In this paper, we explore how the prospect of artificial placenta technology (nearing clinical trials in human subjects) should encourage further consideration of the loss experienced by individuals when their pregnancy ends unexpectedly. Discussions of pregnancy loss are intertwined with procreative loss, whereby the gestated entity has died when the pregnancy ends. However, we demonstrate how pregnancy loss can and does exist separate to procreative loss in circumstances where the gestated entity survives the premature ending of the pregnancy. In outlining (...) the value that can be attached to pregnancy beyond fetal-centric narratives, we illustrate how pregnancy loss, separate to procreative loss, can be experienced. This loss has already been recognised among parents who have experienced an unexpected early ending of their pregnancy, resulting in their child being cared for in neonatal intensive care unit. Artificial placentas, however, may exacerbate these feelings and make pregnancy loss (without procreative loss) more visible. We argue that pregnancy is an embodied state in which gestation is facilitated by the body but gestation itself should be recognised as a process—and one that could be separable from pregnancy. In demarcating the two, we explore the different ways in which pregnancy loss can be understood. Our objective in this paper goes beyond contributing to our philosophical understanding of pregnancy towards practical-orientated conclusions regarding the care pathways surrounding the artificial placenta. We make recommendations including the need for counselling and careful consideration of the language used when an artificial placenta is used. (shrink)

De Bie et al. (2023) propose an organizing framework for different stages of human gestational development from conception to the viable premature. They also identify ethical considerations and con...

De Bie et al. posit thatthe best way to describe the person who would receive current AWT is as a “fetal neonate” or fetonate. Neonatal pertains to the fact that the subject is removed from the wom...

This paper aims to problematize pregnancy and support the development of a safe alternative method of gestation. Our arguments engage with the health risks of gestation and childbirth, the value assigned to pregnancy, as well as social and medical attitudes toward women’s pain, especially in labor. We claim that the harm caused by pregnancy and childbirth provides a prima facie case in favor of prioritizing research on a method of extra corporeal gestation.

Romanis and Adkins discuss pregnancy loss in relation to artificial amnion and placenta technology (AAPT) for treatment of extremely preterm infants.1 I agree with the authors that AAPT, although it is expected to provide better care for extremely preterm infants, will also be challenging for parents. I, therefore, commend Romanis and Adkins for promoting a more holistic care that includes parents and pregnant persons. However, I believe that they create two false dichotomies, one between the pregnant person/parent and the fetus/child (...) and one between current neonatal intensive care unit (NICU) and AAPT that hinder holistic care. Romanis and Adkins correctly point out that much of the discourse and care surrounding preterm deliveries focuses mainly on the infant. I agree with Romanis and Adkins that true holistic care should also include the parents rather than focusing exclusively on the child. However, the language they use to petition for more inclusive care can be problematic and counteractive to achieve holistic care. The problem is that they accuse any fetal/child consideration of being fetal-centric and, in the same breath, they state that it is something to be challenged. This attitude is problematic as it feeds into the rhetoric of the maternal–fetal conflict. This is a common rhetoric in reproductive and neonatal care used mainly in situations …. (shrink)

De Bie et al. (2023) provide a helpful framework for understanding many of the ethical considerations regarding artificial womb technology (AWT), particularly in relation to existing reproductive t...

De Bie et al. (2023) call attention at the conclusion of their essay to the “novel questions” generated by complete ectogenesis. The question I explore is how complete ectogenesis from conception t...

Successful deployment of “artificial womb technology (AWT)” is anticipated within a decade or so. In the case of “partial” ectogestation, in vivo gestation precedes fetal transfer to an artificial...

This issue of Christian Bioethics explores theological, metaphysical, and ethical questions surrounding emerging reproductive technologies. Narratives concerning such technologies are often manipulated via “language games.” Language games involve toying with language to ensure that one’s vision of the good gains or retains political prominence. Such games are common in academic discussions of “artificial womb” technologies. Abortion proponents, for example, are already using language to dehumanize subjects within “artificial wombs.” This is unsurprising. Were relevant subjects considered persons, then abortion access (and (...) other forms of “reproductive autonomy”) might be curtailed. Here, I show that abortion proponents’ language games often depend on dubious metaphysical claims. Second, I argue that Christians should oppose dehumanizing language games, since those games undermine “neighbor-love,” which Christians are commanded to show others. I also highlight how discussions of other technologies—such as medication abortion—are affected by confused (or manipulative) language. Ultimately, the language games I critique aim to preserve and expand the “rights” of the powerful to dehumanize, control, and kill vulnerable human beings. Since neighbor-love commands Christians to provide for “the least of these,” however, Christians must expose these manipulative language games, refute them, and resist the corrupt ideologies from which they flow. (shrink)

In 2017, Partridge et al. published remarkable experimental results concerning the use of a new artificial womb technology (AWT) with lambs, developed at Children’s Hospital of Philadelphia, called...

How could ectogestative technology disrupt gender roles, parenting practices, and concepts such as ‘birth’, ‘body’, or ‘parent’? In this chapter, we situate this emerging technology in the context of the history of reproductive technologies and analyse the potential social and conceptual disruptions to which it could contribute. An ectogestative device, better known as ‘artificial womb’, enables the extra-uterine gestation of a human being, or mammal more generally. It is currently developed with the main goal of improving the survival chances of (...) extremely premature neonates. We argue that the intended use of the technology in neonatal intensive care units, as an alternative to current incubators (’partial-ectogestation’), challenges concepts such as ‘birth’, ‘fetus’, and ‘neonate’, and has several ethico-legal implications. We moreover address a more futuristic scenario where the entire embryological and fetal development could happen within an artificial womb (’full-ectogestation’). Such a scenario reveals the disruption of gender roles, parenting practices, and concepts such as ‘mother’, ‘father’, and ‘parent’. Both full- and partial-ectogestation would have implications for engineering and design, law-making, ethics, and philosophical anthropology. (shrink)

Artificial womb technology for extracorporeal gestation of human offspring (ectogenesis or ectogestation) has profound ethical, sociological and religious implications for Muslim communities. In this article we examine the usage of the technology through the lens of Islamic ethico-legal frameworks specifically the legal maxims (al-Qawaid al-Fiqhiyyah) and higher objectives of Islamic law (Maqaṣid al-Shariah). Our analysis suggests that its application may be contingently permissible (halal) in situations of dire need such as sustaining life and development of extremely premature newborns, for advancing (...) fetal medicine and avoiding maternal co-morbidities during fetal treatment, and for enabling motherhood for women without functional wombs, or who face grave medical risks in pregnancy. However, its application may be proscribed (haram) for enabling healthy women to avoid pregnancy and childbirth, or to achieve parenthood equity. Specification of these views to particular policy, legal contexts and Fatwa will require multidisciplinary Shariah-based bioethical deliberations between jurists, policymakers, and scientists. (shrink)

The commentaries in response to our feature paper1 are indicative of the varied perspectives that can be taken towards artificial amnion and placenta technology (AAPT) and more specifically its relationship with pregnancy (loss). Kennedy rightly argues that empirical research is essential for understanding the experiences of pregnancy loss and AAPT2 and our own advocacy of empirical research is evident in previous work.3–5 Kennedy also acknowledges the current impossibility of researching AAPT experiences since it has not yet been applied in clinical (...) settings. It is precisely for this reason that we draw on the reported experiences of neonatal intensive care (NICU) parents since they present the closest analogy which can be drawn with the technology.1 What we reject in Kennedy’s response, however, is the claim that the experiences of NICU parents have been ‘exploited’ by us.2 Studies documenting the experiences of NICU parents were drawn on to indicate that our considerations are more than mere speculation. As stated, the experiences of NICU parents, particularly the pregnant individual who experiences pregnancy loss, are the closest indication we have of how AAPT and what it entails may be experienced. To claim that this data is being exploited by us is to undermine the very purpose that such research is undertaken—to indicate how future care may be improved. It would be much more harmful to not use this information. While we believe that experiences of …. (shrink)

In their scoping review of the literature on artificial womb technology (AWT), De Bie et al. report that “complete ectogenesis has been hailed as an alternative to abortion,” (De Bie et al. 2023, 7...

De Bie et al. argued that the decision “to transfer the fetus to AWT falls under maternal autonomy” while “once the fetonate is being supported by AWT, decision making would become a shared parenta...

In their article, De Bie et al. (2023) provide a scoping review of the ethical and socio-legal issues arising from research into, and the potential, maybe even likely deployment of, artificial womb...

Five years ago, remarkable animal experiments on artificial womb technology (AWT) at Children’s Hospital of Philadelphia (CHOP) got us thinking about the ethical for premature babies. We recognized...

De Bie et al. (2023) found that most feminist literature praises Artificial Womb Technologies (AWT) for its potential to increase equality among the sexes. This literature frames gestation as a poi...

De Bie et al. provide a novel framework for assessing ethical considerations in artificial womb technology (AWT) based on four phases of human prenatal development (DeBie 2023). As the authors note...

The paper by De Bie et al. (2023) provides an overview of various ethical arguments related to artificial womb technology (AWT). We believe some important feminist concerns about this technology ne...

The review by De Bie et al. (2023) provides an overview of the current ethical literature on artificial womb technology (AWT). Two characteristics stand out, and provide the basis for our commentar...

De Bie et al. (2023) introduces a framework to conceptualize ethical issues based on four different domains, but the problem lies in the domains being falsely bounded. Apart from the step from doma...

As strong as the ethical overview of artificial womb technology (AWT) by De Bie and colleagues is (De Bie et al. 2023), it does not adequately address ethical considerations that may arise within C...

Recent discussion on artificial womb technology (AWT) has given rise to a proliferation of terms to denote the subject of AWT. De Bie et al. opt for “fetal neonate” or “fetonate’ as “the best way t...

De Bie et al. (2023) provide a thorough review of the existing literature concerning Artificial Womb Technology (AWT) using the PRISMA-ScR method. The summary of the scoping review they conducted a...

De Bie et al. (2023) hold out their paper as an effort “to identify the broad range of ethical concerns and considerations regarding AWT” and to organize them “into a comprehensive framework to org...

In their comprehensive review article, De Bie et al., using some references, discreetly point out that pregnant women’s decision in Domain III to undergo fetal extraction via C-section should conti...