Abstract
A "non-compliant" or "non-adherent" patient presents an ethical dilemma that commonly arises in chronic care. It occurs when a patient fails to follow a mode of self-management that medical professionals assume to be appropriate for the patient to practice daily. Or a patient who does practice self-management, does it in a way that is considered incorrect by medical professionals. As one factor of the dilemma, we will point out that the "teaching/educating approach" to support patients' self-management is widely prevalent among medical professionals who treat patients with chronic illnesses. We will also examine the ideas of QOL and EBM on which the teaching/educating approach is based to show that for the purpose of maintaining patients' QOL, it is important to clarify the appropriate treatment approach. Second, we will show that it is also important to pay close attention to each element of the patient's QOL. Finally, pointing out a flaw in the "teaching/educating approach," we will attempt to present a strategy to resolve the dilemma of non-compliant or non-adherent patients.
