<p>This thesis paper defends a novel conception of the child's best interest in regard to elective pediatric surgeries (EPS). First, children's capacity for decision-making is examined, and the best decision-making model for EPS is identified as the Best Interest Standard. What follows is a discussion of the interests of children in EPS, the correlation of fundamental interests to rights, and guidelines for weighing children's competing interests. Next, the role of families is considered, especially the rights and duties of parents. Finally, a reinterpretation of the Best Interest Standard is proposed, identifying as paramount a child's ability to make elective medical decisions for herself when she reaches maturity. </p>

<p> This dissertation provides an ethical justification of surgical weight loss interventions for the treatment of obesity. Situating obesity as not merely a public health concern but also fundamentally a problem of clinical medicine confronting individual patients and physicians, the dissertation argues that the time frame of public health interventions is too long for individuals presently facing obesity and its deleterious physical and social co-morbidities. It argues that failure to address weight loss on an individual level, and specifically to consider the clinical appropriateness of weight loss surgery (WLS), raises serious questions about failure to respect autonomy and promote patient welfare. Moreover, social skepticism or rejection of WLS as a treatment option raises concerns about fairness, as this failure indicates that obesity is not regarded in relevantly similar ways to other life-threatening and health-impairing conditions. </p><p> The dissertation examines various reasons that obesity and its myriad interventions, including WLS, are inadequately addressed in the clinical setting. It argues that considerations with cultural and ethical valence play a critical role in obesity's different and unfair treatment within clinical medicine. Gendered and theologically informed attributions of blame, self-blame, shame, and self-stigma influence the attitudes and actions of both patients and clinicians with regard to addressing obesity. Inappropriate and conceptually confused ascriptions of responsibility impede social acceptance of, and access to, WLS. The dissertation's criticism and subsequent reconceptualization of these ascriptions of responsibility from a perspective informed by feminist epistemology and ethics provide the foundation upon which to consider reform of current clinical practices surrounding treatment of obesity. This dissertation concludes that WLS is both ethically and clinically justified.</p>