In a recent post we discussed about anthropology and assisted reproduction. Certainly an interesting knowledge, but, what is the specific application of anthropology to human reproduction?
Legislation and development programs
That knowledge we would define as more academic is essential for policy makers when regulating assisted reproduction. The British legislation created after the pioneering times of the 1980s, when assisted reproduction was making its first steps, was greatly shaped by the commission lead by Mary Warnock.
Despite she is a philosopher; she used a very interesting and useful anthropological approach. Instead of asking herself which practices where ethical and which not, she asked herself which ones were socially acceptable and which ones not. Answering this kind of question requires in depth cultural and sociological research, but it allows legislation to remain always advanced. It will admit what society is ready to admit and reject what society rejects.
As a contrast, German legislation on embryo protection (Embryonenschutzgesetz) was done with a Kantian approach of moral imperative; after 25 years it hasn’t solved society’s fertility needs and has failed to protect unborn embryos, since it has created a flow of Germans to third countries seeking medical aid. Great Britain is one of the world’s leading countries in assisted reproduction and has created an industry; Germany not.
Another leading country is Spain, with 20% of worldwide scientific production in fertility and 200 of 800 European clinics. Spain’s dominant position is owed also to an advanced legislation. In Spain bioethical committees are often composed by anthropologists, like Dr. María Jesús Buxó, for instance, that achieve that policy makers take into consideration not only lobbies and parties interests, but also cultural and social aspects. Here you can read (in Spanish) a great interview with Dr. Buxó on bioethics and law.
Another application of anthropology to reproduction is development aid. We saw already in the former post that infertility is a stigma in many countries. Working with anthropologists or anthropology trained healthcare professionals has allowed creating many programs for safe pregnancies in Latin America, consanguinity and male sterility in Arab countries or preventing risky sexual patterns in India and Africa.
Within the sphere of private medicine, the most interesting use of anthropology is the application of ethnography to the on line world, the so called netnography, which we have also discussed in this blog. Netnography is key in order to understand patients and their needs: observe and listen what they say in blogs, forums and social networks.
A random search in Google shows in the first pages 35 forums on infertility. Each one has between 500 and 800 active users, which means that a good ethnographic analysis that can be later improved with good qualitative software can allow us to listen to conversations of between 18.000 to 28.000 users: real people looking for a treatment or getting through it.
Forums are the best source of patient insights; we saw already why insights are so important. By the way, in this blog by Chantelle Meckenstock , an anthropology studying mother, you can find an easy and light netnography about on line fertility communities.
Co-creation and fertility: the best word to mouth, the best tweet to tweet
For me, the most useful and personally rewarding application of anthropology to fertility is patient co-creation. At IVF-SPAIN we have worked with patients from the clinic design up to the first software used by the clinic, the collaborative creation of the patient’s experience map, not to forget the genomic living lab that has been addressed here too.
What were the results? The most important one is that a biomedical product or service as a much higher acceptance that one that has been designed only using the clinical, quality, commercial, functional, etc. perspective. Acceptance means a very clear differentiation against competition and to invaluable word to mouth, tweet to tweet patient recommendations. You can read about the positive effects of patient involvement at IVF-SPAIN in this eyeforpharma article.