Asian Bioethics Review

315 Rethinking the Family In this age of modern biotechnology, a lot of attention has been given to challenges to traditional conceptions of the family. Perhaps the most prominent of these challenges have arisen from the use of assisted reproductive techniques and have been written about extensively. Some challenges relate to the impact of genetic research on knowledge concerning paternity and kinship. There are also challenges regarding our knowledge of gene-related diseases. In many ways, modern biotechnology has radically altered our understanding of kinship and enhanced our power to understand and reshape gene-based kinship structures. In addition, there is another type of impact on kinship and the family that has emerged without the implications being given much critical notice. This other type refers to ways in which modern biotechnology has given rise to interdependencies in the treatment and control of medical conditions. Some of these interdependencies stem from the ability to extend knowledge about one person to knowledge about genetic relatives. Thus, some knowledge about predispositions for particular diseases of particular individuals can be generalised into knowledge about predispositions of genetically related individuals. This interrelatedness goes beyond mere knowledge. As expected, knowledge of genetics has opened up new opportunities for the control and treatment of illness and disease. For those who are genetically related, unique opportunities for treatment are possible, for example, through the transplant of cells or tissues to replace damaged counterparts in the bodies of diseased relatives. The opportunity for relatives to support treatment through the transplantation of various cells, tissues and organs not only empowers those relatives to provide unprecedented benefits; the opportunity also creates pressures for people to make their body parts available to those who need them. Thus, we have been witness, for example, to cases of “saviour siblings” being conceived to become bone marrow donors. In narratives describing various examples, we may observe Asian Bioethics Review December 2009 Volume 1, Issue 4 315–317 F R O M T H E E D I T O R F r o m t h e E d i t o r A s i a n B i o e t h i c s R e v i e w D e c e m b e r 2 0 0 9 Vo l u m e 1 , I s s u e 4 316 how slippery the language has become as opportunities to provide essential assistance get transposed into expectations on the part of possible beneficiaries, and slip even further into ascriptions of obligation and responsibility, as when observers compare the “minimal risks” faced by the donor of a kidney with the “death sentence” faced by the relative with end-stage renal disease. The use of immunosuppresants to deal with issues of rejection has enlarged the pool of possible transplant donors and broadened the range of interdependencies . The need for genetic kinship has been transcended. People who have unique opportunities to provide essential assistance can be connected to those whose lives can be enhanced without the two parties being genetically related. People serving as domestic workers, drivers or factory hands have found themselves emotionally related to their economic patrons, and under pressure to donate organs for transplant. People drawn into the network become not only people who could be donors but also people who are expected by others to be donors for them. These additional donors get caught in a network that ascribes to them not only opportunities for beneficence, but also additional obligations and responsibilities. As the pool of possible transplant donors becomes bigger, so does the corresponding network of dependencies. In the manner described, modern biotechnology makes many new benefits possible, which can only be gained if individual human beings were to provide the necessary additional contributions. We have seen the expansion of power but this has been accompanied by the imposition of obligations and responsibilities on people who are in a position to provide a necessary condition for the attainment of essential benefits. As we talk about reaping the benefits of contemporary biotechnology, we have to be mindful of where the burdens are falling and who are being made to assume them. Indeed, modern biotechnology has seen an...