Parental Decision Making: The Best Interest Principle, Child Autonomy, and Reasonableness

Area of Science:

• Bioethics
• Medical Ethics
• Child Welfare

Background:

• Evaluating the moral acceptability of parental medical decisions for children is complex.
• Johan Bester proposed a Best Interest Standard (BIS) to guide parental medical decision-making.

Purpose of the Study:

• To identify and address problems within Bester's version of the Best Interest Standard (BIS).
• To propose an improved framework for guiding parents' medical decisions for their children.

Main Methods:

• Critical analysis of Bester's Best Interest Standard (BIS).
• Examination of the standard's accommodation of child autonomy and assessment of parental reasoning.
• Proposal of an alternative framework based on established bioethical principles.

Main Results:

• Bester's BIS inadequately incorporates the child's autonomy.
• The criteria for assessing the reasonableness of parental arguments in Bester's BIS are too weak.
• Addressing these identified weaknesses renders Bester's BIS ineffective.

Conclusions:

• Bester's Best Interest Standard (BIS) should be replaced.
• A revised framework incorporating the principles of autonomy, beneficence, non-maleficence, and a standard of reasonableness is recommended for guiding parental medical decisions.