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Part of the book series: The International Library of Bioethics ((ILB,volume 90))

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Abstract

The family is the basic unit of society, and the interests of family members and the family unit are always relevant. Despite much rhetoric, neither parents nor physicians (let alone the state!) have a true fiduciary relationship with children under their care. Parents are responsible for the physical care of their children, and for their education leading them to a status as productive adults. They are responsible for their children’s flourishing. Neither their responsibility to an individual child nor their responsibility to the government is categorical. First, parents appropriately balance the interests of all family members (including their own), and the corporate interests of the family as a whole. Second, the state has non-coercive means of intervention at its disposal. This chapter reviews and expands on some prior approaches to parental authority and responsibility. The chapter classifies parental behavior into four categories, based on the maximum appropriate state response. Parental behavior within the Zone of Acceptability warrants no government attention. The next two zones represent divisions of Gillam’s Zone of Parental Discretion. Parental action within the Zone of State Attention may elicit educational efforts and the provision of services. Parental behavior within the Zone of Concern invites nudges, mandatory programs with op-out possibilities, etc. Finally, parental behavior within the Zone of Unacceptability justifies coercive state action to reverse or punish potential or actual harm. Harm may not involve the child per se, but can involve third parties, as with parental vaccination refusal.

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Notes

  1. 1.

    ‘Physician’ is used to refer to all health care professionals.

  2. 2.

    Hardwig convincingly shows that substituted judgment does not help, using a reductio ad absurdum argument that I here concretize. Imagine two comatose 16-year-old boys, Harry and Draco. Dr. Ridgeon can cure them with a new medicine, but there is only enough to treat one of them. Using the substituted judgment standard Ridgeon notes that Harry is altruistic, and has risked his life several times to help other people—even people he disliked. Draco, on the other hand, regularly boasted that he would drown his mother to achieve fame and fortune. Ridgeon appropriately concludes that Harry would offer the drug to Draco, who would take it. She cures Draco, and lets Harry die on the basis of substituted judgment.

  3. 3.

    Sometimes a mens rea is not necessary, as when a parent is physically unable to exercise parental functions.

  4. 4.

    The Charlie Gard litigation took place in the UK, where Parham was not precedential.

  5. 5.

    The FreeEconhelp (2020) blog provides a very simple explanation of marginal benefit and cost, with a helpful graph.

  6. 6.

    The interests of the three Talleyrands are not fungible, but I will compare them anyway to make a point about Pareto analysis.

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Jacobs, A.J. (2022). What We Owe Parents and Family. In: Assigning Responsibility for Children’s Health When Parents and Authorities Disagree: Whose Child?. The International Library of Bioethics, vol 90. Springer, Cham. https://doi.org/10.1007/978-3-030-87698-2_4

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