Life after death: posthumous sperm procurement. Whose right to decide?
Notice bibliographique
Résumé
There are a growing number of cases in Australia whereby women have been granted legal rights to posthumous sperm procurement (PSP) from their deceased partners. The 1998 landmark case of ‘AB/YZ’ was the first request granted for PSP (AB v Attorney-General, Unreported, Supreme Court of Victoria, Gillard J, 21 July 1998); however, at that time it was illegal in Victoria to use the sperm of a deceased man for fertility treatment (section 43, Infertility Treatment Act, Vic 1995). Despite amendments to section 43 of the act, several of AB/YZ's requests to export the sperm to another state for assisted reproductive therapy (ART) were denied, until 2005 when permission was granted [YZ v Infertility Treatment Authority (2005) VCAT 2655]. It is unknown whether AB/YZ has achieved a pregnancy, but the 7 years that it took for her request to succeed demonstrated the complex legal processes involved. To date, at least two live children have been born in Australia through PSP (www.theaustralian.com.au/news/features/a-matter-of-life-and-death/story-e6frg8h6-1226613250144#). Posthumous sperm procurement (PSP) must be performed 24–36 hours postmortem. It involves epididymal aspiration, percutaneous testicular biopsy, and/or removal of the testes. Although a relatively simple procedure, it raises numerous ethical and medico-legal issues, including the rights of the deceased, the question of informed consent, the best interest of the child, and the motivation of the applicant (Bahadur G. Hum Reprod 2002;17:2769–75). It is undoubtedly a challenging situation for clinicians, exacerbated by the fact that its request is typically made urgently. In Australia, complex judgments between different jurisdictions further complicate matters. As ART continues to advance, requests for PSP have become increasingly common globally, with numbers in the USA increasing by 60% from 1997 to 2002 (Bahm S et al. Fertil Steril 2013;100:839–43). The ethical challenges posed by PSP have led to strict regulations globally. Canada, France, Germany, and Sweden deem it illegal, regardless of the deceased's advanced directive. The USA has no formal legislative regulations, and its use is guided by professional societies. In Australia the law allows for a coroner to authorise tissue to be removed for medical purposes; however, for PSP some states (Victoria and New South Wales) require prior written consent. South Australia and Western Australia forbid it, whereas others (Northern Territory and Australian Capital Territory) have no legal requirements. The 2007 Australian National Health & Medical Research Council Ethical Guidelines on ART state that posthumous use of gametes requires advance consent, but has no guideline regarding PSP (www.nhmrc.gov.au/_files_nhmrc/publications/attachments/e78.pdf). The UK requires written informed consent prior to both PSP and sperm storage, thereby ensuring that couples discuss and make advanced formal plans. Australia has made great progress in terms of the legal precedents permitting PSP and supporting women in achieving the joys of motherhood, in spite of losing their loved ones. The current legislative regimes were not designed to deal with PSP, however, and clearer, accessible, and consistent laws are needed to support clinical and legal stakeholders when faced with such requests (Kroon B et al. ANZJOG 2012;52:487–90). With the increasing number and complexity of requests for PSP this has become a significant medico-legal challenge in modern obstetrics. None to declare.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,017 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».