[Dilemmas regarding access to non-reimbursed treatments in the Netherlands: an ethical perspective]

With the expected rise in healthcare costs, the growing burden of expensive treatments on healthcare budgets and the increasing emphasis on efficient uses of resources, physicians are increasingly confronted with ethical dilemmas regarding access to treatments which are not (yet) reimbursed within the basic healthcare package. In practice, physicians and hospital executives seem to have different experiences and perspectives regarding these dilemmas. While some physicians actively pursue access to non-reimbursed treatments, based on the values of beneficence and liberty, others do not, basing themselves on the values of solidarity and justice. This article provides an overview of the relevant ethical values, to enable physicians to make a well-considered decision when confronted with dilemmas regarding access to non-reimbursed treatments in the consultation room.