Bioethics Institute Ghent, Department of Philosophy and Moral Sciences, Ghent, Belgium.
Bioethics. 2020 May;34(4):364-370. doi: 10.1111/bioe.12715. Epub 2020 Feb 9.
In this paper, we aim to stimulate ethical debate about the morally relevant connection between ectogenesis and the foetus as a potential beneficiary of treatment. Ectogenesis could facilitate foetal interventions by treating the foetus independently of the pregnant woman and provide easier access to the foetus if interventions are required. The moral relevance hereof derives from the observation that, together with other developments in genetic technology and prenatal treatment, this may catalyse the allocation of a patient status to the foetus. The topic of foetal medicine is of growing interest to clinicians, and it also deserves due attention from an ethical perspective. To the extent that these developments contribute to the allocation of a patient status to the foetus (and to its respective interests for medical treatment), normative questions arise about how moral responsibilities towards foetal interests should be balanced against the interests of the pregnant woman. We conclude that, even if ectogenesis could facilitate foetal therapy, it is important to remain sensitive to the fact that it would not circumvent the key ethical concerns that come with in utero foetal treatment and that it may even exacerbate potential conflicts between directive treatment recommendations and the pregnant woman's autonomous decision to the contrary.
本文旨在引发关于胚胎外生性和胎儿作为治疗潜在受益人的道德相关性的伦理辩论。胚胎外生性可以通过独立于孕妇来治疗胎儿,从而为胎儿的干预提供更容易的途径,如果需要干预的话。这种相关性的道德意义来源于这样一个观察,即与基因技术和产前治疗的其他发展一起,这可能会促使将患者身份分配给胎儿。胎儿医学的话题越来越引起临床医生的兴趣,也应该从伦理角度得到应有的关注。在这些发展有助于将患者身份分配给胎儿(以及胎儿各自的治疗利益)的程度上,关于如何平衡对胎儿利益的道德责任与孕妇利益的规范性问题就出现了。我们的结论是,即使胚胎外生性可以促进胎儿治疗,重要的是要始终意识到,它不会回避与宫内胎儿治疗相关的关键伦理问题,而且它甚至可能加剧指令性治疗建议与孕妇自主决策之间的潜在冲突。