An ethical case for pediatric posthumous assisted reproduction
Friday, October 13, 2023
3:15 PM – 4:30 PM ET
Location: Atlantic (Third Floor)
Posthumous Assisted Reproduction (PAR) is the process by which stored gametes are used to produce genetic offspring after the death of the parent. The reproductive technologies that enable PAR are well established, but the ethical implications of the practice are often contested, particularly regarding who should be allowed access to PAR and under what circumstances. Objections often focus on concerns for the resulting offspring and violating the autonomy of the deceased. There are, however, a few areas of consensus among professional medical organizations like the American Society for Reproductive Medicine (ASRM) and the European Society for Human Reproduction and Embryology (ESHRE): 1) written consent is preferable to implied consent; 2) parental requests for PAR are less ethically compelling than partner requests; and 3) the reproductive materials of minors should be destroyed if they died before reaching the age of majority. Here, we present two challenges to the second and third claims above. First, in prioritizing reproduction among cisgender, heterosexual couples using their gametes in a “joint reproductive project,” PAR guidelines discount non-heteronormative nuclear family formations, including multi-generational families. Second, by disregarding their views, the ESHRE’s and ASRM’s positions conflict with the practice in reproductive health of allowing minors to make their own decisions regarding contraception, pregnancy, etc. As reproductive freedoms continue to erode in the US, we believe these guidelines should be re-examined to explicitly include non-heteronormative family structures and to uphold the autonomy of minor patients.
Lisa Campo-Engelstein, Professor and Chair – Director, Institute for Bioethics and Health Humanities, UTMB School of Public and Population Health; Arthur Caplan – Professor, Department of Population Health, Division of Medical Ethics, NYU Grossman School of Medicine; Gwendolyn Quinn – Professor, Department of Population Health, Division of Medical Ethics, NYU Grossman School of Medicine