By Ryan Pferdehirt, D.Bioethics, HEC-C

July 2021

Noncompliant or Nonadherent Patient Bioethics Case Study

Rick is a 78-year-old male patient, suffering from ESRD, among other ailments. Rick is known to the hospital staff as being a “problem patient.” He has a history of noncompliance and behavioral issues, including being verbally abusive to family and staff.

With the hospital staff having him sign behavior contracts that he violated, Rick has been discharged from most other hospitals and health facilities in the area. He will not be accepted at any other hospital. Due to his ESRD, he is not able to be discharged to home because he does not have adequate means of transportation for dialysis. No local SNF or other care facility will accept him due to his noncompliance and behavioral issues. The only accepting facility is in Salt Lake City (1000+ miles away).

Rick and his family are refusing discharge to Salt Lake City.

Social Work has requested ethics support.