PGD/PGS in Spain Beyond the Geneticization Thesis : The Political Economy of

LIST OF FIGURES AND TABLES vii ACKNOWLEDGMENTS ix ABBREVIATIONS AND ACRONYMS xi Prologue 1 Chapter 1: Why Compare? 13 Chapter 2: Controlling Narratives 42 Chapter 3: A Question of Europe 68 Chapter 4: Unsettled Settlements 94 Chapter 5: Food for Thought 119 Chapter 6: Natural Mothers and Other Kinds 146 Chapter 7: Ethical Sense and Sensibility 171 Chapter 8: Making Something of Life 203 Chapter 9: The New Social Contract 225 Chapter 10: Civic Epistemology 247 Chapter 11: Republics of Science 272 APPENDIX: CHRONOLOGY 293 NOTES 295 REFERENCES 339 INDEX 361

Designs on Nature: Science and Democracy in Europe and the United States

The first social transformation of American medicine institutionally established medicine by the end of World War II. In the next decades, medicalization-the expansion of medical jurisdiction, authority, and practices into new realms-became widespread. Since about 1985, dramatic changes in both the organization and practices of contemporary biomedicine, implemented largely through the integration of technoscientific innovations, have been coalescing into what the authors call biomedicalization, a second transformation of American medicine. Biomedicalization describes the increasingly complex, multisited, multidirectional processes of medicalization, both extended and reconstituted through the new social forms of highly technoscientific biomedicine. The historical shift from medicalization to biomedicalization is one from control over biomedical phenomena to transformations of them. Five key interactive processes both engender biomedicalization and are produced through it: (1) the political economic reconstitution of the vast sector of biomedicine; (2) the focus on health itself and the elaboration of risk and surveillance biomedicines; (3) the increasingly technological and scientific nature of biomedicine; (4) transformations in how biomedical knowledges are produced, distributed, and consumed, and in medical information management; and (5) transformations of bodies to include new properties and the production of new individual and collective technoscientific identities.

Biomedicalization: Technoscientific transformations of health, illness, and U.S. biomedicine.

The DNA mystique: the gene as cultural icon.

This Article considers the influence and implications of the application of genetic technologies to definitions of disease and to the treatment of illness. The concept of “geneticization” is introduced to emphasize the dominant discourse in today's stories of health and disease and the social construction of biological phenomenon is described. The reassurance, choice and control supposedly provided by prenatal genetic testing and screening are critically examined, and their role in constructing the need for such technology is addressed. Using the stories told about prenatal diagnosis as a focus, the consequences of a genetic perspective for and on women and their health care needs are explored.

Prenatal genetic testing and screening: constructing needs and reinforcing inequities.

BACKGROUND: Results of assisted reproductive techniques from treatments initiated in Europe during 2005 are presented in this ninth report. Data were mainly collected from existing national registers. METHODS: From 30 countries, 923 clinics reported 418 III treatment cycles including: IVF (II8 074), ICSI (203 329), frozen embryo replacement (79 140), oocyte donation (ED, II 475), preimplantation genetic diagnosis/screening (5846) and in vitro maturation (247). Overall, this represents a 13.6% increase since 2004, partly due to inclusion of 28 4I7 cycles from Turkey. European data on intrauterine insemination using husband/partner's semen (IUI-H) and donor semen (IUI-D) were reported from 21 countries and included I28 908 IUI-H and 20 568 IUI-D cycles. RESULTS: In I6 countries where all clinics reported to the IVF register, III5 cycles were performed per million inhabitants. For IVF, the clinical pregnancy rates per aspiration and per transfer were 26.9% and 30.3%, respectively. For ICSI, the corresponding rates were 28.5% and 30.9%. After IUI-H, the clinical pregnancy rate was I2.6% per insemination in women <40. After IVF and ICSI, the distribution of transfer of one, two, three and four or more embryos was 20.0%, 56.I%, 2I.5% and 2.3%, respectively. Huge differences exist between countries. The distribution of singleton, twin and triplet deliveries after IVF and ICSI was 78.2%, 21.0% and 0.8%, respectively. This gives a total multiple delivery rate of 2I.8% compared with 22.7% in 2004 and 23. I% in 2003. In women <40 years of age, IUI-H was associated with a twin and triplet pregnancy rate of II.0% and I.I%, respectively. CONCLUSIONS: Compared with earlier years, there was an increase in the reported number of ART cycles in Europe. Although fewer embryos were transferred per treatment, there was a marginal increase in pregnancy rates and a reduction in multiple deliveries.

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Assisted reproductive technology and intrauterine inseminations in Europe, 2005: results generated from European registers by ESHRE ESHRE. The European IVF Monitoring Programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE)

PGD/PGS in Spain Beyond the Geneticization Thesis : The Political Economy of

References

Designs on Nature: Science and Democracy in Europe and the United States

Biomedicalization: Technoscientific transformations of health, illness, and U.S. biomedicine.

The DNA mystique: the gene as cultural icon.

Prenatal genetic testing and screening: constructing needs and reinforcing inequities.

Assisted reproductive technology and intrauterine inseminations in Europe, 2005: results generated from European registers by ESHRE ESHRE. The European IVF Monitoring Programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE)

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Beyond the Geneticization Thesis: The Political Economy of PGD/PGS in Spain