Defining the Threshold of Human Birth: Ethical Introduction of Artificial Placenta (AP) and Artificial Womb (AW) Technology in the Neonatal Intensive Care Unit (NICU)
Saturday, September 21, 2024
8:45 AM – 9:45 AM CT
Location: Midway 3-4 (First Floor)
Abstract: AP and AW technology may move into first-in-human trials in the next few years. The ethical implications of this technology have inspired debate in the literature, with some ethicists and philosophers advocating to create a new “status of being” to describe a patient supported by AP/AW technology. These proposed states of being range from “gestateling” (a fetus outside the womb) to “fetonate” (a neonate with full human rights but retained fetal physiology). Adopting the “gestateling” paradigm requires changing the accepted definition of birth from “separated from the mother’s womb” to “utilizing the pulmonary system for oxygenation.” This not only has important implications for the “gestateling’s” humanness and legal personhood, but competing definitions and arguments also raise questions about the intersection of reproductive choice and NICU care. This is especially salient after the Dobbs decision and the multiplicity of state abortion laws that have been enacted. Adopting the “gestateling” paradigm in states with restrictive abortion laws may imperil a neonatologist’s ability to offer end-of-life care and comfort measures, thereby unjustly obligating non-beneficial care to a dying neonate. Conversely, states with permissive abortion laws may allow for the termination of a patient supported by AP/AW technology as they do not meet the proposed redefinition of birth. It is imperative that clinicians quickly establish a consensus on how to incorporate AP/AW technology into clinical practice justly. In this session, we will provide practical recommendations for the ethical consideration of these patient’s moral status and rights when introducing AP/AW technology to the NICU.
Learning Objectives:
After participating in this conference, attendees should be able to:
Compare and contrast the traditional understanding of birth and its associated rights with the “birth-by-location/birth-by-physiology" paradigms proposed in the literature
Understand the ethical arguments surrounding the status of being for patients supported by AP/AW technology and the corresponding impact on both the human rights of the patient and parental authority
Identify core principles for the introduction of AP/AW technology into clinical practice that should guide clinicians’ understanding of the patient and their ethical responsibilities
Ashley Fernandes – Professor of Pediatrics, The Ohio State University College of Medicine; Stephanie Kukora – Children's Mercy Hospital
