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Can One Sibling Pull the Plug If the Others Don’t Want To?


Case No. 3: A girlfriend wants to retrieve her dying boyfriend’s sperm.

A 25-year-old man was out drinking with friends when he fell and hit his head on the bar. He was rushed to the hospital, where doctors discovered he had severe swelling and bleeding of the brain. Before the doctors declared him legally brain-dead, the man’s girlfriend arrived and asked for a testicular biopsy—she wanted to retrieve his sperm before he died so she could conceive his child. The doctors had to decide whether the patient would have granted her request.

The Issues
The first thing to determine, the ethicists agree, is whether the man has an end-of-life plan in place—and if so, whether it mentions anything about his girlfriend. Since the man had no such plan, the question becomes, Was there any reason to believe he would have given her his sperm? The girlfriend would have little claim to the patient’s sperm, says Rosamond Rhodes of Mount Sinai, “unless there’s compelling evidence about this man’s desire to participate in his own posthumous reproduction.” If there is a written document about it, for example, or if the man had been discussing IVF before his death, the girlfriend might have the right to a retrieval. “But even if the girlfriend suddenly remembered a conversation—‘If I pass out drunk one night and hit my head, you can have my sperm’—that doesn’t mean physicians must accept this as clear evidence of a patient’s wishes,” says Nancy Berlinger of the Hastings Center. Of course, the request would be stronger coming from a wife, or some other person to whom the man (and his estate) is already legally bound. “For all these physicians know, the girlfriend is hoping to secure a piece of the patient’s estate by producing an heir,” says Berlinger.

The Outcome
Because there was no end-of-life plan in place, the final decision fell to the man’s family, who were initially open to the retrieval as a way to continue their son’s legacy. The ethics team met with the girlfriend and family and explained their concerns about the girlfriend’s request. They also suggested that another way of giving new life was through organ donation. The patient was officially declared brain-dead later that day. The girlfriend and parents thought about the decision overnight and came to the conclusion that they didn’t want to harvest the sperm. Instead, they consented to organ donation, and after the ventilator was discontinued, the man’s organs were transplanted into four people.

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