Is it acceptable to utilize brain-dead women as surrogates? It seems that even in death, women are still being objectified.

I suffer from tokophobia, an intense fear of pregnancy. This phobia, along with my lack of desire for children, leads me to respond to invasive questions about my reproductive plans with a scoff and a declaration of “not in this lifetime.” Little did I know that science would take this as a challenge.

Whole Body Gestational Donation (WBGD) refers to the practice of offering one's entire body for gestation in the unfortunate event of becoming brain-dead. While I support organ donation for its life-saving potential, the concept of WBGD, which involves creating life, leaves me feeling both disturbed and horrified.

Women are frequently reduced to their reproductive capabilities, and the thought of such objectification extending into death is unfathomable. The advancement of science suggests that I could be subjected to pregnancy even after death, a notion that makes my skin crawl.

Initially, I hastily labeled WBGD as unethical and immoral, viewing it as a regression for women's rights. Fear clouded my judgment, but I have since endeavored to analyze this scientific development from multiple perspectives. While there may be benefits to WBGD, I firmly believe that just because something can be done, it doesn’t mean it should be done.

Who proposed the idea of WBGD? In 2000, Rosalie Ber published a report discussing ethical issues in gestational surrogacy, suggesting that using patients in a persistent vegetative state (PVS) could bypass the ethical and legal dilemmas associated with surrogacy. However, no jurisdiction has adopted Ber's recommendations, paving the way for Smajdor's 2022 report titled "Whole Body Gestational Donation," which builds upon Ber's work and posits that WBGD is a preferable alternative to using a PVS host.

Smajdor's report generated significant online debate at its release, possibly fueled by sensationalist media coverage. A recent article in Health News delved into the ethical quandaries posed by Smajdor's findings, revealing a complex moral landscape.

Is WBGD feasible? Smajdor's report implies that it is, yet the Health News article raises doubts. One of the most perplexing aspects is that WBGD necessitates the host body to be deceased. The NHS clarifies that brain-dead individuals are legally and clinically considered dead and will not regain consciousness.

Brain-dead individuals rely on life-support machines for respiration and circulation. However, the movements of their chest can be misleading, as they are not breathing autonomously but rather through mechanical assistance.

My previous role as a police officer exposed me to death, perhaps contributing to my struggle to reconcile the classification of brain-dead individuals as deceased. In my perception, a dead body is cold, pale, and stiff with rigor mortis, while a brain-dead person retains warmth and circulating blood, giving an illusion of life.

Families of brain-dead individuals likely grapple with this classification as well.

Differentiating between organ donation and WBGD reveals stark contrasts. Organ donation has become a widely accepted practice, yet Smajdor asserts that WBGD is technically akin to organ donation, requiring ventilation to preserve the body for donation.

However, the time frames differ significantly—WBGD involves a nine-month gestation period. While I am comfortable with my organs being harvested posthumously to save lives, the thought of enduring pregnancy after death terrifies me.

What about consent? My initial fears conjured dystopian images of medical facilities filled with deceased women bearing inflated abdomens. While common sense informs me that embryos would be inserted through medical procedures akin to IVF, my imagination wanders to darker scenarios.

Smajdor acknowledges the need for explicit consent before WBGD can occur, which must come from a person in sound mind—essentially, someone who is alive. However, she also admits that consent can be fluid.

For instance, in the UK, organ donation switched from an opt-in to an opt-out system, a change not widely understood. Many may unknowingly donate organs without truly informed consent. If WBGD becomes a reality, how can I trust that my wishes will be respected? There’s a terrifying prospect that consent might be manipulated, reducing it to a default position.

The notion of women being viewed as mere "foetal containers," even posthumously, undermines feminist principles. Smajdor anticipates backlash against this idea and suggests that men could also serve as host bodies, as certain organs can sustain pregnancies outside of the uterus.

While male pregnancy is typically viewed as risky, the absence of life risk in a deceased host could change the equation. However, I question why women remain the primary focus of WBGD. Will we never cease to reduce women to mere vessels for gestation, in life or death?

Moreover, I wonder how many men would volunteer their bodies for WBGD, especially those staunchly against abortion.

Is WBGD a viable alternative to surrogacy? Commercial surrogacy is illegal in many places due to its myriad ethical, moral, and legal complications. Pregnancy is inherently fraught with risk, and Smajdor herself states, “Pregnancy should, in medical terms, be contraindicated for women generally.” She further adds that “to expose oneself to pregnancy and childbirth risks would be deemed foolish in any other context.”

Surrogate mothers often come from desperate circumstances, driven by financial necessity to carry children for wealthy clients. While some may argue that this is a matter of choice, true free will is questionable when it arises from desperation.

Countries like India and Thailand have banned commercial surrogacy due to its ethical dilemmas, while Russia has recently prohibited surrogacy for foreigners, leaving Ukraine as a primary destination for such practices.

I oppose all forms of surrogacy, yet I recognize the irony in voicing my opinion on how others choose to use their bodies. As an advocate for those without children, I aim to shift the conversation away from our empty wombs.

That said, babies should not be treated as commodities. Rejection of a child born with disabilities, as highlighted in the case of baby Bridget, underscores the darker realities of surrogacy that often go unmentioned.

If the surrogate body is deceased, do the ethical and moral issues surrounding surrogacy dissipate? I remain uncertain. While WBGD simplifies the welfare concerns of the surrogate host, I argue that respect should be afforded to all, even in death.

We must also consider the welfare of the child involved. In our pro-natalist culture, we often overlook whether bringing a child into existence serves the best interests of the unborn. WBGD could serve the desires of hopeful parents and profit-driven entities, but the child becomes an afterthought in this process.

The importance of prenatal bonding cannot be overstated. During the nine-month gestation period, will the biological parents truly commit to being present and engaged with the host body? The practicality of such an endeavor seems implausible.

Is WBGD a realistic possibility? In the UK, there are 18 cases of brain-dead individuals for every million people. Even with a robust consent protocol, the likelihood of finding a suitable host for WBGD appears slim.

Yet, should a situation arise where it becomes feasible, I fear that WBGD would prioritize potential life over the rights of the deceased. Smajdor claims that WBGD is “available to anyone who wishes to avoid the risks and burdens of gestating a foetus in their body,” but this raises sensitive issues for those grappling with infertility or related challenges.

While options like IVF and adoption exist, both have their limitations in guaranteeing a child. Does the introduction of WBGD cater to pro-natalist attitudes instead of considering the welfare of the unborn?

Ultimately, my central question remains: “Why?”

Maintaining a WBGD host body is resource-intensive, and the costs associated with this practice would likely be astronomical, rendering it accessible only to the wealthy elite.

I can't help but perceive WBGD as a medical gimmick that exploits the vulnerable while enriching those behind it. In the end, WBGD may do more harm than good.

What are your thoughts?