Darrel Dennis argues that people’s religious beliefs should be an important factor in decisions regarding posthumous sperm retrieval.

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A fertility specialist recently asked the students at our college’s Biomedical Sciences Club whether posthumous sperm retrieval for religious reasons was ethical. He described a case involving a Mormon woman in the United States. Her husband was pronounced brain dead following a car accident and she wanted to retrieve his sperm so she could have his baby. There was no written advance directive from the deceased man authorizing the procedure.

The woman argued that according to the teachings of The Church of Jesus Christ of Latter-day Saints, she is only allowed one husband in her lifetime and that having children is necessary for her entry to the highest degree of heaven. This type of marriage is known as celestial marriage, where man, wife, and children live together forever through a “sealing” process. In court, it was noted that this argument did not accord with official religious doctrine. Moreover, the Church of Jesus Christ of Latter-day Saints discourages artificial insemination of single women. Mormon women who deliberately refuse to follow the rules set by the counsel of the Church are subjected to Church discipline.

The first birth following posthumous sperm retrieval was baby Brandalynn, born in 1999. The process involved intracytoplasmic sperm injection, where a single sperm is injected into a single oocyte. Since then, requests for posthumous sperm retrieval have steadily increased. Some countries—including Sweden, France, and Germany—prohibit posthumous sperm retrieval. In Canada, according to the Assisted Human Reproduction (Section 8 Consent) Regulations, this type of retrieval is illegal without a prior written informed consent. Even with written consent, many guidelines need to be met, such as only the partner or spouse of the deceased donor can make the request. The surviving partner or spouse is also required to undergo extensive counseling to discuss the ethical and social issues within posthumous sperm retrieval.

Image description: Injecting sperm into a human egg. ICSI (intracytoplasmic sperm injection) image from microscope.

In the United States, there is no standard protocol or guideline regarding posthumous sperm retrieval at the federal or state level. Where there is legislation, it mostly allows posthumous sperm retrieval in the presence of prior written consent from the deceased. In the absence of written consent, The American Society of Reproductive Medicine allows posthumous sperm retrieval in some cases, when requested by the living spouse.

In recent years, there have been cases in which the United States Supreme Court has sided with religious freedom. For example, in Masterpiece Cakeshop v. Colorado Civil Rights Commission the Supreme Court stated that it is unconstitutional for the state of Colorado to punish Jack Philips for refusing to make a wedding cake for a gay couple since this would challenge his religious beliefs about marriage. Likewise, in the Town of Greece v. Galloway, the Supreme Court ruled in favor of the town’s practice of beginning their legislative sessions with prayers.

In the case of the Mormon woman, described above, her personal religious beliefs influenced what she considered to be morally acceptable in her circumstances. We should not judge someone’s beliefs. If this woman genuinely believed that she must bear children from her dead husband to reach the highest degree of heaven, then we should respect this sincerely held belief even if it conflicts with the ethics of her Church. Furthermore, if just one of the Church leaders were to support her decision, then the disconnect within the Church may lead to a new interpretation of what is acceptable.

Many religions have different interpretations of their ethical views on medical practices. These interpretations make it difficult for physicians to mitigate the conflict between deterministic and evidence-based attitudes toward providing care. Therefore, traditionally, physicians have left religious interpretation in the hands of religious leaders.

Recently, the importance of religion has been integrated into scientific studies. These studies have shown that people who are religious or spiritual have better mental health and can adapt more quickly to their health problems than those who are not religious or spiritual.

Physicians should acknowledge the validity of religious perspectives because many people view the world through the lens of religion. Also, physicians should try to understand how their own religious beliefs can influence how they deliver care. With reference to posthumous sperm retrieval, the partner’s or spouse’s spiritual well-being should inform the plan of care.

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Darrel Dennis is a senior public health major at Texas A&M University.