Procreation machines: Ectogenesis as reproductive enhancement, proper medicine or a step towards posthumanism?

Abstract

Full ectogenesis as the complete externalization of human reproduction by bypassing the bodily processes of gestation and childbirth can be considered the culmination of genetic and reproductive technologies. Despite its still being a hypothetical scenario, it has been discussed for decades as the ultimate means to liberate women from their reproductive tasks in society and hence finally end fundamental gender injustices generally. In the debate about the application of artificial wombs to achieve gender equality, one aspect is barely mentioned but is of crucial relevance from a medical‐ethical perspective: whether and how could full ectogenesis be justified as a proper use of medicine? After characterizing the technology as a special form of human enhancement and as an extension of medical practice that goes beyond the traditional field of medicine, this paper critically assesses the theoretical possibilities of legitimizing this extension. We identify two ways of justification: either one argues that ectogenesis fulfils a proper goal of medicine (a justification we call pathologization), or one argues that the application of ectogenesis achieves a non‐medical goal (which we call medicalization). Because it is important from a medical‐ethical point of view to avoid an inappropriate instrumentalization or misuse of medicine and thus an undue medicalization of non‐medical problems, a set of necessary conditions has to be met. It is doubtful whether full ectogenesis for non‐medical purposes could fulfil these conditions. Rather, its comprehensive usage could be seen as a revolutionary modification of what it means to be human.

The path toward ectogenesis: looking beyond the technical challenges

“…One of the most dominant ectogenesis related strands is the possible positive effect on women in terms of liberation from reproductive inequalities and the social inequalities built on the back of that [ 14 , 15 , 19 , 21 , 23 , 24 , 26 – 32 , 74 , 81 – 84 ] As analyzed by Cavaliere, this view consists of two separate, though closely connected arguments: the equality-promoting argument and the freedom-promoting argument [ 23 ].…”

“…One issue here is whether such use of AWT is undue use of obstetric technology [ 81 ]. There is, however, no clear ethical reason why ectogenesis cannot be used to achieve a non-medical goal if that goal is valuable and acceptable [ 81 , 86 ].…”

“…One issue here is whether such use of AWT is undue use of obstetric technology [ 81 ]. There is, however, no clear ethical reason why ectogenesis cannot be used to achieve a non-medical goal if that goal is valuable and acceptable [ 81 , 86 ]. Yet, it is not evident that women’s exclusive role in the gestation of children is the origin of gender inequalities more generally [ 24 , 72 , 73 , 81 ].…”

“…There is, however, no clear ethical reason why ectogenesis cannot be used to achieve a non-medical goal if that goal is valuable and acceptable [ 81 , 86 ]. Yet, it is not evident that women’s exclusive role in the gestation of children is the origin of gender inequalities more generally [ 24 , 72 , 73 , 81 ]. If not pregnancy but other biological gender differences, gender roles and/or oppressive social structures are the problem, ectogenesis will not resolve gender inequality.…”

Space ectogenesis: securing survival of humans and Earth life with minimal risks – reply to Szocik

“…The core of both strategies is complete ectogenesisthe development of an early-stage embryo to a neonate entirely outside the natural womb. While bioethical concerns have slowed research and development of complete ectogenesis (Eichinger and Eichinger, 2020;Baron, 2021), it could nevertheless be available in the near future to assist parents in having children (Bulletti and Simon, 2019;Räsänen and Smajdor, 2020;Kimberly et al, 2020).…”