Technologies of personhood: Human reproductive technologies

Part One of the dissertation compares two California infertility clinics. In one clinic, infertility medicine was practiced as an elite medical specialty. This clinic was characterized by civility, caution, exclusivity, and an ethic of care. Staff roles were distinct and involved little flexibility or overlap. Order, both epistemic and social, followed a simple hierarchy. The status quo was maintained as a good in itself, and was enforced by internalized norms of civility. Good clinical practice was separated from scientific research and from career advancement. In the second clinic, infertility medicine was socially and technically innovative. Patient/practitioner relationships revolved around a technical understanding of care. Attempts to attract patients, pedagogy, staff role flexibility, and innovation characterized the clinic. Technique and knowledge transfer were prized, and social innovation in parenting options accompanied the technical innovation. Order was enforced through a commitment to technical excellence, the potential for growth, and the satisfactions of job flexibility. Increasing external regulation of infertility medicine did not appear to be undermining the epistemic cultures of either clinic. Both clinics used certification to bolster (while somewhat altering) the ways of going on that they already exemplified. Despite being instituted in response to public distrust of reproductive technologies, external regulation is counteracting the threat rational citizen vigilance poses to epistemic order by replacing it with institutionalized vigilance.;In Part Two, it is first argued that reproductive technologies are altering kinship. Pre-existing idioms of relatedness are drawn upon to re-craft and make sense of the changing configurations of biological kinship. Second, it is argued that infertility clinics reveal ways in which modern self-hood depends on technical interventions on the body. Objectification of the patient is not inimical to personhood unless the patient-as-object ceases to reference the patient-as-subject. A concluding chapter points to the bi-polarity of public reactions to reproductive technologies, and the pervasive opportunities for public distrust that this raises. It summarizes the way that regulation is mitigating this, as argued in Part I, and suggests alternatives to citizen vigilance, following the arguments of Part II, for patients and the public to affect the development of reproductive technologies.