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Time for legal, ethical and cultural change in paediatric organ donation

8 September 2011
Drs Joe Brierley and Vic Larcher of Great Ormond Street Hospital co-author paper, which calls for review of current situation across Europe.
Authors of a paper published in the September issue of Acta Paediatrica argue that many parents of children who are dying are not provided with adequate opportunities to consent to donate their child’s organs, if they so wish.

Drs Brierley and Larcher say because of discrepancies, both between and within European countries, donation opportunities are not maximised, and conclude it is time for legal, cultural and ethical change across Europe.

They believe change would allow parents, families and even children more choice, and call for a uniform approach to organ donation across different centres.

Key findings of the paper include:

  • A call for discussion around whether competent children should be able to consent to ‘living donation’, if the potential recipient’s life depends on it
  • A call for discrepancies across Europe to be ironed out – to encourage a uniform approach which helps families to make decisions
  • There are complex issues around how to maintain potential organs in optimal condition, while respecting the fact a child has just died or is dying. Techniques and organisation should be explored, balanced with families wishes and ethical considerations
  • Organ donations from children born without the frontal section of the brain (anecephalic babies) have not been carried out in Europe for many years. The UK deems such transplants would be legally acceptable and this clinical and ethical issues around this type of donation should be explored

Dr Joe Brierley, consultant paediatric intensivist and lead author said:

“Medical advances in children’s intensive care mean that many more lives are being saved than was previously the case.  At the same time, positive improvements in road safety mean that fewer organs are available from children involved in road traffic accidents, because fewer accidents occur.

“Changes across Europe to bring a uniform approach to organ donation would, we believe, make the process much clearer and transparent for parents and families at what is a tragic time for them.

“It is absolutely vital that any attempt to increase organ donation rates should not compromise respect for human life, or a patient’s right to excellent palliative or intensive care.”

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Notes to editors

Article reference: Brierley J, Larcher V, Organ donation from children: time for legal, ethical and cultural change, Acta Paediatrica 2011. 100. p1175-1179

Dr Joe Brierley is a consultant paediatric intensivist at Great Ormond Street Hospital. He is also the Trust’s clinical lead for organ donation. Dr Vic Larcher is a consultant in general paediatrics and ethics at Great Ormond Street Hospita

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