Artificial wombs, infanticide and the implications for abortion

Infanticide and Personhood

A recent article published in the Journal of Medical Ethics has caused a veritable shitstorm (a technical term in philosophy) for the authors and the editors of the journal. Briefly, the article argues that in some cases infanticide is justified since there is no moral difference between a foetus just before birth, and a newborn infant. Hence, if it’s ok to abort a late-stage foetus, it should be ok to kill the newborn. They claim it is ok to do both on the grounds that neither a foetus or the newborn has yet developed necessary characteristics for personhood (such as self-awareness), and therefore should not be entitled to a moral or legal “right to life”.

Legally, in the UK, personhood only begins at birth. Yet the foetus is not entirely unprotected before this. In the UK (apart from Northern Ireland), obtaining an abortion is legal before 24 weeks of pregnancy. After 24 weeks, abortion is only legal if there is evidence that the foetus is likely to be severely disabled, if the woman’s life is at risk, or to avoid severe physical or mental harm to the woman (in practice, interpretation of ‘severe physical or mental harm’ is probably rather lax). This implies it is not considered ok to abort a late-stage foetus merely on the grounds that it is not yet a person, and infanticide is therefore also not justified merely on the grounds that it is not yet a person.

I agree that neither a foetus or a newborn has the characteristics required to be considered a person, yet pragmatically the clear-cut dividing line of birth seems to be the only real option for legal personhood, and the rights such legal recognition entails. If it is set at a later date of development, such that infanticide of newborns is allowed, then there is no obvious point where to stop. Setting it at an earlier date could be plausible for some point late in pregnancy, but then there will inevitably medical emergencies whereby a doctor may have to commit what would be legally defined as murder in order to save the life of the woman involved. This would in all likelihood lead to doctors refusing to treat heavily pregnant women, leading to deaths of both woman and child.

The purpose of this post is not to rehash the current debate on abortion. Rather, it is to discuss out how a possible future technology, an external artificial womb, is likely to confuse the situation even further, if that is at all possible.

Artificial Wombs: why bother?

What would be the point of developing an artificial womb? The primary motives currently include:

(a)enhancing the survival chances of premature infants

(b)rescuing sick foetuses

(c)the possibility of genetically-related children for women with reproductive diseases (e.g. womb and ovarian cancer) without the need for a surrogate

(d)scientific curiosity regarding human prenatal development; and

(e)enhancing equality in society, as argued by some feminists such as Shulamith Firestone, by allowing reproduction without imposing all the risks and harms of pregnancy on women. Firestone has also argued that natural pregnancy leads to inequality and divisive hierarchies in society as a consequence of favouring one child over another merely on the basis of genetic and gestational connections to the parents

Their development may also be supported by certain bioconservatives, who would traditionally otherwise oppose major technological changes relating to sex and reproduction. This is because of the perceived potential to eliminate foetal deaths that occur in abortion.

Artificial wombs will likely come about as ‘merging’ of IVF and human embryo research with neonatal incubators. In the UK, research is allowed on human embryos up to 14 days old. As far as we know, such embryos develop in vitro fairly normally. If it were legal, it seems highly likely that it would already be possible for them to develop a bit further. There would have to be some means to replicate the tasks of the placenta, such as gas exchange and nutrition, and ultimately control of hormones and antibodies. Whilst exactly how these tasks are achieved by the placenta is exceedingly complex, back in the 1990s researchers in Japan successfully kept alive goat foetuses in an artificial womb, some for up to ten days, suggesting it is not beyond the realms of possibility of understanding. And in 2002, human embryos were implanted into the wall of a tissue grown from cells from the inner membrane of the uterus.

Babies born after 24 weeks of pregnancy currently have approximately a 50% chance of survival outside the mother thanks to modern neonatal intensive care units (NICUs), though rare cases have been documented of survival of newborns as young as 21/22 weeks. This viability of 24 weeks is the reason for having the UK legal limit of abortion where it is.

Artificial wombs: the end of foetal death from abortion?

If artificial wombs are developed, then the reason for having the 24-week deadline becomes void; embryos that successfully grow in artificial wombs will by definition be viable from IVF to whenever the foetus is considered ‘born’. So should abortions from ‘natural’ pregnancies still be allowed? Since it may be possible to transfer an embryo from a mother’s (real) womb and place it in an artificial womb, there may well be pressure on mothers to undergo surgery to ‘rescue’ the embryo, rather than abort it*. What stage of development, if any, is an acceptable limit for terminating a ‘pregnancy’ using an artificial womb? When should the embryo/foetus obtain rights of personhood? The two main factors that currently provide answers to these questions, foetal viability and birth, would not apply to artificial wombs. At least, birth would no longer exist for foetuses grown in artificial wombs in the sense we currently understand it: seperation of foetus from the woman’s body and entry into the external world.

It would seem rather inconsistent to grant legal protection to foetuses of a particular age that develop in an artificial womb but not grant the same protection to those that develop in a natural womb. Of course, the latter must consider the rights of the woman. However, granting greater protection for artificial-womb-foetuses than natural-womb-foetuses could lead to women being pressured into only having children via artificial wombs. This pressure would be enhanced by the risk of miscarriage in natural pregnancy, and the fact that artificial wombs would conceivably allow greater opportunity to repair foetal defects, via surgery or gene therapy.

The very technology that some feminists view as potentially extremely liberating, would in fact be restricting for women who wish to experience natural pregnancy. The possibility of such technology also demonstrates why it is essential to consider, in advance, the rights of embryos and foetuses. Even if one believes that the current debate on abortion ends with the woman having the absolute right to abort a foetus of any stage of development, this position says little of relevance as to how we should treat embryos and foetuses in the context of a world with artificial wombs.

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*A significant practical argument against this saving of would-be abortions is the shear number of new infants that would be brought into existence, and the financial cost imposed on social services. One estimate is that one year’s worth of saved embryos and foetuses in America could be in excess of $150 trillion dollars (over an average of 22 years before a child becomes self-sufficient).