Why Should Their Wombs Be Going to Waste?" The Proposal That Made a Medical Association Apologise

The sentence that started it all was published in an academic journal and presented as a philosophical thought experiment.

"What about all those brain-stem dead female bodies in hospital beds? Why should their wombs be going to waste?"

That is a direct quote. From a professor. Published in a peer-reviewed journal. Endorsed — briefly — by a national medical association.

The backlash was immediate and fierce. The apology came within days. But the fact that this idea traveled from a philosophy paper to a medical institution's official publication without anyone stopping to say "wait" — that is the part worth examining.

The Proposal

Anna Smajdor is a Professor of Practical Philosophy at the University of Oslo, Norway. She published a paper titled "Whole Body Gestational Donation" in the journal Theoretical Medicine and Bioethics, arguing that brain-dead men and women should be kept alive and used as gestational surrogates.

The concept is known as Whole Body Gestational Donation, or WBGD. The core argument goes like this: pregnancy carries serious health risks for living women. Brain-dead patients on ventilators have already lost consciousness and the capacity to experience harm. Therefore, with prior consent — before brain death occurs — their bodies could be maintained on life support and used to gestate embryos for couples who cannot or prefer not to carry a pregnancy themselves.

"We already know that pregnancies can be successfully carried to term in brain-dead women. There is no obvious medical reason why initiating such pregnancies would not be possible," Smajdor stated.

She also suggested that brain-stem dead men could potentially be adapted to gestate, "thereby circumventing some potential feminist objections."

That last line tells you everything about the framework being applied here. The feminist concern isn't that women's bodies might be used as vessels without their ongoing awareness or agency. The feminist concern, in this framing, is simply that men aren't included.

How a Medical Association Ended Up Apologising

In November 2022, the Colombian Medical College published a Spanish translation of Smajdor's paper. They initially defended their actions by claiming it was representative of the author's view.

The public reaction in Colombia was furious. Women's rights advocates, politicians, and medical ethicists responded with alarm — not just at the paper itself, but at the institutional legitimacy the Colombian Medical College had lent it by publishing and initially defending it.

On February 1, 2023, the Colombian Medical College tendered an apology. They had endorsed a paper suggesting that brain-dead women could serve as human incubators. They had defended it. And when the country responded with outrage, they apologized.

The idea was still in print. The paper was still available. The philosopher had not retracted it.

The apology was for the association. Not for the concept.

The Argument Being Made — And Why It Falls Apart

The argument for WBGD rests on a specific chain of logic. Pregnancy is dangerous. Living surrogates face real physical and psychological risks. Brain-dead patients cannot experience harm. Therefore, if a woman consented in advance — like an organ donor card — her body could carry a pregnancy without harming her.

It sounds, in the abstract, like a utilitarian calculation. It unravels the moment you apply any pressure to it.

Medical researchers critiquing the proposal point out that consent for eight months of ICU treatment can never be assumed to derive from consent for organ donation — the two are of an entirely different ethical and medical order. The brain-dead state poses a high risk for deficient embryo and fetal development. And from a resource perspective, occupying an ICU bed for eight months is medically unjustifiable when living, healthy surrogates could carry the same pregnancy.

There is also the question of what "prior consent" actually means when the body doing the work is legally dead.

As bioethicists opposing the proposal argue: how does the fact of death change the need for consent to be truly free? Is consent given by a woman who only agrees to surrogacy for economic reasons any freer just because the object of the contract takes place after her death? This does not seem to make sense.

And critics raise a darker possibility. Some warn that signatures could be forged if women did not give consent before being declared brain dead. Others say women could be wrongfully declared brain dead to be used as surrogate bodies for high net worth clients.

That last scenario is not paranoia. It is the logical endpoint of a system where a woman's body has commercial value and the woman herself is no longer present to object.

What Most People Don't Know About This

This is not a new idea. It has been circulating in bioethics literature since at least 2000. The Colombian controversy was not the first time a medical institution flirted with it — it was just the first time the public found out quickly enough to respond.

The WBGD concept is distinct from — but related to — cases that already happen with some regularity. Pregnant women who suffer catastrophic brain injuries or brain death sometimes have their bodies maintained on life support, against their previously expressed wishes, in order to carry a fetus to term. These are not theoretical scenarios. They have occurred in Texas, in other US states, and across Europe.

In one documented case examined by the AMA Journal of Ethics, a brain-dead pregnant woman had an advance directive explicitly stating she did not want life support. Her husband agreed with her wishes. The hospital continued life support anyway to carry the fetus. Her husband said: "I don't feel right using my wife's body as an incubator if she's not alive."

The law overrode both of them.

What the WBGD proposal does is take the logic already embedded in those laws — that a woman's body can be maintained against her will to carry a fetus — and expand it. Scale it. Make it a donation option. Give it a name and a journal paper and a medical association willing to publish the translation.

What most people also don't know: Smajdor herself, in an explanatory text after the backlash, wrote that her personal view as an ethicist was that "the prospect of whole-body gestational donation is deeply disturbing." She presented the paper as a thought experiment — a provocation designed to explore questions, not a policy recommendation.

The Colombian Medical College did not frame it that way when they translated and published it.

Why This Still Matters Today

The Colombian Medical College apologized. The controversy moved on. The paper remains in circulation.

That is the problem with where this conversation sits. The proposal is extreme enough to generate outrage when it surfaces publicly. But it is embedded in a slow-moving current of bioethics literature that processes these questions largely out of public view, in journals that non-specialists rarely read, in conferences where the language is technical enough to obscure the visceral reality of what is being discussed.

The reality is this: a proposal to maintain brain-dead women on life support for nine months, in intensive care units, in order to gestate embryos for paying clients, is not a thought experiment that sits in a neutral ethical space. It sits in a very specific context — one in which women's reproductive capacity is already treated as a resource to be managed, accessed, and legislated over by people who are not the women themselves.

The same legal systems that maintain brain-dead pregnant women on life support against their advance directives are the ones that would govern "prior consent" under WBGD. The same healthcare systems that profit from surrogacy markets, from placenta procurement, from reproductive technology at scale, would administer the program. The same institutions that initially endorsed the paper before the public noticed would be the ones making the calls.

As bioethicists opposing WBGD put it, the proposal "could be seen as objectifying women's reproductive functions and commodifying their reproductive capacity, even if they are dead or previously consented. It also sends an implicit message or reinforcement to deeply entrenched assumptions and prejudices against women."

That framing matters. Because the question is not only whether this specific proposal ever becomes policy. The question is what it reveals about the default assumptions already baked into how reproductive medicine thinks about women's bodies — alive or otherwise.

The Colombian Medical Association apologized. That is something.

The question worth sitting with is why the apology was necessary in the first place — and what it says about the systems that thought endorsing it was reasonable until the public made enough noise.