‘You Don't Need Proof When You've Got Instinct!’: Gut Feelings and Some Limits to Parental Authority

While, in Europe and beyond, decisions about children who lack competence to contribute to their treatment decisions are based upon their best interests, both the European Court of Human Rights and bioethical theorists consider that there must be substantial involvement of parents in these decisions. In the United Kingdom (UK), legal and clinical guidelines say that critically ill children’s best interests must be agreed by their parents and doctors, or the courts, in a process of shared decision-making. There is widespread acceptance that there should be limitations on parental authority in shared decisions, yet parental authority is ill defined, and without some agreement on the source of parental authority it is difficult to limit it either cogently or consistently. This paper presents results from an empirical ethics investigation into shared decision-making in the paediatric intensive care unit, a study that focused on critical decisions in which an infant child’s treatment or non
-treatment might be decided.