Uterine transplantation (UTx) is a programme of treatment aimed at providing a unique solution to absolute uterine factor infertility, enabling patients to have children as a result of their own pregnancies. As a transplant procedure performed for fertility purposes it may be thought obvious that the welfare of any children created should be assessed prior to treatment provision. However, major concerns about the breadth and scope of such requirements, and the potential threat they pose to patients' reproductive autonomy, have been raised. In this paper, I analyse novel questions regarding the role of the pre-conception welfare principle in UTx. After outlining traditional critiques of the principle, I focus on the unique issues raised by its application in the two areas of medicine occupied by UTx. As a treatment for a particular form of infertility, I explore whether law and policy regulating traditional assisted reproductive technologies applies equally to the case of UTx, and whether a distinction (in welfare terms) does and should exist between fertility treatment involving gametes and embryos and gynaecological surgery for fertility purposes. As a quality-of-life-enhancing transplant, I consider and reject proposals in favour of using pre-conception welfare considerations to inform patient listing and the allocation of deceased donor uteri on the grounds that such assessments may both compromise patient autonomy and lead to unjust discrimination against particular patients or groups of patients.

中文翻译：

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为什么子宫移植需要我们重新思考孕前福利原则的作用

子宫移植 (UTx) 是一项治疗计划，旨在为绝对子宫因素不孕症提供独特的解决方案，使患者能够因自己的怀孕而生育孩子。作为为生育目的而进行的移植手术，显然应该在提供治疗之前评估所创建的任何儿童的福利。然而，人们对此类要求的广度和范围以及它们对患者的生殖自主权构成的潜在威胁提出了主要担忧。在本文中，我分析了关于孕前福利原则在 UTx 中的作用的新问题。在概述了对该原理的传统批评之后，我将重点关注其在 UTx 占据的两个医学领域的应用所引发的独特问题。作为一种特定形式的不孕症的治疗，我探讨了规范传统辅助生殖技术的法律和政策是否同样适用于 UTx 的案例，以及涉及配子和胚胎的生育治疗之间是否存在并且应该存在区别（在福利方面）和用于生育目的的妇科手术。作为提高生活质量的移植手术，我考虑并拒绝支持使用孕前福利考虑来告知患者名单和已故供体子宫分配的建议，理由是此类评估可能会损害患者的自主权并导致对特定患者或患者群体的不公正歧视。以及涉及配子和胚胎的生育治疗与用于生育目的的妇科手术之间是否存在并且应该存在区别（在福利方面）。作为提高生活质量的移植手术，我考虑并拒绝支持使用孕前福利考虑来告知患者名单和已故供体子宫分配的建议，理由是此类评估可能会损害患者的自主权并导致对特定患者或患者群体的不公正歧视。以及涉及配子和胚胎的生育治疗与用于生育目的的妇科手术之间是否存在并且应该存在区别（在福利方面）。作为提高生活质量的移植手术，我考虑并拒绝支持使用孕前福利考虑来告知患者名单和已故供体子宫分配的建议，理由是此类评估可能会损害患者的自主权并导致对特定患者或患者群体的不公正歧视。