Gamete retrieval in terminal conditions: is it practical? What are the consequences?

There is an increasing interest in, and request for, gamete retrieval from recently deceased or near-dead subjects for the purpose of posthumous procreation. This usually arises in an emergency situation with little time for physicians to consider ethical ramifications. Advance planning is needed to help these physicians make thoughtful decisions. After considering the complexity of the issues involved, the Ethics Consult Service and the Ethics Committee at the University of Virginia requested that we develop a policy on gamete retrieval for subjects in terminal conditions, which would govern and guide involved providers should this process be requested. Our team consisted of members of the Ethics Consult Service and Ethics Committee, as well as personnel who might be intimately involved in the gamete retrieval process, including the director of the Human Gamete and Embryo Laboratory, a urologist, and a reproductive endocrinologist. In addition to reviewing the current literature describing the actual processes involved, we explored the ethical implications of gamete retrieval in these situations. A policy was developed and approved by the Ethics Committee at our institution, and is included in this article.