Ethics Manual

Highlights

Patients Near     the End of Life Advance Care     Planning Problems of     Life-Sustaining     Treatments

Relative Issues

(Patients Rights)

Disclosure

Informed Consent

Decisions about     Reproduction

Medical Risk to     Physician and     Patient

Patients' Rights

Considerable literature is available in the medical field regarding duties of doctors or the professional code that the doctor swears to uphold.  But the medical man very conveniently forgets that because the doctor has duties towards the patient, the patients have certain rights.  The World Medical Association has adopted both the International Code of Medical Ethics and the Declaration of Lisbon (1981).  

These documents yield a set of duties and  correlative rights that are far more stringent than any national law could impose on doctors in their capacity as individual citizens.

As patients are now considered as consumers as per the Consumer Protection Act 1986, here is an attempt to make the patients aware of some of their rights.

Considering the wide variety of medical services, though it is almost impossible to formulate the rights of all the patients, the following rights are affirmed.
The Patients has a right to:

	Choose his own doctor.
	Considerate and respectful care.
	Access to emergency services.
	Obtain from his physician complete current information concerning his          diagnosis, treatment, prognosis and alternative therapies available, in the terms that the patient can reasonably be expected to understand.
	Know full details about the physician who is responsible for his care.
	Receive from his physician information necessary to give informed consent prior to  the start of any procedure/treatment.
	Be informed of the medical consequences if he refuses a much needed procedure (informed refusal).
	Be treated in privacy and that the doctor should maintain  professional secrecy.
	Receive complete information and explanation concerning the need for and alternative to any transfer to another facility.  The institution to which the patient is to be transferred must first have accepted the patient for transfer.
	Consult another doctor.
	Refuse to participate in any research projects or human experimentation.
	Expect reasonable continuity of care.
	Examine and receive an explanation of his bill.
	Know what hospital rules and regulations apply to his conduct as a patient.
	Access to his hospital records.
	Complain and seek redressal.

All the rights of the patients should be posted conspicuously in all the hospitals and dispensaries.  Copies of it should be furnished to the patients at the time of his admission to any hospital.

It is better to regard the patients rights as being an inherent property of a caring, mutually respectful and properly Hippocratic relationship.  In other words, the doctor's oath to pay first consideration to the health of their patients should guarantee patient's rights.

The medical profession must take an active role in promoting and safeguarding patient's rights by maintaining standards for medical practice that embody the ideas of the Declaration of Lisbon.  They should accept and enforce the idea that patients have a right to respectful and competent care and that the doctors have a correlative duty to provide that care at a standard that exceeds anything that  common law could intelligently require.

Disclosure

To make health care decisions and work intelligently in partnership with the physician, the patient must be well informed. Effective patient-physician communication can dispel uncertainty and fear and can enhance healing and patient satisfaction. Information should be disclosed whenever it is considered material to the patient's understanding of his or her situation, possible treatments and probable outcomes. This information often includes the costs and burden of treatment, the experience of the proposed clinician, the nature of the illness and potential treatments.

However uncomfortable to clinician or patient, information that is essential to the patient must be disclosed. How, when and to whom information is disclosed are important concerns that must be addressed.

Information should be given in terms that the patient can understand. The physician should be sensitive to the patient's responses in setting the pace of disclosure, particularly if the illness is very serious. Disclosure should never be a mechanical or perfunctory process. Upsetting news and information should be presented to the patient in a way that minimizes distress. If the patient is unable to comprehend his or her condition, it should be fully disclosed to an appropriate surrogate.

In addition, physicians should disclose to patients, information about procedural or judgment errors made in the course of care if such information is material to the patient's well-being. Errors do not necessarily constitute improper, negligent or unethical behavior, but failure to disclose them might become so.