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Journal of Medical Ethics logoLink to Journal of Medical Ethics
. 1998 Aug;24(4):231–236. doi: 10.1136/jme.24.4.231

The cost of refusing treatment and equality of outcome.

J Savulescu 1
PMCID: PMC1377671  PMID: 9752624

Abstract

Patients have a right to refuse medical treatment. But what should happen after a patient has refused recommended treatment? In many cases, patients receive alternative forms of treatment. These forms of care may be less cost-effective. Does respect for autonomy extend to providing these alternatives? How for does justice constrain autonomy? I begin by providing three arguments that such alternatives should not be offered to those who refuse treatment. I argue that the best argument which refusers can appeal to is based on the egalitarian principle of equality of outcome. However, this principle does not ultimately support a right to less cost-effective alternatives. I focus on Jehovah's Witnesses refusing blood and requesting alternative treatments. However, the point applies to many patients who refuse cost-effective medical care.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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