The development of medical therapies and technologies means that children who would once have died when they suffer organ system failure now often survive. However, a proportion do not return to normal health, but have persisting chronic organ dysfunction. Other children remain in severe organ failure, but the technologies maintaining them have developed to a state where children with irreversible vital organ failure can be kept alive. Both groups can benefit from organ transplantation - which can, therefore, be described as either life-saving or life-transforming.
Paradoxically, improvements in medical care detailed above - in combination with measures such as seatbelts and motor-vehicle speed restrictions– has lead to a decrease in deaths from severe traumatic brain injury - the commonest situation in which child-size organs are procured for transplantation.
UK organ donation initiatives have ignored children to date (OK so generic improvements might help somewhat) Donation rates remain low – many ICUs do not facilitate child-donation, parents often refuse and in small infants UK guidelines uniquely prevent donation unlike elsewhere.
This dissertation aims to explore ethical and legal issues in child organ donation and to develop a set of practical recommendations, akin to the Organ Donor Task Force.