Autonomy, Birth and Partial Ectogenesis: New Technology, Old Problems? What role can the law play in ensuring that the introduction of Partial Ectogenesis does not further erode autonomy during birth?

Abstract

Partial ectogenesis refers to the procedure whereby a foetus is extracted from the human womb and transferred to an artificial womb chamber to complete gestation ex utero. As partial ectogenesis moves closer to becoming a clinical reality, this thesis considers the impact that the introduction of the procedure may have upon autonomy during birth. I argue that while partial ectogenesis has the potential to bolster the autonomy of pregnant and birthing people, by offering them the option to ‘opt out’ of bodily gestation at an earlier stage in pregnancy, the realisation of this potential is far from certain. In Section One I set out the legal background against which partial ectogenesis would be introduced, analysing the gap between the letter and the operation of the law when it comes to protecting the autonomy of birthing people. I demonstrate that, despite being clearly protected in law, respect for autonomous decision making during birth remains fragile in practice – and that partial ectogenesis has the potential to compound this problem. In Section Two I explore the connection between partial ectogenesis and Scots abortion law, demonstrating that in some circumstances the law itself might impose barriers to access to partial ectogenesis. Broadening the discussion beyond Scotland, I argue that the criminal law should not play a part in determining who can access partial ectogenesis. In Section Three I evaluate the way that partial ectogenesis is defined and framed, arguing that it is vital to be careful and deliberate with the language that is used to speak about this process in order to ensure that the birthing person remains central in conversations about, and decision making during, birth. Finally, I locate the introduction of partial ectogenesis within the current, obstetric landscape and demonstrate that this could interact with pre-existing problems in maternity and birthing services in a manner which both inhibits the autonomy-supporting potential of partial ectogenesis and worsens existing issues. I conclude that the law alone is insufficient to prevent partial ectogenesis from further eroding autonomy during birth. Further, I argue that we cannot limit ourselves to the goal of preventing further erosion of autonomy, but rather must also seek to push back against that which has already occurred.

Date of Award	31 Dec 2022
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Rebecca Bennett (Supervisor) & Alexandra Mullock (Supervisor)