Health first Harmony lists your rights as a patient Most of us are unaware of our rights as patients — the right to privacy, the right to refuse treatment and/or seek redress. Twenty organisations under the Jan Swasthya Abhiyaan (JSA; the Indian circle of the People’s Health Movement, which consists of over 20 networks and 1,000 organisations) launched a 10-day long statewide campaign on patients’ rights in Mumbai on 7 April to mark World Health Day. Abhiyaan distributed pamphlets at three civic hospitals in the city on the inaugural day and performed street plays to raise awareness. The group has sent a draft of rules under the ‘Bombay Nursing Home Registration Act’ to the state to advocate for patients’ rights and related issues. “These rules have been drafted keeping in mind issues like minimum standards for treatment, quality of care and patients’ rights,” Leni Chaudhuri, senior research officer of NGO Centre for Enquiry into Health and Allied Themes (CEHAT), tells Harmony. “We want to gather people’s support to ensure the rules are finalised and implemented.” CEHAT was officially chosen by the Department of Health, Government of Maharashtra, to initiate a consultative process to draft these rules. These are the rights we need to be aware of: RIGHT TO HEALTHCARE Every patient has a right to equal access to healthcare services without any discrimination with regard to socioeconomic background, caste, gender or HIV status. RIGHT TO EMERGENCY TREATMENT According to a Supreme Court directive, a patient should get emergency treatment irrespective of any legal or financial considerations. RIGHT TO INFORMATION The patient or the designated representative should be provided with the necessary information about the likely cause of the illness; the investigations and treatment being planned; its cost; expected outcomes, including likely complications; alternatives available; and consequences of not taking treatment. The patient should have access to his or her clinical records at all times. On admission, the patient should be informed about the treating doctor, rules and regulations of the nursing home, and approximate expenses that would be incurred. At the time of discharge, the patient should get a discharge card with the summary of clinical findings, investigations, diagnosis, treatment, state of his/her health at the time of discharge, and follow-up advice. RIGHT TO PRIVACY All examination should be carried out in a private environment with a person present on the request of the patient. In case of a woman, a female attendant must be present at the time of examination. RIGHT TO CONFIDENTIALITY All records of patients must be kept restricted to only the team treating the patient. This information should be disclosed to anyone only with the patient’s consent. RIGHT TO AUTONOMY AND DECISION MAKING Informed consent should be taken before giving anaesthesia, blood or blood product transfusions, and any invasive or high-risk procedures or treatment. In case of a minor or unconscious patient, consent should be obtained from a close relative. The patient has a right to refuse treatment, and to a second opinion. The current physician should cooperate by providing necessary information to the second physician. The second opinion should be in writing. RIGHT TO QUALITY CARE Every patient should receive good quality care that reflects satisfactory levels of technical performance, and care and regard for personal values and beliefs. RIGHT TO SEEK REDRESSAL Every patient has the right to complain about any aspect of service provided and call for investigation by a competent authority. Every nursing home should display the information on such competent authority prominently. IN CASE OF NURSING HOME UNDERTAKING CLINICAL RESEARCH Documented policies and procedures should guide all research activities in compliance with national and international guidelines. IN CASE OF AN HIV +VE PATIENT No person suffering from HIV should be denied care on the basis of HIV status. Not having a Voluntary Testing and Counselling Centre cannot become grounds to refuse care. For management of a patient who is HIV positive, the nursing home would follow guidelines circulated by NACO (National AIDS Control Organisation). Every patient has the following responsibilities: Provide personal and family health information Participate in decision-making about treatment, and comply with the plan of care Enquire about the related costs of treatment and arrange for payment. Source: Centre for Enquiry into Health and Allied Themes (CEHAT) Featured in Harmony Magazine May 2008