2 February 2023

Birth from a dead 'surrogate mother

A professor at the University of Oslo proposes using the bodies of women in irreversible comas, which can be damaged without ethical complications, to carry out pregnancies for others. But also men in a vegetative state (so feminists don't get angry) by grafting embryos into their livers. And children? Theme not considered
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It may have been inspirational Habla con ella, films by Pedro Almodovar in which the young dancer Alicia, in a coma after an accident, becomes pregnant by Benigno, the nurse who looks after her.

Anna Smajdor, Professor of Medical Bioethics University of Oslo, takes up and elaborates on a suggestion made in 2000 by Israeli researcher Rosalie Ber 'to circumvent the moral problems of gestational surrogacy' using women in a persistent vegetative state (PVS) as surrogates. The practice is called 'gestational whole-body donation'. (WBGD, whole-body gestational donation).

According to Smajdor, the WGBD "offers a alternative means of gestation for prospective parents who wish to have children but cannot or prefer not to gestate'. It would be a matter of considering "the possibility of donating one's whole body for gestational purposes just as some people donate parts of their bodies for organ donation. We already know that pregnancies can be successfully completed in brain-dead women. There is no obvious medical reason why such pregnancies would not be possible'.

The couple's embryos would be grafted into the uterus of the brain-dead woman which should therefore be properly ventilated and supported until their development.

Smajdor suggests 'using the framework for organ donation: "wherever organ donation is legal, WBGD with brain death would be a relatively simple modification.

Unlike Habla con ella "the pregnancy must not arise through 'natural' conception, in other words as a result of rape. "The commissioning parents might prefer creating an embryo for implantation using their own gametes or those of donors. So impregnation could be a surgical matter, preceded and followed by appropriate hormone therapy to ensure maximum chance of success'. 

The advantage is that "the pregnant woman is already dead and cannot be harmed. The commissioning parents can decide on abortion or selective reduction according to their own wishes, without having to worry about the effects on the pregnant woman'. Usually "We do not dare to transfer too many embryos into living women, because selective reduction is traumatic and harmful to the pregnant woman. There are no such problems in relation to the WBGD donor. Whether she needs more or less of a particular drug or whether fetal interventions are required, we will have none of the potential conflicts that may arise for ordinary pregnancies. Parents can transfer as many embryos as they can generate, maximising the chances of at least one viable birth and, if necessary, discarding damaged or diseased ones in advance'.

But there is more and better: WGBD mothers can also be men. In this way 'feminist concerns could be mitigated ... The prospect of a male pregnancy is not, as many would imagine, fanciful or science fiction. In 1999, Robert Winston told reporters that there were no inherent medical problems with the onset of a male pregnancy: the danger would be in childbirth. We already know that pregnancies can come to term outside the womb. The liver is a promising implantation site, thanks to its excellent blood supply. However, as Winston noted, this could be risky, even fatal, for the person carrying the pregnancy. But for brain-dead donors, the concept of 'fatal' is meaningless: the pregnant person is already dead. Therefore, even if the liver is irreparably damaged after gestation, this would not pose a problem if not to the extent that it might mean that pregnant males could only carry one pregnancy to term'.

"The prospect of the male gestant might therefore appease some feminists who might otherwise consider brain-dead gestation to be a step too far in the objectification of women's reproductive functions'.

What might be thought by those born to brain-dead mothers -because you have to tell them sooner or later, the right to the truth about one's origins is enshrined in international conventions; what becomes of that complex epigenetic relationship between the pregnant woman and the foetus, a true biochemical and sensory dialogue between the mother's body and that of the child; in short Professor Smajdor does not deal with all these other facets.

translation and adaptation by Marina Terragni, original article published here

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