Should Deceased Donation be Morally Preferred in Uterine Transplantation Trials?

Bioethics. 2016 Jul;30(6):415-24. doi: 10.1111/bioe.12247. Epub 2016 Feb 1.


In recent years much research has been undertaken regarding the feasibility of the human uterine transplant (UTx) as a treatment for absolute uterine factor infertility (AUFI). Should it reach clinical application this procedure would allow such individuals what is often a much-desired opportunity to become not only social mothers (via adoption or traditional surrogacy arrangements), or genetic and social mothers (through gestational surrogacy) but mothers in a social, genetic and gestational sense. Like many experimental transplantation procedures such as face, hand, corneal and larynx transplants, UTx as a therapeutic option falls firmly into the camp of the quality of life (QOL) transplant, undertaken with the aim, not to save a life, but to enrich one. However, unlike most of these novel procedures - where one would be unlikely to find a willing living donor or an ethics committee that would sanction such a donation - the organs to be transplanted in UTx are potentially available from both living and deceased donors. In this article, in the light of the recent nine-case research trial in Sweden which used uteri obtained from living donors, and the assertions on the part of a number of other research teams currently preparing trials that they will only be using deceased donors, I explore the question of whether, in the case of UTx, there exist compelling moral reasons to prefer the use of deceased donors despite the benefits that may be associated with the use of organs obtained from the living.

Keywords: autonomy; beneficence; non-maleficence; quality of life transplants; reproductive ethics; transplantation ethics; uterine transplants.

MeSH terms

  • Female
  • Humans
  • Infertility, Female / surgery*
  • Infertility, Female / therapy*
  • Living Donors*
  • Organ Transplantation / ethics*
  • Quality of Life
  • Sweden
  • Tissue Donors / ethics*
  • Tissue Donors / psychology
  • Tissue and Organ Procurement / ethics
  • Uterus / transplantation*