Artificial placenta: Miles to go before I sleep…

Sahoo, Tanushree; Gulla, Krishna Mohan

doi:10.1016/j.ajog.2019.06.037

Cited by 8 publications

(14 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Yet, if ectogenesis pushes the limit of viability (i.e. make more or even all fetuses viable) this might further reinforce pressures on pregnant persons to undergo fetal removal when fetal therapy is advocated [ 35 , 39 , 47 , 62 ]. Usuda et al nuanced this by stating that it seems unlikely that fetuses much below 20 weeks gestation could be maintained on an artificial placenta, as this would require catheterization of umbilical vasculature and possibly compromise the fetal heart [ 61 ].…”

Section: Main Textmentioning

confidence: 99%

“…This latter concern is one important reason not to be over-confident about the expected application of AWT in humans soon. As noted by Sahoo and Gulla, the differences in the development of the fetal lung and brain in ewes compared to humans may have led to favorable outcomes in the animal model, indicating that the same result might not be replicated in human fetuses [ 47 ]. The current animal data and the substantial physiological differences between the test animals and humans do not demonstrate a reasonable expectation of clinical benefit yet [ 42 ].…”

Section: Main Textmentioning

confidence: 99%

“…Further dissemination of AWT should only be allowed in case of established results that reassure safety and effectivity. An important consideration throughout these research phases, as well as when this technology becomes clinically available, is the question of liability for potential injuries during the gestation in the ectogenetic incubator [ 29 , 47 ].…”

Section: Main Textmentioning

confidence: 99%

“…Both approaches successfully enabled development of lamb fetuses in a sterile environment, using extracorporeal perfusion [4,5,7,18,42,44,45]. These studies have shown significant improvement of AWT as it purportedly moves closer towards clinical application in humans, which is as yet an undeveloped technology [2,4,5,13,46,47].…”

Section: Main Textmentioning

confidence: 99%

“…Besides improvements in extracorporeal circuit configuration and advances in oxygenator technology, significant progress has been achieved both in demonstrating the physiological effects of the artificial environment and the feasibility of extra-corporeal support of younger animals biologically comparable to a 22-24-week gestation human fetus [4,5,13,16,46,55]. It is said that this will be the primary clinical target population of AWT as a life support platform for extremely preterm infants [4,5] Yet, as hinted at by Sahoo and Gulla, it is likely that if found successful, its use may ultimately cover a wider period of gestation and possibly also facilitate a wider range of applications [47].…”

Section: Donated Uteri Bioengineered Uteri Extend Protocol and Eve Protocolmentioning

confidence: 99%

See 4 more Smart Citations

The path toward ectogenesis: looking beyond the technical challenges

Segers

2021

BMC Med Ethics

View full text Add to dashboard Cite

Background Breakthroughs in animal studies make the topic of human application of ectogenesis for medical and non-medical purposes more relevant than ever before. While current data do not yet demonstrate a reasonable expectation of clinical benefit soon, several groups are investigating the feasibility of artificial uteri for extracorporeal human gestation. Main text This paper offers the first comprehensive and up to date discussion of the most important pros and cons of human ectogenesis in light of clinical application, along with an examination of crucial ethical (and legal) issues that continued research into, and the clinical translation of, ectogenesis gives rise to. The expected benefits include advancing prenatal medicine, improving neonatal intensive care, and providing a novel pathway towards biological parenthood. This comes with important future challenges. Prior to human application, important questions have to be considered concerning translational research, experimental use of human fetuses and appropriate safety testing. Key questions are identified regarding risks to ectogenesis’ subjects, and the physical impact on the pregnant person when transfer from the uterus to the artificial womb is required. Critical issues concerning proportionality have to be considered, also in terms of equity of access, relative to the envisaged application of ectogenesis. The advent of ectogenesis also comes with crucial issues surrounding abortion, extended fetal viability and moral status of the fetus. Conclusions The development of human ectogenesis will have numerous implications for clinical practice. Prior to human testing, close consideration should be given to whether (and how) ectogenesis can be introduced as a continuation of existing neonatal care, with due attention to both safety risks to the fetus and pressures on pregnant persons to undergo experimental and/or invasive procedures. Equally important is the societal debate about the acceptable applications of ectogenesis and how access to these usages should be prioritized. It should be anticipated that clinical availability of ectogenesis, possibly first as a way to save extremely premature fetuses, may spark demand for non-medical purposes, like avoiding physical and social burdens of pregnancy.

show abstract

Section: Main Textmentioning

confidence: 99%

Section: Main Textmentioning

confidence: 99%

Section: Main Textmentioning

confidence: 99%

Section: Main Textmentioning

confidence: 99%

Section: Donated Uteri Bioengineered Uteri Extend Protocol and Eve Protocolmentioning

confidence: 99%

See 3 more Smart Citations

The path toward ectogenesis: looking beyond the technical challenges

Segers

2021

BMC Med Ethics

View full text Add to dashboard Cite

show abstract

Why bother the public? A critique of Leslie Cannold’s empirical research on ectogenesis

Smajdor

2021

Theor Med Bioeth

View full text Add to dashboard Cite

Can discussion with members of the public show philosophers where they have gone wrong? Leslie Cannold argues that it can in her 1995 paper ‘Women, Ectogenesis and Ethical Theory’, which investigates the ways in which women reason about abortion and ectogenesis (the gestation of foetuses in artificial wombs). In her study, Cannold interviewed female non-philosophers. She divided her participants into separate ‘pro-life’ and ‘pro-choice’ groups and asked them to consider whether the availability of ectogenesis would change their views about the morality of dealing with an unwanted pregnancy. The women in Cannold’s study gave responses that did not map onto the dominant tropes in the philosophical literature. Yet Cannold did not attempt to reason with her participants, and her engagement with the philosophical literature is oddly limited, focussing only on the pro-choice perspective. In this paper, I explore the question of whether Cannold is correct that philosophers’ reasoning about abortion is lacking in some way. I suggest that there are alternative conclusions to be drawn from the data she gathered and that a critical approach is necessary when attempting to undertake philosophy informed by empirical data.

show abstract