Summary: | How should we make decisions about medical treatment for a very young child? What should we do when there is a disagreement between parents and clinicians about what would be best for the child? The conventional answer, as found in textbooks, professional guidelines and the law, is that decisions should be based on the best interests of the child. However, as noted by Giles Birchley in an article in this issue,1 a number of ethicists have argued that the focus should instead be on harm; parents should be overruled where their decision would cross a threshold level of harm.2 ,3 Birchley, in his article, disagrees. He argues that the harm threshold (HT) suffers from problems of negative connotations, narrow scope and indeterminacy, and that it would be better to clarify the values that should inform best interests.
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