TABLE 3

Standards for Surrogate Decision-Making in Pediatrics

Best-interest standardSurrogate should aim to maximize benefits and minimize harms to the patient, while using a holistic view of the patient’s interests
Harm principleIdentify a harm threshold below which parental decisions will not be tolerated
Constrained parental autonomyParents may balance the best interest of the patient with the family’s best interest if the patient’s basic needs are met
Shared, family-centered decision-makingProcess that builds on collaborative mechanism between families and clinicians