Medical decisions for children are usually justified by the claim that they are in a child's best interests. More recently, following criticisms of the best interests standard, some advocate that the family's interests should influence medical decisions for children, although what is meant by family interests is often not made clear. I argue that at least two senses of family interests may be discerned. There is a ‘weak’ sense of family interests and a ‘strong’ (...) sense. I contend that there are problems with both approaches in making medical decisions for children but that the weak sense is more plausible. Despite this, I argue that claims for family interests are not helpful in making medical decisions for children. (shrink)

The often‐posed dichotomy between the interest and choice theory of rights can obfuscate a proper understanding of children's rights. We need a gradualist model in which the grounds for attributing rights to a being change in response to the development of autonomy. Rights for children initially function to protect their interests but, as they develop into full‐fledged autonomous choosers, rights function to ensure that their choices, even those that do not serve their welfare, are respected.

In the context of critically ill children, Baines contended that the best interests test was neither objective nor coherent, and thus of little applicability in making end-of-life decisions. In reply, Bridgeman attempted to refute these claims through legal analysis and contended that the doctrine allowed for responsive, fact-specific, context-sensitive and prudential reasoning. This paper is a response to Bridgeman, and argues that an examination of case law reveals the subjective and value-laden nature of the test. Courts must make decisions (...) in contested cases, but there is no reason to hold that a judge can divine the best interests of a critically ill child better than either parents or medical staff. This paper analyses a number of cases where judicial decisions appear at odds with the child's best interests, and argues that as the outcome depends upon the value system of the decision-maker the test is unhelpful in contested end-of-life cases. (shrink)

In this paper I argue that reference to a developmental account of agency can help explain, and in cases also alter, our current practices when it comes to the non-consensual medical treatment of children. It does this through its explanation of how stages of development impact the types of interests we have.

In order for children to receive the best possible medical treatment, it is essential that research is conducted to discover safe and effective interventions and dosages. This article focuses on the legal and ethical implications of recruiting into health-care research minors who are not competent to consent. It considers the role played by best interests in obtaining valid parental consent for the participation of children in research, both at common law and under the Regulations that govern clinical trials of (...) medicinal products. In doing so it questions the legality of parental consent to children's involvement in research, and identifies some inconsistencies in parental understandings of best interests in relation to medical research and treatment. (shrink)

Researchers summoned a Baltimore County woman to an office at the Johns Hopkins School of Public Health last spring to tell her the bad news. They had found a genetic threat lurking in her 7-year-old son's DNA—a mutant gene that almost always triggers a rare form of colon cancer. It was the same illness that led surgeons to remove her colon in 1979. While the boy, Michael, now 8, is still perfectly healthy, without surgery he is almost certain to develop (...) cancer by age 40.This genetic fortune-telling was no parlor trick. It was the product of astonishing advances in recent decades in understanding how genes build and regulate our bodies. And as scientists pinpoint new genes and learn to forecast the onset of more inherited disorders, millions of people are likely to demand their medical prognosis. (shrink)

Researchers summoned a Baltimore County woman to an office at the Johns Hopkins School of Public Health last spring to tell her the bad news. They had found a genetic threat lurking in her 7-year-old son's DNA—a mutant gene that almost always triggers a rare form of colon cancer. It was the same illness that led surgeons to remove her colon in 1979. While the boy, Michael, now 8, is still perfectly healthy, without surgery he is almost certain to develop (...) cancer by age 40.This genetic fortune-telling was no parlor trick. It was the product of astonishing advances in recent decades in understanding how genes build and regulate our bodies. And as scientists pinpoint new genes and learn to forecast the onset of more inherited disorders, millions of people are likely to demand their medical prognosis. (shrink)

For many, it is far from clear where the prerogatives of parents to educate as they deem appropriate end and the interests of their children, immediate or future, begin. In this article I consider the educational interests of children and argue that children have an interest in their own well-being. Following this, I will examine the interests of parents and consider where the limits of paternalism lie. Finally, I will consider the state's interest in the education of (...) children and discuss a familiar view that argues that we have a central obligation to cultivate good citizens. The article will focus on the tensions which inevitably arise from the sometimes conflicting interests between them. (shrink)

This work clarifies the role of the best interest standard (BIS) as ethical principle in the medical care of children. It relates the BIS to the ethical framework of medical practice. The BIS is shown to be a general principle in medical ethics, providing grounding to prima facie obligations. The foundational BIS of Kopelman and Buchanan and Brock are reviewed and shown to be in agreement with the BIS here defended. Critics describe the BIS as being too demanding, narrow, opaque, (...) not taking the family into account and not suitable as limiting principle. This work responds to these criticisms, showing that they do not stand up to scrutiny. They either do not apply to the BIS, only apply to misuses of the BIS or criticise a BIS that is not seriously defended in the literature. (shrink)

Proponents of children's liberation (CL) argue that there are no morally relevant differences between children and adults. Consequently, special protective laws that limit children's freedom are unjustified, and should be abolished. Protectionists reject the premise of this argument, and hence also the conclusion. Proponents of CL mostly fix upon the capacity for instrumental reasoning as the criterion that should separate autonomous from non-autonomous individuals. I argue that most children are substantially worse at instrumental reasoning than most adults, and although drawing (...) a line between the two categories has an arbitrary element, outstanding exceptions on both sides can be justly accommodated. Furthermore, the capacity for instrumental reasoning is a necessary but not sufficient basis for equal rights. A morally decent society is more demanding of individuals than the skeptical or libertarian one that most plausibly grounds CL. To construct and live in such a society requires both prudence and morality. But there is evidence that children need protection and limits to develop these traits. So there are morally relevant differences between children and adults after all, and the argument from justice fails. The utilitarian arm of the argument also fails: because of these morally relevant differences, CL would have worse consequences than those envisioned by its supporters. Parents would lose important authority, and there would be more homeless children. Consequently, the gap between advantaged and disadvantaged persons would become larger and more irreversible. (shrink)

No citizen should be denied the right to vote due solely to her age. We can see this by showing that all objections to it fail. It might be objected that it is not unjust to so deprive children because children as a group are unintelligent or irrational, have their interests already represented by the parents, or are justly deprived of many other rights, among other reasons. But all these objections fail because there is no evidence to support it, (...) even if true, this would not justify disenfranchisement, or, most prominently argued here, they deprive individuals of political rights based upon their membership in a group. The voting age should be abolished. (shrink)

A new analysis of the Best Interests Standard is given and applied to the controversy about testing children for untreatable, severe late-onset genetic diseases, such as Huntington's disease or Alzheimer's disease. A professional consensus recommends against such predictive testing, because it is not in children's best interest. Critics disagree. The Best Interests Standard can be a powerful way to resolve such disputes. This paper begins by analyzing its meaning into three necessary and jointly sufficient conditions showing it: is (...) an "umbrella" standard, used differently in different contexts, has objective and subjective features, is more than people's intuitions about how to rank potential benefits and risks in deciding for others but also includes evidence, established rights, duties and thresholds of acceptable care, and can have different professional, medical, moral and legal uses, as in this dispute. Using this standard, support is given for the professional consensus based on concerns about discrimination, analogies to adult choices, consistency with clinical judgments for adults, and desires to preserve of an open future for children. Support is also given for parents' legal authority to decide what genetic tests to do. (shrink)

This paper presents four different understandings of the family and their concomitant views of the authority of the family in pediatric medical decision making. These different views are grounded in robustly developed, and conflicting, worldviews supported by disparate basic premises about the nature of morality. The traditional worldviews are often found within religious communities that embrace foundational metaphysical premises at odds with the commitments of the liberal account of the family dominant in the secular culture of the West. These disputes (...) are substantial and ultimately irresolvable by sound rational argument because of the failure to share common foundational premises and rules of evidence. It is in light of these fundamental disagreements that there is a need to evaluate critically the claims and agenda advanced by the Convention on the Rights of the Child. (shrink)

This article brings into relief two desiderata in childrearing, the importance of which the pandemic has made clearer than ever. The first is to ensure that, in schools as well as outside them, children have ample opportunities to enjoy goods that are particular to childhood: unstructured time, to be spent playing with other children, discovering the world in company or alone, or indeed pursuing any of the creative activities that make children happy and help them learn. I refer to these (...) as “special goods of childhood.” The second desiderata is to turn childrearing into a more communal practice, with lesser parental monopoly of care. For this, we need to give children access to multiple caring adults, and thus more opportunities to form secure and protected relationships. (shrink)

Timothy Michael Fowler has argued that, as a consequence of their commitment to neutrality in regard to comprehensive doctrines, political liberals face a dilemma. In essence, the dilemma for political liberals is that either they have to give up their commitment to neutrality (which is an indispensible part of their view), or they have to allow harm to children. Fowler’s case for this dilemma depends on ascribing to political liberals a view which grants parents a great degree of freedom in (...) deciding on the education of their children. I show that ascribing this view to political liberals rests upon a misinterpretation of political liberalism. Since political liberals have access to reasons based upon the interests of children, they need not yield to parent’s wishes about the education of their children. A correct understanding of political liberalism thus shows that political liberals do not face the dilemma envisaged by Fowler. (shrink)

The notion of the best interest of children figures prominently in family and reproductive policy discussions and there is a considerable body of empirical research attempting to connect the interests of children to how families and society interact. Most of this research regards the effects of societal responses to perceived problems in families, thus underlying policy on interventions such as adoption, foster care and temporary assumption of custodianship, but also support structures that help families cope with various challenges. However, (...) reference to the best interest of children can also be applied to a more basic issue in family policy, namely that of what is to be considered a family in the first place. This issue does not raise any questions regarding the proper conditions for when society should intervene in or change the family context of a child. Rather, it is about what social configurations should be recognized as a potentially fitting context for children to enter into and (if all goes well) eventually develop into adulthood within /.../ such that society’s default institutional arrangements allow it to have (by sexual and artificial reproduction, adoption, and combinations of these), care for and/or guard children. [This] will frame any further discussion of /.../ policies having further implications for, for example, the practices of adoption and reproductive technology, as well as regulation of custody in the event of separation or parental disagreement. (shrink)

Based on the experiences of one of the authors teaching philosophy for children in Iran, the paper asks whether respecting children's rationality, in the form of cultivating their ability and disposition to think critically, is in their best interest in an authoritarian context such as Iran. It argues that, in authoritarian contexts, respect for children's capacity for rational thought must be balanced with responsibility for their safety in their community. In other words, children's ‘best interest’ must consider children both as (...) individuals and as members of communities. The paper proposes that P4C should be used not only to teach analytic critical thinking and foster a ‘critical spirit,’ but also to help students develop the practical wisdom to judge where, when, and how best to use these skills and dispositions. (shrink)

The existing ethico-legal regulation of adolescent children's participation in health research in South Africa is currently unclear. The article interrogates the existing framework governing children's consent to research participation, with specific emphasis on discrepancies in consent norms in law and ethical guidelines. Against the backdrop of the constitutional directive that requires that a child's best interests are of paramount importance in every matter concerning the child, the article assesses whether sufficient consideration is given to children's evolving maturity and capacities (...) when consent to their participation in health research is sought. The article provides specific recommendations and proposes a legislative change to consent provisions in the National Health Act 61 of 2003 in order to address the existing lacunae and to align the framework with constitutional imperatives and international fundamental rights considerations. (shrink)

Recently there has been a flurry of interest and activity, both scholarly and political, about the role and importance of fathers in child rearing. One manifestation of this interest is a movement that began in the United Kingdom, but is increasingly influential in the United States and Canada, asserting fathers’ rights in custody disputes following divorce. Advocates assert that fathers should have equal standing with mothers in such cases, and that current practice fails to grant them this standing. U ntil (...) the nineteenth century, most Western legal systems granted fathers property rights in their children and failed to grant mothers any rights at all. Thus, fathers were almost always able to claim custody successfully after divorce. In the latter part of the nineteenth century, the “Tender Years Doctrine” displaced this practice. This view holds that children, especially young children, have special need of maternal nurture, and that mothers are naturally more suited to the task of raising young children than fathers are. (shrink)

New-born screening programs for congenital disorders and chronic disease are expanding worldwide and children “at risk” are identified by nationwide tracking systems at the earliest possible stage. These practices are never neutral and raise important social and ethical questions. An emergent concern is that a reflexive professionalism should interrogate the ever earlier interference in children’s lives. The Flemish community of Belgium was among the first to generalize the screening for hearing loss in young children and is an interesting case to (...) study the public justification of early interventions for families with deaf children. This article uses a critical lens to study the archive of the government child healthcare organization in Flanders in order to uncover underlying constructions of childhood, deafness, and preventive health. We focus on two interrelated themes. The first is the notion of exclusion of the human factor through the mediation of technology. The second is the idea of deafness as endangering a healthy development, an impairment that can nevertheless be treated if detected early enough. It is argued that, since deafness cannot be viewed as a life-threatening condition, the public interest which is implicitly defended is not the rescue of deaf children rather the exclusion of otherness. (shrink)

The argument for children's rights in health care has been long in the making. The success of this position is reflected in the 1995 American Academy of Pediatrics recommendations for the role of children in health care decisionmaking, which suggest that children be given greater voice as they mature. But there are good moral and practical reasons for exercising caution in these health care situations, especially when the child and parents disagree. Parents need the moral and legal space within which (...) to make decisions that will facilitate their child's long‐term autonomy, not only her present‐day autonomy. Moreover, third‐party intrusion, by physicians or the state, should be resisted unless negligent and abusive decisions are in the making. (shrink)

There is an increased focus on, and evidence of, children's capability to both understand and make decisions about issues relating to participation in medical research. At the same time there are divergent ideas of when, how and to what extent children should be allowed to decide for themselves. Furthermore, little is known about parents' views on these matters, an important issue since they often provide the formal consent. In this questionnaire study of 2500 families in south-east Sweden (with and without (...) research experience) we explored parents' views on issues relating to information, consent and research data. We found that parents are generally positive about supplying their child with individual information (93.3%; median age 7) and assuring the child's consent/assent to participation (74.3%; median age 12). However, parents' views vary regarding the extent to which children should influence research data: as many as 47–61% of our sample were opposed to children's rights to decide about the use and storage of biological samples and natural history data. Parents who are opposed to child consent and a wider influence on their research participation argue that parental authority and research quality are two important factors opposing enhanced child influence. Drawing on this, we underline the need to discuss how to balance children's rights against parental autonomy and research interests before implementing any standardized protocols granting children the right to consent and revoke data in long-term research. (shrink)

According to the Home Literacy Model (Sénéchal & LeFevre, 2002, 2014), young children can be exposed to two distinct types of literacy activities at home. First, meaning-related literacy activities are those where print is present but is not the focus of the parent–child interaction, for example, when parents read storybooks to their children. In contrast, code-related literacy activities focus on the print, for example, activities such as when parents teach their children the names and sounds of letters or to read (...) words. The present study was conducted to expand the Home Literacy Model by examining its relation with children’s engagement in literacy activities at home and at school as Finnish children transitioned from kindergarten to Grades 1 and 2. Two facets of children’s engagement were examined, namely, children’s independent reading at home and their interest in literacy activities. Finnish children (N = 378) were tested and interviewed at the ends of kindergarten, Grade 1, and Grade 2. Mothers completed questionnaires on their home literacy activities at each test time, and they reported the frequency with which their children read independently twice when children were in grade school. Tested was a longitudinal model of the hypothesized relations among maternal home literacy activities (shared reading and teaching of reading), children’s reading skills, independent reading, and their interest in literacy activities/tasks as children progressed from kindergarten to Grade 2. Stringent path analyses that included all auto-regressors were conducted. Findings for a revised model that excluded child interest extended previous research in four ways. First, the frequency of shared reading and teaching of reading at home predicted the frequency of children’s independent reading one year later. Second, children with stronger early literacy skills in kindergarten read independently more frequently once they were in Grade 1. Third, parents adapted, from kindergarten to Grade 1, their teaching behaviors to their children’s progress in reading, whereas shared reading decreased over time. Fourth, children’s own reports of interest in literacy activities were mostly not linked to other variables. Taken together, these results add another layer to the Home Literacy Model. (shrink)

New-born screening programs for congenital disorders and chronic disease are expanding worldwide and children “at risk” are identified by nationwide tracking systems at the earliest possible stage. These practices are never neutral and raise important social and ethical questions. An emergent concern is that a reflexive professionalism should interrogate the ever earlier interference in children’s lives. The Flemish community of Belgium was among the first to generalize the screening for hearing loss in young children and is an interesting case to (...) study the public justification of early interventions for families with deaf children. This article uses a critical lens to study the archive of the government child healthcare organization in Flanders in order to uncover underlying constructions of childhood, deafness, and preventive health. We focus on two interrelated themes. The first is the notion of exclusion of the human factor through the mediation of technology. The second is the idea of deafness as endangering a healthy development, an impairment that can nevertheless be treated if detected early enough. It is argued that, since deafness cannot be viewed as a life-threatening condition, the public interest which is implicitly defended is not the rescue of deaf children rather the exclusion of otherness. (shrink)

For many years the prevailing paradigm for medical decision making for children has been the best interest standard. Recently, some authors have proposed that Mill’s “harm principle” should be used to mediate or to replace the best interest standard. This article critically examines the harm principle movement and identifies serious defects within the project of using Mill’s harm principle for medical decision making for children. While the harm principle proponents successfully highlight some difficulties in present-day use of the best interest (...) standard, the use of the harm principle suffers substantial normative and conceptual problems. A medical decision-making framework for children is suggested, grounded in the four principles. It draws on the best interest standard, incorporates concepts of harm, and provides two questions that can act as guide and limit in medical decision making for children. (shrink)

The “best interest standard” is the guidance principle for pediatric healthcare in the United States (US) and the United Kingdom (UK). In the UK, the best interest standard may also be used as an intervention principle when parents make good but non-ideal decisions whereas intervention in the US requires a determination of abuse or neglect. I examine whether and how the different uses of the best interest standard influence predictive genetic testing of children.

The genetic testing and screening of children has been fraught with controversy since Robert Guthrie developed the bacterial inhibition assay to test for phenylketonuria and advocated for rapid uptake of universal newborn screening in the early 1960s. Today with fast and affordable mass screening of the whole genome on the horizon, the debate about when and in what scenarios children should undergo genetic testing and screening has gained renewed attention. United States professional guidelines — both the American College of Medical (...) Genetics /American Society of Human Genetics statement and the American Academy of Pediatrics Statement on the genetic testing of children and the new AAP and ACMG joint policy statement and technical report — as well as the old UK guidelines by the Working Part of the Clinical Genetics Society and the new United Kingdom guidelines by the British Society of Human Genetics all give the same answer: genetic testing and screening should only be done if it is in the child’s best interest. (shrink)

Next SectionWainwright and Gallagher propose that when child protection concerns emerge significant difficulties arise for General Practitioners because of conflicts between the individual interests of children and parents who are their patients and the Paramountcy Principle. From a psychodynamic perspective their analysis does not give sufficient weight to the nature of personal as opposed to interpersonal conflict of a conscious or unconscious nature. When issues of major import arise, ordinary parenting inevitably involves parents in putting their children's needs first (...) if competing possibilities occur. It is an over-simplification to present this as a conflict between the interests of children and parents. Parents' own best interests are served by securing their children's safety and welfare. An appreciation of this is crucial in order to implement child protection procedures appropriately. Errors may occur because the complex emotions and relationships involved lead professionals to experience themselves as potential agents of harm rather than benefit. (shrink)

There is an increased focus on, and evidence of, children's capability to both understand and make decisions about issues relating to participation in medical research. At the same time there are divergent ideas of when, how and to what extent children should be allowed to decide for themselves. Furthermore, little is known about parents' views on these matters, an important issue since they often provide the formal consent. In this questionnaire study of 2500 families in south-east Sweden we explored parents' (...) views on issues relating to information, consent and research data. We found that parents are generally positive about supplying their child with individual information and assuring the child's consent/assent to participation. However, parents' views vary regarding the extent to which children should influence research data: as many as 47–61% of our sample were opposed to children's rights to decide about the use and storage of biological samples and natural history data. Parents who are opposed to child consent and a wider influence on their research participation argue that parental authority and research quality are two important factors opposing enhanced child influence. Drawing on this, we underline the need to discuss how to balance children's rights against parental autonomy and research interests before implementing any standardized protocols granting children the right to consent and revoke data in long-term research. (shrink)

Volume 20, Issue 4, May 2020, Page 116-118.

In a research proposal recently submitted to one of the research ethics committees in Wales, children suffering from otitis media, or ‘glue ear’ as it is more familiarly known, were to be tested for allergic reactions to a number of substances using skin-prick tests. Small lancets would be used to pierce the skin of the forearm, allowing the penetration of traces of the allergenic reagent. The size of the subsequent inflamed area of skin would be measured. To demonstrate the expected (...) correlation between glue ear and an allergic reaction, it would be necessary to see whether other children who did not suffer from glue ear also had the same reactions. If they did not, of course, then some causal association between the reaction and the disease condition could be inferred and investigated, with the hope of improving the treatment of the disease itself. (shrink)

While the substantiation of “best interests” has received much attention, the question of how “the child” is conceptualised to ensure any action taken or decision made is in the particular child’s best interests has been largely neglected. In this paper, I argue that the lack of robust understanding of who “the child” is means that we continue to make many generalisations and category-based assumptions in determining the child’s best interests. In addressing the challenge of doing right by (...) the individual child, I propose a three-step approach based on a theoretical model of the child that avoids presumptions about child-typical needs and insists on an assessment of the child’s individual characteristics, needs, qualities, and circumstances, making it the only conceptualisation fully meeting the child centrism criterion required by children’s rights as determined by the United Nations Convention on the Rights of the Child. (shrink)

Children's vulnerability gives rise to duties of justice towards children and determines when authority over them is legitimately exercised. I argue for two claims. First, children's general vulnerability to objectionable dependency on their caregivers entails that they have a right not to be subject to monopolies of care, and therefore determines the structure of legitimate authority over them. Second, children's vulnerability to the loss of some special goods of childhood determines the content of legitimate authority over them. My interest is (...) in the so-far little-discussed goods of engaging in world discovery, artistic creation, philosophical pursuits and experimentation with one's self. I call these ‘special goods of childhood’ because individuals, in general, only have full access to them during childhood and they make a distinctive and weighty contribution to wellbeing. Therefore, they are part of the metric of justice towards children. The overall conclusion is that we ought to make good institutional care part of every child's upbringing. (shrink)

Margaret Mohrmann, Paul Lauritzen, and Sumner Twiss raise questions about my account of basic interests, liberal theory, and the challenges of multiculturalism as developed in "Children, Ethics, and Modern Medicine." Their questions point to foundational issues regarding the justification and limitation of parental authority to make decisions on behalf of children in medical and other contexts. One of the central questions in that regard is whether adults' decisions deserve to be respected, especially when they seem contrary to a child's (...) or adolescent's basic interests. Questions about respect, in turn, focus attention on others' decisions about what seems good for families and children, decisions that may be paternalistic or utilitarian. Such decisions are further complicated by a child's or adolescent's budding autonomy and need for respect and recognition. Pediatric bioethics grounded in an account of a child's basic interests produces a theory of negative and positive rights for assessing adults' actions in relation to children, especially (but not only) when adults demand respect in their expressions of care. (shrink)

As family physicians, general practitioners play a key role in safeguarding children. Should they suspect child abuse or neglect they may experience a conflict between responding to the needs and interests of the child and those of an adult patient. English law insists on the paramountcy of the interests of the child, but in family practice many other interests may be at stake. The authors argue that uncritical adoption of the paramountcy principle is too simplistic and can (...) lead, paradoxically, to greater harm. They argue for a more subtle and nuanced view of interests and of conflicts of interest in safeguarding children. (shrink)

This paper advances a novel conception of the child’s best interest in regard to pediatric surgeries that do not promote the preventive or therapeutic health needs of children, or elective pediatric surgeries (EPS). First, children’s capacity for decision-making is examined, and the best decision-making model for EPS is identified as the Best Interest Standard. What follows is a discussion of the interests of children in the context of EPS, the correlation of fundamental interests to rights, and guidelines for (...) weighing children’s competing interests. Next, the rights and duties of parents as proxy decision makers are considered. Finally, a reinterpretation of the Best Interest Standard is proposed, identifying as paramount a child’s ability to make elective medical decisions for herself when she reaches maturity. (shrink)

Children’s age and developmental capacity leave them incapable of making medical decisions for themselves. Decisions for children are traditionally made under the best interest standard. Ross calls into question whether the best interest standard can function as both a guidance and intervention principle, able to be applied across the spectrum of pediatric decision making. Ross describes constrained parental autonomy as an alternative model, arguing that it affords parents the ability to make decisions within the context of their family while upholding (...) a child’s current and future interests. Although the model provides a robust framework for intrafamilial decision making, I question whether it can be broadly applied to children living in non-intimate families. (shrink)

Children are routinely treated paternalistically. There are good reasons for this. Children are quite vulnerable. They are ill-equipped to meet their most basic needs, due, in part, to deficiencies in practical and theoretical reasoning and in executing their wishes. Children’s motivations and perceptions are often not congruent with their best interests. Consequently, raising children involves facilitating their best interests synchronically and diachronically. In practice, this requires caregivers to (in some sense) manage a child’s daily life. If apposite, this (...) management will focus partly on a child’s well-being. To be ably executed, an account of children’s well-being will need to be articulated. This chapter focuses on the nature of children’s well-being. It has five sections. The first section clarifies the focus. The second section examines some hurdles to articulating a view of children’s well-being. The third section evaluates some accounts of children’s well-being. The fourth section addresses the view that children possess features essential to them that make their lives on balance prudentially bad for them. The fifth section sums things up. (shrink)

This paper examines a variety of social scientific studies purporting to demonstrate that transracial adoption is in the best interests of children. Finding flaws in these studies and the ethical and political arguments based upon such scientific findings, we argue for adoption practices and policies that respect the racial and ethnic identities of children of color and their communities of origin.