Between Death and Donation: Ethical Considerations in Pediatric Heart Transplantation
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In this chapter, I offer philosophical analyses of the problem of organ scarcity and the solutions that have been offered by some medical ethicists against the backdrop of a discussion of heart transplants in pediatric patients. The solution that I find most promising is that of “nudging.” By definition, “nudging” is the practice of encouraging families to donate the organs of their recently deceased loved ones. I find this solution to be interesting because, on the one hand, it can be used to address the problem of organ scarcity, and, on the other hand, more needs to be done to protect parents who are thinking about donating the organs of their recently deceased child from organ procurement agents who act in aggressive or excessive ways. I offer some refinements to the practice of nudging that are designed to protect parents from harm and allow hospitals to do good for their patients. I conclude that adherence to my suggestions will increase organ donation, remove problems with over-zealous organ procurement policies, and increase good will among all concerned.
KeywordsPediatric heart transplant Organ shortage Organ procurement Institutional nudging And interpersonal nudging
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