Three decades after Baby Doe: how neonatologists and bioethicists conceptualize the Best Interests Standard

Objective:the objective of this study is to determine how neonatologists and bioethicists conceptualize and apply the best interests standard (bis).study design:members of the american society for bioethics and humanities and the american academy of pediatrics section on neonatal-perinatal medicine were surveyed to determine how they conceptualized the bis and ranked the appropriateness of forgoing life-sustaining therapy (lst).results:neonatologists’ median response supported an infant-specific bis conceptualization that linked the infant’s and family’s interests. they did not support allowing limitations on the family’s obligations. ethicists’ supported a conceptualization that linked the infant’s and family’s interests and limitations on the family’s obligations, a less infant-specific conceptualization. ethicists were less or equally likely to agree with forgoing lst in seven of eight cases.conclusions:ethicists endorsed a conceptualization of the bis that includes the effects on the family and rejected an infant-specific one. neonatologists split between these two and rejected limiting the family’s obligations. critical appraisal of the bis is needed in neonatal ethics.