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P-6.06 Bioethics, transplantation and gender: Some reflections on uterus transplantation

Carlos E. Pregno, Argentina

Researcher and Associate Professor
Law School
Universidad de Buenos Aires

Biography

PhD. Researcher and Associate Professor (Facultad de Derecho, Universidad de Buenos Aires, Argentina). Full Member of the Bioethics Committee of the Argentine Society of Transplants.

Abstract

Bioethics, transplantation and gender: Some reflections on uterus transplantation

Carlos Pregno1, Ana C. Molina Villar1.

1Facultad de Derecho, Universidad de Buenos Aires, Buenos Aires, Argentina

The first uterus transplant that is recorded dates from 2000. In the last two decades about thirty of them were done with relative success, since some grafts worked and healthy children were born. Indeed, it is an innovative procedure to treat Absolute Infertility of Uterine Cause that generates certain bioethical questions, e.g.:
Being that there is no danger of life for the recipient and that the best results have been obtained with living donors, is it justified to affect the psycho-physical integrity of a person? Here there is no additional feature to what happens in all transplants with living donors.
Even if the donor's self-endangered is justified by the legitimate exercise of their individual autonomy or that this is not a problem due to resorting to cadaveric donors, would the uterus transplant be a valid strategy, even for people who already have children but who want to be mothers again? These questions allude to specific problems of distributive justice such as the allocation of resources in health.
How much the rights cost is a question as uncomfortable as it cannot be extended to the rule of law, especially in deficit countries. In that intelligence, how much do the health systems financed with public money need to invest to attend to the health of the population? Should society pay for an uterus transplant just because a person wishes to be a mother, especially if there are other options such as adoption or pregnancy by replacement (when state legislation permits)? In the same line, how many uterus transplants can the same person aspire to? These issues are sensitive because definitions of sexual and reproductive rights matter.
it is important to keep in mind that it is not only the costs demanded by the process of ablation and implantation of the uterus but also those generated in the post-transplant. Then, how long should immunosuppressive medication cost? How many pregnancy attempts should be made? Should all pregnancies that the person wants have to be financed?
Perhaps the most provocative question has to do with the possibility of a male person aspiring to have a uterus implanted. If the surgical technique resolves anatomical issues and manages to make a uterus work in a man's body, could he become pregnant, if he is also given the corresponding hormonal therapy? If this finally happens, it is likely that we will attend the most revolutionary scientific-technological innovation that medicine has been able to sponsor, as long as it will imply a true subversion in social relations -in general- and family/conjugal - in particular - with profound impact on the legal-political organization of our culture.

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