"I was not going to be the point of obstruction denying a service that was available to this family on that day," writes Robert H. Ritter, MD, in this letter to the editor.
Editor's note: The below letter was written in response to the Urology Times blog post "Sperm harvest request raises ethical, legal questions" by Henry Rosevear, MD.
Regarding Dr. Rosevear’s article, I had a similar experience in 2007 during my chief resident year. In my case, a lady contacted me, via the on call answering service, requesting a post-mortem sperm harvest a few hours after her young husband was killed in a head-on motor vehicle collision with a semitruck.
After an extended conversation with the hospital’s legal department and the PhD director of the infertility department, we realized the service that we could provide as the on call urologist was to perform a postmortem epididimectomy (and provide the specimen to the infertility lab). The guidance I received from the hospital legal department was, “Doctor, do what you think is right.” My attending physician who was supervising me gave me much the same guidance.
Ultimately, my decision-making process came down to this: I was not philosophically opposed to the idea (I was told the spouse would have a 6-month “cooling off” period to fully consider her choice). I realized by doing the procedure I would be potentially opening a Pandora’s box for someone. But I also knew I was the on call provider trained (or in my case completing my training) in the procedure required to be performed at that exact point in time. I was not going to be the point of obstruction denying a service that was available to this family on that day. After obtaining the appropriate consent and locating the deceased in the morgue, I was able to perform the required procedure.
As I retell the story over the years, I recall how the pathology resident who answered my call about how to gain after-hours access to the morgue suggested I do so with the help of a custodian. I told him I was slightly uncomfortable with that and that given that this was not a routine urology on call issue (gross hematuria, flank pain, urinary retention, etc.), I asked that the on call pathology resident come in and help me gain access to the morgue and locate the correct deceased individual.
I also recall the desperation and tragedy of the whole situation. The deceased still had on his C-collar from the valiant failed trauma resuscitation attempt.
Robert H. Ritter, MD