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The article looks at best interest standard (BIS) which is a guidance principle used in medicine, law and elsewhere instructing surrogates making decisions for individuals lacking decisionmaking capacity to maximally promote their good. It argues that that the BIS is an umbrella concept covering three distinct but interrelated notions that are linked conceptually and historically. It states that the BIS can be used as a standard of reasonableness.

The author discusses the role of best interest's standard that is a minimal standard of care and can be used to generate actual duties in specific circumstances. She states that best interests standard is used for expressing an ideal on how to make choices for people without the ability to make decisions. She mentions that the use of best interest's standard as an indeterminate ideal is incorrect with its use as a way to determine actual duties.

The Maryland Court of Appeals in Grimes v. Kennedy Krieger Institute was sharply critical of the lead abatement study conducted by this Institute, an affiliate of Johns Hopkins University. Grimes ruled that investigators might, given the facts of the case, have a special relationship with subjects, thereby creating a duty of care that could, if breached, give rise to an action in negligence. This ruling has implications for pediatric research practices and long-standing disputes among informed people of good will about what pediatric studies should be permitted. [ABSTRACT FROM AUTHOR]

Our cultural disagreements can often be anticipated, negotiated and resolved using shared methods of moral reasoning. This claim is incompatible with any extreme version of communitarianism or strong ethical relativism, which hold that one's culture is the final arbiter of good, bad, right and wrong, or that the rights of the community should trump individual rights within that community. This view is discussed and found to be implausible using the example of common grounds for responding to different cultural views about being truthful in medical practice. Its implausibility stems from difficulties individuating cultures, and accounting for intercultural goals, values and methods. Given our increasingly diverse populations, problems arise as clinicians from one culture try to care respectfully and compassionately for people from other groups. Yet working from shared values and goals, we can use some bridging methods such as discussing grim news in the third person. Claims that something is a cultural belief or attitude, moreover, cannot always be taken at face value. Various meanings of `multiculturalism' are distinguished. [ABSTRACT FROM AUTHOR]

Discusses the vulnerability of adolescents as research subjects. Manipulation of assent from minors or consent from legally competent adults; Controversy over the Student Athlete Using Random Notification study; Emphasis on consequentialist reasoning.