BackgroundCurrent guidelines do not clearly outline when assent should be attained from paediatric research participants, nor do they detail the necessary elements of the assent process. This stems from the fact that the fundamental justification behind the concept of assent is misunderstood. In this paper, we critically assess three widespread ethical arguments used for assent: children’s rights, the best interests of the child, and respect for a child’s developing autonomy. We then outline a newly-developed two-fold justification for the assent process: (...) respect for the parent’s pedagogical role in teaching their child to become an autonomous being and respect for the child’s moral worth.DiscussionWe argue that the ethical grounding for the involvement of young children in medical decision-making does not stem from children’s rights, the principle of best interests, or respect for developing autonomy. An alternative strategy is to examine the original motivation to engage with the child. In paediatric settings there are two obligations on the researcher: an obligation to the parents who are responsible for determining when and under what circumstances the child develops his capacity for autonomy and reasoning, and an obligation to the child himself. There is an important distinction between respecting a decision and encouraging a decision. This paper illustrates that the process of assent is an important way in which respect for the child as an individual can be demonstrated, however, the value lies not in the child’s response but the fact that his views were solicited in the first place.SummaryThis paper demonstrates that the common justifications for the process of assent are incomplete. Assent should be understood as playing a pedagogical role for the child, helping to teach him how specific decisions are made and therefore helping him to become a better decision-maker. How the researcher engages with the child supports his obligation to the child’s parents, yet why the researcher engages with the child stems from the child’s moral worth. Treating a child as having moral worth need not mean doing what they say but it may mean listening, considering, engaging or involving them in the decision. (shrink)

In his critique of egoism as a doctrine of ends, G. E. Moore famously challenges the idea that something can be someone. Donald Regan has recently revived and developed the Moorean challenge, making explicit its implications for the very idea of individual welfare. If the Moorean is right, there is no distinct, normative property good for, and so no plausible objectivism about ethics could be welfarist. In this essay, I undertake to address the Moorean challenge, clarifying our theoretical alternatives so (...) that we may better decide what to admit into our moral ontology and better assess what may be at stake in whether objectivists treat good or good for (or neither) as fundamental. I compare the Moorean and welfarist pictures of value, providing an account of the form and function of good for. According to this account expresses a distinct relational value that has its source in the value of persons. Good for value is thus a form of extrinsic value that provides agent-neutral reasons for action, and it plays a pervasive normative role in regulating child rearing, guiding individual life choices, and shaping social policy formation. (shrink)

Well-being can be promoted in two ways. Firstly, by affecting the quantity, quality and allocation of bundles of consumption (the Resource Approach), and secondly, by influencing how people benefit from their goods (the Taste Approach). Whereas the former is considered an ingredient of economic analysis, the latter has conventionally not been included in that field. By identifying the gain the Taste Approach might yield, the article questions whether this asymmetry is justified. If successfully exercised, the Taste Approach might not only (...) enable people to raise their wellbeing, but also provide solutions to a number of issues such as sustainable development and global justice. The author argues that recently developed accounts such as Happiness Economics (HE) and Libertarian Paternalism (LP) both can be considered specifications of the Taste Approach. Furthermore a third specification is identified: Inexpensive Preference Formation (IPF). Whereas LP suggests that choice architecture should be exercised when rationality fails, IPF holds that governance in certain instances should improve choices also in absence of no such failure. (shrink)

Preferences play a role in well-being that is difficult to escape, but whatever authority one grants to preferences, their malleability seems to cause problems for any theory of well-being that employs them. Most importantly, preferences appear to display a status-quo bias: people come to prefer what they are likely rather than unlikely to get. I try to do two things here. The first is to provide a more precise characterization of the status-quo bias, how it functions, and how it infects (...) commonly accepted theories of well-being. The second is to give an alternative characterization of an agent's preferences that succeeds in avoiding the status-quo bias. (shrink)