San Diego International Law Journal

Library of Congress Authority File


Document Type



The Comment will compare the laws governing end-of-life care for minors in the United Kingdom, Israel, Australia, and the United States; it will explore cases like Tinslee’s that have illustrated the disagreements between guardians and physicians over end-of-life treatment decisions for critically ill children, and it will focus on two prominent British cases. The Comment will examine the historical influences and motivations of the diverse legal schemes and how different legal systems address the relevant issues. It will conclude by proposing a model standard.

Parts I and II will explore the two pivotal concerns in determining who should make the decision for a child’s end-of-life treatment. Part I will explain the best interest test and will consider two cases of critically ill children and how the laws led to the results in each case. Part II will describe the role of autonomy in medical decisions generally, and how the autonomy of the guardians in cases involving minor children should remain intact except for the most extreme cases. Part III will discuss other considerations in determining end-of-life treatment, including the role of mediation and alternatives to court rulings, and legislature on experimental treatment, advance directives, and do-not-resuscitate orders. Part IV will propose a legal solution and a Model Code, which will formulate a test based on the patient’s “extreme suffering” that gives deference to guardian autonomy. Part IV will also review the negative implications of the best interest test on disability rights. The Comment will culminate with an illustration of how the two cases discussed in Part I would have resulted in different outcomes had the Model Code been used; it also theorizes how an ongoing case would be decided under the Model Code.