Ethical Issues Raised by the Media Portrayal of Adolescent Transplant Refusals.
Pediatrics
; 146(Suppl 1): S33-S41, 2020 08.
Article
em En
| MEDLINE
| ID: mdl-32737230
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transplante de Órgãos
/
Recusa do Paciente ao Tratamento
/
Temas Bioéticos
/
Consentimento dos Pais
/
Meios de Comunicação de Massa
Tipo de estudo:
Prognostic_studies
Aspecto:
Ethics
/
Patient_preference
Limite:
Adolescent
/
Female
/
Humans
/
Male
País/Região como assunto:
America do norte
/
Europa
Idioma:
En
Revista:
Pediatrics
Ano de publicação:
2020
Tipo de documento:
Article