She Ain’t Hefty™, She’s My Mother

Late last week, my social media feed was flooded with videos showing a fetal lamb kicking and squirming inside a large liquid-filled bag. Thankfully, it wasn’t some obscene animal torture video. Rather it was a news article about a recent development in medical technology: the first successful demonstration of an artificial womb.

Developed by researchers at the Children’s Hospital of Philadelphia, the artificial womb is known (descriptively enough) as a Biobag. It is essentially a large Ziploc™ bag that encloses the fetus and bathes it in a protective solution similar to the amniotic fluid inside the uterus. An external tube is used to pump oxygenated blood and nutrients to the growing fetus, replacing the placenta that would normally connect the mother to the unborn child.

So far the Biobag has only been used in the laboratory. To date, eight lambs have been delivered prematurely and then allowed to complete their gestational development in an artificial womb-like environment. All of the lambs developed normally, and researchers hope that Biobag-like technology can soon be used in the clinic to provide care and treatment for premature infants.

Premature birth is the leading cause of death in newborn infants. About 10 percent of all births globally are premature, with the infant born before 37 weeks of pregnancy. Annually, more than 15 million children worldwide are born prematurely. A great many of these children will die from preterm-related ailments, despite receiving intensive support and care (where available). Of those that survive, most will suffer from lifelong disabilities, including vision and hearing problems, developmental delays, and cerebral palsy.

The earlier a child is born, the more likely they will die or suffer long-term health problems because their organs have not had the chance to develop fully. Artificial wombs like the Biobag could solve that by allowing premature infants to continue developing in a uterus-like environment until their organs have fully matured.

Despite the potentially miraculous advance in treating prematurity that the Biobag represents, when the fetal sheep video went viral there were a lot of comments condemning the research (and not just from activists opposed to the use of animals in laboratory experiments). Much of the criticism that I read online made overt or oblique reference to Aldous Huxley’s novel Brave New World.

Written in 1931 as a parody of the escapist utopian fiction that was popular during the Great Depression, Huxley’s book envisioned a society rigidly stratified into biological castes, with members of each caste genetically engineered and raised in artificial wombs. From the intelligent and handsome Alphas who rule to the stunted but strong Epsilons who do menial tasks, each is biologically and psychologically conditioned to happily fulfill the social roles into which they are born. Only so-called ‘Savages’ are conceived and born the natural way, and they are relegated to living outside society on isolated reservations.

So are we one step closer to Huxley’s dystopia as these critics claim? Will the well-heeled elites soon be able to place an order for a child with the good looks of Heidi Klum, athletic prowess of LeBron James, and the musical genius of Lady Gaga, decanting her from an artificial womb in time to fly off to the Bahamas for the 10th annual Fyre Festival? Is the Biobag, as one online critic so ineloquently and inaccurately decried, the “evil tool of Satan-worshipping atheists”?

Quite frankly, these arguments and criticisms are absurd. It is true that scientists are developing new technologies that may soon make it possible to gestate an infant outside of the womb; the Biobag is proof of that. It is also true that researchers have invented new tools that enable us to correct genetically inherited defects in utero; a newly developed technique called mitochondrial replacement therapy can be used to prevent the transmission of certain diseases through germ-line gene replacement. But to call these technologies “evil” or to imply that they will be used to create a race of Nietzschean Übermensch is overly fallacious.

First and foremost, new technologies like the Biobag are not “evil.” Like all tools – from a chainsaw to an atomic bomb – an artificial womb is ethically neutral. A chainsaw can be used for good (like trimming the branches from a tree before they fall and damage your roof) or can be used for evil (like dismembering your neighbor because they painted their house an ugly color). The moral issue that arises is not with the tool or technologies themselves but with how they are used.

Second, most of the criticisms of the Biobag – that it will be used to grow humans from embryos, that employers will require women to use artificial wombs to avoid paid maternity leave – rely heavily on so-called “slippery slope” arguments.

A common rhetorical device used in debates, a slippery slope argument is an attempt to dissuade a particular course of action because it will lead to some unacceptable conclusion. We should not legalize physician aid-in-dying, for example, because it will lead to doctors euthanizing the sick, disabled, or elderly. Similarly, we should not develop an artificial womb because it will allow us to create designer babies.

But this sort of reasoning is fallacious. There is no reason to believe that one event must inevitably follow from another. We should not assume, for instance, that an artificial womb created to treat prematurity would be used for anything other than that. Moreover, just like we criminalize the use of a chainsaw to harm others, we can create laws and policies to prevent socially unacceptable uses of a morally neutral technology like the Biobag.

Despite what the critics say, it is absurd to think that plastic bags will soon replace natural mothers. What the Biobag offers is hope to the families of children born prematurely, rather than the bleak future that Huxley envisioned.

[This blog entry was originally presented as an oral commentary on Northeast Public Radio on May 4, 2017, and is available on the WAMC website.]

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About Sean Philpott-Jones

A public health researcher and ethicist by training, Sean holds advanced degrees in microbiology, medical anthropology, and bioethics. He is currently Chair of the Bioethics Department at Clarkson University's Capital Region Campus and Director of the Bioethics Program of Clarkson University-Icahn School of Medicine at Mount Sinai, and Director of two Fogarty-funded programs to provide research ethics education in Eastern Europe and in the Caribbean Basin. Until his term expired in August 2012, he served as Chair of the US Environmental Protection Agency’s Human Studies Review Board, an advisory panel that reviews the scientific and ethical aspects of research involving human participants submitted to the EPA for regulatory purposes.
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