Skip to main content
SpringerLink
Log in

Best Interests: Puzzles and Plausible Solutions at the End of Life

  • Original Article
  • Published:
Health Care Analysis Aims and scope Submit manuscript

Abstract

This paper argues that the concept of best interests in the context of clinical decisions draws on concepts rooted in the philosophical discipline of axiology. Reflection on the philosophical origins enables a distinction to be drawn between those interests related to clinical goals and those global interests that are axiological in nature. The implication of this distinction is most clearly seen in the context of end of life decisions and it is argued here that greater weight ought to be given to the positive requests, and not merely competent refusals, of patients at the end of life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Airedale NHS Trust v. Bland. (1993). AC 789.

  2. Boyd, K. M. (2002). Mrs Pretty and Ms B. Journal of Medical Ethics, 28, 211–212.

    Article  PubMed  CAS  Google Scholar 

  3. Brock, D. (1993). Quality of life measures in health care, medical ethics. In M. Nussbaum & A. Sen (Eds.), The quality of life (pp. 95–132). Oxford: Clarendon Press.

    Chapter  Google Scholar 

  4. Dworkin, R. (1986). Autonomy and the demented self. Milbank Quarterly, 64(Suppl. 2), 4–16.

    Article  Google Scholar 

  5. Dworkin, R. (1993). Life’s dominion: An argument about abortion, euthanasia and individual freedom. New York: Alfred A Knopf.

    Google Scholar 

  6. Evans, S. (2004). Whose life is it anyway? Healthcare news brief. London: Hempsons Solicitors. Autumn: 1.

    Google Scholar 

  7. General Medical Council. (2002). Withholding and withdrawing life-prolonging treatment: Good practice in decision making. London: GMC.

    Google Scholar 

  8. In Re T (Adult: Refusal of treatment). (1993). Fam 95.

  9. Mill, J. S. (1859). On liberty. In M. Warnock (Ed.) (1977), Utilitarianism. Fontana: Glasgow.

  10. Mooney, G. (1994). Key issues in health economics. New York: Harvester Wheatsheaf.

    Google Scholar 

  11. Ms B v. An NHS Hospital Trust. (2002). 2 All ER 449.

  12. Mulhall, S., & Swift, A. (1997). Liberals and communitarians (2nd ed.). Oxford: Blackwell. Publishers Ltd.

    Google Scholar 

  13. Parfit, D. (1991). Reasons and persons (reprint, 1st ed.). Oxford: Clarendon Press.

  14. Pretty v. United Kingdom. (2002). 35 EHRR 1.

  15. R (On the Application of Oliver Leslie Burke) v. The General Medical Council. (2005). EWCA Civ. 1003.

  16. Randall, F., & Downie, R. S. (1999). Palliative care ethics: A companion for all specialties (2nd ed.). Oxford: Oxford University Press.

    Google Scholar 

  17. Re C (Adult: Refusal of Medical Treatment). (1994). 2 FCR 151.

  18. Savulescu, J. (1997). Liberal rationalism and medical decision making. Bioethics, 11(2), 115–129.

    Article  PubMed  Google Scholar 

  19. Shakespeare, T. W. (2006). Disability rights and wrongs. London: Routledge.

    Google Scholar 

  20. Woods, S. (2005). Respect for persons: Autonomy and palliative care. Medicine Health Care and Philosophy, 8, 243–253.

    Article  Google Scholar 

  21. Woods, S. (2007). Death’s dominion: Ethics at the end of life. Berkshire: Open University Press.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Policy Ethics and Life Sciences Research Centre, Newcastle University, Citygate, St James Boulevard, Newcastle upon Tyne, NE1 4JH, UK

    Simon Woods

Authors
  1. Simon Woods
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Simon Woods.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Woods, S. Best Interests: Puzzles and Plausible Solutions at the End of Life. Health Care Anal 16, 279–287 (2008). https://doi.org/10.1007/s10728-008-0083-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10728-008-0083-y

Keywords

Search

Navigation