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Harm isn't all you need: parental discretion and medical decisions for a child

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  • Contributors DW drafted the manuscript and TN helped to plan, edit and research.

  • Funding Wellcome Trust (WT106587/Z/14/Z).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • i This is a composite case experienced by DW. Details have been altered.

  • ii Birchley is correct in this sense—all cases that fall above the HT would also sit above the BIT (choices that impose a significant risk of serious harm by definition do not maximally promote the well-being of the child). However, the reverse does not apply.

  • iii One example is the difference between oral and intramuscular preparations of vitamin K. Although it appears from epidemiological studies that intramuscular vitamin K is more effective than oral vitamin K in preventing haemorrhagic disease,7 there have been no randomised controlled trials that have looked at this question.4

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