The Ethics of Organ Transplants: The Current Debate

By Arthur L. Caplan; Daniel H. Coelho | Go to book overview
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7. The Use of Anencephalic
Neonates as Organ Donors

Council on Ethical and Judicial Affairs,
American Medical Association

Hundreds of children die each year of cardiac, hepatic, or renal failure because there are not enough hearts, livers, or kidneys available for transplantation from other children. Consequently, various measures have been considered over the years to increase the organ supply for pediatric transplantation. One approach that has received particular attention is the possibility of using organs from anencephalic neonates. 1,2,3 Because anencephalic neonates face a certain and generally imminent death and because they lack any degree of consciousness, many commentators have proposed that organs of anencephalic neonates be used for transplantation, and many parents of such neonates request that their child's organs be given to other children. Permitting such organ donation would allow some good to come from a truly tragic situation, sustaining the lives of other children and providing psychological relief for those parents who wish to give meaning to the short life of the anencephalic neonate. Indeed, two years ago, parents of an anencephalic neonate went before the Florida Supreme Court, seeking permission to donate their anencephalic child's organs. 4 However, under current law, which requires persons to be dead before their life-sustaining organs may be removed for transplantation, it is not possible to use the organs of anencephalic neonates. Accordingly, the Florida court denied the parents' request, and the use of organs from anencephalic neonates remains a matter of debate rather than practice.

In 1988, this Council examined the ethical issues surrounding the use of organs from anencephalic neonates and concluded that it is ethically acceptable to remove organs from anencephalic neonates only after they have died,

Originally published in JAMA 273, no. 20 ( May 24/31, 1995): 1614-18.


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