[Noncompliance: a "contraindication" for organ transplantation?].
Noncompliant behaviour is often taken to constitute a "contraindication" to an otherwise necessary organ transplantation. At the face of it this appears reasonable, given that strict adherence to the regimen of immunosuppressive medication following the transplantation is a prerequisite of the therapy's success. Nonetheless, from an ethical point of view the classification as contraindication is questionable. Firstly, doing so may lead to lose sight of the manifold possibilities to change patient behaviour. Secondly, the classification wrongly suggests that the physician ought to relate to the patient as a neutral observer and judge rather than as a participative guide and assistant. Clinical practice as well as medical guidelines on organ transplantation ought to take account of this special status of the criterion of non-compliance.
Boldt
J
J
Institut für Ethik und Geschichte der Medizin, Albert-Ludwigs-Universität Freiburg. boldt@egm.uni-freiburg.de
D000075202:Contraindications; D026690:Ethics, Clinical; D006801:Humans; D016377:Organ Transplantation; D010817:Physician-Patient Relations; D016312:Treatment Refusal