How Young Is Too Young to Be a Living Donor?
How Young Is Too Young to Be a Living Donor?
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DOI：
10.1111/ajt.12307
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发表时间：
2013-07-01
影响因子：
8.8
通讯作者：
Grant, D.
中科院分区：
文献类型：
--
作者：
Campbell, M.;Wright, L.;Grant, D.
评估希望成为活体器官捐献者（LDs）的青少年和成年早期的人提供了独特的挑战。在加拿大的几个省份，16岁可以合法同意活体器官捐赠。虽然世界卫生组织指出，青春期大致相当于10-19岁，但与判断有关的大脑部分继续发展到25岁左右。因此，一些年轻人在判断手术益处和风险的能力完全成熟之前，在法律上可以捐献器官。潜在的年轻活体捐赠者（YLD）可能在经济上和/或心理上依赖于他们的接受者（例如父母），这可能难以确定YLD的捐赠是否是自愿的。本文提出了管理使用年轻人作为LD的三个伦理挑战的方法：（1）确定YLD对活体器官捐赠后果的理解能力，（2）确定YLD的捐赠是否是自愿的，（3）评估YLD独特的风险和收益。我们的结论是，有令人信服的道德理由提供活体捐赠的机会，以选定的年轻人。一个彻底和公平的评估过程可以解决与YLD相关的社会，情感和发展问题。
Assessing people in adolescence and early adulthood who wish to become living organ donors (LDs) provides unique challenges. In several Canadian provinces, 16-year-old can legally consent to living organ donation. While the World Health Organization states that adolescence corresponds roughly to the ages of 10-19 years, parts of the brain associated with judgment continue to develop into the mid-20s. Therefore, it is legally possible for some young people to donate organs before their capacity to judge the benefits and risks of surgery has fully matured. Potential young living donors (YLDs) may be financially and/or psychologically dependent on their recipients (e.g. parents), which can make it difficult to determine if the YLD's donation is voluntary. This paper suggests ways to manage three ethical challenges in the use of young people as LDs: (1) determining the YLD's ability to appreciate the consequences of living organ donation, (2) determining whether the YLD's donation is voluntary and (3) evaluating the unique risks and benefits to the YLD. We conclude that there are compelling ethical reasons to offer the opportunity of living donation to selected young people. A thorough and fair evaluation process can address social, emotional and developmental issues associated with YLDs.