Abstract
For young children, best-interests decisions are necessarily made by proxy consent. This implies that someone other than the child-patient makes the medical decisions. This individual then acts as a proxy decision maker. Although it is usually a parent who acts as proxy for his or her child, other parties may also sometimes act as proxy decision makers. In the health care setting, other potential decision makers include nurses, doctors, social workers, and courts. Regardless of who makes the decision, practical questions remain about how to determine the child’s best interests. These questions are especially complex when considering genetic testing for cancer predisposition. Generally speaking, determination of best interests involves an assessment of benefits versus burdens with respect to a particular diagnostic test or treatment. For the purposes of this analysis, the best interests evaluation would center on benefits and burdens of genetic testing.
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