Samuel Berger writes, in a very thoughtful piece in The Nation, about the evolving phenomena of "choice" politics—focusing on the newly emerging pitfalls in the matter of reproductive technologies. Berger's question is, to put it plainly: Does having the option to do something mean that we should do it? From the article:
The shifting parameters of reproductive choice will oblige Americans of all political persuasions—but above all progressives—to revisit some of our most dearly held tenets. Support for reproductive choice is grounded in the notion that the choices themselves are private matters that are the individual's alone.
He then raises the connection between these societal tenets and abortion rights:
Biotechnological innovations, however, are quickly shifting certain reproductive decisions from matters of private choice to ones of public concern, regardless of the moral status of fetuses and embryos. Parents in the twenty-first century will have the ability to control the genetic makeup of their children in ways that were unthinkable fifty years ago. The choices they make will thus significantly affect the structure of society. As progressives, we must acknowledge the new challenges posed by these reproductive technologies and, when necessary, craft policies to limit their potentially harmful impact.
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Berger looks at the characteristics of an emerging brave new world in which it's not only a matter of sex selection, the ability to select children's traits through pre-implantation genetic diagnosis (PGD), and screening for genetically transferred diseases that is at stake. Instead, for Berger these are matters relevant to our social structures that will affect our healthcare system dramatically.
Berger's proposed solution is regulation. Per his argument, these are issues that require collective decision-making, and cannot remain solely in the realm of individual choice. He mentions the British Human Fertilisation and Embryology Authority, established in 1990 as a place to look for an example of the kind of thing he is thinking about. Here enters the "challenge to progressives on choice:"
A regulatory body serves little purpose, however, without a theoretical framework to inform it. Progressives, then, will need a new way to distinguish what reproductive technologies and practices should be regulated.
Berger acknowledges that economic status, race and ethnicity, and sex and gender are points of contention in understanding the effects that new reproductive biotechnologies might have on our society. Yet, it is crucial to state that these are also factors in our legal and healthcare systems as they stand today. Sexism, racism and poverty are inextricable considerations for new reproductive technologies, as well as current social infrastructures. A regulatory body, unless equipped to challenge currently existing discrimination and disparities, will merely elide the interests of our society's most vulnerable members: communities of color, LGBTQ people, the poor, the incarcerated, the disabled, immigrants and, of course, women—people for whom the politics of choice was never quite as simple as a matter of public vs. private.
All this is to say that even reproductive health is a matter far beyond choice, and it always has been for marginalized communities denied access to the resources and social status required to make choices. Berger pushes us to challenge our notions of choice and perceptions of public and private domains. But for many communities these boundaries have never been clear. If we are to formulate progressive regulatory legislation on matters of reproductive technology, as we will inevitably have to do, then we will be well served to remember the long and tortured history of the politics of choice.
For an excellent resource on understanding the history of alongside a critique of the choice framework, see:
Jael Silliman, Marlene Gerber Fried, Loretta Ross, and Elena Gutiérrez, Undivided Rights: Women of Color Organize for Reproductive Justice. South End Press: Cambridge. 2004.