Ectogenesis, medicalisation and difficulties for the doctor

By Victoria Adkins.

In the literature concerning ectogenesis – the process of gestating a foetus outside of the human body (in an artificial womb) – discussions have been concerned with its possible implications for pregnant women. However, in order to consider these implications effectively we must also look at the relationship between pregnant women and their doctors, as well as a doctor’s treatment of the foetus.

In my paper, I have sought to shed light on the current medicalised nature of pregnancy and childbirth, whilst also examining how this may be impacted by ectogenesis. The issues raised by medicalisation include changes in the exchange of information between doctors and pregnant women, concerns of presumed consent in prenatal testing and heightened expectations of medicine. Additionally, there is a concern that foetuses have come to be treated as patients in their own right. Each of these issues can limit a women’s autonomy in decisions regarding her pregnancy or cause tension between her and her doctor.

Ectogenesis may impact each of these existing problems by putting more expertise at the feet of the doctor, causing informed consent to become more questionable (due to a lack of understanding in the technology) and encouraging a further increase in the expectations of medicine. In relation to the foetus, although treatment may be physically easier with the separation of mother and foetus, difficulties arise for doctors in determining how to treat foetuses gestated by different means.

These implications will impact women and other intended parents, but will also have implications for healthcare professionals who will be responsible for delivering the “treatment”. Whilst the status of an ectogenic foetus has been discussed at length elsewhere (for example see papers by Elizabeth Chloe Romanis and Nick Colgrove), I seek to highlight how any such status may also impact treatment decisions for doctors, thereby exposing the practical difficulties of this unsettled dispute.

In order to prevent the medicalisation of reproduction causing any further damage to pregnant women or intended parents’ autonomy, I argue that extensive information provision and new legislation, as well as clear treatment guidance, is necessary. Whilst the call for revised legislation is nothing new in the debate regarding ectogenesis, I hope to have illustrated that such changes are not only necessary for women but also for the healthcare professionals responsible for their care and that of a foetus, however it is gestated.

 

Paper title: The impact of ectogenesis on the medicalisation of pregnancy and childbirth

Author: Victoria Adkins

Affiliations: PhD Student at Royal Holloway, University of London

Competing interests: None declared.

Social media accounts of post author: @VickyAdkins1990

 

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