Techniques have been available to retrieve viable sperm from men after their death for over a decade. However, the relatively uncommon requests for the procedure were performed mostly for men who gave consent prior to their death. Since 1994, the postmortem procurement of sperm without consent is being requested and performed throughout the United States in increasing numbers, according to a study conducted by the Center for Bioethics at the University of Pennsylvania Medical Center. The prevalence of requests and procedures, as well as the circumstances and moral and legal issues surrounding them, are described in the June issue of The Journal of Urology.
Senior author Arthur L. Caplan, PhD, director of the Center for Bioethics, explains, "We've found that requests and procedures for postmortem sperm procurement are occurring in greater numbers than we had anticipated and we can expect a continued increase in the future."
By conducting structured telephone surveys with personnel at 273 assisted reproductive facilities in the United States, researchers reported a total of 82 requests for postmortem sperm procurement between 1980 and 1995 at 40 facilities in 22 states. Notably, between 1994 and 1995, more than half of the total requests (43) were made and 25 of these requests were honored at 15 facilities, mostly in California. Moreover, all requests from facilities in Arizona, Illinois, Indiana, Louisiana, New York, and North Carolina were made in the same year -- no requests were reported before 1994.
In addition, information was gathered regarding the deceased, the individual who made the request, intended use of the sperm, and who made the decision whether to honor the request. Of the causes of death reported, 86.4% resulted from sudden trauma such as an automobile or motorcycle accident. Many of the requests were made by the wife of the deceased, with intended use of the sperm primarily for the widow, fiancee, or girlfriend. However, social workers, friends of the wife, parents of the deceased, and an intensive care unit nurse were reported to have made requests as well.
"The magnitude of the requested procedure and the potential to create children of men who have died, without their consent, demand debate and resolution to establish medical, ethical, and legal guidelines that may be used in the future," Dr. Caplan states. "While many questions remain unanswered, we know that postmortem sperm procurement is being requested and performed at an increasing rate."
The Center for Bioethics is an interdisciplinary, interprofessional unit of the University of Pennsylvania. Faculty are drawn from many fields and disciplines including medicine, philosophy, nursing, law, public policy, communications, and the allied health professions. The Center is especially concerned with addressing ethical issues arising in the fields of genetics, pediatrics, critical care, health policy, human experimentation, and long-term care. Its mission is to advance scholarly and public understanding of ethical, legal, social, and public policy issues in health care.
The University of Pennsylvania Medical Center's sponsored research ranks fifth in the United States, based on grant support from the National Institutes of Health, the primary funder of biomedical research in the nation -- $149 million in federal fiscal year 1996. In addition, for the second consecutive year, the institution posted the highest growth rate in its research activity -- 9.1 percent -- of the top ten U.S. academic medical centers during the same period.
Editor's Note: Dr. Arthur Caplan can be reached directly by calling (215) 898-7136.
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