The effect of patients' noncompliance on their surgeons' obligations

Effective physicians recognize that most patients have difficulty following instructions for a variety of reasons. That difficulty is best understood as nonadherence rather than noncompliance. The surgeon's role is to make the patient's choice informed, to be aware of the risk factors for nonadherence, and not to make adherence any more difficult than it has to be. The patient's role is to make choices between value-laden alternatives. Society's role is to distribute scarce medical resources equitably to patients who can and want to adhere to the necessary regimen to benefit from them.