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March 1994

Heart TransplantationOther Ethical Questions

Arch Pediatr Adolesc Med. 1994;148(3):321-322. doi:10.1001/archpedi.1994.02170030091020

IN 1975 I sat in a hospital cafeteria in awe as Dwight McGoon, a pioneer in congenital heart surgery, deftly drew a diagram on a paper napkin of the new circulatory path he would construct later that morning for an infant with a never-before-described cardiovascular abnormality. With his complex drawing completed he quietly observed, "Someday we will transplant a new heart into this type of patient." As the ads say, "That day is today," yet only a minuscule number of pediatric patients benefit from the magic of cardiac transplantation. Why then should pediatricians concern themselves with the nuances of pediatric heart transplantation, since many pediatricians will never see a patient who needs a transplant? The answer lies in the diverse social and ethical implications of the procedure. The microcosm of pediatric heart transplantation encompasses many of the ethical dilemmas that physicians and society struggle with daily, as well as some