From: Roland, Roth
Email: rolnroth@pacbell.net
Course: Child Development 169: Motivating Children and Adolescents in Educational
Settings
College: San Jose State University
Instructor: Dr. Eugene Matusov
ClassWeb: http://www.ematusov.com/CD169/
ChildrenObservations: No
Date: 30 May 1997
Time: 15:54:06
Remote Name: ppp-206-170-2-196.sntc01.pacbell.net
This paper looks to cover many issues regarding children and organ transplants. Personally, no one in my family within the last three generations has received an organ transplant. My father recently had heart bypass surgery, but except for this operation, no one in my family has had any major surgery, let alone an organ transplant. "Pediatrics, like adult medicine, has experienced a revolution in organ transplants in the past decade. Liver, heart, and kidney transplants have become common rather than experimental procedures, with survival figures similar to those seen in adults (Stuber, 1993)." With the continued success rates of organ transplants in children, continued success for organ receivers is sure to be seen. Adolescents are given special psychological treatment before and after the transplant. ³This treatment is very different from the pre- and post-operation counseling that adult patients get,² says Rodrigues, Green, & Boggs (1994). Children must be told about possible side effects that may occur with the operation. ³The difficulty in telling a child their life strands are not yet taught is often traumatizing for the child. Still, the rage and debate lives on. Although it primarily is escalated when dealing with rock stars that drink their livers to extinction, the debate becomes a lot more mute when children and their need for organs comes into play. Save the children, Dr. Hennesy, donate that prostate!
A young father just witnessed the most horrific event of his life: his 6-year-old son, the pride and joy of his life, has been hit by a car while playing outside in the street. Everything is happening so fast: His son gets hit by the speeding car. The ambulance is coming. The ambulance people are taking the child to the hospital. The doctor says there is minimal chance of survival, and that if the child does survive, he will probably be a vegetable for the rest of their life. Just when the world has completely crashed, just when everything that his life has meant in the past seven years is crushed, the doctor calmly asks:
"How do you feel about taking your child off life support and donating his organs to waiting and needing children down the hall?"
This scenario is played over and over every day across America. The answers vary the gamut from, "Yes, take any organs," to "Take them all but his heart," to "No, take no organs." The issue of organ transplants is to some an ethical one, to others a religious one, and to others a practical one.
This paper looks to cover many issues regarding children and organ transplants. Personally, no one in my family within the last three generations has received an organ transplant. My father recently had heart bypass surgery, but except for this operation, no one in my family has had any major surgery, let alone an organ transplant.
In my opinion, organ transplants are a good thing. Extending a personıs life, especially if they are young, is an opportunity that society should never overlook. I think the idea of saving someoneıs life with a part of someone who is dying is quite incredible. To the best of my knowledge, all the members of my family, from my grandparents on down, have the donor sticker on their driverıs license. What is interesting is that Judaism, which my family practices, does not allow for organ transplants. Except for the eye and liver, Judaism forbids the donation or transplant of human organs, yet we are all registered donors.
Organ transplants give children a second lease on life, the ability to grow up as human beings. Except for rare cases, people do not choose or cause reason for the need of an organ. Some argue that it is not oneıs place to interfere with Godıs work and claim having a transplant would be that interference. I disagree. If God is the peaceful One that everyone claims to be, why would He be upset if someone tries to better and extend their lives?
Often the need for a transplant in an adult is difficult to come by, but for children, it is even more difficult. For young children, whose body size limits donors to other children, the size of the potential donor pool is particularly true (Stuber, 1993). Although transplants have been performed in adults for some time, transplants in the field of Pediatrics have occurred in such numbers much later than for adults.
"Pediatrics, like adult medicine, has experienced a revolution in organ transplants in the past decade. Liver, heart, and kidney transplants have become common rather than experimental procedures, with survival figures similar to those seen in adults (Stuber, 1993)." With the continued success rates of organ transplants in children, continued success for organ receivers is sure to be seen.
Unlike some famous cases of rock stars getting new livers after killing their original one with alcohol, ³The majority of pediatric transplants are done for conditions that are either congenital or began very early in life (Singer, 1989).² These children are not drinking booze, requiring a new liver, nor are they smoking packs and packs of cigarettes, requiring a new lung. They simply had bad luck or exposure to some substance either pre-natal or during their short lives that resulted in this predicament. They should not have to suffer. This is why the argument against giving organs to those who abused their current system does not wash with children. But it is not just hearts and livers that can be transplanted. Bone marrow is a very common transplant that is often overlooked in the organ transplant debate.
³Bone marrow transplant (BMT) is the last resort for children with leukemia for whom conventional treatments have failed,² say Dobkin, Poirier, & Bonny (1995). The main difference in BMT is the donor does not have to be dying for the operation to occur. Anyone can be a bone marrow donor, and the American Red Cross has a database of registered possible donors. Even though it is not life-threatening for the donor, ³BMT, like other organ transplants, is clearly a demanding procedure for the patient, the family, and [the] staff,² conclude Dobkin, Poirier, & Bonny (1995).
What is the effect on the children before, during and after a donation is made to them? That is exactly what Zamberlan (1992) researched and compiled. In terms of general health, Zamberlan found ³all the children reported improvements in health, noting they had Œbeen goodı or Œfairly healthyı since the transplant.² Even though one might figure that some may not feel much better because of the operation, all felt the transplant was positive and productive.
In todayıs transplants, the person receiving the organ has much say with what happens. Never before has this been the case with children and their transplants until today. An important difference between pediatric and adult transplant patients is the person who makes the transplant decision. ³The input a child has in a medical decision varies with the childıs age and maturational level (Stuber, 1993). While the parents give the legal consent for their childıs organ transplant, the child of today is generally expected and encouraged to give assent to the decision.
Transplant teams now feel it is extremely risky, if not pointless, to perform a transplant on an adolescent who does not want it, mainly because of the likelihood that they will not take proper after-surgery care. While many see the post-operation room life as relatively normal, nothing could be further from the truth. The child will have to take medication to prevent organ rejection as well as get general check ups more frequently than non-organ needed adolescents.
Because of a lack of donors, the waiting list can be quite long, with many children dying before they can be found a match. ³The wait can be brief or quite prolonged. It is always a stressful time for the child and family, now aware in a concrete way that transplantation offers life, but still waiting for it to finally happen (Morton, Reynolds, Garralda, Postlethwaite, & Goh, 1993).
The effect of an organ donation is quite clear. The knowledge that life is still an option for a dying child gives that child and their family hope for the future. Sure, the number of people in the world will grow faster for every person that does not die because of an illness resulting in an organ donation, but the sheer number of donations is so minuscule that it is insignificant. With current scienceıs discoveries in the field of genetics, the day of cloning ever present, and artificial organs not far away, Earth may soon find the need for donor organs unnecessary.
Yet with all the positive feedback regarding the success of organ donations, the procedures are far from perfect. Not all operations are successful. As one young girl put it, ³As I waited in the hospital for two weeks before a match was found, two kids on my floor died either during the operation or because of a serious rejection shortly after. That really scared me going into my liver transplant operation (Zamberlan, 1993).²
Adolescents are given special psychological treatment before and after the transplant. ³This treatment is very different from the pre- and post-operation counseling that adult patients get,² says Rodrigues, Green, & Boggs (1994). Children must be told about possible side effects that may occur with the operation. ³The difficulty in telling a child their life strands are not yet taught is often traumatizing for the child.
Regardless of whether or not a needy child receives the opportunity to get a donor organ, the issue to me is quite simple: if science can save the child's life, save the child's life. If the child can be saved, I don't give a damn about world population explosion and the need to keep it down. I don't care about the religious dillema of "if God wanted the child to live past five, He'd of given him a good heart." That's all a bunch of bull honkey in my corner.
Still, the rage and debate lives on. Although it primarily is escalated when dealing with rock stars that drink their livers to extinction, the debate becomes a lot more mute when children and their need for organs comes into play. Save the children, Dr. Hennesy, donate that prostate! References Dobkin, P. L., Poirier, R. M., & Bonny, Y. (1995). Family factors affecting bone marrow transplantation: A case report. Psychotherapy and Psychosomatics, 64 (2), 102-108.
Hobbs, S. A. & Sexton, S. B. (1993). Cognitive development and learning in the pediatric organ transplant recipient. Journal of Learning Disabilities, 26 (2), 104-113.
Morton, M. J. S., Reynolds, J. M., Garralda, M. E., & Postlethwaite, R. J. (1994). Psychiatric adjustment in end-stage renal disease: A follow up study of former pediatric patients.
Pinard, L., & Minde, K. (1991). The infant psychiatrist and the transplant team. Special Issue: Childn and adolescent psychiatry. Canadian Journal of Psychiatry, 36 (6), 442-446.
Rudman, L. A., et. al. (1995). My transplant is my life: Compliance status as a moderator of differential susceptability to item context efforts. Personality and Social Psychology Bulletin, 21 (4), 140-148.
Stewart, S. M., Silver, C. H., Nici, J., Walker, D. (1993). Neuropsychological function in young children who have undergone liver transplants. Journal of Pediatric Psychology, 16 (5), 569-583.
Stuber, M. L. (1993). Psychiatric aspects of organ transplantation in children and adolescents. Psychosomatics, 34 (5), 379-387.
Zamberlan, K. W. (1992). Quality of life in school-age children following liver transplantation. Maternal Child Nursing Journal, 20 (3-4), 167-228.