Posthumous retrieval and use of gametes or embryos: an Ethics Committee opinion
Ethics Committee of the American Society for Reproductive Medicine
Committee members:Judith Daar, Jean Benward, Lee Collins, Joseph Davis, Owen Davis, Leslie Francis, Elena Gates, Elizabeth Ginsburg, Sigal Klipstein, Barbara Koenig, Andrew La Barbera, Laurence McCullough, Richard Paulson, Richard Reindollar, Ginny Ryan, Mark Sauer, Rebecca Sokol, Sean Tipton, Lynn Westphal, …
Ethics Committee of the American Society for Reproductive Medicine (2018). Posthumous retrieval and use of gametes or embryos: an Ethics Committee opinion. Fertility and sterility. https://doi.org/10.1016/j.fertnstert.2018.04.002
Ethics Committee of the American Society for Reproductive Medicine. Posthumous retrieval and use of gametes or embryos: an Ethics Committee opinion. Fertility and sterility. 2018. doi:10.1016/j.fertnstert.2018.04.002
Ethics Committee of the American Society for Reproductive Medicine. "Posthumous retrieval and use of gametes or embryos: an Ethics Committee opinion." Fertility and sterility, 2018.
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RRM Academy Synopsis
ASRM holds posthumous use ethical with or without written consent
The ASRM Ethics Committee says using a dead person's sperm, eggs or embryos can be ethical with written authorization, or sometimes without it if a surviving spouse or partner asks. Its 2018 opinion reports no patient data.
Key Findings
The committee holds that retrieving or using sperm or eggs after death is "ethically justifiable" when the dead person left written authorization. Embryo use is also justifiable given such documentation.
If no written directive prohibits it, the committee finds it reasonable for a surviving partner to use embryos the couple made together, unless other evidence suggests the deceased would object.
For gamete retrieval requests from a surviving spouse or partner without written documentation, the committee concludes physicians are not ethically obligated to comply, yet programs "could ethically act on these requests."
On the child, the committee says objections need "clear evidence" of psychological damage significantly worse than in other cases. It finds "no current evidence" of that.
The committee says explicit instructions forbidding use should be honored. Without written instructions, it says programs should decline requests from others, such as the deceased's parents.
The ASRM Ethics Committee's Position
“In the absence of written documentation from the decedent, programs open to considering requests for posthumous use of embryos or gametes should only do so when such requests are initiated by the surviving spouse or partner.”
Quoted verbatim from this paper.
Interpretation
This is the ASRM Ethics Committee's reasoned position. The committee notes that its opinion is not the only accepted standard of practice. State laws vary on whether retrieval and use are permitted and whether a resulting child is legally recognized. The document replaces the committee's 2012 report of the same name.
RRM Context
This opinion addresses stored gametes and frozen embryos after a death. Restorative reproductive medicine instead works to find and treat the cause of infertility in living couples. The committee values documented consent, counseling and time to grieve. Restorative clinicians value informed consent the same way.
Our editorial summary of this paper, not the article's abstract.
Abstract
Posthumous gamete (sperm or oocyte) retrieval or use for reproductive purposes is ethically justifiable if written documentation from the deceased authorizing the procedure is available. Retrieval of sperm or eggs does not commit a center to their later use for reproduction, but may be permissible under the circumstances outlined in this opinion. Embryo use is also justifiable with such documentation. In the absence of written documentation from the decedent, programs open to considering requests for posthumous use of embryos or gametes should only do so when such requests are initiated by the surviving spouse or partner. This document replaces the report of the same name, last published in 2012.
Ethics Committee of the American Society for Reproductive Medicine, 2016
Ethics and Policy › Reproductive Ethics › Posthumous Reproduction · Clinical Guidelines and Standards › Guidelines by Issuing Body › United States Professional Societies
Judith Daar, Jean Benward, Lee Collins, Joseph Davis, Owen Davis, Leslie Francis, Elena Gates, Elizabeth Ginsburg, Sigal Klipstein, Barbara Koenig, Andrew La Barbera, Laurence McCullough, Richard Paulson, Richard Reindollar, Ginny Ryan, Mark Sauer, Rebecca Sokol, Sean Tipton, Lynn Westphal, 0000-0003-0284-2845
J Daar, J Benward, L Collins, Joe Davis, Joey Davis, J Davis, O Davis, L Francis, E Gates, Liz Ginsburg, Beth Ginsburg, Betsy Ginsburg, E Ginsburg, S Klipstein, Barb Koenig, B Koenig, Andy Barbera, Drew Barbera, A Barbera, Larry McCullough, L McCullough, Rick Paulson, Dick Paulson, Rich Paulson, R Paulson, Rick Reindollar, Dick Reindollar, Rich Reindollar, R Reindollar, G Ryan, M Sauer, Becky Sokol, R Sokol, S Tipton, L Westphal
PMID 29908779 29908779 DOI 10.1016/j.fertnstert.2018.04.002 10.1016/j.fertnstert.2018.04.002 Ethics Committee of the American Society for Reproductive Medicine et al. 2018, Ethics Committee of the American Society for Reproductive Medicine 2018
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