a University of Nevada Las Vegas.
Am J Bioeth. 2018 Aug;18(8):9-19. doi: 10.1080/15265161.2018.1485757.
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.
多年来，儿童医疗决策的主流模式一直是最佳利益标准。最近，一些作者提出，密尔的“伤害原则”应该被用来调解或取代最佳利益标准。本文批判性地考察了伤害原则运动，并指出了在将密尔的伤害原则用于儿童医疗决策中存在的严重缺陷。尽管伤害原则的支持者成功地强调了目前使用最佳利益标准所存在的一些困难，但伤害原则的使用存在实质性的规范和概念问题。本文提出了一个基于四项原则的儿童医疗决策框架。它借鉴了最佳利益标准，纳入了伤害概念，并提供了两个可以作为儿童医疗决策指导和限制的问题。
