The ethics of termination of fetal life if ex-utero gestation technology develops

RDM_83 again

Firstly this is something I thought about a while ago and am interested in other peoples views on this and I think that if this technology ever comes to pass it would have interesting ethical dilemas.
Posting it hear because I would hazard that most posters here are pro-choice and I am not really interested in a religious based argument
(mods feel free to lump it into the abortion discusion thread if its more appropriate there or a different forum)

My question is basically this.

At some point in the future it may be possible to carry to term human life outside the womb from a very early stage.
In this case termination of pregnancy as occurs in most abortions would not result in the death of the fetus.

This would mean that after a woman has an abortion a child could still result, AFAIK doctors have a duty to protect life where ever possible (including fetal life).
This would be viewed as a positive by many, however the issue is that for some adoption itself is apparently a traumatic experience.

Therefore would the 'Termination of Fetal Life' separate to the 'Termination of Pregnancy' be ethical in a situation where the 'mother' demands it, even though there is no direct impact on her health or quality of life but the existence of the child itself may cause some level of mental distress.

Turtwig

It would depend on two things.

• Whether the foetus has the same rights as an adult human. Basically interpretation of personhood again.
• Whether the adoption has an impact on the mother's physical or mental being.

Even if we assume the foetus isn't human in any way we still have to justify destroying it. Justification here isn't so easy. Unless it can be significantly proven that adoption bears significant health risks to the mother then I can't see the termination being justified. The foetus doesn't really pose a threat to her and it's not occupying her own body.

swampgas

I must confess I seem to have a very utilitarian approach to human reproduction - much as Mother Nature seems to have.

I don't see why a foetus should survive unless there is an adult human willing to act as its (future) parent. A foetus doesn't exist in a vacuum, it is a means to an end - a functioning child and ultimately a functioning adult human, ideally capable of producing its own offspring in the fullness of time.

Dades

This is the thing about the abortion debate - there is no right/wrong, black/white answer. And as medical technology moves along the lines will remain blurred.

Turtwig

swampgas wrote: »

I must confess I seem to have a very utilitarian approach to human reproduction - much as Mother Nature seems to have.

I don't see why a foetus should survive unless there is an adult human willing to act as its (future) parent. A foetus doesn't exist in a vacuum, it is a means to an end - a functioning child and ultimately a functioning adult human, ideally capable to producing its own offspring in the fullness of time.

The issue here, correct me if I'm wrong OP, is that there is a human willing to look after it but that in itself may cause harm or distress to the mother. Under those circumstances should the mother be allowed to terminate. Here it's not quite clear but I guess if we're assuming technology we can also assume better mental and physical health assessment too. Basically, I think it boils down to impact, if the mother's quality of health is significantly affected by an outcome of a foetus she should have first choice as it's her health and her body. The difficulty here is determining "significantly". How much morbidity should one accept before being allowed the right to terminate. I guess a sort of morbidity index like those they use to determine eligibility for drug grants might work. Depending on the impact the adoption would have on the woman where she falls on objectively on the scale would determine if she was allowed to terminate foetal life. Presumably under this scenario the father's opinion would also have to be given some weight.

riffmongous

Jernal wrote: »

The issue here, correct me if I'm wrong OP, is that there is a human willing to look after it but that in itself may cause harm or distress to the mother... Presumably under this scenario the father's opinion would also have to be given some weight.

This would surely cause some huge amount of troubles, considering even at the moment this is an issue. Personally I would find the idea of a termination in this scenario abhorrent at first, even without a willing adopter. How to deal with things like a suicide risk for the mother though I would have no idea

swampgas

Jernal wrote: »

The issue here, correct me if I'm wrong OP, is that there is a human willing to look after it but that in itself may cause harm or distress to the mother. Under those circumstances should the mother be allowed to terminate. <...> Presumably under this scenario the father's opinion would also have to be given some weight.

Once the woman is no longer acting as the physical "incubator", the ethical issues become somewhat similar to those with IVF.

The big question is who owns or has rights to your DNA? And does an embryo or foetus have rights of its own which supercede those of its parents?

There was a case a while back where a woman wanted to go ahead with IVF using (I think) frozen sperm or embryos even though the relationship with her husband had ended and he did not want the pregnancies to be attempted.

Where the embryo or foetus is no longer implanted in a womans body, surely there is a case for both genetic parents to have a say as to what happens?

RDM_83 again

Jernal wrote: »

The issue here, correct me if I'm wrong OP, is that there is a human willing to look after it but that in itself may cause harm or distress to the mother. Under those circumstances should the mother be allowed to terminate.

Jernal wrote: »

It would depend on two things.

• Whether the foetus has the same rights as an adult human. Basically interpretation of personhood again.

Yes thats the basic gist of it, its interesting to me because if this technology does ever arise the boundaries of what is a potential independent human life would be pushed back to an very early date.

It brings about a question of the level of 'ownership' that the mother or possibly the father can have as the creator of that life, does the fact they are responsible for its creation mean that they have ultimate control over its cessation.

Dades wrote: »

This is the thing about the abortion debate - there is no right/wrong, black/white answer. And as medical technology moves along the lines will remain blurred.

Others may disagree with me (particularly as my views on the wider debate vary) but too me this dilemma is rather different to the present day debate as the present day debate focuses on Abortion is of it being the Termination of Pregnancy, the ethical implications are very different when one sets out to explicitly Terminate Fetal Life rather than it being the unfortunate bi-product of the procedure.

swampgas wrote: »

I don't see why a foetus should survive unless there is an adult human willing to act as its (future) parent. A foetus doesn't exist in a vacuum, it is a means to an end - a functioning child and ultimately a functioning adult human, ideally capable of producing its own offspring in the fullness of time.

Not really the argument I am trying to go for, but a new born child is functionally utterly dependent on an adults, and even with this pragmatic approach the issue is not resolved where there is a willing adoptive parent.
I do think we probably have very different views of new borns than people would have had through out other periods of history when infant mortality was extremely high and in cultures where infanticide was common.

Jernal wrote: »

Basically, I think it boils down to impact, if the mother's quality of health is significantly affected by an outcome of a foetus she should have first choice as it's her health and her body. The difficulty here is determining "significantly". How much morbidity should one accept before being allowed the right to terminate. I guess a sort of morbidity index like those they use to determine eligibility for drug grants might work. Depending on the impact the adoption would have on the woman where she falls on objectively on the scale would determine if she was allowed to terminate foetal life. Presumably under this scenario the father's opinion would also have to be given some weight.

In this scenario however does the argument that its her health and her body apply? Once the 'Termination of Pregnancy' occurs the fetus is not part of her body by any measure though non-sentient its a genetically different "individual" thats not dependent on her body in any way.

I am not disregarding the impact adoption can have on the 'natural mother' (I remember there was a poster who spoke of its impacts on her on a different thread), but the use of a morbidity index seems problematic on a number of levels

kylith

I can see how ex-utero gestation would be beneficial for people who have problems conceiving, but I really can't see how a foetus would survive being removed from the womb and being transplanted into an artificial one since the placenta would already be formed.

robindch

RDM_83 again wrote: »

At some point in the future it may be possible to carry to term human life outside the womb from a very early stage. In this case termination of pregnancy as occurs in most abortions would not result in the death of the fetus.

It depends on the point during pregnancy at which you declare that a fertilized egg acquires the rights of a live human being. The religious tend to choose the time of conception while the irreligious tend to choose a later time - the choice really just comes down to personal preference.

nagirrac

robindch wrote: »

It depends on the point during pregnancy at which you declare that a fertilized egg acquires the rights of a live human being. The religious tend to choose the time of conception while the irreligious tend to choose a later time - the choice really just comes down to personal preference.

Religious views on that question are almost as diverse as non religious. Within the various Protestant traditions for example, you have a spectrum from total opposition to abortion from conception onwards to support for abortion rights. Most religions allows for abortion in the early stages of pregnancy, although the cut off varies a lot and is usually associated with when the "soul" enters the body (this varies by religion but I think 3 to 4 months is typical). On the related question of rights as a full human being, I am pretty sure Jews for example believe this right is associated with birth.

Even within the Catholic church the strong anti abortion stance is recent, 1930 and Pope Pius XI. Early Christian theologians allowed for abortion up to 3 months.

RDM_83 again

kylith wrote: »

I can see how ex-utero gestation would be beneficial for people who have problems conceiving, but I really can't see how a foetus would survive being removed from the womb and being transplanted into an artificial one since the placenta would already be formed.

I picture big vats of blue liquid filled with bubbles to be honest its not a technology I can see happening in the immediate future but who knows what advances will occur in even 20 years of biomedical research.

robindch wrote: »

It depends on the point during pregnancy at which you declare that a fertilized egg acquires the rights of a live human being. The religious tend to choose the time of conception while the irreligious tend to choose a later time - the choice really just comes down to personal preference.

This is one of the reasons I think that this is an interesting ethical question and why I asked here as those with a opposition to abortion would simply believe that the fetus should be incubated to term. So I am more interested in how this dilemma would be resolved outside of a religious context (obviously not implying all atheists are pro-choice though)

If there is a capacity for independent life (from the mother) throughout the fetal development, then the criteria of humanity becomes more rooted in the idea of consciousness or reaction to stimuli.

If this technology develops then abortion no longer becomes a de-facto termination of life but rather a completely separate issue.

So in a sense the question of when "Humanity" itself is legally conferred becomes secondary as after the termination of pregnancy the fetus isn't part of another human being in any meaningful sense either genetically of physically, but it could still have indirect negative psychological effects on the mother.

recedite

kylith wrote: »

.. I really can't see how a foetus would survive being removed from the womb and being transplanted into an artificial one since the placenta would already be formed.

This is true. Also, the act of abortion kills the foetus, with the limbs being removed one piece at a time in the case of late term abortions.

A better example of the ethical dilemma posed by the OP would be to consider a case where the foetus was grown from the start in vitro.
(ie in bubbly blue liquids). Then we can consider the question of who has ownership, or whether ownership of one human by another is possible at all.

magicbastarder

kylith wrote: »

I really can't see how a foetus would survive being removed from the womb and being transplanted into an artificial one since the placenta would already be formed.

i can't see how it would be possible either, but i can see how it could be possible.

sephir0th

robindch wrote: »

It depends on the point during pregnancy at which you declare that a fertilized egg acquires the rights of a live human being. The religious tend to choose the time of conception while the irreligious tend to choose a later time - the choice really just comes down to personal preference.

Personal preference perhaps, but one side (conception) chooses that side under the claim that a soul is implanted, or there is 'potential' for life at this point which is arbitrary and not founded in reason.

I prefer to at least apply some reason here - look at the point in development at which the capacity to suffer begins or/and self-awareness, and stay on the safe side by a large enough buffer until science understands the development more.

gaynorvader

I think you'd need to have someone willing to take care of the child once it's born. Would there still be a greater danger with this hypothetical technology over a normal abortion, or are you assuming them to be equally dangerous/safe to a pregnant woman's health?

RDM_83 again

sephir0th wrote: »

Personal preference perhaps, but one side (conception) chooses that side under the claim that a soul is implanted, or there is 'potential' for life at this point which is arbitrary and not founded in reason.

I prefer to at least apply some reason here - look at the point in development at which the capacity to suffer begins or/and self-awareness, and stay on the safe side by a large enough buffer until science understands the development more.

The "rational side" isn't really that clear cut either, AFAIK a new born child doesn't have self awareness. Capacity to suffer is probably easier to determine, but you could argue that though the Nervous System isn't integrated in the brain pre possibly 22-28 weeks there is a possible discomfort response before that, additionally if anaesthesia is used the impact of pain is absent, rationally that could allow 'termination of life' until an extremely late stage if self awareness is the only concern.
Anyway I started this thread separately because its not really about current abortion issues, which remember centre on the "termination of pregnancy".

gaynorvader wrote: »

I think you'd need to have someone willing to take care of the child once it's born. Would there still be a greater danger with this hypothetical technology over a normal abortion, or are you assuming them to be equally dangerous/safe to a pregnant woman's health?

Morally though why would a 'potential' child thats wanted hold any more value than one thats unwanted.
Practically I believe that even if this technology came to pass it would only be applied in the way you say but I am not sure that practicality should always enforce laws and ethics, practically it probably does make sense to carry out involuntary sterilisation above a certain family size in many 3rd world countries.

recedite wrote: »

A better example of the ethical dilemma posed by the OP would be to consider a case where the foetus was grown from the start in vitro.
(ie in bubbly blue liquids). Then we can consider the question of who has ownership, or whether ownership of one human by another is possible at all.

Yeah that would carry the same dilemma, however I think in the termination of pregnancy example, there is a greater emphasis on the fact that the child is not wanted by at least one parent, but yes it is about ownership but its also about the idea of what happens when termination of pregnancy becomes detached from termination of fetal life. Does any (indirect) mental discomfort on the mothers part over-rule any fetal "right to life"

recedite

You can't in practice separate "termination of pregnancy" from "abortion".
The religious make that distinction sometimes when they want to justify an abortion which is needed to save the mothers life. They say the abortion is only a side effect of the procedure to terminate the pregnancy, and is not the intended consequence. Its a sham argument IMO.

I suggest assigning rights of undeveloped humans in the same way we do for animals, on a sliding scale. So we give a chimpanzee more rights than a tadpole. In the early stages, a human zygote is not very different to a frog zygote.

RDM_83 again

recedite wrote: »

You can't in practice separate "termination of pregnancy" from "abortion".
.

Thats why I placed it as hypothetical exercise, and I deliberately used the terms "termination of pregnancy" and "termination of fetal life" in my posts rather than the term abortion. I have heard both "sides" arguing about nomenclature even a quick google throws up different definitions (from non-biased sites!)

recedite wrote: »

I suggest assigning rights of undeveloped humans in the same way we do for animals, on a sliding scale. So we give a chimpanzee more rights than a tadpole. In the early stages, a human zygote is not very different to a frog zygote.

Ok, but in terms of ownership of the zygote, if there is a disagreement on the "treatment" desired, does control automatically fall the mother, the zygote is a product of two peoples genetic material after all.
Note in this situation I am hypothesizing that the procedure for destruction of the zygote is equal to the procedure procedure for extraction and incubation in terms of pain/risk.
Does the fact that the fact that its a genetically different organism allow the state/wider society have an input into its treatment, after all a tadpole can stop a major road development (or in the Irish case its a Snail)

recedite

RDM_83 again wrote: »

after all a tadpole can stop a major road development (or in the Irish case its a Snail)

True, but not because individual snails had rights. It was because the species was deemed to be endangered.

IMO the question of ownership of the zygote/embryo/foetus depends on whether you have decided to assign human rights to it.

If not, then ownership has to be divided between the two parents (and the laboratory, if it exists in vitro). Perhaps the proportions partly depend on the work and/or the expense each party has already put in.
And in the case of the parents, especially the male, partly on a genetic ownership basis, similar to copyright, even if little "work" has been done.

If human rights are assigned (due to it being in the later stage of development) and there is a threat to violate those human rights, then wider society can step in to make the new person a ward of court.

sephir0th

RDM_83 again wrote: »

The "rational side" isn't really that clear cut either...

I definitely don't think it's clear cut either. I just think, at least, some sort of reasoned framework is applied. One thing is for sure, the moment of conception (if you can even argue it's a moment) is of no significant relevance - it's just a clump of cells.

If we are going to argue about 'potential', then I am potentially killing thousands every time I masturbate. Also, given the statistics, god would be the biggest abortionist!

gaynorvader

RDM_83 again wrote: »

{...}

Morally though why would a 'potential' child thats wanted hold any more value than one thats unwanted.
Practically I believe that even if this technology came to pass it would only be applied in the way you say but I am not sure that practicality should always enforce laws and ethics, practically it probably does make sense to carry out involuntary sterilisation above a certain family size in many 3rd world countries.

{...}

That's not quite what I was getting at. If there is no guardian for the potential child it should be terminated while it is still a mass of cells, before it becomes closer to a human child. If there were a guardian, and no harm was caused to the pregnant woman, there should be no reason why the foetus should not be allowed gestate in the artificial womb.

oldrnwisr

RDM_83 again wrote: »

Firstly this is something I thought about a while ago and am interested in other peoples views on this and I think that if this technology ever comes to pass it would have interesting ethical dilemas.
Posting it hear because I would hazard that most posters here are pro-choice and I am not really interested in a religious based argument
(mods feel free to lump it into the abortion discusion thread if its more appropriate there or a different forum)

My question is basically this.

At some point in the future it may be possible to carry to term human life outside the womb from a very early stage.
In this case termination of pregnancy as occurs in most abortions would not result in the death of the fetus.

This would mean that after a woman has an abortion a child could still result, AFAIK doctors have a duty to protect life where ever possible (including fetal life).
This would be viewed as a positive by many, however the issue is that for some adoption itself is apparently a traumatic experience.

Therefore would the 'Termination of Fetal Life' separate to the 'Termination of Pregnancy' be ethical in a situation where the 'mother' demands it, even though there is no direct impact on her health or quality of life but the existence of the child itself may cause some level of mental distress.

This is an interesting thought exercise but also a frustrating one because the parameters are not well defined and because it is far too removed from any realistic scenario.

Firstly, you need to define what you mean by "from a very early stage". Are we talking 2 weeks, 2 months, 4 months etc.

Secondly, once you define what you mean by "very early stage" you need to establish how a foetus/embryo/zygote could be safely removed from its mothers womb and what kind of technology you could use to carry the foetus to term. For example, let's say that your "early stage is 6 weeks. At this point the embryo is just a clump of rapidly dividing cells. How would you propose to a) remove it safely and b) continue to provide a growth medium for it? If it is possible to care for an embryo at this stage of development then it is not implausible to conceive of being able to grow a human from a zygote. So the question at this stage would become whether people should be grown for the benefit of society?

It seems to me that the only plausible early stage scenario is well into the foetal stage somewhere around 16 weeks. At this point the foetus has organs that are established but yet still vastly underformed and is very far from viability. It could be possible with some advances in techniques like ECMO and AIMD to foresee the ability to incubate a foetus from this stage. However, the problem here is that it isn't going to be much of a solution. Current figures suggest that approximately 91% of all abortions are performed before 12 weeks. If we were to change this to 16 weeks and include all abortions performed for emergency purposes then we are talking about 97%. So even in a semi-plausible scenario you are talking about a solution which is only going to be 3% effective in reducing the number of abortions.

Then you would have to consider the risks associated with developmental problems, i.e. the chances that the foetus will develop a severe mental or physical defect as a result of this procedure. This is already a problem for preterm births although it has lessened slightly in the last 20 years. The quality of life that you're trying to save must be a consideration and not just life at any cost.

In conclusion, I think that the parameters of the scenario are too unrealistic to contribute anything to the overall debate. Changing these parameters to increase plausbility is going to have a proportional negative impact on the effectiveness and relevance of the solution.

Finally, one more caveat which I hesitate to mention because of its divisiveness. If you mean to protect foetal life then you need to define life in a meaningful way. This is, personally, one of the most annoying aspects of debating abortion. The idea that life begins at conception is, frankly, ludicrous. It has no meaning in the context of the debate.

RDM_83 again

oldrnwisr wrote: »

It seems to me that the only plausible early stage scenario is well into the foetal stage somewhere around 16 weeks. At this point the foetus has organs that are established but yet still vastly underformed and is very far from viability. It could be possible with some advances in techniques like ECMO and AIMD to foresee the ability to incubate a foetus from this stage. However, the problem here is that it isn't going to be much of a solution. Current figures suggest that approximately 91% of all abortions are performed before 12 weeks. If we were to change this to 16 weeks and include all abortions performed for emergency purposes then we are talking about 97%. So even in a semi-plausible scenario you are talking about a solution which is only going to be 3% effective in reducing the number of abortions.

Then you would have to consider the risks associated with developmental problems, i.e. the chances that the foetus will develop a severe mental or physical defect as a result of this procedure. This is already a problem for preterm births although it has lessened slightly in the last 20 years. The quality of life that you're trying to save must be a consideration and not just life at any cost.

In conclusion, I think that the parameters of the scenario are too unrealistic to contribute anything to the overall debate. Changing these parameters to increase plausbility is going to have a proportional negative impact on the effectiveness and relevance of the solution.

Ok if it was in the time period you consider possible, within the UK thats still in the region of 3000 terminations (or less because of exclusions for emergency terminations). To put that in context thats probably about half the number of terminations that occur annually to Irish woman, if I was too say that the numbers of Irish woman having abortions is so low as too be insignificant I would rightly be torn to shreds.
Anyway its more put forward as a thought problem at present, predicting future technological trends even 30 years ahead is highly uncertain.

oldrnwisr wrote: »

Finally, one more caveat which I hesitate to mention because of its divisiveness. If you mean to protect foetal life then you need to define life in a meaningful way. This is, personally, one of the most annoying aspects of debating abortion. The idea that life begins at conception is, frankly, ludicrous. It has no meaning in the context of the debate.

True, but it is alive at conception, the micro-organisms in my body would never be considered "not alive" by a biologist but they are unthinking and completely dependent on me for life.
Humanity is a different matter, but I've not seen this issue being examined clinically and rationally by the pro-choice side either, if its contingent on awareness how do we define it, as I said earlier a new born baby lacks many of the features of humanity (there's a good ethics paper on the idea of post natal termination that dwells on this)

here's the link to the paper its an interesting read
http://jme.bmj.com/content/early/2012/03/01/medethics-2011-100411.full

recedite wrote: »

True, but not because individual snails had rights. It was because the species was deemed to be endangered.

IMO the question of ownership of the zygote/embryo/foetus depends on whether you have decided to assign human rights to it.

Yeah thats true about conservation law.


Yes thats one of the issues that I feel should be examined and isn't presently, its why I keep talking about the idea of termination of life being separate to termination of pregnancy in this case.

recedite

RDM_83 again wrote: »

here's the link to the paper its an interesting read
http://jme.bmj.com/content/early/2012/03/01/medethics-2011-100411.full

Its interesting alright. The e-mail responses down below it are disappointing though, they mostly focus on dictionary definitions and fail to see the point.

"Birth" itself is somewhat arbitrary moment these days. A very premature baby can be moved into an incubator where it basically resumes its previous existence as a foetus. Even the moment the foetus/baby starts air-breathing is not hugely significant from an ethical standpoint, in terms of its "personhood".
The main difference is that it has been seen or "observed" by others.
This is really what prompts us to assign human rights. Its purely subjective of course, there is no objective reason to suddenly assign it full human rights at that particular moment.
Maybe that's why babies have evolved to look so cute. Self-protection.