(openPR) - The field of organ transplantation is at its most poignant when a child dies in circumstances where he/she may be considered a potential donor. Undeniably the death of a child is one of the most distressing of bereavements as parents naturally expect to outlive their children. Marion J. Sibelink and colleagues (Medical Center Groningen/NL) analyzed key issues that needed to be resolved to enhance the probability of the best parental decision-making about paediatric organ donation.

The factors that appeared to contribute to a negative donation decision are the following:
- the short period of time from having a child in a good health to death
- unrealistic expectations of resuscitation
- no opportunity to see the deceased child and grieve over the death
- lack of knowledge about the donation process and no information about the procedure for an autopsy
- inappropriate timing of organ request
- insensitive request for organ donation that was perceived as an attack
- inappropriate approach by professionals who made the request
- no opportunity for discussions with family members
- parents´ need to keep the child whole and intact

Some families report consolation in being associated with a donor who they regard as a hero; whose remarkable achievement leaves a profound and poignant legacy of life, which can ripple out far beyond the recipient, their family and community. Such an association may affirm the status and worth of the bereaved and atone for their sacrifice. Likewise, some families report that the donation helped them to cope by giving meaning to death. Not offering the choice of donation to parents could therefore be considered unethical, Sibelink and colleagues remark.


M.J. Sipelink, T.C. Bellali, M.R.G. Sque, B.J.J.M. Haase-Kromwijk: Children as Donors: Issues for Parents and Professionals. In: W. Weimar, M.A. Bos, J.J.V. Busschbach (Eds.) Organ Transplantation: Ethical, Legal and Psychosocial Aspects. Pabst, Lengerich/Berlin 2011, 432 pages, ISBN 978-3-89967-639-6

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