Is postmortem sperm retrieval ethical if the deceased did not leave explicit instructions?(Pro & Con)

YES

Requests for postmortem sperm retrieval are becoming more common, and often they are quite compelling. The typical request comes from the wife of a recently deceased man who, before her husband's death, would have welcomed pregnancy.

Performing this procedure is very gratifying because as a physician, you have a natural instinct to help people. You can give the wife something to look forward to, at a time when she may have lost hope.

But an incredible number of considerations must be taken into account before a sperm retrieval procedure is performed. As soon as we had our first request at New York-Presbyterian Hospital, we began putting together a set of guidelines, with input from legal experts, psychologists, institutional representatives, medical ethicists, and medical experts.

In our experience, relying on these criteria will lead you to turn down most requests. (The guidelines are available at www.cornellurology.com/uro/cornell/guidelines.shtml.) Four main considerations must be addressed:

* Determine who has the right to decide. Most localities have no laws about who can take and use sperm. Among localities that do, there is little consistency. Sperm are variously considered a body part for which a family member can provide retrieval consent, personal property, or something else altogether. In any case, the next of kin--the wife--must be the one requesting retrieval for us to consider the procedure.

* Determine that the man probably would have approved. We need convincing evidence that the man would have wanted to have children with this woman in this way. Obviously, the best evidence is written consent, such as a will, but this is relatively rare. In the absence of a will, we consider evidence from family members--usually the wife--that the man had such a wish. But if there's a discrepancy between the wife and other family members, we will not proceed.