ABSTRACT
This chapter helps to advance our understanding of why the family is seen as problematic in bioethics and to suggest ways in which bioethics could engage more constructively with the reality of family decision making. It focuses on family decision making involving the competent adult person since family involvement in that context is viewed much more negatively in bioethics than family involvement in decisions concerning incompetent children or adults. If convincing arguments can be found for the involvement of family in some health care decisions involving competent adults much will have been achieved. The main requirement is a requirement for reciprocity in family discourse. Reciprocity has two components, it entails that the principles and standards that are proposed have to be principles and standards that are viewed as reasonable for everyone to accept as fair terms of cooperation, and that there is a willingness to discuss the fair terras that others propose.
