Posthumous gamete retrieval and reproduction: would the deceased spouse consent?

Policy and medical decision-making has been hindered by the absence of reliable data on attitudes toward having one's own gametes retrieved posthumously and used to produce a child in the event of an untimely death. The purpose of this study is to directly and empirically examine whether the presumption against consent is justified in the case of posthumous gamete retrieval following sudden death. Respondents (N=2064) were contacted using a random-digit dialing method that gave every household telephone in the continental United States an equal probability of being contacted, and were asked: "Suppose you were to experience an early death and your spouse wanted to have a biological child with you. Would you or would you not want your spouse to be able to use your sperm/eggs following your death to have a child with you?" Among reproductive age respondents (18-44 years), 70% of males and 58% of females wanted their spouse to be able to use their gametes and, for the most part, attitudes were fairly consistent across demographic characteristics. Religiosity was the best predictor of attitudes--those who described themselves as more religious were less likely to desire posthumous gamete retrieval--but the majority (58%) of respondents who were very religious approved of retrieval. Overall, these data indicate that abandoning the prevailing presumption against consent in favor of a presumption of consent on the part of the deceased will result in the deceased's wishes being honored two and three times more often for females and males, respectively. Three main arguments against a presumption of consent in this context are discussed: autonomy of the deceased, conflict of interest, and the decision-making capacity of a grieving spouse.