Testing the limits of freedom of contract: the commercialization of reproductive materials and services

This article examines the cases for and against commercializing, or "commodifying," reproductive materials and services. Using a supply/demand third-party framework, three basic scenarios in which commercial-exchange relationships may be possible--exchange of gametes and zygotes, exchange of gestational services, and exchange of fetal material--and the major parties of interest, or stakeholders, are identified. The study sketches the liberal, essentialist, and radical contingency theories that shape the debate over the commercialization of reproductive materials and services. The article then attempts to derive some basic governing principles that reflect as much common ground as possible amongst these various normative perspectives, while recognizing that complete reconciliation is impossible. Taken together, these principles are designed to reflect a strategy of "constrained commodification," where commercialization or commodification, that is, financial remuneration, plays a relatively neutral role in the utilization of reproductive materials and services. In light of these principles, the article concludes by sketching legal and regulatory regimes with respect to the exchange of gametes and zygotes, gestational services, and fetal tissue.     

Anticipating demographic superiority: Kazakh thinking on integration and nation building

"In order to understand and to forecast what kind of nations will take shape in the new states of the former Soviet Union it is important to focus on the express objectives and actual strategies of the nation builders.... In this article I will concentrate on the ideological aspect, that is, on official and semi-official statements outlining the idea of ?the Kazakhstani nation', as Kazakhstani nation builders would like to see it develop." Particular attention is given to the changes in the ethnic composition of the country due primarily to the different demographic characteristics of the main ethnic groups that make up the population, the ethnic Kazakhs and Russians, and to the political implications of the growth of the Kazakhs from a minority to a majority ethnic group.     

Sanctioned violence: development and the persecution of women as witches in south Bihar

In South Bihar, India, socially sanctioned witch-hunting and persecution led to the deaths of 15 women in 1994 and 24 women and children in 1994. This article presents case studies to suggest that the underlying causes of this behavior are not superstition and illiteracy but are efforts to maintain women's inferior status by enforcing female economic subjugation, sexual exploitation, and the persecution of widows and independent, vocal women. In these cases, superstitious beliefs were exploited by community members with ulterior motives who compensated village witch doctors for collaborating with any accusation made against a local woman. After an introduction and presentation of the issues, the article describes the social and economic context and presents four case studies of women accused of witchcraft. The women involved were either forced to consume human excreta and then banished; raped and left for dead when five other family members were murdered, including a year-old baby; or protected through the intervention of a nongovernmental organization or a district welfare officer. The article then discusses the implications of this phenomenon for development work through a look at the power of social sanction, the role of witch doctors, the gender dimension, the power of the village headmen and the traditional administration system, and the larger motives behind the behavior. The article ends by suggesting interventions such as focusing on eliminating atrocities towards women, forming support groups, sensitizing officials, incorporating gender sensitivity in development efforts, and increasing access to health and education.     

Congress advances on health care reform: one step at a time

In adopting the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Congress made a series of small but significant steps toward improving access to health care benefits. The Act's centerpiece is its new requirements for group health plans and for the health insurance industry for assuring portability, access, and renewability of health insurance coverage. Of nearly equal importance is the pilot program established for testing the viability of medical savings accounts. Other health-related changes include adjustments in the rules governing duplication and coordinating of Medicare-related plans, recommendations with respect to privacy of health information of employees, an increase in the deduction for health insurance costs for self-employed individuals, and permission for unemployed persons to make withdrawals from IRAs and other qualified plans for certain medical services' costs. This article summarizes these and other key provisions of HIPAA.