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S. Michael Mauer, MD; Arthur Caplan, MD; Thomas E. Nevins, MD; John S. Najarian, MD
University of Minnesota Minneapolis

JAMA. 1989;262(3):348.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor. —

In their commentary, Drs Reinhart and Kemph¹ express concern about the proportional benefit of renel transplantation in children. We agree that older children (6 to 7 years and older) should be included in the information and consent process and that their emerging autonomy must be respected. Unpleasant options including no active treatment, as well as the risks, costs, and inconveniences of all possible therapies, should be explored thoroughly. The lure of paternalism or unfair efforts to influence or limit the family's choices must be avoided. At the same time, the pediatrician must be the primary professional advocate for the patient and only secondarily for the family and society.

Unfortunately, the commentary by Drs Reinhart and Kemph is seriously inaccurate. While they pose an important question, it is placed in a 20-year-old time frame. Their references to the pediatric transplantation literature are out of date, most . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Deputy Editor (West).

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