four pillars of medical ethics

• beneficence: act in the best interest of the patience
• non-maleficence: do no harm
• autonomy: respect the right of people to make decisions for themselves
• justice: seek fairness with what we do

…on children

• autonomy is very adult centric… “substituted judgment is hard”
• altruistic surrogacy: act in the children’ best interest
• altruism: doesn’t require the consent / knowledge of others + doing something for someone else

ethical equivalency

Agreeing to withhold a treatment is equivalent to agreeing to stop it.