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Ethics and ectogenesis

Article  in  Australian nursing journal (July 1993) · June 2010

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Megan-Jane Johnstone
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 BY MEGAN–JANE JOHNSTONE

Ethics and ectogenesis

The development of effective artificial uteri
and ectogenesis (the growth of a human
fetus outside of a women’s womb) are no
longer the stuff of science fiction. Scientists
have been attempting to create artificial
uteri since the 1950s. Over the past several
decades, research has been successfully
carried out on maintaining extracted human
uteri from outside of a woman’s body, and
implanting embryos into these uteri.
Although survival rates remain poor (less
than a few hours) and the technical problems
remain formidable, some scientists predict
that efficient artificial uteri in humans could
be available very soon - especially for late
term fetuses where it would be easier to
connect embryonic umbilical arteries and
veins to equipment designed to pump, filter
and nourish blood (Adinolfi 2004; Caplan et
al 2007). Ectogenesis is already used in
experimental animal science (Adinolfi 2004).
Goat fetuses whose umbilical cords were
connected to machines artificially providing
nutrients and hormones, and removing
waste products, have reportedly been kept
alive for up to three weeks in plastic tanks
containing amniotic fluid. After being
removed from the tanks, some goats lived
for several days.
A question of nursing ethics
Ectogenesis raises many confronting ethical
issues. Some see ectogenesis as a ‘panacea’
for reproductive health in women (eg. it
could serve as a treatment for infertility,
ethics
fetuses in artificial uteri until independently
viable). They further warn that ectogenesis
could result in serious unforeseen conse-
quences to infant health (not least emotion-
al health) in offspring born by this method
(Coleman 2004; Gelfand and Shook 2006).
Arguably a more serious concern is whether
our conventional moral systems of thinking
and deciding are up to the task of framing
an appropriate response to this issue, which
includes asking the ‘right’ questions and
providing a ‘right’ response to the questions
raised. Such questions might include:
• Can ectogenesis ever be morally ‘right’ and
permissible?
• Under what conditions, if any, might ectoge-
nesis be morally justified?
• What are the moral implications of ectogen-
esis for the reproductive rights of women,
men and their children?
• What are the moral implications of ectogen-
esis for society generally and the value
systems which hold society together?
• What might be the unintended consequences
of legitimising ectogenesis as a reproductive
health treatment option?
Is ectogenesis important?
Why, if at all, is ectogenesis important? More
to the point, is it really an issue that warrants
attention by the nursing profession?
Coleman (2004) argues that the most
important theoretical application of ectogenesis
is in the abortion debate. Since the key
problem with abortion is the fatal evacuation
of a fetus from its mother’s uterus (called
‘severance theory’), ectogenesis stands to
beyond the abortion debate, however, and
thus holds relevance for nurses generally.
Reflecting a profound transformation from
science fiction to science fact, ectogenesis
raises pointed questions concerning the value
and meaning of human life - who we are, what
we value about who (and what) we are, the
purpose of human life, reproduction and
‘human beingness’, and what we are destined
(and are now being designed) to become.
These are all questions of pertinence to
nurses, both as health professionals and as
responsible citizens.
Meanwhile, critical questions remain of
how the field of ectogenesis has been able to
progress as far as it has without the level of
public and professional debate that has
otherwise become characteristic of other
controversial reproductive health issues,
such as in vitro fertilisation (IVF), surrogacy,
‘designer babies’, embryonic stem cells, and
genetic engineering. What has enabled this
situation to occur warrants deep scrutiny
by anyone who has an interest in and is
concerned about the human condition and the
role of science in helping to improve it.
Without such scrutiny there is a risk that
scientific innovations will be progressed,
which while ostensibly aimed at improving the
human condition might, inadvertently, have
quite the opposite effect.
REFERENCES
Adinolfi, M. 2004. The artificial uterus. Prenatal
Diagnosis, 24(7):570-572.
Caplan, A., Perry, C., Plante, L., Saloma, J. and Balzer,
F. 2007. Moving the womb. Hastings Center Report,
37(3):18-20.

provide a more acceptable alternative to ‘dramatically change the landscape of the Coleman, S. 2004. The ethics of artificial uteruses:
implications for reproduction and abortion. Ashgate
surrogacy and abortion, and pro- abortion debate’. Coleman (2004, Publishing, Aldershot
vide viable options for women p.2) suggests that it does this Gelfand, S. and Shook, J. (eds). 2006. Ectogenesis:
facing the loss of a pregnancy
WHY, IF AT ALL, by allowing ‘the separation of artificial womb technology and the future of human
due to faulty placental implanta- IS ECTOGENESIS two currently inseparable reproduction. Rodopi: Amsterdam.
tion or medical conditions that IMPORTANT? events, the evacuation of the
MEGAN-JANE JOHNSTONE IS PROFESSOR OF
make pregnancy dangerous). MORE TO THE fetus from the uterus, and the
NURSING IN THE SCHOOL OF NURSING AND
Others, on the other hand, warn death of the fetus’. For nurses
POINT, IS IT MIDWIFERY AT DEAKIN UNIVERSITY IN VICTORIA.
it could seriously erode women’s who are opposed to abortion PROFESSOR JOHNSTONE HAS EXTENSIVE
reproductive rights and health
REALLY AN then, ectogenesis stands as an INTEREST AND EXPERTISE IN THE AREA OF
(eg. in a coercive society, women ISSUE THAT important issue – although one PROFESSIONAL ETHICS IN NURSING.
deemed by authorities to be WARRANTS that is not without complications
‘unfit’ to carry a pregnancy to ATTENTION BY owing to its dependence on fetal
term could be placed under a
‘coercive treatment order’ and
forced by the state to place their
THE NURSING
PROFESSION?
and fetal tissue experimentation.
The importance of ectogenesis
as an ethical issue extends
33
JUNE 10 VOLUME 17 NUMBER 11 AUSTRALIAN NURSING JOURNAL 33
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