Taking the Family Seriously: Beyond Best Interests

Abstract

William Ruddick leads us beyond a simple-minded appeal to the best interests of children in determining levels of treatment. Nothing ever happens to anyone only in terms of his best interests, nor should it. Treatment and care are provided to adults not just in terms of what would be best for them. Consideration is given as well, and correctly, to the financial, psychological, and social costs to others. Societies establish levels of treatment by also asking the question, how will particular policies of providing care affect the providers and those who pay for the care? Ruddick’s “biographical” question for parents, “How will treatment affect our lives?”, reminds us that families should be concerned about their own burdens as well. The best-interests standard as a single standard is unreasonable. It would suggest that choices about the best interests of children can be made apart from decisions regarding the best interests of their families and society. Taken in isolation, it would suggest that obligations to achieve the best interests of children are absolute and cannot be defeated by costs or by obligations to others.