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Best interests
Best interests is the test used to make a decision for someone who cannot make it themselves.
Summary
- It applies to children and to adults who lack capacity.
- It is wider than medical benefit. The patient's own wishes, feelings, beliefs and values must be considered, and the people close to them consulted.
- If doctors and the family cannot agree, a court decides.
In practice
- On 13 October 2023 Mr Justice Peel ruled in the case of Indi Gregory that withdrawing invasive treatment was in her best interests, because its burdens outweighed its benefits.
- Under section 4(5) of the Mental Capacity Act 2005, a decision about life sustaining treatment must not be motivated by a desire to bring about the person's death.
In Hong Kong
- The Medical Council of Hong Kong's code says that where parents refuse treatment that is clearly in a child's best interests, particularly treatment needed to save the child's life, the doctor should consider seeking legal advice (section 2.12.5).
- For an unconscious patient, the family's views should be considered, provided they fit with the patient's best interests and the patient's right to decide for themselves (section 2.13.1).
Interview questions
- Who decides what is in a child's best interests?
- Is keeping a patient alive always in their best interests?
- How would you find out what an unconscious patient would have wanted?
Sources
- The National Archives, case lawcaselaw.nationalarchives.gov.uk/…/2556
- legislation.gov.uklegislation.gov.uk/…/4
- Medical Council of Hong Kongmchk.org.hk/…/Code_of_Professional_Conduct_%28English_Version%29_%28Revise
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