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Conceptual challenges to the harm threshold.

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The harm threshold and Mill's harm principle.

Maggie Taylor¹

¹Center for Healthcare Ethics, Cedars Sinai Medical Center, 116 N Robertson Blvd, Suite 900D, Los Angeles, CA, 90048, USA. maggie.taylor@cshs.org.

Theoretical Medicine and Bioethics

|November 18, 2023

Summary

The Harm Threshold (HT) for state intervention in parental medical decisions is re-evaluated. John Stuart Mill's philosophy suggests intervention should focus on parental duty violations, not just harm severity.

Keywords:

Medical decision-making for children Parental duties State intervention in the family The harm principle The harm threshold

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Area of Science:

Bioethics
Political Philosophy
Medical Law

Background:

The Harm Threshold (HT) permits state intervention in parental medical decisions only if serious harm to the child is likely.
This standard is debated for its adequacy in balancing parental rights and child welfare.

Purpose of the Study:

To assess the theoretical basis of the Harm Threshold, particularly its grounding in John Stuart Mill's Harm Principle.
To propose an alternative intervention principle based on Mill's ethical theory.

Main Methods:

Text-based analysis of John Stuart Mill's philosophical works.
Conceptual assessment of the Harm Principle's application to pediatric medical decision-making.

Main Results:

Mill's Harm Principle does not adequately justify the Harm Threshold.
State intervention justification stems from the violation of parental duty, not solely the degree of harm.
Mill's texts support a less laissez-faire approach than interpreted by HT proponents.

Conclusions:

The Harm Threshold's interpretation of Mill is challenged.
Parental liberty's protected domain is weakened.
A Mill-grounded pediatric intervention principle should focus on the nature of harm (duty violation) rather than its severity.