meant to write about Babel this evening as it haunts me and s0metim3s’ post brought it back. But Alice Dreger writes about the ashley treatment which is all the outrage at the moment. And she holds back any invective to draw out the way parental decision making is continually recoded along an axis of selfish/less-ness.

I’ve been thinking about formula and daycare and pull-ups, and how I am a selfish mother. I’ve been thinking about that because I don’t believe Ashley’s parents’ protestations that “the Ashley Treatment” (as they themselves dubbed it) is all about their daughter’s well-being and comfort and not about their own. I know that’s what they are supposed to say – that they are doing it only for her. When I became a mother, I learned this was the line I was supposed to toe: I do everything for my child, and never, never anything that might put myself before my child. Heck, I learned this while I was still pregnant. Try having a glass of wine with dinner in public when you are eight months pregnant, and you discover that people will go to pretty extreme measures to make sure you understand Motherhood Means Selflessness.

Dreger goes on to relate her experiences of depression in trying to live up to the best methods of caring for her son, which in turn is a contravention (there is literature on how depressed mothers are bad for the child). Read it, she tells it much better than I could. She goes on to argue that apportioning praise and blame in the debate of the selfishness/selflessness of decisions covers over why some decisions are easier than others, why it might be in a child’s interest to get particular surgeries and how it could be otherwise:

The problem I see with Ashley’s parents is less their decision than their dishonesty about it. Would menstrual pain and adult breast development really be so painful for Ashley that they warrant hysterectomy and mastectomy? Unlikely. It sounds more like Ashley’s parents find they have their hands full enough – literally – and they can’t handle any more. They don’t want to handle any more. I get that. Why not just be honest about that?

Because we’re not allowed to be selfish parents and selfish caregivers of people with disabilities, that’s why. And yet I can’t help but feel that if we were honest about this, then we could have a much more honest discussion about why we might choose for others genital normalizing surgeries, conjoined twin separations, growth hormones for “idiopathic short stature,” and “the Ashley treatment.” And maybe if we had that more honest discussion, we wouldn’t choose them so often. Maybe then we’d do a better job figuring out how we are really weighing best interests, and see that sometimes it isn’t the patient whose suffering we’re supposedly preventing – that it isn’t always the putative patient who need an intervention.

The pervasiveness of this drive to reason altruistically isn’t just riven through post-natal decisions. As Marin Gillis points out throughout 2006 American women were repeatedly asked to think of themselves as permanently potentially pregnant (the second link was originally published here) and to adopt lifestyles of preconceptive care. The primary recommendations here, apart from folic acid supplements, are to not drink, smoke or take drugs, which are hardly new warnings from the medical/public health field. The newness is in that these practices are frowned on not for ones own health or duty to the state but as self-abnegation on behalf of ones unborn child that could occur without warning. Women’s bodies and behaviours under such medical programs become the fate, skin, and thereby immune systems of potential children. Men are the germline, their bodies do not touch the child’s after conception..?:

(Men should be wary of exposures to toxins that cause birth defects and should avoid sexually transmitted diseases, experts say) (original parenthesis).

Addendum: Sue Trinidad writes on PGD, on the way the norms and standards of which tests are ordered construct the very points and decisions that have to be made. It is choices that are selfish or not, but it is the way choices are built into their singularly specific contexts that determines how the vicissitudes of self-interest or altruism are to fall, and this shaping of points of decision is what keeps getting pushed out of sight (as Dreger notes) in health and reproduction.