Wozniak Phillip Stefan, Fernandes Ashley Keith
College of Medicine, The Ohio State University, Columbus, Ohio, USA
College of Medicine, The Ohio State University, Columbus, Ohio, USA.
J Med Ethics. 2020 Nov 18. doi: 10.1136/medethics-2020-106754.
Research teams have used extra-uterine systems (Biobags) to support premature fetal lambs and to bring them to maturation in a way not previously possible. The researchers have called attention to possible implications of these systems for sustaining premature human fetuses in a similar way. Some commentators have pointed out that perfecting these systems for human fetuses might alter a standard expectation in abortion practices: that the termination of a pregnancy also (inevitably) entails the death of the fetus. With Biobags, it might be possible, some argue, that no woman has the right to expect that outcome if the technology is able to sustain fetal life an abortion. In order to protect the expectation that the termination of a pregnancy always entails the death of the fetus, Elizabeth Romanis has argued that fetuses sustained in Biobags have a status different than otherwise 'born' children. In support of that view, she argues that these 'gestatelings' are incapable of independent life. This argument involves a misunderstanding of the gestational support involved, as well as a misapprehension of neonatology practice. Here, we argue that any human fetus sustained in a Biobag would be as 'independent' as any other premature infant, and just as 'born'. Neonatologists would seem to have certain presumptive moral responsibilities toward any human fetus gestating in a Biobag. It remains a separate question whether the perfection and widespread application of Biobags for premature human beings would or should alter the expectation that ending a pregnancy also entails fetal death.
研究团队利用宫外系统（生物袋）来支持早产的胎羊，并以前所未有的方式使其成熟。研究人员已提请人们注意这些系统可能对以类似方式维持早产人类胎儿生命产生的影响。一些评论家指出，完善这些用于人类胎儿的系统可能会改变堕胎实践中的一个标准预期：即终止妊娠也（不可避免地）导致胎儿死亡。一些人认为，有了生物袋，如果这项技术能够维持胎儿生命——堕胎，那么可能没有女性有权期望出现那种结果。为了保护终止妊娠总会导致胎儿死亡这一预期，伊丽莎白·罗曼尼斯认为，在生物袋中维持生命的胎儿与其他正常“出生”的孩子具有不同的地位。为支持这一观点，她认为这些“体外孕育儿”无法独立生存。这一论点既涉及对所涉及的孕期支持的误解，也涉及对新生儿学实践的错误理解。在此，我们认为，任何在生物袋中维持生命的人类胎儿都将与其他任何早产儿一样“独立”，也同样是“出生”的。对于任何在生物袋中孕育的人类胎儿，新生儿科医生似乎都负有某些推定的道德责任。生物袋用于早产人类的完善和广泛应用是否会或应该改变终止妊娠也意味着胎儿死亡这一预期，这仍然是一个有待探讨的问题。
