Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health, New York, New York.
Division of Medical Ethics, Department of Population Health, New York University School of Medicine, New York, New York.
Bioethics. 2020 May;34(4):338-345. doi: 10.1111/bioe.12723. Epub 2020 Feb 12.
As the technology for ectogenesis continues to advance, the ethical implications of such developments should be thoroughly and proactively explored. The possibility of full ectogenesis remains hypothetical at present, and myriad concerns regarding the safety and efficacy of the technology must be evaluated and addressed, while pressing moral considerations should be fully deliberated. However, it is conceivable that the technology may become sufficiently well established in the future and that eventually full ectogenesis might be deemed ethically acceptable as a reproductive alternative to gestation within a human womb under certain circumstances. If the safety and efficacy of full ectogenesis are established, if ethical dilemmas are sufficiently well addressed, and if the technology is offered as a reproductive option to cisgender heterosexual individuals or couples desiring to become parents, there is a moral obligation grounded in social justice to ensure that full ectogenesis be made available to individuals or couples identifying as members of sexual- or gender-minority groups who likewise seek to pursue parenthood. We examine the history of access to current family-building options, including assisted reproductive technology, surrogacy and adoption, for these populations and conclude that in the absence of robust empirical evidence suggesting an increased risk of harm to children of individuals and couples who identify as members of sexual- or gender-minority groups, equitable access to ectogenesis as a pathway to parenthood for sexual and gender minorities must be assured as a matter of reproductive justice.
随着胚胎外生性技术的不断发展,应该彻底、积极地探索这些发展所带来的伦理影响。目前,完全的胚胎外生性的可能性仍然是假设性的,必须评估和解决关于技术的安全性和有效性的无数关注,同时要充分审议紧迫的道德考虑因素。然而,可以想象的是,该技术在未来可能会得到充分的建立,并且最终在某些情况下,完全的胚胎外生性可能被认为是一种在人类子宫内妊娠的生殖替代选择是符合伦理的。如果完全的胚胎外生性的安全性和有效性得到确立,如果伦理困境得到充分解决,并且如果该技术被作为一种生殖选择提供给想要成为父母的顺性别异性恋个体或夫妇,那么就有基于社会正义的道德义务确保完全的胚胎外生性可用于同样寻求追求父母身份的性别或性少数群体的个体或夫妇。我们研究了当前生育选择(包括辅助生殖技术、代孕和收养)对这些人群的准入历史,并得出结论,在没有强有力的实证证据表明身份为性别或性少数群体的个体和夫妇的孩子面临更高风险的情况下,为性别和性少数群体提供作为生育途径的胚胎外生性的平等准入必须作为生殖公正的问题得到保障。