Affiliation:
1. Departments of Pediatrics, Medicine, and Surgery, University of Chicago, Chicago, Illinois
Abstract
Cases of adolescents in organ failure who refuse solid organ transplant are not common, but several have been discussed in the media in the United States and the United Kingdom. Using the framework developed by Buchanan and Brock for surrogate decision-making, I examine what role the adolescent should morally play when deciding about therapy for life-threatening conditions. I argue that the greater the efficacy of treatment, the less voice the adolescent (and the parent) should have. I then consider how refusals of highly effective transplant cases are similar to and different from refusals of other lifesaving therapies (eg, chemotherapy for leukemia), which is more commonly discussed in the media and medical literature. I examine whether organ scarcity and the need for lifelong immunosuppression justify differences in whether the state intervenes when an adolescent and his or her parents refuse a transplant. I argue that the state, as parens patriae, has an obligation to provide the social supports needed for a successful transplant and follow-up treatment plan, although family refusals may be permissible when the transplant is experimental or of low efficacy because of comorbidities or other factors. I conclude by discussing the need to limit media coverage of pediatric treatment refusals.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics, Perinatology, and Child Health
Reference82 articles.
1. Successful homotransplantation of the human kidney between identical twins;Merrill;J Am Med Assoc,1956
2. Foster v Harrison, 68674 Eq Mass Sup Jud Ct (1957)
3. Masden v Harrison, 68651 Eq Mass Sup Jud Ct (1957)
4. Huskey v Harrison, 68666 Eq Mass Sup Jud Ct (1957)
5. Minors as living solid organ donors;Ross;Pediatrics,2008
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献