Clarifying the best interests standard: the elaborative and enumerative strategies in public policy-making.
One recurring criticism of the best interests standard concerns its vagueness, and thus the inadequate guidance it offers to care providers. The lack of an agreed definition of 'best interests', together with the fact that several suggested considerations adopted in legislation or professi...
| Main Authors: | , , |
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| Format: | Journal article |
| Language: | English |
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BMJ Publishing Group
2016
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| _version_ | 1797064785695604736 |
|---|---|
| author | Lim, C Dunn, M Chin, J |
| author_facet | Lim, C Dunn, M Chin, J |
| author_sort | Lim, C |
| collection | OXFORD |
| description | One recurring criticism of the best interests standard concerns its vagueness, and thus the inadequate guidance it offers to care providers. The lack of an agreed definition of 'best interests', together with the fact that several suggested considerations adopted in legislation or professional guidelines for doctors do not obviously apply across different groups of persons, result in decisions being made in murky waters. In response, bioethicists have attempted to specify the best interests standard, to reduce the indeterminacy surrounding medical decisions. In this paper, we discuss the bioethicists' response in relation to the state's possible role in clarifying the best interests standard. We identify and characterise two clarificatory strategies employed by bioethicists -elaborative and enumerative-and argue that the state should adopt the latter. Beyond the practical difficulties of the former strategy, a state adoption of it would inevitably be prejudicial in a pluralistic society. Given the gravity of best interests decisions, and the delicate task of respecting citizens with different understandings of best interests, only the enumerative strategy is viable. We argue that this does not commit the state to silence in providing guidance to and supporting healthcare providers, nor does it facilitate the abuse of the vulnerable. Finally, we address two methodological worries about adopting this approach at the state level. The adoption of the enumerative strategy is not defeatist in attitude, nor does it eventually collapse into (a form of) the elaborative strategy. |
| first_indexed | 2024-03-06T21:19:20Z |
| format | Journal article |
| id | oxford-uuid:40e65004-7d91-436f-a19b-cbf9d4a33d60 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T21:19:20Z |
| publishDate | 2016 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:40e65004-7d91-436f-a19b-cbf9d4a33d602022-03-26T14:40:35ZClarifying the best interests standard: the elaborative and enumerative strategies in public policy-making.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:40e65004-7d91-436f-a19b-cbf9d4a33d60EnglishSymplectic Elements at OxfordBMJ Publishing Group2016Lim, CDunn, MChin, JOne recurring criticism of the best interests standard concerns its vagueness, and thus the inadequate guidance it offers to care providers. The lack of an agreed definition of 'best interests', together with the fact that several suggested considerations adopted in legislation or professional guidelines for doctors do not obviously apply across different groups of persons, result in decisions being made in murky waters. In response, bioethicists have attempted to specify the best interests standard, to reduce the indeterminacy surrounding medical decisions. In this paper, we discuss the bioethicists' response in relation to the state's possible role in clarifying the best interests standard. We identify and characterise two clarificatory strategies employed by bioethicists -elaborative and enumerative-and argue that the state should adopt the latter. Beyond the practical difficulties of the former strategy, a state adoption of it would inevitably be prejudicial in a pluralistic society. Given the gravity of best interests decisions, and the delicate task of respecting citizens with different understandings of best interests, only the enumerative strategy is viable. We argue that this does not commit the state to silence in providing guidance to and supporting healthcare providers, nor does it facilitate the abuse of the vulnerable. Finally, we address two methodological worries about adopting this approach at the state level. The adoption of the enumerative strategy is not defeatist in attitude, nor does it eventually collapse into (a form of) the elaborative strategy. |
| spellingShingle | Lim, C Dunn, M Chin, J Clarifying the best interests standard: the elaborative and enumerative strategies in public policy-making. |
| title | Clarifying the best interests standard: the elaborative and enumerative strategies in public policy-making. |
| title_full | Clarifying the best interests standard: the elaborative and enumerative strategies in public policy-making. |
| title_fullStr | Clarifying the best interests standard: the elaborative and enumerative strategies in public policy-making. |
| title_full_unstemmed | Clarifying the best interests standard: the elaborative and enumerative strategies in public policy-making. |
| title_short | Clarifying the best interests standard: the elaborative and enumerative strategies in public policy-making. |
| title_sort | clarifying the best interests standard the elaborative and enumerative strategies in public policy making |
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