Value Theory and the Best Interests Standard1

Bioethics 9 (1):50-61 (1995)
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Abstract

The idea of a patient's best interests raises issues in prudential value theory–the study of what makes up an individual's ultimate (nonmoral) good or well‐being. While this connection may strike a philosopher as obvious, the literature on the best interests standard reveals almost no engagement of recent work in value theory. There seems to be a growing sentiment among bioethicists that their work is independent of philosophical theorizing. Is this sentiment wrong in the present case? Does value theory make a significant difference in interpreting best interests? In pursuing this question, I begin with a quick sketch of broad kinds of value theories, identifying representatives that are plausible enough to count as contenders. I then explore what each account suggests in (1) neonatal treatment decisions, and (2) decisions for patients in persistent vegetative states. I conclude that while these accounts converge somewhat in their interpretations of best interests, they also have importantly different implications.

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David DeGrazia
George Washington University

References found in this work

The Limits of Well-Being.Shelly Kagan - 1992 - Social Philosophy and Policy 9 (2):169-189.
Deciding for Others.Gerald Dworkin, Allen E. Buchanan & Dan W. Brock - 1991 - Philosophical Quarterly 41 (162):118.
Getting down to cases: The revival of casuistry in bioethics.John Arras - 1991 - Journal of Medicine and Philosophy 16 (1):29-51.
Welfare, Happiness, and Pleasure.L. W. Sumner - 1992 - Utilitas 4 (2):199-223.

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