Children as Organ Donors: A Model of Ethical Analysis

AbstractIn this introduction I discuss several ethical issues pertaining to the question other authors raise regarding whether we should permit minors to donate an organ-such as part of their liver or a kidney-to a sibling. I discuss particularly limits of what ethical analysis can accomplish; overriding, disproportionate effects of what might appear to be no more than minor nuances; exceptional expertise "ethics experts" can and can't offer; how patients' and family members' feelings may prevail over rational arguments; the importance of recognizing and respecting patients' felt relationships with others; and our global obligations to people worse off. A core feeling considered is a child's feeling of guilt if the child doesn't donate and this sibling dies. A nuance considered is a sibling wanting to donate to an identical twin. I consider some providers' bias that an intervention is death prolonging rather than life prolonging. When providers arrive at an impasse and continue to reasonably differ, switching the question to how an ethical resolution should be reached and by whom is recommended. Practical applications such as this that can be implemented by providers now are offered in regard to each of the ethical issues addressed.