Uterus Transplantation: Legal and Ethical Contemporary Challenges

Uterus transplantation is a clinical procedure with the goal of restoring fertility in patients affected by Absolute Uterine Factor Infertility (AUFI). Before the implantation of the uterus, either from a deceased or a living donor, the patient needs to undergo in vitro fertilisation, so that embryo transfer will be possible after the surgery. Despite this procedure still being at the experimental stage, it is predicted that it will become available as a routine treatment in the near future. The aim of this paper is to investigate the main legal and ethical issues which characterise this novel technology, in order to understand whether its introduction could be lawful and morally justified. In particular, we will firstly analyse the status of womb transplantation, and we will try to understand whether it should be characterised, for legal purposes, as an artificial reproductive technology (ART) or as a mere organ transplant, and whether we should consider it a life-saving or a quality-of-life treatment. Then, we will turn on the main questions regarding the moral feasibility of uterine transplantation. In particular, we will compare it with the alternatives of adoption and gestational surrogacy, but we will also discuss the risks and benefits for donors, recipients and the resulting children, concluding with an enquiry on whether or not the procedure should be publicly funded. Finally, we will address the main points regarding the selection criteria used to determine access to the treatment, with a particular reference to the feasibility and the legal and ethical implications of including transgender women, cisgender men, and in general all individuals who do not identify as cisgender women, as potential candidates for uterus transplantation. Throughout all this discussion, we will take into consideration mainly the legislative frameworks in force in the United Kingdom and the United States, so as to understand how these jurisdictions would regulate this novel reproductive technology.