The Disruption of Human Reproduction

This is already my third post about ectogestative technology, better known as “artificial womb technology”. While in the first post, I explored the idea that this technology could potentially advance gender justice, in the second, I approached the technology from the perspective of post-phenomenology. In this third post, I look at the technology as an example of a socially disruptive technology. Ongoing research in the philosophy of technology investigates the ways in which 21st Century technologies such as artificial intelligence, synthetic biology, gene-editing technologies, and climate-engineering technologies affect “deeply held beliefs, values, social norms, and basic human capacities”, “basic human practices, fundamental concepts, [and] ontological distinctions”. Those technologies deeply affects us as human beings, our relationship to other parts of nature such as non-human animals and plants, and the societies we live in. In this post, I sketch the potential disruptive effects of ectogestative technology on practices, norms, and concepts related to expecting and having children.

What makes ectogestative technology socially disruptive? To answer this question, let us first look at partial-ectogestation, the use of the technology for the partial process of extra-uterine gestation, e.g., after a fetus has been born prematurely. Let’s imagine a scenario in which an ectogestative device is used for fetuses at 22-24 weeks of gestation, where the doctors expected the fetuses to die or survive with severe handicaps had the pregnancy been continued or the preterm been placed in an incubator. The doctors in charge of the babies in the devices are monitoring their development closely, and whenever they observe something worrisome, they intervene as quickly as possible. As a baby in an ectogestative device is not inside its mother’s body anymore, the doctors feel the responsibility to give it the best possible medical care. They treat it as they would treat any other patient. While their baby is gestating in the device, the parents are not sure if it has already been born. On the one hand, it feels as if it has, since it is not inside its mother’s womb anymore. On the other hand, it feels as if it hasn’t been born yet, since it is still inside a womb-like environment.

In this scenario, one disruption concerns the ontological status of the human being inside the ectogestative device. Is it a fetus since it still has the fetal physiology and continues to develop in a womb-like environment? Or is it a neonate since it has been born in the sense of birth-as-location change? The concept of birth is being disrupted, too, since it is unclear whether it applies to a case in which only a change in location has taken place, not a change in physiology. The disruption concerning the identity of the human being in the device manifests itself, among others, in the discussion in the literature about how to call it. Elizabeth Romanis has argued that the “terms used to describe preterms and fetuses are inappropriate in this context and so a different term, which avoids the connotations of using either ‘newborn’ or ‘fetus’, is needed”. She suggested the term “gestateling”. Other terms suggested include “perinate” and “fetonate”. How the ontological status of the human being inside the device is understood has ethical, legal, social, and political implications.

Let us now consider a more futuristic scenario, in which embryos conceived through IVF can be implanted in an ectogestative device for full-ectogestation. In wealthy countries, the technology has become broadly available. Prospective parents can usually choose between having a baby in the traditional way and using an ectogestative device. Reasons for opting for ectogestation vary from the desire to avoid the burdens of pregnancy to the hope to achieve greater equality between mothers and fathers to the possibility for homosexual couples or groups of people to become parents without the need for any women to carry the baby. In this scenario, we can imagine the disruption of the conceptual cluster involving concepts such as “mother”, “father”, and “parent”. As full-ectogestation would enable the development of human beings in the absence of a gestational mother, the distinction between mothers and fathers would become questionable. The other two dimensions of motherhood, the genetic and the social dimensions, also apply to fathers. The question thus arises as to whether we still need the concepts “mother” and “fathers”. Doesn’t the concept “parent” suffice?

These are just some of the potential disruptions. If you would like to know more, you can read chapter 5 of the open access book written by myself and colleagues from the Ethics of Socially Disruptive Technologies consortium. You can also listen to this podcast or the one soon to be found here.