Contrary to their interpretation, Pentz and colleagues’ results support the American Academy of Pediatrics’ (AAP’s) recommendation that a donor advocate (or similar mechanism) be appointed for all minors who are being considered as hematopoietic stem cell donors. The primary role of the donor advocate is to help potential donors and their parents understand the donation process and to promote potential donors’ interests and well-being. The article describes a number of situations in which understanding could have been improved. Delaying or preventing donation is a secondary aspect of the advocate’s role, and the need to exercise this authority would not have been expected in such a small sample.

Pentz and colleagues’ article has several significant methodologic limitations. It is based on a secondary analysis of interviews conducted from 2007 to 2010, before the publication of the AAP’s policy statement. This limitation has broader implications than the authors acknowledge. In...

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