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In Defense of Ectogenesis


In his article “Research Priorities and the Future of Pregnancy” in this issue of CQ, Timothy Murphy evaluates some of the arguments I advanced in an earlier publication, “The Moral Imperative for Ectogenesis.

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1. Murphy prefers the term “extracorporeal gestation,” abbreviated to ExCG. For brevity and clarity I will adhere to his terminology throughout the rest of this article.

2. Smajdor, A.The moral imperative for ectogenesis. Cambridge Quarterly of Healthcare Ethics 2007;16:336–45.

3. Murphy, T.Research priorities and the future of pregnancy. Cambridge Quarterly of Healthcare Ethics 2011;21, under the heading “The Case against Pregnancy.”

4. See, for example, (last accessed 19 Sept 2011).

5. See note 3, Murphy 2011.

6. Ibid., under the heading “The Case against Pregnancy.”

7. Hebert, PR, Reed, G, Entman, SS, Mitchel, EF Jr., Berg, C, Griffin, MR.Serious maternal morbidity after childbirth: Prolonged hospital stays and readmissions. Obstetrics and Gynecology 1999;94(6):942–7.

8. Schutte, JM, Steegers, EAP, Schuitemaker, NWE, Santema, JG, de Boer, K, Pel, M, et al. . Rise in maternal mortality in the Netherlands. BJOG: An International Journal of Obstetrics & Gynaecology. 2010;117(4):399–406.

9. See, e.g.,Mathers, CD, Lopez, AD, Murray, CJL. The burden of disease and mortality by condition: Data, methods, and results for 2001. In Lopez, AD, Mathers, CD, Ezzati, M, Jamison, DT, Murray, CJL, eds. Global burden of disease and risk factors. Washington DC: The International Bank for Reconstruction and Development/The World Bank. 2006:45–234 (see in particular the table on p.71).

10. See World Health Organisation. Working for Health: An Introduction to the World Health Organisation, 2007; available at (last accessed 6 Mar 2011).

11. National Health Service (unspecified authors). Measles—Don’t Let Your Child Catch It, 2009;available at (last accessed 6 Mar 2011).

12. Marino, BS, Tomlinson, RS, Drotar, D, Claybon, ES, Aguirre, A, Ittenbach, R, et al. . Quality-of-life concerns differ among patients, parents, and medical providers in children and adolescents with congenital and acquired heart disease. Pediatrics 2009 Apr;123(4):708–1.

13. Ibach, F, Dyer, RA, Fawcus, S, Dyer, SJ.Knowledge and expectations of labour among primigravid women in the public health sector. South African Medical Journal 2007;97(6):461–4.

14. Mullin, A.Reconceiving pregnancy and childcare. Cambridge: Cambridge University Press; 2005.

15. See note 14, Mullin 2005, at 66.

16. Ceballo, R, Lansford, JE, Abbey, A, Stewart, AJ.Gaining a child: Comparing the experiences of biological parents, adoptive parents, and stepparents. Family Relations 2004;53(1):38–48, at 38.

17. See note 16, Ceballo et al, 2004, at 38.

18. See note 3, Murphy 2011, under the heading “Pain and Suffering.”

19. See note 3, Murphy 2011, under the heading “Pain and Suffering.”

20. Smajdor, A. Between fecklessness and selfishness: Is there a biologically optimal time for motherhood? In: Simonstein, F ed. Reprogen-Ethics and the Future of Gender. Dordrecht: Springer; 2009.

21. See note 14, Mullin 2005.

22. Petrou, S, Cooper, P, Murray, L, Davidson, LL. Economic costs of post-natal depression in a high-risk British cohort. British Journal of Psychiatry 2002;181:505–12.

23. Stein, A, Gath, DH, Bucher, J, Bond, A, Day, A, Cooper, PJ.The relationship between post-natal depression and mother–child interaction. British Journal of Psychiatry 1991;158:46–52.

24. Lakha, F, Glasier, A.Unintended pregnancy and use of emergency contraception among a large cohort of women attending for antenatal care or abortion in Scotland. The Lancet 2009;368(9549):1782–7.

25. Rothman, BK.The tentative pregnancy: Prenatal diagnosis and the future of motherhood. London: Unwin and Hyman; 1988.

26. Taylor, JS. Image of contradiction: Obstetrical ultrasound in American culture. In: Franklin, S, Ragoné, H, eds. Reproducing Reproduction: Kinship, Power, and Technological Innovation. Philadelphia: University of Pennsylvania Press; 1998.

27. Smajdor, A.Ethical challenges in foetal surgery. Journal of Medical Ethics 2011;37:88–91.

28. See note 3, Murphy 2011.

29. See note 14, Mullin 2005.

30. See note 3, Murphy 2011, under the heading “The Case against Pregnancy.”

31. See note 2, Smajdor 2007.

32. See note 3, Murphy 2011, under the heading “Forcing Choices.”

33. Thorngren-Jerneck, K, Herbst, A.Perinatal factors associated with cerebral palsy in children born in Sweden. Obstetrics & Gynecology 2006;108(6):1499–1505.

34. Gilbert, WM, Nesbitt, TS, Danielsen, B.Childbearing beyond age 40: Pregnancy outcome in 24,032 cases. Obstetrics & Gynecology 1999;93(1):9–14.

35. Ecker, JL, Frigoletto, FD.Cesarean delivery and the risk-benefit calculus. New England Journal of Medicine 2007;356:885–8.

36. Talge, NM, Neal, C, Glover, V.Translational research and prevention science network: Fetal and neonatal experience on child and adolescent mental health. Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? Journal of Child Psychology and Psychiatry 2007;48(3–4):245–61.

37. Kass, L. The wisdom of repugnance. In: Kass, L, Wilson, JQ, eds. The Ethics of Human Cloning. Washington, DC: American Enterprise Institute Press; 1998:3–61.

38. Harris, J.On Cloning. London: Routledge; 2004:109.

39. See note 3, Murphy 2011, under the heading “Beyond Pain and Suffering.”

40. See note 3, Murphy 2011, under the heading “Parity between Men and Women.”

41. Burley, JC. The price of eggs: Who should bear the cost of fertility treatments? In: Harris, J, Holm, S, eds. The Future of Human Reproduction. Oxford: Clarendon Press; 1998:127–49.

42. Farrelly, C.Equality and the duty to retard human ageing. Bioethics 2010;24(8):384–94.

43. Dworkin, R. The foundations of liberal equality. In: Peterson, GB, ed. The Tanner Lectures on Human Values. Salt Lake City: University of Utah Press; 1990:XI:3–119.

44. Dworkin, R.Justice in the distribution of health care. McGill Law Journal 1993;38(4):883–98, at 886.

45. See, for example, note 41, Farrelly 2010. Farrelly applies Dworkin to the question of aging, arguing that age is brute luck, and that therefore governments should work to reduce the negative effects that this has.

46. Rawls, J.Justice as Fairness. Cambridge: Belknap Press; 1971, at 42–3.

47. See note 45, Rawls 1971.

48. Daniels, N. Democratic equality: Rawls’s complex egalitarianism. In: Freeman, SR, ed. The Cambridge Companion to Rawls. Cambridge: Cambridge University Press; 2003:231–76, at 242.

49. Slaves might be benefited a little if, for example, society was so rich through their labor that their health and life spans were increased.

50. Okin, S.Justice, Gender and the Family. New York: Basic Books; 1989.

51. See note 20, Smajdor 2009.

52. See note 27, Smajdor 2011.

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