In the best interest of the patient. Applying this standard to healthcare decision making must be done in a community context.
Acting in the "best interest" of another implies taking certain steps or following certain rules so that the person and his or her concrete human community will survive and potentially flourish. The long-term understanding of best interest refers to the balance of benefits and burdens with respect to the ultimate goals or purposes of a community within which an individual is situated; short-term best interest refers to that balance with respect to a specific healthcare decision, without reference to the overall situation. However, considering only short-term best interest is unsatisfactory in the final analysis. Any decision to sacrifice individual preference for communal best interest should include three crucial aspects: (1) The individual must be a willing (or potentially willing, in the case of a child) member of the community, (2) individuals never lose their moral standing in the community, and (3) society can justify failure to accept the autonomous decisions of some individuals only (a) if it is impossible, (b) that failure is necessitated by attempts to meet the needs of other individuals, and (c) that decision is not based on unfair or unjust practices. Applying the concept of best interest to nontherapeutic research on children, one can conclude that the indirect benefit to the child is in his or her best interest only when the long-term benefit to the community, in terms of both survival and flourishing, is adequately considered. In addition, healthcare surrogate decision makers, acting in the best interest of a person who cannot make decisions and has not previously expressed his or her wishes, must take into account the long-term interests of the community.
St. Joseph's Health System, Atlanta.
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Trau
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McCartney
D026688:Bioethical Issues; D002648:Child; D003258:Consumer Behavior; D003657:Decision Making; D005610:Freedom; D017408:Guidelines as Topic; D015276:Health Care Rationing / Q000592:standards; D006805:Human Experimentation; D006801:Humans; D007872:Legal Guardians; D008020:Life Support Care / Q000592:standards; D028681:Moral Obligations; D033281:Nontherapeutic Human Experimentation; D033282:Parental Consent; D010344:Patient Advocacy / Q000592:standards*; D026684:Personal Autonomy; D040841:Resource Allocation; D018570:Risk Assessment; D012935:Social Justice; D012945:Social Values; D013534:Survival; D014481:United States; D026712:Value of Life