Understanding Children's Best Interests for Healthcare Decisions: A Critical Interpretive Review
Abstract
‘Best interests’ is a key ethical norm for children’s medical decision-making. While intended to guide parents and healthcare practitioners (HCPs) in their decisions, it has been criticized for its ambiguity and inconsistent application. In the context of childhood vaccination, ‘best interests’ faces unique challenges due to parental vaccine hesitancy, their preventative nature, and their dual benefits to individuals and the public. I employed critical interpretive review (CIR) methodology to analyze 58 empirical and non-empirical publications on children’s best interests and healthcare decisions, including vaccination. I identified five themes that furthered understandings of children’s best interests and healthcare decisions. ‘Best interests’ was not uniformly conceptualized among the reviewed works. The factors that make up a child’s ‘best interests’ were influenced by the various interpretations of ‘best interests’. This thesis provides insights into HCPs’ interpretations of best interests, highlighting areas for further consideration, namely, how to navigate the subjectivity of these decisions.