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interpretive. At the most open textured end of the spectrum are the development of<br />

judge made law and application of legal principle.<br />

Legal principle<br />

Lord Donaldson explains the role of principle in legal process:<br />

This process of using the common law to fill gaps is one of the most<br />

important duties of the judges. It is not a legislative function or process<br />

– that is an alternative solution the initiation of which is the sole<br />

prerogative of Parliament. It is an essentially judicial process and, as<br />

such, it has to be undertaken in accordance with principle.<br />

Lord Donaldson, Re F [1990] p. 13<br />

Eckhoff (1976) describes legal principle – in contrast with legal rules – as vague and<br />

general, “serving as grounds for interpreting or changing laws and as ground for action<br />

in cases not covered by rules of law… They serve as a kind of ‘normative raw material’<br />

out of which new law is made” (Eckhoff, 1976, p. 211). The best interest test is an<br />

example of a legal principle.<br />

In the introductory chapter I referred to Re F [1990], the case of a 36 year old woman<br />

with learning disability for whom non-therapeutic sterilisation was proposed. The<br />

English courts were asked to intervene. The common law respects the autonomous right<br />

of any person to consent or refuse medical treatment. However, F lacked the capacity to<br />

consent to the sterilisation procedure. In the absence of any other legal mechanism for<br />

medical treatment and non-treatment decisions, the House of Lords adopted the best<br />

interest principle. The best interest test finds its origins in family law, specifically child<br />

welfare and custody cases (Henaghan, 2002; Mnookin, 1975; 1985; Myser, 1994). The<br />

principle developed from the courts’ assertion that when a proxy makes a decision on<br />

behalf of a child, they must act out of concern for the child’s welfare (Kennedy &<br />

Grubb, 2000, p. 778).<br />

In line with Hart’s open texture thesis, the vague and interpretive best interest test<br />

developed for making health care treatment decisions on behalf of adults who lack<br />

capacity. But how is the standard to be interpreted and applied? Within the current<br />

40

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