RT Journal Article SR Electronic T1 Medical ethics for children: applying the four principles to paediatrics JF Journal of Medical Ethics JO J Med Ethics FD BMJ Publishing Group Ltd and Institute of Medical Ethics SP 141 OP 145 DO 10.1136/jme.2006.018747 VO 34 IS 3 A1 Baines, P YR 2008 UL http://jme.bmj.com/content/34/3/141.abstract AB I will argue that there are difficulties with the application of the four principles approach to incompetent children. The most important principle – respect for autonomy – is not directly applicable to incompetent children and the most appropriate modification of the principle for them is not clear. The principle of beneficence – that one should act in the child’s interests – is complicated by difficulties in assessing what a child’s interests are and to which standard of interests those choosing for children should be held. A further problem with the four principles approach is that parental authority does not follow clearly from the four principles.