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
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