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Book Club Kit: The Handmaid's Tale

Instructions and Overview

The Handmaid's Tale

Margaret Atwood

ISBN: 038549081X 

ISBN-13: 9780385490818

Format: Paperback, 320pp

Pub. Date: March 1998

Publisher: Random House

The following questions were developed by Women's Bioethics Project advisory board member and bioethics researcher Sue Trinidad. They were tested and revised based on feedback from book clubs around the country. We would like to thank the many people who took the time to help us develop this program.

The questions are arranged in four sections: Commodification of Women's Bodies/Assisted Reproduction, Redefining Concepts of Motherhood, The Role of Genetic Relatedness and Commercial Surrogacy. They are designed to raise key ethical issues, provide important information on the science, and help you get in touch with your own moral compass. With a nod to the realities of many women’s lives, we have written them in such a way that you can participate in the discussion even if you haven’t read the books.

We suggest you read through the questions and select 5-10 for discussion purposes. After your discussion, we encourage all readers to
check out the Policy Questions section of the website for more detailed information on the science, ethical frameworks to consider these issues, and policy options.

Bioethics Book Club Discussion Questions

The Handmaid’s Tale is set in the dystopia of Gilead in the speculative, not-too-distant future. The narrator, known to us only as Offred (literally “Of-Fred,” having been stripped of her own name) tells of a region of the United States taken over by a fundamentalist insurgency. This theocratic regime forces women into total subservience, in keeping with the Gileadean interpretation of Christian Scripture. One day, suddenly, women are prohibited from working, cannot have their own money, and are not allowed to travel freely. Things get worse from there.

Years of pollution and abuse of the environment have resulted in widespread infertility, and the society is reorganized around breeding. Fertile women are abducted, designated as Handmaids, and sent to an indoctrination facility. When their “training” is complete, they are assigned to male elites (Commanders) and go to live in their households under the supervision of the Commanders’ Wives. This supervision is no mere thing: in keeping with the Gileadean interpretation of the Biblical story of Rachel and her handmaid Bilhah, while the Commander copulates with his Handmaid, the Wife must maintain physical contact with her. This makes any child that results from the Ceremony legally and morally the child of the Wife, who takes possession of the newborn immediately. Handmaids, for their part, are treated solely as vessels. They are required to behave chastely and meekly at all times, for such are the female virtues in Gilead. The Handmaids have no social outlets, are forbidden to read, may not smoke or drink, and are required to follow prescribed plans for diet and exercise so as to increase the likelihood of conception. Those who do not become pregnant after being assigned to three different Commanders are designated Unwomen and shipped out to the hinterlands, where they are given the job of cleaning up toxic waste.

Margaret Atwood is an accomplished writer, with a particular gift for creating dystopian worlds. (See the Book Group Guide for Oryx and Crake, another WBP pick, here.) 
Many of Atwood’s books begin in the middle of a story, with hints dropped here and there about what has come before. At what point in the book did you piece together the backstory of Gilead? What were the clues?
Atwood has referred to her work as “speculative fiction,” driven by a series of what-if questions. Do you find the vision of the novel plausible, or is it simply too far-fetched? Do you find the idea of a fundamentalist takeover more, or less, worrisome than you think it would have been when the book was originally published in 1986?

Bioethical Issue: Commodification of Women's Bodies / Assisted Reproduction

• In Gilead, women are either Madonnas (the Handmaids and Wives whose value lies in fertility and/or submission) or whores (women who, like Offred’s friend Moira, work in brothels that serve the Commanders). In Gilead, women with children of their own are forced to give them up so the women can become Handmaids. If they are lucky enough to become pregnant during their “service,” the babies they bear are handed over to the Wives. Part of what keeps the society working is the opposition of these different groups of women, who are held in place by their mutual antagonism. 
What questions does this scenario raise about motherhood? About the value Gilead places on motherhood and female sexuality?

Which women have the best deal? Which the worst? Why?
• The novel was originally published at a time when reproductive freedom was a strong rallying cry for the feminist movement. Although as a society we have not yet reached political consensus on abortion, it is no longer the only contested issue in the area of women’s reproductive freedom. Recent years have seen a dramatic increase in the development and use of assisted reproductive technologies (ART). We’ve come a long way from the days of the turkey baster: fertility treatments, in vitro fertilization (IVF), and preimplantation genetic diagnosis (PGD) are all available to those who can pay for them, at least in the United States. Surrogacy is one part of this increasingly complex picture.

Bioethical Issue: Redefining Concepts of Motherhood

• Advances in ART mean that surrogacy today can take many forms. Imagine that Maura and Frank want to become parents, but Maura has not been able to become pregnant despite multiple rounds of IVF. They decide to hire a surrogate, Sally. In a traditional surrogacy arrangement, Sally’s egg would be fertilized with Frank’s sperm. Alternatively, Maura’s egg could be fertilized with Frank’s sperm and transferred into Sally’s uterus—gestational surrogacy. Or a donor egg could be fertilized with Frank’s sperm and transferred into Sally’s uterus—gestational surrogacy with a donor egg.

In the last case, a child resulting from these procedures would have a “genetic mother” (the egg donor); a “gestational mother” (Sally), and a “social (legal) mother” (Maura).
In these scenarios, are all the women “mothers”? Why or why not?

What does it mean to be a mother?

Even if women who are egg donors or gestational surrogates are not “mothers,” they might still have certain rights or interests. What does the social/legal mother owe to these other players?

Should such arrangements be subject to government regulation? If so, what protections should be provided for each party?

Bioethical Issue: The Role of Genetic Relatedness

• Some women feel strongly about having a child who is “really theirs”—a mix of their and their partner’s genes. As Alex Kuczynski wrote in a recent article about her surrogacy experience in the New York Times Magazine, “[H]aving a biologically related child felt necessary. What began as wistful longing in my 20s had blistered into a mad desire that seemed to defy logic. The compulsion to create our own bloodline seemed medieval, and I knew we could enjoy our marriage—our lives—without a child. Yet I couldn’t argue myself out of my desire. A child with our genes would be a part of us. My husband’s face would be mirrored in our child’s face, proof that our love not only existed, but could be recreated beyond us. Die without having created a life, and die two deaths: the death of yourself, and the death of the immense opportunity that is a child.”
How should we think about genetics and family? What is your reaction to Kuczynski’s statement, “A child with our genes would be a part of us?”

Recent news reports describe “family reunions” of children conceived from the sperm of the same (usually anonymous) donor. What do you think about this practice?

Bioethical Issue: Commercial Surrogacy—Should Surrogates Be Paid, and if so, For What?

• When surrogacy arrangements first hit the news, they were generally within families: the sister (or, in rarer cases, the mother or friend) of a woman who was having trouble becoming or staying pregnant would do it for her. These were not economic exchanges, but gifts in the context of an existing relationship. With the emergence of commercial surrogacy, many questions arise.

Perhaps the primary concern about commercial surrogacy arrangements—those in which the gestational carrier is paid for the use of her womb—carry the risk of poor women. In the New York Times Magazine story referenced above, Kuczynski explains that many lawyers and surrogacy advocates screen out poor women as surrogates—not only because of concerns about exploitation, but also because of other, more practical concerns: poor women, an informant told her, “are less likely to be in stable relationships, in good health and of appropriate weight. Surrogates are often required to have their own health insurance, which usually means the surrogate or her spouse is employed in the kind of secure job that provides such a benefit.” Kuczynski herself characterizes gestational surrogacy as “organ rental.”
How much control ought the would-be parent(s) have over the gestational carrier’s life and habits during her pregnancy? Should they accompany her to doctor’s visits? Require that she refrain from smoking or drinking? Avoid certain foods, certain activitities?

Most of us likely react negatively to the similar requirements imposed on Offred. Is that only because Offred has not entered into the arrangement of her own free will?
What duties do the would-be parents and the gestational carrier owe each other? For example: 
Should the would-be parents pay for the gestational carrier’s medical expenses following the pregnancy? What if unanticipated complications arise?
What happens if the gestational carrier changes her mind and does not wish to give the baby up?

What happens if the child is born with severe disabilities?

Should the would-be parents guarantee a certain standard of living for the child?

The argument against commercial surrogacy states that society has an interest in protecting women from exploitation. If large sums of money are available for selling eggs or carrying someone else’s fetus to term, poor women might be unduly induced to do so, possibly at risk to their health or future fertility. Opponents of this view argue that policies that limit or prohibit commercial surrogacy are overly paternalistic, imposing “protections” that infringe upon women’s right to choose what to do with their own bodies, what risks they are willing to bear, and for what price.
Is it more important for society to protect women from reproductive exploitation, or is it more important to guard women’s right to serve as a paid surrogate?
One way to think about policy regarding gestational surrogacy is to look for comparisons to other cases. In general, current US policy forbids the sale of organs and of children; but there are some other comparisons we can make. For example, women who make their eggs available for use in IVF are generally paid for doing so. However, the practice is legally categorized as donation: the money is provided to cover the donor’s time, expenses, discomfort, and inconvenience, not to buy an egg. That said, there have been reports of higher payments for women who fit certain criteria—such as being enrolled in college, or having certain desirable physical or behavioral traits. In contrast, men who “donate” sperm are generally paid for doing so. And people can be paid for giving blood and plasma.
Which of these cases—if any—seems to fit the case of commercial surrogacy?

How is commercial surrogacy similar to, and different from, each of these examples?

Which differences seem ethically important?

Some commentators have suggested that surrogacy is less like selling an organ and more like being paid for a service—that is, more like a certain, specialized, kind of work.
Do you agree that gestational surrogacy is a kind of labor, in which the surrogate is an employee, providing a service to an employer?

Some view gestational surrogacy as having important parallels to prostitution. In both practices, women receive payment for the use of their bodies. Is this a parallel to gestational surrogacy? Why or why not?


We encourage you to check out the Policy Questions section of the website for more detailed information on the science, ethical frameworks to consider these issues, and policy options.
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