Compliance and quality of life: confessions of a difficult patient.

Noncompliance has been treated as a deviant behavior. This paper argues that nonadherence is more complex and is the expression of independence and a judgment about the utility of any medical, surgical, or rehabilitation intervention. The quality of one's life is a personally defined concept and so too are the reasons why a patient refuses to do what is recommended. Appropriate health behavior should be thought of as a behavior that meets the person's goals and achieves some mutually definable outcome.