Neonatal liver cell donation: a case report.

Traditional organ transplant options for newborns have been rare. There continues to be an increasing need for organs for transplant and a limited number of available organs, especially for small children. Liver cell transplantation is a promising alternative to orthotopic liver transplantation to treat liver-based inborn errors of metabolism.1 The procedure is minimally invasive and can be performed repeatedly. The safety of the procedure has been well established, and the clinical results are encouraging.1 The liver cell donation process is an option for families who experience the loss of a newborn and offers them a legacy for their child by providing life for others. The purpose of this article is to discuss the neonatal liver cell donation process and present a case report of an anencephalic infant whose parents chose to participate in this unique program.

Stress and distress in pediatric nurses: lessons from Baby K.

BACKGROUND: Nurses experience stress and suffering when they care for critically ill and dying patients. Moral distress occurs when nurses are unable to translate their moral choices into moral action. In response to this stress, nurses may experience burnout. OBJECTIVE: To investigate the attitudes and perceptions of the nurses who were ordered by the court to provide long-term care for Baby K, a female child with anencephaly. METHOD: A questionnaire was developed to provide descriptive insight into the stress and distress the nurses experienced while caring for Baby K. RESULTS: Nurses caring for Baby K experienced stress and suffering. Although they felt supported and respected as nurses in their workplace, they felt conflict with the legal system. To compensate for feelings of powerlessness, the nurses simply put on a professional face and continued to provide care. They feared making mistakes, many felt guilty and angry, and all felt that they were not included in decision making. CONCLUSIONS: (1) Suffering among caregivers occurs and must be recognized, (2) measures must be taken to reduce the stress and distress of healthcare professionals as they provide care to patients who cannot recover, and (3) in addition to these measures, society must provide guidance to healthcare professionals, especially concerning the care of patients who are permanently unconscious.

The baby K case: ethical challenges of preserving professional integrity.

Caring for Baby K, an infant born with anencephaly, created moral distress and violated the integrity of some nurses. This article explores the nature of professional nurses' claims of violations of their integrity, argues for a broader moral framework for examining such dilemmas, and suggests strategies for addressing these issues in the clinical setting.

Nurses' experience caring for anencephalic infants who are potential organ donors.

A descriptive study explored the experience, attitudes, and concerns of 75 nurses who gave direct care to anencephalic infants in a program of potential organ donors. One ethical issue for a majority of nurses was concern about whether the program allowed dignity for the life of the infant. Other concerns were whether the infants felt pain, and the infants' physiological responses.

Ethical issues in organ retrieval from anencephalic infants.

A number of ethical issues have been created by the possibility of transplanting organs from anencephalic infants to other children who need an organ in order to live. The issues of moral justification of the practice, adequacy of informed consent procedures involved, and the potential constraints on female integrity are explored and the relevant arguments for and against transplantation efforts are discussed. Nurses are encouraged to become knowledgeable about the issues and to enter into public discussion of the issues as policy initiatives are proposed.