Risks and benefits of pediatric bone marrow donation: a critical need for research

Healthcare providers assume that there are minimal risks and potential psychosocial benefits for children who undergo a bone marrow harvest for the benefit of their critically ill siblings. Ethical justifications for the use of children as donors rely on there being minimal risks since donors receive no direct medical benefits from the intervention. There is little empirical research regarding psychosocial consequences. This article review relevant research in three contexts: a) psychosocial outcomes for adults and children who donate tissue and organs; b) psychosocial impacts on a sibling of a pediatric cancer patient; and c) children's decision-making regarding medical decisions. The relevant research literature supports the belief that the psychosocial impact on a child bone marrow donor will be influenced by the survival of the recipient, the age of the donor, and the donor's participation in the decision to donate. In order to empirically validate the actual psychosocial risks (and benefits) for donors, it is argued that direct research is needed so that a donor's well-being can be protected.