title: Should doctors intentionally do less than the best?
abstract: The papers of Burley and Harris, and Draper and Chadwick, in this issue, raise a problem: what should doctors do when patients request an option which is not the best available? This commentary argues that doctors have a duty to offer that option which will result in the individual affected by that choice enjoying the highest level of wellbeing. Doctors can deviate from this duty and submaximise--bring about an outcome that is less than the best--only if there are good reasons to do so. The desire to have a child which is genetically related provides little, if any, reason to submaximise. The implication for cloning, preimplantation diagnosis and embryo transfer is that doctors should only produce a clone or transfer embryos expected to enjoy a level of wellbeing which is less than that enjoyed by other children the couple could have, if there is a good reason to employ that technology. This paper sketches what might constitute a good reason to submaximise.
authors.affiliation: Murdoch Institute, Royal Children's Hospital, Melbourne, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Savulescu
mesh_terms: D026686:Beneficence; D002669:Child Welfare; D019976:Cloning, Organism; D028661:Complicity; D003657:Decision Making; D006233:Persons with Disabilities; D004992:Ethics, Medical; D005260:Female; D030342:Genetic Diseases, Inborn; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D028681:Moral Obligations; D018579:Patient Selection; D026684:Personal Autonomy; D011247:Pregnancy; D019836:Preimplantation Diagnosis; D012945:Social Values; D013315:Stress, Psychological