Page 69 - 《南京医科大学学报（社会科学版）》2026年第1期

第1期 总第132期 南京医科大学学报（社会科学版）京医科大学学报（社会科学版） ·
南
2026年2月 Journal of Nanjing Medical University（Social Sciences）of Nanjing Medical University（Social Sciences） · 63
Journal

Critical reflections on the protection of legal interests in minor organ

donation: a comparative study between China and the United States

LI Zhenkang
School of Civil and Commercial Law，Southwest University of Political Science and Law，Chongqing 401120，China
Abstract：China faces a pronounced imbalance between the supply of and demand for organ transplantation，
while the legal and ethical tensions become even more acute when organ donation involves minors. The current
legal framework prohibits living organ donation by minors and strictly restricts guardians from being the proxy
for post ⁃ mortem organ donation. However，in contexts such as being the only compatible match among
immediate family members and when a minor’s genuine wishes are difficult to express，the existing system
insufficiently addresses practical medical challenges. Adopting a comparative law perspective，this paper
systematically reviews U.S. case law on organ donation involving minors. From the“substituted judgment”
doctrine articulated in Strunk v. Strunk to the“best interests”standard developed in Curran v. Bosze，U.S. judicial
practice has gradually shaped a dual⁃layered safeguard system that integrates substantive review with procedural
control. Drawing on the valuable U.S. experience while remaining grounded in China’s national context，this
paper proposes three avenues for improving the existing regime: refining informed consent mechanisms，

strengthening procedural justice，and standardizing privacy governance and protection，aims to achieve a
dynamic balance between life⁃saving needs and the protection of minors’rights and interests within a strict rule⁃
of⁃law framework.
Key words：minors；organ donation；best interests standard；procedural justice