This paper explores the concept of ectogenesis in both the partial and the complete forms and argues for the moral permissibility of artificial womb technology in some restricted contexts. The author proposes that artificial wombs could licitly be employed for the purpose of saving the lives of infants born at very young gestational ages either by miscarriage or by delivery induced for very serious medical reasons. The author also proposes that artificial womb technology may be licitly used for the rescue (...) of embryos created through in vitro fertilization and subsequently abandoned by their parents, but the technology would have no ethical application when used electively. National Catholic Bioethics Quarterly 10.3 (Autumn 2010): 515–528. (shrink)

In his article “Research Priorities and the Future of Pregnancy” in this issue of CQ, Timothy Murphy evaluates some of the arguments I advanced in an earlier publication, “The Moral Imperative for Ectogenesis.

Recently, I argued that human subjects in artificial wombs ‘share the same moral status as newborns’ and so, deserve the same treatment and protections as newborns. This thesis rests on two claims: subjects of partial ectogenesis—those that develop in utero for at time before being transferred to AWs—are newborns and subjects of complete ectogenesis—those who develop in AWs entirely—share the same moral status as newborns. In response, Elizabeth Chloe Romanis argued that the subject in an AW is ‘a unique human (...) entity…rather than a fetus or a newborn’. She provides four lines of response to my essay. First, she argues that I have ‘misconstrued’ what birth is. Once we correct that error, it becomes clear that subjects of partial ectogenesis have not been born. Second, she argues that my claims imply that non-implanted embryos ‘would also be “born”’. But that is absurd. Third, she claims I fail to ‘meaningfully respond’ to distinctions she draws between subjects of ectogenesis and neonates. Finally, she criticises my essay for focusing on subjects of AWs rather than focusing on pregnant persons. I respond to each of these charges. In doing so, I reaffirm that some subjects of ectogenesis are newborns and all subjects of ectogenesis—even those that have not been born—share the same moral status as newborns. (shrink)

In 2017 and 2019, two research teams claimed ‘proof of principle’ for artificial womb technology (AWT). AWT has long been a subject of speculation in bioethical literature, with broad consensus that it is a welcome development. Despite this, little attention is afforded to more immediate ethical problems in the development of AWT, particularly as an alternative to neonatal intensive care. To start this conversation, I consider whether experimental AWT is innovative treatment or medical research. The research–treatment distinction, pervasive in regulation (...) worldwide, is intended to isolate research activities and subject them to a greater degree of oversight. I argue that there is a tendency in the literature to conceptualize AWT for partial ectogenesis as innovative treatment. However, there are sufficiently serious ethical concerns with experimental AWT that mean that it must not be first used on humans on the basis that it is a ‘beneficial treatment’. First, I outline the prospects for translation of AWT animal studies into treatment for human preterms. Second, I challenge the conceptualizations of experimental AWT as innovative treatment. It must be considered medical research to reflect the investigatory nature of the process and guarantee sufficient protections for subjects. Identifying that AWT is research is crucial in formulating further ethico‐legal questions regarding the experimental use of AWT. Third, I demonstrate that clinical trials will be a necessary part of the clinical translation of AWT because of requirements laid out by regulators. I consider the justification for clinical trials and highlight some of the crucial ethical questions about the conditions under which they should proceed. (shrink)

Recent animal research suggests that it may soon be possible to support the human fetus in an artificial uterine environment for part of a pregnancy. A technique of extending gestation in this way (“ectogestation”) could be offered to parents of extremely premature infants (EPIs) to improve outcomes for their child. The use of artificial uteruses for ectogestation could generate ethical questions because of the technology’s potential impact on the point of “viability”—loosely defined as the stage of pregnancy beyond which the (...) fetus may survive external to the womb. Several medical decisions during the perinatal period are based on the gestation at which infants are considered viable, for example decisions about newborn resuscitation and abortion, and ectogestation has the potential to impact on these. Despite these possible implications, there is little existing evidence or analysis of how this technology would affect medical practice. In this paper, we combine empirical data with ethical analysis. We report a survey of 91 practicing Australian obstetricians and neonatologists; we aimed to assess their conceptual understanding of “viability,” and what ethical consequences they envisage arising from improved survival of EPIs. We also assess what the ethical implications of extending gestation should be for newborn and obstetric care. We analyze the concept of viability and argue that while ectogestation might have implications for the permissibility of neonatal life‐prolonging treatment at extremely early gestation, it should not necessarily have implications for abortion policy. We compare our ethical findings with the results of the survey. (shrink)

Recently, I argued that human subjects in artificial wombs (AWs) “share the same moral status as newborns” and so, deserve the same treatment and protections as newborns. This thesis rests on two claims: (A) “Subjects of partial ectogenesis—those that develop in utero for at time before being transferred to AWs—are newborns,” and (B) “Subjects of complete ectogenesis—those who develop in AWs entirely—share the same moral status as newborns.” In response, Elizabeth Chloe Romanis argued that the subject in an AW is (...) “a unique human entity…rather than a fetus or a newborn.” She provides four lines of response to my essay. First, she argues that I have “misconstrued” what birth is. Once we correct that error, it becomes clear that subjects of partial ectogenesis have not been born. Second, she argues that my claims imply that non-implanted embryos (existing in vivo) “would also be ‘born.’” But that is absurd. Third, she claims I fail to “meaningfully respond” to distinctions she draws between subjects of ectogenesis and neonates. Finally, she criticizes my essay for focusing on subjects of AWs rather than focusing on pregnant persons (who should be at the “centre” of debates over AWs). I respond to each of these charges. In doing so, I reaffirm that (contra Romanis) some subjects of ectogenesis are newborns and all subjects of ectogenesis—even those that have not been born—share the same moral status as newborns. (shrink)

The contemporary philosophical literature on abortion primarily revolves around three seemingly intractable debates, concerning the (1) moral status of the fetus, (2) scope of women’s rights and (3) moral relevance of the killing/letting die distinction. The possibility of ectogenesis—technology that would allow a fetus to develop outside of a gestational mother’s womb—presents a unique opportunity for moral compromise. Here, I argue those opposed to abortion have aprima faciemoral obligation to pursue ectogenesis technology and provide ectogenesis for disconnected fetuses as part (...) of a moral compromise. (shrink)

Subjects of ectogenesis—human beings that are developing in artificial wombs (AWs)—share the same moral status as newborns. To demonstrate this, I defend two claims. First, subjects of partial ectogenesis—those that develop in utero for a time before being transferred to AWs—are newborns (in the full sense of the word). Second, subjects of complete ectogenesis—those who develop in AWs entirely—share the same moral status as newborns. To defend the first claim, I rely on Elizabeth Chloe Romanis’s distinctions between fetuses, newborns and (...) subjects of ectogenesis. For Romanis, the subject of partial ectogenesis ‘is neither a fetus nor a baby’ but is, instead, a ‘new product of human reproduction’. In this essay, I begin by, expanding upon Romanis’s argument that subjects of partial ectogenesis are not fetuses while arguing that those subjects are newborns. Next, I show that the distinction that Romanis draws between subjects of partial ectogenesis and newborns needs to be revised. The former is a kind of the latter. This leads us to an argument that shows why different moral statuses cannot be justifiably assigned to subjects of partial ectogenesis and subjects of complete ectogenesis, respectively. As subjects of partial ectogenesis share the same moral status as newborns, it follows that subjects of complete ectogenesis share the same moral status as newborns as well. I conclude by considering implications that this essay may have for the research and development of AW technology and conceptual links between a subject’s moral status and birth. (shrink)

Ectogenesis, or the use of an artificial womb to allow a foetus to develop, will likely become a reality within a few decades, and could significantly affect the abortion debate. We first examine the implications for Judith Jarvis Thomson’s violinist analogy, which argues for a woman’s right to withdraw life support from the foetus and so terminate her pregnancy, even if the foetus is granted full moral status. We show that on Thomson’s reasoning, there is no right to the death (...) of the foetus, and abortion is not permissible if ectogenesis is available, provided it is safe and inexpensive. This raises the question of whether there are persuasive reasons for the right to the death of the foetus that could be exercised in the context of ectogenesis. Eric Mathison and Jeremy Davis have examined several arguments for this right, doubting that it exists, while Joona Räsänen has recently criticized their reasoning. We respond to Räsänen’s analysis, concluding that his arguments are unsuccessful, and that there is no right to the death of the foetus in these circumstances. (shrink)

Both many critics of abortion and many defenders of abortion have suggested that artificial wombs could end the abortion debate. If the fetus is removed from the uterus, women have an end to an unwanted pregnancy. If the living fetus is then put in an artificial uterus for ectogenesis, there is no termination of the life of the fetus. Joona Räsänen challenges this view in his article, Ectogenesis, abortion and a right to the death of the fetus. Räsänen provides three (...) arguments for a right to secure the death of the human being in utero, namely the ‘right not to become a biological parent argument’, the ‘right to genetic privacy argument’, and the ‘right to property argument’. This article critiques these three arguments for a right to the death of the fetus. (shrink)

In 2017, a Philadelphia research team revealed the closest thing to an artificial womb the world had ever seen. The ‘biobag’, if as successful as early animal testing suggests, will change the face of neonatal intensive care. At present, premature neonates born earlier than 22 weeks have no hope of survival. For some time, there have been no significant improvements in mortality rates or incidences of long-term complications for preterms at the viability threshold. Artificial womb technology, that might change these (...) odds, is eagerly anticipated for clinical application. We need to understand whether AWT is an extension of current intensive care or something entirely new. This question is central to determining when and how the biobag should be used on human subjects. This paper examines the science behind AWT and advances two principal claims. First, AWT is conceptually different from conventional intensive care. Identifying why AWT should be understood as distinct demonstrates how it raises different ethico-legal questions. Second, these questions should be formulated without the ‘human being growing in the AW’ being described with inherently value laden terminology. The ‘human being in an AW’ is neither a fetus nor a baby, and the ethical tethers associated with these terms could perpetuate misunderstanding and confusion. Thus, the term ‘gestateling’ should be adopted to refer to this new product of human reproduction: a developing human being gestating ex utero. While this paper does not attempt to solve all the ethical problems associated with AWT, it makes important clarifications that will enable better formulation of relevant ethical questions for future exploration. (shrink)

This paper aims to address how artificial gestation might affect equality of opportunity for the unborn and any resultant generation of “ectogenetic” babies. It will first explore the current legal obstacles preventing the development of ectogenesis, before looking at the benefits of allowing this technology to control fetal growth and development. This will open up a discussion of the treatment/enhancement divide regarding the use of reproductive technologies, a topic featured in various bioethical debates on the subject. Using current maternity practices (...) in Western society as a comparator, this paper will conclude that neither naturally nor artificially gestated fetuses have interests that can conflict with those of potential parents who might want to use this technology to control fetal development. Such control may include selective implantation of embryos of a desired gender, deliberate choice of genetic traits, or maintenance of an ideal incubation environment to avoid fetal damage. Objections on the basis of disability as well as concerns regarding eugenics will be addressed. The paper will conclude that none of these objections are compelling grounds to prevent the development and use of ectogenesis technologies for the purpose of achieving specific reproductive goals, particularly when compared to current practices in pre-implantation genetic diagnosis and selective abortion on the grounds of undesired traits. As such, when deciding whether to support ectogenesis research, the enduring interests of parents must be the primary consideration, with societal concerns regarding potential misuse the only valid secondary consideration. (shrink)

To what extent are women obliged to be child-bearers? If reproductive technology could offer some form of ectogenesis, would feminists regard it as a liberating reproductive option? Three lines of reproductive rights arguments currently used by feminists are applied to ectogenesis. Each fails to provide strong grounds for prohibiting it. Yet, there are several ways in which ectogenesis could contribute to women's oppression, in particular, if it were used to undermine abortion rights, reinforce traditional views of fertility, increase fetal rights (...) in pregnancy, and perpetuate the unequal distribution of scarce medical resources. A re-thinking of women's relationship to pregnancy is needed in order to challenge ectogenetic research. (shrink)

This article addresses the oft-neglected nexus between the mother and the machine, specifically in relation to the notion of ectogenesis (that is, conception, gestation and birth outside the maternal body). After a discussion of the technologies and the discourses of ectogenesis as symptomatic of what I call an ectogenetic desire, I move on to critically consider the work of Smith-Windsor on her own maternal experience with an incubator. This is followed by an evaluation of feminist writings on reproductive technologies, leading (...) to a discussion of why the critical dichotomy between the maternal body and the machine needs to be reevaluated, to develop the possibility of a different ethics of/for the maternal body. (shrink)