Question

Research 'Patient Bill of Rights' on the Internet. Read about when it started, why it started and what it covers. Then give a specific example of when it must be applied and discuss how choice, consent and refusal affect any medical decision.

Answer 1

Patient Bill of Rights

The American Hospital Association in 1973 adopted the Patient's Bill of Rights for the first time and then revised in October 1992. The patient's bill of rights was adopted to provide effective and fully informed treatment while protecting the privacy and dignity of the patient as a responsible individual who has the decision-making capacity. The Patient's Bill of Rights must be translated or simplified as per the specific patient's level of understanding. According to the American Hospital Association, a patient's rights can be exercised on his or her behalf by a designated surrogate or proxy decision-maker if the patient lacks decision-making capacity, is legally incompetent, or is a minor.

Bill of Rights covers the following;

1. The patient has the right to considerate and respectful care.

2. The patient has the right to obtain relevant, current, and understandable information about diagnosis, treatment, and prognosis.

3.  The patient is entitled to get information related to the specific procedures and/or treatments available, the risks involved, the possible length of recovery and the medically reasonable alternatives to existing treatments along with their accompanying risks and benefits except in emergencies. Patient has the right to medical treatment in emergency situations when the patient lacks the ability to make decisions and the need for treatment is urgent.

4. The patient has the right to know the identity of physicians, nurses, and others involved in his or her care.

5. The patient also has the right to know the immediate and long-term financial significance of treatment choices.

6. The patient has the right to make decisions about the acceptance of treatment and to refuse a recommended treatment or plan of care. The patient also has the right to be informed of the medical consequences of this action.

7. The patient has the right to have an advance directive (such as a living will, health care proxy, or durable power of attorney for health care).

8. The patient has the right to privacy. The patient has the right to expect that all communications and records pertaining to his/her care will be treated confidentially by the hospital.

9. The patient has the right to review his or her medical records and to have the information explained or interpreted as necessary, except when restricted by law.

10. The patient has the right to consent to or decline to participate in the proposed research studies conducted by health care institutions.

11. The patient has the right to expect reasonable continuity of care and to be informed of the available care options when hospital care is no longer appropriate.

12. The patient has the right to be informed of available resources for resolving disputes, grievances, and conflicts. The patient has also the right to be informed of the hospital's charges for services and available payment methods.

In a specific example, a patient refused to undergo dialysis after getting diagnosed with chronic renal failure. He refused to take dialysis even though the consequences of such denial were fully informed. He chose to take some sort of alternative therapy against the advice of the physician and died after a few months. Without the consent of the patient, health care providers cannot perform any procedures, even though the patient is risking his or her life by denial of treatment. From an ethical perspective, physicians and other healthcare professionals have the responsibility or duty to protect the life and health of a patient. However, ultimately, the patient has the final decision regarding the medical treatment they receive even when it means they choose to decline such treatment.