By Fred Rum M.D., Donald Pfaff PH.D. (auth.), Donald W. Pfaff (eds.)
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The second key concept that demands deeper analysis is "best interest," as that notion is invoked in paternalistic justifications for overriding patients' refusals. Let us look first at "best interest" before turning to autonomy. In the previous chapter, it was noted that the concept of best interest can be construed in a narrowly medical sense, referring to outcomes stated in terms of survival months or years, chances of remission and decreased morbidity, and also in a broader sense that takes into account other values the patient may adhere to.
The authority of others to decide about biomedical interventions with incompetents. ), pp. 115-152. Plenum, New York. Code of Federal Regulations (1981). 45 CFR 46 Protection of human subjects. OPRR Reports (revised as of January 26, 1981). R (1982). Ethical and cultural dimensions of informed consent. Ann. Intern. Med. 96, 110-113. Donagan, A. (1977). Informed consent in therapy and experimentation. J. Med. Philosophy 2,310-327. Dworkin, G. (1982). Consent, representation and proxy consent. In: Who Speaks for the Child, pp.
1981). Competence, marginal and otherwise. Int. J. Law Psychiat. 4, 53-72. Goldstein, J. (1982). Medical care for the child at risk: On state supervention of parental autonomy. In: Who Speaks for the Child, pp. 153-188. Kant,1. (1785). Fundamental principles of the metaphysics of morals. Originally published in 1785. Macklin, R (1982). Return to the best interests of the child. In: Who Speaks for the Child, pp. 265-301. Meisel, A, and Roth, L. H. (1981). What we do and do not know about informed consent.