Sweden is Pioneering Womb Transplants

Story here

I’m no bioethicist or moral theologian, but my guess is that the Church would regard this as immoral or, at best, sketchy. Any actual moral theologians out there who’d like to comment?

It’s stuff like this that demonstrates the complete and total inadequacy of a “Bible only” theology. Before you know it, you will have 5 different appeals to “The Bible” to justify/condemn this brand new technology. One person will appeal to the fact that Sarah gave Hagar to Abraham as a surrogate mother, so it’s all fine. Somebody else will appeal to the story of Onan. Still another will cite the condemnation of ripping open women’s wombs. Somebody else will find some verse from revelation and speculate about a soulless baby being born who will grow up to antichrist. Another will say “The Bible does not command womb transplantation, so it’s evil” while another will say, “The Bible does not forbid womb transplantation, so it’s fine.”

Just lemme hear what a couple of sober Catholic theologians have to say. The Bible does not directly address womb transplantation. So we need to approach the question by another route.

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  • Julia

    I think the fact that they have to conceive the children by in vitro fertilization, means that this is not a moral option. If they can connect the Fallopian tubes in a future surgery, then I don’t know. (This is just my armchair ethicizing, I am not a professional.)

  • http://brianniemeier.com/ Brian Niemeier

    Are womb transplants moral in light of Catholic theology? As in most cases, I’d hesitate to give this question a blanket “yes” or “no”. Based on the article and some cursory research, my first impression is no, with a few qualifications.

    My first question was where the transplant organs were coming from. CCC 2296 says regarding organ donation: “Moreover, it is not morally admissible to bring about the disabling mutilation or death of a human being…” I’m strongly inclined to think that removing a healthy woman’s uterus violates this injunction.

    In Britain and Turkey they’re only using organs from deceased donors. I could be wrong, but harvesting a corpse’s womb doesn’t seem any worse than harvesting its heart or lungs. So the way I read it, Britain and Turkey are OK on the donation end. Living relatives donated their wombs to the Swedish recipients, so that’s a pretty clear violation of the Catechism’s teaching.

    The other major issue is how the transplants will affect the marital act. As Julia pointed out, this surgery doesn’t reconnect the fallopian tubes. The Swedish study used IVF, which violates clear and consistent Church teaching.
    http://old.usccb.org/prolife/programs/rlp/98rlphaa.shtml
    It’s not clear if IVF is absolutely necessary for transplant patients to conceive. Catholic teaching allows for methods that assist conception via the marital act as long as they don’t replace it altogether. Most theologians approve of a procedure called LTOT, but I’d want to ask a medical specialist whether that method would work if the tubes are completely severed. Another procedure called GIFT sounds more feasible, but the jury’s still out on whether or not it’s morally acceptable.
    My best assessment is that a womb transplant wouldn’t entail grave intrinsic evil if you get the uterus from a deceased donor who consented before death, and if no method that does violence to the marital act is used to conceive afterward. If IVF is necessary for conception at this stage, getting the transplant itself doesn’t seem inherently wrong, but it would be pretty much pointless since the stated reason for doing the transplants is to cure infertility.
    I wouldn’t see an immediate problem if they could reconnect the fallopian tubes of a uterus transplanted from a corpse such that conception could follow from normal marital relations.

    • http://chicagoboyz.net/ TMLutas

      Just to have fun, consider a case where the uterus recipient brings snowflake babies to term.

      • Anna

        But embryo adoption is also not approved at this time. It isn’t condemned either; it’s one of those “do your very diligent research with theologians on both sides, pray and get spiritual direction, and then go with your conscience” matters at this point. With Janet Smith on one side and Fr. Tad on the other, both sides certainly have solid points. Anyway, to say that womb transplant would certainly be ethical as long as the woman did embryo adoption isn’t accurate.

        • http://chicagoboyz.net/ TMLutas

          I said it was a fun scenario. Having fun?

          Rescuing stranded babysicles out of the IVF facility freezer and bringing them to a full life is not chopped liver. It’s not, as you point out, something without its own complications.

          As Pope Francis observes, we seem to be stuck on certain issues. This is one of the fairly long line of ones that have been back burnered.

      • http://brianniemeier.com/ Brian Niemeier

        Wow. There’s a moral thought experiment with all kinds of difficult implications. Do you propose a scenario in which an infertile woman has a new uterus implanted for the specific purpose of bringing frozen embryos to term?
        If so, the intent behind the transplant is nobler than in a case where the transplant is performed with the intention of using IVF. Then again, a woman who receives a transplanted womb from a deceased donor who gave consent and a woman who still has her original, healthy womb both face the same basic dilemma when it comes to frozen embryo adoption. There’s no licit solution according to Dignitas personae, so while I clearly see the good intentions behind adopting snowflake children, I’m hesitant to declare it an unalloyed good.
        Pray for all victims of IVF.

        • http://chicagoboyz.net/ TMLutas

          Ultimately, economic arrangements fail and IVF clinics dump the babies. I guess rescuing a baby from a bankrupt clinic can have the same issues as firemen breaking a burning house to search it for people trapped. Is that also not licit? Neither are an issue that I’ve seriously considered.

          • Anna

            I know people who have done embryo adoption; they adopted 13 babies, IIRC, only one of which survived until birth (and only for a few hours). So if womb transplant is sold to all sorts of people, including those who would plan snowflake adoptions, as some sort of sure way out of infertility, it would be (as most of the IVF industry already is) snake oil, but with even more serious health complications than ordinary IVF.

            I could see embryo adoptions being licit in a situation such as you describe. But with the current state of that industry overall, I think making embryo adoption a more ordinary thing for people who object to IVF itself would lead to even more abuse by the IVF clinics (e.g. by them purposely making extras to re-sell to adoptive couples).
            Dignitatis Personae is right: there’s no truly just solution for these manufactured-bought-and-sold children, just messy attempts to patch the damage a bit. Sort of like returning assets to relatives of those killed in the Holocaust…

            • http://chicagoboyz.net/ TMLutas

              I largely agree with you except that I think you don’t have the financials quite right. Let’s say current practice is to create 2 and that moves to 4, a doubling. The clinics lose IVF rounds that way because of mom decides she wants more kids, they just implant, not fertilize as well. I think it’s probably been calculated and the current practice probably maximizes revenue. I can’t imagine that they wouldn’t.

          • http://brianniemeier.com/ Brian Niemeier

            I’d think it licit for firemen to break into a house for the purpose of saving lives because private property rights are subordinate to a person’s right to life. Firefighters are also lawfully authorized to inflict a certain amount of property damage in the line of duty, so the situation is analogous to a police officer entering a private home when probable cause has been established.
            Fr. Pacholzyk’s bases his objection to snowflake embryo adoption on spousal rights, specifically a husband’s exclusive right to be the one who impregnates his wife. Is that right absolute when innocent lives are at stake? I don’t know. Janet Smith makes some powerful counter-arguments.

  • Dan C

    Another point that is worrisome for other more recent and novel forms of transplantation: does the risk (life threaten ing immunosuppression) worth the procedure.

    I know: uterus, sex, etc….it’s a chance to talk about the only great sin in Catholicism…sex. But really, there is an evaluative system of ethics that dares to discuss other matters than reproduction.

    Novel transplantation: faces and hands, for example, are not transplanting life- requiring organs. The question has been, is it ethical to do so. For the profoundly disfigured, whose lives have been dramatically altered by face transplants, the answer seems “yes.”

    Infertility is not anything close to even limb amputation in terms of disability. Infertility is barely of psychological consequence again compared to the impact of some of the grave facial deformities potentially targeted by face transplants.

    This procedure inflicts risk for minimal benefit.

    Other questions: what is the impact to embryogenesis and birth defects of immunosuppressives? Is the risk to the donor reasonable?

    These are areas of ethics that can be approached by Catholics that has intersection with secular ethics. These questions are primary to the entire matter and are as important as those involving reproduction.

    • Dan C

      Also, the resources that go into this research and supporting these patients, even if the ethical questions regarding these procedures are answered neutrally may quite frankly be better spent on other matters.

    • http://chicagoboyz.net/ TMLutas

      Keep an eye on adult stem cell organ printing. Immunosuppression should only be a transitional disability.

      • Dan C

        I agree that advances in tissue engineering are hopeful. It is a nascent field that has few successes so far, but more than gene therapy. It promises solutions, but such “personalized organ regeneration” as you describe will be labor intensive (hence requiring many highly trained disciplined people to do, hence expensive).

        The challenges- induced pluripotent stem cells may have oncogenic problems. This is a concern. Also, directed differentiation has been challenging- that is- making stem cells mature into the tissues one wants. “Challenging” is a euphemism. Try “really really hard.”

        • http://chicagoboyz.net/ TMLutas

          My observation is that the technology is following the classic ‘S’ curve shape and we haven’t really hit the exciting middle part where the risk of technique outracing moral sense is at its highest. Yet. I’m starting to suspect that we’re getting close.

          Before we hit that wild part, we would do well to think through the likely issues and be prepared. As far as cost goes, unless we go socialized medicine globally, I expect costs to come down and automation to be applied to this technique. It definitely is a hard-to-do hand craft right now. It won’t stay that way.

  • Brett Powers

    Meh. If the end result requires in vitro, then this is no good. Likewise, donors need be either cadavers or women who are for sure infertile (like possessing ovaries whose supplies of ova are exhausted, a rare but genuine condition) or clearly post-menopausal, and. But “decidedly infertile” is not a truly common condition. Meaning the donor base is decidedly rare aside from post-menopausal women.

    And none of this even begins to address the perils introduced by immunosupressants and their influence on fertility.

  • Mariana Baca

    I think on the recipient’s side, the only issue is receiving donor gametes like ovaries or testes. If the uterus would work with a woman’s own ovaries, I don’t see the moral problem.

    The donor would need to be post-menopause or otherwise infertile (like missing ovaries), or dead. I assume most donors would be from car accidents or the like. Most women don’t volunteer for hysterectomies even if they are infertile or want to be, so I don’t expect a huge influx of live donors.

    • Mariana Baca

      I would actually be more worried about black market donations, e.g. buying uteruses from India or China or somesuch. Which would be immoral regardless, but especially so, here, when privileged first-world people will be like: We are providing them a service by sterilizing them and I get to have a baby.

  • http://chicagoboyz.net/ TMLutas

    Since we are already creating 3d printed organs from our own cells, any rulings really ought to address the likely end point of the technology, not just what is obviously going to be a crude transitional technology.

    • Dan C

      We are not creating 3-D usable organs of our own cells at this time. This is research. Like that magazine picture of the fetus holding the surgeon’s hand- it like fetal therapy or gene therapy- may be harmful.

      (Yes, that staple of the pro-life movement-that picture of the fetus holding the surgeon’s hand-was a morally coercive technique to enroll pregnant women into research that we are fairly convinced actually turned out harmful to the fetus. The research was less morally problematic than the picture itself. And it’s mainly ignorant, but highly propagandized use.).

      • http://chicagoboyz.net/ TMLutas

        The bureaucratic paperwork hasn’t been completed yet, but human veins were first printed in 2010. Chinese researchers claim to have successfully printed a functioning human kidney in 2013.

        I don’t think that we disagree on the facts of current medical progress. What we seem to be disagreeing on whether we should chase the researchers, only considering and pronouncing on what gets out of the lab or should we instead step ahead to the likely end state of where this technology will lead us and think about all the likely variations that will manifest including end states where the technology will likely stabilize.

        I can see a good case being made either way.

  • Obpoet

    Perhaps at the second coming, there will be no inn at the womb.

  • amy r.

    According to facts I’ve read in a couple stories, purpose of this procedure would not be moral. The only point of doing this is for the recipient to carry a baby to term. But the doctors do not connect the woman’s ovaries to her new womb; the only way she could get pregnant would be by IVF, which is why the womb transplant would be immoral – it is explicitly done for the purpose of using IVF technology.

  • PalaceGuard

    “One person will appeal to the fact that Sarah gave Hagar to Abraham as a surrogate mother, so it’s all fine.” Given that the ultimate result of that “gift” was the creation of the current Israelis vs. Arabs situation, I think the intended message was that “all was NOT fine”.


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