When patients seek medical help, they expect to be protected and that healthcare decisions preserve their safety - they expect to receive more benefit than harm. Harm can be caused through both action and inaction, for example by failing to provide adequate therapy because of cost constraints. Restrictions on the use of antibiotics that prevent or discourage the use of the best available treatment may jeopardise the health/recovery of patients, and undermine their trust in their doctor. What the public and patients may be less clear about is the complex interplay between competing priorities; providing quality care vs. ensuring cost efficiencies in a public healthcare system, which is under increasing pressure to deliver comprehensive care. As new technology becomes available, and the need for and expectations of healthcare increase, the pressure on governments to manage soaring healthcare costs may impact on the care that patients receive, as individuals, from their doctor. Patients vary in their desire to be involved in decisions about their treatment. Some are happy to trust the professionals; others want information from various sources, an open dialogue about the options and the ultimate right to make the best choice for themselves. Governments are keen to have more empowered patients, in the belief that this will drive up standards of care and increase patient satisfaction. This may result in greater pressure from patients for the best treatments to be made available.