A Medical Anthropological Exploration of Health Care Decision-Making

自20世纪60年代以来，文化人类学家对技术变化对文化的影响进行了系统的研究。这项研究探索了家庭医疗决定是如何做出的，这是人类学长期以来公认的一个领域，被认为是文化的基本驱动力之一。新的技术进步为夫妻提供了新的社会和经济选择，这些选择到目前为止是不可能的，因为社会规范和生物限制决定了在相对较窄的窗口内生育孩子。卵母细胞冷冻保存这项可以延长女性生育力的新技术，可能会改变21世纪女性的生活。卵母细胞冷冻保存被吹捧为女性衰老方式的一场革命，被誉为一项生育保险政策，尤其是作为老年职业女性延长生物钟的一种方式。这项人种学研究项目将是对美国和以色列女性卵母细胞冷冻保存的第一次实证研究，这两个国家是最早进入辅助生殖领域的国家，但围绕生殖的法律、经济、宗教和文化要求截然不同。这项研究基于目前提供卵母细胞冷冻保存的五家主要体外受精(IVF)诊所，将对第一代卵子冷冻器进行深入的半结构化和生殖史访谈，评估教育、职业、财务稳定性、关系状况、种族、宗教背景、医疗诊断和生育预后等变量如何影响医疗决策。这个项目旨在考察自然与文化、生殖与生产、母亲与工作之间的紧张关系，这些关系在当今关于公共卫生的各种辩论中都可以观察到。它还将在医学人类学和科学技术研究中贡献重要的关于辅助生殖技术的新学术研究。随着卵母细胞冷冻保存技术的发展，社会、文化、法律、宗教和伦理方面的反应也将随之发展。这项研究有望揭示科学和社会的另一个新界面，可能会回答一系列问题，这些问题对于制定健全的社会政策和相关的生物伦理准则至关重要，这些准则将指导各种医疗技术设施和它们所服务的个人。

Cultural anthropologists have conducted systematic studies of the effects of changing technology on culture since 1960s. This research explores how family medical decisions are made, a domain long recognized within anthropology as one of the fundamental drivers of culture. New technological advances have afforded couples new social and economic choices that were until now impossible, as social norms and biological constraints dictated having children within a relatively narrow window. The new technology of oocyte cryopreservation, a technology that can prolong a woman's fertility, may change women's lives in the 21st century. Touted as a revolution in the way women age, oocyte cryopreservation is being heralded as a fertility insurance policy, and particularly as a way for older career women to extend their biological clocks. This ethnographic research project will be the first empirical study of oocyte cryopreservation among women in the United States and Israel, two of the earliest entrants into this field of assisted reproduction, but with strikingly different legal, economic, religious, and cultural mandates surrounding reproduction. Based in five major in vitro fertilization (IVF) clinics where oocyte cryopreservation is now available, the study will involve in-depth semi-structured and reproductive history interviews with the first generation of egg freezers, assessing how variables such as education, career, financial stability, relationship status, ethnicity, religious background, medical diagnosis and fertility prognosis affect medical decisions. This project intends to examine the tensions between nature and culture, reproduction and production, and motherhood and work that are observable today in various debates about public health. It will also contribute vital new scholarship on assisted reproductive technologies within medical anthropology and science and technology studies. As oocyte cryopreservation technology evolves, so will the social, cultural, legal, religious, and ethical responses. This study promises to reveal another new interface of science and society, potentially answering a host of questions crucial to the production of sound social policy and relevant bioethical guidelines, which will guide various medical technology facilities and the individuals they serve.