A patient comes to a medical facility with a life-threatening disease. The diagnosis is simple and certain. Indicated treatment is the administration of a specific drug. There is very little risk in using the drug, and no alternative therapy has any real probability of success. The patient refuses. Is it permissible to override the refusal?
If the patient is fully rational, has a well-developed, consistent set of values, acts with full knowledge and makes no mistakes, there can be no conflict between her welfare and her choice. If the physician is likewise endowed, and is committed to the welfare of the patient, a problem will not arise. In the real world, though, this ideal is not always met. From the perspective of the participant physician, there may appear to be a breach between the patient's choice and her welfare. The moral (and legal) issue is what should be done in an imperfect world.