1 Bioethics Beyond Altruism 23the primacy of the mother-infant dyad, adoptive mothers, men, friends,
extended family members, and trans people can breastfeed (Diamond
1995 ; Kirkman and Kirkman 2001 ; MacDonald et al. 2016 ; Shaw
2004 ). Fiona Giles develops this conversation about breastmilk dona-
tion in her chapter to draw on the memoir of Trevor MacDonald, a
transgender dad, who, with his partner, became part of a bridging net-
work of milk donors and supporters, building relationships with peo-
ple they might never have otherwise met. Giles provides a case study
of the risks and benefits of informal milk sharing within the context of
contemporary Western mothering, where the norm is exclusive breast-
feeding and exclusionary mothering. She shows how a sharing economy
builds relational frameworks of embodied care, enacting the values of
‘social maternity’ (Shaw 2004 ) and ‘inclusive breastfeeding’ (Tavakoli
2014 ) as alternatives to isolated and privatised mothering practices.
In the final chapter of the volume, Rhonda Shaw and Maggie
Morgan discuss the ethics of breastmilk donation in a New Zealand
Neonatal Intensive Care Unit (NICU) alongside the burgeoning phe-
nomenon of peer-to-peer milk sharing over the Internet. They note the
current WHO hierarchy of infant feeding, which recommends breast-
feeding, expressed breastmilk, donor breastmilk and formula. The
authors argue that, while the use of donor human milk for premature
babies in the NICU (and normal birth babies where maternal milk is
not available or in low supply), has become the preferred form of infant
feeding, breastmilk’s status as ‘liquid gold’ is not absolute. Like other
contributors to the volume, the authors build on previous work in the
social sciences, feminist theory and STS to suggest that the value attrib-
uted to breastmilk as a body product, food and/or medicine depends on
its ‘career’ history, the way it is shared and the actors involved through-
out the course of its exchange. The chapter ends by picking up on key
themes from preceding chapters of the volume that link the donation
and transformation of human biological materials in moral and bio-
intimate tissue economies. While the volume essays vary as to their
object of study and their methodological approach, they each dem-
onstrate the ongoing contribution of theoretically informed empiri-
cal research to bioethical discussions about developments in medicine,
health care, and the life sciences.