Fetuses in Artificial Wombs: Medical Marvel or Misogynist Malpractice?

11/10/2015 11:15

By Paula Mejia


Women no longer give birth in Aldous Huxley's classic Brave New World. Instead, surgically removed ovaries are fertilized then bred in artificial receptacles. That was all pulled out of Huxley's imagination with the help of LSD, but he might have accurately predicted our impending brave new future regarding birth.


Transhumanist journalist and scholar Zoltan Istvan wrote   [http://motherboard.vice.com/read/artificial-wombs-are-coming-and-the-controversys-already-here] on Monday about current concrete developing research in artificial womb technology, called ectogenesis. The practice would allow humans to breed without giving birth in perhaps 20 years, Istvan predicts in his Motherboard column. The term ectogenesis was coined by British scientist J.B.S. Haldane in 1924, a friend and inspiration of Huxley's who predicted that live human births would make up less than 30 percent of all births by the year 2074.


Reproductive Health and Social Justice's Soraya Chemaly wrote about developments by two leading scientists in the ectogenesis field. In Japan, Yoshinori Kuwabara of Juntendo University successfully nurtured goat embryos in a machine filled with amniotic fluid, while Helen Hung-Ching Liu, of Cornell University's Reproductive Endocrine Laboratory at the Center for Reproductive Medicine and Infertility, grew a mouse embryo in an artificial womb in 2003, and kept a human embryo alive for 10 days in 2011.

Current legislation halts research projects involving human embryos after 14 days. So it will be a while at least a decade, according to Istvan before ectogenesis research can fully gestate human embryos.


Although it holds the potential to be an efficient and occasionally life-saving procedure, ectogenesis has already sparked debate. Is 'human' still applicable if embryos are not technically bred of a human womb?  What about 'mother'? Istvan notes that the most prevalent philosophical issue driving ectogenesis is that it will shift perceptions of women in society. Will the feminine mystique be lost by such an artificial process replacing what's been long a mainstay of the female domain?, he asks.


This question has caused a rift between leading scientists and feminist scholars, who state that ectogenesis 'could hand over women's sacred birthing ability to science. In her book The Captured Womb: A History of the Medical Care of Pregnant Women, Ann Oakley claims that ectogenesis encourages long-standing misogynistic medical practices appropriating women's wombs for science's sake. Ectogenesis is problematic for the socially conservative and religious, too. Journalist and Green Mountain College professor John Nassivera wrote in America, the National Catholic Review that depriving a growing fetus from the intimacy of its mother's body is a very serious thing


Yet supporters claim ectogenesis will be beneficial to both science and humanity, making childbirth safer for mothers as well as fetuses. Women unable to procreate, infertile couples and same-sex couples needing a surrogate could have children with ectogenesis.


In his article, Istvan supports ectogenesis because it could improve the health of babies: "The theory is that every heartbeat, kick, and moment of a fetus's life could be carefully monitored, from zygote to the moment the baby takes its first breath of air. Every nutrient the fetus gets would be measured, every movement it makes would be filmed, every heartbeat would be analyzed for proper timing," he writes. As with all new technology, traditional biological and social customs could give way to newer practices promising safety, efficiency, and practicality


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[Note:  Small world.  As we constantly observe these days, scientific experiments such as 'ectogenesis' discussed in the article below are usually 'justified' because they are so 'beneficent'. Who could possibly object to such 'beneficence'?  Depends on how you define 'beneficence'.  Beneficent for whom?  Does the 'bene' (the good) refer to individual human beings only (as in the traditional Hippocratic Oath), or does it refer only to the majority of human beings in  'society' (at the expense of the individual minority in a society) -- as in the utilitarian 'greatest good for the greatest number of individuals in society'?  Indeed, in bioethics the proportion of the risks to the benefits affecting the majority determines what is 'ethically' justified -- contrary to the demands of longstanding international ethics imperatives such as the Nuremberg Code and the Declaration of Helsinki where neither benefits nor risks to society must be allowed to trump the good of individual patients in research. 


Defining 'beneficence' only in terms of the 'greatest good for the greatest number of individuals in society' is the definition of 'beneficence' in the original Belmont Report (1978), the formal 'birth of bioethics' -- thus the 'good of the majority' trumps considerations for the individual minorities in society.  Since then the Belmont Report has been modified to include both individuals and the majority of individuals in its definition of 'beneficence' at the same time, but how can the same term refer both to individuals and to the majority in society?  Isn't that contradictory?  Yes, and the revised Belmont Report admits as much.  Further, since 'society' needs the data to even determine what the risks and benefits of such research are, the Belmont Report strongly advises that every individual citizen in society has a strong moral obligation to volunteer for even high risk experimental research for the greater good of society -- even if no 'beneficence' results to that particular citizen!  As 'explained' in the Belmont Report:  [http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html]


The term "beneficence" is often understood to cover acts of kindness or charity that go beyond strict obligation. In this document, beneficence is understood in a stronger sense, as an obligation. Two general rules have been formulated as complementary expressions of beneficent actions in this sense:  (1) do not harm and  (2)  maximize possible benefits and minimize possible harms.


The Hippocratic maxim "do no harm" has long been a fundamental principle of medical ethics. Claude Bernard extended it to the realm of research, saying that one should not injure one person regardless of the benefits that might come to others. However, even avoiding harm requires learning what is harmful; and, in the process of obtaining this information, persons may be exposed to risk of harm. Further, the Hippocratic Oath requires physicians to benefit their patients "according to their best judgment." Learning what will in fact benefit may require exposing persons to risk. The problem posed by these imperatives is to decide when it is justifiable to seek certain benefits despite the risks involved, and when the benefits should be foregone because of the risks.


The obligations of beneficence affect both individual investigators and society at large, because they extend both to particular research projects and to the entire enterprise of research. In the case of particular projects, investigators and members of their institutions are obliged to give forethought to the maximization of benefits and the reduction of risk that might occur from the research investigation. In the case of scientific research in general, members of the larger society are obliged to recognize the longer term benefits and risks that may result from the improvement of knowledge and from the development of novel medical, psychotherapeutic, and social procedures.  ... 


Effective ways of treating childhood diseases and fostering healthy development are benefits that serve to justify research involving children -- even when individual research subjects are not direct beneficiaries. Research also makes it possible to avoid the harm that may result from the application of previously accepted routine practices that on closer investigation turn out to be dangerous. But the role of the principle of beneficence is not always so unambiguous. A difficult ethical problem remains, for example, about research that presents more than minimal risk without immediate prospect of direct benefit to the children involved. Some have argued that such research is inadmissible, while others have pointed out that this limit would rule out much research promising great benefit to children in the future. Here again, as with all hard cases, the different claims covered by the principle of beneficence may come into conflict and force difficult choices.


Is this what most people mean by ˜beneficence'  Oh, and  'justice' in the Belmont Report is oddly defined in terms of John Rawls; Theory of Justice, where 'justice' means 'fairness' -- fairness in the distribution of the risks and benefits of research'.  Is that how most people understand justice?!  And does the third bioethics principle of 'autonomy' simply conveniently defer any accountability for any harmful consequences of such research to the 'autonomous' volunteer whose 'choice' is to be honored (and who therefore is responsible), rather than require any accountability from any researchers or Ethics Committee members?  Not to mention that all 3 'bioethics principles' inherently contradict each other.  But transhumanists and their colleagues know that their subtle equivocal bioethics language works to their benefit with the public and with funding institutions.  And it does. 


With bioethical definitions of terms like 'beneficence' 'justice' and 'autonomy' defined so equivocally (same term used, different definitions/meanings), the road is already linguistically paved for 'bioethical justification' for any 'beneficent' research -- such as ectogenesis:  Some have argued that such research is inadmissible, while others have pointed out that this limit would rule out much research promising great benefit to children in the future.  We just need the 'data', no matter what. Interesting that transhumanist Zoltan Istvan and most other transhumanists/posthumanists use this subtle equivocal bioethics language to advance their agendas (although not surprising when another bioethics founder Art Caplan is on the Board of Trustees of the Institute for 'Ethics' and Emerging Technologies (IEET):  http://ieet.org/index.php/IEET/staff;   see also,  http://ieet.org/index.php/IEET/more/caplanbot09;    also,  http://ieet.org/index.php/IEET/category/C46;   see also, http://ieet.org/index.php/IEET/more/caplan20140325).   Well, wouldn't ectogenesis provide needed 'data' to achieve their ultimate goal of making 'posthumans'?  Why else would transhumanists push unethical research such as ectogenesis?


The article first appeared here. Small world. -- DNI]