Self-Governed Agency: A Feminist Approach to Patient Noncompliance

In this paper, I consider Michael Bratman's account of self-governed agency as a lens through which to understand and respond better to patient noncompliance. I argue that, to the extent we ought to understand patients as ordinary people in their capacity to evaluate, choose, and act, we ought to accept that noncompliance could be a rational decision deserving of respect. Understanding noncompliance as rational can benefit the doctor-patient relationship in that the two can work toward mutually agreed upon goals—even when those goals prioritize nonhealth-related values. I argue that this promises benefits both to patient health and medical efficiency.