Artificial womb technologies - Innovation at the edge of viability: Ethical considerations

Jennifer Paul; Felix R De Bie; Hannah Johnston; Ryan M Antiel

doi:10.1016/j.jpedsurg.2025.162827

Artificial womb technologies - Innovation at the edge of viability: Ethical considerations

J Pediatr Surg. 2026 Feb;61(2):162827. doi: 10.1016/j.jpedsurg.2025.162827. Epub 2025 Nov 19.

Authors

Jennifer Paul¹, Felix R De Bie¹, Hannah Johnston¹, Ryan M Antiel²

Affiliations

¹ Duke University, Department of Surgery, Division of Pediatric Surgery, Durham, NC, USA.
² Duke University, Department of Surgery, Division of Pediatric Surgery, Durham, NC, USA; Trent Center for Bioethics at Duke University, Durham, NC, USA. Electronic address: ryan.antiel@duke.edu.

PMID: 41265706
DOI: 10.1016/j.jpedsurg.2025.162827

Abstract

Artificial womb technologies (AWT) represent true innovation, and a potential paradigm shift in neonatal care at the edge of viability. As AWT progresses from animal models to first-in-human trials, it raises complex ethical, legal, and societal questions. In this paper, we review the rationale for AWT in extremely premature infants as well as the ethical implications, organized in seven ethical domains: Beneficence and Harm; Parental Autonomy and Responsibility; Legal and Moral Status; Reproductive Rights; Justice and Access; Cultural and Societal Perspectives; and Research Ethics and Oversight. We conclude with a discussion of the next steps towards responsible clinical translation of AWT.

Keywords: Artificial womb technology; Ethical considerations; Extreme prematurity.

Publication types

Review

MeSH terms

Female
Fetal Viability*
Humans
Infant, Extremely Premature*
Infant, Newborn
Inventions / ethics
Personal Autonomy
Pregnancy
Reproductive Rights / ethics