A University of Oslo professor has triggered widespread anger online after theorising that the bodies of vegetative or brain-dead female patients could be utilised as surrogates to carry unborn children to term – something she calls “whole body gestational donation” or WBGD and an idea that “deserves serious consideration”.
The paper by Dr Anna Smajdor, an associate professor at the University of Oslo, was first published in November 2022 in the medical journal Theoretical Medicine and Bioethics.
According to the article, with WBGD, vegetative women's bodies could be used as surrogates for potential parents who wish to have children but cannot, or prefer not to, based on proven cases of brain-dead women giving birth to healthy babies.
Smajdor says female patients in a persistent vegetative state (PVS) who had provided prior written agreement may act as surrogates, allowing embryos to be implanted in their uteruses and carried to term. If a person were to pass away or be in a serious accident, their consent would be comparable with that of organ donors, she said.
Brain death, also referred to as death by neurological standards, is the permanent loss of all brain functions, including those of the brain stem. Brain death involves loss of function of both the cerebrum, the “thinking” part of the brain, and the brain stem, the deep brain structure responsible for reflexes and breathing.
A vegetative state is a condition in which patients show signs of consciousness and still have a chance of recovering since their brain stem continues to function.
Devastating brain injuries, such as those caused by head trauma, bleeding in the brain, strokes, or the loss of blood flow to the brain after the heart stops, can end in brain death. There were reportedly 15 405 cases in the US in 2016, or around 2% of all hospital deaths attributed to brain death.
Legal and ethical debates focus on attitudes about patients declared permanently vegetative carrying babies to full term. Vegetative patients do not possess the capacity to refuse continued treatment, and it is unclear how to protect them from treatment that they would probably refuse if they were able to.
Smajdor says while the maximum amount of time a brain-dead patient can be kept on life support is "unknown," with the longest case lasting 110 days, the idea should not be completely disregarded.
Smajdor’s article argues that expectant mothers face a multitude of complications such as diabetes, which increases the chances of miscarriage and birth difficulties, and high blood pressure, which can cause life-threatening fits known as eclampsia. Both pose health hazards to pregnant women.
Smajdor acknowledged that WBGD "might stand out as being unacceptable from a feminist perspective, as it dissociates the functions of reproduction from the person."
But she adds: “We cannot yet forgo the uterus altogether for the reproduction of our species but we can transfer the risks of gestation to those who are no longer able to be harmed by them."
In the days following its publication, the paper sparked controversy among many people. According to The Telegraph congressional member, Jennifer Pedraza slammed the idea as 'misogynistic'.
She said: “Women are not utensils to be thrown away after use; women have human rights, even if some people forget this.”
Although the institution first defended the study, they subsequently issued an apology, stating that they would only promote "medical development at the service of humanity.”