| dc.description.abstract | Respect for patient autonomy is a fundamental principle of biomedical ethics. However, it holds relatively little weight in pediatric medicine, in which parents act as proxy decision-makers for their children. Challenges to this sort of parental authority have focused on parent-clinician disagreement, without recognizing children as individuals who may – and often do – have opinions about their own healthcare. The most compelling arguments for granting parents decision-making authority instead of doctors focus on their unique ability to understand their children’s desires and interests. Clearly, arguments that parents should have a right to overrule their children’s decisions would need to be supported by different means. Because the law gives parents authority over their children’s medical care by default, few appear to have felt it necessary to justify the practice. The primary goal of this project is to demonstrate that allowing parents to overrule their children’s medical decisions is, for the most part, unjustifiable. Following a critical examination of the assumption that parents have an inherent right to make decisions on their children’s behalves, I compare the standards used to evaluate decisional capacity in children and adults. After finding that the capacity and competence of children is severely underestimated relative to that of adults, I present several positive arguments for extending decisional authority to children in the realm of their own healthcare. I conclude by acknowledging that because children develop various cognitive capacities asynchronously, parents may consent to some treatments on their children’s behalf, if and only if that treatment is the most consistent with the child’s self-professed interests. | |
