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)

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)

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)

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 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.

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)

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)

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)

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

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)

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 (...) class='Hi'>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)

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)

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)

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)

In this paper, I argue that the development of an artificial womb is already well on its way. By putting together pieces of information arising from new scientific advances in different areas, (neo-natal care, gynecology, embryology, the human genome project and computer science), I delineate a distinctive picture, which clearly suggests that the artificial womb may become a reality sooner than we may think. Currently, there is a huge gap between the first stages of gestation (using in vitro fertilization) and (...) the 22nd week (inside the womb). At the present time this gap seems an insurmountable barrier for fully developing a fetus outside a natural womb – a notion better known as ectogenesis. The history of science however, suggests that impenetrable barriers are such only temporarily. It is just a matter of time (and due research) until someone – intentionally or by chance – accesses the right answer and finds a way to overcome existing obstacles. Despite misgivings that the case of the artificial womb presents too many barriers, it would be naïve to suppose things would happen any differently. I observe in this paper, that it is time to acknowledge the consequences of new developments in different areas of scientific research which are leading to the advent of an artificial womb; and I modestly suggest that we might initiate a discussion on this topic now, while we have still enough time to decide what we may want and why. (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)

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)

Giulia Cavaliere disagrees with claims that ectogenesis will increase equality and freedom for women, arguing that they often ignore social context and consequently fail to recognise that ectogenesis may not benefit women or it may only benefit a small subset of already privileged women. In this commentary, I will contextualise her argument within the broader cultural milieu to highlight the pattern of reproductive advancements and technologies, such as egg freezing and birth control, being presented as the panacea (...) for women’s inequality. While these advancements and technologies can benefit women, I argue medicine is not the best tool to ‘cure’ social problems and should not be co-opted as an agent of social change. Systemic social changes, not just technomedical approaches, are needed to address the root of gender inequality, which is social in nature, not medical. (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)

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)

Procreative obligations are often discussed by evaluating only the consequences of reproductive actions or omissions; less attention is paid to the moral role of intentions and attitudes. In this paper, I assess whether intentions and attitudes can contribute to defining our moral obligations with regard to assisted reproductive technologies already available, such as preimplantation genetic diagnosis (PGD), and those that may be available in future, such as reproductive genome editing and ectogenesis, in a way compatible with (...) person‐affecting constraints. I propose the parent–child relationship argument, which is based on the moral distinction between creating and parenting a child. Hence, I first argue that intentions and attitudes can play a role in defining our moral obligations in reproductive decisions involving PGD. Second, I maintain that if we accept this and recognize reproductive genome editing and ectogenesis as person‐affecting procedures, we should be committed to arguing that prospective parents may have moral reasons to prefer reproduction via such techniques than via sexual intercourse. In both cases, I observe an extension of our procreative responsibility beyond what is proposed by the consequentialist person‐affecting morality. (shrink)

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)

Many years ago, the esteemed patriarch of bioethics, Joseph Fletcher, spoke loud and clear in favor of rationality in reproduction. By rationality, he meant not merely limiting population growth, which he certainly favored, but bringing to bear human analytic and creative intelligence on the random and instinctive activities of sexual intercourse and procreation that we share with all mammals. In his 1974 book, The Ethics of Genetic Control: Ending Reproductive Roulette, he foresaw most of the issues that we are (...) facing today. He reflected on artificial insemination, prenatal diagnosis, cloning, eugenics, ectogenesis, ovum transfers, and genetic engineering. He examined these innovations to the extent that he felt that each of them represents a way of exercising rational and responsible control over life and reproduction. The subtitle of his book, “Ending Reproductive Roulette,” proclaims his faith. Dr. Fletcher's dedication to rationality led him to make the astonishing statement, “Man is a maker and the more rationally contrived and deliberate anything is, the more human it is. Therefore, laboratory reproduction is radically human compared to conception by ordinary heterosexual intercourse.”. (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)

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)

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)

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)

A growing body of scholarship argues that by disentangling gestation from the body, artificial wombs will alter the relationship between men, women, and fetuses such that reproduction is effectively ‘degendered’. Scholars have claimed that this purported ‘degendering’ of gestation will subsequently create greater equity between men and women. I argue that, contrary to the assumptions made in this literature, it is law, not biology, that acts as a primary barrier to the ‘degendering’ of gestation. With reference to contemporary case law (...) involving disputes over frozen embryos, I demonstrate that though reproductive technologies have already made it possible for gendered progenitors to have an ‘equal’ say in gestation, law mires the possibilities of these technologies in traditional stories of gendered parenthood. Looking to the way binary assumptions about gender limit the self-determination of trans men and nonbinary and genderqueer people who are gestational parents, I argue the ‘degendering’ of gestation will come not with artificial wombs but with the end of limited legal paradigms for gendered gestational parenthood. (shrink)

Reproductive biotechnologies can separate concepts of parenthood into genetic, gestational and social dimensions, often leading to a fragmentation of heteronormative kinship models and posing a challenge to historical methods of establishing legal and/or moral parenthood. Using fictional cases, this article will demonstrate that the issues surrounding the intersection of current and emerging reproductive biotechnologies with definitions of parenthood are already leading to confusion regarding social and legal family ties for offspring, which is only expected to increase as new (...) technologies develop. Rather than opposing these new technologies to reassert traditional concepts of the family, however, this article will explore the opportunities that these technologies represent for re‐imagining various culturally cherished values of family‐making in a way that is inclusive of diverse genders, sexualities and cultures. It will consider IVF, gametogenesis, mitochondrial donation, surrogacy, artificial gestation, CRISPR‐Cas9 gene editing, foster care and adoption as some of many possible pathways to parenthood, including for members of the LGBTIAUQ+ community. (shrink)

Ectogenesis, the gestation of the foetus outside of the human body, will not for much longer be in the realm of science fiction; a number of projects attempting to develop ectogenetic technology are currently under way. This book examines the ethical implications of the development of ectogenesis. Examining the implications for abortion ethics in particular, this book also deals with the ethical objections to developing such a technology and the uses to which it may be put, such as (...) creating embryos to supply donor organs for transplantation. The development of the artificial uterus may well be similar to cloning: a sudden technological advance with dramatic ethical implications, thrust suddenly into the public eye. (shrink)

According to Chloe Romanis, it is worth distinguishing interventions such as surrogacy, uterus transplantation (UTx), and potentially artificial placenta technology, as falling under the genus assisted gestative technologies (AGTs) rather than the more general term assisted reproductive technologies (ARTs). The proposed genus of assisted gestative technologies is a helpful first step in the endeavour to distinguish between the different ethico-legal landscapes across various ‘assisted reproductive technologies.’ Yet, if assisted gestative technologies can be considered a genus of assisted (...) class='Hi'>reproductive technologies, we might consider surrogacy, uterus transplantation (UTx), and artificial placenta technology their individual species. Between these various species of AGTs, I would argue, there remains enough ethico-legal diversity to warrant independent discussion about the descriptive and normative functions of each AGT and the relationship between gestation, genetic relatedness, and legal/moral parenthood. (shrink)

This chapter explores current and prospective reproductive technologies and some of their likely implications for reproductive and family ethics and policymaking. The technologies discussed include uterus transplants, mitochondrial transfer, ectogenesis, the development of in vitro gametes, and solo reproduction. The chapter considers the impact of these developments on the content of concepts such as 'infertility', 'mother', or 'father'. Another layer to this process of redefinition originates in ongoing socio-cultural changes that shift the focus in parenting from the (...) way in which children have come into the world, to relationships within the family. Considering these scenarios beforehand can help to clarify some of the current challenges in defining and regulating infertility. The chapter therefore aims to raise a number of questions rather than provide answers. (shrink)

I am happy to comment on T S Petersen’s1 examination of the ‘individualization argument against non-medical egg freezing ’. Petersen intervenes in the ethical discussion on egg freezing by critically reconsidering a specific type of argument against oocyte cryopreservation for reasons that are not directly related with medical issues. Petersen dissects the claim that such non-medical usage is ‘an individualistic and morally problematic solution to the social problems that women face, for instance, in the labour market’.1 Proponents of this argument (...) believe that egg freezing should not be used by women on an individual level to solve social problems but that one should instead address gendered inequalities on the labour market. Petersen asserts that this individualisation argument is unconvincing—although morally appealing—because of empirically and ethically flawed assumptions. I am enthusiastic—with some minor reservations—about his unravelment of the individualisation argument and his call for more empirical backing. As I understand his presentation, the argument that is the subject of Petersen’s analysis is a recurring argumentative trope in the broader realm of assisted reproduction ethics. For instance, the anticipated positive effect of artificial womb technology in terms of liberation from reproductive and related social inequalities is one of the most dominant ectogenesis …. (shrink)

In the future, full ectogestation – in which artificial placenta technology would be used to carry out the entirety of gestation – could be an alternative to human pregnancy. This article analyzes some underexplored objections to ectogestation which relate to the possibility for new and continuing forms of social oppression. In particular, we examine whether ectogestation could be linked to an unwarranted de-valuing of certain aspects of female reproductive embodiment, or exacerbate objectionable kinds of scrutiny over the reproductive (...) choices of gestating persons. Without discounting the potential benefits of full ectogestation, we conclude that the socially oppressive potential of ectogestation, on top of other concerns, warrants further critical ethical reflection. (shrink)

The theme of human extinction is increasingly at the center of the current debate on moral philosophy and bioethics. We look at space missions and station construction projects capable of accommodating a large population and at the colonization of other planets with great hope. However, solutions are not excluded either, which for now certainly appear to be much more original. One of the most original projects involves launching a spacecraft containing cryopreserved human embryos, which, once they arrive at destination on (...) another planet, must be thawed and birthed by intelligent machines through artificial wombs (ectogenesis). In this paper, I do not intend to analyze whether the embryo space colonization project is indeed feasible. Instead, I will focus on examining the primary moral questions raised by the embryo space colonization project to determine whether, at least prima facie, it can be deemed morally acceptable. I will begin by discussing the objection advanced by Konrad Szocik (2021), according to which any embryo space colonization project is doomed to failure because it cannot offer the hoped-for solution to the problem of the extinction of the human species (second paragraph). In the third paragraph, then, I will ask whether embryo space colonization is able to ensure the people it brings into the world an adequate or at least the morally appropriate quality of life. Finally, in the fourth and last paragraph, I will examine the question of the morality of human reproduction that passes through the guidance and choice of intelligent machines. I will argue that to evaluate the morality of this project we should consider not only the interests and quality of life of the first people who could be born but also the interests of all possible subsequent generations. (shrink)

In her recent paper, Emanuele Mangione proposes combining maternal spindle transfer (MST) and reciprocal effortless in vitro fertilisation (ReIVF) to enable both females to have genetic and gestational ties with the same child, which can particularly benefit lesbian couples. This response rejects Mangione’s proposal for the reason that the additional biological ties created by MST+ReIVF, compared with the reception of oocytes from partner (ROPA), are unnecessary. ROPA is currently the most effective method for redistributing biological ties within lesbian couples, allowing (...) one member to provide the egg and the other to carry the fetus. The additional biological ties created by MST+ReIVF are quantitatively too small to significantly enhance parental bonding or couple relationships, and their potential harms to both prospective parents and children outweigh any minor benefits. Furthermore, like ROPA, MST+ReIVF fails to address deeper feminist concerns. Therefore, I propose a new idea: combining in vitro gametogenesis with ectogenesis, which can offer far more reproductive choices and greater potential to address deeper feminist concerns than MST+ReIVF. (shrink)

The author examines two open questions for religious ethicists: whether continuing to have children is a bad idea, given the challenges of antinatalism and climate change, and how we should evaluate the future of reproductive technology. Kao responds to these questions without resolving them by drawing upon human rights, the reproductive justice framework, and principles of social justice.

This article revisits the question of ectogenesis (out-of-body gestation) as our neonatal care and biogenetic technologies bring us closer to the possibility. In 1923, J.B.S. Haldane wrote approvingly of ectogenesis as a eugenic technique, using a science fiction format. In the 1970s and 1980s, feminists debated whether ectogenesis, if possible, would be liberating or oppressive for women. Given current legal and bioethical issues, we must now take seriously the possible costs of ectogenesis: the possibility of growing (...) bodies for use as spare parts, the erosion of the autonomy of women in the reproductive process, the denigration of the body through the loss of the physicality of pregnancy and childbirth. (Abstract prepared by Aaron Lee.). (shrink)

The introduction of contraceptive technologies hasresulted in the separation of sex and procreation. Theintroduction of new reproductive technologies (mainlyIVF and embryo transfer) has led not only to theseparation of procreation and sex, but also to there-definition of the terms mother and family.For the purpose of this essay, I will distinguishbetween:1. the genetic mother – the donor of the egg;2. the gestational mother – she who bears and gives birth to the baby;3. the social mother – the woman who raises (...) the child.This essay will deal only with the form of gestationalsurrogacy in which the genetic parents intend to bethe social parents, and the surrogate mother has nogenetic relationship to the child she bears anddelivers. I will raise questions regarding medicalethical aspects of surrogacy and the obligation(s) ofthe physician(s) to the parties involved. I will arguethat the gestational surrogate is a womb to rent,that there is great similarity between gestationalcommercial surrogacy and organ transplant marketing.Furthermore, despite claims to freedom of choice andfree marketing, I will claim that gestationalsurrogacy is a form of prostitution and slavery,exploitation of the poor and needy by those who arebetter off. The right to be a parent, although notconstitutional, is intuitive and deeply rooted.However, the issue remains whether this rightoverrules all other rights, and at what price to theparties involved. I will finally raise the followingprovocative question to society: In the interim periodbetween today''s limited technology and tomorrow''sextra-corporeal gestation technology (ectogenesis),should utilizing females in PVS (persistent vehetativestate) for gestational surrogacy be sociallyacceptable/permissible – provided they have leftpermission in writing? (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)

Pregnancy has a profound impact on individuals’ lives, yet the subjective experience is often absent from the discourse on reproductive rights and ethics. Although pregnancy is an epistemically transformative experience, phenomenology can help us describe common structures in the many different subjective experiences of pregnancy. Doing so shows us that the effects of pregnancy go beyond the physical symptoms; they invade the experience of the self and the world and transform identity. If someone wants to formulate an argument against (...) abortion, they will have to include the existential impact of pregnancy. In this paper I will further explore the impact of pregnancy through a phenomenological analysis of birth and birthmothers and show that the existential impact of pregnancy does not cease to exist after birth. Giving birth fundamentally changes the world of the pregnant person and leads to irreversible changes in identity. Their world will never return to the way it was before pregnancy. Arguments against abortion would have to take these existential implications into account as well. Finally, I will argue that a similar argument will also become relevant in the discourse on ectogenesis. (shrink)

The Human Fertilisation and Embryology Act 2008: a missed opportunity?Amel AlghraniCorrespondence to Dr Amel Alghrani, Institute for Science, Ethics and Innovation, Centre for Social Ethics and Policy, School of Law, University of Manchester, Oxford Road, Manchester, M13 9PL; [email protected] 16 September 2009 Accepted 24 September 2009 Regulating reproduction is no easy feat. In the past three decades we have witnessed a reproductive revolution and great strides have been made to alleviate the effects of infertility. Reproductive advances such as (...) in-vitro fertilisation , sex selection, reproductive cloning and embryo selection for the purpose of creating “saviour siblings” have all emerged as part of a rapid and ever-changing branch of medicine, each promising to upset the status quo and transform human reproduction.Following much activity in this area, the lengthy process of updating the legislation is now complete. The Human Fertilisation and Embryology Act 2008 received Royal Assent on 13 November 2008. The majority of the HFE Act 2008’s amendments will come into force in October of this year, with the exception of the provisions pertaining to parenthood, which commenced in April 2009. Welcoming Royal Assent, Professor Lisa Jardine, Chair of the Human Fertilisation and Embryology Authority, stated:“This is a momentous day for the HFEA and for those with fertility problems. The regulatory system that has served us so well has been renewed. Parliament has provided a clear framework for the future and a solid base on which to regulate 21st century practice within 21st century law.”1However, as scientific endeavours into developments such as artificial gametes, womb transplantation and ectogenesis continue apace, it could be argued that Jardine was perhaps overly optimistic about the achievements of the new legislation. The HFE Act 2008 is an amending statute, and as Jackson 2 notes “much of the regulatory architecture” in the 1990 legislation “remains intact”. In retaining the architecture of the 1990 legislation, and merely amending or adding certain provisions, has the government missed an ideal opportunity to consider how to equip the regulatory framework for the next phase/era of assisted reproduction?The next …. (shrink)

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)

The author's goal in this article is to develop an argument for why women should have a right to abortion-as-termination even if some form of ectogenesis is created. First, the author shows why ectogenesis as an alternative to abortion does not protect women's bodily autonomy because women are being forced to submit to coerced medical treatment and perform reproductive labor for others. Second, the author considers a further implication of her argument: If abortion-as-termination is kept, how far (...) into gestation should this right extend? Third, and finally, the author considers whether people have the right to refuse genetic parenthood. (shrink)

The past few years has seen a resurgence in the public interest in space flight and travel. Spurred mainly by the likes of technology billionaires like Elon Musk and Jeff Bezos, the topic poses both unique scientific as well as ethical challenges. This paper looks at the concept of generation ships, conceptual behemoth ships whose goal is to bring a group of human settlers to distant exoplanets. These ships are designed to host multiple generations of people who will be born, (...) live, and die on these ships long before it reaches its destination. This paper takes reproductive ethics as its lens to look at how genetic enhancement interventions can and should be used not only to ensure that future generations of offspring on the ships, and eventual exoplanet colonies, live a minimally good life but that their births are contingent on them living genuinely good and fulfilling lives. The paper makes the further claim that if such a thesis holds, it also does so for human enhancement on Earth. (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)