Good Research Paper On Posthumous Semen Retrieval – Ethical Dilemmas
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Posthumous semen retrieval refers to collecting sperm from the donor’s body after he passed away, as a means of utilizing it in reproduction processes (Williams, 2012; Young, 2013; Hans & Yelland, 2013). Also called postmortem sperm retrieval, the process of retracting sperm from a deceased body, without prior written consent of the deceased implies ethical considerations, because it generates dilemmas on whether the death person would have approved to reproduction, the birth and development of a child without his presence. Other ethical aspects of similar significance are involved in the posthumous semen retrieval, such as the respect for the dead body, the welfare of the child brought to world with the deceased’ sperm or the entire reproduction system in the absence of a physical partner (Hans & Yelland, 2013). Moreover, scholars indicate that even if the deceased donor previously agreed with postmortem sperm retrieval, health practitioners should not consent to this practice unless the future mother can demonstrate that she can assure the welfare of the child (Kroon, Kroon, Holt, Wong & Yazdani, 2012).
In terms of purely medical consideration, the cryopreserved reproductive material is a bodily integrated component of the deceased’s body, which is the sole person who can dispose of its body, otherwise the wishes of the deceased face the moral risk of not being respected (Young, 2013). Nursing profession is primarily responsible for the welfare of the patients. Considering that the patients’ integrity and personal wishes might be violated in the post-mortem phase, the nursing profession is seriously affected by this ethical dilemma.
The postmortem sperm retrieval is a challenging situation for nursing profession, escalated by the recently increased solicitations for such processes, mostly from widows of their recently dead partners in accidents or sudden deaths (Hans & Yelland, 2013). Considering the gravity of sperm retrieval after the recent death of the partner and the coercion exercised by the surviving partners and relatives in one direction or another, the nursing activity is becoming a battleground for various forces: the desire of procreation, legal aspects and ethical considerations. Scholars consider that in such cases, the nurses’ activity should be clearly regulated and procedures should be instituted based on common efforts of health practitioners and regulating bodies (Ahluwalia & Arora, 2011).
However, there is no general law regarding the posthumous extraction at an international level, different practices and regulations applying in various regions of the world. While in Great Britain and Czech Republic posthumous extraction is only allowed if prior consent exists, in Israel, Italy or Japan the prior consent is not necessary and no legislation or guidelines are defined for healthcare practitioners (Epker, Groot & Kompanje, 2012). In Canada, Sweden, Germany, France or Hungary the posthumous extraction is not allowed, while in United States there is no law for postmortem sperm extraction (Epker, Groot & Kompanje, 2012).
In this context, nursing professionals are confronted with high pressures from the deceased partners’ side and pressured by the moral and ethical responsibilities towards the death patient. Because there is no law regulating the postmortem sperm extraction and no consistent medical guidelines, the requests for this type of reproduction process are treated individually, with professionals from various disciplines, involving physicians, attorneys and sociologists among others (Ahluwalia & Arora, 2011). Later studies indicate that U.S. hospitals were required to develop their own, internal procedures regarding postmortem semen retraction, yet, because there is no unity among the practices applied in various hospitals, health practitioners still require the stipulation of the legislation on this subject (Williams, 2012).
When discussing about the legal, financial, moral or familial aspect of having and raising a child without the father of child, where the full financial responsibility and the welfare of the child will fall in the mother’s hands, some solicitants of the posthumous semen retrieval renounced their requests (Ahluwalia & Arora, 2011).
When dealing with the posthumous semen retrieval process from the perspective of the nursing practice, the ethical dilemmas are primarily related to the welfare and integrity of the deceased, a former patient with rights and liberties. The ethical responsibilities of nurses towards their patients refer primarily to assuring qualitative care services, not to harm the patient and to respect the patients’ decisions, and to make sure that his or her decisions are respected by other medical bodies (Browne, “Ethical Responsibilities of Nurses”). Nurses’ ethical responsibility towards patients also includes the commitment and loyalty for patients (Fowler, 2010). In the context of the postmortem sperm retraction, nurses involvement in the patients’ wellbeing and their responsibility towards the deceased patients could be considered as atypical, because the posthumous requests are regularly made when the donors suffer accidents or sudden death (Ahluwalia & Arora, 2011). Nevertheless, the nurses’ profession should be consistent with the ethical responsibility towards the patient, regardless of the time spent carrying for the patient, even if the nurses’ ethical practice guidelines differs depending on the specialization (Fowler, 2010; Browne, “Ethical Responsibilities of Nurses”).
Morality is the field of human perceived right and wrong actions, outside the professional field (Fowler, 2010). In terms of morality, when confronted with posthumous semen retraction requests, nurses might face situations wherein grieving widows argue the retraction of the semen as the desire of the deceased to have a child together. Morality is not guided by professional standards, and each nurse might perceive such a situation from different perspectives, depending on each professional’s set of moral values. Hence, one moral dilemma in this case with which nurses might face is whether the reproduction of the dead patient is moral or not. The morality might be approached from the widow’s perspective. Nurses might consider whether it is morally right or wrong to neglect the widow’s request of retrieving his death husband’s sperm for giving birth to his child, considering the affection and the love that connected the two while the patient was alive. Another moral dilemma that the post-mortem semen retrieval request might generate is towards the un-born child. Nurses might ask whether it is morally right for the child to live without his natural father, to be raised by another man or solely by the mother, without the affection of his father.
As some healthcare practitioners sustain, the posthumous semen retraction should not be approved even if the deceased previously consented with this act, if the welfare of the child cannot be guaranteed (Ahluwalia & Arora, 2011; Kron et al., 2012). But a both ethical and moral dilemma imposes at this stage. Firstly, if the patient’s desire was to preserve his semen after his dying, than it is the nurses’ ethical responsibility to assure that the patient’s post-mortem wishes are respected and followed. Secondly, if the during the lifetime the patient agreed with the process of posthumous semen retraction, than it would be morally wrong not to comply with his wish, declared in the full command of his abilities. However, the physicians’ concern for being against the postmortem semen retraction is related with the outcomes of the offspring, and not of the death patient.
The sperm collection from a recently deceased donor implies bioethical principles that reflect healthcare professionals’ responsibility towards the patient and the offspring of the patient. Both issues represent ethical responsibilities for healthcare practitioners, answering two different bioethical principles that they need to be aware of when dealing with the postmortem semen collection. Regarding the responsibility towards the patient, earlier discussed as a moral issue as well, medical professionals need to respect the ethical principle of autonomy (Kroon et al., 2012; Young, 2013). Ahluwalia and Arora, (2011) indicate that although there should be respected the patients’ wishes, his or her wishes should be adjusted to specific situations, which may contradict the patient’s wishes. The autonomy has two limitations in this case: (1) autonomy should be applied when the person’s critical reasoning reflects well-considered and sustained decisions; (2) the parents should take into consideration the future child’s wellbeing if their decision will be implemented (Williams, 2012). Just as the patient has his autonomy to request for postmortem semen collection, the physician also has his own autonomy as a qualified moral agent, to decline it, if he considers the patient’s decision unsupportive.
The other bioethical principle related with the postmortem sperm retraction refers to the beneficence theory, which refers at the welfare of the child, considering that such situations are perceived as highly risky for the future child and his or her development (Fowler, 2010; Knapp, Quinn, Bower & Zoloth, 2011). As Ahluwalia and Arora (2011), children might suffer traumatic experiences when understanding that they are raised as orphans and for this reason, among others concerning the child’s welfare, the doctors have the right to decline this procedure, even if the patient gave his consent before dying. In addition, the beneficence ethical principle can be argued also through the claim that the child might be stigmatized as growing up raised only by his mother, having a dead father, or a new father, who might not grow much attached of another man’s child (Williams, 2012). These are potential situations, which can occur if the doctors agree with the semen collection after the donor passed away. However, the situations can be less negative and the child can grow happy, in good financial and social circumstances, raised solely by his or her mother, or together with a new partner. Nevertheless, the issue remains controversial, as the healthcare practitioners face challenging and opposing ethical principles.
My personal morality regarding the posthumous semen retrieval is primarily influenced by the moral values instilled by my parents, educators and the community in which I was raised, but also by personal beliefs, shaped during my individual development as an adult, while interacting with various situations. Although traditionally I was taught that a child needs both his or her mother and father, I have met cases wherein single – parents children were educated and well socialized, having a normal development. If written consent from the deceased partner exists, which certifies the wife’s right to request his semen retraction for further reproductive purposes, I would be willing to proceed with the semen collection process. This action would nevertheless be decided after a detailed discussion with the widow, for understanding the foundations of the request as well as the maturity and responsibility level that the person demonstrates. Giving birth to a child is a beautiful experience, but it involves high responsibility in the same time. Agreeing with this process would also be the responsibility of the hospital, of the physician who agreed with the process. The desire to have a child with a deceased person involves a moral discussion about what is the greatest good for the greatest amount of people. The mother and the dead father would receive what they would desire, and in addition a new life will be brought to life. At this point, the major good for the greatest amount of people involved in the postmortem reproduction is to agree with the semen retrieval.
I am currently living in a community of independent, open - minded individuals. While they respect the social values generally accepted, agreeing with what is morally right and wrong, they have broader visions regarding life, favoring individual happiness over obsolete traditions. From my personal moral perspective, living in a family is the most suited condition for the child’s development, but cases are, wherein the child grew up harmoniously in a single – parent family. The community amongst which I currently live influenced my moral values, making me more open-minded. But my inclination towards allowing the sperm collection from the deceased donor, if he previously agreed to such act, is more determined by my own perception that everybody has the right to live and giving birth to a child is a decision made out of love, which should be respected.
Ahluwalia, U. & Arora, M. (2011) “Posthumous reproductive and its legal perspective” International Journal of Infertility and Fetal medicine. Vol. 2, no. 1, pp. 9 – 14.
Browne, C. (n.d.) Ethical responsibilities of nurses. Available at http://work.chron.com/ethical-responsibilities-nurses-10778.html.
Epker, J.L, Groot, Y.J. & Kompanje, E.J.O. (2012) “Ethical and practical considerations concering perimortem sperm procurement in a severe neurologically damaged patient and the apparent discrepancy I validation of proxy consent in various postmortem procedures” Legal and Ethical Issues.
Fowler, M. (2010) Code of ethics for nurses. Maryland: American Nurses Association.
Hans, J.D. & Yelland, E.L. (2013) “American attitudes in context: Posthumous sperm retrieval and reproduction” Clinical Research & Bioethics. Vol. 1, no. 8, pp. 1 – 9.
Knapp, C., Quinn G., Bower, B. & Zoloth, L. (2011) “Posthumous reproduction and palliative care” Journal of Palliative Medicine. Vol. 14, no. 8, pp. 895 – 898.
Kroon, B., Kroon, F., Holt, S., Wong, B. & Yazdani, A. (2012) “Post-mortem sperm retrieval in Australia” Australian and New Zeeland Journal of Obstetrics and Gynecology. Vol. 52, pp. 487 – 490.
Young, H. (2013) “The right to posthumous bodily integrity and implications of whose right it is” Market Elder’s Advisor. Vol. 14, no. 2, pp. 197 – 267.
Williams (2012) “Over my dead body: The legal nightmare and medical phenomenon of posthumous conception through postmortem sperm retrieval” Campbell Law Review. Vol. 34, no. 181, pp. 181 – 204.
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