The doctrine of informed consent, for example, is based on the premise of full disclosure of information so that patients can make informed choices about their health care - it is not based on a right to health care. In total, it is doubtful that the current patient choice jurisprudence would give patients a legal right to purchase medical resources through a private parallel healthcare system. Clearly there are expanding legal obligations on healthcare providers to respect patients' healthcare choices and to disclose all relevant information about healthcare procedures. The concept of patient choice is primarily based on respect for the ethical principle of autonomy. This principle states that all decisions of consequence should be made autonomously and therefore in an independent, self-determined and informed manner.6 Autonomy does not, however, grant patients a right of access to medical treatment simply because they desire, or choose, such treatment.
Autonomy is a liberty generating principle.
It grants liberty rights, the right to decline or withdraw. It does not grant a right to access. Surely persons should not have a right of access at public or insurers' expense to treatments they desire that are not deemed beneficial by peer review or by a consensus of subscribers to the insurance plan. In addition, respect for autonomy is not necessarily the paramount ethical principle in all healthcare situations. If we as a society come to a given conclusion regarding the fair allocation of healthcare resources, then the ethical principle of justice may appropriately outweigh considerations of patient autonomy.