Insight
The slippery slope of presumed consent in post-humous reproductive health cases
By Bethany Corbin, healthcare innovation and femtech attorney
It sounds like something out of a sci-fi film: A young man, on the cusp of starting a family with his wife, suffers a serious accident that renders him brain dead.
His wife, longing for the family they never started, requests access to his post-humous sperm to become pregnant and build the family she was denied.
After a long and arduous battle with the court system, the wife is granted permission to use her dead husband’s sperm to create her family, even though her husband never stated his family-building preferences in a will or otherwise provided consent to the use of his sperm.
If the situation seems fantastical (and a bit scary), beware: This is a true and landmark case that has shifted the consent paradigm for reproductive health on its head in the UK.
While the Human Fertilisation and Embryology Act of 1990 (as amended in 2008) requires written, informed consent to the use of a person’s reproductive materials, the case of Y v A Healthcare NHS Trust [2018] EWCOP18 (affirmed by the Court of Protection in Re X (Catastrophic Injury: Collection and Storage of Sper) [2022] EWCOP 48) departed significantly from this requirement to allow “presumed consent” as an alternative to informed consent.
This trend by the UK courts does not align with the strict letter of the law and is more akin to an opt-out organ donation framework for reproductive health. It begs two questions: (1) What is really in the best interests of a patient who lacks capacity to procreate? (2) Should gametes be treated the same as all other organs?
These are heavy questions that have sparked global debate. On one end of the spectrum, a 2016 article published in the journal Reproductive Biomedicine & Society Online argues that gametes, similar to organs, are resources that should be considered for use after death, given their life-creating properties.
The authors contend that once an individual is dead, they no longer have a meaningful interest in the use of their reproductive material and post-humous conception should follow a framework of presumed consent.
The authors base their argument in large part on studies conducted showing that the majority of men support their partners accessing their sperm for post-humous conception.
On the other end of the spectrum, however, is the fundamental need to protect the best interests of the patient, who is no longer capable of understanding or consenting to the creation of life.
Numerous situations may arise where a partner seeks to exploit a vulnerable individual for their reproductive materials. For example, imagine the situation where a husband has repeatedly said “no” to creating a family. If he then suffers a life-threatening accident, his spouse could claim that he had agreed to start a family and that his consent should be presumed.
The same rationale could apply to an abusive boyfriend seeking to exploit his girlfriend’s reproductive materials and demanding the post-humous harvesting of her eggs to be used in the future. This creates an environment that can easily result in exploitation of incapacitated individuals who do not have the ability to defend their own interests.
The rights and wishes of the deceased must have meaning if we are to respect human autonomy. These individuals are vulnerable, unable to protect their own interests, and at the mercy of others who may try to exploit them.
This becomes particularly concerning when we add in the scenarios of abusive relationships, suicide, and reproductive coercion. If the law does not protect the rights of the vulnerable, who will? In essence, the trending case law prioritises the interests of the living over the rights of the dead.
Presumed consent for post-humous conception is an incredibly slippery slope. Reproductive material is fundamentally different from other organs in that it is not lifesaving, but rather life-creating. If we allow an individual’s partner or family to make their post-humous reproductive choices, where do we draw the line?
In the case of Y v A Healthcare NHS Trust, the court relied on circumstantial evidence to presume the husband’s consent – such as the early fertility treatments undertaken by the husband. But what about cases in which such evidence is fabricated or in which consent has been withdrawn prior to the accident?
The fact of the matter is, there will always be factual permutations and attempts by individuals to manipulate existing legal frameworks to obtain the outcome they want. It won’t always be clear what the deceased wanted or whether the evidence of their desires has been forged.
As a society, our laws have historically protected the most vulnerable. Any decision to depart from this history should be made by a body of elected representatives that can carefully consider the broader ethical implications of this decision and its downstream impacts, not the courts.
Bethany Corbin is a healthcare innovation and femtech attorney on a mission to help thought-leading companies revolutionise women’s health. Through her company, FemInnovation, Corbin partners with emerging companies at the forefront of healthcare transformation to ensure they are building robust, scalable, and legally compliant businesses focused on enhancing health equity.
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News
WHO hosts parliamentary dialogue on women’s health
The World Health Organization (WHO) welcomed a delegation of parliamentarians to its Geneva headquarters for a high-level dialogue on women’s health and sexual and reproductive health and rights.
The meeting on 20 January 2026 focused on women’s health, sexual and reproductive health and rights, noncommunicable diseases (long-term conditions such as cancer and diabetes) and global health cooperation.
The exchange was convened by the Konrad-Adenauer-Stiftung and the UNITE Parliamentarians Network for Global Health, bringing together parliamentarians from Albania, Germany, Georgia, Mexico, Slovakia, South Africa, Sri Lanka, Sweden and Zimbabwe.
A central theme was the need to move beyond fragmented approaches to women’s health.
Dr Alia El-Yassir, WHO director for gender, equity and diversity, highlighted that outcomes are shaped by gender inequalities, social norms and structural barriers across the life course, requiring coordinated action across health systems.
Thirty years after the Beijing Declaration and Platform for Action, a landmark framework adopted in 1995 to advance gender equality and women’s rights, Dr Anna Coates, WHO gender equality technical lead, noted that progress on women’s health remains uneven.
She called for health systems that are more gender-responsive and able to address women’s health holistically across the life course.
Parliamentarians stressed that health is inseparable from wider social and economic policies, and called for stronger links between evidence, legislation and measurable impact at country level.
The meeting also focused on sexual and reproductive health and rights, where parliamentarians expressed interest in engaging on issues that directly affect their constituents.
Dr Pascale Allotey, director of WHO’s Department of Sexual, Reproductive, Maternal, Child, Adolescent Health and Ageing, outlined WHO’s life-course approach to sexual and reproductive health and rights.
She highlighted how needs evolve from birth to older age and how these are shaped by social determinants, humanitarian crises and demographic trends.
Dr Allotey underscored the role of parliamentarians in advancing sexual and reproductive health and rights and the importance of continued engagement with WHO to support evidence-based policy-making.
The agenda highlighted cancer as a growing priority for women’s health and for health system sustainability. Dr Prebo Barango, lead for the Cervical Cancer Elimination Initiative, Dr Meghan Doherty, consultant for palliative care, and Santiago Milan, lead for the WHO Global Platform for Access to Childhood Cancer Medicine, presented WHO’s integrated approach to cancer control.
Palliative care is treatment and support that aims to improve quality of life for people with serious illness by managing pain and other symptoms.
The discussion underlined the need for sustained political commitment and domestic investment to address noncommunicable diseases.
Parliamentarians shared national experiences showing the social and economic impacts of cancer on families and caregivers, reinforcing the importance of improving health literacy, reducing stigma and delivering people-centred care.
The meeting also addressed the state of global multilateralism.
Dr Jeremy Farrar, assistant director-general for health promotion, disease prevention and care, outlined how WHO has restructured to enhance efficiency, impact and capacity to support countries.
He reaffirmed WHO’s commitment to more systematic engagement with parliaments, recognising their role in shaping health policy, legislation and budgets.
The exchange concluded with a call for continued collaboration, including through partnerships with the Konrad-Adenauer-Stiftung and the UNITE Parliamentarians Network for Global Health, ahead of the UNITE Global Summit 2026 on 6–7 March in Manila, the Philippines.
Insight
FDA approves Agilent test for ovarian cancer
Agilent has FDA approval for a test to identify ovarian cancer patients who may be eligible for immunotherapy.
Agilent’s PD-L1 IHC 22C3 pharmDx is the only FDA-approved companion diagnostic to help identify patients with epithelial ovarian, fallopian tube or primary peritoneal carcinoma whose tumours express PD-L1 and who may be eligible for treatment with KEYTRUDA, Merck’s anti-PD-1 therapy.
A companion diagnostic is a test used alongside a specific treatment to show whether a patient is suitable for that therapy. PD-L1 is a protein on some cancer cells that helps tumours evade the immune system.
These cancers affect the reproductive system and the lining of the abdominal cavity.
The test enables pathologists to assess PD-L1 expression at diagnosis to support treatment decisions in a disease where options remain limited for many.
This is the seventh FDA-approved companion diagnostic indication for PD-L1 IHC 22C3 pharmDx for use with KEYTRUDA.
Nina Green, vice president and general manager of Agilent’s clinical diagnostics division, said: “Delivering effective precision oncology requires close collaboration between diagnostics and therapeutics, and this FDA approval reflects Agilent’s long-standing industry partnership in companion diagnostics.
“We are proud to enable pathologists to identify patients with EOC who may benefit from immunotherapy.
“As the first immuno-oncology approval for this disease, this milestone underscores our commitment to advancing precision medicine and expanding access to innovative cancer treatments worldwide.”
PD-L1 expression with this test was evaluated in the KEYNOTE-B96 clinical trial supporting its use to identify patients who may benefit from KEYTRUDA.
In the US, ovarian cancer caused approximately 12,730 deaths in 2025 and the five-year survival rate was 51.6 per cent between 2015 and 2021.
In addition to these cancer types, the test is indicated in the US to help identify patients with non-small cell lung cancer, oesophageal squamous cell carcinoma, cervical cancer, head and neck squamous cell carcinoma, triple-negative breast cancer and gastric or gastro-oesophageal junction adenocarcinoma who may benefit from treatment with KEYTRUDA.
The test was developed by Agilent with Merck as a companion diagnostic for KEYTRUDA.
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