2. Position Paper 2
Sometimes life plans are cut short, and death comes too quickly for the young. Many
male patients give consent for sperm donation or sperm retrieval in reproductive difficulty cases.
What if there was no signed consent? Take for instance this scenario of a recently married couple
of two months with no children. Thirty-one year old husband suffers a cardiac arrest, when it
became apparent that the husband will not survive the wife inquiries about post-mortem sperm
retrieval. In this case the family agreed that the patient intended to have children, but no
indication under what circumstance (Weller, 2013). Reproduction post-mortem sperm retrieval
may be done by insemination, fertilizations or embryo transfer. Post-mortem sperm retrieval was
first reported in 1980, the pregnancy of post-mortem sperm retrieval was reported in 1998, and
the successful birth was reported in March of 1999 (Strong, Gingrich, & Kuttech, 2000). Does
the family have a right to create a child without the permission of the patient? Is post-mortem
sperm retrieval ethical?
Surgical sperm retrieval is the technique where a small number of sperm is obtained
directly from the epididymis or testicles. This procedure is used frequently by couples where the
male partner cannot ejaculate, small amounts of sperm are collected for in vitro fertilization. In
post-mortem sperm retrieval however the sperm is extracted after the male partner has died. Just
because a man can make babies after death, does that entitle his family to create his child without
him? (Weller, 2013). Respect of the deceased needs to be maintained in many cultures handling
of the deceased can be considered disrespectful. It is disrespectful to previously alive person to
use their gametes for reproduction purposes to which they would have objected (Strong, 1999).
Even if there was any question on whether or not the deceased would have wanted the procedure
done. An argument also questions the family’s mental state immediately after the family
members’ death. Researchers say that regardless of the details of any protocol the ultimate goal
3. Position Paper 3
is to establish policies that respect the wishes of the deceased and that are in the best interest of
the family and the future child (Weller, 2013).
Without written consent there is no concrete answer to whether or not the deceased would
have wanted to undergo post-mortem sperm retrieval. Researches in Australasia indicate that,
Given the personal stake that the surviving partner has in the matter, the partner’s strong
conviction that this is what the deceased would have wanted should not be seen as enough
(Kroon, Holt, Wong, & Yazdani, 2012). This ethical debate has also communicated that even
though written consent is desired it is not a guarantee, and only determinate that procedure will
be carried out. Considerations of possible genetic disorders, social outcomes, and counseling that
the live partner would have to participate in also play a role in the process of post-mortem sperm
retrieval approval.
The ethics of post-mortem sperm retrieval is not straightforward even when prior consent
is obtained. The meaning behind why procreation after death plays a significant role especially
since it is in a nontraditional way. Advocates for post mortem sperm retrieval express the
positive attributes within the deceased culture. The importance of carrying on the family name,
and a living legacy behind for the family to enjoy from the deceased. The significant question is
would the child born under these conditions suffer? The procreation of this child under the
assumption that it is reproduced in a desired environment suggests that the child will not suffer,
it will be loved. In majority of cases what impulses these women is the love they had with their
partners, and the need for a child that was desired by both to overcome the loss. It is as if
developing a positive outcome from a negative one. The well-being of the child to be and the
respect for the dead person seem to be the strongest argument against this ethical issue (Eduardo,
& Raposo, 2012).
4. Position Paper 4
The reports of post-mortem sperm retrieval have also been stated in another type of
scenario. A young twenty-one year old college student with, a “good head on his shoulders”
returning from a night of drinking with a friend are attacked (James, 2010). The college student
suffering trauma to the temporal lobe dies ten days later from a subdural hematoma. The mother
investigates the possibility of post-mortem sperm retrieval. There was no consent signed by the
twenty-one year old student to have the sperm retrieved. A twenty-one year old male college
student who thinks to have a long life ahead of him has been cut short. Many young adults do not
think to have a living will set up because of maturity levels. The sperm is surgically removed
from the epididymis or testes. The mother reviews applications for a surrogate, and she is
inseminated conceiving a grandchild for the grieving mother. Does this scenario raise a higher
concern ethically because the child will be raised by the grandmother? Attention to the child’s up
bring needs to be address for the reason that it will be missing not only one parent but both. The
age of the guardian also has a role since the child will have a lot of physical demands. Do
different situations involving post-mortem sperm retrieval matter? Every situation is diverse, and
should be evaluated keeping again what is of best importance to the child. The love for a child in
today’s world is unfortunately not enough.
The involvement emotionally, and finically is a huge commitment. There is not only a
responsibility to a child but there is a major cost associated with post-mortem sperm retrieval.
Finding an egg donor who will undergo injections and tests will cost at least $20,000 (James,
2010). Hiring a surrogate to be inseminated and to carry the child could cost another $50,000
(James, 2010). The Anouna, a company that does five or ten a year stated that sperm retrieval is
about $3,000 alone. Every year the cost of health care in today’s society only increases with the
demand of the local community. Once the ethical approval is achieved, the financial cost are
5. Position Paper 5
paid, and there is legal permission obtained there is no guarantee that the egg, and sperm will
take. In a study of neonatal Intracytoplasmic sperm injection using non-ejaculated sperm
concluded that of 657 pregnancies, 426 were on going after twenty weeks eventually leading to
530 children, twelve were stillborn, and five died during the first seven days. (Belvia, Schrijver,
Tournaye, Liebaers, Haentjens, & Bonduelle, 2011). Potter syndrome was also an awareness in
the study which is a condition where there is a pulmonary hypoplasia resulting from not enough
amniotic fluid. Potter syndrome was the result of three terminated pregnancies in the neonatal
study.
The legal considerations of post-mortem sperm retrieval have also been questioned on
inheritance purposes. Once the posthumous child is born does this child have the same rights as
children born prior to the death of the deceased parent? In 1984, a California judge ruled that a
child born from posthumous parenting could receive an inheritance; and in a 2002 Massachusetts
case the judge ruled that heirs born could not receive Social Security benefits from the deceased
(Knapp, Quinn, Bower, & Zoloth, 2011). Posthumous children will be an ongoing ethical, legal,
and moral debate for many years to come. Despite, the determination to conceive the challenge
once conception is reached will not only be the battle fought for these families, and children.
Special considerations should be taken when post-mortem sperm retrieval becomes a
choice within a family. Respecting the deceased, and following the wishes they would have
wanted is the ethical route to go by. If the deceased did not express interest in post-mortem
sperm retrieval then those wishes should be respected, and carried out. The procreation of a
child using post-mortem sperm retrieval should be thought out on a rational mind set. In the end
of the journey a life will be formed, and the responsibility of a living being should be taken
seriously. Avoiding family conflict by having discussions of post-mortem sperm retrieval prior
6. Position Paper 6
to death can limit confusions on ethical considerations. Every case is different, and each case
should be studied based on the belief, culture, and desire of the deceased. The issues raised by
these types of cases are complex and deserve further debate (Strong, Gingrich, & Kuttech 2000).
7. Position Paper 7
References
Belva, F., Schrijver, D., Tounaye, H., Leibaers, I., Devroey, P., Haentjens, P., Bonduelle, M.
(2011). Neonatal outcome of 724 children born after ICSI using non-ejaculated sperm.
Human Reproduction. 26(7). (1752-1758). DOI 10.1093/humrep/der121.
Eduardo, D., & Raposo, V. (2012). Legal Aspects of Post-Mortem Reproduction:
Comparative Perspective of French, Brazilian and Portuguese legal systems. Medicine
and Law, 31(2), 181-198.
Knapp, C., Quinn, G., Bower, B., & Zoloth, L. (2011). Posthumous Reproduction and Palliative
Care. Journal of Palliative Medicine, 14(8), 895–898.
http://doi.org/10.1089/jpm.2011.0102
Kroon, B., Kroon, F., Holt, S., Wong, B., & Yazdani, A. (2012). Post-Mortem sperm
Retrieval Australasia. Australian and New Zealand Journal of Obstetrics and
Gynecology, 52(2), 487-490. doi:10.1111/j.1479-828X.2012.01469.x
Strong, C. (1999). Ethical and Legal Aspects of Sperm Retrieval After Death or
Persistent Vegetative State. Journal of Law, Medicine & Ethics, 27(4), 347-358.
Strong, C., Gingrich, J., & Kuttech, W. (2000). Ethics of sperm retrieval after death or
persistent vegetative state. Human Reproduction, 15(4). 739-745.
Weller, C. (2013). Sperm Retrieval after Death: What are the Ethical Concern?. Medical
8. Position Paper 8
Daily. http://www.medicaldaily.com/sperm-retrieval-after-death-what-are-ethical-
concerns-246798
James, S. (2010). Sperm retrieval: Mother Creates Life after Death. ABC News.
post-mortem/prhttp://abcnews.go.com/Health/Wellness/mother-murdered-son-hopes-
create-grandchild-int?id=9913939.
