dc.contributor.authorLim, Chong Ming
dc.contributor.authorDunn, Michael C.
dc.contributor.authorChin, Jacqueline J.
dc.identifier.citationLim, C. M., Dunn, M. C., & Chin, J. J. (2016). Clarifying the best interests standard: the elaborative and enumerative strategies in public policy-making. Journal of Medical Ethics, in press.en_US
dc.description.abstractOne 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.en_US
dc.format.extent18 p.en_US
dc.relation.ispartofseriesJournal of Medical Ethicsen_US
dc.rights© 2016 The Authors. This is the author created version of a work that has been peer reviewed and accepted for publication in Journal of Medical Ethnics, published by BMJ Publishing Group on behalf of the authors. It incorporates referee’s comments but changes resulting from the publishing process, such as copyediting, structural formatting, may not be reflected in this document.  The published version is available at: [http://dx.doi.org/10.1136/medethics-2016-103454].en_US
dc.subjectBest interests standarden_US
dc.subjectPublic policyen_US
dc.titleClarifying the best interests standard: the elaborative and enumerative strategies in public policy-makingen_US
dc.typeJournal Article
dc.contributor.schoolSchool of Humanities and Social Sciencesen_US
dc.description.versionAccepted versionen_US

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