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死后精子获取:生殖革命。

Posthumous sperm retrieval: a procreative revolution.

机构信息

Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy.

Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, University of Foggia, Policlinico "AUO Riuniti", Foggia, Italy.

出版信息

Med Glas (Zenica). 2021 Feb 1;18(1):114-121. doi: 10.17392/1256-21.

Abstract

Aim Postmortem sperm retrieval with consequent artificial insemination has become a technically possible option for future use in assisted reproductive technology (ART). The authors have set out to discuss the social and ethical significance of posthumous sperm retrieval, and the laws currently in force in Italy, the United States and elsewhere. Methods International literature from 1997 to 2020 has been reviewed from Pubmed database, Google Scholar and Scopus, drawn upon American, Italian and international sources (an ethically acceptable solution can only be achieved through an overhaul of the laws currently in effect). One of the most contentious issues was about donor consent. In Italy, a donor's will to retrieve his sperm in the event of premature disappearance can be proven according to the Law 219/2017, through advance health care directives. Results A substantial increase, both in requests and protocols, was documented in the United States. In Italy, over the last two years, three rulings were issued concerning posthumous insemination. However, no official standardized protocols, guidelines or targeted legislation exist at the national level to regulate medical activity in that realm, whereas established laws often set implicit limitations. Conclusion Current legal frameworks appear to be inadequate, because in most cases they were conceived under conditions that have radically changed. The need for newly-updated regulatory frameworks to promptly bridge that gap is increasingly clear, if current social needs related to reproductive rights are to be met in the foreseeable future.

摘要

目的

死后精子采集并随后进行人工授精,已成为辅助生殖技术(ART)中未来应用的一种可行技术选择。作者旨在讨论死后精子采集的社会和伦理意义,以及意大利、美国和其他国家目前的法律。

方法

从 1997 年到 2020 年的国际文献,从 Pubmed 数据库、Google Scholar 和 Scopus 中进行了回顾,参考了美国、意大利和国际来源(只有通过全面修订现行法律,才能找到符合伦理要求的解决方案)。最具争议的问题之一是关于供体同意。在意大利,根据 2017 年第 219 号法律,通过提前医疗指令,可以证明供体在提前死亡时取回精子的意愿。

结果

在美国,请求和方案都有大量增加。在意大利,过去两年中,就死后授精问题发布了三项裁决。然而,在国家层面上,没有官方的标准化方案、指南或有针对性的立法来规范该领域的医疗活动,而既定法律通常设定了隐含的限制。

结论

现行法律框架似乎不够充分,因为在大多数情况下,这些框架是在条件已经发生根本变化的情况下制定的。如果要在可预见的未来满足当前与生殖权利相关的社会需求,那么显然需要更新监管框架来尽快填补这一空白。

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