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Framing gestation: assistance, delegation, and beyond
  1. J Y Lee
  1. University of Copenhagen, Kobenhavn, Denmark
  1. Correspondence to Dr J Y Lee, University of Copenhagen, København, Denmark; ji.young.lee{at}

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Assisted conception (assistance with the process of fusing an ovum with a sperm cell to form a zygote prior to pregnancy) can be distinguished from assisted gestation (assistance with the ‘generative process between conception and birth’).1 These processes have tended to be grouped together under the generic term assisted reproductive technology (ART) in the bioethical literature. According to Chloe Romanis, however, it is worth distinguishing interventions such as surrogacy, uterus transplantation (UTx), and potentially artificial placenta technology, as falling under the genus assisted gestative technologies (AGTs). This is because gestation carries unique ethico-legal implications as compared with conception.

The proposed genus of assisted gestative technologies is a helpful first step in the endeavour to distinguish between the different ethico-legal landscapes across various ‘assisted reproductive technologies.’ I am generally in favour of adopting AGT as a term which separates various forms of gestational services from other kinds of reproductive technologies. Yet, if assisted gestative technologies can be considered a genus of assisted reproductive technologies, we might consider surrogacy, UTx, and artificial placenta technology their individual species. Between these various species of AGTs, I would argue, there remains enough ethico-legal diversity to warrant independent discussion about the descriptive and normative functions of each AGT and the relationship between gestation, genetic relatedness and legal/moral parenthood.

Descriptive and normative heterogeneity in surrogacy, UTx and ectogestation

Chloe Romanis claims that legal and social issues about attribution of parenthood and the importance that might be placed on information about gestational origins affect all forms of AGTs.1 I take it ethical ambiguities arise because the relationship between who gestates, genetic relatedness to the prospective child, and claims to legal/moral parental responsibility can be disrupted or made ambivalent with the involvement of third-party support. For many of those who do not require reproductive assistance, the gestational labour, genetic relatedness and parental responsibility would traditionally …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • This is with the exception of, of course, ‘carers monitoring an artificial placenta’ for example, as Romanis points out in her paper. While there is no doubt there may be multiple agents who assist and provide ‘labour’ in this sense, they arguably lack a comparable candidacy for gestational parenthood relative to, say, a surrogate.

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