title: Pressure placed on paediatric haematopoietic stem cell donors: Views from health professionals.
abstract: OBJECTIVE
  Paediatric haematopoietic stem cell donors undergo non-therapeutic procedures and endure known and unknown physical and psychosocial risks for the benefit of a family member. One ethical concern is the risk that they may be pressured by parents or health professionals to act as a donor. This paper adds to what is known about this topic by presenting the views of health professionals.
  
  
  METHODS
  This qualitative study involved semi-structured interviews with 14 health professionals in Australasia experienced in dealing with paediatric donors. Transcripts were analysed using established qualitative methodologies.
  
  
  RESULTS
  Health professionals considered that some paediatric donors experience pressure to donate. Situations that were likely to increase the risk of pressure being placed on donors were identified, and views were expressed about the ethical 'appropriateness' of these practices within the family setting.
  
  
  CONCLUSIONS
  Children may be subject to pressure from family and health professionals to be tested and act as donors, Therefore, our ethical obligation to these children extends to implementing donor-focused processes - including independent health professionals and the appointment of a donor advocate - to assist in detecting and addressing instances of inappropriate pressure being placed on a child.
authors.affiliation: Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology, Brisbane, Queensland, Australia.|Law School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Shih-Ning
authors.initials: SN
authors.lastname: Then
mesh_terms: D044362:Australasia; D016026:Bone Marrow Transplantation / Q000941:ethics / Q000523:psychology*; D002648:Child; D003657:Decision Making; D006282:Health Personnel / Q000523:psychology*; D006412:Hematopoietic Stem Cells; D006801:Humans; D010290:Parents / Q000523:psychology*; D010372:Pediatrics; D036301:Qualitative Research; D014019:Tissue Donors / Q000941:ethics / Q000523:psychology*; D009927:Tissue and Organ Procurement
keywords: bone marrow transplantation; ethics; paediatrics; qualitative research; sibling