038 Experience of ethical issues among professionals working in paediatric transplantation – an international survey and multi-professional focus group. (December 2018)

• Record Type: Journal Article
• Authors: Hennessy, M
• Is Part Of: Archives of disease in childhood. Volume 103:Supplement 2(2018)
• Page Start: A15
• Page End: A16
• Publication Date: 2018-12
• Subjects: Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/goshabs.38
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Background: Professionals working in paediatric transplantation commonly encounter complex ethical dilemmas, which they are tasked with solving. If these dilemmas are not approached correctly both donors and recipients can be exposed to significant risks. Most ethical research in transplantation is focused on adult cases whilst paediatric ethical issues have not been systematically researched and discussed by the multi-professional community. This study is the first to identify the areas of practice in which ethical dilemmas may be encountered by paediatric transplant professionals and the types of issues most commonly experienced. Methods: This project consisted of two studies; the first being a questionnaire of 190 (80%) members of the International Pediatric Transplant Association (IPTA) from over 30 different countries. This survey identified ethical issues encountered by professionals within different areas of paediatric transplantation. The second study was a multidisciplinary focus group that explored the preliminary data from the survey. Results: 56 (38%) respondents from the international questionnaire had experienced an ethical dilemma between 2016–2018. Between 2016–2018, surgeons were more likely to have encountered an ethical issue compared to Physicians (60% vs 35.7%, p=0.035). Clinicians from Europe were more likely to have experienced an ethical issue in living organ donation compared to those from North America (78.9% vs 52.5%, p=0.005), with common themes of ethical concern relating to psychosocial evaluation, follow up care of donors and registering non-adherent patients on the waiting list. 100 respondents (69%) requested the development of ethical guidelines for specific issues whilst the focus group highlighted the importance of a shared approach. Conclusion: The results of this study will help direct future research into paediatric transplantation ethics with the aim of producing educational resources, policies and ethical guidelines.