Skip to main content
Log in

Autonomy, Wellbeing, and the Case of the Refusing Patient

  • Scientific Contribution
  • Published:
Medicine, Health Care and Philosophy Aims and scope Submit manuscript

Abstract

A moral problem arises when a patient refuses a treatment that would save her life. Should the patient be treated against her will? According to an influential approach to questions of biomedical ethics, certain considerations pertaining to individual autonomy provide a solution to this problem. According to this approach, we should respect the patient’s autonomy and, since she has made an autonomous decision against accepting the treatment, she should not be treated. This article argues against the view that our answer to the question of whether or not the refusing patient ought to be treated should be based on these kinds of considerations pertaining to individual autonomy and maintains that finding a plausible answer to this question presupposes that we resolve questions concerning subjectivity and objectivity of individual wellbeing.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • R.J. Arneson (1999) ArticleTitle‘Human Flourishing Versus Desire Satisfaction’ Social Philosophy and Policy 16 IssueID1 113–142 Occurrence Handle10.1017/S0265052500002272

    Article  Google Scholar 

  • T.L. Beauchamp J.F. Childress (1994) Principles of Biomedical Ethics Oxford University Press New York

    Google Scholar 

  • M. Bernstein (1998) ArticleTitle‘Wellbeing’ American Philosophical Quarterly 35 IssueID1 39–55

    Google Scholar 

  • R.B. Brandt (1979) A Theory of the Good and the Right Clarendon Press Oxford

    Google Scholar 

  • A.E. Buchanan D.W. Brock (1989) Deciding for Others: The Ethics of Surrogate Decision Making Cambridge University Press New York

    Google Scholar 

  • R. Crisp (1990) ArticleTitle‘Medical Negligence, Assault, Informed Consent, and Autonomy’ Journal of Law and Society 17 IssueID1 77–89

    Google Scholar 

  • N. Daniels (1979) ArticleTitle‘Wide Reflective Equilibrium and Theory Acceptance in Ethics’ Journal of Philosophy 76 IssueID5 256–282

    Google Scholar 

  • J. Finnis (1980) Natural Law and Natural Rights Clarendon Press Oxford

    Google Scholar 

  • R. Gillon (2003) ArticleTitle‘Ethics Needs Principles – Four Can Encompass the Rest – and Respect for Autonomy Should Be “First Among Equals”’ Journal of Medical Ethics 29 IssueID5 307–312 Occurrence Handle10.1136/jme.29.5.307 Occurrence Handle1:STN:280:DC%2BD3svlvVCgug%3D%3D Occurrence Handle14519842

    Article  CAS  PubMed  Google Scholar 

  • S.M. Glick (2000) ArticleTitle‘The Morality of Coercion’ Journal of Medical Ethics 26 IssueID5 393–396 Occurrence Handle10.1136/jme.26.5.393 Occurrence Handle1:STN:280:DC%2BD3crgsFGgtw%3D%3D Occurrence Handle11055045

    Article  CAS  PubMed  Google Scholar 

  • J. Glover (1981) Causing Death and Saving Lives Penguin Books Harmondsworth

    Google Scholar 

  • H.A. Gylling (2004) ArticleTitle‘Autonomy Revisited’ Cambridge Quarterly of Healthcare Ethics 13 41–46 Occurrence Handle15045914

    PubMed  Google Scholar 

  • J. Harris (2003) ArticleTitle‘Consent and End of Life Decisions’ Journal of Medical Ethics 29 IssueID1 10–15 Occurrence Handle10.1136/jme.29.1.10 Occurrence Handle12569187

    Article  PubMed  Google Scholar 

  • L. Haworth (1986) Autonomy: An Essay in Philosophical Psychology and Ethics Yale University Press New Haven CT

    Google Scholar 

  • T.A. Mappes J.S. Zembaty (1991) Biomedical Ethics McGraw-Hill Inc New York

    Google Scholar 

  • E. Matthews (2000) ArticleTitle‘Autonomy and the Psychiatric Patient’ Journal of Applied Philosophy 17 IssueID1 59–70 Occurrence Handle10.1111/1468-5930.00140 Occurrence Handle1:STN:280:DC%2BD38%2Fjs1KisA%3D%3D Occurrence Handle11758594

    Article  CAS  PubMed  Google Scholar 

  • R. Nozick (1974) Anarchy, State and Utopia Basic Books New York

    Google Scholar 

  • M.A.L. Oshana (2001) ArticleTitle‘The Autonomy Bogeyman’ The Journal of Value Inquiry 35 209–226 Occurrence Handle10.1023/A:1010345019890

    Article  Google Scholar 

  • M.A.L. Oshana (1998) ArticleTitle‘Personal Autonomy and Society’ Journal of Social Philosophy 29 IssueID1 81–102 Occurrence Handle10.1111/j.1467-9833.1998.tb00098.x

    Article  Google Scholar 

  • D. Parfit (1984) Reasons and Persons Clarendon Press Oxford

    Google Scholar 

  • J. Rawls (1971) A Theory of Justice Harvard University Press Cambridge, MT

    Google Scholar 

  • B. Secker (1999) ArticleTitle‘The Appearance of Kant’s Deontology in Contemporary Kantianism: Concepts of Patient Autonomy in Bioethics’ Journal of Medicine and Philosophy 24 IssueID1 43–66 Occurrence Handle10.1076/jmep.24.1.43.2544 Occurrence Handle1:STN:280:DyaK1M3jsl2msQ%3D%3D Occurrence Handle10223442

    Article  CAS  PubMed  Google Scholar 

  • L.W. Sumner (1996) Welfare, Happiness, and Ethics Clarendon Press Oxford

    Google Scholar 

  • G. Thomson (1987) Needs Routledge and Kegan Paul London

    Google Scholar 

  • R.M. Veatch (2000) ArticleTitle‘Doctor Does Not Know Best: Why in the New Century Physicians Must Stop Trying to Benefit Patients’ Journal of Medicine and Philosophy 25 IssueID6 701–721 Occurrence Handle10.1076/jmep.25.6.701.6126 Occurrence Handle1:STN:280:DC%2BD3M7mt1Ciug%3D%3D Occurrence Handle11262633

    Article  CAS  PubMed  Google Scholar 

  • S. Wolf (1990) Freedom Within Reason Oxford University Press New York

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J. Varelius.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Varelius, J. Autonomy, Wellbeing, and the Case of the Refusing Patient. Med Health Care Philos 9, 117–125 (2006). https://doi.org/10.1007/s11019-005-3436-4

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11019-005-3436-4

Keywords

Navigation