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Artificial Wombs and the Intellectual Tasks of Building Cultures of Life

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When Pope Emeritus Benedict XVI met with artists in the Sistine chapel in 2009, he noted that “an essential function of genuine beauty, as emphasized by Plato, is that it gives man a healthy ‘shock,’ it draws him out of himself, wrenches him away from resignation and from being content with the humdrum.”[1] Artists are often among the first social commentators, who like the saints, see the depths of reality with piercing acuity. In the shadow of the Industrial Revolution, surrealist artists perceived the “unintended consequence” of mass production: alienation and fragmentation. Artists, like Rene Magritte, intuited the coming dissolution of human intimacy. “The Lovers” (1934) depicts a man and woman turned toward one another in an intimate embrace, and against the grey background their faces are shrouded in cloth. They kiss but their lips never touch and their eyes never meet. The viewer is “shocked” so to speak. Their kiss is a non-kiss, their embrace a non-embrace. Their intimacy is a simulacrum of intimacy, set against the dark sky—or is it smoke? The same year, Hans Bellmer’s, “The Doll,” shows a dissembled mannequin. Body parts are lumped together in a disarrayed heap.

In 1932, a few years before Magritte and Bellmer, Aldous Huxley published the dystopian masterpiece Brave New World. It is a foreboding literary critique of industrialization and the destruction of human community. The crisis goes all the way down to forgetting the language of marriage, motherhood, and fatherhood, and extends to the highest reaches of a culture which has turned against culture because technology no longer bends with the grain of the universe. Human beings are no longer created. They are decanted.

Artists can act as prophets who point to the consequences of technological advancement, which is nearly always tied to wealth, power, and prestige. I couldn’t help but think of this as I read the study published last week in the journal Nature Communications. Scientists from the Children’s Hospital of Philadelphia (CHOP) reported promising findings of research on the use of extracorporeal fetal support—artificial wombs. In Huxley’s Brave New World, Mr. Foster, a scientist and assistant director at the Hatchery and Conditioning Centre, happily describes the process of mass-producing human beings:

“For of course,” said Mr. Foster, “in the vast majority of cases, fertility is merely a nuisance. One fertile ovary in twelve hundred—that would really be quite sufficient for our purposes. But we want to have a good choice. And of course one must always have an enormous margin of safety. So we allow as many as thirty percent of the female embryos to develop normally. The others get a dose of male sex-hormone every twenty-four meters for the rest of the course. Result: they’re decanted as freemartins—structurally quite normal (except,” he had to admit, “that they do have the slightest tendency to grow beards), but sterile. Guaranteed sterile. Which brings us at last,” continued Mr. Foster, “out of the realm of mere slavish imitation of nature into the much more interesting world of human invention.”

He rubbed his hands. For of course, they didn’t content themselves with merely hatching out embryos: any cow could do that. “We also predestine and condition. We decant our babies as socialized human beings, as Alphas or Epsilons, as future sewage workers or future. . . . ” He was going to say “future World controllers,” but correcting himself, said “future Directors of Hatcheries,” instead.[2] 

This is not to say that artificial wombs are ipso facto unethical. Indeed, they are truly remarkable. Fetal surgeon and lead author Alan Flake and a team of scientists suspended eight fetal lambs, ranging in gestational age from 104 to 135 days, in extra-uterine devices called “Biobags.” Blood, oxygen, and fluids circulate into and out of sterile, airtight sacs, allowing the lambs to continue to gestate as they would in a ewe’s womb. The Biobag looks somewhat like a vacuum-sealed storage bag, except, instead of a bag of crushed clothing stuffed in the back of the closet and forgotten until next spring, fetal lambs receive the nutritional support required for lung and brain maturation. Over the course of four weeks one can observe the exterior markers of ongoing development—movement, an increase in size, the growth of wool coats, the opening and closing of eyes.

This technology has the potential to revolutionize the care of prematurely born infants. After abortion, extreme premature birth is the leading cause of infant death in the United States, and, according to the researchers, nearly half of cerebral palsy cases can be attributed to premature birth. Infants who survive extreme preterm birth often suffer the effects of organ immaturity and lung disease. Rather than spend weeks or even months in an incubator, premature infants could continue normal fetal development in an extra-uterine simulated womb. Under some limited conditions this technology has the potential to save human life at its most fragile and vulnerable.

Researchers were quick to point out that the “goal is not to extend the current limits of viability,” but to improve outcomes for infants who are cared for in neonatal intensive care units.”[3] Flake further emphasized, “I want to make this very clear: We have no intention and we’ve never had any intention with this technology of extending the limits of viability further back.”[4] Intention or not, news of this technological leap has raised multiple concerns. What might it mean to mechanize and thus eliminate women from pregnancy and childbirth, to unmake motherhood (and fatherhood)? How might it impact the already gaping disparities in healthcare between the wealthy and the poor?

Bioethicists are already expressing reservations about the dangers of humanizing prenatal human beings. Lehigh University bioethicist Dena Davis expressed her concern that this could blur the line between a fetus and a baby in an interview with NPR. “Up to now,” she said, “we’ve been either born or not born. This would be halfway born, or something like that. Think about that in terms of our abortion politics.”[5] The manifest logic of this statement fundamentally prioritizes the false logic of politics, which functions through the power of assertion, against seeing reality as it truly is. The introduction of the state of “halfway born” dislodges what has to date been one of the strongest political assertions of the pro-choice movement: the preborn fetus is not a baby. The fetus is not a human person and not a member of the human community. In other words, the fetus is disposable. The baby, on the other hand, is human, and makes a claim upon society. Though one might wonder if bioethicists who are sympathetic to this view have forgotten the practice of partial birth abortion, which permitted the preborn child to be “halfway born” and then terminated. Artificial wombs do reintroduce the possibility of a mediating, middle state, that of the half-born, and they will likely require pro-choice advocates to double down on the right of a woman to terminate nascent life, regardless of viability.

The insistence that artificial womb technology will never push the limits of viability to the point where woman’s bodies are functionally replaced by technology and human gestation becomes mechanized, merely because “when you do that you open a whole new can of worms,” rings hollow in an age governed by an ethos of “what we can do we may do.” Thus, when legitimate ethical concerns are met with dismissals like, “that’s a pipe dream at this point,” one ought to pay attention, not to the predicative “pipe dream,” but rather its qualifier, “at this point.”[6] Science has shown little interest in internally regulating itself. In fact, researchers are already looking to extending the technology beyond its clinical application, including isolation of the fetus for stem cell and gene therapy and the “intriguing experimental model for addressing fundamental questions regarding the role of the mother and placenta in fetal development.”[7] 

Science, technology, and engineering progress often seem cloaked in an air of neutral inevitability. Yet, they too have built-in assumptions and predilections, such as the premise that what one can do one ought to do, or, the presumption that all knowledge can be secured empirically. Let me be clear: I am not arguing that science, technology, engineering, and math are ipso facto evils. Indeed, Pope Francis reminds us in his encyclical on the care for our common home that “technology has remedied countless evils which used to harm and limit human beings” (Laudato Si’, §102). But science and technology are also not purely objective, especially given the tendency “to make the method and aims of science and technology an epistemological paradigm” (LS §107). He further observes that when technological and scientific advances are linked with business interests they become weapons in the will-to-power:

Technology tends to absorb everything into its ironclad logic, and those who are surrounded with technology “know full well that it moves forward in the final analysis neither for profit nor for the well-being of the human race,” that “in the most radical sense of the term power is its motive—a lordship over all.” As a result, “man seizes hold of the naked elements of both nature and human nature.” Our capacity to make decisions, a more genuine freedom and the space for each one’s alternative creativity are diminished.

The technocratic paradigm also tends to dominate economic and political life. The economy accepts every advance in technology with a view to profit, without concern for its potentially negative impact on human beings (LS §§108-109). 

Several years ago, I read a collection of Rowan Williams’ homilies. In one homily the former Archbishop of Canterbury recounted a moment during a recent pilgrimage to Bethlehem when he had cradled a newborn baby in his arms at Holy Family Hospital. The infant child was one among many who, abandoned by their mothers, received some of the best care in the entire region, costing hundreds of dollars a day. These children, the poorest of the poor, received the best medical care in the West Bank bese, as medical director, Dr. Robert Tabash, said (as he peered into an incubator in the hospital’s NICU), “the poor deserve the best.” Meditating on Dr. Tabash’s simple, piercing utterance, Williams declares:

I wonder if you can take in just how revolutionary it is. They do not deserve what’s left over when the more prosperous have had their fill, or what can be patched together on a minimal budget as some sort of damage limitation. And they don’t “deserve” the best because they’ve worked for it and everyone agrees they’ve earned it. They deserve it simply because their need is what it is and because where human dignity is least obvious it’s most important to make a fuss about it.[8]

Holy Family Hospital uses technology. Incubators were once, like artificial wombs, a new life-saving technology. Yet, it is clear that the hospital’s use of technological innovation is based on its obligation to serve the poorest of the poor, those who are weakest and most vulnerable. This is a vision that includes but also goes beyond do’s and don’t’s of contemporary bioethics. This is a vision in which we “make a fuss” about those who seem least important; it is a vision that doesn’t eschew science and technology wholesale, but places them in a broader vision of “progress, one which is healthier, more human, more social, more integral” (LS, §112). Absent such a way of seeing—absent a compelling and coherent account of the human person and the formation of practices grounded in the preferential option for the poor—technology’s dazzling power will continue to leave us unable to render coherent judgments about its role in culture and society.

Featured Image: Leonard da Vinci, Studies of Embryos, 1513. Source: Wikimedia Commons, PD-Old-100.

[1] Benedict XVI, “Meeting with Artists,” https://w2.vatican.va/content/benedict-xvi/en/speeches/2009/november/documents/hf_ben-xvi_spe_20091121_artisti.html

[2] Aldous Huxley, Brave New World (New York: Harper Perennial, 2006), 13.

[3] Alan Flake, et. al., “An Extra-Uterine System to Physiologically Support the Extreme Premature Lamb,” in Nature Communications 8, April 25, 2017, Accessed Online: https://www.nature.com/articles/ncomms15112.

[4] Ibid.

[5] Rob Stein, “Scientists Create Artificial Womb That Could Help Prematurely Born Babies,” in All Things Considered (NPR), April 25, 2017, Accessed Online: http://www.npr.org/sections/health-shots/2017/04/25/525044286/scientists-create-artificial-womb-that-could-help-prematurely-born-babies.

[6] Ibid.

[7] Flake, et. al., op. cit.

[8] Rowan Williams, “The Poorest Deserve the Best,” in Choose Life (London: Bloomsbury, 2013), 41.