Paeds Vivas · pain-palliative-and-end-of-life-care
Organ and tissue donation in children — branching viva
Branching viva on organ and tissue donation in children: definition and ethical standard, classification, stepwise plan, contested escalation, and family or sibling support.
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Target exams
Opening question
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. Give the one-sentence definition and the governing ethical standard. [1]
Branch 1 — classification and red flags
Classify the situation using the major axes for this topic and name the red flags that force escalation. [1][2]
Branch 2 — stepwise shared decision-making
Walk through the bedside pathway from recognition to a documented plan, including how you make a recommendation rather than an open menu. [1]
Branch 3 — contested disagreement
The family disagrees with the team. Outline second opinion, clinical ethics and court pathways while continuing comfort care. [1][2]
Branch 4 — family and sibling support
Explain how you support parents and siblings through the decision and into bereavement care. [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