Why treat noncompliant patients? beyond the decent minimum account

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3 Scopus citations


Patients' medical conditions can result from their own avoidable risk taking. Some lung diseases result from avoidable smoking and some traffic accidents result from victims' reckless driving. Although in many nonmedical areas we hold people responsible for taking risks they could avoid, it is normally harsh and inappropriate to deny patients care because they risked needing it. Why? A popular account is that protecting everyone's "decent minimum," their basic needs, matters more than the benefits of holding people accountable. This account is deficient. Protecting the decent minimum is not always served by offering noncompliant patients either nonbasic or basic care. Nor is protecting that minimum always served by unconditional medical care better than by nonmedical interventions. To interpret the decent minimum in democratic terms is a futile response to these challenges. Ideas for new accounts are suggested.

Original languageEnglish (US)
Pages (from-to)572-588
Number of pages17
JournalJournal of Medicine and Philosophy
Issue number6
StatePublished - Dec 2011
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Issues, ethics and legal aspects
  • Philosophy


  • decent minimum
  • democratic equality
  • dignity
  • luck egalitarianism
  • personal responsibility


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