Regenerative tissue transplantation from children: legal protection, medical ethics and practice

Abstract

This thesis examines the position of children who donate regenerative tissue to potentially save the life of another. The great good that can come about through their participation is at the cost of the donor child undergoing physically invasive and unnecessary medical procedures. The non-therapeutic element of a child’s involvement brings about legal and ethical issues that are the subject of this thesis. The central aim of this thesis is to determine if Australian child donors are treated appropriately and are sufficiently protected in acting as tissue donors, and whether a new regulatory response is needed for their benefit. The research engages with the ethical literature and legal analysis, and complements these theoretical perspectives with a qualitative analysis of interviews with medical professionals who are experienced in dealing with child donors. This research demonstrates that domestic regulation – in the form of law and professional guidelines – has had little influence on how donor children are treated in clinical practice. Until recently, the practical safeguards offered to protect donor children from physical and psychological harm also varied between hospitals and were often limited in nature. However, there has been a recent trend towards improved, standardised care for Australian donor children due, primarily, to a desire to conform to international accreditation standards. Two conclusions are reached: first, donor children have, to date, not been sufficiently protected – either theoretically in law or practically through consistent national treatment; and, second, existing domestic regulation has failed to effectively regulate this area. I recommend implementing a new domestic regulatory response to benefit Australian donor children. There is a need to provide donor children with more attention, to listen to them more and for them to be consistently treated around the country. To achieve this, engagement with the medical profession is essential.