Canaries in the mines?

Since we are generally not required to act altruistically, one question that arises is may children or incompetent adults be permitted – or required – to act for the benefit of others where the law would ordinarily only permit such an act if it were justified by a valid consent? In this article I consider how the law regulates decision making for children and incompetent adults and whether acts that would otherwise be considered altruistic are permissible. Using organ donation as an example I argue that the law does permit them but only by manipulating the ‘best interests’ test. I consider some of the arguments in favour of allowing such decisions and conclude that it is apparent that there are circumstances in which they should be permitted but that the best interests test is inadequate and dishonestly conceals the real justifications for the decision.