It is now possible for physicians to recognize that a pregnant
woman's foetus is facing life-threatening problems, perform surgery
on the foetus, and if it survives, return it to the woman's uterus
to finish gestation. Although foetal surgery has existed in various
forms for three decades, it is only just beginning to capture the
public's imagination. These still largely experimental procedures
raise all types of medical, political and ethical questions. Who is
the patient? What are the technical difficulties involved in foetal
surgery? How do reproductive politics seep into the operating room,
and how do medical definitions and meanings flow out of medicine
and into other social spheres? How are ethical issues defined in
this practice and who defines them? Is foetal surgery the kind of
medicine we want? What is involved in reframing foetal surgery as a
women's health issue, rather than simply a paediatric concern? In
this ethnographic study of the social, cultural and historical
aspects of foetal surgery, Monica Casper addresses these questions.
The Making of the Unborn Patient examines two important and
connected events of the second half of the 20th century: the
emergence of foetal surgery as a new medical speciality and the
debut of the unborn patient. Drawing on a wide range of sources,
Casper shows how biomedical work has intersected with reproductive
politics for three decades to generate new cultural meanings of
foetuses, women and medicine itself. Since its inception, foetal
surgery has been controversial both inside and outside of medicine
precisely because it transgresses a number of boundaries,
challenging our most cherished assumptions about pregnancy,
maternal sacrifice, foetal life and death, and the limits of
technology. Like many other medical innovations, especially those
at the beginnings and ends of human life, foetal surgery is
proceeding rapidly but without careful reflection about what it
means and without public debate about its consequences. Foetal
surgery is risky, expensive and fraught with peril for both women
and their foetuses. This book offers a critical social and cultural
analysis of this nascent yet significant innovation in biomedicine.
Analyzing original data, Casper explores early foetal surgery
efforts and the emergence of the unborn patient in the 1960s. She
examines several related practices, including foetal physiology,
diagnostic technologies, animal experimentation, and foetal wound
healing research, and the ways in which they have shaped foetal
surgery. She presents ethnographic data collected at one of the
premier US foetal treatment facilities, offering a
behind-the-scenes look at the various kinds of work involved in
operating on human foetuses. She also examines the many ethical
dilemmas involved in research on human subjects in experimental
foetal surgery. Perhaps most significantly, the book draws
attention to the many ways in which foetal surgery affects women's
health.
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