Due to having a history of non-compliance
“Non-compliance” is a medical term, here stemming directly from commonly accepted organ transplant procedures.
Everyone has a different genetic makeup — it’s what makes us all different. When you get an organ transplant, the new body part may not be a perfect match for you, causing a number of lifelong symptoms and pains. The only solution is to adapt to taking a series of pills multiple times per day, every single day, for life.
Stokes was noted by the hospital to have a chance, whether historically or in the future, to miss or delay pre-care medications. This means that he is a likely candidate to not take pills or otherwise not follow the prescribed medication schedules. Non-compliance is extremely strict, such that the hospital determined that he did not have the responsibly take his medicine and care for the heart. Hearts in particular are extremely hard to get and require years on a waitlist.
Stokes' parents have suggested that their son’s past bad behavior played a factor, but this is standard procedure. Competition and care for heart transplants is so severe that, by disregarding medicine instructions, anyone can and will have their waitlist spot removed.
To help improve the meaning of these lyrics, visit "Letter to the Family of Anthony Stokes Denying Heart Transplant" by Children's Healthcare of Atlanta and leave a comment on the lyrics box