Compliance with prescribed therapeutic regimens is a construct that begs for consideration from an ethical perspective.This article offers a dialectical study of the nurse-client relationship, derived from Gadow's framework of ethical knowledge, that provides an alternative to compliance as context for nursing therapeutics. The dialectic move from compliance as thesis to isolated autonomy as antithesis is explored. Gadow's notion of engagement is elaborated on and offered as a synthesis that transcends the paternalistic and coercive assumptions underlying compliance and overcomes the dilemmas presented by the issues of power, consumerism, and beneficence that are inherent in isolated autonomy.
Associate Professor, Department of Nursing, New Mexico State University, Las Cruces, New Mexico, Doctoral Student, University of Colorado, School of Nursing, Denver, Colorado.
The author gratefully acknowledges the assistance of Dr. Peggy Chinn and Ms. Kathy Gramling and the encouragement of Dr. Sally Gadow in the development of this article.