Journal of Medical Ethics 42 (8):542-549 (2016)

Authors
Chong-Ming Lim
Stanford University
Abstract
One recurring criticism of the best interests standard concerns its vagueness, and thus the inadequate guidance it offers to care providers. The lack of an agreed definition of ‘best interests’, together with the fact that several suggested considerations adopted in legislation or professional guidelines for doctors do not obviously apply across different groups of persons, result in decisions being made in murky waters. In response, bioethicists have attempted to specify the best interests standard, to reduce the indeterminacy surrounding medical decisions. In this paper, we discuss the bioethicists’ response in relation to the state's possible role in clarifying the best interests standard. We identify and characterise two clarificatory strategies employed by bioethicists —elaborative and enumerative—and argue that the state should adopt the latter. Beyond the practical difficulties of the former strategy, a state adoption of it would inevitably be prejudicial in a pluralistic society. Given the gravity of best interests decisions, and the delicate task of respecting citizens with different understandings of best interests, only the enumerative strategy is viable. We argue that this does not commit the state to silence in providing guidance to and supporting healthcare providers, nor does it facilitate the abuse of the vulnerable. Finally, we address two methodological worries about adopting this approach at the state level. The adoption of the enumerative strategy is not defeatist in attitude, nor does it eventually collapse into (a form of) the elaborative strategy.
Keywords best interests  political philosophy  legitimacy
Categories (categorize this paper)
DOI 10.1136/medethics-2016-103454
Options
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

PhilArchive copy

 PhilArchive page | Other versions
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library

References found in this work BETA

Principles of Biomedical Ethics.Tom L. Beauchamp - 1979 - Oxford University Press.
Well-Being, Time, and Dementia.Jennifer Hawkins - 2014 - Ethics 124 (3):507-542.

View all 13 references / Add more references

Citations of this work BETA

View all 9 citations / Add more citations

Similar books and articles

Financial Interests and Research Bias.David B. Resnik - 2000 - Perspectives on Science 8 (3):255-285.
Beyond Serving a Purpose: Additional Ethical Focuses for Public Policy Agents.Vanessa Scholes - 2011 - In Jonathan Boston, Andrew Bradstock & David Eng (eds.), Ethics and public policy: contemporary issues. Victoria University Press.

Analytics

Added to PP index
2016-05-05

Total views
426 ( #17,219 of 2,419,597 )

Recent downloads (6 months)
39 ( #20,745 of 2,419,597 )

How can I increase my downloads?

Downloads

My notes