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Unique Benefits of Ectogenesis Outweigh Potential Harms Unique benefits of ectogenesis outweigh potential harms Citation of the final article: Kendal, Evie 2019, Unique benefits of ectogenesis outweigh potential harms, Emerging Topics in Life Sciences, vol. 3, no. 6, pp. 719-722. Published in its final form at https://doi.org/10.1042/etls20190112. This is the accepted manuscript. © 2019, The Author Reprinted with permission. Downloaded from DRO: http://hdl.handle.net/10536/DRO/DU:30131603 DRO Deakin Research Online, Deakin University’s Research Repository Deakin University CRICOS Provider Code: 00113B Title Unique benefits of ectogenesis outweigh potential harms. Author details Dr Evie Kendal Lecturer of Bioethics and Health Humanities Deakin University, School of Medicine Waurn Ponds, Victoria, Australia [email protected] Abstract This article will consider some of the ethical issues concerning ectogenesis technology, including possible misuse, social harms and safety risks. The article discusses three common objections to ectogenesis, namely that artificial gestation transgresses nature, risks promoting cloning and genetic engineering of offspring, and would lead to the commodification of children. Counterbalancing these concerns are an appeal to women’s rights, reproductive autonomy, and the rights of the infertile to access appropriate assisted reproductive technologies. The article concludes that the unique benefits of promoting the development of ectogenesis technology to prospective parents and children, outweigh any potential harms. Introduction Full ectogenesis refers to the artificial gestation of human embryos until independent viability, without the need for a woman’s womb at any stage.1 It represents the closing of a gap between existing artificial reproductive technologies, including in vitro fertilisation (IVF) and humidicrib incubation, to cover the entire development period. While only speculative at this time, many scientists working in this field believe the technology could become a reality with sufficient practical and legal support.2 Ethical and social concerns about ectogenesis abound. Chief among them are concerns of “playing god” or transgressing the bounds of nature in reproduction. Similar accusations were levelled at the scientists involved in achieving the first IVF birth.3 Other potential fears include that ectogenesis will be used to create human clones, genetically modify human infants, or create mass‐market baby farms. This article will consider each of these issues in turn, before establishing why the unique benefits of promoting the development of ectogenesis technology outweigh any potential harms. This argument will rest on a defence of reproductive autonomy, women’s health and liberty, and promoting the needs of prospective parents currently unable to achieve their goal of making a family. Objections to ectogenesis Playing god and transgressing nature The first objection to ectogenesis is that artificial gestation represents inappropriate human interference into natural pregnancy and is therefore immoral. Such a view has its historical roots in Catholic dogma, and forms the basis of the Church’s opposition to IVF and most of modern fertility medicine, due to its potential to disturb the “natural” and “sanctified” processes of human reproduction.4 Options for countering this objection either appeal to consistency, e.g. accepting this characterisation would necessitate rejection of treatments already well‐established, such as IVF, or rejecting the premise that such interference would be in conflict with Catholic ideals. The latter has been used to suggest ectogenesis might find some support among religious groups due to its ability to prevent loss of fetal life through abortion or prematurity,5 whereas the former argues that without also opposing partial ectogenesis processes, including incubation of prematurely born infants, this objection lacks strength. Full ectogenesis would merely improve the efficacy and extend the period for which artificial gestation were possible, it would not in itself represent a wholly new form of fetal development ex utero. Furthermore, religious objections to human interference in reproduction imply that chance or fate should play a major role in these processes, a perspective that is difficult to justify when considering the many risks to women and fetuses that could be avoided through artificial gestation in a controlled environment.6 Especially in cases where the use of IVF and/or ectogenesis could prevent significant harm or disease, the suggestion it would be more moral to forego such preventive measures because they transgress certain notions of naturalness is problematic. Human reproductive cloning and genetic engineering For reasons that are not intuitively obvious, opponents of ectogenesis sometimes conflate the issues surrounding this future technology with that of two entirely different processes – human reproductive cloning and genetic engineering.7 A recent example can be seen in the debate between Joona Räsänen and Christopher Kaczor (and others) where the right not to become a genetic parent, e.g. by means of stolen genetic material used to artificially incubate offspring, was considered using the example of a clone of the “wronged” person.8 As both reproductive cloning and genetic engineering involve embryonic, rather than fetal, manipulation, neither requires the use of sophisticated or prolonged artificial gestation. Thus, ectogenesis would not represent a vital methodological step in either of these ethically challenging processes, so even if they were to be banned on moral grounds, this need not justify the continued ban on research into ectogenesis present in many countries.9 At most, ectogenesis might exacerbate existing concerns about cloning and genetic engineering by means of providing a method to mass produce such infants, without the need to engage surrogates to gestate and birth them. However, such a situation could be avoided through regulation of ectogenesis services and limitations to use. Baby farms and the commodification of children At the time of writing, a publication in Nature10 has stirred media interest, with headlines like “Scientists Create a Device That Can Mass‐Produce Human Embryoids” appearing in response to the development of a technology that can rapidly create synthetic analogues for primitive embryos.11 This fear of mass‐producing human life can also be found in debates surrounding ectogenesis, namely, that were the technology realised on a mass scale, it could facilitate the creation of baby farms where prospective parents could simply purchase the baby of their dreams. This would undermine the fundamental social belief that children should not be treated as commodities.12 However, situations in which the wealthy can choose to outsource their gestational labour already exist in commercial surrogacy, where another woman’s body is contracted to gestate the commissioning parents’ offspring. If outsourcing this labour to a machine is considered morally suspect, requiring it of another person must logically be far more so. There is also the practical limitation that full ectogenesis is likely to be very expensive, as even when comparing the costs of gestating a fetus inside the body of a woman on full life support with that of using a humidicrib, physicians have claimed women’s bodies as the “cheapest incubators we have.”13 As such, fears of mass infant production are unlikely to be sustained, but even if they were, this would represent a better option than establishing a mass market of surrogate‐born children, a reality that is already theoretically possible given existing technologies. Put another way, even those who oppose both ectogenesis and surrogacy for their potential role in the commodification of children or gestational labour, might be convinced that the former produces less harm and suffering than the latter. Support for ectogenesis Reproductive autonomy and women’s liberty One of the major arguments in favour of promoting the development of ectogenesis is that it would promote sexual equality in human reproduction and avoid the risks and burdens of pregnancy and childbirth on women. The option of creating biological children without relying on a woman’s body for gestation represents a radical shift in perspective regarding gender roles in society and the family unit.14 Pregnancy carries a number of health risks for women, and no matter how safe it may become, even in the most developed countries women still die in childbirth and from pregnancy‐related complications every year.15 Ectogenesis provides a means to avoid this risk while still achieving the same outcome. Furthermore, providing an alternative to biological gestation enhances reproductive autonomy, both for those who choose to use it and those who do not. At present, most women who “choose” to gestate their biological offspring do so in the absence of a viable alternative, thereby rendering that “choice” redundant. Similarly, women who do not wish to or cannot safely maintain a pregnancy may “choose” to remain childless, but only due to the lack of available substitutes. Thus, even if the predictions of low initial uptake16 prove accurate, the advent of ectogenesis services provides positive choices and increases reproductive autonomy. Potential risks to women’s liberty, such as recent debates that suggest ectogenesis could be used to undermine abortion rights,17 while concerning, can and should be mitigated by strengthening legislation in this area before any release of this technology.
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