Assisted gestative technologies

Abstract

A large body of literature considers the ethico-legal and regulatory issues surrounding assisted conception. Surrogacy, however, within this body of literature is an odd-fit. It involves a unique demand of another person—a form of reproductive labour—that many other aspects of assisted conception, such as gamete donation do not involve. Surrogacy is a form of assisted gestation. The potential alternatives for individuals who want a genetically related child but who do not have the capacity to gestate are ever increasing: with the advent of uterus transplantation (UTx), and the anticipated development of artificial placentas.In this paper, I highlight the pertinent conceptual differences between technologies assisting conception and those assisting gestation to demonstrate that distinct issues arise when assisted gestative technologies (AGTs) are used. I argue that there is utility in considering AGTs as a genus of technologies. These technologies perform the same function from the perspective of putative parents and might exist on a spectrum of alternatives when they become more available. Moreover, since many of the same or very similar ethical, social and legal issues are raised by surrogacy, UTx and ectogestation, analysis of these issues will be better contextualised by considering these technologies together. Many of the matters currently being highlighted for reform in the context of surrogacy will inevitably impact on how other forms of assisted gestation are governed. The conversation should be broadened; we should consider how far other emerging technologies might be accommodated in revised regulatory schemes.

Delegating gestation or ‘assisted’ reproduction?

“…As an added bonus, what you got above is also a plausible explanation for the persisting ‘assistive’ narrative: reproduction and especially gestation continue to be ‘handled with care’ by the literature, but confusing roles only perpetuates privilege. Instead, the same way in which sex has been emancipated from reproduction—and gestation ought to be emancipated from conception1—it is similarly important to take the next step, abandoning a narrative in which women continue to need assistance and care; while they are actually bosses, delegating tasks that they can not be bothered with (economic delegation); or that someone might be better at (strategic delegation).…”

“…This paper argues that we ought to distinguish between ‘assisted’ gestation and ‘delegating’ gestation—and that the relevant difference does not depend on whether it is another human or technological system doing the work 1…”

How useful is the category of ‘assisted gestative technologies’?

“…Elizabeth Chloe Romanis argues that surrogacy, uterine transplantation (UTx) and ectogestation belong to a genus of ‘assisted gestative technologies” (“AGTs”) 1. These technologies are conceptually distinct from assisted reproductive technologies (ARTs) in that they support gestation rather than conception.…”

Looking back and looking forward

“…On the reproductive ethics front, articles include an analysis of when the government is justified in coercing parents and the implications for abortion, 6 and a Feature Article on the ethics of assisted gestative technologies 7 -along with many insightful commentaries on that topic. Some of the main arguments that the reader will find in this issue include: ► That ethical considerations in biobanking (sample collection, storage, sharing) during public health emergencies like the COVID-19 pandemic ought to include respect for research subjections, promoting the common good, solidary, benefit sharing, and reciprocity.…”

“…6 ► And finally, that the field ought to use and develop the conceptual category of "assisted gestative technologies" (eg, uterine transplants, artificial wombs) since that these technologies raise distinct ethical, legal and social issues from those related to assisted conception. 7 There is much to absorb and think about in this issue of JME-readers will appreciate the range of issues discussed. Perennial issues in medical ethics continue to warrant further discussion as well as future issues as science and medical technology develops.…”