Introduction

In this essay, I argue that subjects of ectogenesis (‘gestatelings’) share the same moral status as newborns. In the first two sections, I defend the claim that subjects of partial ectogenesis are newborns. The first section makes use of Elizabeth Chloe Romanis’s distinction between fetuses and gestatelings, as well as accepted definitions of terms like ‘live birth’.i ,1 Next, I argue that subjects of partial ectogenesis are a kind of newborn. Thus, even though Romanis’s suggestion—that gestatelings are not newborns—is false, there is still a way to refine the gestateling/newborn distinction in productive ways. Both the sections, therefore, refine Romanis’s distinctions in a way that leads to the conclusion that subjects of partial ectogenesis are newborns. Moving forward, I use this finding to demonstrate that subjects of complete ectogenesis also share the same moral status as newborns. Thus, all the three sections combine to support the main claim of this essay: subjects of ectogenesis—whether partial or complete—share the same moral status as newborns

I conclude by considering the potential implications of this essay. First, whatever restrictions and safeguards are in place concerning medical research on newborns should be applied to gestatelings. This is significant given the alternatives. Gestatelings may be said to deserve the same protections as embryos or fetuses, for example. Those protections are (often) relatively weak compared with protections afforded to newborns. That gestatelings deserve the same protections afforded to newborns, therefore, is not a trivial matter. Additionally, as I show that subjects of complete ectogenesis share the same moral status as newborns (despite having not been born), it follows that birth is not necessary to be deserving of the moral status and protections afforded to newborns. This seems to put pressure on the view that birth is a necessary rite of passage to be deserving of relatively significant moral status and legal protections.

Subjects of partial ectogenesis are newborns

To show that subjects of partial ectogenesis are newborns, I rely on (1) Romanis’s distinction between fetuses and subjects of partial ectogenesis and (2) a consideration of how terms like ‘live birth’ are defined by international legal and medical authorities. First, Romanis distinguishes between three types of human subjects: fetuses, newborns and gestatelings. These distinctions may not be morally relevant, Romanis notes, but they are important distinctions to make if we are to avoid confusion when discussing artificial womb (AW) technology.1 The subject of an AW, after all, ‘is neither a fetus nor a baby’ but is, instead, a ‘new product of human reproduction’ altogether.1 The term ‘fetus’ clearly does not refer to gestatelings because ‘most medical definitions of the fetus imply it is located inside a human gestator by describing it as ‘unborn’.1 Gestatelings are not located within a human gestator. So ‘fetus’ does not refer to them. Researchers who have called gestatelings ‘fetuses’, therefore, have misapplied the term.2 Misapplication of terms introduces confusion into discussions of AWs. To avoid that confusion, we need to keep fetuses and gestatelings separate.

As we unpack Romanis’s distinction between fetuses and gestatelings, I will restrict ‘gestateling’ to subjects of partial ectogenesis (as this is what Romanis does for much of her essay). ‘Fetus’ does not apply to gestatelings because fetuses are ‘unborn’. Gestatelings are not ‘unborn’. Does that imply that gestatelings have been born? For a moment, suppose it does. In that case, why distinguish between gestatelings and newborns (as Romanis does)? Perhaps gestatelings are a type of newborn. If so, then there is merit to using the term ‘gestateling’, just as there is merit to using terms like ‘preterm’ and ‘term’ to refer to different types of newborns. If we take that approach, however, Romanis’s claim that the subject of an AW ‘is neither a fetus nor a baby’ is false.1 It is correct that gestatelings are not fetuses, but incorrect to say they are not babies (ie, newborns).

In contrast, perhaps gestatelings are neither ‘unborn’ nor ‘born’.ii Given how terms like ‘live birth’ are usually understood, however, this suggestion is implausible. The WHO, European Union, US Law and international medical community all define ‘live birth’ (or ‘birth’) in ways that apply to gestatelings.3–7 ,iii For example, the WHO defines ‘live birth’ as

…the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life—for example, beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles—whether or not the umbilical cord has been cut or the placenta is attached.3

Gestatelings satisfy this definition.iv If we agree with Romanis that ‘fetus’ should not be used to refer to gestatelings—as doing so introduces confusion into discussions of AWs—then claiming that gestatelings have not been born also introduces confusion. We should refer to gestatelings as newborns because terms like ‘live birth’ straightforwardly apply to them (ie, they have been born). Refusing to acknowledge that subjects of partial ectogenesis have been born would either demonstrate a misunderstanding of terms like ‘live birth’ or would rely on a highly unconventional use of those terms.

In response, maybe we should redefine what it means to be born.v Maybe so, but that discussion moves us beyond the scope of this essay. For now, I will simply suggest that given widespread agreement on the terms, we need a compelling reason to think that current conceptual boundaries require revision. Further, given the legal ramifications that would follow from redefining what it means to be born, such a task should not be taken lightly. Either way, what is clear is that terms like ‘live birth’—as currently used by international legal and medical authorities—apply to subjects of partial ectogenesis.

Despite having been born, however, Romanis claims that ‘newborn’ ‘cannot appropriately’ be used to refer to gestatelings.1 She explicitly states that the subject of an AW ‘is neither a fetus nor a baby’.1 It is a different sort of thing. For Romanis, therefore, it is not just that ‘newborn’ does not apply to gestatelings. Gestatelings are (for Romanis) a distinct ‘product of human reproduction’.1

In tracing this line of thought, it makes sense to say that ‘newborn’ does not refer to gestatelings if gestatelings are not newborns. In that case, to call a gestateling ‘newborn’ would be to call it something it is not (just like calling a gestateling ‘fetus’ is to call it something it is not). But if gestatelings are newborns, then it is unclear why they ‘cannot appropriately be described’ as such.1 Thus, if one wishes to argue that ‘newborn’ does not refer to gestatelings, the most intuitive option is to suggest (as Romanis does) that gestatelings are not newborns.

Revising the gestateling/newborn distinction

Why think that gestatelings are not newborns?vi Romanis gives four reasons: (1) gestatelings are treated (or behave) ‘as if’ they have not been born, (2) newborns exercise some independent capacity for life but gestatelings do not, (3) gestatelings depend on AWs in ways that newborns do not depend on neonatal intensive care technology, and (4) gestatelings are socially ‘isolated’ in ways that newborns are not.1

None of these features is relevant to whether or not something is a newborn, however. Being a newborn means having been born recently. Subjects of partial ectogenesis have been born recently. Thus, they are newborns. The issue has nothing to do with how they are treated, how they behave, the capacities they exercise, their relative dependence on technology or their social interactions. None of the features Romanis discusses, therefore, support the claim that gestatelings are not newborns.

Romanis may simply be concerned that terms like ‘newborn baby’ carry connotations of features associated with term infants. Usually, gestatelings are not term infants. Connotations associated with ‘newborn’ are, therefore, misleading when applied to gestatelings. By analogy, however, it would be strange to assert that ‘fruit’ cannot appropriately be used to refer to tomatoes given that connotations of ‘fruit’ include sweetness (whereas tomatoes are relatively savoury). ‘Fruit’ is appropriately used in reference to tomatoes because they are fruit. This is so regardless of the connotations associated with ‘fruit’. Likewise, ‘newborn’ is appropriately applied to subjects of partial ectogenesis because they are newborns. This is so regardless of connotations associated with ‘newborn’.

Still, we can salvage Romanis’s distinction. ‘Newborn’ is an ambiguous term. It may refer to preterm infants, term infants or subjects of partial ectogenesis, for example. ‘Gestateling’, therefore, provides us with a clearer way of referring to a particular kind of newborn. Thus, the new term is more informative than ‘newborn’. This may be enough to justify Romanis’s development of new terminology for subjects of ectogenesis.

There are, however, three reasons why this adjustment does not support Romanis’s original distinction. First, it undermines her claim that it is ‘inappropriate’ to call gestatelings ‘newborns’. Referring to a gestateling as a newborn may violate some Gricean maxim(s) in certain contexts—in that, the speaker fails to be as informative as they could be, given that there are more informative terms available than ‘newborn’.8 But that does not support the claim that ‘newborn’ cannot appropriately be used to refer to gestatelings. Second, the revised distinction undermines Romanis’s suggestion that subjects of ectogenesis are a ‘new product of human reproduction’.1 Gestatelings are not a new type of product; they are newborns (although very young ones). Third, the revised distinction does not allow Romanis to bracket the question of ‘whether there is any difference in moral status’ between subjects of partial ectogenesis and newborns.1 That is, Romanis claims her distinction leaves open the possibility that gestatelings and newborns have different moral statuses. The adjusted distinction—which specifies that gestatelings are a kind of newborn—closes off the possibility of neutrality. Subjects of partial ectogenesis deserve the same moral treatment and protection as newborns because they are newborns.

Subjects of complete ectogenesis are (morally equivalent to) newborns

I have argued that subjects of partial ectogenesis are newborns. So, they share the same moral status as newborns. From this, it can be demonstrated that subjects of complete ectogenesis share the same moral status as newborns (and deserve whatever protections come with it). This is so despite the fact that subjects of complete ectogenesis have not been born. I proceed in two parts. First, by explaining why subjects of complete ectogenesis are not newborns. Second, by arguing that they deserve the same moral status as newborns nonetheless.

Implications

I have argued that subjects of ectogenesis—whether partial or complete—deserve the same moral status and protections as newborns. I will conclude by outlining three potential implications of this thesis. First, and most importantly, as AW technology develops, whatever protections apply to newborns (in an experimental or clinical setting) should be extended to gestatelings. This is significant given the alternatives. Gestatelings might, for example, be afforded the same protections as embryos, fetuses or newborns. Of these groups, newborns tend to receive the highest moral status and highest levels of legal protection. That gestatelings are afforded those same protections (as opposed to being treated as embryos or fetuses) is, therefore, no small matter.

Second, my thesis does not imply that gestatelings have a right to life nor does it imply they have a right not to be killed. Arguments from Tooley, Singer, and Giubilini and Minerva, and Räsänen support the permissibility of infanticide.11–16 Räsänen, for example, argues that parents’ right to ‘genetic privacy’ gives them a right to end the lives of newborns that carry their genetic code.14–16 The same arguments may apply to gestatelings. Kaczor, Manninen, Hendricks, and Rodger et al, on the other hand, argue that infanticide is impermissible.17–21 If infanticide is impermissible, then insofar as gestatelings share the same moral status as newborns, terminating gestatelings will be just as wrong as infanticide. So while I show that gestatelings share the same moral status as newborns, it is still open whether or not it is permissible to kill gestatelings (insofar as the (im)permissibility of infanticide is an open matter). What cannot be justified is assigning to gestatelings a different moral status than the status assigned to newborns.

Third, having shown that subjects of complete ectogenesis share the same moral status as newborns, it follows that a human individual need not be born to be deserving of whatever moral status is assigned to born individuals. As discussed above, this does not imply that all unborn human beings deserve the same moral status as newborns. But it does undermine the view that birth is a necessary rite of passage to be deserving of relatively significant moral status and legal protection.