Parental Medical Decision Making: In Whose Best Interest?

I indicated in my last post that the in evaluating the ethics of the parental medical decision-making scenarios I presented, the goal would be in terms of the best interest with regard to the child patient. However, this goal may not be the most realistic and most just in this situation.

A 1985 article in the Journal of Medical Philosophy (vol. 10, nr 1, pages 45-61 ) titled ”Parental discretion and children's rights: background and implications for medical decision-making.” by F. Schoeman raises the issue of in whose best interest should parental decision making for their children be considered appropriate by law and society—only that of the child involved or of the child, parents and the family as a whole. The abstract of the paper is as follows:

”This paper argues that liberal tenets that justify intervention to promote the welfare of an incompetent do not suffice as a basis for analyzing parent-child relationships, and that this inadequacy is the basis for many of the problems that arise when thinking about the state's role in resolving family conflicts, particularly when monitoring parental discretion in medical decision-making on behalf of a child. The state may be limited by the best interest criterion when dealing with children, but parents are not. The state's relation with the child is formal while the parental relation is intimate, having its own goals and purposes. While the liberal canons insist on the incompetent one's best interest, parents are permitted to compromise the child's interest for ends related to these familial goals and purposes. Parents decisions should be supervened, in general, only if it can be shown that no responsible mode of thinking warrants such treatment of a child.”

Do you agree that parents who make medical decisions for their child also have the responsibility to consider the decision in terms of their entire family and not solely in what is in their sick child's best interest? How should possible conflicts of interest in this situation be evaluated and handled? ..Maurice.