4 ideas
Lia Lee, a Hmong refugee child in Merced, California, had severe epilepsy that her parents understood as qaug dab peg ('the spirit catches you and you fall down'), a condition both dangerous and a sign of spiritual distinction. Her doctors prescribed a frequently changing, complex anticonvulsant regimen that the non-literate family could not follow and partly distrusted; after noncompliance, Lia was placed in foster care.
Catastrophic outcomes can come from parties who are each competent, loving, and acting in good faith, when their underlying models of the problem are incompatible. Assigning blame to one side hides the real cause, which is the unbridged gap between their frameworks, not any bad intent or incompetence.
Each party to an illness holds an explanatory model: what the illness is called, what caused it, what it means, and what treatment should achieve. Asking patients directly about theirs (Arthur Kleinman's questions: What do you call it? What caused it? What do you fear?) turns noncompliance from defiance into a visible mismatch of models that can be negotiated.
The medical ideal of 'compliance' defines success as the patient obeying the doctor, so resistance gets read as neglect and escalated through authority, such as foster care or legal action. With a people whose history is one of fleeing coercion, this escalation deepens distrust and lowers adherence, so mediation and partial accommodation, such as a simplified regimen or tolerance of shamanic healing, would have worked better than enforcement.