It is generally agreed that the corollary of the right to consent to treatment is the right to refuse it. While choosing to accept recommended therapy can be an affirmation of the patient’s autonomy, so too can be his/her decision to avoid or reject it. Both are about self-determination or control over our lives, which, as Frey says, ‘ … is one of the most important goods we enjoy.’1

While rejecting treatment may seem in some cases to be irrational, especially when there is hope of palliation or cure, there may be reasons – possibly unknown to healthcare professionals – that lead people to make the decision not to accept it. As Charlesworth says: