TY - JOUR

T1 - Positioning Uterus Transplantation as a ‘More Ethical’ Alternative to Surrogacy?

T2 - Exploring Symmetries between UTx and Surrogacy Through Analysis of a Swedish Government White Paper

AU - Guntram, Lisa

AU - Williams, Nicola Jane

PY - 2018/10

Y1 - 2018/10

N2 - Within the ethics and science literature surrounding uterus transplantation (UTx) emphasis is often placed on the extent to which UTx might improve upon, or offer additional benefits when compared to, existing ‘treatment options’ for women with uterine factor infertility (AUFI) such as adoption and gestational surrogacy. Within this literature UTx is often positioned as superior to surrogacy because it can deliver things that surrogacy cannot (such as the experience of gestation). Yet, in addition to claims that UTx is superior in the aforementioned sense it is also often assumed (either implicitly or explicitly) that UTx is less fraught with ethical difficulties and thus should be considered a less morally problematic option. This article seeks to examine this assumption. Given that much UTx research has been performed in Sweden, a country where surrogacy is effectively although not currently explicitly forbidden, we do this through an analysis of the arguments underpinning a 2016 Swedish white paper which considered amending existing policy such that altruistic surrogacy arrangements would be permitted. By applying the white paper’s arguments for a restrictive position on altruistic surrogacy to the case of UTx using living altruistic donors we find that such arguments, if they hold in the case of surrogacy, apply similarly to UTx. We thus suggest that, for reasons of consistency, a similar stance should be taken towards the moral and legal permissibility of these two practices.

AB - Within the ethics and science literature surrounding uterus transplantation (UTx) emphasis is often placed on the extent to which UTx might improve upon, or offer additional benefits when compared to, existing ‘treatment options’ for women with uterine factor infertility (AUFI) such as adoption and gestational surrogacy. Within this literature UTx is often positioned as superior to surrogacy because it can deliver things that surrogacy cannot (such as the experience of gestation). Yet, in addition to claims that UTx is superior in the aforementioned sense it is also often assumed (either implicitly or explicitly) that UTx is less fraught with ethical difficulties and thus should be considered a less morally problematic option. This article seeks to examine this assumption. Given that much UTx research has been performed in Sweden, a country where surrogacy is effectively although not currently explicitly forbidden, we do this through an analysis of the arguments underpinning a 2016 Swedish white paper which considered amending existing policy such that altruistic surrogacy arrangements would be permitted. By applying the white paper’s arguments for a restrictive position on altruistic surrogacy to the case of UTx using living altruistic donors we find that such arguments, if they hold in the case of surrogacy, apply similarly to UTx. We thus suggest that, for reasons of consistency, a similar stance should be taken towards the moral and legal permissibility of these two practices.

KW - Uterus Transplantation

KW - Surrogacy

KW - Transplantation Ethics

KW - Reproductive Ethics

KW - Legislation and Policy

KW - Consistency

U2 - 10.1111/bioe.12469

DO - 10.1111/bioe.12469

M3 - Journal article

VL - 32

SP - 509

EP - 518

JO - Bioethics

JF - Bioethics

SN - 0269-9702

IS - 8

ER -