The medical ethics of bone marrow transplantation in childhood

Bone marrow transplantation has been utilized for the treatment of severe aplastic anemia in a program at The Children's Hospital Medical Center. A protocol has been developed to help ensure that the interests and rightful claims of all involved parties will be taken into account. Three cases are presented. In one case all involved parties concurred with the plan for bone marrow transplantation. In a second case the prospective donor was deemed mentally incompetent to give truly informed consent for the procedure. In a third case the parents were unwilling to have their child undergo transplantation. The ethical issues raised in these cases suggest the need for further development of a moral technology to enhance decision-making competence and to aid in the recognition and application of the rights of children without impeding the advancement of pediatric medicine.