Abstract
A woman who finds herself pregnant against her plans (e.g. because contraceptives have failed) has only two available options: continuing or terminating the pregnancy. Continuing the pregnancy may not be an option due to lack of economic resources, possible birth defects, or other life plans; yet terminating the pregnancy may be considered immoral by the woman, the society in which she lives, or both, and the decision may thus be a source of great distress. This chapter suggests that a hypothetical future technology aimed at extracting and cryopreserving foetuses could provide unwillingly pregnant women with an alternative to the dilemma of either continuing or terminating the pregnancy. Cryopreserved foetuses could be reimplanted at a later time, when circumstances are more favourable to continuing a pregnancy and raising a child.
Keywords
AbortionTermination of pregnancyCryosuspension of pregnancyCryonicsEctogenesis
In the previous chapter, we considered how cryothanasia —the cryopreservation of an individual who would otherwise choose to be euthanized or to commit suicide—could be used as a practical option to bypass issues caused by disagreement about the moral permissibility of choosing death. We saw how, rather than mercifully kill someone experiencing unbearable and incurable suffering and asking for euthanasia, we could instead cryosuspend them in the hope that science will someday find a way to eliminate the cause of their suffering (and, obviously, to revive them).
Of course, euthanasia is not the only divisive medical practice in our societies. Abortion is perhaps even more controversial than euthanasia, as it involves the killing of a human being who, for obvious reasons, cannot give consent to the procedure. So, whereas in the case of euthanasia, the request to be killed comes from an autonomous and rational person, this is not the case with abortion , where the killing is not justified on the basis of the fact that the embryo or foetus is asking to be aborted. Arguments justifying abortion are more complex than those based on the simple right to autonomy involved in euthanasia, and the whole debate on abortion is therefore more complex and more heated.
Even though abortion is legal in many more countries than euthanasia is (“The World’s Abortion Laws Map”, 2014), the debate about the moral permissibility of abortion is as lively today as it was 50 years ago. People hold deeply felt opinions about the morality of abortion , and such opinions seem to be rooted in non-negotiable ethical views. The ongoing disagreement about the moral value of embryos and foetuses , and about whether to prioritize women’s bodily autonomy (the pro-choice view) or foetuses’ (alleged) right to life (the pro-life view), seems practically unsolvable. Even though clear arguments have been developed on both sides of the debate, it seems that it is very difficult to move people who hold pro-choice views to the pro-life side, and vice versa. But even among people who share pro-choice or pro-life views, there are disagreements surrounding the reasons why abortion is moral or immoral, and regarding what exceptions to the rule, if any, should be allowed within a given moral framework.
For instance, some people on the pro-choice side argue that abortion is permissible only up to a certain stage of the pregnancy. Similarly, some people on the pro-life side would consider abortion permissible if the pregnancy is the result of sexual assault, or the pregnancy somehow threatens the pregnant woman’s health or life.
From the pro-life side, abortion is considered immoral because it involves the death of the embryo /foetus . Causing the death of an embryo /foetus is considered wrong either because it violates the principle that one should never kill an innocent human being or because it would be in the best interest of the foetus to continue to develop and have a life. From a pro-choice perspective, meanwhile, abortion is permissible either because embryos and foetuses are not yet fully human in a morally relevant sense (hence it is morally permissible to kill them) or because a woman’s autonomy over her own body cannot be outweighed by the right to life of any individual who depends on the woman to survive, regardless of their moral status.
In this chapter, I will consider how cryosuspension of embryos and foetuses could serve as an alternative to the termination of an unwanted pregnancy and thereby help bypass moral disagreements about abortion .
In a paper co-authored with Anders Sandberg , we considered the positive impact that could result from developing a new technology aimed at cryosuspending foetuses (Minerva & Sandberg, 2015). Such technology could prove helpful in emancipating women from biological constraints related not only to unwanted pregnancy, but also to unwanted decrease in fertility due to ageing.
Giving Pregnant Women Another Option
Medicalizing the reproductive process has brought about radical changes in the way we approach parenthood. For instance, as we saw in the first chapter, in vitro fertilization (IVF) and embryo cryopreservation (EC ) have become common procedures, and hundreds of thousands of children have born thanks to these technologies. IVF allows embryos to be created in the lab, after which they can be stored almost indefinitely using EC . Most cryopreserved embryos are later implanted when it is most convenient for the mother and then let develop into foetuses, others remain at the embryonic stage and may be used for research purposes, and the rest are eventually destroyed. Contraceptives , too, have had a profound impact on family planning and procreation , allowing women to choose whether , when, and with whom to have children.
However, when a woman finds herself pregnant against her plans, for instance, because contraceptives have failed, she has only two available options: continuing or terminating the pregnancy. In the future, technology could provide unwillingly pregnant women with a third option, namely cryosuspension of pregnancy—thus removing the need to choose between having a child they either cannot have or do not want to have at that particular moment, and undergoing an abortion they either do not want to have or cannot have for moral, legal, or personal reasons.
No attempt has been made (yet) to extract an embryo or a foetus already implanted in a uterus in order to cryopreserve it. If the extraction and the cryopreservation were successfully performed, the embryo /foetus could remain cryopreserved for years, and be reimplanted at a time where a woman feels ready to continue the pregnancy and raise the child.
At a purely theoretical level, there is no reason to assume that the cryopreservation of an embryo or foetus extracted from the womb would not work (Pavone, Innes, Hirshfeld-Cytron, Kazer, & Zhang, 2011), but the process of extracting a human being of few cells, or after a few weeks of development could be particularly difficult. To begin with, the extraction of the embryo /foetus from the uterus could damage the embryo/foetus , the uterus, or both. This part seems to be the one presenting the biggest technical difficulties: embryos (and, to a lesser extent, foetuses ) are extremely small and delicate, and extracting them from a womb without damaging or accidentally killing them would not be easy. But new and sophisticated techniques for performing surgeries on extremely small and fragile tissues are under constant development, so we should not exclude the possibility that such technical obstacles will someday be overcome.
Alternatively, the same result could be obtained by inducing the preterm birth of a foetus of viable age (around 23 weeks) and then proceeding with the cryopreservation. This option would remove some of the risks associated with removing an extremely small and fragile organism from the womb, but it would present the inconvenience of requiring women to continue the pregnancy for several weeks, which could cause psychological and/or physical discomfort to at least some of them.
Even though such technical difficulties should not be underestimated, they do not constitute a valid reason for discarding cryosuspension of pregnancy altogether. As I have discussed in previous chapters, it is crucial to assess the moral permissibility and expected utility of any given project well before technical feasibility is achieved. If there are not enough good reasons to try to develop a technology, or if there are enough good reasons to avoid the outcome that the technology hopes to achieve, then resources should not be invested in th
e project at all. This is why ethical analysis must always be one step ahead of the technology itself, and why it is important to discuss the implications and overall worthiness of potential future technologies as well as possible future developments of existing technologies.
In the following pages, we will explore the reasons why both abortion and continuation of an unwanted pregnancy can be suboptimal solutions under some circumstances, and how cryosuspension may offer a way out of such dilemmas.
Would Objections to Abortion Apply to Cryosuspension of Pregnancy?
According to philosopher Don Marquis, abortion is not morally permissible because it deprives embryos and foetuses of their future, which—given that embryos and foetuses have their own future ahead of them in the same way as the rest of us have our own futures ahead—is as valuable as anyone else’s future (Marquis, 1989). Just as it is wrong to deprive adults of their future life, even though they do not know what the future holds in store for them, it is also wrong to deprive embryos and foetuses of “a future like ours”, in Marquis’ own words.
As we saw in Chap. 3, Thomas Nagel argued that one is harmed by death even if one no longer exists after one is dead, because the harm of death consists in being deprived of the counterfactual life one would otherwise have continued to enjoy.
These two arguments can be tied together to form an argument against abortion, based on a kind of harm that abortion inflicts on the embryo or foetus. In the same way that we can imagine a counterfactual life for a person who died in their 30s, and say that their death was bad because it deprived them of a future life, we can also imagine a counterfactual life for the embryo or foetus being aborted, and say that their abortion was bad because it deprived them of a future life.
However, one could reply by pointing out that the two types of future at stake—the one of a foetus and the one of an actual person—are not morally equivalent, in the sense that being deprived of one is not as bad of being deprived of the other. In this view, before a person becomes minimally self-aware, their counterfactual life is not morally relevant in the same way that the counterfactual life of someone who has not been and never will be conceived is morally (ir)relevant. This line of argument boils down to a crucial difference between attributing a counterfactual life to an entity that is not developed enough to appreciate the fact they are and will be alive, and attributing a counterfactual life to an actual person such as myself: while my counterfactual life has value because my current self is capable of attributing value to it, the counterfactual life of an embryo or a foetus has no value because the embryo or foetus does not have the capacity to attribute any value to it (Giubilini, 2012).
Regardless of when during foetal development one thinks it would start being wrong or harmful to deprive a human being of their counterfactual future, it seems that cryosuspension of such individuals would not entail any such harm. The cryopreservation of this embryo or foetus would not deprive it of a future life, but merely postpone the beginning of their “biographical” life (as opposed to their biological life, which would nevertheless start at conception). So if one gets pregnant in 2020 and decides to extract the embryo or foetus from the womb and cryopreserve it, then insofar as the embryo will be reimplanted in the uterus at some point in the future, that embryo/foetus has not been deprived of its future life.
What Type of “Future Like Ours”?
One could object that, even if an embryo that is extracted, cryopreserved, and then reimplanted has not been deprived of its future altogether, it has nevertheless been deprived of the particular biographical life that it would have had, had it been allowed to develop “naturally” after its conception. In other words, it would have been deprived of “its” own future, which would have been replaced with a different future.
Thus, an embryo that was conceived in, say, 2020, but then cryopreserved and eventually reimplanted in 2040, would be deprived of the counterfactual life it would have lived if it had developed naturally and been born nine months after conception. Of course, the biographical life one will have if reimplanted and born 20 or more years after they were conceived will be different from that which they would have experienced had they been born 9 months after conception. For example, consider how a child born in the 1980s grew up without access to the internet or mobile phones. Given how each of those technologies ended up radically changing our lives, it would be false to say that the same embryo born in the 80s rather than today would have had the same biographical life. And, of course—besides the different kinds of technologies available to people growing up in different decades—there would be major differences in the kind of education, culture, and social environment to which the child would be exposed, all of which would greatly influence their life in a multitude of ways.
But even though it is obvious that the same individual born today versus 30 years ago would have a different biographical life—a different narrative, so to speak—it is far from clear whether the embryo would have an interest in being born at one time rather than the other; nor is it clear how they might be harmed by being born 10, 20, or 30 years after they were conceived. Just like embryos that are created in the lab and implanted at a later time are not harmed by the fact that they spent some years or decades as cryopreserved embryos, embryos and foetuses reimplanted after cryosuspension of pregnancy should not be considered harmed by either this process or the delay of coming into existence. Moreover, we need to remember that the realistic alternatives for these embryos and foetuses would have been either abortion or being brought into existence under suboptimal conditions, as their parents were not ready to take care of them.
Only if one could predict future events that would shorten the overall life of a future child, or negatively affect their overall well-being, there might be a reason to avoid the cryopreservation of the embryo. For instance, if one knew that an asteroid would impact the Earth and destroy human civilization in 2060, they would have good reasons to bring that future child into existence as early as possible, thereby giving it as many years of life as possible before certain death in 2060. But in the absence of information of this sort, it seems that cryopreservation of embryos/foetuses is not harmful, at least insofar as they are eventually implanted.
So, if one is against abortion for the reason that it deprives the embryo or foetus of a future like ours, then cryopreservation after removing it from the womb would be a better alternative to abortion.
Potentiality
Deprivation of a future life, however, is not the only reason why abortion is considered morally impermissible. According to a different objection, abortion is immoral because it causes the death of a potential person. Embryos and foetuses are potential persons, meaning that, in absence of adverse events, they can develop into people. While it is true that they are human beings in a biological sense (i.e. they are members of the species Homo sapiens) from conception, under certain views being a person is different from merely being human. On certain views, a person is an individual with self-awareness—the capacity to appreciate that they are alive—and an interest in continuing to live. Some humans, like indeed embryos and foetuses, do not meet such requirements. Given that embryos or foetuses do not have these capacities and hence do not meet the requirements for personhood, they are not persons in the same sense that an adult human being is a person. However, they surely have the potential to become a person like you and me, but there is disagreement about whether potential persons and actual persons should be attributed the same moral status. Let us briefly illustrate how the opposite argumentative lines go.
Let us start from the pro-choice view. If someone kills me (a fully developed adult person), they frustrate my preference to keep living, reach certain goals, develop certain skills, and so on. However, if someone had killed me when I was just an embryo, they would not have prevented me from achieving my goals, since I would not have had any at the time. Not all living beings (humans or not) have an interest in continuing to live, as such interest only develops in
beings capable of attributing a value to their being alive, and to fulfilling their projects. As we saw in Chap. 3, for instance, Bernard Williams attributed to “categorical” desires the power to propel us into the future: if such desires never existed, or are depleted over a long life, then one has no interest in living. The odd implication of this approach is that newborns and people with severe cognitive impairments also have no interest in living, hence their death is not bad to them (Giubilini & Minerva, 2012).
According to the opposite view, being someone with the potential to become a person with an interest in continuing to exist is sufficient for being attributed a right to life. It does not matter if the criteria for calling someone a “person” are actually satisfied or not; if someone has the potential to become a person, they should be treated as such. An odd implication of this view is that, according to this argument, eggs and sperm should also be considered potential people, as they too develop into persons given the right set of circumstances. And yet, we do not think there is anything bad about the monthly expulsion of an unfertilized egg, even though, had they been fertilized, they could have become a person. Moreover, within two weeks following conception, an embryo can split itself into several twins, or even become a kind of tumour called “teratoma”. So it is difficult to tell whether those embryonic cells are indeed a potential person, several potential people, or a potential tumour (Ford, 1991). Thus, when arguing against abortion on the basis that it is the killing of a potential person, one has to deal with the difficulties of drawing a line between what does and does not count as a potential person.
However, also in this case it does not matter, for the purpose of assessing the moral permissibility of cryosuspension, whether the argument from potentiality as applied to abortion is successful or not. Cryosuspension entails neither the loss of the embryo/foetus nor the loss of its potentiality, since, once revived, the embryo/foetus will continue to develop and realize its potential. Development of potentiality is delayed, but not prevented, which is irrelevant if we think that what matters is potentiality itself.
The Ethics of Cryonics Page 16