In theory, an artificial womb could help save the lives of premature babies and even give some frozen embryos the opportunity to be born while changing the contours of the nation’s abortion debate.
But as with anything else, the emerging medical technology that simulates an unborn baby’s environment in utero could be abused, raising frightening scenarios — once only imagined in dystopian novels like “Brave New World” — of babies being manufactured for sinister purposes in laboratories.
“This technology could be misused to industrialize the gestation of human beings,” said Dominican Father Nicanor Austriaco, a biology and theology professor at Providence College.
Father Austriaco told Our Sunday Visitor that the Catholic moral tradition has not really addressed the ethics of artificial wombs, though it speaks about the goodness of pregnancy and natural child-bearing.
“Given how we use NICU incubators today, I think that I can say that there is nothing intrinsically wrong with using a womb-like NICU incubator as long as there is a proportionate reason for gestating the child outside of his mother’s uterus,” Father Austriaco said.
Impact on viability
The idea of an artificial womb may sound like science fiction, but the technology is quite real. The first patent was issued in 1955. Last year, researchers at Children’s Hospital of Philadelphia created the first functioning artificial womb that successfully gestated a premature fetal lamb.
“I prefer to think of the artificial womb as a highly advanced neonatal ICU incubator,” Father Austriaco said. “This takes the hype out of the topic and encourages us to think more clearly about the technology.”
As explained in a study released earlier this year, the team at Children’s Hospital developed their “Biobag” to give infants who are born several months too early a more natural environment, mimicking the uterus, in which to continue developing.
Babies who are born before 23 weeks — the point of viability — and are cared for in hospital neonatal intensive care units, commonly known as the NICU, have a less than 50 percent chance of survival, according to the available medical literature.
“Today, we struggle to keep 23-week preemies alive,” Father Austriaco said. “A womb-like incubator would allow us to extend the threshold of viability to younger and younger preemies.”
Moving fetal viability back from 23 weeks would theoretically impact the nation’s abortion laws, and possibly its jurisprudence, because the U.S. Supreme Court has ruled that states cannot ban abortion before viability.
“It will be interesting to see how this technology would push abortion-rights activists,” said Charles Camosy, a Fordham University moral theologian who has written about the artificial womb’s potential impact to abortion laws.
“In some ways, the viability threshold was arbitrary anyway. After all, it is really just a function of the current state of medical technology in a given community and era,” Camosy told OSV, adding that if the technology develops, he could foresee a day when abortion rights activists do an about-face and challenge the Supreme Court’s precedent in Roe v. Wade as not being sufficiently protective of a woman’s “Constitutional right to control her body.”
Meanwhile, Father Tadeusz Pacholczyk, the director of education for the National Catholic Bioethics Center, told OSV that using artificial womb technology to rescue premature children or related scenarios where pregnancy is no longer medically feasible would not raise any fundamental ethical concerns “as long as the safety and well-being of the child in the incubator and during the transfer process were reasonably assured, and as long as the reason for the transfer of the child from mother to incubator was appropriately deemed to be serious and not trivial.”
In addition to the high mortality rate, premature babies who are born before 23 weeks have a higher likelihood — anywhere from 70 to 90 percent — of experiencing major health complications such as cerebral palsy, blindness and mental impairment.
“Hopefully, the artificial womb or Biobag could be perfected to the point where these children could be able to grow and develop normally, and to a further level of maturity, so that they could survive and not have the level of complications that these children have now in the NICU,” said Dr. Les Ruppersberger, a past-president of the Catholic Medical Association and a recently retired obstetrician from Philadelphia.
Ruppersberger told OSV that the intended purpose of the Biobag — to be a healthier and safer version of the NICU — would be “an excellent boon, ethically, morally and medically, to what we have available now if it could be perfected to the point where it was safe and had some realistic safeguards that would minimize any abuse.”
“If you can perfect the technology, you could allow these children to be gestated without being exposed to drugs, environmental toxins or medications the mother may take,” said Ruppersberger, who added that one-third of all neonatal deaths in the United States are due to premature birth.
“If we could improve our care for these children, we may be able to eliminate those deaths and some of the complications associated with them,” Ruppersberger said.
Much debate remains
Another possible benefit of an artificial womb is that it could provide a chance for countless frozen embryos — produced for in vitro fertilization — to be born. That possibility depends on the technology being advanced enough for an embryo to safely be transferred to the artificial womb.
“That might be much further in future, but it is not completely technologically out of the question,” said Dr. John F. Brehany, the director of institutional relations for The National Catholic Bioethics Center.
Brehany told OSV that the idea of using an artificial womb to gestate embryos is a topic of debates in Catholic bioethical circles. Some argue the frozen embryos have a right to be born while others raise concerns about the children being born out of wedlock and apart from sex between a husband and wife. Father Pacholczyk warned the approach could essentially offer “a baby in a bottle” approach to bringing life into the world.
“Having been conceived in glassware, and having never been within the womb of a woman, there would be a sense in which the decision to gestate an IVF embryo inside an artificial womb would constitute a continuation of that same dynamic of depersonalization and objectification of that embryonic human which had begun with his or her creation in a laboratory petri dish,” Father Pacholczyk said.
“We would be extending the initial mistreatment of that embryo, continuing to approach him or her as a kind of commodity or token to be manipulated, potentially in an anonymous way, maybe even as part of an ‘embryo farm’ where young humans are en masse gestated,” Father Pacholczyk added.
Father Austriaco warned of the risk of some women choosing to avoid “the inconvenience and messiness of pregnancy” by availing themselves of artificial womb technology.
“You see this already with surrogate mothers who are paid to gestate the babies of healthy women of child-bearing age who simply do not want to be bothered,” Father Austriaco said. “In fact, one advantage of a womb-like incubator is that it would not sue you for parental rights!”
The emerging technology bears intriguing life-saving possibilities, but also carries the specter of large-scale abuses that Brehany said require sober thought and deliberation.
Said Brehany, “As Catholics, we should help people model responsible research and responsible application. An important general principle is that you don’t use people as objects, and you don’t produce human beings like objects.”
Brian Fraga is an OSV Newsweekly contributing editor.