TY - JOUR T1 - The cost of refusing treatment and equality of outcome. JF - Journal of Medical Ethics JO - J Med Ethics SP - 231 LP - 236 DO - 10.1136/jme.24.4.231 VL - 24 IS - 4 AU - J Savulescu Y1 - 1998/08/01 UR - http://jme.bmj.com/content/24/4/231.abstract N2 - 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. ER -