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At least 19 recordsLinked to original sources
PubMed2004

Where does a man stand on issues of assisted reproduction, surrogacy, artificial insemination within lesbian relationships and posthumous conception?

This article takes issues more commonly associated with women: assisted reproduction, surrogacy, artificial insemination within lesbian relationships and posthumous conception and considers what role a man may play in this domain. To this end the article commences with a short scenario of possible life events then traverses the current legal position to examine the extent that the law either facilitates or frustrates a man's desire and ability to fulfill the role of either father or parent in the above situations. The article considers the issues of assisted reproduction technology in both a regulated and an unregulated environment.

Australia↗
PubMed2004

Response to Orr and Siegler--collective intentionality and procreative desires: the permissible view on consent to posthumous conception.

Orr and Siegler have recently defended a restrictive view concerning posthumous sperm retrieval and conception, which would limit insemination to those cases where the deceased man has provided explicit consent for such a procedure. The restrictive view dominates current law and practice. A permissible view, in contrast, would allow insemination and conception in all but those cases where the posthumous procedure has been explicitly refused, or where there is no reasonable evidence that the deceased person desired children. I describe a phenomenology of procreative desires which supports the permissible view, and which is compatible with requirements concerning the interests of the decedent, concepts of medical infertility, and the welfare of the future child. The account illustrates how our current obsession with individual rights and autonomy can be self-defeating and repressive.

Attitude to Death↗
PubMed1998

Infertility in Jewish couples, biblical and rabbinic law.

The Jewish religion is family orientated, and life is guided by 'Halacha', a code of conduct based on biblical and rabbinic law. There is a duty to have children, in view of the first biblical commandment 'be fruitful and multiply', which sanctions most treatments for infertility. Interpretations vary among Orthodox, Conservative and Progressive rabbis, but it is only rabbis who have authority to advise infertile couples on which procedures concur with Jewish law, and their appraisals tend towards leniency in the interests of domestic happiness. Prohibitions against 'wasting seed', and against marriage to a man with 'wounded testes or severed membrum', may be waived to allow semen collection for analysis and treatment for male infertility. All types of assisted conception are approved, including in vitro and micro-assisted fertilization, provided the gametes are from married couples. In short cycles, artificial insemination can be permitted in the post-menstrual week of 'niddah' when coitus is forbidden. Jewish descent from the mother is automatic but, for Orthodox couples, a technical violation of the law against adultery or incest can spoil the marriage prospects of a child or interrupt the paternal priestly line of Cohen or Levi. Donor gametes are largely unacceptable to Orthodox rabbis, since egg donation confuses the definition of the mother, and because sperm donation creates subterfuge in a child's genealogy and a risk of consanguinity. However, Progressive and Conservative rabbis place more emphasis on the social attributes of parents and frequently approve of gamete donation. The Jewish status of children resulting from surrogacy or adoption can be settled by religious conversion. Objections to treating unmarried couples, single or lesbian women, and to posthumous conception, arise because such households are not traditional families.

Journal Article↗
PubMed1999

Postmortem sperm procurement: a legal perspective.

PURPOSE: Postmortem sperm procurement with subsequent artificial insemination has become a technically feasible method for posthumous conception. A variety of legal questions exist involving the rights and relationships of the deceased, his family and his issue. We addressed these questions and designed a workable protocol for postmortem sperm procurement. MATERIALS AND METHODS: MEDLINE, WESTLAW and LEXIS medical literature, and case law searches were conducted. United States and international case law, United States (federal and state) statutes, Uniform Law Commissions Acts, and law review commentaries and articles were reviewed. RESULTS: While postmortem sperm procurement is being requested throughout the United States, no standard protocol or procedural guidelines have been established by federal or state statute. Furthermore, the courts have not yet addressed this specific scenario in reported case law. Statutes and case law do address related factual scenarios and issues, including property rights in human bodies, rules governing transplantation of human organs/body parts, rights of parties in in vivo sperm bank donations and responsibilities of parents to the conceptus of artificial insemination. CONCLUSIONS: A workable protocol can be established by analyzing case law and statutes addressing factually similar scenarios. Urologists must focus on the express intent of the decedent and limit any postmortem sperm retrieval to the specific requests made by the decedent. Decedent requests should be documented in writing. The decedent must be competent and of majority age. In the absence of decedent expressed affirmative directive calling for sperm retrieval, no other relative or guardian may authorize this retrieval. Issues regarding the legitimacy and inheritance rights of the conceptus will most consistently be addressed when explicitly provided for in the will of the decedent.

Cadaver↗
PubMed2003

Understanding the motivations, concerns, and desires of human immunodeficiency virus 1-serodiscordant couples wishing to have children through assisted reproduction.

OBJECTIVE: To survey the attitudes of human immunodeficiency virus (HIV)-serodiscordant couples interested in assisted reproduction and better characterize their motivations for reproducing. METHODS: A prospectively designed questionnaire and open-ended interview of 50 consecutive HIV-serodiscordant couples interested in undergoing assisted reproduction to avoid transmission of virus were studied. Demographic characteristics and attitudes regarding beginning a family were obtained. By design, males were HIV seropositive (age, 38.0 +/- 5.4 years, range 26-51 years) and healthy. Women were HIV seronegative (age, 34.5 +/- 5.1 years, range 24-45 years). Most couples were married (44 of 50) and in long-term relationships (duration of relationship, 8.9 +/- 4.9 years, range 1-20 years). RESULTS: Before presentation, nine of 50 couples had conceived and delivered a child (three of nine instances with knowledge of paternal HIV status). Previous timed intercourse occurred in 8% of couples (four of 50). Six individuals stated they would proceed with timed intercourse if no other alternatives existed. Forty-eight percent said they would prefer artificial insemination with donor sperm in lieu, if assisted reproduction failed or were unavailable. Forty-three percent of respondents would pursue "posthumous conception" if cryopreserved sperm or embryos were available in the event of the partner's death. Most couples discussed the possibility of single parenting (45 of 50; 90%) or the possibility for adoptive parenting (29 of 50; 58%). Couples were aware of risk, and 92% (46 of 50) understood that their child might contract HIV. CONCLUSION: Human immunodeficiency virus-serodiscordant couples are actively seeking reproductive assistance and often consider or practice unsafe measures to achieve pregnancy. Reproductive issues and concerns unique to these couples need to be addressed before treatment.

Adult↗
PubMed2005

Deaths of HIV-positive men in the context of assisted reproduction: five case studies from a single center.

Provision of reproductive services to individuals infected with HIV-1 is gaining popular acceptance and is generally endorsed by specialists in reproductive medicine. In the situation in which the male is HIV positive and the female partner is not infected, a large body of evidence has demonstrated that the use of assisted reproductive technology is effective for achieving pregnancy, while eliminating the risk of viral transmission to the mother and fetus. No reports have documented the well-being of the HIV-infected partners subsequent to seeking fertility services. In the current report, we document the cases of five HIV-positive men who died secondary to complications of HIV infection shortly after participating in the assisted reproduction program for HIV-1-serodiscordant couples at Columbia University. Three of these couples successfully achieved pregnancy and live birth, including one set of triplets, and one case of posthumous conception; the fourth case resulted in the cryopreservation of all embryos after the sudden death of the male before the time of embryo transfer; the fifth couple failed to conceive. None of the deaths, which occurred within a few months to 2 years from initial consultation, were related to infertility treatment. The demographic and social statuses of these patients were not different from the general population of men seeking assisted reproduction in our clinic. Regarding the HIV infection status of these cases, three patients had a longer duration of infection compared to the general population of men in our cohort, and one had a significantly lower CD4 cell count. All five men had stable HIV viral loads, and were determined by their primary care providers to be clinically healthy at the time of entry into the program for assisted reproduction. The untimely deaths of these patients underscores the importance of the thoughtful consideration of the complex issues involved in family planning for these individuals, including advanced directives for the use of cryopreserved gametes and embryos, and the social, emotional, and practical issues for the children and surviving partners subsequent to the death of the HIV-positive parent.

Adult↗
PubMed2002

Death and conception.

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.

Child↗
PubMed2005

Assisted reproductive practice: religious perspectives.

It is important to those who practise reproductive techniques to learn about different religious perspectives related to reproductive health problems. Religious groups are active in influencing the public regarding bioethical positions, and this is particularly evident with issues concerning procreation, abortion and infertility therapy. The Jewish attitude towards procreation is derived from the first commandment of God to Adam to 'Be fruitful and multiply'. Judaism allows the practice of all techniques of assisted reproduction when the oocyte and spermatozoon originate from the wife and husband respectively. The attitude toward reproductive practice varies among Christian groups. While assisted reproduction is not accepted by the Vatican, it may be practised by Protestant, Anglican and other denominations. According to traditional Christian views, beginning at conception, the embryo has moral status as a human being, and thus most assisted reproductive technologies are forbidden. According to Islam, the procedures of IVF and embryo transfer are acceptable, although they can be performed only for husband and wife. Developments in science and technology and corresponding clinical applications raise new religious questions, often without clear answers. The role of theology in bioethics is integral to clarify perceived attitudes toward these developments for different religious communities. This paper presents the attitude of monotheistic religions to therapeutic procedures, such as IVF-embryo transfer, spermatozoa, oocytes, embryo donation, cryopreservation of genetic material, surrogacy, posthumous reproduction, gender preselection, reproductive and therapeutic cloning.

Attitude↗