A thorny ethical question: should sperm samples taken from fallen soldiers be used?

0:00Today on State of the World, a thorny ethical question. Should sperm samples taken from fallen soldiers be used? You're listening to State of the World from NPR. We bring you the day's most vital international stories, up close, where they're happening. I'm Greg Dixon. Hundreds of young Israeli soldiers were killed in the Gaza War these last few years. Their families were asked to make a quick and unusual decision. Should they retrieve their son's sperm from their bodies for future offspring? Many have said yes. And now, as NPR's Daniel Estrin tells us, come the complicated questions of what loved ones can and should do with that genetic material.

0:47So this is where the sperm is stored, okay? That's Dr. Eran Altman, head of the sperm bank at Rabin Medical Center, where sperm is stored at minus 378 degrees Fahrenheit. How many sperm samples do you have in these four vats? Ten thousand. Ten thousand? More. You're opening it up. Yes. This is the liquid nitrogen coming out, this fog? Among all the sperm samples in this sperm bank from all kinds of donors is the sperm of young Israeli soldiers killed during the recent war. And here is a stunning fact. About a quarter of the soldiers killed in Gaza and elsewhere, a quarter had sperm retrieved from their bodies after their death.

1:38In total, around 250 soldiers and security officers. Dr. Altman did many of the surgical procedures himself. The army became very efficient in bringing us the corpse, very efficient. We got it after several hours of the time of death, several hours. So this really became a priority. Right, yeah. It's called posthumous sperm retrieval. After a man dies, his sperm lives for up to 72 hours. In Israel, many families have retrieved that sperm to be able to birth children with it. This practice was rare in Israel until the October 7th attacks and the war that followed. It's now a major phenomenon in Israel, and it's raised a whole host of ethical questions.

2:25It raises questions that you don't tackle until you have to tackle, right? And we started doing it before we had time to think what is right to do. Should a dead man be allowed to become a father? The question doesn't come up a lot in the U.S. because the practice is not very common in American hospitals. Well, one of the reasons it's not often done is because there's no policy. Megan Elise teaches bioethics at Case Western Reserve University. We actually historically have seen many more requests for posthumous sperm retrieval than we're able to be honored. Because if there's no policy about how to retrieve the sperm, how to store it securely, all of those things, then what happens is it won't get retrieved.

3:15In Israel, it's very different. Israel has a very high birth rate, colored in part by the memory of the six million Jews killed in the Holocaust, the desire for Jewish continuity, and for ensuring a Jewish majority in the battle for land with Palestinians. Culturally, Israelis are very pro-children, which is playing out in a very unusual way today.

3:42Sharon Eisenkot got the knock on the door early on in the war that her 19-year-old son Maor was killed in Gaza.

3:54The same officer who reads me the terrible news comes with another piece of paper, and he explains to me that sperm can be retrieved from Maor, and there's a 72-hour window of opportunity, so I need to make a quick decision. He hands me the paper. I understand what it means, and I sign. Because it was very clear to me that Maor wanted children. He was young and single, like most of the Israeli soldiers, whose sperm was retrieved after they were killed. The decision falls on the parents. Since the war broke out, Israel changed the rules to make it easier. Now you don't need a court order to retrieve the sperm upon death.

4:31But to use that sperm to create offspring, Eisenkot needed to go to court to testify.

4:43She told the judge what her son used to say at dinners, that one day he wanted to have three children. Her son's army friend took the witness stand too and testified about a conversation he had had with Maor shortly before he was killed. Maor said he wasn't afraid to die. He was afraid he wouldn't have children, and he intended to give a sperm donation when he was back home from the front. With all these testimonies, the judge ruled in the family's favor. Now Eisenkot is looking for a woman who wants to become a single mother using Maor's sperm. She says it's the right thing to do.

5:26We as a country take away their right to life, just like that, by sending them to fight. So who are we to also deny them continuity? I spoke to another mother in Israel, Bela Savitsky, whose son Jonathan was killed on October 7th, trying to save other soldiers from a Hamas attack on their base. When they told me that Jonathan is dead, it was like, I cannot explain what happened, but the first thought was, he cannot disappear. He was too wonderful. How can I prevent his disappearance from the earth? And in this second, I thought about the technology which can leave him with me and give me some purpose, you know, to raise his children, to get grandchildren from him.

6:20But too many days had passed by the time her son's body was identified amid all the bodies from the attack, and it was too late to retrieve his sperm. But she took it as her mission to try to help others. She's an epidemiologist, and she helped conduct a study among 600 Israeli men of Army service age. Almost half were opposed. The top reason she found was that they wouldn't want their children to grow up without their biological father. But soldiers did say they'd want to be asked for their consent while they were alive, like being an organ donor. The Israeli military does not ask soldiers if they'd want to be a sperm donor, and the military declined to say if they're considering changing that policy.

7:05So what should be done with the sperm that's already been preserved from this war? I asked Savitsky. For the future, we must create the process which will take their desires into account. But I'm saying about what is already done. 250 sperm retrievals are already taken. I think they should be used because nobody knew what man wants and the parents are full of hope to use it. And, okay, I did not succeed, okay, I failed. But I really hope for other parents that they will hold their grandchild, you know.

7:49This scene from a TV documentary captures the moment the very first baby was born in Israel from the sperm of a soldier killed in the Gaza War. The mother is the widow. They had discussed having children before he was killed. Two more widows of killed soldiers are now pregnant through the same process. Several families have received court orders allowing them to use their son's sperm for offspring. That leaves more than 200 families with sperm frozen in the sperm bank to decide whether their dead sons should bring about new life. Daniel Estrin, NPR News.

8:34That's the State of the World from NPR. Thanks for listening.