Should rationing of health care be explicit?

The aim of this paper is to discuss whether medical professionals should inform patients that there may be drugs or procedures that would benefit them., but which the National Health Service cannot afford to provide. The main body of the paper examines the argument put forward by Professor David Hunter who suggests that rationing of health care should be implicit. I will argue that his arguments are unconvincing. Some of the reasons that Coast and Mechanic give support to implicit rationing of health care are looked at briefly and similarly found to be wanting. In our present culture openness is encouraged from doctors. It is also acknowledged by the medical profession that patients' autonomy should be respected. The importance of autonomy is emphasised in the teaching of our medical students. My submission will be that it is difficult to see how patients' autonomy can properly be exercised unless they are told that treatment is being refused to them that might help their condition.