Although artificial womb technology has been proposed as a solution for neonates born earlier than 22 weeks gestational age, clinical application has yet to come to fruition, precluding researchers’ ability to determine the full extent of the medical and ethical implications associated with the technology.
In a paper published in the Journal of Medical Ethics, Elizabeth Chloe Romanis, PhD candidate at the University of Manchester School of Law Centre for Social Ethics and Policy in the United Kingdom, discussed the conceptual differences and potential implications of artificial womb technology as it applies to human reproduction.
Newborn mortality is largely related to preterm birth, or birth before 37 weeks’ gestation. The biobag, a relatively new development in artificial womb technology, has demonstrated promise in animal studies for supporting life for up to 4 weeks by mimicking the uterine environment. The biobag is comprised of a sealed bag which encapsulates the infant and contains umbilical cord access and a pumpless oxygenator circuit. The biobag remains in early stages of research — which has been performed in only animal models — leading to a tremendous need to determine whether this artificial womb can be safely used in humans.
The intention of use of the biobag is to reduce the incidence of preterm infant mortality as well as disability in “just-viable” preterm infants. According to Ms Romanis, artificial womb technology including the biobag may offer better health improvements in preterm newborns due to its ability to replicate the uterine environment more efficiently than neonatal intensive care support. In addition, conventional neonatal intensive care is invasive and exposes the preterm infant to the outside environment as well as skin-to-skin contact, possibly impacting development. Conversely, the biobag encases the infant and reduces outside disturbances, which researchers suggest may improve outcomes. Despite this supposition, the long-term implications of artificial womb technology remain unknown.
Identifying distinctions between artificial womb technology and neonatal intensive care “is crucial to inform ethicolegal discussion and ensure better protection for affected parties,” Ms Romanis wrote. “Being mindful of these differences allows us to consider what, if any, additional regulation is appropriate to ensure [artificial womb technology] research and its potential clinical applications are ethical.”
Romanis EC. Artificial womb technology and the frontiers of human reproduction: conceptual differences and potential implications [published online August 10, 2018]. J Med Ethics. doi:10.1136/medethics-2018-104910