Why Should Medical Care Be Family-Centered?: Understanding Ethical Responsibilities for Patients’ Family Members

The movement toward family-centered care in medicine has brought more attention to the importance of patients’ families in clinical practice. However, an issue central to the movement—why families matter—remains underexplored in both the family-centered care and the wider biomedical ethics literature. Given the possibility—and reality—of conflicts between patient and family interests, the need to think about how far providers should go in attending to a family’s welfare and wishes, and the focus that family-centered care has placed on further inclusion of families into care, a clearer understanding of providers’ responsibilities for family members is needed. In this paper, I argue for a framework in which providers have non-instrumental responsibilities for their patients’ family members but their responsibilities for their patients remain primary. To reach this conclusion, I first identify both role- and relationship-based reasons for thinking providers have non-instrumental responsibilities for family members. I then explain why clinicians should still largely prioritize the wishes and interests of their patients over those of their families and provide a reasoning structure for use in situations where wishes and interests conflict.