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date: 21 July 2019

Abstract and Keywords

Infants lack capacity, so the state assigns parents the authority to grant permission on behalf of their child for interventions that are routine, non-emergent interventions, or emergent/life-preserving. For the infant who is severely compromised medically and for whom any intervention would be considered futile, a dialectic between preserving “life at all costs” and the infant’s interest in avoiding unnecessary suffering emerges, prompting potential schisms between parents, physicians, the medical facility, and the state—each of which brings its own biases. Physicians are charged with compassionately providing accurate disclosure that is free of bias and refraining from exerting coercive influence. Parents need to be allowed the space and support to thoughtfully deliberate. Medical facilities, through ethics committees, can provide a path to resolving conflicts without resorting to adjudication in courts. Deliberation should focus on the principles of the infant’s best interests and substitute judgment.

Keywords: informed consent, substitute judgment, medical disclosure, unborn child, parental authority, physician duty, right to life, right to die, futile care

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