Page 11 - FSANZ Update Spring 2022

journey of posthumous conception
Panel members at the posthumous conception session of the FSANZ meeting in Sydney (from left) Stephen Page, Cheryl Ayres, Narelle Dickinson, Clare Boothroyd, Jennifer Gaffney and Kita Stoltesz
Dr Clare Boothroyd, who spoke on the issue at the FSANZ conference, said she totally agreed with the need for multidisciplinary protocols and harmonisation of clinical ethics committees to help people make more informed and comfortable decisions about posthumous collection of eggs and sperm.
“There are also significant gaps in Medicare funding support that preclude Australians from accessing what is now feasible and likely to be increasingly requested,” she said.
“There is a need for public consultation to guide political and medical leaders, and couples, in the posthumous use of gametes.”
Narelle Dickinson, a psychologist specialising in perinatal loss and grief, and a FSANZ Board member, outlined implications of posthumous care and experiences of surviving partners.
“Posthumous care is an ethically complex option that allows a surviving partner to reclaim an aspect of the life they had expected to live,” Narelle said.
“Curiously, posthumous birth, initiated by the unexpected death of a parent during pregnancy, generally attracts compassion for the grief and needs of the surviving partner and family, but posthumous conception does not always attract such sympathy.
“Fertility specialists are aware of National Health and Medical Research Council ethical guidelines that state gametes can only be used posthumously when there is evidence that the deceased partner did, or would have, consented to posthumous use. Gametes can only be used by the surviving partner and following that person’s specific request.
“Clear posthumous direction for those already undertaking fertility treatment certainly facilitates later decision making.
Too often grieving spouses feel compelled to go to court to retrieve gametes posthumously, and then go to court again to use them
But what of the families who had not previously had reason to store gametes or embryos?
“Surviving parents are counselled to take care that the deceased’s identity is not imposed onto the child, and to ensure that the child has space to develop their own individual identity. Counselling explores how the child will be informed of their conception and how best to provide information about the deceased parent.”
Stephen Page, a consumer representative on the FSANZ Board and lecturer in family law and ethics in reproductive medicine at the University of New South Wales, examined legal aspects of posthumous conception at the Sydney conference.
“Too often grieving spouses feel compelled to go to court to retrieve gametes posthumously, and then go to court again to be able to use them,” he said.
“Most of the time they do not need to do so. The rules throughout Australia about posthumous use are inconsistent, varying from an absolute ban in Western Australia, to more liberal rules in the ACT, Queensland and Tasmania.
“Having consistency across Australia to enable posthumous use would be a good step forward.”
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