title: Is the best interest standard good for pediatrics?
abstract: We argue that the "best interest standard" for surrogate decision-making is problematic for a number of reasons. First, reliance on the best interest standard is subjective. Second, it leads to behavior that is intolerant and polarizing. Third, appeals to the best interest standard are often vague and indeterminate. After all, cases are usually controversial precisely because reasonable people disagree about what is or is not in a child's best interest. We then recommend that, instead of the best interest standard, parents should be held to a standard that we call the "not unreasonable" standard. By that standard, parents' decisions would be respected unless they were deemed unreasonable. This recommendation would allow a greater range for parental discretion than the best interest standard.
authors.affiliation: Icahn School of Medicine at Mt Sinai, New York, New York rosamond.rhodes@mssm.edu.
authors.forename: Rosamond
authors.initials: R
authors.lastname: Rhodes
authors.affiliation: Icahn School of Medicine at Mt Sinai, New York, New York.
authors.forename: Ian R
authors.initials: IR
authors.lastname: Holzman
mesh_terms: D002648:Child; D002651:Child Advocacy / Q000941:ethics*; D003657:Decision Making; D006801:Humans; D008513:Medicine in Literature; D010290:Parents / Q000523:psychology*; D010344:Patient Advocacy / Q000941:ethics; D010372:Pediatrics / Q000941:ethics*
keywords: best interest; child; ethics; family; law; literature