If a fetus can be transferred to a fabricated womb, can the right to abortion survive?
There’s a scientific development on the horizon that could upend the abortion debate: artificial wombs.
The research remains preliminary, but in April a group of scientists at the Children’s Hospital of Philadelphia announced amazing advances in artificial womb technologies. The authors explained how they had successfully sustained significantly premature lambs for four weeks in an artificial womb they had designed.
This enabled the lambs to develop in a way very similar to lambs that had developed in their mothers’ wombs. Indeed, the oldest lamb — more than a year old at the time the paper was published — appeared to be completely normal.
The technology included placing the premature lambs in a “biobag” containing a bath of simulated amniotic fluid, regularly replenished, with an oxygenator circuit connected to the lamb via the umbilical cord.
The lambs were at a stage of development comparable to that of a 22- to 24-week-old human fetus. Babies born at that stage of gestation have very high mortality rates —roughly 70 percent at 22 weeks — and almost all who survive have long-term health problems. The immediate hope is that artificial wombs could raise the survival rate of human fetuses and improve their lifelong health substantially.
The Supreme Court’s decision in Planned Parenthood v. Casey treats “viability” — when a fetus can survive outside the womb — as the important constitutional dividing line for individual states’ ability to restrict abortion. US states have much more power to restrict abortion after viability than before (although even post-viability there are important constitutional carve-outs, including for abortions to protect the health of the mother).
If — and it is a big “if” — artificial wombs were to become available for human fetuses, we face the following question: Could anti-abortion laws require pregnant women whose fetuses are not yet viable to transfer the fetus to a nurturing site outside the body, possibly by way of minimally invasive surgery? The right to abortion would thereby be restricted.
Let me be very clear: The technology is not ready for human use, which means major changes in abortion policy are not imminent. But that doesn’t mean we shouldn’t begin to wrestle with the implications of such foreseeable medical advances. (And of course, whatever you think of abortion, we should celebrate this kind of research for the benefit it can offer to the families of premature infants.)
The overarching right to abortion can be divided into three distinct rights
Why is this technology relevant to abortion? The reason is that — as I have argued elsewhere — the constitutional right to abortion in America actually amounts to a conjunction of three separate but overlapping “rights not to procreate.” First, there is a right not to be a gestational parent: That is, a woman has the right to stop gestating, or carrying a fetus to term.
Second, there is a right not to be a legal parent: The law cannot force on a woman, against her wishes, the legal duties of parenthood. Finally, the right to have an abortion implies a right not to be a genetic parent — for there to be no child that comes into being that is her genetic offspring.
Typically, when a woman has an abortion, she is able to prevent all three kinds of parentage: She stops gestating the child, there is no child that bears her genetic code that comes into existence, and (therefore) there is no child the law recognizes as her child.
In some cases, however, the rights come apart. Take gestational surrogacy. In one version of such a case, a father who intends to raise a child provides his sperm and a mother who intends to raise the child provides her egg. The egg is then fertilized outside the body (in vitro) and then implanted in another woman. That second woman is the gestational surrogate, carrying the child to term, even though she is not the genetic mother.
Suppose the surrogate decides she wants to have an abortion. She would be exercising her right not to be a gestational parent. But that abortion would not represent an exercise of her right not to be a genetic mother; after all, whether the child is born or not, it is not her genetic child.
Additionally, according to the law in many states where surrogacy is practiced — California, for example — if the child were born, the gestational surrogate would not be the legal mother either. So her abortion would not be an exercise of a right not to be a legal parent either.
Fair enough, you might say: The three rights are unbundled in the unusual case of gestational surrogacy, but what does that have to do with most pregnant women in America? This is where the artificial womb comes in. Imagine, as proposed above, that a fetus could be moved from the mother’s womb to an artificial womb through a minimally invasive surgery beginning at 18 weeks of gestation.
How anti-abortion legislatures might respond to the advent of artificial wombs
Now imagine a US state were to pass a law decreeing that although abortion is available up to that 18-week threshold, once transfer to an artificial womb is possible, a woman who wants to stop gestating cannot abort. She can either continue her pregnancy or transfer the fetus to the artificial womb. This would effectively preserve her right not to be a gestational parent — as she can stop gestating by transfer to the artificial womb — but not her right not to be a genetic parent. That’s because a child would come into being with her genetic code that she does not want to exist. (It is unclear whether she would also be considered the legal parent in such a case, so let’s put that to one side.)
For those who support abortion rights in America, this scenario raises a crucial question: Do they support the right of women to control only whether they gestate or, additionally, a right to terminate a fetus whether or not gestation is involved?
Certainly, the rhetoric of abortion rights in America focuses on avoiding unwanted gestation — think of the slogan “my body, my choice.”
Artificial wombs may lead to a revisiting of the argument posed in one of the most famous articles ever written about abortion, “A Defense of Abortion,” by Judith Jarvis Thomson, first published in 1971. Thomson’s article, which features one of the most famous thought experiments in bioethics, is similarly focused on the right not to gestate.
Artificial wombs and the case of the kidnapped violinist
Thomson seeks to argue that even if a fetus is a person, women should still have the right to abort. Let me (all too briefly) recap the case she makes:
Thomson asks us to imagine that one morning you wake to find you’ve been kidnapped and hooked up to an unconscious famous violinist. (Whether you are male or female is irrelevant.) The violinist is dying from a rare kidney disease, but he will survive if you allow him to use you as a human dialysis machine for nine months. Should you unhook yourself, the violinist will die. The violinist is not at fault for your predicament. The kidnapping and dialysis coupling was instead the work of the Society of Music Lovers, who are devoted to the man’s music and to saving his life.
Thomson concludes that it is intuitively obvious that one has a right to disconnect oneself from the violinist in this situation, that the violinist’s need for your help, however pressing, does not create an obligation upon you to sustain him. While it would not be immoral for you to disconnect, you also may stay connected. But that would be a “supererogatory” moral act (above and beyond one’s moral obligation).
If you agree with Thomson on the case of the violinist, she concludes, you must also agree that a woman has a right to be free of a fetus, even if you believe the fetus to be, like the violinist, a “person,” with all the rights that word entails. (Thomson did not in fact assert that an early fetus has such rights; she was granting one premise of her pro-life opponents’ argument.)
As Thomson herself puts it:
I am not arguing that people do not have a right to life. … I am arguing only that a right to life does not guarantee having either a right to be given the use of or a right to be allowed continued use of another person’s body — even if one needs it for life itself. So the right to life will not serve the opponents of abortion in the very simple and clear way in which they seem to have thought it would.
Thomson’s approach is not without its critics. Some commentators have suggested the thought experiment works as an analogy to abortion following a rape but does not fit every abortion. But my purpose here is not to delve into these objections.
Instead, I want to emphasize how Thomson’s influential argument, as she herself recognizes, is an argument only for a right to disconnect: It’s the right to not gestate, not a right to terminate the fetus. To put the point in terms of Thomson’s hypothetical: If you find yourself hooked up the violinist, the state should protect your right to disconnect the violinist and attach him to an actual dialysis machine, but that does not imply you have the right to disconnect him and kill him.
In a world of artificial wombs — the world that may be opening up as a result of the recent research on premature lambs — a woman might have a right to stop gestating (to transfer the fetus out of the body to an artificial womb) but not a right to terminate the fetus as well.
Distinguishing between ceasing gestation and terminating a fetus could have some important implications for paternal rights. Both typical pro-choice arguments and, indeed, even a decision of the US Supreme Court have rejected the idea of a paternal veto on abortion. In Planned Parenthood of Central Missouri v. Danforth, the Court put it this way: “[A]s it is the woman who physically bears the child and who is the more directly and immediately affected by the pregnancy, as between the two, the balance weighs in her favor.”
But if it became possible to transfer the fetus to an artificial womb, a man opposed to his wife’s (or other sex partner’s) abortion might be able to make a case along the following lines: “No one is forcing you to gestate the fetus, and after we transfer the fetus to an artificial womb, you and I are on equal footing. At that point, the disagreement is: I want to be a genetic parent; you do not. Given this tie, the state should favor life.”
How might one resist this argument? Earlier, I asked you to imagine that transfer to an artificial womb happened via a “minimally invasive surgery”: something on the order of laparoscopic surgery to remove a small tumor. If the surgery were more invasive, as seems plausible, one might think it was just as much a violation of a woman’s right to control her body as forcing her to continue gestation.
And perhaps one might think even a minimally invasive surgery is morally problematic, given the rights we enjoy in most circumstances to reject forced medical treatment of almost any sort. But what if, to really get sci-fi, the transfer worked like the transporter in Star Trek? A tingle and then it’s gone. Would the arguments against mandated use of the artificial womb still hold water?
Confronted with the argument that transfer to an artificial womb could be made mandatory, a different strategy might be to stand up and defend abortion as a right not to be a genetic parent — full stop. The asserted right, in other words, would extend further than the right not to be a gestational parent and include a right to terminate the fetus. In Roe v. Wade itself, the Supreme Court speaks about the burden of motherhood — not merely the burdens of gestating — as underlying the abortion right:
Maternity, or additional offspring, may force upon the woman a distressful life and future. Psychological harm may be imminent. Mental and physical health may be taxed by child care. There is also the distress, for all concerned, associated with the unwanted child, and there is the problem of bringing a child into a family already unable, psychologically and otherwise, to care for it.
The references to the burdens of caring for a child who is already born, and the psychological distress for a family of an unwanted child go beyond a mere focus on the burdens of carrying the child.
It is subsequent cases and the modern abortion rhetoric that have focused more on the physical burdens of gestation. The advent of artificial wombs may press those defending a woman’s right to abortion to return to these earlier themes. But such arguments are more complicated and fraught. As we have seen, they put mothers and fathers on much more of an equal plane when it comes to abortion, and men might well argue that non-gestational burdens fall on both sexes.
The questions raised by artificial wombs also reopen the question of whether the right to abortion at all hinges on the availability of adoption. Once we go beyond the burdens of gestation as the justification for abortion and instead turn to the psychological, financial, and social burdens of unwanted parenthood, the potential of adoption to reduce — but not completely eliminate — some of those burdens may become relevant.
It seems an unalloyed good that prematurely born fetuses may eventually have a greatly improved chance to live and thrive. But welcome new advances also sometimes raise new questions. Here, these laudable medical advances also reopen a host of complicated questions about one of the most hotly contested issues in politics, law, and ethics.
I. Glenn Cohen is a professor at Harvard Law School and faculty director of the school’s Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics. This piece draws on an argument he recently made in the Hastings Center Report. Find him on Twitter@CohenProf.
The Big Idea is Vox’s home for smart discussion of the most important issues and ideas in politics, science, and culture — typically by outside contributors. If you have an idea for a piece, pitch us at email@example.com.
An SR-71 Blackbird once flew from LA to Washington DC in 64 minutes. Average speed of the flight: 2145mph.
“There were a lot of things we couldn’t do in an SR-71, but we were the fastest guys on the block and loved reminding our fellow aviators of this fact. People often asked us if, because of this fact, it was fun to fly the jet. Fun would not be the first word I would use to describe flying this plane. Intense, maybe. Even cerebral. But there was one day in our Sled experience when we would have to say that it was pure fun to be the fastest guys out there, at least for a moment.
It occurred when Walt and I were flying our final training sortie. We needed 100 hours in the jet to complete our training and attain Mission Ready status. Somewhere over Colorado we had passed the century mark. We had made the turn in Arizona and the jet was performing flawlessly. My gauges were wired in the front seat and we were starting to feel pretty good about ourselves, not only because we would soon be flying real missions but because we had gained a great deal of confidence in the plane in the past ten months. Ripping across the barren deserts 80,000 feet below us, I could already see the coast of California from the Arizona border. I was, finally, after many humbling months of simulators and study, ahead of the jet.
I was beginning to feel a bit sorry for Walter in the back seat. There he was, with no really good view of the incredible sights before us, tasked with monitoring four different radios. This was good practice for him for when we began flying real missions, when a priority transmission from headquarters could be vital. It had been difficult, too, for me to relinquish control of the radios, as during my entire flying career I had controlled my own transmissions. But it was part of the division of duties in this plane and I had adjusted to it. I still insisted on talking on the radio while we were on the ground, however. Walt was so good at many things, but he couldn’t match my expertise at sounding smooth on the radios, a skill that had been honed sharply with years in fighter squadrons where the slightest radio miscue was grounds for beheading. He understood that and allowed me that luxury.
Just to get a sense of what Walt had to contend with, I pulled the radio toggle switches and monitored the frequencies along with him. The predominant radio chatter was from Los Angeles Center, far below us, controlling daily traffic in their sector. While they had us on their scope (albeit briefly), we were in uncontrolled airspace and normally would not talk to them unless we needed to descend into their airspace.
We listened as the shaky voice of a lone Cessna pilot asked Center for a readout of his ground speed. Center replied: “November Charlie 175, I’m showing you at ninety knots on the ground.”
Now the thing to understand about Center controllers, was that whether they were talking to a rookie pilot in a Cessna, or to Air Force One, they always spoke in the exact same, calm, deep, professional, tone that made one feel important. I referred to it as the “ Houston Center voice.” I have always felt that after years of seeing documentaries on this country’s space program and listening to the calm and distinct voice of the Houston controllers, that all other controllers since then wanted to sound like that, and that they basically did. And it didn’t matter what sector of the country we would be flying in, it always seemed like the same guy was talking. Over the years that tone of voice had become somewhat of a comforting sound to pilots everywhere. Conversely, over the years, pilots always wanted to ensure that, when transmitting, they sounded like Chuck Yeager, or at least like John Wayne. Better to die than sound bad on the radios.
Just moments after the Cessna’s inquiry, a Twin Beech piped up on frequency, in a rather superior tone, asking for his ground speed. “I have you at one hundred and twenty-five knots of ground speed.” Boy, I thought, the Beechcraft really must think he is dazzling his Cessna brethren. Then out of the blue, a navy F-18 pilot out of NAS Lemoore came up on frequency. You knew right away it was a Navy jock because he sounded very cool on the radios. “Center, Dusty 52 ground speed check”. Before Center could reply, I’m thinking to myself, hey, Dusty 52 has a ground speed indicator in that million-dollar cockpit, so why is he asking Center for a readout? Then I got it, ol’ Dusty here is making sure that every bug smasher from Mount Whitney to the Mojave knows what true speed is. He’s the fastest dude in the valley today, and he just wants everyone to know how much fun he is having in his new Hornet. And the reply, always with that same, calm, voice, with more distinct alliteration than emotion: “Dusty 52, Center, we have you at 620 on the ground.”
And I thought to myself, is this a ripe situation, or what? As my hand instinctively reached for the mic button, I had to remind myself that Walt was in control of the radios. Still, I thought, it must be done - in mere seconds we’ll be out of the sector and the opportunity will be lost. That Hornet must die, and die now. I thought about all of our Sim training and how important it was that we developed well as a crew and knew that to jump in on the radios now would destroy the integrity of all that we had worked toward becoming. I was torn.
Somewhere, 13 miles above Arizona, there was a pilot screaming inside his space helmet. Then, I heard it. The click of the mic button from the back seat. That was the very moment that I knew Walter and I had become a crew. Very professionally, and with no emotion, Walter spoke: “Los Angeles Center, Aspen 20, can you give us a ground speed check?” There was no hesitation, and the replay came as if was an everyday request. “Aspen 20, I show you at one thousand eight hundred and forty-two knots, across the ground.”
I think it was the forty-two knots that I liked the best, so accurate and proud was Center to deliver that information without hesitation, and you just knew he was smiling. But the precise point at which I knew that Walt and I were going to be really good friends for a long time was when he keyed the mic once again to say, in his most fighter-pilot-like voice: “Ah, Center, much thanks, we’re showing closer to nineteen hundred on the money.”
For a moment Walter was a god. And we finally heard a little crack in the armor of the Houston Center voice, when L.A. came back with, “Roger that Aspen, Your equipment is probably more accurate than ours. You boys have a good one.”
It all had lasted for just moments, but in that short, memorable sprint across the southwest, the Navy had been flamed, all mortal airplanes on freq were forced to bow before the King of Speed, and more importantly, Walter and I had crossed the threshold of being a crew. A fine day’s work.
We never heard another transmission on that frequency all the way to the coast.”
-Brian Schul, Sled Driver: Flying The World’s Fastest Jet
Eclipse chasers may seem a little intense—they often go to great lengths to see total solar eclipses around the world, booking hotels and flights years in advance. If you didn’t plan years ahead for totality on August 21, or if you find yourself addicted after experiencing it, you’re in luck. The next eclipse is just less than two years out, and another chance comes to the United States in just seven years. Here’s a list of notable upcoming total solar eclipses, and some of the stunning places you can view them.
July 2, 2019, or December 14, 2020
The next possible opportunity to see a total solar eclipse is in Chile and Argentina in 2019, but the air might be a little brisk and clouds could get in the way—July is winter in the Southern Hemisphere. But the 2020 eclipse passes over the same countries during the summer. Both Termas Geometricas, a cluster of hot springs in Chile, and the caves of Villarrica Volcano lie in the path of totality. They might not be the best places to view the eclipse itself, but they’ll make for great stops once it’s over.
April 8, 2024
It’s unusual for the same region to experience two eclipses in close succession, but the United States will have another total eclipse soon, this time from Texas up to the Great Lakes. Mexico and Canada will catch totality, too. The path of totality for this eclipse even crosses the August 21 path, so some places—Carbondale, Illinois, aren’t you lucky—will get to see two in less than a decade. And this time around, totality will last nearly twice as long as for the 2017 eclipse. There will be plenty of picturesque places to watch. Unique viewing locations include El Faro de Mazatlán, a lighthouse in Mexico, or next to a model of Earth in Houlton, Maine. Hopefully April showers won’t be an issue.
August 12, 2026
This solar eclipse makes landfall in just two places—western Iceland and Spain—but the view will be great no matter which country you pick. Iceland's famous Blue Lagoon lies right in the path of totality, and so does Reykjavík. Farther south in Spain, there are plenty of castles and monastery ruins that would make stunning backdrops.
August 2, 2027
At its height, this total eclipse will last a whopping six minutes and 23 seconds near Luxor in Egypt. Gibraltar, the northern coast of Africa, Saudi Arabia, Yemen, and Somalia also lie along the path of totality. If you’ve been looking for an excuse to check out Oran, Tangier, or Luxor, this eclipse fits the bill. Or you could watch the eclipse from a small sliver of Spain in Morocco, or the ruins of an ancient Roman city on the Libyan coast.
China's and North Korea's capital cities both lie along this eclipse's path of totality, along with part of Japan, north of Tokyo. The Beijing Ancient Observatory may have been constructed to view distant stars, but visitors will be able to experience one minute and 33 seconds of totality there. Alternatively, you could watch the eclipse surrounded by Japanese macaques at the Jigokudani Monkey Park in Nagano, Japan.
August 23, 2044
Only a small slice of Montana and a swath of Alberta and the Northern Territories will see this total solar eclipse, but that includes some incredible landscapes. The unearthly rock formations of Makoshika State Park, in eastern Montana, will offer a quiet place to watch the eclipse (and impressively dark skies for stargazing). The Hoodoos of Drumheller Valley are similarly strange rock formations in Alberta, and also lie in the path of totality.
August 12, 2045
If, by the time this eclipse rolls around, coast-to-coast paths of totality seem like old hat to you, you can spice up your eclipse-viewing experience with a trip to the Caribbean or South America. The path of this one starts in Northern California and bends down to pass through Florida (right over both Disney World and Miami), but the location of longest totality—six minutes and five seconds—is in the Bahamas, near the Great Isaac Cay. Book your boat now. Nearly all of the Dominican Republic and the northern coast of South America, from Venezuela to Brazil, will also see full occlusion.
August 2, 2046
People along the path of totality through Angola, Botswana, South Africa, and virtually all of the nation of Swaziland will be treated to nearly five minutes of darkness during this eclipse. Some areas in the path are not especially comfortable—such as the Makgadikgadi Salt Pans, which you will likely have all to yourself—but an ancient stone calendar in South Africa would be a fitting setting.
Other Notable Total Solar Eclipses
Two eclipses will be visible from parts of Indonesia, and a small bit of Australia on April 20—first in 2023 and again in 2042. Another eclipse visible in Australia, as well as parts of southern Africa, will take place on November 25, 2030. Australia and New Zealand will see other eclipses on July 13, 2037, and December 26, 2038. Some of the least accessible eclipses include one on November 14, 2031, that just barely grazes Panama, another on March 30, 2033, that will only be visible in northern Alaska and a tiny bit of Russia, and one on December 15, 2039, that can only be seen in remote parts of Antarctica (remote even by Antarctic standards). Parts of Africa, Saudi Arabia, Iran, Afghanistan, Pakistan, and China will see an eclipse on March 20, 2034, and Africa will catch another on April 30, 2041.