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EDITORIAL

Best Interest, Harm, God’s Will, Parental Discretion, or Utility
John D. Lantos

The impassioned and well-reasoned essays in this edition of the journal all agree with two claims: (1) children have moral claims that should be protected and recognized, and (2) we need ongoing discussions on how to determine and weigh the interests of children when we make decisions for them. They disagree about how we should determine and weigh those interests. The disagreements suggest that we...

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Are Organ Donors Really Dead: The Near-Irrelevance of Autoresuscitation
Robert M. Veatch

In 2017, 10,288 people in the United States donated organs after they died. Most were pronounced dead using brain criteria, but 1885 were declared dead the old-fashioned way (using circulatory criteria) because their hearts had stopped beating. They became so-called DCD or “donation after circulatory death” donors. When the heart stoppage indicates that circulation has ceased, the physician pr...

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Ethical Considerations in the Manufacture, Sale, and Distribution of Genome Editing Technologies
Jeremy Sugarman, Supriya Shivakumar, Martha Rook, Jeanne F. Loring, Christoph Rehmann-Sutter, Jochen Taupitz, Jutta Reinhard-Rupp & Steven Hildemann

New genome editing technologies are playing an increased role in an array of advanced research and development efforts in the life sciences. In tandem, there has been broad recognition of the need to address the ethical issues associated with the use of these genome editing tools. Although many uses of genome editing technologies do not raise novel ethical concerns, some have rightly attracted con...

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Target Article

The Harm Principle Cannot Replace the Best Interest Standard: Problems With Using the Harm Principle for Medical Decision Making for Children
Johan Christiaan Bester

For many years the prevailing paradigm for medical decision making for children has been the best interest standard. Recently, some authors have proposed that Mill’s “harm principle” should be used to mediate or to replace the best interest standard. This article critically examines the harm principle movement and identifies serious defects within the project of using Mill’s harm principle...

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When Parents Refuse: Resolving Entrenched Disagreements Between Parents and Clinicians in Situations of Uncertainty and Complexity
Janine Penfield Winters

When shared decision making breaks down and parents and medical providers have developed entrenched and conflicting views, ethical frameworks are needed to find a way forward. This article reviews the evolution of thought about the best interest standard and then discusses the advantages of the harm principle (HP) and the zone of parental discretion (ZPD). Applying these frameworks to parental ref...

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