Ectogenesis, or “artificial womb technology,” has been heralded by some, such as prominent feminist Shulamith Firestone, as a way to liberate women. In this chapter, we challenge this view by offering an alternative analysis of the technology as relying upon and perpetuating a problematic model of pregnancy which, rather than liberating women, serves to devalue them. We look to metaphysics as the abstract study of reality to elucidate how the entities in a pregnancy are related to one another. We (...) consider two models of the metaphysics of pregnancy: (1) the Parthood Model, whereby the fetus is a part of what/who gestates it; and (2) and the Fetal Container Model, whereby the gestator is a container for the fetus. We suggest that under the assumption of the Fetal Container Model, we are more likely to think that any container will suffice for gestation, even an artificial one. In contrast, under the assumption of the Parthood Model, we are less likely to treat the gestator as interchangeable or replaceable, given the parthood relationship between gestator and fetus. This chapter argues that ectogenesis is conceptually linked to the Fetal Container Model and advocates a more cautious approach in promoting ectogenesis as a tool for women’s liberation. (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)

In a recent article in this journal, Kathryn MacKay advances a defence of ectogenesis that is grounded in this technology’s potential to end—or at least mitigate the effects of—gender‐based oppression. MacKay raises important issues concerning the socialization of women as ‘mothers’, and the harms that this socialization causes. She also considers ectogenesis as an ethically preferable alternative to gestational surrogacy and uterine transplantation, one that is less harmful to women and less subject to being co‐opted to further oppressive (...) ends. In this article, I challenge some of the assumptions that underlie MacKay’s case in favour of ectogenesis by questioning whether the relationship between women’s capacity to gestate and birth children and gender‐based oppression is as strong as MacKay makes it out to be. I subsequently argue that—even if MacKay’s reading of this relationship is accurate—ectogenesis is not a desirable means to end gender‐based oppression. It embodies a strategy that could be used to pursue liberating projects that follow what Iris Marion Young defines as ‘the ideal of assimilation’, but that must be resisted. I then concur with MacKay’s contention that ectogenesis is better than gestational surrogacy and uterine transplantation. My argument is that many of the problematic issues that MacKay herself sees as features of these practices will not disappear with ectogenesis. Finally, I conclude that MacKay’s narrow focus on women’s biology and ectogenesis as a solution to gender‐based oppression results in the overlooking of broader systemic issues that contribute to the upholding of oppressive norms. (shrink)

Many people believe that the abortion debate will end when at some point in the future it will be possible for fetuses to develop outside the womb. Ectogenesis, as this technology is called, would make possible to reconcile pro-life and pro-choice positions. That is because it is commonly believed that there is no right to the death of the fetus if it can be detached alive and gestated in an artificial womb. Recently Eric Mathison and Jeremy Davis defended this (...) position, by arguing against three common arguments for a right to the death of the fetus. I claim that their arguments are mistaken. I argue that there is a right to the death of the fetus because gestating a fetus in an artificial womb when genetic parents refuse it violates their rights not to become a biological parent, their rights to genetic privacy and their property rights. The right to the death of the fetus, however, is not a woman's right but genetic parents’ collective right which only can be used together. (shrink)

Full ectogenesis as the complete externalization of human reproduction by bypassing the bodily processes of gestation and childbirth can be considered the culmination of genetic and reproductive technologies. Despite its still being a hypothetical scenario, it has been discussed for decades as the ultimate means to liberate women from their reproductive tasks in society and hence finally end fundamental gender injustices generally. In the debate about the application of artificial wombs to achieve gender equality, one aspect is barely mentioned (...) but is of crucial relevance from a medical‐ethical perspective: whether and how could full ectogenesis be justified as a proper use of medicine? After characterizing the technology as a special form of human enhancement and as an extension of medical practice that goes beyond the traditional field of medicine, this paper critically assesses the theoretical possibilities of legitimizing this extension. We identify two ways of justification: either one argues that ectogenesis fulfils a proper goal of medicine (a justification we call pathologization), or one argues that the application of ectogenesis achieves a non‐medical goal (which we call medicalization). Because it is important from a medical‐ethical point of view to avoid an inappropriate instrumentalization or misuse of medicine and thus an undue medicalization of non‐medical problems, a set of necessary conditions has to be met. It is doubtful whether full ectogenesis for non‐medical purposes could fulfil these conditions. Rather, its comprehensive usage could be seen as a revolutionary modification of what it means to be human. (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 a well known story Derek Parfit describes a disconnection between two entities that normally (in real life) travel together through space and time, namely your personal identity consisting of both mind and body. Realising the possibility of separation, even if it might never happen in real life, new questions arise that cast doubt on old solutions. In human reproduction, in real life, at present the fetus spends approximately nine months inside the pregnant woman. But, we might envisage other possibilities. (...) Historically, the first era is the normal conception inside the woman, the growth of the fetus in the womb and then, after nine months, birth and the appearance of a new individual. The second era is In Vitro Fertilisation (IVF). The fetus starts outside the woman as a fertilised egg, moves to the body of the woman and spends nine month there, where the body of the woman and the fetus travel together in space-time to separate at birth. In the third era of reproductive ectogenesis, the two never travel together. The fetus spends its gestational time entirely outside the woman’s body. We have two entities separated in space-time the whole time. The intimate connection consisting in the fetus being a part of the woman’s body is gone. (shrink)

The possibility of achieving ectogenesis, or the growing of a human fetus to term in an artificial womb, is approaching reality as a result of advances in treatment of premature newborns and in in vitro fertilization techniques. In their 1984 book, The Reproductive Revolution, issued in North America as Making Babies, Peter Singer and Deane Wells offered several arguments for ectogenesis. James examines their arguments and rejects two of them, that ectogenesis offers a less problematic alternative to (...) surrogate motherhood, and that ectogenesis could make it possible to reconcile fetal rights with the right to abortion on demand. He grants Singer and Wells' argument that the childless have a claim to state support of their desire to nurture, but contends that government-supported ectogenesis should still be rejected because the adoption of unwanted children is a preferable alternative to the use of an exotic, expensive, and still unproven technology. (shrink)

This book raises many moral, legal, social, and political, questions related to possible development, in the near future, of an artificial womb for human use. Is ectogenesis ever morally permissible? If so, under what circumstances? Will ectogenesis enhance or diminish women's reproductive rights and/or their economic opportunities? These are some of the difficult and crucial questions this anthology addresses and attempts to answer.

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)

In this commentary, I consider how Giulia Cavaliere’s arguments about the limited reach of the current justifications offered for full ectogenesis in the bioethical literature apply in the context of partial ectogenesis. I suggest that considering the extent to which partial ectogenesis is freedom or equality promoting is more urgent because of the more realistic prospect of artificial womb technology being utilised to facilitate partial gestation extra uterum as opposed to facilitating complete gestation from conception to term. (...) I highlight concerns about potentially harmful social narratives surrounding pregnancy and about the current legal framework surrounding gestation limiting access to technology in the advent of partial ectogenesis. I do not advocate that these concerns mean that we ought not develop artificial wombs, but like Cavaliere I suggest that we must be mindful of these concerns, and I posit that legal reform must accompany technological developments. Ectogenesis as a political perspective, through which we consider the value in social reproduction and the experiences of pregnant people, is useful to prevent political capture of this technology for regressive policies. Using this perspective to examine the law is also a useful tool to expose just how restrictive the law is in relation to gestation and female reproductive health. (shrink)

As the technology for ectogenesis continues to advance, the ethical implications of such developments should be thoroughly and proactively explored. The possibility of full ectogenesis remains hypothetical at present, and myriad concerns regarding the safety and efficacy of the technology must be evaluated and addressed, while pressing moral considerations should be fully deliberated. However, it is conceivable that the technology may become sufficiently well established in the future and that eventually full ectogenesis might be deemed ethically acceptable (...) as a reproductive alternative to gestation within a human womb under certain circumstances. If the safety and efficacy of full ectogenesis are established, if ethical dilemmas are sufficiently well addressed, and if the technology is offered as a reproductive option to cisgender heterosexual individuals or couples desiring to become parents, there is a moral obligation grounded in social justice to ensure that full ectogenesis be made available to individuals or couples identifying as members of sexual‐ or gender‐minority groups who likewise seek to pursue parenthood. We examine the history of access to current family‐building options, including assisted reproductive technology, surrogacy and adoption, for these populations and conclude that in the absence of robust empirical evidence suggesting an increased risk of harm to children of individuals and couples who identify as members of sexual‐ or gender‐minority groups, equitable access to ectogenesis as a pathway to parenthood for sexual and gender minorities must be assured as a matter of reproductive justice. (shrink)

ABSTRACT The nature of two influential theories on the moral status of abortion logically commits them to welcoming the advent of ectogenesis as a solution to the abortion conflict. However, qualitative research into women's response to ectogenesis reveals that both women in favour and women opposed to abortion rights reject the technology on surprisingly similar grounds. The abortion framework which led women to reject ectogenesis as an ethical resolution to unwanted pregnancy is contrasted with the moral framework (...) which shapes formal ethical discussions of abortion. It is argued that the need for ethical relevance requires the views of ethicists to move closer to those of women [1]. (shrink)

In this paper, we aim to stimulate ethical debate about the morally relevant connection between ectogenesis and the foetus as a potential beneficiary of treatment. Ectogenesis could facilitate foetal interventions by treating the foetus independently of the pregnant woman and provide easier access to the foetus if interventions are required. The moral relevance hereof derives from the observation that, together with other developments in genetic technology and prenatal treatment, this may catalyse the allocation of a patient status to (...) the foetus. The topic of foetal medicine is of growing interest to clinicians, and it also deserves due attention from an ethical perspective. To the extent that these developments contribute to the allocation of a patient status to the foetus, normative questions arise about how moral responsibilities towards foetal interests should be balanced against the interests of the pregnant woman. We conclude that, even if ectogenesis could facilitate foetal therapy, it is important to remain sensitive to the fact that it would not circumvent the key ethical concerns that come with in utero foetal treatment and that it may even exacerbate potential conflicts between directive treatment recommendations and the pregnant woman's autonomous decision to the contrary. (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)

In this discussion note on Michal Pruski and Richard C. Playford’s “Artificial Wombs, Thomson and Abortion – What Might Change?,” I consider whether the prospect of ectogenesis technology would make abortion impermissible. I argue that a Thomson-style defense may not become inapplicable due to the right to life being conceived as a negative right. Further, if Thomson-style defenses do become inapplicable, those who claim that ectogenesis would be an obligatory alternative to abortion cannot do so without first showing (...) that fetuses have a right to life, something that Thomson assumed rather than argued for. I also include a discussion on ethical problems concerning what to do about children born from artificial wombs put there by those who looked to terminate their pregnancies because they sought to avoid parenthood. (shrink)

Michal Pruski and Richard C. Playford argue that if partial ectogenesis technology becomes available then it would undermine Judith Jarvis Thomson’s defense of abortion. Thomson argues that even if a fetus has a right to life, this is not a positive right to be given whatever one needs to survive; it is not a right to use the mother’s body or to risk her life without her permission. Pruski and Playford argue that when the risks involved in ectogenesis (...) are comparable to those of abortion, then minimal decency requires gestational mothers to opt for ectogenesis over abortion. This argument hinges on egregious misunderstandings of (1) ectogenesis technology, (2) medical and surgical abortion, and (3) medical consent. (shrink)

The benefits of full ectogenesis, that is, the gestation of human fetuses outside the maternal womb, for women ground many contemporary authors’ arguments on the ethical desirability of this practice. In this paper, I present and assess two sets of arguments advanced in favour of ectogenesis: arguments stressing ectogenesis’ equality-promoting potential and arguments stressing its freedom-promoting potential. I argue that although successfully grounding a positive case for ectogenesis, these arguments have limitations in terms of their reach (...) and scope. Concerning their limited reach, I contend that ectogenesis will likely benefit a small subset of women and, arguably, not the group who most need to achieve equality and freedom. Concerning their limited scope, I contend that these defences do not pay sufficient attention to the context in which ectogenesis would be developed and that, as a result, they risk leaving the status quo unchanged. After providing examples of these limitations, I move to my proposal concerning the role of ectogenesis in promoting women’s equality and freedom. This proposal builds on Silvia Federici’s, Mariarosa Dalla Costa’s and Selma James’ readings of the international feminist campaign ‘Wages for Housework’. It maintains that the political perspective and provocation that ectogenesis can advance should be considered and defended. (shrink)

Bioethics scholarship considering the possibility of gestating an embryo to full term in an artificial womb (ectogenesis) often overstates the capacities of current technologies and underestimates the barriers to the development of full ectogenesis. Moreover, this debate causes harm by (1) neglecting more immediate problems in the development of artificial wombs, (2) treating abortion as a “problem with a technological solution,” bolstering anti-abortion rhetoric, and (3) presuming the stability of women’s reproductive rights. The ectogenesis conversation must consider (...) anticipated uses of the technology (neonatal intensive care) and acknowledge the immediate context (recognizing abortion as essential healthcare and existing reproductive inequities). (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)

BackgroundBreakthroughs in animal studies make the topic of human application of ectogenesis for medical and non-medical purposes more relevant than ever before. While current data do not yet demonstrate a reasonable expectation of clinical benefit soon, several groups are investigating the feasibility of artificial uteri for extracorporeal human gestation.Main textThis paper offers the first comprehensive and up to date discussion of the most important pros and cons of human ectogenesis in light of clinical application, along with an examination (...) of crucial ethical (and legal) issues that continued research into, and the clinical translation of, ectogenesis gives rise to. The expected benefits include advancing prenatal medicine, improving neonatal intensive care, and providing a novel pathway towards biological parenthood. This comes with important future challenges. Prior to human application, important questions have to be considered concerning translational research, experimental use of human fetuses and appropriate safety testing. Key questions are identified regarding risks to ectogenesis’ subjects, and the physical impact on the pregnant person when transfer from the uterus to the artificial womb is required. Critical issues concerning proportionality have to be considered, also in terms of equity of access, relative to the envisaged application of ectogenesis. The advent of ectogenesis also comes with crucial issues surrounding abortion, extended fetal viability and moral status of the fetus.ConclusionsThe development of human ectogenesis will have numerous implications for clinical practice. Prior to human testing, close consideration should be given to whether (and how) ectogenesis can be introduced as a continuation of existing neonatal care, with due attention to both safety risks to the fetus and pressures on pregnant persons to undergo experimental and/or invasive procedures. Equally important is the societal debate about the acceptable applications of ectogenesis and how access to these usages should be prioritized. It should be anticipated that clinical availability of ectogenesis, possibly first as a way to save extremely premature fetuses, may spark demand for non-medical purposes, like avoiding physical and social burdens of pregnancy. (shrink)

Hendricks set out to construct an antiabortion version of Jeff McMahan’s Embryo Rescue case in which you have two choices—(1) save a woman from an unwilling pregnancy or (2) save a fetus from being killed. In his Pregnancy Rescue case, he contends we ought to choose (2), which he thinks shows abortion is immoral. However, I argue the Pregnancy Rescue case is a false dilemma because you can save both. I propose an alternative, more elegant dilemma, the Ectogenesis Rescue (...) case with the same choices (1) and (2). Hendricks also believes his case can serve as an antiabortion version of Thomson’s Violinist case, showing that abortion is immoral even if a fetus is not a person. However, while Thomson’s Violinist substitutes the fetus with a person, Hendricks fails to substitute the fetus with something that is not a person. I propose an alternative, the Snakebite Rescue case, which does this. (shrink)

We can imagine a world in which ectogenesis provides a safe gestating space that eliminates maternal morbidity and mortality while maximising healthy outcomes for babies. In this world, women, no longer physically—and visibly—pregnant, are no longer economically, socially or physically disadvantaged due to the potential for pregnancy and birth. Because everyone can access the same technology, women are able to work without fear of pregnancy-related discrimination or restrictions, and health disparities among individuals in gestation and birth based on socioeconomic (...) status are eliminated. This imagining allows us to explore the ethical and social underpinnings of such a world, and consider how to achieve it in our current paradigm. Having explored the freedom and equality that is possible in an ideal hypothetical where all have equal access to such technologies, we can now imagine that same world without ectogenesis: women, no longer economically, socially or physically disadvantaged due to pregnancy and birth, despite still becoming pregnant. Such is the potential political perspective and provocation that can be spurred on by discussion of ectogenesis. As Cavaliere argues, the technological reality of ectogenesis may not achieve the freedom and equality that …. (shrink)

The medicalisation of pregnancy and childbirth has been encouraged by the continuing growth of technology that can be applied to the reproductive journey. Technology now has the potential to fully separate reproduction from the human body with the prospect of ectogenesis—the gestation of a fetus outside of the human body. This paper considers the issues that have been caused by the general medicalisation of pregnancy and childbirth and the impact that ectogenesis may have on these existing issues. The (...) medicalisation of pregnancy and childbirth is criticised for its impact on the relationship between doctors and pregnant women and the way in which doctors treat fetuses. It is argued that ectogenesis may cause more imbalance in the doctor and intended parent relationship and may result in an increased lack of clarity regarding a doctor’s duty to the fetus. This paper finds that extensive guidance and revised legislation will be necessary to minimise the impact of ectogenesis on the existing issues caused by the medicalisation of reproduction. (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)

This paper imagines what the liberatory possibilities of (full) ectogenesis are, insofar as it separates woman from female reproductive function. Even before use with human infants, ectogenesis productively disrupts the biological paradigm underlying current gender categories and divisions of labour. I begin by presenting a theory of women’s oppression drawn from the radical feminisms of the 1960s, which sees oppression as deeply rooted in biology. On this view, oppressive social meanings are overlaid upon biology and body, as artefacts (...) of culture and history. I then argue that ectogenesis should be pursued to replace two modes of assisted gestation that can be seen as outgrowths of oppressive assumptions about women's function, ectogenesis should be pursued to replace two modes of assisted gestation. These are gestational surrogacy and uterine transplant, which arise partly from gendered, pronatalist, and geneticist norms. These practices are supported by assumptions about women’s identity and value. Pursuing technologies such as ectogenesis, which weaken the presumed link between biology and gender, is beneficial to (trans-inclusionary radical) feminist aims, as part of a broad project of challenging dominant power relations resting on and maintaining gender categories. By allowing the conceptual separation of female reproductive function from ‘woman’, ectogenesis raises questions about how we determine who counts in this gender identity, and also how we value those who claim the identity ‘woman’. I conclude that ectogenesis has the potential to challenge traditional patriarchal family structures, and thence all other male-dominated structures (of work, education, cultural production), allowing a reimagining of the family and society in more radical ways than we have yet achieved. (shrink)

In this short response, I agree with Cavaliere’s recent invitation to consider ectogenesis, the process of gestation occurring outside the body, as a political perspective and provocation to building a world in which reproductive and care labour are more justly distributed. But I argue that much of the literature Cavaliere addresses in which scholars argue that artificial wombs may produce greater gender equality has the limitation of taking a fixed, binary and biological approach to sex and gender. I argue (...) that in taking steps toward the possibility of more just practices of caregiving and family making, we must look first not to artificial womb technologies but to addressing the ways that contemporary legal and social practices that enforce essentialising, binary ways of thinking about reproductive bodies inhibit this goal. (shrink)

edited by Tuija Takala and Matti Häyry, welcomes contributions on the conceptual and theoretical dimensions of bioethics.

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)

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.

While artificial womb technology is currently being studied for the purpose of improving neonatal care, I contend that this technology ought to be pursued as a means to address the unprecedented rate of unintended pregnancies. But ectogenesis, alongside other emerging reproductive technologies, is problematic insofar as it threatens to disrupt the natural link between procreation and parenthood that is normally thought to generate rights and responsibilities for biological parents. I argue that there remains only one potentially viable account of (...) parenthood: the voluntarist account, which construes parental rights as robust moral obligations that must be voluntarily undertaken. The problem is that this account mistakenly presumes a patriarchal divide between procreation and parenthood. I propose a reframing of procreation and parenthood from a feminist perspective that recognises gestational motherhood as involving robust moral obligations that ought to be voluntarily undertaken. If this were the case, all gestational mothers would be, by definition, willing mothers. To make this happen I argue that ectogenesis technology must be a widely available reproductive option. (shrink)

Breastfeeding is analogous to pregnancy as an experience, in its exclusiveness to women, and in its cost and the effects it has on equitable share of labor. Therefore, the history of formula feeding provides useful insights into the future of full ectogenesis, which could evolve into a more severe version of what formula feeding is today: simplify life for some women and provide couples with a more equitable share of work at the cost of stigma, guilt and a daily (...) diet of studies purporting to show the benefits of natural pregnancy. Making pregnancy an optional route to motherhood would make women's life trajectory more similar to men's and thus put pressure on women to compete with men on the ground shaped by men's preferences. Despite being a treasured experience of many women today, bearing children could become the luxury of the few, the province of the very poor and a choice working women will pay a high price for as women who choose pregnancy become stigmatized as self-indulgent or unprofessional and penalized for it in the workplace. At the same time, scarce societal resources that could be used to support pregnant women and working mothers would instead be directed toward proving to women or even forcing them to gestate children "the right way." While not necessarily threatening on its own, when added to formula feeding, IVF, stem-cell produced ova and sex robots, full ectogenesis could diminish men's stake in women's wellbeing and even existence. (shrink)

Let me begin by thanking the Journal of Medical Ethics editors and the four commentators for taking time to read, reflect and offer thoughtful comments on my paper. The issues they raise warrant careful attention. Regrettably, I am only able to address some of their key concerns due to space constraints. In my paper, ‘Gestation, Equality and Freedom: Ectogenesis as a Political Perspective’, I outline two sets of critiques of liberal defences of ectogenesis and contend that these defences (...) are limited in their reach and scope. Building on Federici’s,1 and Dalla Costa’s and James’2 readings of the of the international feminist campaign ‘Wages for Housework’, I argue that the value of ectogenesis is to similarly advance a political perspective and a provocation. Framing ectogenesis in these terms enables to critically engage with the physical and social burdens of pregnancy, childbirth and childrearing, which all too often are borne by women. It also allows to demand for better medical and social services for mothers and women more generally, as well as better working and living conditions for these and other disadvantaged groups. Lisa Campo-Engelstein thoughtfully broadens my reading of liberal defences of ectogenesis and contextualises them within the history of ‘reproductive advancements and technologies’.3 She illustrates that …. (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)

It is a pleasure to comment on Giulia Cavaliere’s ‘ Gestation, Equality and Freedom: Ectogenesis as a Political Perspective’ in what one might say is ‘enthusiastic disagreement’. The enthusiastic part is because the article is deserving of much praise for adding an important feminist and political theoretical perspective on ectogenesis. The disagreement may come more from disciplinary differences or disposition. As I understand her argument, Cavaliere intends to attack two common arguments in favour of research into ectogenesis—that (...) is, gestation of a human fetus outside the womb—one that sounds in the potential of the technology to promote equality, the other that it has the potential to promote liberty. On the first her critique is that the risks and burdens of gestation for women are most pronounced for the worst off, but ectogenesis is unlikely to be used by them. On the second her critique is, i nter alia, that treating ‘ectogenesis as a means to address workplace inequalities calls for solutions that change the way society reproduces itself rather than a labour market …. (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)

The potential benefits of an alternative to physical gestation are numerous. These include providing reproductive options for prospective parents who are unable to establish or maintain a physiological pregnancy, and saving the lives of some infants born prematurely. Ectogenesis could also promote sexual equality in reproduction, and represents a necessary option for women experiencing an unwanted pregnancy who are morally opposed to abortion. Despite these broad, and in some cases unique benefits, one major ethical concern is the potential impact (...) of this emerging technology on abortion rights. This article will argue that ectogenesis poses a challenge to many common arguments in favour of a pregnant woman’s right to choose, but only insomuch as it highlights that their underlying justifications for abortion are based on flawed conceptions of what the foetus and pregnancy actually are. By interrogating the various interests and relationships involved in a pregnancy, this article will demonstrate that the emergence of artificial gestation need not impact existing abortion rights or legislation, nor definitions of independent viability or moral status. (shrink)

edited by Tuija Takala and Matti Häyry, welcomes contributions on the conceptual and theoretical dimensions of bioethics. The section is dedicated to the idea that words defined by bioethicists and others should not be allowed to imprison people's actual concerns, emotions, and thoughts. Papers that expose the many meanings of a concept, describe the different readings of a moral doctrine, or provide an alternative angle to seemingly self-evident issues are therefore particularly appreciated. The themes covered in the section so far (...) include dignity, naturalness, public interest, community, disability, autonomy, parity of reasoning, symbolic appeals, and toleration. All submitted papers are peer reviewed. To submit a paper or to discuss a suitable topic, contact Tuija Takala at [email protected]. (shrink)

Traditionally reproduction, gestation and childbirth have all been regarded as being primarily a woman's domain. As natural reproduction occurs inside a woman's body, respect for autonomy and bodily integrity requires the pregnant woman to have the conclusive say over the fate of the embryo/fetus growing within her. Thus traditionally the ethics and law of reproduction is dominated by the importance of respecting women's reproductive choices. This paper argues that emerging technologies demand a radical rethink of ethics and law in the (...) area of reproduction. The creation and storing of embryos outside of a woman's body and maintaining a pregnancy in a brain dead woman's body and future possibilities such as ectogenesis and male pregnancy raise important issues that cannot simply be answered by appealing to the rights of women to control their bodies. There are those who argue that when reproduction or reproductive products exist outside of a woman's body each gamete donor should have an equal say over the fate of the embryo/fetus. Others, however, argue that giving an equal say to gamete donors in practice usually means allowing the male donor to veto the reproductive enterprise and this is unacceptable. As a result it has been suggested that women should be favoured when it comes to such reproductive choices. This paper examines both sides of this debate in order to answer the fundamental ethical and policy question: 'Is there any reason why women should necessarily retain control over reproduction rather than simply over their own bodies?'. (shrink)

This paper argues that uterine transplants are a potentially dangerous distraction from the development of alternative methods of providing reproductive options for women with absolute uterine factor infertility. We consider two alternatives in particular: the bioengineering of wombs using stem cells and ectogenesis. Whether biologically or mechanically engineered, these womb replacements could provide a way for women to have children, including genetically related offspring for those who would value this possibility. Most importantly, this alternative would avoid the challenge of (...) sourcing wombs for transplant, a practice that we argue would likely be exploitative and unethical. Continued research into bioengineering and ectogenesis will therefore remain morally important despite the recent development of uterine transplantation, even if the procedure reaches routine clinical application. (shrink)

Can discussion with members of the public show philosophers where they have gone wrong? Leslie Cannold argues that it can in her 1995 paper ‘Women, Ectogenesis and Ethical Theory’, which investigates the ways in which women reason about abortion and ectogenesis. In her study, Cannold interviewed female non-philosophers. She divided her participants into separate ‘pro-life’ and ‘pro-choice’ groups and asked them to consider whether the availability of ectogenesis would change their views about the morality of dealing with (...) an unwanted pregnancy. The women in Cannold’s study gave responses that did not map onto the dominant tropes in the philosophical literature. Yet Cannold did not attempt to reason with her participants, and her engagement with the philosophical literature is oddly limited, focussing only on the pro-choice perspective. In this paper, I explore the question of whether Cannold is correct that philosophers’ reasoning about abortion is lacking in some way. I suggest that there are alternative conclusions to be drawn from the data she gathered and that a critical approach is necessary when attempting to undertake philosophy informed by empirical data. (shrink)