Use of Brain-Stem Dead Women as Surrogate Mothers?


Anna Smajdor has proposed the use of “brain-dead” women as surrogate mothers.

This controversy is part of an article titled “Whole body gestational donation” –– published in the Theoretical Medicine and Bioethics journal and written by Dr Anna Smajdor, a professor at Oslo University. She is studying the idea proposed in 2000 by Rosalie Ber, an Israeli doctor. What exactly was proposed? No less than the use of the bodies of women in a persistent vegetative state or so-called “brain-dead” to bear and give birth to children… If beforehand they have provided their consent…

This is not in any way a scientific experiment. But Anna Smajdor, uses the basis of the history of several situations where pregnant women victims of accidents – strokes, for example – could be kept alive artificially, under artificial respiration in particular, for the time necessary to continue their pregnancy and so ensure the survival of the unborn child. A pregnancy was thus sustained for 110 days[1], allowing the foetus to reach an age of 32 weeks, permitting a birth with an acceptable degree of prematurity. Such situations are tragic and, obviously, unintentional. This is not in any way ethically comparable with what is being suggested by the author, which is incidentally widely considered as controversial.

An “alternative to gestational surrogacy”

Among the arguments tabled, it is suggested it could be an alternative to gestational surrogacy, that “it could become an option for anyone wishing to avoid the risks and burden of gestation of a foetus in their own body … Or also that this is not very different from organ donation…

The author does not hesitate to put forward absurd reasoning. For example, that this situation would be ethically more acceptable than 3-parent IVF, uterus transplants, or “male pregnancy”, which were less documented before nevertheless being tested clinically. Even that it would be more acceptable because it is better documented than conventional IVF was, when it was launched.

The author opens the thinking by mentioning the status of the embryo and the foetus, in research on the embryo and in abortion. She notes, for example that “the legal motivations for abortions generally include deficiencies or diseases affecting the foetus“. She therefore concludes that “subject to very close monitoring, it is reasonable to think that – if foetuses are seriously damaged by unexpected factors resulting from gestation in a state of cerebral death – this does not necessarily result in the birth of seriously damaged babies. This could rather result in the ending of the process at the discretion of the legal parents. (…) who may opt for an abortion or “selective reduction” according to their own wishes, without having to concern themselves with any effects on the gestational donor…“. Recognising that “abortion, in particular late abortion, may be traumatic for pregnant women, both emotionally and physically” and that it constitutes “a problem which makes gestational surrogacy ethically embarrassing“, she considers that “if the woman is already dead”, she cannot be affected“…

Pregnant women, “mere foetal containers”?

The author also considers as an “additional advantage compared with standard pregnancies, that the donor would be under absolute medical supervision and control”. She has no hesitation moreover in considering physiological pregnancy and childbirth as being risks which could thus be avoided for living women.

The only drawback according to Anna Smajdor to this fallaciously idyllic scene, is an argument which she presents as feminist: the risk of worsening, through this technique, of the image of pregnant woman as “a foetal container”… and one step further towards the exploitation of the reproductive functions of women.

In Alliance VITA’s view, these ideas have little chance of finding support in medical spheres, but they do show the importance of recalling that the view of procreation, pregnancy, maternity and parentality must be constantly humanised and protected. The culture of the right to a child at all cost, and whatever the cost confuses the spirit but pregnancy can never be considered, for the mother or for the child, as a mere content-container relationship.

[1] Saïd, Abuhasna, Amer Al, Jundi, and your Rahman Masood, Abdallah Dirar and Chedid Faris. 2013. A brain-dead pregnant woman with extended somatic support and successful neonatal outcome: A grand rounds case with a detailed review of literature and ethical considerations. 

International Journal of Critical Illness and Injury Science 3: 220-224.

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