Living Legacy: Brigham Conducts Posthumous Reproduction Survey

Consider this hypothetical: In the early years of a happy marriage, one partner dies in an accident. The couple had talked about having children someday, but they’d never made any firm plans. Suddenly, the hospital gives the surviving spouse an unexpected choice: Do you want to use your partner’s genetic material to make a child? You have just 24 hours to decide, because after that, the procedure won’t work.

Posthumous reproduction has been around since 1980, and scenarios like this arise a few times each year at Brigham and Women’s Hospital. Until recently, healthcare providers had no clear policy for how to proceed in such emotionally high-stakes situations. Each decision was made on a case-by-case basis, and involved asking tough questions such as: Is this what the spouse would have wanted? Is there risk of a lawsuit related to the child’s right to inheritance?

Last summer, though, Sara Barton, a fertility specialist at the Brigham, and her colleagues published the first nationwide survey on posthumous reproduction with the goal of helping hospitals develop more specific guidelines.

Barton is scheduled to present her findings this weekend at the annual meeting of the American Society for Reproductive Medicine. She found that nearly half of the 1,049 people surveyed favored retrieving gametes from men. Slightly fewer (43 percent) favored doing so from women. Interestingly, when the question became personal, the response was less positive. Of those polled, 36 percent said they’d want their own spouse to take their genetic material, while 32 percent said they’d take their spouse’s.

Barton’s team also discovered that higher income and education made people more likely to support posthumous reproduction, but gender, race, religion, and region played only a negligible part in the decision. Older people tended to hold a more negative view, but not to the degree that Barton expected. “Perhaps,” she surmises, “people who are older and have had the opportunity to experience children and family are hesitant to withhold those experiences from a younger generation.”

While the question of posthumous reproduction is rare, Barton advises partners to clarify and document their feelings about the issue. A vast majority (70 percent) of supporters in her study agree that prior written consent is paramount, and the Brigham has now rewritten its policy to require it, putting the hospital at the vanguard of the issue.