There has been a
paradigm shift in the doctor-patient relationship. The balance is no more
tilted in favor of the doctor as patients do not regard doctors as “parent figures”
who took medical decisions on their behalf. They are equal partners in decision
making today.
All patients have the
right to know their health status and treatment. This right to information
arises out of the principle of patient “autonomy”, which means that patients
have the right to choose their doctor, the type of treatment. They even have
the right to reject treatment.
Understanding this right
of the patient builds a strong doctor-patient relationship, which is based on
mutual trust and respect.
Patient autonomy is the
legal and ethical basis for informed consent, which again gives the patient the
right to make decisions about their health based on the information given.
Failure to give all the facts to the patients that are necessary for them to
take a decision regarding their treatment is a violation of their rights.
A valid consent has
three components: Disclosure, Capacity and Voluntariness i.e. provision of
relevant information by the doctor, capacity of the patient to understand the information
given and take a decision based on the adequate information, without force or
coercion. This is informed consent. Any permission given under any unfair or
undue pressure makes the consent invalid.
Informed consent is not
only an ethical obligation, but also a legal pre-requisite today. Not taking
consent is gross negligence.
The National Human Rights
Commission has drafted a charter of patient rights to be implemented by the
Ministry of Health and Family Welfare.
The Right to Information is as
follows:
“Every patient has a right to adequate relevant
information about the nature, cause of illness, provisional / confirmed
diagnosis, proposed investigations and management, and possible complications
to be explained at their level of understanding in language known to them.
The treating physician has a duty to ensure that
this information is provided in simple and intelligible language to the patient
to be communicated either personally by the physician, or by means of his / her
qualified assistants.
Every patient and his/her designated caretaker have
the right to factual information regarding the expected cost of treatment based
on evidence. The hospital management has a duty to communicate this information
in writing to the patient and his/her designated caretaker.
They should also be informed about any additional
cost to be incurred due to change in the physical condition of the patient or
line of treatment in writing. On completion of treatment, the patient has the
right to receive an itemized bill, to receive an explanation for the bill(s)
regardless of the source of payment or the mode of payment, and receive payment
receipt(s) for any payment made.
Patients and their caretakers also have a right to
know the identity and professional status of various care providers who are
providing service to him / her and to know which Doctor / Consultant is
primarily responsible for his / her care.
The hospital management has a duty to provide this
information routinely to all patients and their caregivers in writing with an
acknowledgement.”
Applicable laws
· Annexure 8
of standards for Hospital level 1 by National Clinical Establishments
Council set up as per Clinical Establishment Act 2010
· MCI Code of
Ethics
· Patients
Charter by National Accreditation Board for Hospitals (NABH)
· The Consumer
Protection Act, 1986
Dr KK
Aggarwal
Padma
Shri Awardee
President
Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)
Group
Editor-in-Chief IJCP Publications
President
Heart Care Foundation of India
Past
National President IMA
No comments:
Post a Comment