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Welfare means relationality, virtue and altruism

Published online by Cambridge University Press:  02 January 2018

Jonathan Herring
Exeter College, University of Oxford
Charles Foster*
The Ethox Centre and Green Templeton College, University of Oxford


This paper examines the nature of welfare and best interests as used in medical and family law. It argues that these are commonly presented in individualistic terms, requiring the court to promote the interests of a child or incompetent adult without reference to the interests of others. However, this paper argues that, properly understood, best interests and welfare should be taken as concepts which recognise the importance of relational interests, the performance of obligations, and the virtue of altruism.

Research Article
Copyright © Society of Legal Scholars 2012

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1. Adoption and Children Act 2002, s 1 similarly provides that when a court or adoption agency is coming to a decision relating to the adoption of a child, ‘[T]he paramount consideration… must be the child's welfare, throughout his life,’ s 1(2). This changed the previous position under the Adoption Act 1976, s 6, by which the child's welfare was the first, but not the paramount, consideration.

2. As has the meaning of best interests in the law governing adults lacking mental capacity, now found in the Mental Capacity Act 2005. For a summary of the current law see Herring, J Medical Law and Ethics (Oxford: Oxford University Press, 3rd edn, 2010) ch 4Google ScholarPubMed. For detailed discussion of the notions of welfare and best interests see eg JM Eekelaar ‘Beyond the welfare principle’[2002] CFLQ 237; J Herring ‘The Human Rights Act and the welfare principle in family law – conflicting or complementary?’[1999] CFLQ 223; Donnelly, M ‘Determining best interests under the Mental Capacity Act 2005’ (2010) 19 Medical Law Review 27 CrossRefGoogle Scholar; J Coggon, ‘Doing what's best: organ donation and intensive care’ in Danbury, C et al (eds) Ethics and Law in Critical Care (Oxford: Oxford University Press, 2010)Google Scholar.

3. Eekelaar, above n 2; Herring, J ‘Caregivers in medical law and ethics’ (2008) 25 Journal of Contemporary Health Law and Policy 1 Google Scholar.

4. [1996] 2 FLR 314 at 328.

5. Mental Capacity Act 2005, s 4(7).

6. For a discussion of how the courts have managed to attach weight to the interests of others, while holding onto the language of the welfare principle, see Herring, above n 2.

7. Cp W v M and Others[2011] EWHC 2443 (Fam).

8. In re B (A Minor) (Wardship: Sterilisation)[1988] AC 199 at 202.

9. [2001] Fam 147.

10. [2007] EWHC 2003 (Fam) at [99].

11. Department of Constitutional Affairs Code of Practice (London: TSO, 2007) para 5.7.

12. [1997] 8 Med LR 217 at 225. See too Re J (a minor) (Wardship: medical treatment)[1991] Fam 33.

13. [2000] 1 FCR 361.

14. Re A (Male Sterilisation)[2000] 1 FLR 549.

15. Ealing LBC v S[2008] EWHC 636 (Fam); In the Matter of P[2009] EWHC 163 (Ch).

16. Griffin, J Well-Being: Its Meaning, Measurement, and Moral Importance (Oxford: Clarendon, 1986)Google Scholar; Scanlon, T What We Owe Each Other (Cambridge, MA: Harvard University Press, 1998)Google Scholar; Kraut, R What is Good and Why; The Ethics of Well-being (Cambridge, MA: Harvard University Press, 2007)CrossRefGoogle Scholar.

17. Feldman, F Pleasure and the Good Life (New York: Oxford University Press, 2004)CrossRefGoogle Scholar.

18. Bronsteen, J, Bucafussco, C and Masur, J ‘Welfare as happiness’ (2010) 98 Geo LJ 1583 Google Scholar.

19. Molyneux, D ‘“and how is life going for you?”– an account of subjective welfare in medicine’ (2007) 33 J Med Ethics 568 CrossRefGoogle Scholar.

20. Harris, J and Holm, S ‘Should we presume moral turpitude in our children? Small children and consent to medical research’ (2003) 24 Theoretical Medical Bioethics 121 CrossRefGoogle Scholar.

21. Badhwar, N ‘Self-interest and virtue’ (1997) 14 Social Philosophy and Policy 226 CrossRefGoogle Scholar; Hursthouse, R On Virtue Ethics (Oxford: Oxford University Press, 1999)Google Scholar; Slote, M Morals from Motives (New York: Oxford University Press, 2001) esp ch 6–7CrossRefGoogle Scholar; Sumner, LW ‘Is virtue its own reward?’ (1998) 15 Social Philosophy and Policy 18 CrossRefGoogle Scholar.

22. Aristotle (J Barnes (ed)) The Complete Works of Aristotle (Princeton: Princeton University Press, 1984 [C4 BCE]); Aristotle (R Crisp (ed)) Nicomachean Ethics (Cambridge: Cambridge University Press, 2000 [C4 BCE]); Carson, T ‘Happiness and the good life’ (1978) South Western Journal of Philosophy 9 Google Scholar; Carson, T ‘Happiness, contentment, and the good life’ (1981) Pacific Philosophical Quarterly 62 Google Scholar.

23. See also Haybron, D ‘Happiness, the self and human flourishing’ (2008) 20 Utilitas 21 CrossRefGoogle Scholar.

24. Kraut, above n 16, p 127. Although he adds (p 127) that something must also be enjoyed.

25. Hurka, T ‘Value and friendship: a more subtle view’ (2006) 18 Utilitas 232 CrossRefGoogle Scholar.

26. R Hursthouse ‘Virtue Ethics’ in Stanford Encyclopaedia of Philosophy available at

27. J Herring ‘Vulnerability, children and the law’ in M Freeman (ed) Law and Childhood Studies (Oxford: Oxford University Press, forthcoming).

28. Portmore, D ‘Welfare, achievement and self-sacrifice’ (2007) 2 Journal of Social Philosophy 1 Google Scholar.

29. Griffin, above n 16, p 64; Crisp, R ‘Utilitarianism and accomplishment’ (2000) 60 Analysis 264 CrossRefGoogle Scholar.

30. J Raz ‘The role of wellbeing’ available at:

31. R Crisp ‘Well-being’ available at

32. See also Haybron, above n 23.

33. Wolf, S ‘Happiness and meaning: two aspects of the good life’ (1997) Social Philosophy and Policy 207 at 209CrossRefGoogle Scholar.

34. Although s 1(3)(f) does require the court to consider the capability of the parents to meet the needs of the child.

35. Jeske, D Rationality and Moral Theory: How Intimacy Generates Reasons (London: Routledge, 2008)Google Scholar.

36. Crisp, above n 31.

37. Carle, S ‘Theorizing agency’ (2005) 55 American Universities Law Review 307 Google Scholar.

38. Barvosa-Carter, E ‘Mestiza autonomy as relational autonomy: ambivalence and the social character of free will’ (2007) 15 Journal of Political Philosophy 1 CrossRefGoogle Scholar.

39. Donchin, A ‘Autonomy, interdependence, and assisted suicide: respecting boundaries/crossing lines’ (2000) 14 Bioethics 187 CrossRefGoogle Scholar.

40. Foster, C Human Dignity in Bioethics and Law (Oxford: Hart, 2011)Google Scholar.

41. Herring, above n 2.

42. Ibid.

43. Sevenhuijsen, S ‘the place of care: the relevance of the feminist ethic of care for social policy’ (2003) 4 Feminist Theory 179 CrossRefGoogle Scholar.

44. Woodhouse, B ‘Hatching the egg: a child-centered perspective on parents’ rights’ (1993) 14 Cardozo L Rev 1747 at 1825Google Scholar.

45. Eekelaar, above n 2.

46. Eekelaar, J ‘the interests of the child and the child's wishes: the role of dynamic self-determinism’ (1994) 8 IJLPF 42 Google Scholar.

47. Ibid, at 48.

48. Ibid.

49. Munby, LJ ‘Consent to treatment’ in Grubb, A, Laing, J and McHale, J (eds) Principles of Medical Law (Oxford: Oxford University Press, 2010) p 548 Google Scholar.

50. (1992) 175 CLR 218 at 270.

51. [1997] EWCA Civ 1361.

52. For a lengthier discussion see Herring, J ‘Farewell welfare?’ (2005) 27 JSWFL 151 Google Scholar.

53. See Airedale NHS Trust v Bland[1993] AC 789 at 871–872 and 894–895; Re Doe (1992) 583 NE 2d 1263 (Mass); Re Quinlan (1976) 355 A 2d 647 (NJ).

54. Re J (A minor) (wardship: medical treatment)[1991] Fam 33; Re E (A minor) (wardship: medical treatment)[1993] 1 FLR 386; Re W (A minor) (medical treatment: court's jurisdiction)[1993] Fam 64; Note, too, that s 4(6) of the Mental Capacity Act 2005 provides that the person making a best interests determination ‘. . . must consider, so far as is reasonably ascertainable – (a) the person's past and present wishes and feelings (and, in particular, any relevant written statement made by him when he had capacity), (b) the beliefs and values that would be likely to influence his decision if he had capacity, and (c) the other factors that he would be likely to consider if he were able to do so…’

55. Choudhry, S and Herring, J European Human Rights and Family Law (Oxford: Hart, 2011) ch 3Google Scholar.

56. Re MB (Medical treatment)[1991] 2 FLR 426; Re A (male sterilisation)[2000] 1 FLR 549; Re S (adult patient: sterilisation)[2001] Fam 15.

57. [2010] EWHC 3005 (COP).

58. Para 56.

59. See, for instance, Re J (Specific Issue Orders: Muslim upbringing and circumcision)[1999] 2 FLR 678; affirmed at [2000] 1 FLR 571.

60. See eg Re L (an infant)[1968] P 119; S v MC, E v W[1972] AC 24; B (BR) v B(J)[1968] P 466.

61. Herring, above n 2.

62. For present purposes we do not seek to probe the motives behind the discharge of an obligation imposed by a relationship. It does not affect our argument if an altruistic act turns out, if one looks hard enough, to be an example of mutually back-scratching reciprocal altruism.

63. See, for instance, Re B (A minor) (wardship: sterilization)[1988] AC 199; Rochdale Healthcare NHS Trust v C[1997] FCR 274.

64. See Foster, above n 40.

65. We accept, though, that the relationship between flourishing and altruism is more complex than we have painted it as being here. A detailed account of that relationship is not, however, relevant to the thesis we are now advancing.

66. Duff, A Answering for Crime (Oxford: Hart, 2007) ch 1Google Scholar.

67. (1990) 566 NE 2d 1319.

68. [1997] Fam 110, 113–114.

69. At 1331.

70. Lyons, B ‘Obliging children’ (2011) 19 Med L Rev 85 CrossRefGoogle Scholar.

71. [1997] Fam 110 at 113–114.

72. G Williams ‘Children as means and ends in large-scale medical research’ Bioethics, available at; Harris and Holm, above n 20, at 121–129; J Coggon ‘Doing what's best: organ donation and intensive care’ in Danbury et al, above n 2.

73. World Medical Association, Declaration of Helsinki (2008).