Pediatric priority in kidney allocation: challenging its acceptability.
Any organ which is allocated to one individual represents a missed opportunity for someone else. Given the important repercussions which organ allocation policies inevitably have for certain people, any prioritization policy should rest on a solid argumentative basis. In this study, we analyze the widespread practice of prioritizing pediatric patients in the allocation of kidneys. While official policy documents offer no arguments in support of pediatric priority, such arguments can be found in the academic literature on pediatric renal transplantation. Our study is the first to bring together and critically analyze these. We identify five commonly cited arguments and show that none of these succeeds in justifying pediatric priority policies. We argue that the legitimacy of such policies may be further undermined by their potential adverse effects on both adults and children.
Bioethics Institute Ghent, Ghent University, Ghent, Belgium.
Laura
L
Capitaine
Kristof
K
Van Assche
Guido
G
Pennings
Sigrid
S
Sterckx
D000328:Adult; D000367:Age Factors; D002648:Child; D004608:Eligibility Determination; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000941:ethics* / Q000401:mortality / Q000706:statistics & numerical data; D019520:Living Donors / Q000941:ethics / Q000706:statistics & numerical data; D008297:Male; D010372:Pediatrics; D011050:Policy Making; D019057:Quality-Adjusted Life Years; D040841:Resource Allocation; D018570:Risk Assessment; D015996:Survival Rate; D009927:Tissue and Organ Procurement / Q000941:ethics* / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014850:Waiting Lists
allocation; kidney transplantation; pediatric; policy