Referral of pediatric oncology patients for marrow transplantation and the process of informed consent.
A survey of 24 pediatric oncologists from 21 institutions not performing bone marrow transplants found that 156 patients were referred for transplants in the years 1984/85; only 10 of these patients were not transplanted. No patient in good clinical condition whose disease was under control was denied transplantation after evaluation at a transplant center. The decision for transplantation was made by the families and the referring pediatric oncologists, almost always before the patient was seen at a transplant center. The fact that almost all patient and family evaluations at transplant centers take place after a family has decided to have a marrow transplant has obvious implications regarding informed consent. Referring pediatric oncologists must attempt to provide the best possible information to families when decisions regarding marrow transplantation are actually being made.
Chauvenet
A R
AR
Department of Pediatrics, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27103.
Smith
N M
NM
D016026:Bone Marrow Transplantation; D002648:Child; D004992:Ethics, Medical; D005544:Forecasting; D006801:Humans; D007258:Informed Consent; D009369:Neoplasms / Q000628:therapy*; D033282:Parental Consent; D018579:Patient Selection; D012017:Referral and Consultation; D018570:Risk Assessment; D011795:Surveys and Questionnaires