Efrat Lelkes, MD, Angira Patel, MD, MPH, Anna Joong, MD, and Jeffrey G. Gossett, MD
Current policy requires separate informed consent for some Public Health Service increased-risk donors, and this can make shared decision making harder.
AMA J Ethics. 2020;22(5):E401-407. doi:
10.1001/amajethics.2020.401.
Trauma-informed care ensures ethical treatment for children experiencing physical or psychological distress associated with a medical event or procedure.
AMA J Ethics. 2017;19(8):793-801. doi:
10.1001/journalofethics.2017.19.8.pfor1-1708.
We really can't promise both more transplants and better outcomes. The controversies over organ allocation really represent intellectual exhaustion in the face of a long series of inadequate policy responses to the decade-long trend of the kidney supply increasing only at the expense of organ quality and patient outcomes.
Specific advocate guidelines are needed for the protection of children in state custody who are potential research subjects in trials that would expose them to greater-than-minimal risk but also hold the prospect of direct benefit.