I am trying to understand the principles relevant to a particular bioethics scenario. For simplicity, I will describe it as follows:

A doctor refuses to treat a patient suffering from an illness because it is the result of cause x. The treatment can be described as follows:

  1. It comes with some risks, but if untreated, the sequelae of the patient's illness are considered to be the greater harm.

  2. Had the illness arisen from cause y, instead of cause x, the doctor would have no problem rendering treatment.

  3. Although I don't consider it relevant, the doctor's refusal to is not a moral claim about the character of the patient. They simply do not recognise the x-induced illness as a pathology.

Additionally, as a consequence of the doctor's refusal to treat, the patient decides to self-medicate themselves, thereby subjecting themselves to additional harms. These harms are a secondary consequence arising from the refusal to treat the illness.

In this scenario, I can identify two relevant principles:

  1. In refusing to render treatment, the principle of beneficence is being violated.

  2. In refusing to grant the patient equal moral status, the principle of justice is being violated.

However, I was hoping for clarity regarding the additional harms that the patient is being unnecessarily subjected to. Is this also subsumed under beneficence, or would these secondary harms resulting from the doctor's inaction now be considered a violation of the principle of non-maleficence?

Any suggestions or references for further reading would be appreciated!

  • It makes a difference if the illness was self induced/caused. In this case the doctor is not responsible for the additional harms his refusal causes. If following the law constitutes "justice," then, a doctor refusing treatment because the law does not permit it, IS following the "justice principle."
    – Guill
    Commented Dec 5, 2017 at 18:54

1 Answer 1


Are you working this merely using the Principles of Biomedical Ethics? Then note that non-maleficence isn't a standalone inviolable principle. Many treatments and procedures harm and kill patients. The trick is to prefer treatments in which benefits outweigh harms!

To wit, beneficence and non-maleficence are 2 sides of the same coin. You seek treatments that maximize benefits while minimizing harms. If not, treating the patient harms more than assists the patient, which is unethical. If the treatment in question is the standard of care for a particular illness, and it's withheld due to the patient's particular identity, then this violates justice — for example, a physician who refuses chemotherapy to a schizophreniac, because the physician dislikes mentally ill patients.

I cannot write more, because your post is so vague. Can you edit your post to add details? Why would the physician refuse to treat an illness due to its cause? What's this illness?

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