Document Type



Master of Arts



Date of Defense


Graduate Advisor

Eric Wiland


Lauren Olin

Jill Delston


Pediatric patients must rely on proxy decision-makers, usually a parent or guardian, to make their health care choices for them. There are 3 main frameworks in place for such decision-making. The default is usually that the decision-maker will make the decision that they feel is in the best interest of the child. Limitations on the decision-maker are an aspect often discussed with abuse and neglect at the forefront as thresholds for when limitations and intervention are deemed necessary. Concern for the child’s future autonomy is not made a consideration. Instead, the values and beliefs of the decision-maker are used to validate the choices made for the child. It should be the responsibility of those involved in the decision-making process to preserve the future autonomy of the child. This leads to the question of whether a decision should even be made or held in reserve for the future, if possible. In situations where that is not possible, such as a life-threatening or serious health condition, the assurance of a future where the child has the ability to become autonomous should then be the first consideration.