MEDRADSC 3Y03 - Parents and Children

Who should make healthcare decisions for children?

Parents of physicians

According to Diekema’s essay, when should the physician or govt agencies override the parents’ decision?

Only in exceptional cases should the family privacy or autonomy be violated

Diekema rejects the ___ and defends the ___

Diekema rejects the ‘best interests' standard and defends ‘harm principle’

Why should the state not interfere with families?

• Parents tend to promote well-being

• Parents best judge of what is good for their kids

• Parental freedom is a good thing

Best interest standard

The govt is justified in intervening to overrule parental decisions about a child’s medical treatment when the parent’s decision is not in child’s best interests

Why does Diekema reject the ‘best interest’ standard?

• Best interest is hard to determine and involves a value judgement

• Physicians may be tunnel visioned, focusing on medicalized understanding of best interest while parents may think more broadly (e.g survival vs quality of life)

• Requiring parents to always act in the best interests of their children → govt micromanaging all parenting aspects

Harm principle

Govt agencies are justified in intervening to overrule parental decisions about a child medical treatment when the parent’s decision is sufficiently harmful to the child

Best interest standard vs the harm principle

Harm principle: req that parents’ decision cannot be too harmful (lower bar)

Best interest: optimal outcome

Questions when applying the harm principle

“Does refusing tx risk serious harm?”,

“Is the intervention of proven efficacy?”

“What are the benefits and burdens?'“

“Would any other option prevent serious harm and be less intrusive to parental autonomy?”

1944 supreme court ruling

The right to practice religion freely does not include the right to expose the community or the child to communicable disease or the latter to ill health or death

What counts as harm is a ___

Value judgement

Why must someone make decisions for children?

Incapable of making their own healthcare decisions

What is the central question Diekema’s essay on paternalism address?

When a physician or govt agency should override a parent’s medical decision for their child

Unrealistic expectation that makes the ‘best interest’ standard problematic

Parents act in the best interests of their children all of the time

According to the harm principle, what 2 opposing factors must be weighed when evaluating an intervention under the harm principle?

Benefits and burdens of intervention

What does the blood transfusion example show?

Framework can be co-opted by different views to support different conclusions