best interests

a legal and moral standard often invoked in questions of medical ethics. A doctor has professional and legal obligations to act in a way that maximizes a patient's welfare or wellbeing. Although it is often difficult to define and assess a person's best interests, the principle of autonomy holds that a mentally competent adult is usually in the best position to judge this. When the patient lacks mental capacity, the doctor has an extra responsibility to look after his or her best interests: under the Mental Capacity Act 2005, a doctor must take account of the patient's wishes and try to determine what he or she would have wanted if competent. The doctor is also obliged to consult anyone with an interest in the patient, usually relatives, although this is simply to gather data on what might be in the patient's best interests. The interests of children are especially important, and doctors must be particularly vigilant where there is a potential conflict of interests, as when reporting cases of suspected child abuse or recruiting for paediatric research. Questions also arise over whether a patient's treatment must always be the best possible, especially when resources are scarce and justice requires that other considerations are used to decide such matters.