To the Editor An article by Shah et al¹ published in JAMA Pediatrics argues that the best interest standard is too vague and indeterminate to be the appropriate decision-making standard in cases such as that of Charlie Gard.¹ The authors favor the harm principle advanced by Diekema² as a clearer, more understandable standard. Indeed, the best interest standard requires the complex work of identifying and weighing interests and values. However, the harm principle does not avoid this, nor is it less vague and indeterminate.

中文翻译：

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查理·加德（Charlie Gard）和危害原则的局限性

致编辑Shah等人¹在JAMA Pediatrics上发表的文章认为，在诸如查理·加德这样的案件中，最佳利益标准过于含糊和不确定，无法成为适当的决策标准。¹作者赞成Diekema ²提出的危害原则，将其作为更清晰，更易理解的标准。确实，最佳利益标准要求识别和权衡利益和价值的复杂工作。但是，伤害原则并不能避免这种情况，它也没有那么模糊和不确定。