A person's death need no longer spell the end of his or her future reproductive possibilities. A dead or dying person can have their reproductive tissue removed to enable someone else to have a child.
It was recently reported that a woman in India used the sperm of her dead son, who had died of cancer, to create grandchildren. His mother found an egg donor and another relative acted as a surrogate, and is now the happy grandmother of twins (see BioNews 938). In this case, the donor chose to have his sperm frozen before he had cancer treatment, and gave his mother and sister authority to use it in the event of his death.
Posthumous and perimortem sperm extraction, however, are sometimes used in circumstances such as this if the gametes have not been preserved during life. Such procedures have been carried out in the UK and elsewhere at the request of partners and parents of the dead person. There have been controversies in the past about who exactly has legitimate interests in reproductive tissue harvested from the dead. Spouses may seem the most obvious people who have justifiable claims.
Dead bodies, in fact, contain a variety of material that may be of value to others. One question is whether the removal and use of these materials is acceptable at all. The second is who should have access to it.
The process by which sperm is obtained posthumously is invasive and – some would argue – undignified. It involves the insertion of an electric probe into the patient's rectum. Increasing voltages of electricity are applied until ejaculation occurs. Sperm is discharged into the bladder, due to the absence of normal physiological responses that would ordinarily expel it from the penis.
The sperm is collected via a catheter threaded up through the urethra and into the bladder. The body is thus penetrated anally and through the urethra for the purposes of fulfilling someone else's aspirations for a baby.
I use the term 'undignified' with caution here. It is a notoriously subjective concept. Some people might regard the process as being entirely in keeping with appropriate treatment of a dead, dying or comatose body. Others might regard it as amounting to sexual assault. Ordinarily, the distinction between assault and legitimate interactions with another person's body lie in the fact that consent has been given.
Then, there is the question of who should be able to use the sperm so obtained. Spouses, lovers, parents, grandparents, siblings, friends… How do we determine this? And what is the nature of the urge that makes people want to enter the bodies of others in order to extract their gametes?
Clearly, it is not simply the reproductive urge. It is not obvious that the dead person can be said to reproduce if a child is produced with his posthumously extracted sperm. And in the case of spouses and lovers, a reproductive wish could be more easily fulfilled by finding alternative (living) reproductive partners.
Of course, it is the genes that people are seeking: those mystical symbols of the dead man's essence. Genes are of such importance that we will insert electric probes into the anuses of dead men in order to harvest those precious seeds.
But there is a strange asymmetry in such cases. Children get their genes from at least two people, but the female genetic contributor can go almost without mention. In the Indian story, an anonymous egg donor was used, who was factored out of the subsequent parenting arrangements. She plays no part except that her reproductive tissue was necessary to complete this grandparenting idyll.
We may hope that this woman's consent was at least obtained, but there is no particular reason to think so. The wish for sperm in circumstances such as those described in this story generates the need for eggs – obtained from what may have been a silent, acquiescent female body.
It is increasingly clear that reproductive commodities such as sperm and eggs have a value independent of the person who produces them. A society that allows bodies to be harvested in this way needs to have very careful regulatory systems to ensure that bodies are not plundered for the benefit of others.
I have noted that various interested parties may request or carry out gamete harvesting. Reproductive technologies and embryo research have together reconstituted gametes as a marketable commodity. Sperm and eggs can be, and are, bought and sold. The doctor who can guarantee a supply of gametes, especially eggs, will have a substantial advantage in the fertility treatment market.
The lack of conceptual, regulatory and ethical clarity in this area creates a ripe environment for bodies to be seen as potential sources of gain, whether for friends and relatives who long for the babies of the dead, or those who long to be paid for fulfilling the wishes of those friends and relations.