Death and conception: Opinion

Abstract

The complex moral, ethical and legal concerns that have arisen as a result of posthumous assisted reproduction (PAR) are examined in this report. Difficult questions such as what constitutes informed consent, and whether it is ethical to retrieve spermatozoa from patients who are in a coma, are considered. Legal issues, such as whether gametes can be considered as property and the need to clarify the legal definition of paternity in cases of children born in such circumstances, are also discussed, while other points regarding the advisability of PAR, respecting the wishes of the deceased donor and the need to protect the interests of the unborn child, are outlined. The motives of the gestating women, viewing their desire for PAR perhaps as part of the grieving process, and the effects on the children concerned are examined; it is concluded that there appears to be no adverse effect, but this finding might be premature. The report also asserts the need for responsible accounting on the part of fertility clinics, and calls for fairness, transparency and patience to help the bereaved reach an unbiased yet informed decision. This may be achieved by offering ample time for informed and support counselling. Finally, consideration should be expressed for the welfare of unborn child, in a balanced, pragmatic and sensible manner.

Correspondence Between Legislation and Public Opinion in Bulgaria about Accessto Assisted Reproductive Technologies (ART)

“…Approximately 78% of the individuals stated that they approved of PAR (22). Some authors are in favour of PAR when the deceased has left frozen semen (23)(24)(25). According to (23,24), for the realization of posthumous reproduction, the following three conditions are necessary: written consent given by the deceased; counselling of the surviving partner during the decision making period; a minimum waiting period of 1 year after the death should be imposed before the treatment can be started.…”

“…Some authors are in favour of PAR when the deceased has left frozen semen (23)(24)(25). According to (23,24), for the realization of posthumous reproduction, the following three conditions are necessary: written consent given by the deceased; counselling of the surviving partner during the decision making period; a minimum waiting period of 1 year after the death should be imposed before the treatment can be started. Some authors consider that the refusal of a reproductive centre to perform a posthumous insemination if the centre keeps frozen sperm from the deceased is a violation of article 8 of the European Convention on Human Rights (basic right to family) (25).…”

“…The transfer of a frozen embryo is mostly accepted when the surviving spouse is a woman. In the opposite case, the surviving husband must use a surrogate mother, which can create complications (23). ESHRE recommends that no difference should be made, and that the transfer of a frozen embryo be allowed regardless of the sex of the surviving spouse (24).…”

“…The same arguments are used by Landau (28), when she criticizes the guidelines of the Israeli government for posthumous reproduction, referring to Paragraph 3 of the UN Convention on the Rights of the Child (UN General assembly, 1989), which explicitly states that in all issues involving children the rights of the child have priority over other interests. Others consider that children born as a result of posthumous reproduction will not differ from children bred by single women, where it is established that the psychological effect is minimal (23). PAR is forbidden in Bulgaria.…”

Ethics in Uterine Transport: Values and Principles

“…etkilenmiş olabilir. 47 Benzer şekilde, yukarıdaki örnekte bahsettiğimiz hastanın preeklampsi nedeniyle preterm doğum yapmasına rağmen, güven vermeyen fetal kalp hızının, bu ilaçlara mı yoksa altta yatan böbrek hastalığına mı yoksa 61 yaşındaki bir kadının uterusunun kullanılmasına mı bağlı olduğu açık değildir. 34 UN ile birlikte bağışıklık sisteminin baskılan-masının fetus üzerindeki etkisi bilinmemektedir.…”