PT  - JOURNAL ARTICLE
AU  - J Savulescu
TI  - The cost of refusing treatment and equality of outcome.
AID  - 10.1136/jme.24.4.231
DP  - 1998 Aug 01
TA  - Journal of Medical Ethics
PG  - 231--236
VI  - 24
IP  - 4
4099  - http://jme.bmj.com/content/24/4/231.short
4100  - http://jme.bmj.com/content/24/4/231.full
SO  - J Med Ethics1998 Aug 01; 24
AB  - 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.