The “Noncompliant” Transplant Patient: A Persistent Ethical Dilemma

Journal of Transplant Coordination, Vol. 9, Number 4, December 1999 (eg, throwing) potentially infectious blood or body fluids, or even attacking providers and/or other patients. The negative effects of these types of behaviors may be minimal, moderate, or severe; however, in most instances, the effects are felt not only by the patient but by those around the patient as well. When patients act in ways that healthcare providers find undesirable or counterproductive, the provider’s initial impression may be that the patient is simply choosing to be difficult. However, it is important to consider the potential causes for the patient’s behavior. For instance, a patient who is not taking medication properly may have forgotten the doctor’s instructions. A patient may not be able to read and may be too embarrassed to ask anyone else for assistance, or may choose not to take the medication in the way it was prescribed (or at all) because of the unpleasant side effects it causes. A heart patient may not be following the prescribed “heart healthy” diet because of certain social or cultural norms in the community. Perhaps the prescribed diet is too expensive in light of the fact that the rest of the family won’t eat it and the patient cannot afford to buy additional food. In some cases, the problem may have more to do with distrust of the healthcare system or of specific providers; patients may simply not believe what the physician or other provider has told them or may be worried that they are being lied to or taken advantage of by the provider. And, of course, it is always possible that in The “noncompliant” transplant patient: a persistent ethical dilemma