The "noncompliant" transplant patient: a persistent ethical dilemma

The term noncompliant patient may evoke the image of a difficult, demanding, and troublesome patient. In the transplant environment, patients who are unable or unwilling to adhere to a prescribed plan of treatment raise a number of medical, ethical, and other concerns with respect to individual patient care. Their behavior also raises questions of justice and fairness, especially in light of the limited numbers of transplantable organs available and the very large number of people who are waiting for a transplant. Patients who are unable to do what is necessary to maintain a transplanted organ may create a moral dilemma for the healthcare providers who treat them. This article will (1) attempt to develop a more complete understanding of "patient noncompliance," (2) address concerns that arise both before and after the transplant, and (3) suggest strategies for dealing with noncompliant patients.