This transcript has been edited for clarity. Hi. I'm Art Caplan, and I'm the director of medical ethics at New York University (NYU) School of Medicine. A tragic event took place recently. A young cadet at the West Point Military Academy was skiing and had a terrible accident, where he broke his back and spinal cord and died. He was taken to a hospital north of New York City, in Westchester County, New York. While he was there, his parents came in and said they would like to procure his sperm because they wanted him to have a child. The reason they gave was that they thought his legacy should live on, that he was a wonderful young man. These were people who had come to the United States from China, and they were concerned about having the lineage of the family continue through a male heir. They wanted the hospital to help them have a grandchild. These requests are not common, but they are increasing around the United States. They raise questions about whose request should be honored and whether we should change public policy in light of increasing requests. Now with the ability to procure and freeze eggs, we're going to get requests from [families of] women who die as well. In this case, the hospital decided to ask a judge to weigh in and give an opinion. The judge said, "After hearing all this, you can take the sperm, but we're going to have a second hearing to decide the issue about using the sperm." The reason it's in two parts is that no one is sure how long the sperm would remain viable. We haven't really done studies on that question. It's certainly more than a few hours, but whether it's days is not clear; it's certainly not weeks. Ethically, I would not let the parents utilize the sperm. I've heard the reasons and am moved by them. Having someone who you love so much die without children is a terrible thing for parents and friends to bear. And I understand the argument that it's important to continue the lineage of the family. But it's not clear who would carry this child; he does not have a wife or a longtime girlfriend. We are probably talking about someone who will have to donate an egg and then someone who will be hired as a surrogate mother. By the way, in New York, where the body is, paid surrogacy is illegal. The family is from California so it probably could be done there. But the point is, having someone say, "I'm going to use the sperm in a stranger, and we're going to create a child" is not normally how someone thinks about reproducing. It's also the case that wanting a male heir is probably not a good medical reason to try to have a child. You wonder whether they would not be satisfied and would try to end pregnancies that would produce a female child. I think it's too controversial to say that this young man would have been comfortable prior to death knowing that his parents were going to use [his sperm with] an egg donor and a surrogate so that they could have a male heir and continue the lineage of the family. Maybe he would have said, "I respect my parents and I will honor their wishes," but we just don't know. The situations in which I might allow sperm to be used ethically are when there is a wife and when they can establish that they were trying to have a child. But that leads to a potential change in public policy that the medical community might want to be advocating for, which is, should we add the donation of sperm and eggs to the organ donor card system or computer registry system that we now use? "I would like to donate my heart, I would like to donate my liver, and I'd be willing to donate sperm for my wife or maybe others so that I can have a child." This policy is already in use a little bit in the military, where they are starting to notify people deployed to combat situations that maybe they would want to think about pre-storing sperm, should they be killed. That lets you get the view of the person and understand their wishes so that we're not guessing whether they wanted to do this—if they wanted to use a surrogate or egg donor, or if they wanted the parents to make this decision. We could ask people to lay out more information just as they do about organ donation. I favor that change. It would help to have the kind of guidance that would make us more ethically comfortable as we move into this new age of technology, where it's possible to have a child even after death. Source
