will work. Then wear loose clothes. No one will guess. Then try bed rest. I had a really bad backache when I was pregnant with my twins. I stayed in bed from my third month. Shirin Did you have a Caesarean section? Mehri I gave birth to them naturally. Mehri and Giti started talking about which hospitals were good and which one she should choose. Giti They implanted three embryos. Do you think they have come through? It will be best if there are two. But if all three come through, it will be difficult for you (talking to Mehri). Mehri We will see [ … ]. Shahla asked me to give her the extra embryo if two of them came through [ … ]; (laughing) she still wants a boy. Giti But I have made a nazr [vow] to myself. Mehri (talking to me) There were seven embryos but they transferred three of them. Shirin (turning to Giti) What did you make a nazr for? Giti Insha’allah [God willing, hopefully], if these are healthy, I have made a nazr to donate the rest. But I will charge for them. I want to give the money to special hospitals like cancer hospitals. I know one myself. 129 The Story of Giti and Mehri Mehri Insha’allah , they will be OK. Giti (turning to me) We have frozen the other embryos, but we have to pay for them yearly. Shirin (to Giti) How much? Mehri 350,000 tomans [about US$ 210 in 2010] per year. Mehri Science has developed a lot [ … ]. Shahla only had six embryos. My eggs were good - fifteen of them. But her husband’s sperm were weak. Once he came with Shahla for sampling but when we were in the operation room, they asked her husband to come again for sampling. Giti My husband came here for sperm sampling only once. Giti put her hand on Mehri’s belly and touched it. “Will it be? ” Giti asked. Mehri caressed Giti’s face with her fingers and told her: “Sweetheart, it will be.” Mehri Shahla had a nazrı ¯ [offering nazr ] today. I cooked it myself for her last year. She was pregnant then. I swear to God I did not let her even pick up a plate for four months. I did everything for her. But I told her I could not do it this year. She has to do it on her own. She wants a boy. They are Turks. The word is that Turks like boys better. We are Kurds. We like girls better. We do not care much for boys. My husband says if we have a hundred boys, they will not be equal to one girl. Giti I am sick in my stomach [ … ]. When is the doctor coming? Mehri held Giti’s hands in hers. “My darling, make a nazr [vow] to visit Mecca”. Shirin (asking Mehri) After the embryo transfer, you will not be able to have sex [ nazdikı ¯ , closeness] with your husband, right? Mehri That’s right. Like brother and sister [ … ]. He accepted it from the first day. Giti Not even later [ … ]; it is difficult. Mehri (laughing) Relax! I have told my husband that we cannot have sex [ nazdikı ¯ ]. He knows. The result is important for us. We have to be careful. We have been together for five years. A few months of celibacy is not going to kill us [ … ]. Shahla did not have sex with her husband for three months too. She was told in the clinic that her uterus was weak and that they could not do it. 130 A priceless gift: a short story of surrogacy Finally the doctor arrived. Both women jumped out of their seats with joy. Giti embraced me and asked me to send prayers for her. I could see their lips moving nonstop: “Oh dear God, dear God [ khoda¯ya¯ , khoda¯ya¯ ].” The same night, I was at the airport. I had to catch a flight to Yazd (a city in central Iran) where the first IVF clinic had been established. Giti called me: “Shirin, you won’t believe it; you have no idea how happy I am right now. God has given me three babies. All three have hearts. They are triplets. This is like a miracle. I have been praying [ do’a¯ ] ever since I got back from the clinic.” Three months later: umbilical cord artery I called Giti. She told me that she had put on 15 kilos, was wearing loose clothes and had told everyone that she was pregnant. She was looking for a pregnancy belly prosthetic but had not found one yet. She was very worried these days. It was twenty-three weeks into Mehri’s pregnancy. According to the ultrasound, there was a possibility that one of the embryos might have only one artery in the umbilical cord. She had been told that this situation could cause a disorder and lead to mongolism and that it would be better to abort the embryo. However, it was too late for an abortion. It was very possible that the other two embryos would follow the abortion. Giti was reluctant. “My doctor [gynaecologist] believes that the babies are fine and more than likely nothing complicated will happen. I have consulted with several other embryologists and they - like my doctor - are against abortion” she said, adding: “I do not know if I should ask for an amniocentesis test or not? You have no idea how hard I am finding these days [ … ] how worried I am. It is only remembering God that gives me peace. It is such a powerful force that you can trust and lean on. He has made it possible so far, I am trusting Him for the rest of the way [ … ]”. Giti told me about Mehri: “Her belly has got big; so have her expectations! We had agreed on 5 to 7 million tomans (about US$ 3,000-4,000 in 2011). Now this has become her asking price for every single baby.” They had not signed the contract yet. The clinic had asked Giti to come and sign the contract, so it would be clear how much and in how many instalments they could agree to pay Mehri. Giti explained: “Mehri’s husband is making it difficult, and he wants to charge us more [ … ] but Mehri herself is very kind. I talked to her again and now she is better. Of course, I don’t underestimate the big work she is doing [ … ]. One must be in a real desperate financial situation to agree to do this [ … ]. I don’t know [ … ], but Mehri is very happy about doing this herself. Overall they do not have a stable financial situation. Life is hard on them [ … ], her husband is a labourer [ … ]. I have been buying them everything: meat, chicken, fish. I have told her to take a private taxi when she has to come to the clinic; I pay for that. I have bought a lot of things for her children, I call her everyday [ … ], I go to her 131 The Story of Giti and Mehri place a few times a week [ … ]. She has asked me to bring my husband so they can meet him. They like to come to our house too. But Shahla has advised me not to let this happen, because they will get used to visiting us after this is over.” She added: “Mehri loves Shahla’s daughter. But I have decided to end our relationship after my babies are born. 17 But I will definitely tell my daughters how they have been born”. She then tells me about four years ago: “In the beginning, my doctor advised me to find a relative to do this [surrogacy] for me. My sister is married to my husband’s brother. She offered to do it for us [ … ]. My husband did not disagree but I was not happy about doing it [ … ], you never know what might happen in the future”. Baby bump: Giti gets pregnant Giti’s husband’s relatives did not know anything about the surrogacy. In her family, only her parents and siblings - except the youngest one who was studying in middle school - were aware of their surrogacy arrangements. Everybody else thought that Giti was pregnant for real. She was playing the role of a pregnant woman expecting multiple babies. She wore loose clothes and a pregnancy belly prosthetic, which she had made for her by a theatre seamstress after searching for one for such a long time. Giti told me about the time when she was looking for a pregnancy belly prosthetic: “I looked for it everywhere. I could not find one. I had no idea where to shop for it. I found forty to fifty phone numbers of different drug stores and movie-making offices. But each of them told me different things. One would say ‘we do not have it’, another would say ‘you want to pretend to be pregnant, that involves our responsibility’, another would get angry and hang up on me. One of them asked me: ‘What type of prank are you trying to pull? ’ Many others didn’t know what it was at all to begin with.” She then added: “wherever I called, I felt like dying of embarrassment. I would pray that a woman answered the phone so I could talk to her more comfortably. Finally, a movie director gave me the number of this tailor. She makes clothes for theatre and movies. She has made a perfect (prosthetic) for me. It’s got straps that I can tie firmly at my back. No one can guess. My doctor asked what I had done to look that natural, as if I was pregnant for real. Well, I have gained weight as well. My mother-in-law told me recently how chubby I have got. I am happy. I used to hate being fat but now I am loving it [ … ] but I am also constantly worried that someone might want to touch my belly [ … ] you know [ … ] snoopy people are everywhere [ … ] my uncle’s wife came to me and asked whether she could see what colour my nipples have turned to [ … ] but I don’t let anyone get close to me. I am protecting my precious ones and my pregnant belly”. 17 Due to the fact that Mehri is also the egg donor of her children. 132 A priceless gift: a short story of surrogacy Mehri buys a small apartment It was the thirty-third week into Mehri’s pregnancy. The recent ultrasounds had confirmed that the three embryos were fine and none of the umbilical cords lacked an artery. Giti was extremely happy. She told me: “The arteries were hard to trace in the beginning so they could not detect them [in the ultrasounds]. If you remember we were so worried [ … ] we were even advised to go for an abortion [ … ] Thank God [ … ] everything is going great now [ … ] when we go for an ultrasound my eyes are pinned to the doctor’s mouth; when she does not say anything, I feel like I will pass out; but when she says they are fine, I feel revived.” Giti explained that they had paid Mehri all the money stipulated in the contract and that she had been able to buy a small apartment with it near the place where they used to live. “We had agreed on 9 million tomans, of which we paid 3 million at the beginning and we were supposed to pay the remaining 6 million after the babies were born. Well, they had seen this apartment, which was close to where they lived; it is a few doors away from Shahla’s house. When I heard of it, we decided to give the rest of the money to them sooner so they could use it to buy their apartment. She is no longer a tenant. You must see how happy they are.” Giti told of her own family: “My mother and others [close relatives] are so happy for me. Every time they come to visit me, they bring something for the babies. I have so many baby things now.” She added: “I am thinking of gradually lessening my social interactions [ … ] then I have to see that theatre seamstress again to make my prosthetic belly a bit bigger. I cannot prevent people from visiting me [ … ] some people are nosey [ … ] as soon as they hear I am going to have twins they ask whether I have done IVF. I tell them, ‘no; it has been God’s will’.” She then spoke of her concerns: “I am overwhelmed by anxiety [ … ] I wonder what will happen after the delivery. What happens when I cannot breastfeed my babies? I do not want Mehri to breastfeed them. I have talked to my doctor and he told me that I could give them formula. He has also given me drugs so my breasts will be able to produce milk [ … ] I do not know what to do anymore. I once saw a woman at the clinic who had her children through surrogacy. She had told her family that she had done IVF and since she was on drugs for that she could not breastfeed her children and so she had to give them formula.” The triplets were all girls. Giti and her husband were so happy to have them. Giti said: “I pray for them to be healthy [ … ] that is what matters most. My husband and I always wanted to have a baby girl [ … ] now we are going to have three [ … ] we are so happy but at the same time we are mindful of our responsibilities too [ … ] three girls and we have to raise them properly.” Giti had picked the names for her baby girls. “From the time I was assured of this pregnancy, I have been on the Internet to choose my girls’ names,” she said. The names have 133 The Story of Giti and Mehri Indo-European roots and they belong to goddesses of Greek and Iranian mythologies. IVF certification The hospital Giti and Mehri chose for the childbirth is familiar with surrogacy contracts. It is located in the Central North area of Tehran and its maternity ward includes a gynaecology and obstetrics unit, a delivery room, an IVF and infertility unit and a neonatal care unit. Giti and Mehri’s doctor had given them the IVF certificate and a letter for both of them to be treated as in-patients at the hospital. With these in hand, the birth certificate would be issued under Giti’s name. 18 The delivery accommodation was also extended to Giti, who would stay in the hospital for a couple of days, pretending to have given birth to the babies. In this way, Giti’s and her husband’s family could visit her in the hospital without suspecting anything. The doctor predicted the due date for the first week of April and advised Mehri to hold on to the babies as long as she could. In the event of complications, they would be ready for a Caesarean section. The triplets were born The date was 20th March 2011, one day before spring and the Persian New Year, Nowruz. Mehri called Giti to tell her that all of a sudden her legs had swollen and felt painful. Giti immediately called her doctor. He said that it might be something dangerous and that he would have to visit Mehri right away. Giti recalled the day: “It was 5 p.m. I called Mehri and told her to get a private taxi to the doctor’s office. Her legs were so swollen and her skin had turned blue. As soon as he saw her, the doctor said that she had to be operated immediately; otherwise, she was at risk.” They went to the designated hospital but they were not admitted into the hospital because it was the day before the New Year and the hospital did not have a paediatrician on duty at the ICU. In the meantime, the hospital tried to find them another facility. Mehri’s husband was in the hospital too. In order to perform a Caesarean section, the husband’s consent is necessary. He filled out the form but could not stay in the hospital. He had to rush home, since their children were alone at home. Giti said: “We had a lot of stress. The doctor said that it was dangerous for her heart. I had forgotten all about my children. I just wanted Mehri to come out of this with no harm. I was scared. I thought what if something happens to her? Who would be held responsible? I had not thought about it before. She has two kids of her own. If something happened to her and her children lost their mother, I would not forgive myself for the rest of my life.” 18 See the discussion on issuing birth certificates in chapter 4 . 134 A priceless gift: a short story of surrogacy Finally, a hospital in the northern part of Tehran admitted them. They went through the emergency ward. Giti said: “They did not have any information about surrogacy. The hospital claimed that it was the first time it had come across a case like this. I was told to pray for the health of Mehri and my children.” However, Mehri was not taken to the operating room immediately. It was necessary to have the consent of Mehri’s husband. Giti recalled: “They did not accept our signature. It had to be his. He came to the hospital again. He had left his children at his brother’s; he was very worried.” At last, they performed the Caesarean section on Mehri. At 12: 30 p.m., three healthy baby girls were born. Mehri was doing fine as well. Due to excessive stress and shock, Giti became indisposed and fainted. She was taken to a room to recover. The babies had to spend a few days inside an incubator. The next morning, upon Giti’s request, the head nurse allowed her to take on the role of a new mother during visiting hours. Giti’s and her husband’s family came to visit with flowers and pastries in hand. They were upset that Giti had not called them the night before to announce the triplets’ birth. Giti said: “I told them that my water broke and we had to rush to the hospital and there was no time to call anyone. It was quite a show we put on to hide the fact from them. They saw the babies and left.” She added: “Mehri is doing great too [ … ] they have done an ultrasound of her legs; the veins seem to have widened but thankfully there is no clot to threaten her heart. I was worried to death for her.” In order to issue the birth certificate, the hospital required them to have a written confirmation from the clinic where the IVF and surrogacy were carried out. The clinic where I had first interviewed Mehri and Giti had moved to a hospital in the centre of the city and was closed during the two-week New Year holidays. Finally, it was discovered that the Caesarean section surgeon who operated on Mehri was a colleague of Giti and Mehri’s IVF doctor. He approved the recommendation letter and IVF certificate through which the birth certificates of the girls were issued under the name of Giti and her husband. Giti was recovering just fine and two days later she was discharged. The girls remained in the incubators for another 6 days. August 2011 I called Giti. She was at her mother’s house. I asked about her children. She replied: “They are growing up and they have become so pretty. They have taken after their dad. Everyone who sees them tells me how they look like my husband. He has gone to Dubai for ten days for his work but he calls every day and asks about them. I tell him they have grown so big that they are running; come and see for yourself” [she laughs]. “He is restless; he is exuberantly happy.” Then she added: “For now, someone must stay with me otherwise I cannot handle it. In the 135 A concluding comment fall, my sister-in-law will stay with me and my own sister will be by my side for the winter. I give them formula; my breasts had some milk but it was not enough for the three of them. I am lucky they take the formula.” I asked Giti about Mehri. “I am not in much contact with her anymore. We went to our doctor twice together [ … ] she is doing fine [ … ] the doctor told her not to donate eggs anymore because it could become problematic for her later on,” she replied, adding: “being in the ultrasound room again together reminded me of our days. I somehow grew fond of this room.” Later on, she said: “Mehri is a kind woman. According to Ms. X (the IVF Clinic consultant) we were lucky to have found her [ … ] some surrogate volunteers would make it difficult. There was one who was well into her 7th month and had asked them to deliver the baby because she did not want to carry it anymore. But Mehri held on to them as long as she could [ … ] well, she got a house out of it too [ … ] I had promised her daughter to buy her a bangle [in gold]. I miss Mehri, you know [ … ]. I had become attached to her but I do not like to be in constant contact with her [ … ] sometimes I call her on the phone.” Then she told me about her memories of the last year. She had thrown the prosthetic belly away. Now she was fasting and determined to lose weight. Some years later In 2015, I made a phone call to Giti. Her children were older now and she was too busy with them. She was very interested in reading the chapter I had written about her journey. She asked me to write it in Farsi so she could read it too. I asked her about Mehri. She replied: “I can’t forget her. Truth be told, when the kids are around, I don’t have time to think about anything else. But every now and then, we talk on the phone. She is doing fine [ … ] her husband has found a permanent position at a factory. They get by. But we haven’t seen much of each other since. Just the phone calls.” A concluding comment Uterine intimacy The story of Mehri and Giti clearly portrays the legal and administrative challenges pertaining to surrogacy that still exist in Iran. However, it is not my intention to explore them here. What is of importance here is the personal relationship and closeness that accompany Mehri and Giti in this surrogacy process. I call this type of women’s closeness to each other “uterine intimacy”. It involves the emotional and mental connections that form among the women 136 A priceless gift: a short story of surrogacy who are engaged in assisted reproduction, be it surrogacy or egg donation. These women think about one another, call each other, enquire about hormonal changes during their cycles, and ask about receiving embryos. They talk about their cycle, which needs to be chronologically the same; they share talks about the heartbeat [sound] of the foetus, its movements, etc. Giti and Mehri are from different social backgrounds. They represent two different images of women in Iranian society. They are significantly different in the way they dress. Their differences stem from cultural habits. However, they both belong to the Iranian culture; they share the changes and transformation of the society and a common language. They both believe in nazr and they have both promised to commit to their nazr after fulfilling their wish. They talk about common issues like putting cinnamon in a stew; they feel so close that Mehri shares with Giti the most intimate details of her sexual encounter with her husband. The uterine intimacy brought them closer, rather than being kept apart by the social class difference. Uterine intimacy, I would argue, creates a female dynamic that can be extremely beneficial to those undergoing the hardships of IVF. Priceless gift In many studies about surrogacy (both theoretical and empirical, e.g., Dalton 2000, Pande 2014), two categories have been recognized for surrogacy, 19 each of which reflects the agreement and contract signed between the surrogate mother and the intended parents. Firstly, commercial surrogacy, in which the surrogate mother accepts to carry the baby for a compensation from the intended parents. Many believe this is an unethical relation that can lead to exploitation. And secondly, non-commercial and altruistic surrogacy, in which the surrogate mother accepts to carry the baby out of kindness and altruism, without receiving any money or compensation for her act. However, I do not agree with this classification. As mentioned in the previous chapter, despite the fact that the majority of surrogate mothers mentioned their financial needs as the main motivation for accepting surrogacy, they consider their act as ethical and altruistic behaviour and a gift to a couple and a woman suffering from childlessness. Many of them reiterated the legitimacy ( halalness ) of the money they earned through surrogacy and indicated that compared with many other illegitimate and unethical ways of earning money in the society, 19 The difference between the two types of surrogacy, traditional and gestational (see chapter 5 ), are not important for our concerns here. When I refer to surrogacy here I mean both types. 137 A concluding comment their action deserves to be recognized as an ethical, righteous and benevolent act that is well-worth compensation. A righteous deed that, according to many surrogate mothers I had spoken with, “resolves both our [the surrogate’s] problems and theirs [the intended parents’].” Perhaps this is the reason why they felt comfortable and at ease when talking with me about the money received and why they felt no stigma attached to the money and compensation for surrogacy. At the same time, the intended parents talked about giving the payment in the form of compensation to the surrogate mother for the task she was undertaking for them - a task that not everyone is capable of doing. Despite haggling about the amount to be paid, all of the intended parents expressed a sense of inner contentment when paying the money, knowing that the money would resolve the financial difficulties of a family in need. When speaking of the money, they mainly referred to the way the money was going to be spent rather than the amount paid to the surrogate mother. Some of the phrases, such as “they were able to buy an apartment”; “they were able to pay off their debts”; “they are finally freed from renting”; “she could provide a security deposit for her husband’s shop”, and suchlike demonstrate an acknowledgment of the work of surrogate mothers, not reducing it to a commercial contract and ultimately making the work of surrogate mothers priceless - a definition that the surrogate mothers I spoke with referred to many times, calling their act a priceless gift . An act that despite being initiated by financially-charged motivation and a contract, subsequently develops into complicated ethical and emotional relations where a woman is gifting another woman with motherhood, not just a child. In fact, by priceless gift , I do not mean the child as a gift. My reference is to all the troubles and hardships the surrogate goes through during the whole process to enable a family to feel the joy of becoming parents after so long. This is a twoway relation, which Maus defined as “reciprocal” and “symmetrical” (Mauss 1990). Being aware of the surrogate’s living conditions, the intended parents make efforts to support her. When Giti made the whole payment to the surrogate before the birth of the baby, for instance, it counted as a gift to the surrogate. Therefore, the relation here, at least from my point of view, is not based on “clients” and “sellers” or “sale” and “purchase”. It is based on self-abnegation, self-sacrifice, compassion and sympathy to resolve an infertile couples’ problem, allowing another woman to enjoy motherhood, financial needs, economic difficulties, pain, tears, hope, love, prayer, happiness, anxiety, concern and vows ( nazr ). It is people’s need for one another that is being highlighted - as well as the persistence and creation of human relations and values that I would like to call “a priceless gift”. 7. “M as in Mother”: medical perspectives, clinical environments and social dynamics Each act of forbidding or allowing produces social relations, makes society, a society where each person, according to their cultural choices, will have to live and to work for its reproduction. Maurice Godelier, (2011 [2004]: 430), The Metamorphoses of Kinship When you start, it is a strange thing, but once you know that there is no other choice, you get used to thinking about egg donation as the last resort to get pregnant. In the beginning, it was so strange that I did not want to do it. Even when my sister offered me her eggs, I did not accept her offer. However, when I got used to seeing the number of couples coming here [to the clinic] to use donated eggs, even donated embryos and surrogacy, I started to change my mind. Today I consider egg donation a medical treatment. Excerpt from an interview with an egg recipient, a thirtyeight-year-old translator, Tehran, 2006 We do everything in our clinic in accordance with the consent and agreement of the donor and recipient couples. They sign a contract including their fingerprints that contains clear and precise clauses. Excerpt from an interview with the director of an IVF clinic, Tehran, 2010 I have argued that assisted reproductive technologies do not necessarily displace foundational Iranian cultural values and assumptions about kinship and reproduction. Rather, many of these assumptions and values are truly being reinforced and entrenched by these technologies. In this chapter, I illustrate some of these values and assumptions and how they are enacted within everyday clinical settings and interactions. I explore the moral reasoning underlying the concepts of kinship and reproduction that move people when they turn to - or refrain from - certain technologies of assisted conception, and the ways in which they are contested and negotiated. Having looked at the practice of surrogacy in the last two chapters, I will now provide a cultural account of the practice of gamete and embryo donation in Iran. I focus particular attention on the perspectives and everyday experiences of infertile couples, gamete donors and the people who work in Iranian infertility clinics. In so doing, I present some vignettes from my fieldwork inside these clinics, as well as the clinical environments and the regulatory and administrative framework. 139 “M as in Mother”: medical perspectives, clinical environments and social dynamics As we shall see, Iranian IVF clinics witness a wide range of people from different walks of life - both poor and wealthy - who are looking for ways to pay the expenses and take advantage of different reproductive options and possibilities even during their worst financial struggles (see for example the case of Batoul below). Furthermore, writing of his experience of infertility clinics in Lebanon, Clarke cited the following observation by Inhorn: “In the Middle East, infertility and IVF are shrouded in layers of secrecy and social suffering [ … ] ethnographic access is shaped - and potentially limited - by powerful feelings of privacy and protectiveness” (Clarke 2009: 153 citing Inhorn). In Iranian IVF clinics, on the contrary, I observed little of the infertility stigma Clarke (2009: 152-181) and Inhorn (cited ibid.: 154) address in their work on Lebanon and Egypt. 1 As my ethnographic examples below and elsewhere in this study clearly show, in Iranian infertility clinics, many people spoke with each other - sometimes loud enough for everybody else around them to hear. They openly discuss their problems with the staff and nurses in the reception area in such a way that by sitting and listening for couple of hours in that area, one could learn a lot about different personal histories. Men were not an exception either. In my study, many of them spoke with me about their infertility problems; I did not experience any difference between men and women sharing their infertility stories. 2 I conducted my research in the cities of Tehran, Yazd and Qom. Like other metropolises around the world, Tehran is a big crowded city with a diverse cultural structure and endless possibilities. Qom is the centre of Shia theology and the religious capital of Iran. Yazd is located in central Iran, housing the very first Iranian IVF clinic and even today the sacred fire of Zoroastrians still burns in its fire temples. 3 In this chapter, I will describe the experiences and encounters I have had in the IVF clinics in these cities. Clearly, as Kahn (2010: 297) in her article “The Mirth of the Clinic: Fieldnotes from an Israeli Fertility Center” 1 In his study, Clarke considers surrogacy and gamete donation as very sensitive issues in Lebanon as compared with Western countries. He writes: “Many effective techniques, regularly practised in the Western settings where most of these doctors learnt these skills, are highly controversial in Lebanon. Although all doctors were happy to talk about IVF and infertility treatment, sensitivities were aroused by the subject of the use of donor gametes, [ … ]. Surrogacy was another difficult topic” (Clarke 2009 : 161 , my italics). However, as current studies of ART in Western countries show, issues such as embryo and gamete donation and surrogacy are also controversial topics and procedures in Western countries. In some German-speaking countries, for instance, the practices of egg donation and surrogacy are not even allowed. Therefore, it can be concluded that there is no unified approach to assisted reproductive technologies even in Western countries. However, according to my observations in 2015 , in the Iranian IVF clinics these procedures are normal rather than exceptional. 2 Which had been an issue for Inhorn in Lebanon, for instance (cited in Clarke 2009 : 154 ). 3 Yazd is a Persian term meaning sacred. 140 “M as in Mother”: medical perspectives, clinical environments and social dynamics writes, “a fertility clinic is both like and unlike any other workplace. Personalities conflict, political opinions clash, unexpected alliances are formed, hierarchies are reinforced and railed against, mundane discussions are commonplace, jokes are shared and enjoyed. And yet the post office it’s not; it’s the context for human conception.” In this context, furthermore, certain concepts - motherhood and the fact that no one is born without God’s will - carried a strong presence in my study. These concepts enjoyed a prominent and consistent position in all dialogues pertaining to assisted conception - among both religious and non-religious people. The sacred aura of these two concepts had such a strong presence that they nearly overrode the primacy of technological thinking, which lost colour in the presence of sacred being. In other words, “assisted conception may have become banal, but it has not become mundane” (Kahn 2010: 297). Even in the operating room, when the male doctor begins by inserting a catheter into the female vagina and releases the embryos, both doctor and patient start to recite the name of God ( khoda¯ ) - an intimacy between doctor, patient and God, as I observed many times in the course of my fieldwork. Here again, assisted reproductive technologies renew and emphasize the connection between the human and the divine in the ongoing process of creation. Furthermore, the clinics where I did my research were generally over-crowded and busy. The clinic’s directors, physicians, receptionists and technicians, laboratory and operating room personnel, nurses, donors and infertile couples made up the overall ambiance of the clinics, which was uniquely warm and busy. A great deal of information and knowledge is produced and circulated in these clinical settings and interactions. This knowledge, I would argue, is not only restricted to biomedical matters. It springs mainly from the profound Iranian culture and religion. For instance, after spending many hours sitting in IVF clinics, listening to conversations and following the stories, I noticed the significant role played by the nurses and administrative staff working at the reception area. Some of these nurses are charged with the task of choosing appropriate gamete and embryo donors for infertile couples or matching the intended parents with surrogates. The mutual connection they have with physicians on the one hand and with visitors - both infertile couples and donors - on the other provides them with a particular knowledge that intensifies the crucial role they play in the clinic. They become confidantes for those who have been seeking infertility treatments for years or for those who come to the clinic as donors and surrogates. The knowledge they employ is not only biomedical and professional. It is also a type of knowledge that has its roots in the culture and the society they live in; it is a type of knowledge that uses specific language and concepts related to the grammar of kinship - a grammar of social proximity (see chapter 2). By grammar, as I wrote earlier, I mean certain legal and ethical norms and values 141 A cultural account of gamete and embryo donation that form the social proximity and regulate it within the dynamic framework of society. A cultural account of gamete and embryo donation Donor eggs As we saw in the previous chapters, there is no uniform viewpoint among religious scholars, especially when it comes to issues involving the third-party donation of eggs and sperm. For example, the temporary marriage ( mut a ) of the donor egg recipient’s husband and the egg donor has been proposed by some Shia scholars as a shar ı ¯ solution to legitimize egg donation. In this way, at the time of insemination, both the egg donor and the egg recipient are in a marriage bond - temporary or permanent - with the producer of the sperm (the father). Other scholars, on the contrary, following the principle of the absence of sexual act, consider the insemination of the donor’s egg with the sperm of a man other than her husband outside of the woman’s body and then the implantation of the fertilized egg in the uterus of man’s wife religiously permissible. In this case, the use of temporary marriage is not required. The divergence of religious legal opinions, however, has not prevented the practice and regulation of egg donation in Iranian infertility clinics, as a doctor working in the donation department of an IVF clinic in Tehran told me: It is an open issue as to which fiqhı ¯ argument an infertility clinic should adhere to. As far as egg donation goes, we do not have any [ shar ı ¯ ] problem; we have religious approval for egg donation [ … ]. At the moment we are faced with the problem of finding a donor since the patients usually have a hard time finding a suitable donor [on their own]. 4 Egg donation is proposed in all of the IVF clinics I visited in Iran, but the regulations of each clinic are different. Some clinics leave it to the infertile couples to find their own donors, which often leads them to ask a close relative or friend to become a donor. A few clinics have their own egg donors available. Some clinics keep the identity of donors and recipients confidential and the matching of donors and recipients is carried out by the clinic staff. Others leave it to the donors and recipients to decide whether they wish to remain anonymous. According to my recent observations in 2015, as mentioned previously, many cli- 4 Author’s interview, Tehran, 2010 . 142 “M as in Mother”: medical perspectives, clinical environments and social dynamics nics have changed their regulatory policies and now prefer confidential donation or keeping the recipient’s identity unknown to the egg donor. 5 However, a donor must provide identifying information, and this information is kept confidential in some clinics while in others it is made accessible to the recipient couple. Some clinics advocate using donor eggs in combination with temporary marriage (as we shall see below in the case of Batoul), and therefore look for a donor who is divorced or widowed. Others will accept a married or single woman as an egg donor. However, most clinics look for egg donors who are in the age group of 21 to 35 years old, and who have ideally had a child of their own. 6 In the early stages of the practice of egg donation - as in the cases of embryo donation and surrogacy - I came across many women in clinics who suggested close members of their kin as egg donors. Whenever possible, infertile women preferred to have eggs donated from their sisters in particular, but also from their brother’s wife ( zan-da¯da¯sh ), husband’s brother’s wife ( ja¯rı ¯ ), and occasionally uterine relatives like their mother’s sister’s daughter ( dokhtar-kha¯leh ) and mother’s brother’s daughter ( dokhtar-da¯ı ¯ ). 7 When I asked whether a woman can donate eggs to her infertile sister, the head of the embryo transfer committee of an IVF clinic answered: This is yet another debate. On the one hand, it is argued that donating eggs to mah ˙ a¯rem [unmarriageable members of kin] 8 is prohibited. On the other hand, some fuqaha¯ do not set any particular restriction on it. Hence, the donated egg can come from a sister. 9 These are different points of view, which are put forward by our fuqaha¯ . Therefore, it is an open issue as to which argument an infertility clinic adheres to. 10 5 In my study in 2015 , I also observed many young unmarried women acting as egg donors. 6 See appendix 2 for an advertisement poster for egg donation. 7 However, it is not allowed for a woman to donate eggs to her infertile brother’s wife, or for a man to donate sperm to his sister’s husband. In fact, no clinics, to best of my knowledge, produce an embryo from the sperm and eggs of a brother and sister. Neither is there any religious permissibility for it. However, in referring to my writings (e.g. Garmaroui Naef 2012 ), Tremayne ( 2012 ) considers this as a problem of assisted reproduction in Iran. This is in particular a misunderstanding of my ethnography and a misleading issue in the context of the practice of ART in Iran in general. In my writings, I refer to religious permissibility and the practice of carrying and donating embryos between siblings. For instance, as we saw in the previous chapters, a sister can donate an embryo (produced by her eggs and her husband’s sperm) to her brother and his wife. Or, in the case of surrogacy, a woman can carry the embryo of her brother (produced by his sperm and his wife’s eggs) and give birth to it. Again, we should note here that the embryo has a different nature from egg and sperm. 8 As discussed in chapter 2 . 9 Again here, He´ritier’s theory of incest of the second type remains problematic. 10 Author’s interview, Tehran, October 2005 . 143 A cultural account of gamete and embryo donation To my question about conditions for becoming an egg donor, the director of another private infertility clinic in Tehran answered: The egg donor must be either divorced or widowed. In addition, she must already have at least one child. I know our fuqaha¯ have admitted that married women can donate eggs. But in my clinic no such donations are undertaken. 11 I then asked about the reason. It is easier to interact with single women. A husband could cause difficulties. However, if the infertile married couple proposes any known donor including close relatives, then there is a possibility that she is married. Most of the time, this concerns the wife’s sister or a friend of hers. I was interested to know whether the egg donor is kept anonymous or not. He answered: Egg donors and recipients get to know each other and settle the financial aspects directly. They inform us about their agreement, and we take care of the medical issues. But in the case of sperm donation, the anonymity of donor is protected; however, in my experience the recipients do not desire to know the sperm donors either. A nurse working at the reception of the same clinic told me that usually, [infertile] women who consult her are interested to see who might donate eggs. She observes that it is easier for women to normalize the process of egg donation than for men to normalize the use of donated sperm. She continued: So far, all the women [egg recipients] were interested in meeting their egg donors, although they did not want their husbands to see them. In my experience, I usually meet with those women alone. The egg recipient probably does not want her husband to remember the egg donor later when he sees the children. The men usually show no interest in seeing the egg donor. The reason may possibly be because their wives do not give them this possibility [she laughs]. 11 Author’s interview, Tehran, 2006 . 144 “M as in Mother”: medical perspectives, clinical environments and social dynamics However, in another IVF clinic in a public hospital, the director told me that they provide embryo donation for the treatment of male infertility but no sperm donation. However, regarding egg donation, he explained: To this day, I have had good experiences of egg donation. Women who have already had children and are under thirty-five years old are allowed to donate eggs at our clinic, with no regard to their marital status at the time, or whether they are close relatives of the egg recipients or not. 12 To my question about anonymity of donation, the director of this clinic has another perception. He said: “The egg recipients can see the donor if they wish, but not vice versa”. Donor sperm As we have already noted, a distinction can be made, in the context of Shia discussions, between the act of placing sperm directly into the woman’s uterus, which according to the majority of religious scholars is not allowed, and the act of implanting an embryo into the uterus of a woman - whether a surrogate or the intended mother - for which there is religious moral permissibility. The in vitro embryo in this context is the result of a legal union and not the result of an illicit or impure ( na¯pa¯k ) sexual act. Many infertile couples - both religious and nonreligious - that I interviewed referred to this distinction and preferred the use of embryo donation to sperm donation. Yet this opinion is not held by all authorities and individuals, which in effect leaves great latitude to medical practitioners and would-be parents, as one doctor who performed the entire range of donor procedures (including eggs, sperm and embryos) at a private IVF clinic told me: “We offer all appropriate procedures for patients; it depends on the infertile couples which procedure they prefer.” 13 Or in another example, the director of a semisponsored IVF clinic in Tehran explained: You know what kind of problem we have with sperm donation? We have an administrative problem in this case, not legal, ethical or even religious. The problem is that we must know who, how many times and where he has donated sperm. What has been the result of those donations? Men whose donated sperm have produced embryos leading to successful pregnancy and 12 Author’s interview, Tehran, 2006 and 2010 . 13 Author’s interview, Tehran 2010 . 145 A cultural account of gamete and embryo donation childbirth on three occasions must be withdrawn from the list to avoid further sperm donation. This is the only problem we have and it cannot be solved through cooperation between one or two centres [IVF and biomedical research centres]. A data bank is required to which all other centres can be linked. In the meantime, some centres have tried to take the matter under control. They have signed contracts with several reliable and healthy individuals whose medical tests show they are healthy to donate sperm and who agree not to go anywhere else for donation, but there is no guarantee of this. 14 He then explained about the practice of sperm donation in his clinic: We have a different strategy here. Those whose first-time sperm donation has led to a pregnancy will not be called on for further donations. We do not wait for the three-time rule. We consider the fourth month pregnancy [through sperm donation] a complete procedure and then withdraw the sperm donor from the programmes. But these are just salves, not a real solution. Nevertheless, for many couples in my study, sperm donation was not an option for the treatment of male infertility. Some scholars (e.g., Tremayne) look at this from a gender point of view and stress the maintenance of male superiority. I do not agree with this view. As my examples in this study show, despite the involvement of another man’s sperm in embryo donation, many of these couples preferred (and chose) embryo donation over sperm donation. Here again, since the donor couple are connected through marriage, the sperm is not considered impure. Generally speaking, the thinking behind this view 15 seems to be that the other man’s sperm is impure and contaminates the woman’s uterus and thereby the purity of genealogical (and not biological) continuity and kinship relations. Indeed, I would argue that the embryo resulting from a legitimate relationship affirms the superiority of the matrimonial relationship and legitimacy in this procedure rather than male superiority per se. Let us look at some more examples from my ethnography of assisted conception in Iranian IVF clinics. 14 Author’s interview, Tehran, 2010 and 2015 . 15 Similar to the majority opinion of Shia authorities, as discussed in chapter 3 . 146 “M as in Mother”: medical perspectives, clinical environments and social dynamics Vignettes from the field a) The setting: one day in a Tehran IVF clinic, 2010 In the yard of the clinic It is 8: 30 a.m. when I arrive at the IVF clinic. Upon my arrival, the first thing that welcomes me is the crisp cool air of the clinic garden. This garden encourages a good feeling, especially when you get there from the overcrowded and smoke-saturated streets of Tehran. There is a large pool surrounded by tall trees with benches under them. The gardener has just watered the trees and the ground is still wet. I have an appointment for an interview with the director of the clinic. He has not arrived yet. His secretary directs me to a crowded waiting room. I step outside. A young man and an older woman from the clinic staff are sitting on the stairs in front of the entrance, talking. They are speaking loud enough for me to overhear their conversation. The woman expresses her desire to take a vacation in one of northern towns of Iran with her son for a few days. But she says that it costs a lot and she is not sure if she can do it. Meanwhile, a couple enters. They have driven here and parked their car in the yard. The wife has put her arm through her husband’s and they are slowly walking towards the reception area. The husband is carefully watching their pace. From the conversation between the two clinic staff, I gather that the wife has become pregnant after several years. The female worker says: “Thanks be to God, after all these years, she is finally pregnant with twins. Thanks be to God, I am truly happy for both of them.” And then she calls the husband by his name and says: “Congratulations, you must offer pastries [ … ] they are twins.” The male worker smiles too and congratulates the couple. The wife leans closer to her husband. The female worker continues her talk with her co-worker, saying: “They went through a lot every time they came here”, and the man says: “It was God’s will, otherwise it wouldn’t have happened.” In the hallway of the clinic: “It is God’s will” As I go in to see if the director has arrived, I notice two women standing in the hallway of the IVF clinic in front of the laboratory, talking to each other about frozen embryos and assisted reproduction. They represent two different images of Iranian women in society: Tahereh is wearing a black veil with a coloured scarf underneath that matches her shoes and handbag. Azadeh is the other woman, with a perfect nose job and heavy make-up; she is wearing red lipstick, a sheer scarf that shows off her dyed blonde hair from under the scarf and a 147 Vignettes from the field white coat and denim trousers. Tahereh is speaking, as I get involved in their conversation: Tahereh Now I have come to see what will happen. Azadeh It is only God’s will! Do you think it will work? When did you freeze [the embryos]? How long ago? Tahereh It is God’s will. Without His will, I would not have had my son either. Azadeh Did you freeze [for him too]? I interrupt and ask Tahereh whether she has frozen embryos. Tahereh Yes, I have. Shirin Are they yours? Tahereh Yes, they are. Shirin I mean were the egg and sperm yours? Tahereh No, they were donated. The embryos were donated. My husband does not have sperm. We finally received donated embryos. My son was born the same way. I have a son now. Azadeh Lucky you [ … ]. How many did you freeze? Tahereh Well, at the time, we froze two of them but one of them is very weak and I do not think it will work at all. But the other one is a good embryo and today I have come here for the implant. We will see how it goes. Azadeh I bet it will work. Tahereh It will if it is God’s will. Shirin You mean the embryos were like brother and sister? Were they from the same couple? Tahereh Brother and sister? I do not know if that is the right way of describing them, but yes, they were from the same couple, a single donor. 16 Shirin Do you want this one to be a girl? Tahereh I don’t think about such things. As long as it is born healthy, it does not matter if it is a boy or girl. We have to see what God intends for us. Well, anyone would like to have a boy and a girl. I have a son 16 Thus, she does not reduce siblingship to the biological concept. 148 “M as in Mother”: medical perspectives, clinical environments and social dynamics now. But whatever this one turns out to be, it will be God’s will. I would like to have a baby girl but that is not what I am thinking about right now. Just being healthy [is important]. Shirin Did it work at the first donation? Tahereh (replies with laughter) No dear, we have been doing the treatment for fifteen years. At that time we couldn’t freeze, I mean, there was not a chance of freezing. Maybe if it had been possible I would have done it; but it was not possible. Then I learned that this clinic has the means to freeze embryos. When we got donated embryos for my pregnancy with my son, we froze the rest of the embryos. Shirin Are they yours? Tahereh For sure [ … ] they are our children [ … ] the frozen embryos are ours; I mean they are under our name. Here they made it clear that they are no longer related to the donor and the remaining embryos were frozen under our name. Azadeh How promising! In the office of the clinic’s director While I am talking to the director, his secretary peeks in and says there is someone on the line. “There is a gentleman who is asking for embryos [ … ] he has called several times and wants to speak to you,” she says. “Go ahead, put him through, but we don’t have any embryos”, he chuckles and says “I myself will have to give him an embryo since we don’t have any” and picks up the phone. Clinic director: Hello [ … ] how are you [ … ] yes, but we do not have any embryos at the moment [ … ] How many years have you waited? Two years? Well, you have to wait longer. Unfortunately, we do not have any donated embryos. If one becomes available, we will let you know [ … ] you see, we cannot advertise here that we need donated embryos, so someone would have to come and donate the embryo [ … ] we follow up through our colleagues [ … ] we tell those who have donated embryos that if they know of individuals who are willing to donate, they must contact us. Of course if someone shows up, we will let you know [ … ] well, I cannot tell you which centre (IVF clinic) has extra embryos [ … ] they do not tell us that [ … ] even if they have extra embryos, they will use them for their own patients [ … ] we cannot ask them for their embryos [ … ] you can definitely go and check them out [ … ] of course! As soon as someone offers, we will let you know [ … ] Yes, the price 149 Vignettes from the field has gone up [ … ] about 2 million tomans [ … ] the donors currently ask for 2 million tomans [about US$ 2,000 in 2010]. The clinic reception staff On another occasion, in the same clinic in 2006, while I am sitting with Neda, one of the clinic reception staff, a woman approaches the reception room. She seems to be one of the regular patients. Neda knows her. She tells the woman that she is on the list to receive a donated embryo and it can take up to six months or even two years before she gets one. “It is better if you bring a brother or sister to donate an embryo, otherwise it is going to take a long time and cost you a lot money to receive a donated embryo. However, if you have someone who is willing to do this, you do not have to pay this amount of money”, Neda says. The woman asks, “Do you think sperm donation would be a better solution? ” Neda answers: “We do not perform that here [ … ]. If you wait long enough to pass the regulations on it, then you can take advantage of sperm donation.” 17 The woman asks: “Are there other places where they perform such a procedure? ” Neda answers: “We are not aware of them, even if they exist.” After the woman leaves, I ask Neda: “Are there people who are willing to use donated sperm? ” She replies: Many of the women whose husbands have an infertility problem would like to receive a sperm donation. But we do not provide sperm donations here. Those who are not strictly religious do not mind if they receive a sperm donation [ … ]. But we have also many couples who insist on receiving a donated embryo since they believe that receiving donated sperm is haram . Not long ago, there was a man who claimed using a sperm donation was like approving of his wife sleeping with a stranger and committing zina¯ (adultery). Some people like this gentleman are more dogmatic in their beliefs. On the other hand, there are some who do not mind choosing sperm donation. She continues: Some believe it [using gamete donation] is manipulating God’s will. But, I think if God has allowed mankind to master science and medicine and to make all sorts of discoveries and improvements, and if He has seeded these brilliant ideas in man’s mind, why should a couple not take advantage of science and technology when they cannot bear a child on their own and their 17 Since 2010 this clinic also provides sperm donations. 150 “M as in Mother”: medical perspectives, clinical environments and social dynamics marriage might fall apart as a result. After all, the baby is going to grow inside the woman’s uterus and will belong to them. Do you think this is manipulating God’s will? I don’t think so. Recipient’s husband I am sitting in the reception room when the director arrives. He asks Neda: “Didn’t you tell Mina [the egg donor] to come in later? ” Neda answers: “I told her to be here at 11 a.m., but I do not know why she came in early this morning again.” He says: “Tell her to be here on time for her next appointment. If she shows up early again, we will take her off the donors list.” Neda assures him: “I will talk to her today.” After the director has left the room, Neda tells me: Mina is the girl you talked to a few weeks ago. She is divorced. As you have probably noticed she is very flirty and quite gorgeous. She is always wearing makeup and nice perfume when she comes here. Men like that in her. Apart from that, her eggs are of good quality. She has donated four times and each time the pregnancy had been successful. I think she enjoys meeting the husbands of women she is donating eggs to. That is why she likes to come in [early] when both husband and wife are here. Mr. X [the director] doesn’t like her to roam around the clinic like that too much. She continues with laughter: “She distracts the men.” A few hours later, when I go to the clinic’s back yard, I see Mina sitting in a far corner of the yard, smoking a cigarette. She calls out to me and I walk towards her. Mina How is the research going? Have you been able to interview many people? Shirin Yes, I have talked to some people so far. Mina Do you interview egg recipients too? Shirin Yes, I do. Mina What do they say? Shirin Well, they have got stories of their own. Mina They all want to have kids. They fear that not having kids will ruin their marriage. Shirin Neda told me that your eggs are really good and strong. All the previous ones have ended up in successful pregnancies. Do you think it is going to work this time, too? 151 Vignettes from the field Mina No one can tell what will happen in the future. Only God can see what will happen tomorrow. Shirin Mina, I want to ask you a question. What will you do if the husband of a woman you have donated an egg to gets attracted to you? Mina (starts laughing) No way! It is not possible. I do not ever see their husbands. On some occasions I have talked to the woman who receives the egg, but never to the husband [ … ] you never know [ … ] she [the egg recipient] is already under enough psychological pressure for not being able to have a child, let alone fearing that her husband will meet a fertile woman [ … ] No! When I return to the reception room, Neda asks me: “You saw her [Mina] smoking a cigarette, didn’t you? ” Wondering how she had seen her smoking, I nod. She continues: The woman who is going to receive Mina’s egg was here. She was very concerned that the donor we have chosen for her smokes. I tried to convince her by saying that she smokes occasionally but her eggs are really good and the other recipients have got pregnant. I had to tell her something to wipe off that tainted image from her mind, otherwise it would have kept worrying her. Approximately ten months later, I call Neda in Tehran. She informs me about the woman who had received Mina’s eggs and the fact that she had given birth to twins recently. “She is overwhelmed with joy. She brought us a lot of sweets and she has given Mina the same amount she had paid for the egg donation as a gift.” Two sisters Another day while I was sitting in the waiting room of the clinic, two women came in with their children carrying a big box of pastries and they looked very happy. One of them was holding the hand of a fouror five-year-old boy and the other woman was pushing two new-born baby girls in a stroller. First they gave sweets to the doctor and his staff and then the rest of the sweets were distributed among the people sitting in the waiting room. One could hear comments like “Did you give birth to them in this clinic? ”, “Did you do IVF? ”, “With God’s will, you will become a mother, too” and “I hope ours will be twins, too.” When they left, Neda told me: “They were sisters. The younger sister did not have any eggs at all so the older sister became a donor to her. The elder sister has only one son. Their husbands were ecstatic. The younger sister’s husband treated us to a nice thank-you after her delivery.” 152 “M as in Mother”: medical perspectives, clinical environments and social dynamics b) The setting: one day in a Yazd IVF clinic I am sitting in a gynaecology room. It is the most crowded room in this clinic and it is connected through a door to the ultrasound and examining room. There are a number of physicians in the room, all female, and at the same time there are four or five patients, speaking to one another and trying to understand each other’s problems. A woman sitting next to me has undergone IVF twice; the first time the result was negative but this time it turned out to be positive. Three embryos had been implanted. She had done the first ultrasound the day before and she was told that no embryo had formed yet. Now she has come here to see what the verdict will be. She is worried as she walks into the ultrasound room. On the other side of the room, there are two women in veils who are talking sympathetically in loud voices and offering advice to each other. A great deal of information and knowledge is produced and transferred at this level and everyone becomes aware of each other’s problems and treatments. It came to me that this is helpful for infertile couples treated by assisted reproductive technologies. I recall an incident in another clinic where some women who were waiting in a room to get ready for IUI (intrauterine insemination) 18 cheered all together when they heard of another woman’s positive IUI result. One of them said: “When I heard of her positive IUI, it gave me hope [ … ] Now I can go home with a stronger spirit [ … ].” Here it is the same. A young woman has come to undergo IVF again. The couple have not had intercourse for more than a week. But now her husband’s sperm sample [ nemu¯neh-ye esperm ] is needed. Her doctor says: “Did I not tell you to have intercourse a few days before [sperm] sampling” and asks: “Have you done the ultrasound yet? ” The young woman does not know what to say. She smiles. The doctor looks at her file: “You have not done the ultrasound! ” The young woman smiles and says that she does not know what an ultrasound is. After all that, she and her husband go to the lab for the sperm test. 19 Another couple present in the room is from the south-eastern provinces of Iran, where a 18 Intrauterine insemination (IUI) is a relatively simple and common form of artificial insemination, in which the washed sperm is placed directly into the uterus with a catheter. IUI is less invasive and less expensive than IVF and ICSI. 19 The sperm sample test is usually recommended to be scheduled three to five days after sexual abstinence. Not ejaculating for more than five days may result in a lower quality sample. Each clinic has a sperm collection room, which is often very small without any pornographic magazines or erotic pictures on its walls. This room is bigger in some private clinics with a bed and gentle light. In the IVF clinics where I carried out my research, the most common method to collect sperm is by masturbating into a sterile container. It is also allowed for men to be accompanied by their wives for the sperm collection. To collect sperm for both analysis and insemination, most Shia authorities permit masturbation, although in general, like all monotheistic religions, the teachings of Islam disapprove of masturbation. 153 Vignettes from the field majority of Sunni Iranians live. The woman is forty-two years old but her husband states that she is thirty-seven to thirty-eight years old. “She is forty-two, what do you say? ” the doctor corrects the husband. The woman is here to receive the medication to stimulate ovulation but the doctor claims that it is too late for that. “Her ovaries are empty. It is not possible to do it. It is a wasted expense,” the doctor says. The woman does not give up. Her husband insists. “Why did you bring her here so late? ” the doctor asks. “You should have done this sooner.” They have been married for twenty-two years with no children. “Do you not have a second wife? ” the doctor asks the husband. “It is strange.” The man smiles and asks: “What should we do now? ” The doctor says: You have two choices [ … ] There is a way that we, Shia, do it and that is to marry a woman temporarily. She can be an egg donor for you. But since you are Sunni and do not do this [the man nods in approval] the other choice is to continue your life together without children or to marry a younger woman. You can bring her here. We can produce embryos and implant them in the wombs of the two women and it is possible that your [first] wife may become pregnant too. The man laughingly talks to his wife in a language that I do not understand. The woman, who is not pleased at the doctor’s response, turns to her and asks: “Why do you not give me any medication? ” to which the doctor replies: “When I know for sure that it is not possible to find any eggs to ovulate why should I give you any medication? It is going to be a useless cost.” And once again she explains egg donation to her. “Now, it’s up to you to make a decision,” the doctor says at last. People present in the room look on. One of the women suggests to the woman: “Now that you are too old to conceive, why don’t you try the egg donation? ” There is another woman in the room with her sister who has undergone IVF six times and has now had her latest miscarriage. The sister checks into the ultrasound and examining room. The woman asks the doctor if it would be better for her sister to consider egg donation as a treatment option; maybe later miscarriages can be prevented. “They have healthy embryos here. There is nothing wrong with the embryos. Egg donation is not the solution to their problem,” the doctor says, while adding, “they need to consider surrogacy, for example, ask a woman in the family - a sister or a kha¯leh [aunt; mother’s sister] - to come here to get the embryo implanted in her womb so there would be a possibility of preventing further miscarriage.” Pondering for few seconds, the woman goes on: “Well, they have not told anyone about this [ … ] this is even the first time she has brought me here. They 154 “M as in Mother”: medical perspectives, clinical environments and social dynamics [referring to her sister and her husband] are cousins [ pesar amu¯ - dokhtarameh , paternal cross-cousins]. Maybe there is a genetic problem involved. But they want to try as many times as possible. They do not want to tell anyone about it. They want to keep it to themselves. Turning to the doctor, she asks: “please talk to her when she comes back [ … ] maybe she will accept to do it [surrogacy].” In response, the doctor says: “Now is not a good time. She is not feeling well. Because of her miscarriage, she is under pressure. In a couple of months, when she has calmed down, she will be easier to talk to. I’ll talk to her then. She should not be pressured.” The non-transferable embryo On the same day, in an interview with a biologist, I ask him about the beginning of human life. He says: “Even before conception, each cell is alive. However, there are weak sperm as well as weak eggs. During the IVF procedure, we set aside the sperm that show better quality; but when the embryo forms, answering this question becomes difficult.” I ask him about the way to choose between a good embryo and a bad one. He tells me that at the beginning of his career he thought it would be better not to transfer the “low quality” embryos. He then recalled an encounter, which made a deep impression on him. He recalls the incident: “In the early days of the clinic, we had come up with one single embryo through ICSI (intracytoplasmic sperm injection) from a couple whose egg and sperm showed very low quality. Upon examining the embryo, my colleagues and I recognized that the embryo did not withstand the quality criterion, and we therefore called it non-transferable.” Speaking with the couple, it was explained to them that it was better to throw out the embryo and they were advised to get ready for another round of IVF. However, the couple did not agree to this and insisted on transferring the embryo nonetheless. Years later, a woman accompanied by a 13-year-old boy came to see the biologist. She told him that the boy was from the same embryo they had identified as a low-quality embryo 13 years ago and had tried to convince her to throw out. After the incident, choosing between a good or bad embryo has become one of the most ethical challenges and queries he deals with. c) The setting: one day in a Qom IVF clinic Batoul is a forty-three-year-old woman from a village near Qom. She was forty when she got married. She has completed her middle school education. Her husband, a friend of her brother’s, was divorced from his first wife and has a daughter from this first marriage, with shared custody. Batoul has no eggs of her own but she is able to carry a child. She decided to use donor eggs to become 155 Vignettes from the field pregnant. Batoul’s medical doctor introduced her to me. She asked Batoul whether she minded being interviewed by a woman who was doing research about infertility and assisted reproduction while she waited for her treatment in the IVF clinic. Batoul agreed immediately. The day I met her she was very nervous. The woman who was to donate her egg had been taken to the operating room. The interview started with the same simple question as most of the others. “Tell me your story from the start.” Batoul starts with the first sexual intercourse she had with her husband: My hymen was very thick. We could not do it for a couple of days. We made a pilgrimage to Syria to visit Hazrat-e Zaynab and Ruqayyah shrines. 20 I appealed to them. I was bleeding. I asked the holy ones to return me home safely. It finally happened [first marital intercourse]. I wanted a child from the very beginning so I did not use any protection. But my husband was not too keen on doing it very often. She giggles and asks me if I am married - “not to be too shameless and vulgar for you”. Batoul continues: My husband says that if God’s will is to give us a baby, he will. But I tell him that we have to have sex more often for me to get pregnant. But it did not happen. At last, we visited a doctor who told us to visit an IVF clinic but my husband was not willing to do it. Because my husband had divorced his [first] wife, he did not have any money [ … ] but my mother and sister urged us and said they would help us. So we came here for treatment. They told me here that my eggs were very weak and that we had to use donated eggs and find someone to donate them to us. After the medical consultation, Batoul and her husband, like many other couples in this study, decided to consult a local religious authority, not on the permissibility of egg donation and religious solutions, but on helping them to find an appropriate egg donor. Batoul continues: 20 Two important Shia shrines located in Damascus. Zaynab, the sister of Imam Husayn, the third Shia Imam, is another holy female figure in Shia Islam (especially among Iranians). Ruqayyah was the infant daughter of Imam Husayn. Many Iranians used to travel to Syria to visit the shrine of Hazrat-e Zaynab. I did this interview in 2010 before the war in Syria began. 156 “M as in Mother”: medical perspectives, clinical environments and social dynamics The haj-aqa¯ , 21 who is the pı ¯sh-nama¯z [the prayer leader in a mosque] where my husband goes, introduced this lady (the egg donor) to us. My husband had gone to him and told him about our problem. He told him that his wife was upset over this. Then he suggested a woman to us. She was very young but very smart and asked for a lot of money. She was good for egg donation but she did not show up. After that the haj-aqa¯ introduced this lady who is a bit older. She is thirty-one years old. I am worried about whether they will be able to get any eggs from her. She has two children. She is very patient. This is the first time she donates. We have paid for all her medications and injections. Batoul’s husband and the egg donor have made a short-term contract of temporary marriage. Batoul says: Some people here said to me “Why did you let your husband and this woman see each other [ … ] why did you not go with them [ … ] your husband might marry her.” Because, you know, today they signed their [temporary] marriage contract. I did not notice at all. I stayed here in the clinic and they went to the haj-aqa¯ for one hour [ … ] I am not worried about this. I do not even think about it. I do not think this lady will be after my husband. After all, she is going through this trouble for us. It all depends on God’s will. If He wants, it will work; if not, it won’t. I am just worried whether they can take her eggs. My sister had found two donors in Tehran but my husband said it was too far and he could not leave his work every day. He is a worker in a silo. They have given medication to this woman to stimulate her eggs. But, whatever God wishes for us. If He wants, He can make us happy. I talked to the woman who was donating eggs to Batoul after she came out of the operating room. She divorced her husband eight months earlier and in order to do her donation, she and Batoul’s husband had made a one-week temporary marriage contract. She said: I was told that it is better to do the temporary marriage contract because it was easier from shar ı ¯ point of view and I accepted. The only thing I think of now is for that poor woman to have a baby. I have two children of my own. 21 The haj-aqa¯ is a term of respect usually used when addressing an older man who has made the pilgrimage to Mecca, but here it refers to a senior local religious figure. The term used for a woman is haj-kha¯nu¯m. 157 The dynamics of social practice They are fourteen and nine years old. I am recently divorced because my husband was a drug addict and he did not work. He could not manage our living costs. I came to this haj-aqa¯ to help us and he told me that I could do this. I thought about it for a few days. I felt sorry for that woman too. I told myself “let her have a child and become a mother”. That is how I accepted this [ … ] otherwise, I do not have any feelings toward any man. I look at her husband as if he is my brother. The dynamics of social practice Clearly, the social practice of assisted reproduction in Iran is not governed by strict regulations. We can see that in accordance with the religious and legal background described in the previous chapters, and according to the individual cultural choices, the use of assisted reproductive technologies is socially acceptable and thought of as legitimate. 22 Yet I argue that this social practice of ART does not necessarily displace the cosmological phenomena and moral logics that structure kinship and reproduction. Instead, they create new sites and occasions for reproducing and redefining these principles not only in sacred places, parliament and bioethical conferences and meetings but also in everyday clinical settings and interactions. The IVF clinics are not just the place where sperm and egg are mixed together in a test tube; they are the place where a multitude of actors all play a part in making a human being with a cultural identity and turning him or her into a relational being and a member of society. Let us look again at some of these examples. In the first setting, in an IVF clinic in Tehran, Tahereh is a woman who, from the way she is dressed, can be described as a conservative religious woman. Like many other infertile couples where the husband is infertile, she has chosen embryo donation. She has one child already and now she has decided to become pregnant again with the remainder of her frozen (donated) embryos. As explained in chapters 2 and 4, the regulation of embryo donation and adoption in Iran shows the same legal pattern. However, the challenges that exist in the case of adoption - in particular for religious families - have been resolved in the case of embryo donation. As we have seen, adoption was less favoured by many infertile couples and in some cases it was not even considered as an acceptable option. Some of these couples were cautious because adoption, according to Islamic law, does not constitute a ‘natural’ relationship and is thus not subject to mah ˙ ramı ¯yat (marriage prohibition). Perhaps if I had asked Tahereh her opinion about adoption, she would have given 22 See also my argument in chapter 4 concerning the legal regulation of ART in Iran. 158 “M as in Mother”: medical perspectives, clinical environments and social dynamics this reason. 23 But in embryo donation, according to many Shia scholars, the child will be mah ˙ ram (non-marriageable member of kin) to the woman, if it is a boy, since she carries the embryo in her uterus and breastfeeds the baby after birth; hence, if it is a girl it will also be mah ˙ ram to her husband. 24 In the next setting in Yazd, we see that there are many people in the room where they learn about each other’s stories. For the woman who has an egg problem and is from a lower class Sunni family, the physician first suggests the use of egg donation by way of temporary marriage. But the husband does not accept this and the doctor then recommends taking a second wife. Another woman present in the room suggests to the wife that she accept the egg donation. But still the husband does not give in. I met with the couple later that day and the husband told me he would prefer to take care of a child from his family (informal adoption of a sibling’s child) rather than go through a temporary marriage for egg donation. In the setting in the Qom IVF clinic, on the contrary, Batoul, who is also from a lower class family, but in her case Shia, and who has the same reproductive problem as the woman in Yazd, nonetheless agrees to use egg donation. Not only is Batoul fine with egg donation and the temporary marriage of her husband with the egg donor, but she has also contacted a religious figure to find an egg donor. So, here, religion has come out of its theoretical shell and become functional and practical in the production of social relations and the development of society. “M as in Mother” I would like to finish this chapter with some remarks about the title of the chapter. “M as in Mother” ( Mı ¯m Methle Ma¯dar ) is a 2006 Iranian film, directed by Rasoul Mollaqolipour, about a violinist called Sepideh (meaning “dawn”). She was a young relief nurse during the Iran-Iraq war and was injured in a mustard gas attack by Iraq on Sardasht. 25 Years later, when she is expecting her first baby, the doctors tell her that her foetus is affected by a disorder due to the chemical effects of the gas. Sepideh’s husband, Soheil, is moving gradually up the ladder as a diplomat and is very mindful of his position. Tension rises between the couple, first over the question of terminating the pregnancy and then over keeping the 23 Or she would have responded the same way as Sogand dose in the examples of the next chapter. 24 It is like the rabiba principle in Shia jurisprudence, according to which the daughter of the woman from the previous marriage will become mah ˙ ram to her new husband. In fact, here IVF gives this old religious legal principle a rebirth. 25 The Iraqi chemical attack on Sardasht happened on June 28 , 1987 . 159 “M as in Mother” handicapped child who suffers from respiratory problems. They finally divorce and Sepideh raises her son, Saeed, on her own. I watched the film in 2006 in a Tehran cinema during the early period of my ethnographic research in Iran on ART. In those days, I had interviews and conversations with many infertile men and women who had resorted to IVF clinics in the hope of becoming parents. Some of them were paralyzed war veterans. The film was suggested to me by many people and friends who were familiar with the subject of my research: “You must watch this movie to truly understand what it means to become and to be a mother”, one of the staff of an IVF clinic, which provides infertility treatment services to paralyzed war veterans, once told me. The film received a lot of attention from both public and media. In the movie hall, what caught my attention more than the movie itself was the sound of weeping coming from the moviegoers, men and women alike, which reached its peak during the closing scene of the movie. Sepideh, who is undergoing chemotherapy, is lying on a hospital bed. At the same time, her young son Saeed is playing the violin in a concert performed by a group of handicapped children. The song, which was composed by his mother, is a poem dedicated to mothers. As he plays the violin, tears run down his face. Children sing: Bad or good, the world is worth seeing with you, Mother. I want to pick the flowers from the garden only with you, I love your voice, Like the old days, I love your lullabies, I love your simplicity, I love your weariness, I love your prayer veil; I love you when whispering “God”. Stay with me, Because I love the world with you till Eternity. Crying in her bed, Sepideh remembers the war, and the time when she was carrying a child during a chemical attack and thinking of a way to save him. She whispers: “M as in mother.” Saeed is standing on the stage and plays violin. He is a talented boy who suffered mustard gas contamination even though he was born after the war. For few seconds, the film turns into music that accompanies the word “Mother”. We see Soheil who has come to the recital to see his son for the first time. The boy weeps and plays the violin. His presence on the stage conveys the most tragic definition of birth, war and death. As the weeping of the audience in the cinema blends with the image of the weeping audience in the film who have come to watch the concert, there remains only one sound: “Mother; M as in Mother.” The mother portrayed in the movie is the representative of all goodness to some extent. Sepideh, who makes her responsibility towards her disabled child 160 “M as in Mother”: medical perspectives, clinical environments and social dynamics her priority, is the heroine of a society where the mother is fundamentally seen as the symbol of kindness and refuge for humanity. “Beyond doubt, everything commences from the mother and all ends in her”, as Jalal Sattari, Iranian mythologist and writer put it in his book The Image of Woman in Iran’s Culture (Sattari 2007: 289). As I noted in chapter 1, there are numerous textual references to Anahita ( aredui sura banu , “lady of the water”) 26 as the divinity of the waters, motherhood, fertility and purity in Persian literature and she is worshipped and sanctified on various occasions in Avesta and other Middle Persian texts. For instance, as mentioned in Avesta (cited in Bahar 2012: 477): Anahita is the spring that all the waters on earth branch from; she is the source of all the fertilities; she purifies the seed of all males; she purifies the wombs of all the females; she purifies the milk in mothers’ breasts; she does all these things from her heavenly place among the stars; she is the beginning of cosmological seas. According to Bahar, Iran’s prominent linguist, mythologist and Persian historian, the cult of Anahita was greatly influenced by the Cult of Ishtar - the Semitic and Babylonian goddess of fertility - which in itself indicates the cultural impact that ancient Western Asia left on Indo-Persian culture (ibid.: 394). Bahar and Corbin (cited in Bahar, ibid.: 447) argue that even after Islam spread through the Persian territories, Iranians held tight to their beliefs about Anahita in most parts, to the extent that on many occasions they ascribed those virtues to Hazrat-e Fatemeh, the holy and great lady of Shia Islam (see chapter 1), and defended those beliefs from the bottom of their hearts. Nevertheless, the title of this chapter has been adopted from the film. In one of the movie scenes - supported by the official report - Sepideh says: “Of the 12,000 people of Sardasht, 8,000 were contaminated that day.” Sepideh was one of them. As part of my study, I also interviewed disabled men ( ja¯nba¯za¯n ) from the Iran- Iraq war, who had become infertile due to participation in the war and its consequences. After many years of treatment and disappointment, many of them saw assisted conception - particularly embryo donation - as a miracle that had given them and their wives hope for pregnancy and children. As one of them put it: “It is true that the war is still living among us [ … ] but life might smile on us again with this embryo donation, God willing, and our wives can become mothers and hold their babies”. The next chapter discusses the practice of cousin marriages in the light of genetic disorders and emerging biomedical knowledge for managing them. 26 Ba¯nu¯ is an ancient Persian term for “lady”. Within the framework of legal discussions of surrogacy, some jurists have used the word da¯yeh (“foster-mother”) in place of “surrogate mother” (ma¯dar-e ja¯ygozı ¯n); others have suggested using the word ba¯nu¯ (“lady”) and changing the term to ba¯nu¯-ye s ˙ a¯h ˙ eb-e rah ˙ em (“the lady in ownership of the uterus”) or “surrogate lady” (see Milanifar 2008 ). 8. Cousin marriage, siblingship and reproductive technologies Wife This marriage should not take place [ … ] do you understand? They should not marry each other. They have genetic problems, similar genes [ … ] their baby, the one she is carrying right now, is defective. Before her six months is over, she will have a miscarriage [ … ] this marriage should not happen. Husband That’s enough. You have said whatever you wanted to say. What genetic problem? Their wedding is in two days. Wife In two days, it is their funeral. Their wedding today is their funeral tomorrow [ … ] Do you wish Amir-Hafiz [their son] to grieve over not having his own child for the rest of his life? Husband You are talking nonsense woman. Nonsense! Wife Look Ismail! Don’t throw Amir-Hafiz’s future away because you are coy around your brother [ … ] You know what [ … ] it is all my fault. If I had not agreed to this marriage four years ago, it would never have got to this point. Everything would have come to light sooner [ … ] now it has happened. I apologize to everyone. I will throw myself at your brother’s feet, at his wife’s feet; I will beg Akram [her son’s fiance´e] [ … ] they will understand. Husband (yelling) What about you? Do you understand? Do you understand Akram’s condition now? Do you understand her dad’s state? Do you understand Akram being pregnant? Do you understand what it means if Amir-Hafiz turns aside now? Do you realize what a disaster it will be? You want to make a widow of their daughter for nothing? A baby inside her belly without her marriage being recorded anywhere and you are thinking about saving your own son’s future? Is that how it is? This was one of the most critical dialogues of a very popular Iranian TV series called jerahat (“The Wound”), aired during the month of Ramadan in September 2010 and attracting large audiences all over Iran. Jerahat has put cousin marriage and genetic disorders - a subject little portrayed in TV series before - under a 162 magnifying glass. The principal characters of the story are two cousins, Akram and Amir-Hafiz (daughter and son of two brothers; patrilateral parallel-cousin or FBD marriage) whose became engaged four years ago, and now their parents have decided to throw them a wedding party and send them on their way. The premarital medical test not only reveals that Akram is pregnant but that the bride and groom have a genetic problem and should not have children together. Premarital medical tests are mandatory in Iran for all couples planning to get married. The current tests, which are necessary to obtain a marriage certificate, include genetic testing followed by counselling with the aim of combating certain genetic disorders such as thalassaemia. 1 For instance, an article titled “With the permission of the laboratory, yes. A comprehensive guideline to premarital tests for young couples” in an Iranian popular health periodical called peyk-e tandorosti (“The Health Courier”), describes the programme as follows: upon visiting a mahd ˙ ar (marriage / divorce registration office), the would-be husband and wife are informed of the required tests. They are then sent to the laboratory with a stamped letter of recommendation carrying their photos to take a drugs test. The test for syphilis is mandatory for men. 2 The would-be couples are examined for thalassaemia, followed by tetanus vaccinations for women 3 and finally the day concludes with the couples partaking in a family planning counselling class to receive important information. 4 However, Akram’s pregnancy before the official marriage ceremony, a baby with prospective birth defects, and genetic barriers for future pregnancies have 1 Thalassaemia - the beta type in particular - is the most common genetic disorder in Iran. For this reason, health centres across the country have officially made the national thalassaemia prevention program a priority since 1997 . The goal of thalassaemia screening is to identify carriers in couples intending to get married. If both partners in a couple are identified as carriers, they will receive comprehensive information about possible future health setbacks. The final decision is theirs to make. If they turn away from the marriage, the case is closed. If they decide to go through with the marriage, they are issued the marriage permit after completing the required forms. They are also referred to a health centre near their residence where medical experts will monitor the pregnancy status of the woman in order to determine the thalassaemia mutation in the couple before pregnancy, as well as taking necessary measures during pregnancy to determine the thalassaemia condition of the foetus before the fourth month is over. As mentioned in chapter 3 , the Iranian therapeutic abortion law permits the prenatal diagnosis and abortion of affected foetuses. 2 Undergoing a syphilis test before marriage is mandatory for all men as well as for women who are getting married again (peyk-e tandorosti, September 2006 ( 13 ): 27 - 31 ). 3 Men receive these vaccinations during military service. 4 Premarital counselling for young couples includes information on preventing hereditary diseases, pregnancy, proper age for pregnancy, number of children, and appropriate methods of family planning (ibid.: 31 ). 163 Cousin marriage in Iran created a turmoil in the family of two brothers who are known for their success and strength. Both families are against the marriage and ask Akram and Amir- Hafiz to end their relationship; otherwise, they will be ousted from the family. However, Akram and Amir-Hafiz fight their problems whole-heartedly to remain with each other. They begin their life together with the decision that love is stronger than having a child. Jerahat comes to an end when, once again, the two brothers find fellowship and communion with each other. In previous chapters, I discussed the centrality of marriage, siblingship and filiation in the bilateral structure of Iranian kinship system. I argued that the social uses of ART in Iran tend to reveal and reinforce many existing assumptions and practices relating to kinship and reproduction. Cousin marriage is one of these kinship practices. This chapter shows how ART refashions these traditional kinship practices. I do not intend a comprehensive analysis of cousin marriage in Iran. My focus is particularly on media and public discussion of cousin marriage in the light of genetic disorders and emerging biomedical knowledge for managing them. This study of cousin marriage allows me to situate my contribution more clearly in the context of kinship and reproductive technologies. I argue that the social uses of assisted reproductive technologies in Iran appear to strengthen the already-privileged sibling (same-sex or oppositesex) relationship that cousin marriage implies - a privileged relationship that is one of the central components of the Iranian kinship system. Cousin marriage in Iran Cousin marriage of both the cross and parallel kind, and both patrilateral and matrilateral, are allowed in Iran. The studies of cousin marriage in Iran (Abbasi- Shavazi and Torabi 2007; Givens and Hirschman 1994; Saadat et al. 2004 and Akrami 2006 among others) show the strong appeal of this type of marriage, its relative constancy over the last five decades (1951-2001), and even its growth over the last ten years (Abbasi-Shavazi and Torabi 2007). Based on the most recent surveys conducted across the country, 38 % of marriages are cousin marriages, and over 27 % are between first cousins. A survey of inter-generational differences in cousin marriages indicates that despite the increase in urbanization and the benefits of higher education in the second generation, not only has the rate of cousin marriage not fallen, but it has enjoyed a slight rise, from 42 % of cousin marriages among the parents (first generation) to over 45 % among the children (second generation). The survey also points out that the children’s attitudes are influenced more by their own personal characteristics than by their 164 Cousin marriage, siblingship and reproductive technologies parents, and this is even truer among female children (Abbasi-Shavazi and Torabi 2007). Although some cultural characteristics of the Iranian kinship and family such as fertility, marriage and divorce rates have changed under the impact of modernisation and urbanization, cousin marriage has not, remaining constant and even increasing over the last decade. However, I would argue that this stability or increase in cousin marriages emphasises the significant effect of historical background and socio-cultural, political and economic structures of the society in determining family structure and kinship. 5 In other words, cousin marriage should be examined in terms of its functions and as part of the general social system influenced by societal dynamics and policies. For instance, different statistics in Iran indicate an increase in divorces. At the same time, the divorce rate is lowest in cousin marriages. During my research, I spoke with over 30 couples who were relatives before getting married. I learned that most of them regarded cousin marriage as marrying someone they already knew and divorce as indecent or even impossible behaviour. Mutual affection, lack of trust toward strangers, the fact that the two families know one another, and fondness of the prospective couple are other factors the couples agreed on. Another important point is that many of these couples did not consider their marriage as arranged but as a personal choice and decision that had even, in some cases, met with objection from other family members due to the risk of genetic disorders in children. Public discourse, genetic disorders and IVF Akram We grew up together. His mom used to call me her aru¯ s [daughterin-law] ever since I was small. As time passed, I figured out what she meant by that. Now, we are both grown up and madly in love with each other, but everyone says we have to take the genetic test first. What if the test results show that we should not marry? What shall we do then? Coming back to jerahat , shortly after the series ended, sı ¯b-e sabz (“Green Apple”), 6 a monthly health magazine, published a report on the TV series under the title 5 Some experts in Iran believe that the inability to get to know one’s partner properly, lack of honesty, the increased display of unrealistic social roles, the growth of hidden mental illnesses such as depression and the generation gap are among factors that provoke a lack of trust in families and lead them to prefer cousin marriage. 6 Sı ¯b-e sabz (“Green Apple”), September 2010 ( 30 ): 16 - 30 . 165 Public discourse, genetic disorders and IVF “Forbidden Marriages”. Part of the report presented exclusive interviews with several actors from the series, while another part covered interviews with medical and genetic specialists. The actor and actress playing the roles of Amir-Hafiz and Akram were against this type of marriage but asked what they would do if faced with such a situation in real life, they both stressed the priority of love over having children. The actress playing Akram says: If jerahat told the real story of my life, I would have done the exact same things Akram did in the movie. The two of them could never have a healthy baby together [ … ] If I were in this situation for real and loved my partner tremendously, I would do everything in my power to keep him [ … ] When qa¯nu¯n [civil law] and shar’ [religious law] allow me to abort a defective foetus I am carrying, I will do it (ibid.). As explained in chapter 3, according to the legal opinions of many Shia religious authorities, if the mother’s life is at stake or the foetus is diagnosed with birth defects such that caring for it will burden the mother with extreme hardship, abortion is permissible before the ensoulment that is said to happen when the embryo is in its fourth month. This religious permissibility is reflected in the regulation of abortion in Iran. According to the therapeutic abortion law, passed in June 2005, therapeutic abortion can be authorised under the above circumstances. The actor playing the role of Amir-Hafiz has a similar view and says: If someday I learned that the baby my wife was carrying had problems, I would rather that baby not be born because it would be disastrous for both the baby and us. I do not have the heart to see my baby born with Down’s syndrome and let him or her be like that in front of me day in and day out [ … ] Preventing the birth of a baby you have not seen is much easier and more logical compared to when you let the baby be born and it has to suffer through life. I am not willing to take that risk at all. Under such circumstances, the man and woman should accept each other even without a baby in their lives (ibid.). Another section of this report contained information about biomedical and reproductive health-related issues including interviews with experts. In an interview with a professor and specialist in gynaecology and embryo development, the magazine asked about the goal of prenatal diagnosis. She replied: The aim of prenatal diagnosis is to determine any problem or mongolism in a foetus [ janı ¯n ] before it is ensouled [ damı ¯deh shodan-e ru¯h ] and then terminate the pregnancy [if necessary]. Diagnosing such deficiencies can prevent a child from being born with defects. A child with genetic and chromosome disorders has little chance of treatment and life will be hard on him as well as his parents. But when the problem - if it is untreatable - is diagnosed in the early days of the embryonic life, we inform the parents so that the procedure pertaining to legal [therapeutic] abortion can be followed. If it is possible to treat the matter, as in the case of heart complications which are quite 166 Cousin marriage, siblingship and reproductive technologies common, the prenatal diagnosis enables us to be prepared to perform surgery right after birth so the baby can go on living normally (ibid.). The next question of the magazine was whether it is possible to benefit from IVF and yet have a healthy child? IVF is one of the techniques for the treatment of infertility. In this method, several egg cells from the woman are fertilised in a lab environment by sperm cells from the man. The fertilisation results in several egg cells that multiply quickly and can be transferred to the mother’s uterus to, God willing [ be omı ¯d-e khoda¯ ], become the foetus of a healthy baby. In the meantime, for the couples [who are also close-kin] whose babies have higher chances of disorders, we take an extra step which is called PGD. In this technique, the eight-celled embryos are examined and the ones that are healthier are chosen to be transferred to the mother’s womb [ … ]. Through this technique, couples can be guaranteed healthy babies and hence, enjoy being together (ibid.). In another interview with professor Farhoud, who is known as the father of genetic science in Iran, he explained that a TV series like jerahat is not capable of challenging one of the most institutionalized family forms like cousin marriage and that fighting against it and banning the practice seems impossible. He sides with those who do not prejudge cousin marriages and says: We exaggerate in everything [ … ]. One time, we say that the conjugal union of the son and daughter of two brothers has been predestined in the heavens and we force them to live under one roof without perhaps having any feelings for each other another time we deliver the verdict that this type of marriage should be banned. If there is no genetic disorder in a family, then why not benefit from a cousin marriage? A genetic advisor is not entitled to prejudge a couple and must give them the final word as soon as he/ she learns that the couple-to-be come from the same family. Let’s not forget that a majority of disorders that come out of cousin marriages are due to genes present in both parties and they can be prevented by undertaking prenatal diagnosis (ibid.). Furthermore, he reiterates the importance of genetic counselling before cousin marriage and believes that PGD can help to prevent the transmission of defective genes as long as the hereditary nature of a disease and the way it is transmitted has been determined. According to Dr. Farhoudi, cousin marriages are responsible for one-third to two-fifths of genetic-related diseases which, of course, if diagnosable, can be resolved before birth [under the terms of the therapeutic abortion law]. I have argued that the legal regulation of biomedical issues in Iran has emerged within and across a variety of institutions, particularly involving medical, legal and religious scholars. By taking advantage of medical and technological advances, this confluence of religious and secular forces has provided a means to develop legal regulations and national guidelines as well as critical insights for 167 Cases from the field: cousin marriage in practice dealing with biomedical issues, in a society where there is a direct interrelationship between kinship, religion and state. Drawing on both religious and medical language, Dr. Farhoud adds: It is my pleasure to say that we have the official permission of intellectual religious experts for abortion if it is judged to be necessary. What I am trying to say is that we are fortunate in Iran about this. There might be few places where the magnanimity of medical experts has resulted in obtaining the decree of religious leaders. This positive point and the prenatal diagnosis open a bright horizon. Presently, we are successful in diagnosing some forms of deafness, blindness, mongolism, thalassaemia, some forms of haemophilia, and coagulation disorders (ibid.). At the end of the report, the magazine proposed a questionnaire with gifts for readers. The questions included: If you were the young couple in jerahat, and if the pre-marital genetic tests revealed that your baby would be born with genetic disorders, which route would you take? 1- We would go our separate ways 2- We would get married and forget about babies 3- We would get married and use IVF techniques 4- We would get married and adopt a child 5- We would get married and take the risk of having a baby with birth defects (ibid.). A majority of the public chose the obtion of getting married and using IVF techniques. 7 In the rest of this chapter I present some cases from my fieldwork in different IVF clinics in Iran. As we shall see, these case studies support the arguments put forward in this chapter. Cases from the field: cousin marriage in practice a) Sogand Sogand is thirty-one years old and married to her pesar-kha¯leh (mother’s sister’s son, matrilateral parallel-cousin marriage), who is five years older than her. They have been married for twelve years with no children yet. In an interview, she explained to me: “Our mothers are sisters, but our fathers are not related. They are from the same village. My brother married our dokhtarameh (father’s sister’s daughter, patrilateral cross-cousin marriage) too. They have a child. It is a healthy baby. They got married after us. In our family, it is common to marry with cousins but we are the only ones who do not have any children.” 7 Personal communication with the person in charge at the magazine. 168 Cousin marriage, siblingship and reproductive technologies Shirin Did you take a genetic test before getting married? Sogand No, we did not take any genetic test but we went for genetic counselling. All they asked was whether we had any [health] problems in our families, any mongolism, [ … ] but when they did not find any particular problem in the family, they told us [our marriage] would not a be a problem. Shirin What is the reason for your infertility? Sogand It looks as if my weak eggs are to blame [ … ] my ovaries are weak [ … ] that is all [ … ] no one has told us so far that it [the infertility] is because of genetic matters or family marriage. We have not had any problems in our families, but if it is happening for me [ … ] I don’t know. The day I had this interview with Sogand was six weeks after her first IVF. The embryo was conceived but its heart had not yet formed. However, she was still hopeful, like many other infertile women I had met during all the years I had been conducting my research, to undergo IVF again and even entertained the thought of receiving a donated egg. She told me how she got pregnant: Sogand They [IVF doctors] were able to extract seven egg cells from me by using shots and such things. Five of them were all right but two of them were weak. During the fertilisation of those five egg cells, they said one of them was weak [ … ] they implanted all four embryos, from which only one has survived [ … ] but it is six weeks and four days now and the baby’s heart has not formed yet. Shirin If it fails, will you do it again? Sogand I will try it a couple more times [ … ] although it is costly. We have spent over 3 million tomans [about US$ 3,000 in 2010] you know [ … ] for a wage-earner, and these many troubles [ … ] it is difficult. Well, we try to save some money and do this again a few more times. Sogand You know [ … ] it is exhausting [ … ] The only real hardship is the frustration, otherwise, the money can be managed. [If we have to] we will borrow the money to do this. But when they tell you the result, like this time that the ultrasound shows that the baby’s heart hasn’t formed [ … ] well, it is devastating. But we try not to lose faith, especially my husband who tries to maintain a happy atmosphere in our house. 169 Cases from the field: cousin marriage in practice Shirin During your twelve years of marriage, did you ever think about going your separate ways? Sogand No! Never! We really love each other. There is not even any tension between our families. Well, thank God, I am happy with him, as he is with me. Shirin Can you imagine going on with your life without any children? Sogand Sure, why not? It is true that it might be a little bit difficult, but as we have managed to live together without children for twelve years, we will manage to go on for the rest of our lives [ … ] If I insist on having children, it is because of my husband [ … ] he is so kind that I ask God “now that you have blessed me with him why do not you make our life complete by bestowing us a child” [ … ] I say “it is not fair to my husband to suffer because of me” [ … ] I am the one with the problem [ … ] that is why I do everything it takes to get a result from all this. Shirin Have you ever thought about adoption? Sogand Yes, we have. You see, if we adopted a boy, he would be na¯mah ˙ ram to me. If we adopted a girl, she would be na¯mah ˙ ram to my husband. It would be hard on us and the child. We won’t be able to hold, hug, or even kiss the child with comfort [ … ] this would be hard [ … ] Otherwise we would have loved to adopt a child. On the other hand, it isn’t very well viewed in our family. If you have ten kids of your own and then you adopt a child [ … ] that is no problem. But when you have no child and you adopt one, every one shows you with a motion of the eyebrow that “there, there, that is the child they have adopted”. 8 Shirin Why do they think this way? Sogand Well, it is not clear where the filiation of the child has come from. Whether it is illegitimate [ … ], who are the parents? How did they have it? Because of this, our families don’t have a good view of adoption. Even if they don’t say anything to us, they will point out with their eyes that the child is not theirs. Shirin Have you given egg donation a thought? Sogand I want them to use my eggs as much as possible [ … ] but if they say mine don’t work then I will have to think about it [ … ]. That’s hard too, but they still say, if God helps, there might be a chance [ … ] It all 8 See the discussion of adoption in previous chapters. 170 Cousin marriage, siblingship and reproductive technologies depends on God’s will [ … ] things will turn out the way He has destined them to be. b) Farzaneh Farzaneh is nineteen years old and married her twenty-six-year-old cousin (father’s brother’s son) a year ago. The day I met her, she was visiting an IVF clinic for the first time, with her sister, and she wanted to know if getting pregnant would be problematic for her. I asked her whether she knew marrying her cousin might cause their baby to be born with a genetic disorder. Farzaneh Well I knew, but I do not know why I did not care then. I wanted to get married to my cousin. There was no love before marriage [ … ], it happened. I am crazy for him now [ … ], he adores me too. Shirin Then, what is your problem now? Farzaneh I have been worried by the people around me [ … ] they say that the baby of two cousins might be born with problems [ … ] We would both love to have children [ … ] but not now, maybe next year [ … ] Today, I am here because of my sister’s insistence. She was not against our marriage but now she is worried and wants me to do a genetic test. Shirin If the test says that you have genetic problems, will you stay with your cousin? Will he stay with you? Farzaneh Of course I will. And he will definitely. Shirin Did you watch the TV series jerahat ? Do you think they made the right decision to stay together? Farzaneh Yes [ … ], as if they were us. It is also possible to adopt a child [ … ], after all they were engaged for four years. Of course, it was a movie but it also happens in real life [ … ] it is hard to go your separate ways after four years. c) Simin and Amir Simin, a thirty-six-year-old housewife, and her husband Amir, a forty-threeyear-old self-employed man, have decided to conceive with a donor egg. They have been married for nineteen years, and have two children with genetic dis- 171 Cases from the field: cousin marriage in practice orders. Simin and Amir are cousins. Simin is Amir’s mother’s brother’s daughter (matrilateral cross-cousin marriage). Assisted reproductive technologies have brought new hope to their life. After recovering from her previous miscarriage, she has decided to undergo another cycle of IVF using another donor eggs. Simin says: We are close relatives. We have already two sons with genetic disorders; we can have no more children of our own. We decided to try artificial insemination using third-party donation. We have to use either my eggs or my husband’s sperm. We prefer our child to be at least from one of us. This is logical. Well, we decided to use donated eggs, so at least the sperm is from my husband. Turning to me, Amir says: The majority of fuqaha¯ consider sperm donation as haram , but egg donation is allowed [ … ] most of them [ fuqaha¯ ] agree with egg donation; so we decided on egg donation. Being parents to seventeenand nineteen-year-old sons who suffer from genetic disorders, Simin and Amir have been undergoing medical treatment for many years. I asked them if they ever thought about divorce. Simin It [going through the different infertility treatments] brings us closer to each other than ever [ … ]. Amir You know, my wife is the most important person in my life. I have already spent a lot of money to have a child of our own. I am ready to spend more. All is because I love her and I want to make our joint life, our close relationship more beautiful than ever. You know, I am a rich man. If I wanted I could marry anyone I liked, but nobody can take her place in my life. Her father was my da¯ı ¯ (uncle, mother’s brother). I loved my uncle as much as my father, even more. He is no longer with us. I also love my mother [ … ]. Simin There was a special relationship between my father and his [Amir] mother. They had a very close sibling relationship [ … ] a unique closeness [ … ]. Amir There was always a good and close relationship in our family. Divorce was never an option in our family [ … ] never. Simin and Amir, preparing to try IVF again with a second egg donor, address their own concerns about the egg donor: 172 Cousin marriage, siblingship and reproductive technologies Amir We have seen the woman [the first egg donor] and her husband. They were a good family. I am thinking that this one [the second egg donor] also comes from a good family. Today I met her husband; a hard-working man who is not after dirty money ( pol-e haram ). Simin I saw her last week. I also think she is from a good family, a religious family ( ka¯neva¯deh-ye ba¯ ı ¯ma¯n ). She is the type of woman who believes in God. This is very important to me. Amir Having some degree of trust and faith in God is very important to us [ … ]. We don’t want an egg donor from a family without faith or culture. Shirin And what about beauty and physical similarities? Amir Beauty is good, but if you don’t have any religious and cultural background, this beauty doesn’t mean anything to us. We trust Mrs. X [the social worker]. She is like our sister now. I think she cares about us. She knows us well now [ … ]. We explained to her what is important to us in an egg donor. Shirin Does she consider the right one? Amir Yes, the previous egg donor was also a good woman, but it didn’t work [ … ]. Simin Because my uterus didn’t keep the donated egg [the fertilized egg]. I have no problem getting pregnant, my uterus is normal [ … ]. My doctor has explained that it might be because of the shape of my uterus [ … ], now we are trying it again with another egg donor and if it doesn’t work, we will try with surrogacy next time. Amir We want our child to be at least from one of us. If it doesn’t work, we will think about the next step. For sure there is always a way. God always gives us a chance to settle a problem. We already have a good life together. But as you know living in Iranian culture without children is not possible. Children are an important part of our Iranian culture. We are eight brothers. One of my brothers married my wife’s sister. All of their kids are healthy. Another brother of mine married the daughter of my mother’s brother and their children are fine too. Two of my brothers married two daughters of my father’s sister. Their children are also fine and healthy. All of them have gone to school. They are educated. They have become notable people. It is only us who were not lucky. 173 Conclusion Simin It is destiny [ … ]. My parents were related too but my siblings and I are healthy. Amir Our married life is the most important thing. We would love to have children but it is not more important than having each other. We have a beautiful life together and we want to make it more beautiful. If that happens, great [ … ], otherwise, it’s no big deal. Conclusion Cousin marriage of both the cross and parallel kind, and both patrilateral and matrilateral, has a long history in Iran, and the evidence suggests that it is on the increase today. Although some cultural characteristics of the Iranian kinship and family, such as fertility, marriage and divorce rates have changed under the impact of modernization, my analysis shows that the practice of cousin marriage has not weakened, and has even been reinforced. A look at articles published in the Iranian newspapers and popular media and magazines addressing health and family issues shows that although some people do not endorse cousin marriage and go so far as to forbid it, many others believe that it is still best to seek genetic counselling before marriage and to take advantage of biomedical and reproductive technologies. A programme of premarital medical and genetic tests has become part of the modern Iranian medical and public health system. These tests aim to prevent cousin marriage in the case of certain diseases such as thalassaemia. On the other hand, assisted reproductive technologies such as IVF and PGD (pre-implantation genetic diagnosis) are used to test embryos for genetic defects with the aim of supporting cousin marriage. In addition, with the help of assisted reproduction techniques such as the use of donor gametes and embryos or surrogacy, many cousin couples with a family history of genetic disorder may be able to have healthy children. I have argued that the social uses of assisted reproductive technology in Iran tend to strengthen the already-privileged sibling relationship that cousin marriage implies - a privileged relationship that is one of the central components of the Iranian kinship system. 9. Conclusion This book has examined the relationship between kinship, religion and law in the context of assisted reproductive technologies and their application in Iranian society, in which family, religion and state are the three dominant institutions that shape economic, social, and political life. We saw how the representatives of these institutions have come together to form an Iranian coalition model in support of assisted reproductive technologies, including procedures that involve gamete and embryo donation or surrogacy. In particular, the legal opinions on kinship of the Shia religious authorities are the foundation on which Iran’s permissive approach towards reproductive technologies and advanced biomedicine is constructed. In the first two chapters, I argued that the Iranian kinship system does not fit into either the framework of defined theories on kinship in the “Middle East”, particularly characterised by the principle of unilineal descent in the male line and the logic of substance (He´ritier 1999), or that of “new kinship studies” developed by post-Schneiderian and feminist anthropologists (e.g. Carsten 2004 , who treated “kinship” as “relatedness”), associated mostly with issues of gender, substance and personhood (cultural foundations of postmodern Western discourse). On the contrary, through analysis of the formal legal kinship structures in Iran, I showed that the Iranian kinship system is a flexible and integrated bilateral kindred system, which reckons descent through both male and female lines and affines, and which embraces bilateral filiation (filiation through either parent), siblingship and affinity. I rejected Schneider’s relativistic viewpoint that denies the genealogical unity of humankind and considers the concept of kinship as an illusion created by Western anthropologists themselves (Schneider 1984). However, kinship ( khı ¯sha¯vandı ¯ ) in Iran (and Islam in general) has been and still is the dominant subject of many legal and theological discussions, associated in particular with the notion of nasab , an Arabic term variously translated as “consanguinity”, “genealogy”, “lineage”, “descent”, or “relations of filiation”. When it comes to assisted reproductive technologies, nasab is a key concept of fundamental importance. The primary definition of nasab in the Iranian legal literature is that of the natural relationship of a child to its parents through procreation. Iranian experts in both religious and civil law consider this definition as the most commonly understood conception of nasab . However, this natural relation is not a sufficient condition for the establishment of legal filiation. The Iranian Civil Code (ICC), in accordance with Shia law, acknowledges nasab as legitimate and 175 Conclusion lawful only if the mother and father of the child are joined by a valid marriage contract at the time of conception. Thus, the primary concept of nasab in Iranian legal discourse is that of relations of bilateral filiation based on a union of marriage, both de facto and de jure. In this system, as Le´vi-Strauss observed: “Biological ties provide the model on which kinship relations are conceived, but these relations also provide a logical classification system, a mental framework. That framework, once conceived, makes it possible to sort individuals into pre-established categories, assigning to each his or her place within the family and society” (Le´vi-Strauss 2013: 46). Thus, within this context, I defined kinship as a grammar of social proximity structured around legal and moral meanings and values ascribed to physiological and biological facts of human existence. In chapter 3, I proposed an analysis of the moral reasoning embedded in the Shia theological legal discourse on reproductive technologies, and how this traditional religious knowledge interprets assisted reproduction. We saw that most Shia scholars adopt a pragmatic and permissive approach to assisted reproductive technologies and tend to consider them as helping to preserve nasab (legal filiation), whereas Sunni Muslim scholars tend to emphasise the dangers they introduce into filiation and the family order, and consequently reject the use of donor gametes and surrogacy in the reproductive process. I argued that this is because of the two traditions’ different representations of lineage and legitimacy: whereas Sunni (and to a large extent Arab) notions of filiation place more importance on the male line (agnatic filiation), Shia (and to a large extent Iranian) notions take on a more gender-balanced structure under which maternal and paternal filiation are clearly distinguished and in many regards complementary and symmetrical. This leaves room in Shia thinking for the legal permissibility of adoption by conferral of the adoptive parents’ name and for third-party reproduction, including embryo donation and surrogacy. Accordingly, most Shia authorities (though not all) argue that legal maternity, like paternity, is solely determined on the basis of the genetic potential embedded in the female’s seed from which the foetus comes into existence ( takavvon ) and not through gestation and birth. In other words, the sources of the child’s being are a man’s sperm and a woman’s egg. According to this line of legal reasoning, both maternity and paternity are established at conception. The emphasis is on the bringing into existence and not on gestation and birth. Another religious concern involves the question of zina¯ (illicit sexual acts including adultery and incest). Many Shia authorities follow the reasoning that assisted reproduction does not involve the physical act of sexual intercourse, and assisted reproduction involving a third party is therefore not analogous to adultery or incest. Egg and embryo transfer in assisted conception does not entail physical contact between the two parties; therefore, no illicit and impure sexual 176 Conclusion act takes place in reproduction using such procedures. The essential principle that emerges is that in the Shia perspective, the definition of the act of adultery and incest does not depend on the contact and transfer of bodily sexual fluids. It depends on the illegitimate physical act that happens through illicit sexual intercourse rather than the act of conception itself, that is, on physical contact - “the propriety of the actions” in Clarke’s words (2009: 197) - rather than the mixing of reproductive substances. In this context, He´ritier’s thesis of contact and transfer of bodily substances for the study of incest and its implications for kinship thinking and practice remains problematic. With regard to male-factor infertility, the idea of using donor sperm, however, is controversial. Most Shia authorities raise moral objections against the insertion of the donor sperm into the woman’s uterus. However, without a sexual act involved, most scholars consider the offspring to be legitimate, and the originator of the sperm is considered the father of the child. However, Shia authorities recognise other possibilities for the treatment of male-factor infertility: most authorities prefer IVF, ICSI and the use of embryo donation; and a minority permit the insemination of the woman’s egg with the donor’s sperm under laboratory conditions, and then the implantation of the fertilised egg into the wife’s uterus, as long as no forbidden act, such as gaze or touch, has taken place. Clearly, a distinction can be made in the Shia context between the act of placing sperm directly into the woman’s uterus, which according to the majority of religious scholars is not allowed, and the act of implanting an embryo into the uterus of a woman - whether a surrogate or the intended mother - for which there is religious moral permissibility. The in vitro embryo in this context is the result of a legal union and not the result of an illicit or impure ( na¯pa¯k ) sexual act. Thus, the response of Shia religious legal authorities to ART is very complex, yet exceptionally in-depth and concept-oriented. Their response is not limited to the definition of reproductive bodily substances such as sperm, eggs or milk; these are analysed and defined in a legal context, which furthermore paves the way to produce and establish more legal and social relations instead of reducing them to biological relations. Similarly, as Kahn (2000: 171) observed: “In rabbinic debates about new reproductive technologies, bodily experience is consistently singled out as that which establishes a more significant relationship between persons than the simple combination of reproductive genetic material.” Here we can see that rather than displacing them, ART reinforce and reveal many normative Shia concepts and values pertaining to kinship, which are also socially relevant, acceptable, legitimate and desirable. In Chapter 4, I examined how national legislation on ART, which is grounded in these Shia concepts and values, has been constructed. I argued that the dynamic relationship - both conceptual and institutional - between civil and religious 177 Conclusion law in Iran is crucial to understanding the formation of laws and regulations on a diverse array of bioethical issues. By taking advantage of medical and technological advances, this dynamic relationship has made the enactment of Iranian embryo donation and surrogacy regulations possible. 1 However, the existence of various viewpoints on legislative aspects is, in my opinion, an indication of the involvement of different individuals and different medical-political and religious organizations with a wide array of intellectual and affiliated approaches and power in the administrative and legislative system in Iran. In sum, the Iranian approach towards bioethical issues involves all stakeholders and represents a combination of elements drawn from both secular and religious principles. This approach reflects the efforts and ability of Iranian scholars to examine the impact and challenges of modern global biomedicine and then provide answers within their own religious and cultural context and tradition. 2 I argued that the social uses of assisted reproductive technology in Iran tend to reveal and reinforce foundational Iranian and Shia assumptions about kinship and reproduction. In fact, non-religious knowledge (in this case biomedical knowledge) itself reinforces the continuity and production of religious knowledge and interpretations. In this context, religion is capable of the “reinterpretation and appropriation of scientific knowledge” (Kahn 2006: 479) without adopting the modern scientific worldview and medical framework. On the other hand, I argued, while the implementation of ART has come about through the participation of all the stakeholders concerned - from both secular and religious backgrounds - it has also opened up a space for discussion and critical insights that may have a significant impact on the development and production of both religious knowledge - for example elm-e kala¯m (“the science of theological discourse”) and elm-e fiqh (“the science of jurisprudence”) - and non-religious knowledge, particularly, in this context, (secular) ethics, anthropology, civil law ( h ˙ oqu¯q ) and natural and biomedical sciences (e.g., stem cell research). In chapters 5 and 6, I presented an account of the practice of surrogacy in Iran. I examined the ways in which Iranian surrogates and intended couples attempt to transform surrogacy from a controversial issue into a normative concept in 1 It would be also interesting to study this collaboration (or even competition) within the framework of the recent political and economical changes in Iran and its impact on Iranian biopolitics. 2 Moreover, it is wrong to assume that the development of reproductive technologies has only taken place in Western countries and the physicians treating infertility in the Middle East have all been trained in the West (Clarke 2009 : 161 ). This does not apply to Iran, at least. Many Iranian physicians are actively involved in developing and advancing medical science fields such as embryology, fertility preservation, stem cell research, etc. inside Iran and many of their achievements were accomplished while the country was under tight international sanctions. 178 Conclusion infertility treatment. Many surrogates and individuals I talked to in Iran described surrogacy as savab , a God-loving deed of carrying and giving birth to another couple’s child. Savab and mitzvah (Teman 2010: 266) are centuries-old terms that have been inherited through history and tradition, and they are charged with meanings. The definition of savab , for instance, is not limited to acting solely to satisfy God’s will; it also signifies the inner satisfaction and peace someone achieves by doing good. The surrogates and intended couples I spoke with referred to the act of surrogacy as savab because of its nature, not as a means to justify the exploitation of a woman’s body or economic differences. Such terms help tremendously in understanding the social relations or friendship - “though always mingled with reciprocal interest” (Godelier 2011: 539) - that are formed through surrogacy. However, which “post-modern” terms have the capacity to describe such intricate human relations? Most studies define two categories for surrogacy - commercial and altruistic 3 - each of which reflects the agreement and contract signed between the surrogate and the intended parents. Alternatively, the two categories of “traditional” and “gestational” have been defined for surrogacy, once again based on the woman’s egg and her body. Instead of expanding the significance of human relations formed during the process of surrogacy, such categorizations restrict them. Perhaps the challenges facing surrogacy today can be related more to the lack of appropriate terms to define such human relations. In chapter 7, I illustrated how foundational Iranian cultural values and assumptions about kinship and reproduction are enacted within everyday clinical settings and interactions. In Chapter 8, we saw how public opinion is in favour of cousin marriage when it is underpinned by the spouses’ love and will, and rather than discouraging cousin marriage, it encourages genetic consultation, therapeutic abortion, and in particular the use of ART to safeguard the sacred family unit. We saw that in accordance with religious and legal permissibility, and depending on the individual cultural choices, the use of assisted reproductive technologies is socially acceptable and considered legitimate. Although many IVF clinics did not have clear regulations during the early days of gamete donation, they have now established their own regulations which, I would argue, have been shaped by various religious and legal arguments, media and public discussion, medical-political discourse, the clinics’ experiences and financial goals, and again by kinship knowledge and practice. And this is a fact that is understood by both donors and infertile couples. For instance, one of the physicians in a Qom clinic confided to me that many religious couples prefer to seek treatment in Qom rather than Tehran, where the practice of gamete donation is 3 A distinction that has its roots in Christian ethics (Godelier 2011 : 539 ). 179 Conclusion not governed by strict regulations. In sum, it can be said that the regulations and atmosphere present in Iranian IVF clinics is a clear reflection of Iranian society, which is a combination of both secular and religious values that are expressed in different places to different degrees. Appendix 1 An example of a “Surrogate Parenting Agreement” This agreement is made between: 1. Surrogate [and her husband if she is married] I. Mrs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Father’s Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date of Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ID Card # . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Place of Issue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address & Phone II. Mr. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Father’s Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date of Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ID Card # . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Place of Issue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address & Phone 2. Recipient couple I. Mrs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Father’s Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date of Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ID Card # . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Place of Issue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address & Phone II. Mr. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Father’s Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date of Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ID Card # . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Place of Issue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address & Phone Terms of the agreement This agreement enforces the act of surrogacy between the surrogate Mrs. . . . . . . . . . . . and the recipient mother Mrs. . . . . . . . . . . . . considering the consent of the surrogate’s husband and the recipient mother’s husband under the following conditions: 181 An example of a “Surrogate Parenting Agreement” 1- Mrs. . . . . . . . . . . . agrees to pay the surrogate, Mrs. . . . . . . . . . . . . . . ., for services and expenses in carrying out the surrogate’s obligations under this agreement, namely in vitro fertilization (IVF) and childbirth. 2- According to both civil ( qa¯nu¯nı ¯ ) and religious ( shar ı ¯ ) law and regulations, the in vitro embryo, which will be implanted in Mrs. . . . . . . . . . . . . . . . .’s uterus [surrogate] belongs to Mrs. . . . . . . . . . . . [recipient mother] and hence, Mrs. . . . . . . . . . . . will only carry the embryo to term and will surrender the baby to the recipient mother, pursuant to this agreement. 3- All insemination procedures and infertility treatments will exclusively be done in . . . . . . . . . . . Infertility Treatment Clinic and in accordance with religious criteria ( mava¯zı ¯n-e shar ı ¯ ) 4- The surrogate, Mrs. . . . . . . . . . . . and the surrogate’s husband, Mr. . . . . . . . . . . . agree to undergo a DNA test after the birth of the child / children; in the event that the child / children’s results fail to match those of Mr. . . . . . . . . . . . and Mrs. . . . . . . . . . . . [recipient couple], the recipient couple are not held liable to accept the child / children. In this case, the surrogate, Mrs. . . . . . . . . . . . and the surrogate’s husband, Mr. . . . . . . . . . . . are solely responsible for charges incurred as a result of the surrogate’s pregnancy. 5- In the event of twins or multiple birth, the recipient couple, Mrs. . . . . . . . . . . . and Mr. . . . . . . . . . . . will pay the amount of 5 million rials for each child. 6- In the event of a negative Beta-HCG test result or miscarriage, this agreement will terminate, and neither surrogate nor recipient couples will be under any further obligation under this agreement. Mutual consent The recipient couple, Mrs. . . . . . . . . . . . and Mr. . . . . . . . . . . ., agree to disburse all charges pertaining to IVF procedure and delivery and will compensate the surrogate with . . . . . . . . . . . rials for the surrogacy - to be paid under the following circumstances: 1 At the day of embryo transfer 2 On the 2 nd pregnancy test when declared positive 3 Ultrasound of foetal heart 4 At the end of the 1 st trimester 5 At the end of the 4 th month of pregnancy 6 At the end of the 5 th month of pregnancy 7 At the end of the 6 th month of pregnancy 182 Appendix 1 8 At the end of the 7 th month of pregnancy 9 At the end of the 8 th month of pregnancy 10 After giving birth to child / children and after the DNA test result Surrogate’s full name and signature fingerprint Surrogate’s husband’s full name and fingerprint Recipient mother’s full name and fingerprint Recipient father’s full name and fingerprint 183 An example of a “Surrogate Parenting Agreement” 184 Appendix 2 Appendix 2 An advertisement poster for egg donation Donating Egg, Donating Life Eligible donors are required: · To be between the ages of 18 and 30, · To have good general health, · To have had a successful live birth [in the past], · Preferably to hold a high school or higher education diploma. The advantages of becoming a member in the donor’s bank include: · Free health screening, · Guaranteed donor’s anonymity, · Possibility of egg donation up to four times per year, · No risk of side effects, · Enjoying donor’s benefits. 185 An advertisement poster for egg donation Glossary a¯da¯b : ethical codes a emeh-e ma su¯mı ¯n : infallible imams; Shia saints and religious figures ah ˙ ka¯m : rules ah ˙ ka¯m-e erth : rules of inheritance ah ˙ ka¯m-e ezdeva¯j : rules of marriage akhla¯q : character, one’s nature, ethics, morality akhla¯q-e pezeshkı ¯ : medical ethics akhla¯q-e zı ¯stı ¯ : bioethics ART: assisted reproductive technology ba¯nu¯ : lady da¯yeh : foster-mother dı ¯n : religion dolat : state elm : science, knowledge elm-e fiqh : the science of jurisprudence elm-e kala¯m : the science of theological discourse esperm : sperm ezdeva¯j-e movaqat : temporary marriage faqı ¯h : a religious scholar and an expert in Islamic jurisprudence ( fiqh ) farzand-kha¯ndegı ¯ : adoption fatwa : legal opinion fe el-e haram : forbidden act fiqh : Islamic legal discourse, jurisprudence fu¯qaha¯ : religious legal experts, plural of faqı ¯h h ˙ adı ¯th : traditional sayings h ˙ amlı ¯ : gestational, through gestation hazrat : presence, His [or Her] Holiness Hazrat-e Masoumeh: the sister of the eighth Shia Imam h ˙ oqu¯q : law h ˙ oqu¯qda¯na¯n : lawyers and legal experts ICC: Iranian Civil Code ICSI: intracytoplasmic sperm injection 187 Glossary Imam: spiritual and political leader istifta¯’ : to inquire IUI: intrauterine insemination IVF: in vitro fertilisation janı ¯n : embryo kha¯har : sister kha¯har-za¯deh : niece, the sister’s daughter kha¯neva¯deh : family khı ¯sha¯vandı ¯ : kinship khoda¯ : God leqa¯h-e masnu¯ ı ¯ : artificial insemination ma¯dar-e ja¯ygozı ¯n : surrogate mother ma¯dar-e rida ı ¯ : milk mother mah ˙ ram : unmarriageable member of kin mah ˙ ramı ¯yat : marriage prohibition majles : Iranian parliament marja -e taqlı ¯d : source of emulation mashru¯ ı ¯yat : legitimacy mava¯zı ¯n-e shar ı ¯ : religious criteria na¯mah ˙ ram : marriageable na¯pak : impure nasab : legal filiation nasab-e ma¯darı ¯ : maternal filiation nasab-e pedarı ¯ : paternal filiation pa¯kı ¯ : purity PGD: preimplantation genetic diagnosis qa¯nu¯nı ¯ : legal qa¯nu¯n-e asa¯sı ¯ : Constitution qa¯nu¯n-e madanı ¯ : Iranian Civil Code rah ˙ em-e ja¯ygozı ¯n : surrogacy rid ˙ a¯ : suckling, milk kinship s ˙ a¯h ˙ eb-e rah ˙ em : gestational carrier, contributor of the uterus s ˙ a¯h ˙ eb-e tokhmak : contributor of the egg savab : a good deed shabı ¯h-sa¯zı ¯ : cloning shar ı ¯ : religious takavvon : coming into existence talqı ¯h : insemination t ˙ ava¯f : circumambulation, the act of moving around a sacred object 188 Glossary tavasssul : resorting to a saint and religious figures TESE: testicular sperm extraction tokhmak : woman’s egg za¯ı ¯ı ¯dan : giving birth zina¯ : illegitimate sexual intercourse, fornication, adultery, incest zı ¯stan : to live Bibliography Abbasi Shavazi, Mohammad Jalal and Fatemeh Torabi. 2007. “ tafa¯vot-ha¯y-e bein-e naslı ¯ye ’ezdeva¯j-e kı ¯sha¯vandı ¯ dar Iran ” [Inter-generational Differences of Cousin Marriage in Iran]. 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(in Persian) Ziaifar, Said (ed.). 2010. ta thı ¯r-e akhla¯q dar ijtihad. gof-o-gu¯ ba¯ jam ı ¯ az asa¯tı ¯d-e hawza va da¯neshga¯h [ The Effect of Ethics in Ijtihad: A Dialogue with a Group of the Scholars and Professors of the Islamic Seminary and University ]. Qom: Academy of Islamic Sciences and Culture. (in Persian) Tübinger Studien zur Ethik · Tübingen Studies in Ethics 7 Since the first IVF birth in 1990, the Iranian medical community has not only given full support to the use and development of assisted reproductive technology but has aided the emergence of a pow ful, locally-trained body of medical practitioners and biomedical researchers. At the same time, from a religious point of view, most Shia legal authorities - differences of opinion notwithstanding - have taken a relatively permissive view and generally support assisted reproductive technology, including procedures that involve egg, sperm and embryo donation as well as surrogacy arrangements under certain conditions. An examination of the social, legal and ethical aspects of the development and implementation of these technologies in Iran is the subject of this book. It is based on a combination of extensive ethnographic research and textual analysis of important academic and religious seminary publications in Iran, from Shia jurisprudence (fiqh) and Persian histories to the analysis of laws and verdicts. ISBN 978-3-7720-8616-8 er