Welcome to the fertility clinic of the future! Using speculative design to explore the moral landscape of reproductive technologies

The paper examines how the public perceives emerging reproductive technologies and their social and moral implications. It situates the inquiry within a rapidly evolving technological context (e.g., in vitro gametogenesis, genome engineering, mitochondrial donation, human germline editing, extra-uterine support systems) that raises sensitive questions about reproductive rights, legal concepts (liability, privacy, bodily integrity), and categorical distinctions (human/machine, alive/dead, male/female, natural/artificial). The authors argue that responsible, democratic development of reproductive technologies requires public participation that goes beyond risk–benefit framings to include broader social values. The study aims to explore: (1) public perceptions and attitudes toward reproductive techniques; (2) how these technologies might impact health, care, and everyday life; and (3) moral phenomena at a societal level related to technological change in reproductive biology. It responds to gaps in prior work that often focuses on specific stakeholder groups, quantitative methods, or predefined problem framings, and rarely treats citizens as citizens to elicit qualitative moral reflections.

Prior research on public perceptions of assisted reproductive technologies predominantly addresses specific procedures (e.g., gamete donation, preimplantation genetic testing, mitochondrial donation) and often targets patients or distinct stakeholder groups, using surveys or risk-focused frames. Qualitative insights have typically come from cultural or policy analysis rather than open citizen deliberation. Few studies explore broader, personal, and societal implications across multiple reproductive technologies or elicit citizens’ views as citizens. Existing participatory studies have addressed themes such as children's rights to information, access and equality (including age and economic access), and regulatory needs, but have largely overlooked ecological considerations and the value of wonder/naturalness as articulated by lay publics. This study positions speculative design to broaden the debate beyond conventional risk–benefit discussions and to surface complex values underlying appeals to naturalness.

Design: A speculative design exhibition, Reproductopia, served as a speculative model inviting visitors to explore futures of reproductive technologies (e.g., artificial wombs, in vitro gametogenesis, gene editing, embryo screening/selection). Exhibits included Artificial Womb, Youterus (wearable womb), Pig Womb, Mono-Parenting Kit, Lab Romanticism, Virgin Parent Ring, Reunion Network, and “I wanna deliver a dolphin,” each designed to prompt reflection on facets of reproduction (kinship, parenthood, bonding, animal–human relations, rituals, intimacy, etc.). Setting and period: Design gallery @Droog, Amsterdam, October–November 2019. The exhibition was developed by the speculative designers’ collective Next Nature Network. Participants and recruitment: Naturalistic, self-selected gallery visitors (diverse nationalities; many tourists, students, foreign residents). Interviewees were generally culturally interested; varied in sex (most female) and were mostly 30–50 years old. Data collection: Semi-scripted, in-situ interviews integrated into the exhibition interaction. Interviewers first role-played as speculative consultants in a fictitious 2050 clinic, then obtained consent as researchers. Prompts included trying prototypes and reflecting on societal effects (e.g., gender implications). Conversations focused on assumptions, emotions, and fantasy-based responses, with interviewers shifting roles (salesperson/consultant, philosophical inquirer/ethicist, peer/devil’s advocate). A total of 67 conversations with 142 visitors were recorded (average ~30 minutes; range 10–77). Interviews involved individuals, pairs, or small groups (up to 8). Participation was voluntary; two withdrawals occurred. Input from children (if present) was excluded from analysis. Ethics and consent: Verbal consent to record and use anonymized data was obtained; parents consented for children’s presence in recorded interactions, though children’s input was excluded. Data analysis: Transcripts were coded in MAXQDA18. Analysis proceeded in two stages: (1) thematic analysis guided by techno-moral patterns/tropes (after Swierstra & Rupp; Boenink), considering how emerging technologies can enable new uses/users, shift roles/responsibilities, reshape normalcy, mediate choices, create rights/obligations, exacerbate inequality, introduce dependencies, and render routines superfluous; (2) analysis of contextual framings (cultural, personal, imaginative associations) to surface worldviews and underlying values. A final open-coding round identified main lines of reasoning and questions for responsible technological development, leading to six overarching themes. Coding outcomes were discussed among the first four authors; disagreements were resolved by negotiation.

- Six recurrent moral themes emerged in public reflections on reproductive technologies: 1) Rights of the unborn: Emphasis on the child’s need for a unique identity and a sense of belonging (knowledge of lineage, loving care). Concerns about cloning/mono-parenting and genetic copying affecting individuality; debates on ensuring knowledge of genetic history versus risks of over-transparency and carelessness. 2) Access and equality: Calls to ensure equitable access and avoid high costs; deliberation on who should have access (e.g., gay couples, single women, transgender people, those physically unable to conceive/carry, older individuals, people in low-infrastructure settings, poly-amorous groups). Re-examination of age criteria and the idea that biology should not justify discrimination, alongside views that heterosexual couples may offer stability. 3) Social implications of individual choices: Tension between autonomy/private choices and societal consequences. Many endorse natural reproduction as default while supporting technology for those who need it. Concerns about normalization, shifting norms, and potential pressures; proposals such as a ‘parenthood test’ to encourage conscientious decision-making. 4) Society as community: Desire for a less individualized, more caring society; shared responsibility for pregnancy and childrearing; safety through communal support; exploration of new family forms (e.g., with friends) and mechanisms for joint responsibility. 5) Ecology: Ethical consideration of animals and the planet; divergent views on non-human reproduction (e.g., birthing endangered species) versus non-interference; responsibilities toward animal welfare and overpopulation concerns. 6) Value of wonder: Protecting unpredictability, spontaneity, and the experiential ‘magic’ of pregnancy/parenthood; ambivalence between curiosity about technological potential and fear of uniformity and loss of diversity through control and optimization. - Speculative design broadened the debate to include ecology and wonder—issues rarely seen in participatory reproductive technology literature. - The study illuminates complex motivations behind ‘naturalness’ arguments, showing that appeals often relate to well-being, uncertainty, and valuing autonomous change, not a fixed notion of nature. - Descriptive context: 67 interviews with 142 visitors, average 30 minutes, conducted within an immersive speculative clinic setting.

Findings align with prior participatory studies on themes such as children’s rights, access/equality, regulatory needs, and societal values, but extend the discourse by surfacing ecological concerns and the value of wonder—largely absent from earlier public engagement on reproductive technologies. The imaginative, affective engagement enabled by speculative exhibits facilitated participants’ articulation of layered identities and values, moving beyond risk–benefit frames to questions of sociality, trust, governance, and desired futures. The analysis nuances the ‘naturalness’ argument: participants’ reservations about technological control reflect commitments to well-being, unpredictability, and diversity rather than simple adherence to ‘nature.’ The designed artifacts and framings (e.g., animal-focused exhibits) helped reveal these values, while also shaping the moral terrain under discussion. Speculative design appears effective at provoking constructive ambiguity and value conflict, which can be productively negotiated in group deliberation. However, broadening the range of reflections requires diversifying both designers and publics and situating speculative design within more inclusive, policy-relevant deliberative contexts.

The study demonstrates that speculative design can effectively open public deliberation on the social and ethical dimensions of reproductive technologies, yielding six key thematic concerns: rights of the unborn, access and equality, social implications of individual choices, society as community, ecology, and the value of wonder. By eliciting imaginative and emotional engagement, speculative exhibits surfaced issues (notably ecology and wonder) that are underrepresented in prior participatory literature and clarified the complex values underpinning appeals to naturalness. To enhance impact, future work should diversify designers and audiences, integrate speculative design into inclusive public deliberations with clearer links to innovation trajectories and policy, and develop public capabilities for critically engaging with imagined futures.

- Sampling and reach: The exhibition attracted a self-selective, culturally interested public (many tourists/students), limiting demographic diversity and potentially the range of moral viewpoints. - Framing effects: The material design and exhibit framings (e.g., animal-oriented scenarios) likely shaped the issues participants addressed, potentially emphasizing certain concerns (ecology, natural/artificial dichotomies). - Context specificity: Insights derive from an art/design gallery in Amsterdam; generalizability to other cultural contexts or populations is limited. - Method constraints: Semi-scripted, in-situ interviews in a performative setting may elicit imaginative responses that differ from deliberations in policy or clinical contexts; group dynamics (pairs/groups) may influence expressed views. - Data access: Transcripts are confidential and not publicly available, limiting external verification and secondary analysis.