Dr Joy Zhang recently attended the ChinaReproTech conference organised by the Reproductive Sociology Research Group at Cambridge.
A most intriguing theme related to the governance of scientific accountability in China was the twin discourses on ‘insurance’ and ‘assurance’. Both papers in the opening session dwelled on quality ‘assurance’ and the ‘insurance’ of good birth/good life. The idea of ‘insuring’ good birth is incredible. It of course immediately triggers a classic ‘risk society’ question – how can one ‘insure’ the quality of a future being when some genetic and epigenetic risks remain unknown or disputable? This point was further highlighted in later discussions on the ‘illogical’ quick normalisation of IVF technology in China when its first IVF child is merely 27 years old.
Another fascinating point is why ‘insurance’ and ‘assurance’ are needed at all in the regulatory discourse, and why both seem to have received increasing attention from the medical institutions. If it were true that the popularity of IVF is a result of the government re-orientating its population policy and of a social adherence to Confucian culture, then one would suspect that with the centrally enforced and deeply rooted commitment to reproduction, IVF clinics and the services they provide should not expect much social scrutiny and skepticism. Yet a number of talks suggested that this is not the case. Both the Chinese public and doctors have developed heightened awareness of the financial, physical and social risks these new technologies expose them to. Underlying doctors’ active ‘empowerment’ of their patients, is a redistribution of risk and responsibilities. Similarly, underlying the wider family’s support and participation in the ‘making’ of a child is a renegotiation of gender relations and the ‘burden’ of motherhood. Both of the discourses on ‘insurance’ and ‘assurance’ can be seen as reactionary towards the fact that the reproduction business becomes a venue for arbitrating rights and responsibilities at different levels.
The study on reproductive technologies offers insight on the bigger social stratification China is going through. It is an imbalanced process which is often described as the already-vulnerable being subjected to ever greater physical & emotional exploitation (eg. reproductive rights of young single female). This has some truth to it. But the dissemination of scientific facts and availability (and increasing affordability) of new technologies also forms a democratisation of science, in which the once-vulnerable may be equipped with expanded life options and be enlightened (and incentivised) to redefine the terms and conditions of social relations (eg. doctor-patient relation, family relation, role of gender, migrant workers etc).
To expand on this point, one interesting anecdote is that a number of Chinese participants challenged a ‘default’ portrayal of Chinese female as submissive and Chinese society as repressive. The underlying dispute is not so much that the Chinese regime is no longer repressive or that gender tensions are already resolved. But there is a subtle but important difference in framing. For most ‘outside observers’, i.e. North American & European academics, they often treat these facts as the (relatively stable) social condition that these sciences operate in. But Chinese stakeholders see the same facts as a social situation that enlightened scientific progress/education may help to evade.
The discussions in Cambridge reconfirmed one imperative for research on bioethics in China. That is, the implementation, popularisation, and administration of reproductive technologies begs a systematic ‘re-cognition’ of contemporary Chinese values. Here ‘re-cognition’ means two things. One is that just as new biotech is used (by various Chinese authorities) to re-assemble a Chinese identity through DNA sequencing and genetic propensities, academic inquiries need to be willing to ‘cognise’ Chinese values in the making. The other is that the alleged scale, extent and condition in which these new social values (including old Confucian values that reincorporated into fashion) exert their impact need to be empirically substantiated and recognised.
The social stratification challenge faced by China repro-tech is not limited to the negotiation of ‘who should be responsible for what?’, which itself is complicated enough. But a more critical question for an authoritarian regime known for its fragmented and under-institutionalised administrative practice is this: how can different layers and divisions of responsibilities be pined down to an arrangement that ‘insures’ or ‘assures’ accountability of all stakeholders?