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Artificial Wombs: Ethical Reflections on Babies in Bags

In a study [1] published last April, researchers at Children’s Hospital of Philadelphia successfully gestated fetal lambs in artificial wombs referred to as “biobags.”  Although some might be concerned that the breakthrough foreshadows a future where women’s bodies are no longer needed for gestation (known as ectogenesis), the research itself raised no such futuristic scenarios.  It aimed entirely at exploring treatment possibilities for premature babies.

Over one third of infant deaths in the U.S. are attributed to extreme prematurity making it the leading cause of neonatal mortality.  Babies who do survive have an extraordinarily high incidence of severe chronic lung diseases and brain disorders such as cerebral palsy.  Decades of research into forms of neonatal incubation that might spare babies from death or lifelong suffering have gone unsuccessful, until now.

Human viability in developed countries is approximately 23–24 weeks gestation, with 22 weeks the absolute earliest.  The Philadelphia team selected fetal lambs biologically equivalent in age to babies at 22-24 weeks.  The lamb preemies were delivered by C-section and carefully enclosed within soft plastic—“bio”—bags.  Artificial amniotic fluid was gently circulated through the bags to remove toxins.  Tiny tubes, inserted into the fetuses’ umbilical vessels, transported blood out of the biobags on a pumpless circuit where it was oxygenated, picked up fluids and medications, and was returned to the lambs.  (The little fetal hearts alone drove the blood through the circuits.)  The lambs lived and matured for four weeks in the sealed bags.  Their appearance went from pink, hairless and slight to white-woollen, fluffy and robust.  When weaned from the systems, they were found to have no significant organ malformations, including of their lungs, brains and hearts.

If the biobags safely could be adapted for human use, they could save [2] the lives of hundreds of thousands of babies worldwide annually and prevent blindness, deafness, cerebral palsy and other deleterious effects of prematurity in millions more [3].  The team hopes [4] to begin human trials within three to five years.

Practical Ethical Questions

Among Christian ethicists, no substantive objections were raised in the literature towards these remarkable artificial biosystems.  The general consensus was and is that the research points to a triumph in neonatal medicine that ought to be welcomed, and that its adaptation for human use ought to be prioritized and generously funded.

Only abortion defenders raised alarms.  They worried [5] that the technology might result in a significant increase in the survival of extremely premature infants thus threatening to curtail the abortion license.  One clever journalist even opined [6] that the technology “could blur the line between a fetus and a baby!”

Speculative Ethical Questions

The leader of the Philadelphia team insisted that the research had no Matrix-esque intentions.  Its goal, he said [7], was “to help premature infants already being born,” not flirt with earlier limits of viability.

But given the history of biomedical research, especially the development and increasingly worldwide use of illicit forms of assisted reproductive technology (ART), we have reasons to doubt that all researchers’ intentions are or will remain so benign.

So it is not fantastic to ask: what if technology was created that could successfully gestate humans in an extra-uterine environment from a much earlier stage of development, even from the embryonic stage?  I am not asking the technical question of whether this can be done.  I’ll let others more qualified quibble over this.  I’m asking the ethical question, how should we respond to such technology if or when it comes knocking at our cultural doors?

The chief—but not only—moral question is whether the use of such technology would uphold the absolute norms prescribing that (innocent) human life never be intentionally killed and that people only be brought into existence in the context of a loving marital act.

If its perfecting would require the killing of even one human being—one embryo—then it must never be perfected.  If not required, then our assessment can advance to the next step. Otherwise, it stops here.  Utilitarians have whispered in humanity’s ears since the beginning: “Save countless, sacrifice just one!”, and rivers of innocent blood have been spilled by their plea for “just one more.”  No intentional killing of the innocent.  Ever. Anything less is gravely immoral.

If we presume the technology licitly could be perfected, we see that some uses could be legitimate and others immoral.

Those who in using it would formally cooperate with the wrongful purposes of users of illicit forms of ART would do wrong.  For example, some IVF consumers, especially male homosexuals, would have recourse to artificial wombs as techno-surrogates.  Other women would procreate through natural intercourse but choose gestational technology for reasons of convenience, aesthetics or minor health concerns thus wrongfully subjecting their unborn babies to disproportionate risks both by the ‘womb’ transfer and by depriving them of maternal gestation.

The risk itself that the mere existence of such technology would make IVF easier and hence more desirable is a very serious ethical concern for those contemplating its possibility.  If we are concerned about the world created by IVF that’s made intercourse optional for procreating, we should be especially concerned about artificial wombs making gestational motherhood optional.

But the technology also would open possibilities for greatly advancing human good.  Premature babies at earlier and earlier ages could be assisted.  True crises at early stages of pregnancy would not necessarily result in miscarriage.  And the over [8] six hundred thousand frozen embryos in the U.S. could be offered lifesaving options.

People of faith and good morals should resist dismissing such technology out of hand because of the “yuck factor.”  If it could be licitly perfected, and if realistic safeguards put in place to minimize its abuse, then we should welcome it.  Although an artificial womb is not the ideal place for gestating human life, it’s jolly well better than death.