Dimensions and Tensions of the Child’s Well-Being and Stem Cell Transplantation: A Conceptual Analysis

The concepts of the child’s well-being and the child’s best interests are both central to medical practice concerning children. Such concepts become particularly crucial when a healthy child becomes a stem cell donor for her sick sibling. The concept of the child’s well-being inheres a tension between her well-being and her will, her present and future well-being, and the child’s individual well-being and that of the family as a whole. In this essay, I first unfold some key juridical, ethical and philosophical aspects of the concept of the child’s well-being; second, I discuss decision making in the medical realm, asking about the characteristics of the child’s will, the tension generated between the child’s will and well-being, and the stages of decision-making; and third, I refer to the perspective of temporality, which shifts the tragic problem to an open field that can keep those affected (i.e. the donor child, the recipient, and last but not least the whole family) in communication with one another. The internal relationships of the child’s well-being need to be seen in the context of the whole family’s well-being.