Ectogestation involves the gestation of a fetus in an ex utero environment. The possibility of this technology raises a significant question for the abortion debate: Does a woman’s right to end her pregnancy entail that she has a right to the death of the fetus when ectogestation is possible? Some have argued that it does not Mathison & Davis. Others claim that, while a woman alone does not possess an individual right to the death of the fetus, the (...) genetic parents have a collective right to its death Räsänen. In this paper, I argue that the possibility of ectogestation will radically transform the problem of abortion. The argument that I defend purports to show that, even if it is not a person, there is no right to the death of a fetus that could be safely removed from a human womb and gestated in an artificial womb, because there are competent people who are willing to care for and raise the fetus as it grows into a person. Thus, given the possibility of ectogestation, the moral status of the fetus plays no substantial role in determining whether there is a right to its death. (shrink)

Philosophical discussions concerning ectogestation are trending. And given that the Supreme Court of the United States overturned Roe v. Wade (1973) and Casey v. Planned Parenthood (1992), questions regarding the moral and legal status of abortion in light of the advent of ectogestation will likely continue to be of central importance in the coming years. If ectogestation can intersect with or even determine abortion policy in the future, then a new philosophical analysis of the legal status of (...) abortion is both warranted and urgently needed. I argue that, even if there is no ‘moral’ right to fetal destruction once ectogestation becomes a reality, societies ought not to implement legal prohibitions on a pregnant person’s ability to safely obtain an abortion that results in fetal death because such laws are systemically misogynistic. (shrink)

In this commentary, I will consider the implications of the argument made by Christopher Stratman (2020) in ‘Ectogestation and the Problem of Abortion’. Clearly, the possibility of ectogestation will have some effect on the ethical debate on abortion. However, I have become increasingly sceptical that the possibility of ectogestation will transform the problem of abortion. Here, I outline some of my reasons to justify this scepticism. First, that virtually everything we already know about unintended pregnancies, abortion and (...) adoption does not prima facie support the assumption that a large shift to ectogestation would occur. Moreover, if ectogestation does not lead to significant restrictions to abortion then there is unlikely to be any radical transformation of the practice of abortion. Second, abortion is already associated with stigma and so the presence of ectogestation would need to create additional stigma to modify behaviour. Finally, I argue that ectogestation shifts the debate away from the fetus to the human subject of the artificial womb—the gestateling. Therefore, creating a new category of killing—gestaticide—and this would only reorient the debate rather than end it. (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)

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)

In this commentary, I will consider the implications of the argument made by Christopher Stratman in ‘Ectogestation and the Problem of Abortion’. Clearly, the possibility of ectogestation will have some effect on the ethical debate on abortion. However, I have become increasingly sceptical that the possibility of ectogestation will transform the problem of abortion. Here, I outline some of my reasons to justify this scepticism. First, I argue that virtually everything we already know about unintended pregnancies, abortion (...) and adoption does not prima facie support the assumption that a large shift to ectogestation would occur. Moreover, if ectogestation does not lead to significant restrictions to abortion, then there will be no radical transformation of the practice of abortion. Second, abortion is already associated with stigma, and so the presence of ectogestation would need to create additional stigma to modify behaviour. Finally, I argue that ectogestation shifts the debate away from the foetus to the human subject of the artificial womb—the gestateling, therefore creating a new category of killing—gestaticide. However, this would only reorient the debate rather than end it. (shrink)

Ectogestation technology, when feasible, will permit fetal development within an artificial womb. Ectogestation is termed ectogenesis when it is full (gestation occurs exclusively within an artificial womb post in vitro fertilisation) or partial (artificial gestation occurs during the course of in vivo gestation, post a caesarean-like fetal transfer). In what follows, I explore the implications for the gestational versus moral parenthood debate recently spotlighted by Benjamin Lange1 for various alternative uses of ectogestation compared to the baseline case (...) of in vivo gestation. I contrast ectogestation in four different contexts with in vivo gestation followed by vaginal delivery. I document the relevant outcomes, burdens and harms in particular, to the gestating mother, the biological father, the fetus and the child into whom it will develop. The focus on harms in considering intraparental claims to parenthood follows Lange’s focal article1: importantly, however, I focus not on harms from separation from the gestational procreator (as in adoption cases) but instead on harms arising from the use of ectogestation in various forms. I note at the outset, how, for each case discussed below, I indicate opportunities for each biological parent to establish voluntarism-based claims to moral parenthood. In the analyses, except where specifically noted, the default implication is that it is …. (shrink)

Journal of Social Philosophy, EarlyView.

Andrea Bidoli argues that ectogestation could be seen as an emancipatory intervention for women. Specifically, she claims that ectogestation would create unique conditions to reevaluate one’s reproductive preference, address certain specific negative social implications of gestation and childbirth, and that it is unfair to hold ectogestation to a higher standard than other innovations such as modern contraceptives and non-medical egg freezing. In this commentary, I claim that Bidoli—like so many others—unjustly bypasses men and their reproductive desires. For (...) a long time, the discussion of the ethics of ectogenesis has focused on women and their reproductive liberation. However, since in many countries, an increasing number of men in reproductive age face difficulties in finding a partner and lack access to other forms of assisted reproduction, it is men who need ectogestation the most. (shrink)

A few decades from now, it might become possible to gestate fetuses in artificial wombs. Ectogestation as this is called, raises major legal and ethical issues, especially for abortion rights. In countries allowing abortion, regulation often revolves around the viability threshold—the point in fetal development after which the fetus can survive outside the womb. How should viability be understood—and abortion thus regulated—after ectogestation? Should we ban, allow or require the use of artificial wombs as an alternative to standard (...) abortions? Drawing on Cohen, I evaluate three possible positions for the post-ectogestative abortion laws: restrictive, conservative and liberal. While the restrictive position appears untenable, I argue that the liberal and conservative positions can be combined to form a legally and morally coherent basis for post-ectogestative abortion legislation, offering an improvement from the point of both prolife and prochoice positions. (shrink)

Ectogestation is an emerging reproductive technology that involves gestating a fetus in an ex-utero environment through the use of artificial amnion and placenta technologies. Some philosophers take the advent of ectogestation to show that a pregnant person does not have a right to secure fetal demise. But these philosophers face a problem. They must reject one of the following independently plausible but jointly inconsistent claims (A) biological parents of cryopreserved embryos possess the right to destroy their embryos in (...) virtue of owning them; (B) biological parents don’t own the gestating fetus; and (C) biological parents don’t have a right to the death of the fetus. Is this problem intractable? No. The goal of this paper is to offer and partly defend a deflationary way out of the problem. By shifting the focus from a conflict of rights to the pregnant person’s internal reasons, I aim to preserve key intuitions about parental ownership of cryopreserved embryos while providing a plausible way to rethink the abortion debate in light of ectogestation. The paper will conclude by considering what implications this alternative solution may have for the abortion debate. (shrink)

This essay explores the theological and anthropological significance of birth, in order to discern what might be lost with the adoption of complete ectogestation (“artificial wombs”). Specifically, it considers both Saint Augustine and Karl Barth’s respective accounts of humanity’s whence—that is, their theological answer to the question of the nature and significance of our origins as individuals. I suggest that Augustine’s account of his origins emphasizes both his epistemic and biological dependency on his mother and nurses, while Barth’s stresses (...) the individual’s immediate derivation from God. Those disparate answers affect how they construe the relationships of parents and children and work themselves throughout their theological visions and imaginations. I conclude that careful consideration of humanity’s whence cannot answer whether we ought to pursue ectogestation; but it does help us account for how our understanding of God and ourselves might be altered if we gestate human life outside the womb. (shrink)

Journal of Social Philosophy, EarlyView.

A 2017 Nature report was widely touted as hailing the arrival of the artificial womb. But the scientists involved claim their technology is merely an improvement in neonatal care. This raises an under-considered question: what differentiates neonatal incubation from artificial womb technology? Considering the nature of gestation—or metaphysics of pregnancy—(a) identifies more profound differences between fetuses and neonates/babies than their location (in or outside the maternal body) alone: fetuses and neonates have different physiological and physical characteristics; (b) characterizes birth as (...) a physiological, mereological and topological transformation as well as a (morally relevant) change of location; and (c) delivers a clear distinction between neonatal incubation and ectogestation: the former supports neonatal physiology; the latter preserves fetal physiology. This allows a detailed conceptual classification of ectogenetive and ectogestative technologies according to which the 2017 system is not just improved neonatal incubation, but genuine ectogestation. But it is not an artificial womb, which is a term that is better put to rest. The analysis reveals that any ethical discussion involving ectogestation must always involve considerations of possible risks to the mother as well as her autonomy and rights. It also adds a third and potentially important dimension to debates in reproductive ethics: the physiological transition from fetus/gestateling to baby/neonate. (shrink)

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 paper calls for the development of a method of ectogestation as an emancipatory intervention for women. I argue that ectogestation would have a dual social benefit: first, by providing a gestational alternative to pregnancy, it would create unique conditions to reevaluate one’s reproductive preferences—which, for women, always include gestational considerations—and to satisfy a potential preference not to gestate. Enabling the satisfaction of such a preference is particularly valuable due to the pressures women face to embrace pregnancy as (...) central to their identity, while at the same time being penalised by it. Second, ectogestation would address certain specific negative social implications of gestation and childbirth, which cannot be avoided through social measures as they are caused by the corporeal nature of these phenomena. Finally, I argue that it is unfair to hold ectogestation to a higher standard than other innovations such as modern contraceptives and non-medical egg freezing. (shrink)

Since the publication of the successful animal trials of the Biobag, a prototypical extrauterine support for extremely premature neonates, numerous ethicists have debated the potential implications of such a device. Some have argued that the Biobag represents a natural evolution of traditional newborn intensive care, while others believe that the Biobag would create a new class of being for the patients housed within. Kingma and Finn argued in Bioethics for making a categorical distinction between fetuses, newborns and ‘gestatelings’ in a (...) Biobag on the basis of a conceptual distinction between ectogenesis versus ectogestation. Applying their arguments to the clinical realities of newborn intensive care, however, demonstrates the inapplicability of their ideas to the practice of medicine. Here, I present three clinical examples of the difficulty and confusion their argument would create for clinicians and offer a possible remedy: namely, discarding the term ‘artificial womb’ in favour of ‘Biobag’. (shrink)

In this commentary, I discuss Christopher Stratman’s article, “Ecotogenesis and the Problem of Abortion.” First, I try to offer some better defenses of assertions that Stratman makes. Next, I question Stratman’s supposition that “there is no morally relevant difference between a fetus and a cryopreserved embryo.” Finally, I challenge the claim that immoral actions cannot give rise to rights.

This essay defends the asymmetry between the badness of spontaneous and induced abortions in order to explain why anti-abortionists prioritize stopping induced abortions over preventing spontaneous abortions. Specifically, it argues (1) the distinction between killing and letting-die is of more limited use in explaining the asymmetry than has sometimes been presumed, and (2) that accounting for intentions in moral agency does not render performances morally inert. Instead, anti-abortionists adopt a pluralist, nonreductive account of moral analysis which is situated against a (...) backdrop that sees the limits of our ability to control the process of fertility as themselves valuable. Although this view is complex, the paper concludes by arguing that it has the advantage of explaining features of the anti-abortion outlook that have sometimes been overlooked. First, it accounts for why the pre-Roe regime of abortion restrictions primarily imposed penalties on doctors who induced abortions rather than the women who seek them. Second, it explains why the advent of ectogestation will not prompt anti-abortionists to compromise on ‘disconnect abortions,’ which putatively let the embryo die by extracting it from the mother’s womb. (shrink)

In these replies, I shall respond to criticisms offered by Kaczor and Rodger to my article titled “Ectogestation and the Problem of Abortion.” In the process, I shall also try to bring into focus why the possibility of ectogestation will radically alter the shape of the abortion debate.

The development of artificial womb technology is proceeding rapidly and will present important ethical and theological challenges for Christians. While there has been extensive secular discourse on artificial wombs in recent years, there has been little Christian engagement with this topic. There are broadly two primary uses of artificial womb technology—ectogestation as a form of enhanced neonatal care, where some of the gestation period takes place in an artificial womb, and ectogenesis, where the entire gestation period is within an (...) artificial womb. Ectogestation for the latter weeks or months of pregnancy could be possible within a decade or so, while ectogenesis for humans is far more speculative. Ectogestation is likely to significantly decrease maternal and neonatal morbidity and mortality, and so there is a strong case for supporting its development. Ectogenesis, however, may bring a number of challenges, including the commodification of children, and the pathologizing of pregnancy and childbirth. Its long-term effects on those who are created through this process are also unknown. In the event that it becomes ubiquitous, we may also find the central theological significance of pregnancy and birth diminished. The dilemma for Christians is that the development of ectogestation seems likely to normalise the use of artificial gestation, and, in time, pave the way for ectogenesis. (shrink)

Some feminist movements treat new reproductive technologies such as ectogestation as having liberatory power. The author argues against this and situates such technologies as part of a neoliberal program that benefits some individuals at the expense of others. Instead of abolishing hierarchies and the oppression that results from them, ectogestation lends itself to perpetuating inequalities at a structural level for the sake of the supposed bodily autonomy of the neoliberal individual. The issue is not with gestation itself, and (...) it cannot be resolved with ectogestation which only serves to disappear the social problem by disappearing the pregnant people who experience them. (shrink)

This chapter addresses the possibility of artificial wombs. The technology of developing a fetus from embryo to birth in an artificial environment is sometimes called “ectogenesis.” Ectogestation, if it comes to fruition, might offer the extraordinary possibility of saving or improving the lives of babies born extremely early, barely halfway through a normal pregnancy. It could also free women from various forms of gender oppression and liberate people from the constraints of anatomy. On the other hand, some feminists worry (...) that this potential technology could undermine the importance of motherhood, render natural child-bearing a luxury, and diminish the value of women’s lives. Like many advances in reproductive medicine and neonatal care, ectogestation is sure to be accompanied by challenging ethical questions. The chapter then considers the ethical implications of ectogestation in neonatal ethics and abortion. (shrink)

Advances in assisted reproductive technologies can give rise to several ethical challenges. One of these challenges occurs when the reproductive desires of two individuals become incompatible and conflict. To address such conflicts, it is important to unbundle different aspects of (non)parenthood and to recognize the corresponding reproductive rights. This article starts on the premise that the six reproductive rights—the right (not) to be a gestational, genetic, and social parent—are negative rights that do not entail a right to assistance. Since terminating (...) or continuing a pregnancy is a form of assistance, the right (not) to be a gestational parent should enjoy primacy in conflicts. However, while refusing assistance may hinder the reproductive project of another person, “prior assistance” does not entitle someone to violate a reproductive right. Therefore, our analysis provides reasons to argue that someone has a right to unilaterally use cryopreserved embryos or continue the development of an entity in an extracorporeal gestative environment (i.e., ectogestation). Although this could lead to a violation of the right not to be a genetic parent, it does not necessarily entail a violation of the right not to be a social parent. (shrink)

Ectogestation, also known as Artificial Womb Technology (AWT), is a revolutionary reproductive technology that is poised to be one of the greatest innovations of our time. However, like most novel technologies, the potential for egregious harm cannot be ignored. In the United States, a country plagued by racist, heteronormative, capitalistic ideology, ectogestation presents a gateway for the severance of parental rights for Black and marginalized pregnant people. Drawing on key scholarship, we first retell the historical devaluation of Black (...) motherhood through social and legal avenues and then connect these to the disproportionality crisis in the Child Welfare system in the United States. Against this background, we then describe contemporary cases of women who were victimized by the medico-legal system, had their bodily autonomy violated, and had their children removed from their custody. We use these cases to demonstrate that the conditions necessary for ectogestation to be used for fetal removal are already in place. Ectogestation thus, can be used to further the separation of families and the severance of parental rights in marginalized communities. We then offer recommendations for preemptive action to prohibit the misuse of ectogestation should it become available in the future. (shrink)

Artificial placenta technologies (also termed ‘artificial wombs’) for use in place of conventional neonatal intensive care are increasingly closer to first-in-human use. There is growing ethical interest in partial ectogestation (the use of an artificial placenta to continue gestation of an underdeveloped human entity extra uterum), however, there has been little reflection on the ethical issues in the design of the technology. While some have noted the importance of such reflection, and others have noted that a ‘value sensitive design’ (...) approach should be preferred, they have not elaborated on what this means. In this article, we consider what a value sensitive design approach to artificial placenta design might encompass. We believe that applying this framework to the topic at hand raises theoretical and substantive ethical questions that merit further elucidation. Highlighting that there is a careful need to separate preferences from values and that our intervention should be considered only a starting point, we explore some of the values that could be used to make ethical design choices about the artificial placenta: efficacy, compassion and accessibility. (shrink)

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.

A large body of literature considers the ethico-legal and regulatory issues surrounding assisted conception. Surrogacy, however, within this body of literature is an odd-fit. It involves a unique demand of another person—a form of reproductive labour—that many other aspects of assisted conception, such as gamete donation do not involve. Surrogacy is a form of assisted gestation. The potential alternatives for individuals who want a genetically related child but who do not have the capacity to gestate are ever increasing: with the (...) advent of uterus transplantation, and the anticipated development of artificial placentas.In this paper, I highlight the pertinent conceptual differences between technologies assisting conception and those assisting gestation to demonstrate that distinct issues arise when assisted gestative technologies are used. I argue that there is utility in considering AGTs as a genus of technologies. These technologies perform the same function from the perspective of putative parents and might exist on a spectrum of alternatives when they become more available. Moreover, since many of the same or very similar ethical, social and legal issues are raised by surrogacy, UTx and ectogestation, analysis of these issues will be better contextualised by considering these technologies together. Many of the matters currently being highlighted for reform in the context of surrogacy will inevitably impact on how other forms of assisted gestation are governed. The conversation should be broadened; we should consider how far other emerging technologies might be accommodated in revised regulatory schemes. (shrink)

We are all the result of gestation: the process of becoming before birth. The very nature of human gestation, however, has shifted and will continue to shift as a result of technology. Uterus transplantation and ectogestation, and the novel modalities of gestation beyond sex and beyond bodies that they potentially make possible, raise unique conceptual problems that have received little attention. -/- Biotechnology, Gestation and the Law presents the first comprehensive ethico-legal analysis of the nature of gestation and of (...) technologies enabling gestation, offering a concept analysis grounded in ontology, phenomenology, politics, and law. The first three chapters develop a transdisciplinary approach for identifying and exploring the ethical issues raised by uterus transplantation and ectogestation. This addresses the ontological and legal confusion about what gestation is, how we should classify procreative technologies in relation to gestation, and why it is important to have precise classification. The remaining chapters use this framework to undertake a rigorous examination of pressing socio-legal implications of uterus transplantation and ectogestation: who has access to technologies enabling gestation and under what circumstances? Who is/are the parent/s when novel forms of gestation are used? How do these technologies disrupt our notions of reproductive biosex and are they tools of emancipation from gendered roles? This book, and the original conceptual lens it sets out, forges a new direction for legal and social reform directed at addressing the harms of constructed gendered procreative and parenting roles. In speculating about future possibilities, Elizabeth Chloe Romanis brings visibility to the oppressive propagation of biological essentialism that underpins the contemporary regulation of human procreation, and considers how to address this issue now and into the future. (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)

I am grateful to James Cordeiro, Timothy Murphy, Heloise Robinson and Teresa Baron for their perceptive and stimulating comments on my article in this journal. 1 In what follows, I seek to respond to some of the main points raised in each commentary. Cordeiro examines the implications of various forms of ectogestation for the gestational versus moral parenthood debate by contrasting it with in vivo (natural) gestation. 2 His analysis considers the gestating mother’s and biological father’s parenthood claims in (...) light of various outcomes and the burdens and harms ectogestation may impose on them and on the fetus and newborn. I think his analysis helps to illustrate that—even if gestation does not necessarily give rise to a non-instrumentally valuable good in the form of an intimate relationship—corresponding pro tanto claims to moral parenthood might be settled by appeal to harms of ectogestation itself or voluntaristic considerations. Murphy... (shrink)

Debate on whether ectogenesis is a morally desirable solution to gender inequality often starts by analyzing whether gender inequality has been caused by (i) reproductive differences between the sexes or (ii) social structures. I term these two sides the biological model and the social model. Without taking either side, this article contends that both models provide a fragile foundation for assessing the moral desirability of ectogenesis. I draw on Ronald Dworkin's luck egalitarian theory and Ron Amundson's perspective to demonstrate that (...) both models are inherently interactionist and share the view that society's inadequate response to female reproductive traits is crucial in gender oppression. Actions on either biological or social factors are prima facie valid. Meanwhile, neither model can conclusively determine whether ectogenesis is morally desirable. (shrink)

ABSTRACT Most existing literature on the ethics of full ectogenesis has proceeded under the presupposition that science will at some point produce sophisticated technologies for full‐term gestation (from embryo to infant) outside the human womb, delivering neonate health outcomes comparable with (or even superior to) biological gestation. However, the development of this technology—as opposed to the support systems currently being advanced—would require human subject experiments in embryo‐onwards development using ectogenic prototypes. Literature on ectogenic research ethics has so far focused on (...) ‘backwards’ development of partial ectogenesis: incubation and ectogestation technologies that would allow the support of earlier and earlier neonates and foetuses. However, little has been said about the ethics of ‘forwards’ development of (partial or full) ectogenesis, involving the development of embryos and foetuses in prototype environments. Such a prototype might allow us to produce a gestateling or live neonate from a human embryo, but with poorer expected development and health outcomes than from biological gestation; it might also produce only gestatelings (healthy or otherwise) before the technology was developed to a stage where full‐term gestation was achievable. This paper explicates some of the ethical issues that this raises for the development of ‘full’ ectogenesis, and presents prima facie reasons to consider this research problematic and therefore to require extensive further argument in its defence. (shrink)

Elizabeth Chloe Romanis argues that surrogacy, uterine transplantation (UTx) and ectogestation belong to a genus of ‘assisted gestative technologies” (“AGTs”).1 These technologies are conceptually distinct from assisted reproductive technologies (ARTs) in that they support gestation rather than conception. Romanis argues that they also raise some overlapping ethical and policy issues that are best appreciated by ‘considering these technologies together’, thus placing the issues that AGT’s share at the forefront of ethical analysis. The neologism ‘AGTs’ picks out a distinctive and (...) important category of technologies, and there is value in considering the ethical parallels between various AGT’s. However, the category of AGTs should provide neither the only nor the main level of ethical analysis. Surrogacy, UTx and ectogestation share important parallels not only with each other but also with other practices; indeed, some of these parallels are stronger than those AGT’s share with each other. Consider ectogestation. One striking implication of ‘artificial placentas’ is that they may make it possible to terminate a pregnancy without causing the death of the fetus. This is noteworthy in part because it threatens to disrupt one influential defence of abortion rights: that they are protected by something like a moral right to bodily integrity. Once fetuses can be transferred to artificial wombs, bodily integrity would no longer support a …. (shrink)

Ectogenesis technology would make it possible to support the complete gestational development of a human being outside the female body. Proponents argue that this technology offers a welcome opportunity to expand reproductive options for those unable or unwilling to gestate. However, by completely bypassing pregnancy, the use of ectogenesis prevents the formation of gestational family ties. Consequently, it has faced criticism for perpetuating a patriarchal view of the family that undermines the moral significance of gestation. The concern is that the (...) introduction of this technology might result in the loss of reproductive autonomy for those who desire to experience pregnancy, as they face pressures to opt for ectogenesis instead. Existing accounts of family values define parents' rights to rear a child, but they fail to establish a right to gestate that can protect an individual's interest in bearing a child. To provide a more comprehensive account of family values, I argue that pregnancy involves a unique quality of intimacy and can make distinct contributions to one's flourishing. Based on this premise, I defend a fundamental moral right to gestate that can help safeguard the option of pregnancy for those who desire it. In conclusion, I consider how a prospective gestator need not provide optimal conditions for fetal development in the way that ectogenesis promises in order for their choice of pregnancy to be justified. (shrink)

Joshua Shaw argues that one common belief among abortion opponents—that embryos possess full moral status—is inconsistent with their support for ‘parent-friendly’ in vitro fertilisation (IVF) policies, that allow the production of surplus embryos (which are then stored indefinitely or destroyed). These abortion opponents, Shaw argues, should conclude that it is morally objectionable to destroy, discard, or freeze embryos indefinitely. Thus, they should reject current IVF practices and should consider the millions of frozen embryos that currently exist to be an urgent (...) moral crisis. Yet, Shaw notes, many abortion opponents support ‘parent-friendly’ IVF. This raises doubts over their commitment to the claim that embryos possess full moral status. Shaw continues that, contrary to some scholars’ suggestions, artificial-gestation technologies—which could, theoretically, be used to “rescue” surplus embryos—are unlikely to resolve this tension. In fact, they seem likely to increase the number of surplus embryos, worsening existing problems. We agree with Shaw that if embryos possess full moral status, then current ‘parent-friendly’ IVF practices are morally objectionable. We also agree that artificial womb technology cannot change this fact. What those technologies could do, however, is (eventually) rescue frozen embryos that currently exist. Thus, we argue abortion opponents should do two things. First, advocate to alter current ‘parent-friendly’ IVF practices in more ‘embryo-friendly’ ways. Second, advocate to keep existing surplus embryos frozen until they may be rescued. (shrink)

Romanis has written another interesting and important paper on reproductive ethics entitled assisted gestative technologies.1 In this short commentary, I continue the discussion on the question of who should have access to AGTs. This commentary should not be understood as a critical reply but as a friendly extension of one of the paper’s themes. I am not trying to solve the question of who should have access to these technologies but I put forth some groundwork for future work. Romanis calls (...) AGTs new technologies that allow people to undertake gestation involving technological intervention—or to have another person or a device perform the reproductive and gestational labour on their behalf. People using AGTs might or might not use their own genetic material for reproduction. Romanis argues that these AGTs—such as uterus transplantation or artificial wombs—collectively raise ethical, legal and social issues that are distinct for example from assisted conception. One important question related to AGTs is who should have access to such technologies. This is crucial especially …. (shrink)

Artificial womb (AW) prototypes are currently being developed with the aim of improving the medical care of extremely premature infants. Despite the seemingly imminent reality of partial ectogenesis (i.e., gestation partially outside a human womb), there is persisting debate about the moral status of the fetus transferred in an AW—henceforth, the “developing entity.” For some, AWs are simply another neonatal intensive cares’ technology. Thus, developing entities in AWs should deserve the same protections as newborns in incubators. Others consider that AWs (...) are fundamentally different technologies than incubators. Therefore, they believe that developing entities in AWs are new moral entities. These differences in perception generate disagreement about how developing entities in AWs should be treated and how decisions about them should be made. We argue that developing entities in AWs should be considered patients by transposing Chervenak and McCullough's “The fetus as a patient” proposition to the context of partial ectogenesis. As pregnant persons will have to consent to transfer their fetuses in AWs, and this technology will ultimately present itself as a beneficial medical intervention for viable developing entities in AWs, these latter would be patients, even if they are not legally and morally recognized as person. Thus, the moral obligations of beneficence and non‐maleficence owed by physicians to their patients would apply to entities in AWs, ethically guiding their treatment and decision‐making toward them. (shrink)