Medical Decision-Making on Behalf of Young Children: A Comparative Perspective

Table of Contents
List of Contributors
1. Introduction
2. Identifying Who and What, then How: Attending to the Role of the Decision-Maker in the Normative Debate about the Best Interests Standard
	I. Introduction
	II. The 'Who' Question and the 'How' Question
	III. Candidate Principles: Best Interests Standard and Harm Threshold
	IV. Clarifying the Decision at Hand: The 'What' Question
	V. Role-Specificity
	VI. Moving Beyond Best Interests Standard Versus Harm Threshold
3. Parental Rights, Best Interests and Significant Harm: Medical Decision-Making on Behalf of Children in Belgium
	I. Introduction
	II. Exercise of Minor Patients' Rights
	III. Parents' Right to Consent to a Medical Intervention
	IV. Disagreement between Parents and Medical Professionals
	V. Conclusion
4. 'Parental Rights', 'Best Interests' and the Withdrawal of Life-Sustaining Medical Treatment of Children in Scotland: A Lack of Authority
	I. The Legislative Framework
	II. The Procedural Framework
	III. The Scots Law Approach to 'Best Interests' in this Context
5. Parental Decisions on their Children's Medical Treatment in Switzerland
	I. Introduction
	II. Decision-Making Ability and Competence of the Child
	III. Guidelines and Limits of Parental Decision-Making Power for Incompetent Minors
	IV. Dissent between Parents and Doctors
	V. Conclusions
6. Medical Decision-Making on Behalf of Minors: The Hong Kong Context
	I. Introduction
	II. The Legal Position in Hong Kong
	III. Sociocultural Factors Prior to Judicial Intervention
	IV. Conclusion
7. Medical Decision-Making on Behalf of Children in China: A Multidimensional Analysis of Parental Authoritarianism
	I. Introduction
	II. Statutory Restrictions on Medical Decision-Making on Behalf of Children
	III. Parental Authoritarianism in Medical Decision-Making for Children
	IV. Multidimensional Analysis of Parental Authoritarianism in China
	V. Conclusion
8. Parental Rights in Mexican Law
	I. Introduction
	II. Indirect Habeas Corpus8 1049/20179
	III. Legal Rights
	IV. Conclusion
9. Decision-Making on Behalf of Children in the Research and Clinical Context: A United States Perspective
	I. US Legal Framework
	II. Access to Experimental Interventions in the US System
	III. Parental Decisions with Respect to their Children
	IV. Conclusion
10. Withholding and Withdrawal of Life-Prolonging Treatment from Young Children in Israel
	I. Introduction
	II. Legislation
	II. Case-Law
	IV. Conclusion
11. Medical Decision-Making on Behalf of Children in English and Welsh Law: A Child-Centred Best Interests Approach
	I. Introduction
	II. The Current Position Confirmed: The Best Interests Approach
	III. Two Challenges to Orthodoxy
	IV. Evaluating the Challenge to Best Interests
	V. Conclusion
12. Parental Rights, Best Interests and Significant Harms: Singapore and Malaysia Perspectives on Medical Decision-Making on Behalf of Children
	I. Introduction
	II. Threshold for Judicial Intervention and its Normative Basis
	III. Values and Considerations that Inform Judicial Decisions
	IV. Social Forces and Public Perception
	V. Conclusion
13. Decisions about their Body: Children"s Rights and Parental Responsibility in Chile
	I. Introduction
	II. Patient Rights and Responsibilities in Chile
	III. Latin American Context
	IV. Spotlight on the Children
14. Who has the Final Word? On Trust and Legal Uncertainty within the Swedish Healthcare System
	I. Sweden and its Healthcare Regulation Generally
	II. The Requirements of Consensus and Consent in Swedish Healthcare
	III. Children's Rights and the Discretion of Guardians
	IV. The Municipal Social Welfare Committee's Ultimate Responsibility for Children – An Inadequate 'Solution'
	V. The Trust and Consensus Paradigm as an Explanation for the Regulatory Gap
	VI. Who should have the Final Word?
15. Medical Decision-Making on Behalf of Children in Ireland
	I. Introduction
	II. Background: Birth Rate and Decision-Making
	III. The Irish Constitution: The Role of Parents
	IV. 'Exceptional' Cases
	V. Application of the 'Best Interests' Assessment
	VI. The Influence of Professional Standards and Guidelines
	VII. Conclusion
	Medical Decision-Making on Behalf of Children in Ireland
16. Decisionally Incapable Children and Medical Treatment Choices in Canada
	I. Introduction
	II. Parental Rights to Make Treatment Decisions
	III. State Intervention and Constitutional Restraints
	IV. Legislated Child Protection Regimes
	V. The Best Interests of the Child: Legislation and Litigation
	VI. Failure to Provide Necessities of Life
	VII. Conclusion
17. Offering a Reasonable Future: Withdrawal of Life-Sustaining Treatment from Infants in French Law with Illustrations from a Parisian Neonatal Resuscitation Unit
	I. Introduction
	II. Parental Authority
	III. The role of physicians
	IV. Limitation or Withdrawal of Treatment on the Basis of Unreasonable Obstinacy
	V. Offering a Reasonable Future to the Child and the Family: An Illustration of the Practical Application of the French Regime
	VI. Conclusion: The Articulation of the Power of Physicians to Withdraw Life-Sustaining Treatment and Parental Authority Remains Uncertain
18. Parental Responsibility and Medical Decision-Making in Southern Africa: A Comparative Analysis of South Africa and Botswana
	I. Introduction
	II. Medical and Surgical Treatment
	III. Parental Consent to Children's Medical Treatment in Botswana
	IV. Conclusion
19. Young Children and Healthcare Decisions in Spain: Who Decides?
	I. Introduction
	II. Parental Responsibility
	III. Consent to and Refusal of Medical Treatment
	IV. Withdrawal of Life-Sustaining Treatment and Request for Experimental Treatment
	V. Conclusion
20. Who Decides the Best Interests of the Child in the End-of-Life Process? A Look at the Peruvian and Argentine Reality
	I. Introduction
	II. Argentina's Legal Framework
	III. Peruvian Legal Framework
	IV. Analysis of the Scenarios in Argentina and Peru
	V. Conclusion: Protect the Best Interests of the Child by Improving the Quality of Decisions
21. Reviewing Medical Decisions Concerning Infants within the Norwegian Healthcare System: A Public Law Approach
	I. Introduction – Overview of the Legislation Relating to Health
	II. The Competence to Decide on Behalf of the Minor Patient
	III. The Kristina and Ove Cases
	IV. Reflections
22. Children and Medical Decision-Making in Australia Post-Gard: A Possible Reformulation
	I. Introduction
	II. Marion's Case
	III. The Problems of the Therapeutic/Non-Therapeutic Distinction
	IV. The Court as an Uber-Parent – A New Development
	V. Disputes between Parents, Doctors and the Courts – When Should the Court Act as a De Novo Decision-Maker?
	VI. Post-Gard and the 'Risk of Significant Harm' Test in Australia
	VII. Judicial Review of Parental Decisions Regarding Therapeutic Treatments
	VIII. Conclusions
23. Parental Authoritarianism and Medical Decision-Making in Thailand: The Need to Limit Parental Authority
	I. Introduction
	II. Medical Treatment of Children: Autonomy versus Parental Authoritarianism
	III. The Role of Medical Professionals and Judicial Intervention for Preserving the Best Interests of Children
	IV. Conclusion
24. Medical Decision-Making on Behalf of Critically Ill Minors in Greece
	I. Introduction
	II. The Regime of Parental Responsibility in Greek Family Law
	III. Parental Consent to Medical Acts in Greek Law
	IV. End-of-Life Decisions for Terminal Illnesses
	V. Beginning-of-Life Decisions on Behalf of Minors
	VI. Conclusion
25. Making Decisions for Children in Healthcare and Medical Research: African Communal Responsibility or Individual Rights?
	I. Introduction
	II. Communal Responsibility versus Individual Rights in Children's Healthcare
	III. The Place and Value of Children in African Healthcare Contexts
	IV. Children in Healthcare and Medical Research: Some African Examples
	V. Decision-Making for Children in Healthcare
	VI. Conclusion
26. The Relevance of Cultural Competence to Resolving Disputes in Relation to Medical Decisions for Children
	I. Introduction
	II. Best Interests is Culture Bound
	III. Definition of Culture
	IV. Is there a Common Morality
	V. Cultural Competence
	VI. Thinking Fast and Slow: Cognitive and Unconscious Biases
	VII. Uncertainty
	VIII. Approaches to Dispute Resolution
	IX. What Role Should the Courts Play?
	X. Conclusion
27. Legal and Cultural Differences in Medical Decision-Making on Behalf of Very Young Children
	I. Lack of Case-Law
	II. The Limits of Parental Authority
	III. How Does Best Interests Operate?
	IV. Cultural Competence
	V. Conclusion
Index