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The fact that patients frequently fail to follow the medication orders of physicians is documented repeatedly in the literature on" patient compliance"(Marston 1970; Sackett and Haynes 1975). Depending on the disease being studied and the research design being used, noncompliance rates vary from as low as 19% to as high as 72%(Hayes-Bautista 1976). To understand why compliance rates are so low, health-service researchers analyze the compliance problem from the perspective of the physician (Stimson 1974). Underlying these studies is an ideal image of how patients should behave. Patients are assumed to adopt a sick role, resulting in a patient who is unthinking, uncritical, and obedient in the face of the doctor's orders. Noncom-pliance is not explained by allowing for departures from this ideal (ie, seeing the patient as a thoughtful, critical evaluator of professional advice). Instead, it is explained by blaming …