Ethical Theory and Moral Practice

, Volume 22, Issue 2, pp 501–517 | Cite as

Solidarity as a Theoretical Framework for Posthumous Assisted Reproduction and the Case of Bereaved Parents

  • Efrat Ram-TiktinEmail author
  • Roy Gilbar


Bioethicists, medical professionals and lawyers who support Posthumous Assisted Reproduction (PAR) as an ethical procedure in the case of the deceased’s spouse often oppose it in the case of the deceased’s parents. In addition, supporters of PAR usually rely on an individualistic version of liberalism, thus focusing on a personal rather than relational approach to autonomy. This article proposes an alternative and comprehensive theoretical framework for the practice of PAR, based on the concepts of solidarity and relational autonomy. By analyzing empirical data on people’s attitudes towards PAR, we reveal an important distinction between the deceased’s wish and the deceased’s consent. In addition, we show that in the majority of cases individuals report that the well-being of their relatives is paramount once they are dead. This finding, as will be demonstrated in the article, is not fully in line with Tremellen and Savulescu’s position who allow PAR in the case of the deceased’s spouse but not in the case of his parents. We also suggest that a relational autonomy perspective can be used to evaluate the choices and actions of the deceased, and to justify the requests for PAR by his spouse or parents. Furthermore, the discussion leads us to analyze both Sandel’s account of solidarity and the more recent account of Prainsack and Buyx. We conclude that PAR can be considered as a solidarity-based practice, both at the familial and societal level, an aspect that should be given more emphasis in the discourse surrounding PAR.


Posthumous assisted reproduction Solidarity Relational autonomy Bereavement Postmortem sperm retrieval Presumed consent 



  1. ASRM (2013) ASRM posthumous collection and use of reproductive tissue: a committee opinion. Fertil Steril 99:1842–1845CrossRefGoogle Scholar
  2. Attorney General guidelines. Sperm retrieval and its use (Ministry of Justice, Israel, 2003), (last accessed 18.3.2018) (In Hebrew)
  3. Bahadur G (2004) Ethical challenges in reproductive medicine: posthumous reproduction. Int Congr Ser 1266:295–302CrossRefGoogle Scholar
  4. Bokek-Cohen Y, Ravitsky V (2017) Soldiers’ preferences regarding sperm preservation, posthumous reproduction, and attributes of a potential “posthumous mother”. Omega J Death Dying 79:132–156. CrossRefGoogle Scholar
  5. Christman J (2004) Relational autonomy, liberal individualism, and the social constitution of selves. Philos Stud 117:143–164CrossRefGoogle Scholar
  6. ESHRE Task Force on Ethics and Law (2006) Posthumous assisted reproduction. Hum Reprod 21:3050–3053CrossRefGoogle Scholar
  7. Hans JD (2008) Attitudes toward posthumous harvesting and reproduction. Death Stud 32:837–869CrossRefGoogle Scholar
  8. Hans JD (2014) Posthumous gametes retrieval and reproduction: would the deceased spouse consent? Soc Sci Med 119:10–17CrossRefGoogle Scholar
  9. Hans JD, Dooley B (2014) Attitudes toward making babies…with a deceased partner’s cryopreserved gamete. Death Stud 38:571–581CrossRefGoogle Scholar
  10. Hans JD, Frey LM (2013) American attitudes in context: posthumous use of cryopreserved gametes. J Clinic Res Bioethics S1(006):1–8. Google Scholar
  11. Hans JD, Yelland EL (2013) American attitudes in context: posthumous sperm retrieval and reproduction. J Clinic Res Bioethics S1(008):1–9. Google Scholar
  12. Hasiloni-Dolev Y (2015) Posthumous reproduction (PHR) in Israel: policy rationales versus lat people’s concerns, a preliminary study. Cult Med Psychiatry 39:634–650CrossRefGoogle Scholar
  13. Hasiloni-Dolev Y, Schicktanz S (2017) A cross-cultural analysis of posrhumous reproduction: the significance of gender and margins-of-life perspectives. Reprod Biomed Soc Online 4:21–32CrossRefGoogle Scholar
  14. Häyry M (2003) European values in bioethics: why, what, and how to be used. Theor Med Bioeth 24:199–214CrossRefGoogle Scholar
  15. IFA. (2017) PAR – the use of a deceased sperm. Available at: [accessed March 2018] (In Hebrew)
  16. Kant I (1996) The Metaphysics of Morals. Ed. and trans. Mary Gregor. Cambridge University Press, CambridgeGoogle Scholar
  17. Katz O, Hashiloni-Dolev Y (2019) (un)natural grief: novelty, tradition and naturalization in Israeli discourse on posthumous reproduction. Med Anthropol Q.
  18. Kime, P (2016) Military’s new fertility benefit will let troops freeze their sperm and eggs. Available at: [accessed March 2018]
  19. Klass D, silverman PR, Nickman SL (1996) Continuing bonds: new understanding of grief. Taylor & Francis, Washington, DCGoogle Scholar
  20. Kroon F (2016) Presuming consent in the ethics of posthumous sperm procurement and conception. Reprod Biomed Soc Online 1:123–130CrossRefGoogle Scholar
  21. Landau R (2004) Posthumuos sperm retrieval for the purpose of later insemination or IVF in Israel: an ethical and psychological critique. Hum Reprod 19:1952–1956CrossRefGoogle Scholar
  22. Lindemann-Nelson H, Lindemann-Nelson J (1995) The patient in the family: an ethics of medicine and families. Routledge, NYGoogle Scholar
  23. Nakhuda GS, Wang JG, Sauer MV (2011) Posthumous assisted reproduction: a survey of attitudes of couples seeking fertility treatment and the degree of agreement between intimate partners. Fertil Steril 96:1463–1466CrossRefGoogle Scholar
  24. Nedlesky J (1989) Reconceiving autonomy: sources, thoughts and possibilities. Yale J Law Fem 1:7–36Google Scholar
  25. Neimeyer RA (1998) Can there be a psychology of loss? In: Harvey JH (ed) Perspectives on loss. Brunner/Mazel Taylor Francis, Philadelphia, pp 331–342Google Scholar
  26. Orr RD, Siegler M (2002) Is posthumous semen retrieval ethically permissible? J Med Ethics 28:299–303CrossRefGoogle Scholar
  27. Pastuszak AW, Lai WS, Hsieh TC, Lipshultz LI (2013) Posthumous sperm utilization in men presenting for sperm banking: an analysis of patient choice. Andrology 1:251–255CrossRefGoogle Scholar
  28. Pierscionek BK (2008) What is presumed when we presumed consent? BMC Med Ethics 9.
  29. Prainsack B, Buyx A (2011) Reflections on an emerging concept in bioethics. London, Nuffield Council on Bioethics. Available at: [accessed March 2018]
  30. Prainsack B, Buyx A (2012) Solidarity in contemporary bioethics- towards a new approach. Bioethics 26:343–350CrossRefGoogle Scholar
  31. Sandel M (2009) Justice: what is the right thing to do? Farrar, Straus and Giroux, NYGoogle Scholar
  32. Silverman PR, Klass D (1996) What’s the problem? In: Klass D, silverman PR, Nickman SL (eds) Continuing bonds: new understanding of grief. Taylor & Francis, Washington, DCGoogle Scholar
  33. Simana S (2018) Creating life after death: should posthumous reproduction be legally permissible without the deceased’s prior consent? J Law Biosci 5:329–354CrossRefGoogle Scholar
  34. Strong C (1997) Ethics in reproductive and perinatal medicine: a new framework. Yale University Press, CTGoogle Scholar
  35. Strong C, Gingrich JR, Kutteh WH (2000) Ethics of postmortem sperm retrieval. Hum Reprod 15:739–745CrossRefGoogle Scholar
  36. Styer AK, Cekleniak NA, Legedza A et al (2003) Factors associated with disposition of cryopreserved reproductive tissue. Fertil Steril 80:584–589CrossRefGoogle Scholar
  37. Tremellen K, Savulescu J (2015) A discussion supporting presumed consent fr posthumous sperm procurement and conception. Reprod BioMed Online 30:6–13CrossRefGoogle Scholar
  38. Tremellen K, Savulescu J (2016) Posthumous conception by presumed consent. Reprod Biomed Soc Online 3:26–29CrossRefGoogle Scholar
  39. Ram-Tiktin E, Gilbar R, Beck FR, Ben-Ami I, Friedler S, Shalom-Paz E (2019) Expanding the use of posthumous Assisted Reproduction Technique: Should the deceased’s parents be allowed to use his sperm? Clin Ethics, 14:18–25.Google Scholar
  40. Ravitsky V, Bokek-Cohen Y (2018) Life after death: the Israeli approach to posthumous reproduction. In: Boaz H, Lavee S, Hashiloni-Dolev Y, Filc D, Davidovitch N (eds) Bioethics and biopolitics in Israel: socio-legal, political and empirical analysis. Cambridge University Press, Cambridge, pp 202–220CrossRefGoogle Scholar
  41. Ueda N, Kushi N, Nakatsuka M, Ogawa T, Nakanishi Y, Shishido K, Awaya T (2008) Study of views on posthumous reproduction, focusing on its relation with views on family and religion in modern Japan. Acta Med Okayama 62:285–296Google Scholar
  42. Veteran’s Benefit Act, 2010 PUBLIC LAW 111–275—OCT. 13, 2010. Available at: [accessed June 2018]

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of PhilosophyBar-Ilan UniversityRamat-GanIsrael
  2. 2.School of LawNetanya Academic CollegeNetanyaIsrael

Personalised recommendations