A critical discussion of living minors as tissue donors for transplantation purposes in England and Wales, and Scotland.

Hogg, Lindsey and Fovargue, Sara and Murphy, John (2021) A critical discussion of living minors as tissue donors for transplantation purposes in England and Wales, and Scotland. PhD thesis, Lancaster University.

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Abstract

This research explores the regulatory framework of living minors as tissue donors for transplantation purposes in England and Wales (under 18), and Scotland (under 16). My main argument is that this regulatory framework does not adequately protect the minor donor’s interests, therefore, it is in need of clarification and/or reform. When answering my research questions, listed below, I use relational autonomy and a new principle introduced in this thesis of relational parental decision-making to examine the relationships the minor donor has with others. First, should non-regenerative tissue donation from living minors be permitted in England and Wales, and Scotland? My contention is that non-regenerative tissue donation should not be permitted because the gravity of donating it and the irreversibility of the procedure suggests that no potential psychological benefits can outweigh the medical risks, psychological harm, and long-term implications. Secondly, who can and should provide consent/authorisation for living minors to be regenerative tissue donors? Those with parental responsibility (PR) can and should be able to provide consent/authorisation for an incompetent minor. If a minor is competent, they should be able to provide consent/authorisation on their own behalf, and those with PR and the court should not be permitted to override this decision. Thirdly, what test(s) should be used to determine whether consent/authorisation can be provided for a living minor to be a tissue donor? The best interests test should be reformed so the minor’s view and the harm principle are given greater weight, and the addition of relational parental decision-making. The Gillick and 2(4) competence tests should require a minor to understand the moral, family, emotional, and long-term implications, as well as the consequences if they refuse the donation. For those aged 16- and 17- year old, section 8 should be interpreted broadly to cover tissue donation.