Centre for Social Ethics and Policy, School of Law, University of Manchester, Manchester, UK.
J Med Ethics. 2018 Nov;44(11):751-755. doi: 10.1136/medethics-2018-104910. Epub 2018 Aug 10.
In 2017, a Philadelphia research team revealed the closest thing to an artificial womb (AW) the world had ever seen. The 'biobag', if as successful as early animal testing suggests, will change the face of neonatal intensive care. At present, premature neonates born earlier than 22 weeks have no hope of survival. For some time, there have been no significant improvements in mortality rates or incidences of long-term complications for preterms at the viability threshold. Artificial womb technology (AWT), that might change these odds, is eagerly anticipated for clinical application. We need to understand whether AWT is an extension of current intensive care or something entirely new. This question is central to determining when and how the biobag should be used on human subjects. This paper examines the science behind AWT and advances two principal claims. First, AWT is conceptually different from conventional intensive care. Identifying why AWT should be understood as distinct demonstrates how it raises different ethico-legal questions. Second, these questions should be formulated without the 'human being growing in the AW' being described with inherently value laden terminology. The 'human being in an AW' is neither a fetus nor a baby, and the ethical tethers associated with these terms could perpetuate misunderstanding and confusion. Thus, the term 'gestateling' should be adopted to refer to this new product of human reproduction: a developing human being gestating ex utero. While this paper does not attempt to solve all the ethical problems associated with AWT, it makes important clarifications that will enable better formulation of relevant ethical questions for future exploration.
2017 年，费城的一个研究团队展示了迄今为止最接近人工子宫 (AW) 的东西。如果像早期动物试验所表明的那样成功，这种“生物袋”将改变新生儿重症监护的面貌。目前，22 周前出生的早产儿没有生存的希望。一段时间以来，对于接近存活极限的早产儿，死亡率或长期并发症的发生率都没有显著改善。人工子宫技术（AWT）有望改变这种局面，人们急切地期待它能应用于临床。我们需要了解 AWT 是当前重症监护的延伸，还是全新的东西。这个问题是决定何时以及如何在人体上使用生物袋的核心。本文探讨了 AWT 的科学依据，并提出了两个主要观点。首先，AWT 在概念上不同于传统的重症监护。确定 AWT 为什么应该被理解为不同的，这表明了它提出了不同的伦理法律问题。其次，这些问题的制定不应该使用“在 AW 中生长的人类”这一固有价值术语来描述。“在 AW 中的人类”既不是胎儿也不是婴儿，与这些术语相关的伦理束缚可能会导致误解和混淆。因此，应该采用“gestateling”一词来指代这种人类生殖的新产品：在体外发育的人类。虽然本文并不试图解决与 AWT 相关的所有伦理问题，但它做出了重要的澄清，这将有助于为未来的探索更好地制定相关的伦理问题。
