Ethical Considerations of Children as Organ Donors Ethical dilemmas are defined as a situation that "…involves the need to choose from among two or more morally acceptable courses of action, when one choice prevents selecting the other; or, the need to choose between equally unacceptable alternatives (Hamric, Spross, and Hanson, 2000 cited in: A Framework for Resolving Ethical Dilemmas in Healthcare, 2003) Chasson writes that values and ethics have a relationship that is clear and that the mixture of these two can serve to create complications for the nurse and specifically that moral values "are evaluated in terms of positive or negative effects. If the choice between good or bad results is very clear, no confusion or ethical dilemma will ensue…" (nd, p.13) However, when the choice is not clear the moral choices are fraught with great difficulty. Recent studies have demonstrated that living donors are an increasingly important organ transplantation source however, there is a great deal of concern relating to the ethics concerning children as donors of those organs. Involved are various factors that include developmental factors. It is reported in the work of Ross and Thistlethwaite (2008) in the work entitled "Minors and Living Solid-Organ Donors" that solid-organ transplantation "has become standard treatment for a variety of diseases in children and adults." (p.1) The participation of minors as living organ donors is stated to raise ethical issues that are of a serious nature.

Emotional and Psychological Risks

Ethical issues include "potential psychological and emotional benefits" that may be experienced by the donor/child including the development of "greater self-esteem" however, the psychological risk involved must be considered as well. Stated for example is that children may fail to understand "the meaning of the lost body pat or the reason for...

1) In addition, it is reported that the child/donor "may experience guilt and blame if the transplant fails and/or the recipient dies." (Ross and Thistlethwaite, 2008, p. 1) Another risk is stated to be that of the "potential coercive nature of the request: how can children refuse when their parents are asking them to donate?" (Ross and Thistlethwaite, 2008, p. 1) However, there are also potential emotional and psychological risks when a child is barred from organ donation including blame by self or by others for the death of the family member if the child is not allowed to donate the organ.
Medical Risks

Ross and Thistlethwaite (2008) state that there are inherent medical risks involved in organ donation which include the risks of surgery and anesthesia and in fact, the calculated risk of mortality from donating a kidney is stated as "approximately 2 in 10000" and "up to 10-fold greater for a left lateral segment living liver donation." (Ross and Thistlethwaite, 2008, p.1) In fact, all donors are noted to experience acute pain with some developing chronic pain. (Ross and Thistlethwaite, 2008, p.1)

The Debate on Ethical Issues of Children Organ Donation

According to David Steinberg, there are many ethical considerations in the area of children organ donation and states that it is necessary to be wary of "Zinner's contention that some children are able to give informed consent because they possess advanced cognitive functioning." (2005, p.302) Steinberg notes that children are vulnerable and that the "difficult art of moral judgment challenges us to define when an unjustifiable act is permissible because of its utilitarian value." (2005, p.302) The work of Mark Sheldon entitled "Children as Organ Donors: a Persistent Ethical Issue" states that the question of the child as a kidney donor is one…