Faculty Bibliography

PURPOSE: We determined the prevalence of requests for postmortem sperm procurement and the degree to which procurement is performed by those working in the field of infertility. MATERIALS AND METHODS: Structured telephone interviews were conducted with personnel at 273 assisted reproductive facilities in the United States and Canada. The number of facilities reporting requests and the number of facilities reporting that they performed the procedure were determined. RESULTS: The prevalence of requests for postmortem sperm procurement was much greater than initially anticipated. A total of 82 requests was reported at 40 facilities in 22 different states between 1980 and 1995. More than half of the reported requests (43) were made between 1994 and 1995. Of the 82 requests 25 were honored at 14 facilities in 11 different states. No requests or procedures were reported from Canada. CONCLUSIONS: Medical advances in postmortem sperm procurement, cryopreservation and in vitro fertilization permit retrieval of sperm after death for various purposes, including posthumous fatherhood. There are no explicit ethical guidelines, legislation or relevant case law, and fertility specialists must confront these issues before proceeding in a field fraught with moral and policy uncertainties.

"Conflicts of Interest in Clinical Practice and Research" edited by Roy G. Spece Jr, David S. Shimm and Allen E. Buchanan is reviewed

IT WAS NOT hard to tell which way the wind was blowing in the United States Supreme Court Wednesday as the issue of physician-assisted suicide came before the justices. It was blowing with gale force right toward Congress and 50 state legislatures. It blew so strongly that the eddies touched the doorstep of every American who can vote

Hospice is often held out as an alternative to the need for assisted suicide. To date, those in the hospice movement have made any discussion of assistance in dying off-limits on the grounds that proper palliative care can address the concerns about pain that the terminally ill face. But, the movement toward assisted suicide raises questions about the future viability of the hospice movement in its current form. Many who see assistance in dying are concerned, not about pain, but about suffering and loss of dignity. Many are not terminally ill but terrified at the prospect of disability and loss of cognitive capacities. Unless hospice addresses these concerns it is not likely to survive in the face of pressures to legalize assisted suicide.