Project Description and Outcomes
In medical decision-making, patients who are deemed capable have a right to make autonomous decisions. Children are often assumed to lack capacity to make medical decisions, so the task is assigned to their substitute decision maker (SDM). The “best interests standard” is intended to protect children from an SDM acting in their own interests, but has been criticized for being vague, applied inconsistently, and subject to abuse. Our team, comprised of Jacob Shelley, Claire Houston, Gail Teachman, and three Rotman resident members, in collaboration with SickKids, conducted a scoping to understand how the best interests standard is discussed across disciplines including law, applied ethics, policy, and health-related literature, with an aim to improve decision-making in this area. We received a SSHRC Insight Development Grant under the leadership of Dr. Jacob Shelley to fund this project, as well as Rotman’s Graduate Student Fellowship funding.
The focus of the project during this summer was knowledge dissemination. Micaela’s work was integral in sharing the interim results of our project -a scoping review on the best interests standard in children’s decision-making- with important stakeholders at various national conferences. Micaela and fellow Rotman member Zoe Ritchie created and ran a 3-hour workshop for the Canadian Bioethics Society Workshop and Community Forum that promoted interdisciplinary conversation and debate surrounding children’s medical decision-making. Both Rotman students also co-presented at the Child Health Symposium at Western University to share project findings and hot topics that emerged from the workshop with researchers and students focused on child health. The Faculty of Law is also supporting Zoe and Micaela, in association with the SSHRC grant project, to attend The American Society of Bioethics & Humanities Annual Conference in Baltimore this October.
Thank you to the Rotman Graduate Student Fellowship for making this work possible.
M. Forte, Z. Ritchie, J. Shelley, M. Smith. “Finding the best practice in best interests?” Child Health Symposium, London, ON. May 30, 2023. Contribution: co-presenter.
Z. Ritchie, M. Forte, C. Houston, M. Smith, J. Shelley. “How ought the best interests of children be considered in medical decision making? Legal and Ethical Perspectives.” Canadian Journal of Bioethics, November 2023 Issue. Status: invited submission.
Z. Ritchie, M. Forte, L. Soparlo, J. Shelley, M. Smith. How ought the best interests of children be considered in medical decision-making? A collaborative workshop toward a consistent and reliable guide. Canadian Bioethics Society Workshop and Community Forum. Workshop. May 15-18, 2023.