Paeds SAQs · pain-palliative-and-end-of-life-care
Organ and tissue donation in children — formative SAQs
Formative SAQs on organ and tissue donation in children covering definition, classification, bedside pathway, red flags, documentation and family support.
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Target exams
SAQ 1 (10)
A five-year-old sustains catastrophic traumatic brain injury. After optimisation, clinical examination suggests neurological death. The parents ask whether their child can help other children. [1] [2]
a) Define the core problem in one sentence and state the governing ethical standard. (3 marks) [1]
b) Outline the classification axes you would use and why they change management. (3 marks) [1] [2]
c) List the red flags that would force senior, ethics or court escalation. (2 marks) [1]
d) Document the key elements you would write in the clinical record after the family meeting. (2 marks) [2]
SAQ 2 (10)
The family remains uncertain and a junior colleague asks whether stopping a treatment already started is ethically worse than never starting it. A sibling is present and distressed. [1] [3]
a) Explain the ethical relationship between withholding and withdrawing life-sustaining treatment. (3 marks) [1]
b) Describe how you would structure shared decision-making so parents are not left to decide alone. (3 marks) [1] [2]
c) Outline immediate symptom-control priorities while the decision is being made. (2 marks) [2]
d) Describe age-adapted support for the sibling during this phase. (2 marks) [3]
References
- [1]Moynihan KM et al. Epidemiology of childhood death in Australian and New Zealand intensive care units. Intensive Care Med, 2019.PMID 31270578
- [2]Dopson S et al. Exploring nurses' knowledge, attitudes and feelings towards organ and tissue donation after circulatory death within the paediatric intensive care setting in the United Kingdom: A qualitative content analysis study. Intensive Crit Care Nurs, 2019.PMID 31350064
- [3]Lee LA et al. Organ Donation in Canadian PICUs: A Cross-Sectional Survey, 2021-2022. Pediatr Crit Care Med, 2024.PMID 37966310
- [4]Kramer AH et al. Missed Organ Donation Opportunities in Patients With Devastating Brain Injury: A Prospective Population-Based Cohort Study. Crit Care Med, 2026.PMID 41269058
- [5]Jarrah RJ et al. Developing a standard method for apnea testing in the determination of brain death for patients on venoarterial extracorporeal membrane oxygenation: a pediatric case series. Pediatr Crit Care Med, 2014.PMID 24201855
- [6]Weiss MJ et al. The Bucharest international European Society for Organ Transplantation consensus on paediatric controlled donation after circulatory determination of death. Transpl Int, 2026.PMID 42453307