[To what extent do parents have the right to decide for their children?]

To review the hierarchy of bioethical principles when there are conflicting interests between the medical team and the child's parents in decision making in pediatrics. Our hypothesis is that when the parentś decisions can be questioned, they loose the right to decide for their children.

The case of a 9-year-old girl from a Jehova's Witness family is presented. She was a candidate for renal transplantation but her parents were against blood transfusion in case it was required. A member of the medical team presented a denounce to the hospital Medical Ethic Committee and asked for advice. Several materials were reviewed for the ethic aspects involved: the Bioethic Live Plus 1973-4/96, literature provided by people from Jehova's Witnesses, the chapters about ethics in the main pediatric text-books, a journal on Bioethics published by the Brazilian Federal Medical Board, and the Child and Adolescent Act (Brazilian Law 8,069 from January 13th, 1990).

The Committee's finding, based on ethic and legal aspects reviewed in the literature about similar cases, favors the beneficence principle under the justification of preserving life as an ultimate goal, and recommends the interference of the Children and Youth Court so that the patient's interest and greater benefits prevail. Nevertheless, it also recommends that the medical team should make every possible effort to avoid blood transfusion in order to respect this conception of life and protect the people who believe in it, in accordance with the fundamental principle of bioethics which postulates the respect for human dignity and autonomy of belief.