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8.3 - Topical discussion

Published online by Cambridge University Press:  18 August 2009

By
Lorry R. Frankel ,
Amnon Goldworth ,
Mary V. Rorty  and
William A. Silverman
Edited by
Lorry R. Frankel ,
Amnon Goldworth ,
Mary V. Rorty  and
William A. Silverman
Lorry R. Frankel
Affiliation:
M.D. Department of Pediatrics, Division of Gastroenterology, Lucile Packard Children's Hospital, Palo Alto, California 94304, USA
Amnon Goldworth
Affiliation:
Ph.D., Senior Medical Ethicist Lucile Packard Children's Hospital, Palo Alto, California 94304, USA
Mary V. Rorty
Affiliation:
Ph.D. Stanford University Center for Biomedical Ethics, 701 Welch Road, Suite 1105, Palo Alto, California 94304, USA
William A. Silverman
Affiliation:
M.D., Professor of Pediatrics (retired) Columbia University College of Physicians & Surgeons, New York 10032, USA
Lorry R. Frankel
Affiliation:
Stanford University, California
Amnon Goldworth
Affiliation:
Stanford University, California
Mary V. Rorty
Affiliation:
Stanford University, California
William A. Silverman
Affiliation:
Columbia University, New York
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Summary

Transplantation

Like the child in Dr. Burne's case (Chapter 7), the infant in Dr. Chin's case suffered from hypoplastic left heart syndrome. The main indication for cardiac transplantation in children under one year of age is congenital heart disease in more than 75% of those infants, and hypoplastic heart is at the top of the list. Overall survival in the pediatric age group after five years is approximately 65%; however, patients receiving transplants at younger than one year of age have a slightly lower survival rate (62%).

Some ethical dilemmas associated with donors and procurement of organs were briefly visited in Chapter 4. Some additional dilemmas associated with recipients and access to organs are raised in this chapter. The scarcity of organs in relation to the number of possible recipients involves considerations of distributive justice. Some of the most complex issues in transplantation ethics surround the distribution and allocation of organs that become available. The competing and sometimes incompatible principles driving allocation are fairness (allowing equal access to transplantation to as many as possible), efficiency (getting the most and best use possible out of the scarce resource), and need (allocating the organs on the basis of medical urgency). From the standpoint of the best utilization of a scarce resource, an available organ might best be transplanted to the candidate who will derive the greatest benefit, in terms such as number of life years extended or extent to which function is improved.

Type
Chapter
Information
Ethical Dilemmas in Pediatrics
Cases and Commentaries
 , pp. 185 - 189
Publisher: Cambridge University Press
Print publication year: 2005

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References

American Academy of Pediatrics. Policy statement: pediatric organ donation and transplantation. Pediatrics 109 (2002), 982–984
Brower, V.The ethics of innovation: should innovative surgery be exempt from clinical trials and regulations?EMBO Reports 4 (2003), 338–340CrossRefGoogle ScholarPubMed
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  • Topical discussion
    • By Lorry R. Frankel, M.D. Department of Pediatrics, Division of Gastroenterology, Lucile Packard Children's Hospital, Palo Alto, California 94304, USA, Amnon Goldworth, Ph.D., Senior Medical Ethicist Lucile Packard Children's Hospital, Palo Alto, California 94304, USA, Mary V. Rorty, Ph.D. Stanford University Center for Biomedical Ethics, 701 Welch Road, Suite 1105, Palo Alto, California 94304, USA, William A. Silverman, M.D., Professor of Pediatrics (retired) Columbia University College of Physicians & Surgeons, New York 10032, USA
  • Edited by Lorry R. Frankel, Stanford University, California, Amnon Goldworth, Stanford University, California, Mary V. Rorty, Stanford University, California, William A. Silverman, Columbia University, New York
  • Book: Ethical Dilemmas in Pediatrics
  • Online publication: 18 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545504.029
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Save book to Dropbox

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  • Topical discussion
    • By Lorry R. Frankel, M.D. Department of Pediatrics, Division of Gastroenterology, Lucile Packard Children's Hospital, Palo Alto, California 94304, USA, Amnon Goldworth, Ph.D., Senior Medical Ethicist Lucile Packard Children's Hospital, Palo Alto, California 94304, USA, Mary V. Rorty, Ph.D. Stanford University Center for Biomedical Ethics, 701 Welch Road, Suite 1105, Palo Alto, California 94304, USA, William A. Silverman, M.D., Professor of Pediatrics (retired) Columbia University College of Physicians & Surgeons, New York 10032, USA
  • Edited by Lorry R. Frankel, Stanford University, California, Amnon Goldworth, Stanford University, California, Mary V. Rorty, Stanford University, California, William A. Silverman, Columbia University, New York
  • Book: Ethical Dilemmas in Pediatrics
  • Online publication: 18 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545504.029
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Topical discussion
    • By Lorry R. Frankel, M.D. Department of Pediatrics, Division of Gastroenterology, Lucile Packard Children's Hospital, Palo Alto, California 94304, USA, Amnon Goldworth, Ph.D., Senior Medical Ethicist Lucile Packard Children's Hospital, Palo Alto, California 94304, USA, Mary V. Rorty, Ph.D. Stanford University Center for Biomedical Ethics, 701 Welch Road, Suite 1105, Palo Alto, California 94304, USA, William A. Silverman, M.D., Professor of Pediatrics (retired) Columbia University College of Physicians & Surgeons, New York 10032, USA
  • Edited by Lorry R. Frankel, Stanford University, California, Amnon Goldworth, Stanford University, California, Mary V. Rorty, Stanford University, California, William A. Silverman, Columbia University, New York
  • Book: Ethical Dilemmas in Pediatrics
  • Online publication: 18 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545504.029
Available formats
×