‘Fetal containers’: Bioethicist proposes using brain dead women as surrogates

A bioethicist has argued for using women who have been ruled brain dead as surrogates, calling it “whole body gestational donation” (WBGD).

Anna Smajdor of the University of Olso wrote in the journal Theoretical Medicine and Bioethics that women who are brain dead shouldn’t have their wombs going to waste, when people who want children can use them. “We already know that pregnancies can be successfully carried to term in brain-dead women,” she said. “There is no obvious medical reason why initiating such pregnancies would not be possible.”

But the ethics of such a decision seems to have overlooked by Smajdor.

“I suggest that – all other things being equal – it should be an option for anyone who wishes to avoid the risks and burdens of gestating a foetus in their own body,” she said, adding, “I suggest that brain stem dead men would also have the potential to gestate, meaning that the pool of potential donors is further increased – and that certain feminist concerns might thus be assuaged.”

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The donor would have to give consent ahead of time, Smajdor said, but overall, she believes government policies should support it. “States and health services should adapt their policies and procedures to allow for WBGD among other donation options,” she said. “If WBGD is viewed as a straightforward means of facilitating safer reproduction, and avoiding the moral problems of surrogacy, we should be ready to embrace it as a logical and beneficial extension of activities that we already treat as being morally unproblematic.”

Smajdor acknowledged the process is “straightforwardly the use of the body as a foetal container.” But like many apologists for surrogacy, she still argued it should be allowed if the donor agrees — despite the inherently exploitative nature of surrogacy.

While many view surrogacy as an act of altruism, such a contract has a strong tendency to commodify women and children, and can put impoverished women at a disadvantage, with the temptation to sell their wombs to the wealthy to produce desired children. In turn, the act of conception and childbearing become products, with couples choosing the kind of embryo they want, finding and hiring a woman (often low-income) to gestate the child for them, and then waiting for delivery. Surrogates in such situations are often not treated as whole persons, but as gestating wombs that have been purchased for one sole purpose. If things don’t progress according to the buyers’ stipulated plan — perhaps “unwanted” multiples are conceived, or the child is diagnosed with a disability or is found to be the “undesired” sex — then the surrogate may be pressured to have an abortion, regardless of her personal feelings about it. Some surrogates in similar situations have found themselves abandoned (along with the child).

In the Ancient Greek play Antigone by Sophocles, the title character risks her life to bury the body of her brother, arguing that it is immoral to treat a dead body with disrespect. The play is fictional, but the themes are timeless — and very real. If brain death is true death, it does not then grant someone license to use the body of that deceased human being as a tool to give them what they want. The body, even in death, still demands respect, and Smajdor’s proposal is not only disrespectful, but also dehumanizing and exploitative.

Editor’s Note, 1/29/23: An earlier version of this article erroneously conflated brain death with PVS, or persistent vegetative state. That commentary has been removed, and other information has been added. We regret the error.

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