By Dr Azadeh
Definition
Patients’ rights
This report has great importance for the World Health Organization, whose mission is to ensure “health for all”. Grounding this mission in a fundamental human right to health would be an important milestone, and a great step forward realizing this goal.
Formalized in 1948, the Universal Declaration of Human Rights recognizes “the inherent dignity” and the “equal and unalienable rights of all members of the human family”. And it is on the basis of this concept of the person, and the fundamental dignity and equality of all human beings, that the notion of patient rights was developed. In other words, what is owed to the patient as a human being, by physicians and by the state, took shape in large part thanks to this understanding of the basic rights of the person.
Patients’ rights vary in different countries and in different jurisdictions, often depending upon prevailing cultural and social norms. Different models of the patient-physician relationship – which can also represent the citizen-state relationship – have been developed, and these have informed the particular rights to which patients are entitled. In North America and Europe, for instance, there are at least four models which depict this relationship: the paternalistic model, the informative model, the interpretive model, and the deliberative model.
Each of these suggests different professional obligations of the physician toward the patient. For instance, in the paternalistic model, the best interests of the patient as judged by the clinical expert are valued above the provision of comprehensive medical information and decision-making power to the patient.
The informative model, by contrast, sees the patient as a consumer who is in the best position to judge what is in her own interest, and thus views the doctor as chiefly a provider of information. There continues to be enormous debate about how best to conceive of this relationship, but there is also growing international consensus that all patients have a fundamental right to privacy, to the confidentiality of their medical information, to consent to or to refuse treatment, and to be informed about relevant risk to them of medical procedures.
The Universal Declaration of Human Rights has been instrumental in enshrining the notion of human dignity in international law, providing a legal and moral grounding for improved standards of care on the basis of our basic responsibilities towards each other as members of the “human family”, and giving important guidance on critical social, legal and ethical issues. But there remains a great deal of work to be done to clarify the relationship between human rights and right to health, including patient rights. Recognizing this challenge, the United Nations Commission on Human Rights (UNHCR) has designated a Special Rapporteur to provide it with a report that examines and clarifies the broader relationship between human rights and the right to health.
This means providing, at minimum, equitable access to quality medical care, ensuring patients’ privacy and the confidentiality of their medical information, informing patients and obtaining their consent before employing a medical intervention, and providing a safe clinical environment.
All of this makes it imperative that health care providers and genetic counsellors be carefully trained, in order that they can provide appropriate information, guidance and support to patients and their families. These issues, among other, are addressed in greater detail in the section of this web-site that addresses the ethical, legal and social implications (ELSI) of human genomics.
Education, policy and protecting basic rights
Assuring that the rights of patients are protected requires more than educating policy makers and health providers; it requires educating citizens about what they should expect from their governments and their health care providers—about the kind of treatment and respect they are owed. Citizens, then, can have an important part to play in elevating the standard of care when their own expectations of that care are raised. Some countries have recognized this, and have advanced their knowledge of genomics in public, academic and scientific spheres.
The creation of effective patient protection laws relies on public knowledge of genetic science and its applications, along with an awareness of the ethical, social, and legal issues surrounding genomics.
Raising awareness of genomics and genetic services and technologies among the general public and patient populations can lead to fruitful advancement of genomics for broad health benefits. In the 2002 Genomics
Patient rights encompass legal and ethical issues in the provider-patient relationship, including a person’s right to privacy, the right to quality medical care without prejudice, the right to make informed decisions about care and treatment options, and the right to refuse treatment.
WHO Patient Right formalized in 1948, Universal Declaration of Human Right recognise “the inherent dignity” and the “equal and unalienable rights of all members of the human family.”
And it is on the basis of this concept of the person, and the fundamental dignity and equality of all human beings, that the notion of patient rights was developed. In other words, what is owed to the patient as a human being, by physicians and by the state, took shape in large part thanks to this understanding of the basic rights of the person.
Purpose
The purpose of delineating patient rights is to ensure the ethical treatment of persons receiving medical or other professional health care services. Without exception, all persons in all settings are entitled to receive ethical treatment.
Description
Many issues comprise the rights of patients in the medical system, including a person’s ability to sue a health plan provider; access to emergency and specialty care, diagnostic testing, and prescription medication without prejudice; confidentiality and protection of patient medical information; and continuity of care.
At issue, besides basic rights of care and privacy, is the education of patients concerning what to expect of their health care facility and its providers. These basic rights include the right to:
Be treated with respect and dignity
Be informed about condition, treatment options, and the possible results and side effects of treatment
Refuse treatment in accordance with the law, and receive information about the consequences of refusal
Quality health care without discrimination because of race, creed, gender, religion, national origin, or source of payment
Privacy and confidentiality, which includes access to medical records upon request
Personal safety
Know the identity of the person treating the patient, as well as any relationship between professionals and agencies involved in the treatment
Informed consent for all procedures
Information, including the medical records by the patient or by the patient’s legally authorized representative and hospital charges, except for Medicaid and general assistance
Consultation and communication
Complain or compliment without the fear of retaliation or compromise of access or quality of care
The patient is also expected to meet a fair share of responsibility by following the plan of care, providing complete and accurate health information, and communicating comprehension of instructions on procedures and treatment. The patient is further responsible for consequences of refusal of treatment, of not following the rules and regulations of a hospital, and of not being considerate of others’ rights. The patient is also responsible for providing assurance that financial obligations of care are met.
The Hospital provides an informal bill of rights for patients who are hospitalized, which informs patients that they have the right to refuse any procedure or medication that is prescribed, and that states that full information should be provided by the attending physician if the patient has expressed doubts or concerns.
Patient confidentiality. To aimed at protecting patient records by creating limits on the methods in which medical information is shared. Direct authorization from a patient must be gained before information may be released.
Patients’ rights vary in different countries and in different jurisdictions, often depending upon prevailing cultural and social norms. Different models of the patient-physician relationship? Which can also represent the citizen-state relationship? have been developed, and these have informed the particular rights to which patients are entitled. In North America and Europe, for instance, there are at least four models which depict this relationship: the paternalistic model, the informative model, the interpretive model, and the deliberative model.
The Universal Declaration of Human Rights has been instrumental in enshrining the notion of human dignity in international law, providing a legal and moral grounding for improved standards of care on the basis of our basic responsibilities towards each other as members of the “human family”, and giving important guidance on critical social, legal and ethical issues.
But there remains a great deal of work to be done to clarify the relationship between human rights and right to health, including patient rights. Recognizing this challenge, the United Nations Commission on Human Rights (UNHCR) has designated Special Reporters to provide it with a report that examines and clarifies the broader relationship between human rights and the right to health.
This report has great importance for the World Health Organization, whose mission is to ensure “health for all”. Grounding this mission in a fundamental human right to health would be an important milestone, and a great step forward realizing this goal.
What are the patient’s Rights in detail in The Gambia?
The patients’ Rights in detail are;
Right to choose:
The right to choose involves patient to choose where to go and been given the choice to select the health providers from whom they want to receive health services without being manipulated by individuals or institutions
Right to access.
The right to access implies that health services are available and accessible to any individual in need.
Right to information:
The purpose that the patient receive information on health education and preventable diseases in particular form is to prevent life threatening diseases such as HIV, AIDS.
Right to dignity:
The patient right to dignity refers to the way the patient is treated, normally with full respect and considerations without discrimination against, male, female, age, ethnic or tribal origin, religious believes, and skin colour.
Right to confidentiality:
Implies assuring that any information that patient shares with any doctor or nurse at any health facility will not be accessible to any unauthorized doctor and nurse.
Right to privacy:
Exchange of information between patient and health providers should occur in an environment where consultation will not be shared/heard by a third party without patient’s consent.
Right to comfort:
The right to comfort refers to physical and environmental facilities and examination during visit.
Right to safety:
Refers to patient’s protection against possible side effects of medications, including physical and mental conditions.
Right to continuity of care:
The right to continuity of care implies that patients receive services and supplies of medication, laboratory tests and re-supply of mediation.
Right to Understand:
The right to understand refers to the patient’s right to be fully aware of the diagnosis, treatment, and prognosis using words the patient can reasonably understand. If needed, efforts to provide interpreter most be taking.
Right to refuse treatment:
Patient has the right to refuse treatment to the limits permitted by law. The patient has the right to refuse the treatment if it is known to the patient that the treatment chosen is a life threatening.
Consent
Consent, particularly informed consent, is the cornerstone of patients’ rights. Consent is based on the inviolability of one’s person. It means that doctors do not have the right to touch or treat a patient without that patient’s approval because the patient is the one who must live with the consequences and deal with any dis-comfort caused by treatment.
A doctor can be held liable for committing a Battery if the doctor touches the patient without first obtaining the patient’s consent
Informed Consent
Simply consenting to treatment is not enough. A patient must give informed consent. In essence, informed consent means that before a doctor can treat or touch a patient, the patient must be given some basic information about what the doctor proposes to do. Informed consent has been called the most important legal doctrine in patients’ rights.
The information must be presented in language the patient can understand and typically should include the following:
A description of the recommended treatment or procedure;
A description of the risks and benefits – particularly exploring the risk of serious bodily disability or death;
A description of alternative treatments and the risks and benefits of alternatives;
The probable results if no treatment is undertaken;
The probability of success and a definition of what the doctor means by success;
Length and challenges of recuperation; and
Any other information generally provided to patients in this situation by other qualified physicians.
Please note if have any complaint about any issues on the any health services you bring your complaint documents to The Gambia Completion and Consumer rights Production Commission
The Consumer Protection Act 2014 sets out the nine consumer rights enshrined in the Act, and explain what consumers need to know about each of them. It provides answers to the kinds of questions that the ordinary man may ask about the Act for a better understanding of it, and instructs on how and where to lodge complains about goods and services ones pays for, but not satisfied with. Consumers, by definition, include us all. They are the largest economic group, affecting and affected by almost every public and private economic decision. Therefore, in the medical field a consumer is termed the ‘patient’ as he/ she is the end user of the products or services offer by the Health Service operators.
Consumer Rights protected by the Consumer Protection Act 2014
1. The right to satisfaction of basic needs: To have access to basic, essential goods and services, adequate food, clothing, shelter, health care, education, public, utilities, water and sanitation, have rights to fair pricing, to lodge complaints and high quality products.
The Author DR AZADEH Senior Lecturer at the University of the Gambia, Senior Consultant in Obstetrics & Gynaecology, Clinical Director of Medicare Health Services.
