Abstract
One of the fundamental principles of medicine is respect for autonomy. Respect for autonomy
must be aligned with other ethical principles to ensure that treatment benefits the patient while
satisfying health-care provider expectations of conscientious resource use. When a patient
refuses beneficial treatment, these objectives may conflict. When these objectives clash, a
clinician must decide how to proceed. The aim of this thesis is to discuss how a clinician
might respond to a patient who refuses to adhere to recommended treatment. First, I discuss
the ethical basis of informed consent, and how the concept of decision-making capacity could
relate. Then, I examine how restrictions on a competent adult's autonomy may be justified and
whether paternalistic intervention is permissible. I argue that when a patient makes a decision
that is contrary to their own values, clinicians should not simply accept that decision; instead,
they should explore ways to change the patient's mind. In making this argument, I investigate
the ethical basis of the problem, using a link proposed by Julian Savulescu between
autonomy, rationality, and values, and develop some practical solutions to the dilemma.