Why Professionalism Demands Abolition of Carceral Approaches to Patients’ Nonadherence Behaviors

Abstract

Some clinicians’ and organizations’ considerations of how a patient’s prior adherence to health recommendations should influence that patient’s candidacy for a current intervention express structural racism and carceral bias. When clinical judgment is influenced by racism and carceral logic, patients of color are at risk of having their health services delivered by clinicians in ways that are inappropriately interrogative, aggressive, or punitive. This commentary on a case suggests how an abolitionist approach can help clinicians orient themselves affectively to patients whose health behaviors express or have expressed nonadherence. This article argues that an abolitionist approach is key to facilitating clinicians’ understandings of root causes of many patients’ nonadherence behaviors and that an abolitionist approach is needed to express basic health professionalism and promote just, antiracist, patient-centered practice.