Abstract

Within three years of the first successful kidney transplant in the United States between adult identical twins (1954), physicians were in court getting permission to perform kidney transplants between minor identical twins (1957). In the 1970s and 1980s, at least two dozen additional cases involving donation from non-identical twin siblings as well as siblings with cognitive disabilities underwent judicial review. With some notable exceptions, the courts authorized the donations, usually on the grounds that it was in the best interest of both the donor and the recipient. There are data that show that children have also served as donors for other solid organs. In this chapter we examine the ethics of involving minors as living solid organ donors. Our position is that ethically children can serve as living solid organ donors only in very limited circumstances.