25 found
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  1.  81
    Artificial womb technology and the frontiers of human reproduction: conceptual differences and potential implications.Elizabeth Chloe Romanis - 2018 - Journal of Medical Ethics 44 (11):751-755.
    In 2017, a Philadelphia research team revealed the closest thing to an artificial womb the world had ever seen. The ‘biobag’, if as successful as early animal testing suggests, will change the face of neonatal intensive care. At present, premature neonates born earlier than 22 weeks have no hope of survival. For some time, there have been no significant improvements in mortality rates or incidences of long-term complications for preterms at the viability threshold. Artificial womb technology, that might change these (...)
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  2.  41
    Reviewing the womb.Elizabeth Chloe Romanis, Dunja Begović, Margot R. Brazier & Alexandra Katherine Mullock - 2021 - Journal of Medical Ethics 47 (12):820-829.
    Throughout most of human history women have been defined by their biological role in reproduction, seen first and foremost as gestators, which has led to the reproductive system being subjected to outside interference. The womb was perceived as dangerous and an object which husbands, doctors and the state had a legitimate interest in controlling. In this article, we consider how notions of conflict surrounding the womb have endured over time. We demonstrate how concerns seemingly generated by the invisibility of reproduction (...)
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  3.  34
    Assisted gestative technologies.Elizabeth Chloe Romanis - 2022 - Journal of Medical Ethics 48 (7):439-446.
    A large body of literature considers the ethico-legal and regulatory issues surrounding assisted conception. Surrogacy, however, within this body of literature is an odd-fit. It involves a unique demand of another person—a form of reproductive labour—that many other aspects of assisted conception, such as gamete donation do not involve. Surrogacy is a form of assisted gestation. The potential alternatives for individuals who want a genetically related child but who do not have the capacity to gestate are ever increasing: with the (...)
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  4.  56
    Artificial womb technology and the significance of birth: why gestatelings are not newborns (or fetuses).Elizabeth Chloe Romanis - 2019 - Journal of Medical Ethics 45 (11):728-731.
    In a recent publication, I argued that there is a conceptual difference between artificial womb (AW) technology, capable of facilitating gestation ex utero, and neonatal intensive care, providing incubation to neonates born prematurely. One of the reasons I provided for this distinction was that the subjects of each process are different entities. The subject of the process of gestation ex utero is a unique human entity: a ‘gestateling’, rather than a fetus or a newborn preterm neonate. Nick Colgrove wrote a (...)
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  5.  28
    Artificial placentas, pregnancy loss and loss-sensitive care.Elizabeth Chloe Romanis & Victoria Adkins - 2024 - Journal of Medical Ethics 50 (5):299-307.
    In this paper, we explore how the prospect of artificial placenta technology (nearing clinical trials in human subjects) should encourage further consideration of the loss experienced by individuals when their pregnancy ends unexpectedly. Discussions of pregnancy loss are intertwined with procreative loss, whereby the gestated entity has died when the pregnancy ends. However, we demonstrate how pregnancy loss can and does exist separate to procreative loss in circumstances where the gestated entity survives the premature ending of the pregnancy. In outlining (...)
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  6. Challenging the ‘Born Alive’ Threshold: Fetal Surgery, Artificial Wombs, and the English Approach to Legal Personhood.Elizabeth Chloe Romanis - 2019 - Medical Law Review.
    English law is unambiguous that legal personality, and with it all legal rights and protections, is assigned at birth. This rule is regarded as a bright line that is easily and consistently applied. The time has come, however, for the rule to be revisited. This article demonstrates that advances in fetal surgery and (anticipated) artificial wombs do not marry with traditional conceptions of birth and being alive in law. These technologies introduce the possibility of ex utero gestation, and/or temporary existence (...)
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  7.  43
    Partial ectogenesis: freedom, equality and political perspective.Elizabeth Chloe Romanis - 2020 - Journal of Medical Ethics 46 (2):89-90.
    In this commentary, I consider how Giulia Cavaliere’s arguments about the limited reach of the current justifications offered for full ectogenesis in the bioethical literature apply in the context of partial ectogenesis. I suggest that considering the extent to which partial ectogenesis is freedom or equality promoting is more urgent because of the more realistic prospect of artificial womb technology being utilised to facilitate partial gestation extra uterum as opposed to facilitating complete gestation from conception to term. I highlight concerns (...)
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  8.  27
    Why the Elective Caesarean Lottery is Ethically Impermissible.Elizabeth Chloe Romanis - 2019 - Health Care Analysis 27 (4):249-268.
    In the United Kingdom the law and medical guidance is supportive of women making choices in childbirth. NICE guidelines are explicit that a competent woman’s informed request for MRCS should be respected. However, in reality pregnant women are routinely denied MRCS. In this paper I consider whether there is sufficient justification for restricting MRCS. The physical and emotive significance of childbirth as an event in a woman’s life cannot be understated. It is, therefore, concerning that women are having their wishes (...)
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  9.  20
    Surrogacy and uterus transplantation using live donors: Examining the options from the perspective of ‘womb-givers’.Alexandra Mullock, Elizabeth Chloe Romanis & Dunja Begović - 2021 - Bioethics 35 (8):820-828.
    For females without a functioning womb, the only way to become a biological parent is via assisted gestation—either surrogacy or uterus transplantation (UTx). This paper examines the comparative impact of these options on two types of putative ‘womb‐givers’: people who provide gestational surrogacy and those who donate their uterus for live donation. The surrogate ‘leases’ their womb for the gestational period, while the UTx donor donates their womb permanently via hysterectomy. Both enterprises involve a significant degree of self‐sacrifice and medical (...)
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  10.  34
    The Ethical and Legal Status of ‘Fetonates’ Or ‘Gestatelings’.Elizabeth Chloe Romanis - 2023 - American Journal of Bioethics 23 (5):90-92.
    De Bie et al. posit thatthe best way to describe the person who would receive current AWT is as a “fetal neonate” or fetonate. Neonatal pertains to the fact that the subject is removed from the wom...
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  11.  52
    Is ‘viability’ viable? Abortion, conceptual confusion and the law in England and Wales and the United States.Elizabeth Chloe Romanis - 2020 - Journal of Law and the Biosciences 7 (1):lsaa059.
    In this paper, I explore how viability, meaning the ability of the fetus to survive post-delivery, features in the law regulating abortion provision in England and Wales and the USA. I demonstrate that viability is formalized differently in the criminal law in England and Wales and the USA, such that it is quantified and defined differently. I consider how the law might be applied to the examples of artificial womb technology and anencephalic fetuses. I conclude that there is incoherence in (...)
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  12.  35
    Artificial womb technology and clinical translation: Innovative treatment or medical research?Elizabeth Chloe Romanis - 2020 - Bioethics 34 (4):392-402.
    In 2017 and 2019, two research teams claimed ‘proof of principle’ for artificial womb technology (AWT). AWT has long been a subject of speculation in bioethical literature, with broad consensus that it is a welcome development. Despite this, little attention is afforded to more immediate ethical problems in the development of AWT, particularly as an alternative to neonatal intensive care. To start this conversation, I consider whether experimental AWT is innovative treatment or medical research. The research–treatment distinction, pervasive in regulation (...)
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  13.  19
    Abortion Access and the Benefits and Limitations of Abortion- Permissive Legal Frameworks: Lessons from the United Kingdom.Elizabeth Chloe Romanis - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):378-390.
    This paper argues that abortion access is an important subject for bioethics scholarship and reflects on the relationship between legal frameworks and access to care. The author uses the example of the United Kingdom to examine the benefits and limitations of abortion-permissive legal frameworks in terms of access. These are legal frameworks that enable the provision of abortion but subject to restrictions. An abortion-permissive regime—first in Great Britain and then in Northern Ireland—has gone some way to improving access to care (...)
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  14.  45
    Twin pregnancy reduction is not an ‘all or nothing’ problem: a response to Räsänen.Dunja Begović, Elizabeth Chloe Romanis & E. J. Verweij - 2022 - Journal of Medical Ethics 48 (2):139-141.
    In his paper, ‘Twin pregnancy, fetal reduction and the ‘all or nothing problem’, Räsänen sets out to apply Horton’s ‘all or nothing’ problem to the ethics of multifetal pregnancy reduction from a twin to a singleton pregnancy. Horton’s problem involves the following scenario: imagine that two children are about to be crushed by a collapsing building. An observer would have three options: do nothing, save one child by allowing their arms to be crushed, or save both by allowing their arms (...)
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  15.  20
    Appropriately framing maternal request caesarean section.Elizabeth Chloe Romanis - 2022 - Journal of Medical Ethics 48 (8):554-556.
    In their paper, ‘How to reach trustworthy decisions for caesarean sections on maternal request: a call for beneficial power’, Eide and Bærøe present maternal request caesarean sections (MRCS) as a site of conflict in obstetrics because birthing people are seeking access to a treatment ‘without any anticipated medical benefit’. While I agree with the conclusions of their paper -that there is a need to reform the approach to MRCS counselling to ensure that the structural vulnerability of pregnant people making birth (...)
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  16.  66
    Addressing Rising Cesarean Rates: Maternal Request Cesareans, Defensive Practice, and the Power of Choice in Childbirth.Elizabeth Chloe Romanis - 2020 - International Journal of Feminist Approaches to Bioethics 13 (1):1-26.
    The number of cesarean sections performed globally has been consistently rising since the 1980s.1 The number of cesareans performed now greatly exceeds the number that experts predict are necessary.2 In Brazil, the world's "cesarean capital," over half of births are surgical. In the United States, approximately one third of babies are delivered by cesarean, and in the United Kingdom around 26 percent of births are by cesarean.3 Cesarean section can be a life-saving intervention when vaginal birth poses a risk to (...)
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  17.  25
    The relationship between speculation and translation in Bioethics: methods and methodologies.Tess Johnson & Elizabeth Chloe Romanis - 2023 - Monash Bioethics Review 41 (1):1-19.
    There are increasing pressures for bioethics to emphasise ‘translation’. Against this backdrop, we defend ‘speculative bioethics’. We explore speculation as an important tool and line of bioethical inquiry. Further, we examine the relationship between speculation and translational bioethics and posit that speculation can support translational work. First, speculative research might be conducted as ethical analysis of contemporary issues through a new lens, in which case it supports translational work. Second, speculation might be a first step prior to translational work on (...)
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  18.  27
    Equality‐enhancing potential of novel forms of assisted gestation: Perspectives of reproductive rights advocates.Elizabeth Chloe Romanis - 2023 - Bioethics 37 (7):637-646.
    Novel forms of assisted gestation—uterus transplantation and artificial placentas—are highly anticipated in the ethico‐legal literature for their capacity to enhance reproductive autonomy. There are also, however, significant challenges anticipated in the development of novel forms of assisted gestation. While there is a normative exploration of these challenges in the literature, there has not yet, to my knowledge, been empirical research undertaken to explore what reproductive rights organisations and advocates identify as potential benefits and challenges. This perspective is invaluable. These organisations/individuals (...)
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  19.  21
    The Case for Telemedical Early Medical Abortion in England: Dispelling Adult Safeguarding Concerns.Jordan A. Parsons & Elizabeth Chloe Romanis - 2021 - Health Care Analysis 30 (1):73-96.
    Access to abortion care has been hugely affected by the COVID-19 pandemic. This has prompted several governments to permit the use of telemedicine for fully remote care pathways, thereby ensuring pregnant people are still able to access services. One such government is that of England, where these new care pathways have been publicly scrutinised. Those opposed to telemedical early medical abortion care have raised myriad concerns, though they largely centre on matters of patient safeguarding. It is argued that healthcare professionals (...)
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  20.  24
    Translational or translationable? A call for ethno‐immersion in (empirical) bioethics research.Jordan A. Parsons, Harleen Kaur Johal, Joshua Parker & Elizabeth Chloe Romanis - 2024 - Bioethics 38 (3):252-261.
    The shift towards "empirical bioethics" was largely triggered by a recognition that stakeholders' views and experiences are vital in ethical analysis where one hopes to produce practicable recommendations. Such perspectives can provide a rich resource in bioethics scholarship, perhaps challenging the researcher's perspective. However, overreliance on a picture painted by a group of research participants—or on pre‐existing literature in that field—can lead to a biased view of a given context, as the subjectivity of data generated in these ways cannot (and (...)
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  21.  28
    Maternal request caesareans and COVID-19: the virus does not diminish the importance of choice in childbirth.Elizabeth Chloe Romanis & Anna Nelson - 2020 - Journal of Medical Ethics 46 (11):726-731.
    It has recently been reported that some hospitals in the UK have placed a blanket restriction on the provision of maternal request caesarean sections as a result of the COVID-19 pandemic. Pregnancy and birthing services are obviously facing challenges during the current emergency, but we argue that a blanket ban on MRCS is both inappropriate and disproportionate. In this paper, we highlight the importance of MRCS for pregnant people’s health and autonomy in childbirth and argue that this remains crucial during (...)
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  22.  21
    AAPT, pregnancy loss and planning ahead.Victoria Adkins & Elizabeth Chloe Romanis - 2024 - Journal of Medical Ethics 50 (5):318-319.
    The commentaries in response to our feature paper1 are indicative of the varied perspectives that can be taken towards artificial amnion and placenta technology (AAPT) and more specifically its relationship with pregnancy (loss). Kennedy rightly argues that empirical research is essential for understanding the experiences of pregnancy loss and AAPT2 and our own advocacy of empirical research is evident in previous work.3–5 Kennedy also acknowledges the current impossibility of researching AAPT experiences since it has not yet been applied in clinical (...)
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  23.  23
    The relationship between speculation and translation in bioethics: methods and methodologies.Tess Johnson & Elizabeth Chloe Romanis - 2023 - Monash Bioethics Review 1:doi: 10.1007/s40592-023-00181-z.
    There are increasing pressures for bioethics research to have translational purposes. Against this backdrop, we argue in defense of speculative bioethics. We explore methods of speculation and their importance. Further, we examine the relationship between speculative bioethics and translational bioethics and posit that they are not dimorphous enterprises, but often support each other. First, speculative research might be conducted as ethical analysis of contemporary issues through a new lens, in which case it is a means of conducting translational work. Second, (...)
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  24.  27
    Directed and conditional uterus donation.Elizabeth Chloe Romanis & Jordan A. Parsons - 2022 - Journal of Medical Ethics 48 (11):810-815.
    Uterus transplantation (UTx) is highly anticipated for the benefits that it might bring to individuals wanting to carry a pregnancy in order to reproduce who do not have a functioning uterus. The surgery—now having been performed successfully in several countries around the world—remains experimental. However, UTx is at some point expected to become a routine treatment for people without a uterus and considering themselves in need of one: women with absolute uterine factor infertility; transgender women; and even cisgender men who (...)
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  25.  1
    Value sensitive design and the artificial placenta.Elizabeth Chloe Romanis, Seppe Segers & Ben D. de Jong - forthcoming - Journal of Medical Ethics.
    Artificial placenta technologies (also termed ‘artificial wombs’) for use in place of conventional neonatal intensive care are increasingly closer to first-in-human use. There is growing ethical interest in partial ectogestation (the use of an artificial placenta to continue gestation of an underdeveloped human entity extra uterum), however, there has been little reflection on the ethical issues in the design of the technology. While some have noted the importance of such reflection, and others have noted that a ‘value sensitive design’ approach (...)
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