Bioethicists are afraid of homunculi

The scientific world continues to argue about the prospects of an "artificial uterus"

Olga Solodovnikova, "Reactor"

Scientists have been breaking spears for months – how real is the threat of total rearing of children in artificial wombs, without the participation of women in this process. A loud informational occasion in April 2017 was thrown by a group of researchers from the Children's Hospital of Philadelphia (CHOP). They created a so-called bio-package, with the help of which they successfully "carried out" eight prematurely born lambs. The age of each fetus was equivalent to a human embryo at 23-24 weeks.

Each lamb was placed in a transparent plastic bag "Biobag" with an electrolyte solution simulating amniotic fluid, an umbilical cord tube and an oxygenator connecting the umbilical blood vessels of the fetus. The device provided blood circulation and oxygen exchange. In four weeks, the mammals grew up, became covered with fur, opened their eyes and learned to swallow.

The developers stated that "Biobag" can help in the care of premature babies. 23-24 weeks is a critical time for a human embryo. In developed countries, prematurity is the main cause of neonatal mortality. And surviving children have a high probability of subsequent health problems, which include lung diseases, cerebral palsy, hearing and vision disorders. According to CHOP experts, their device can significantly improve the vital signs of newborns in the future. This was the main goal of the team of scientists.

However, "Biobag" immediately became the object of loud discussions, writes The Atlantic. Dan Davis, a bioethicist from Lehigh University (Pennsylvania), developed the theme of an "artificial uterus" in the spirit of Aldous Huxley's dystopia "Brave New World", where conception and bearing of babies take place outside the body of a woman, under the control of an authoritarian state. The doctor was no less willing to cultivate futuristic fear Scott Gelfand from the University of Oklahoma – he expressed concern that soon employers will require employees to use "artificial uterus" to avoid maternity leave. And articles appeared in the UK media where the topic was considered from the point of view of feminists: according to the authors, technology can threaten a woman's right to an abortion.

It is noteworthy that the term "artificial uterus" was not used in principle in CHOP's research work. The text published in Nature Communications uses terms such as "system" and "device". And in the heat of sci-fi speculation, experts have forgotten about the main, already existing, ethical point: all over the world in neonatal intensive care units, parents and doctors are constantly faced with a dilemma, should they resuscitate extremely premature babies with a high probability of death and severe disability?

The Hastings Center, a bioethics research institute near New York, added fuel to the fire in July 2017. The professor 's report was published there Glenn Cohen, bioethicist and lawyer, which outlines the scenario of fetal transfer to an artificial uterus at 18 weeks. Such a development, according to Cohen, may force the courts to ban abortions, starting from this period.

What happens if doctors try to "relocate" an 18-week-old embryo to a "Biobag"? Alan Flake, a surgeon at Philadelphia Children's Hospital and lead author of the study, says there is a huge difference in the size and development of such a small fetus compared to a 23-week-old one. "The smaller the baby, the less blood flow in the system. If there is not enough blood flow, the blood will clot," Flake clarifies, "There is currently no device that could function adequately with a small volume of blood."

Even if an "artificial uterus" hypothetically supports reduced blood flow, it is impossible to associate it with such a tiny embryo – shares the opinion of a colleague Jutta Ahrens is a bioengineer working on artificial placenta technology at the University of Aachen in Germany. The cannulas of the "womb" should connect to the blood vessels of the baby, but the smaller the baby, the smaller its vessels. "In fact, there is a physical limit to everything we do regarding the diameter of fetal vessels," says Jutta, "Our current goal is 24 weeks of pregnancy. Maybe 23 or 22. But I don't think we are able to lower the bar even lower."

Today, several scientific groups around the world are working on the creation of an artificial placenta, which will allow nursing infants with critical body weight. At the same time, almost all researchers assure that they are not trying to reduce the age of viability of the embryo, which is currently 22-24 weeks.

And to the question whether "artificial wombs" can become an alternative to pregnancy in the near future, Alan Flake answers unequivocally: "This is all pure fantasy for fans of sensations. This is ridiculous. We will never have a zero-risk system."

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