The UK adopted the opt-out system (deemed or presumed consent) in end-of-life organ donation enforceable in May 2020. Presumed consent applies to adults but not children. Transplant advocates have recommended that all children on end-of-life care should be referred for potential organ donation to increase the supply of transplantable organs in the UK. To buttress this objective, a UK survey of parents of deceased children mostly with neurologic disorders secondary to severe brain injuries recommended the integration of routine parental discussion of donation regardless of donation eligibility in end-of-life care. Donation discussions emphasize the utility and suitability of organs in dying children for transplantation to maximize consent rate. To ensure that this recommendation does not harm children and parents, contemporary medical, legal, cultural, and religious challenges to end-of-life organ donation should be disclosed in parental discussion of donation and resolved appropriately. To that effect, it is urged that: (1) practice guidelines for the diagnosis and treatment of neurologic disorders secondary to severe brain injuries in children are updated and aligned with recent advances in neuroscience to eliminate potential errors from premature treatment discontinuation and/or incorrect diagnosis of death by brain(stem) criteria, (2) transparent and non-biased disclosure of all empiric information when discussing donation to ensure informed parental decision-making, and (3) a societal dialogue is conducted on the legal, cultural, and religious consequences of integration of routine donation discussion and referral in end-of-life care of children in the UK.

中文翻译：

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在英国将器官捐赠的常规父母要求整合到患有神经系统疾病的儿童的临终关怀中：未解决的医学、法律、文化和宗教挑战。

英国在 2020 年 5 月实施的临终器官捐赠中采用了退出系统（视为或推定同意）。推定同意适用于成人，但不适用于儿童。移植倡导者建议应将所有接受临终关怀的儿童转介进行潜在的器官捐赠，以增加英国可移植器官的供应。为了支持这一目标，英国一项针对大多数患有继发于严重脑损伤的神经系统疾病的已故儿童父母的调查建议将父母对捐赠的常规讨论纳入临终关怀中，而不管捐赠资格如何。捐赠讨论强调器官在垂死儿童移植中的效用​​和适用性，以最大限度地提高同意率。为确保该建议不会伤害儿童和父母，当代医学、法律、应在父母讨论捐赠时披露对临终器官捐赠的文化和宗教挑战，并适当解决。为此，敦促：(1) 更新儿童严重脑损伤继发神经系统疾病的诊断和治疗实践指南，并与神经科学的最新进展保持一致，以消除过早停止治疗和/或不正确治疗的潜在错误通过脑（干）标准诊断死亡，（2）在讨论捐赠时透明和无偏见地披露所有经验信息，以确保父母做出知情决策，以及（3）就法律、文化和在英国儿童临终关怀中纳入常规捐赠讨论和转诊的宗教后果。应在父母讨论捐赠时披露对临终器官捐赠的宗教挑战并妥善解决。为此，敦促：(1) 更新儿童严重脑损伤继发神经系统疾病的诊断和治疗实践指南，并与神经科学的最新进展保持一致，以消除过早停止治疗和/或不正确治疗的潜在错误通过脑（干）标准诊断死亡，（2）在讨论捐赠时透明和无偏见地披露所有经验信息，以确保父母做出知情决策，以及（3）就法律、文化和在英国儿童临终关怀中纳入常规捐赠讨论和转诊的宗教后果。应在父母讨论捐赠时披露对临终器官捐赠的宗教挑战并妥善解决。为此，敦促：(1) 更新儿童严重脑损伤继发神经系统疾病的诊断和治疗实践指南，并与神经科学的最新进展保持一致，以消除过早停止治疗和/或不正确治疗的潜在错误通过脑（干）标准诊断死亡，（2）在讨论捐赠时透明和无偏见地披露所有经验信息，以确保父母做出知情决策，以及（3）就法律、文化和在英国儿童临终关怀中纳入常规捐赠讨论和转诊的宗教后果。