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Discuss how health care providers can ensure that patients’ rights are respected and protected.

Discuss how health care providers can ensure that patients’ rights are respected and protected.

Discuss how health care providers can ensure that patients’ rights are respected and protected.

Discuss how health care providers can ensure that patients’ rights are respected and protected.
Discuss how health care providers can ensure that patients’ rights are respected and protected.

What exactly are patient rights?
In a medical setting, patients have rights, including the right to care and the right to refuse treatment, among other important safeguards.
In a medical setting, patients have rights, including the right to care and the right to refuse treatment, among other important safeguards.
Patient rights are the fundamental principles that govern interactions between patients and medical caregivers, as well as the institutions and individuals who support them. A patient is defined as anyone who has requested or is being evaluated by a healthcare professional. Hospitals, healthcare personnel, insurance companies, and other payors of medical-related costs are all examples of medical caregivers. This is a broad definition, but there are some that are slightly more specific. A legal definition might be as follows: patient rights is a general statement adopted by most healthcare professionals that addresses issues such as access to care, patient dignity, confidentiality, and consent to treatment.

Whatever definition is used, most patients and doctors agree that many details of patient rights have changed and will continue to change over time. This article is intended to provide the reader with a basic understanding of patient rights.

People frequently fail to recognize their specific rights during their care because those rights are either not clearly defined or are included in a bundle of papers that patients must sign during registration. Some basic rights include the right to a screening exam for all patients seeking care at an emergency department and the right not to be turned away if they cannot afford to pay. The specifics of these rights are outlined in the United States’ Emergency Medical Treatment and Active Labor Act (EMTALA) laws. Furthermore, many people believe that patient rights only apply between themselves and their doctor. This is not the case; as stated in the first definition, patient rights can be broad and exist between a wide range of people and institutions. They can, for example, exist between patients, any medical caregiver, hospitals, laboratories, insurers, and even secretaries and housekeepers who may have access to patients or their medical records.

It is not possible to list all of the patient’s rights in this article. However, the majority of written rights that doctors and hospital personnel have patients read (and sign) are abbreviated statements that are summaries of the American Medical Association (AMA) Code of Medical Ethics in whole or in part. Many of these patient rights are enshrined in state or federal statutes, and violations can result in fines or even prison time.

This article will concentrate on the doctor-patient relationship and highlight the most pressing issues. Readers should understand that when the word “doctor” is used in most cases, the reader may substitute many other names such as nurse, caregiver, hospital, insurer, doctor’s office personnel, and many others. Patients’ rights in relation to their doctors exist at numerous levels and across all specialties. As previously stated, the American Medical Association’s (AMA) Code of Medical Ethics outlines fundamental elements of the doctor-patient relationship. These rights include the following, with extensive coverage of the various topics:
Communication that is open and honest is essential in the doctor-patient relationship. The American Medical Association’s Code of Medical Ethics clearly states that it is a fundamental ethical requirement for a physician to always deal honestly and openly with patients. Patients have the right to know their medical history and to be free of any incorrect beliefs about their conditions. There are times when a patient suffers from significant medical complications as a result of a physician’s error or judgment. In these cases, the physician is ethically obligated to provide the patient with all pertinent information to ensure that the patient understands what has occurred. Only full disclosure allows a patient to make informed decisions about future medical care.

Previous patient surveys revealed that almost all patients desired some acknowledgement of even minor errors. Patients were significantly more likely to consider legal action if the physician did not disclose the error for both moderate and severe errors. These findings highlight the importance of open communication between physician and patient.

Consent with Knowledge
Informed consent for treatment and procedures is part of medical communication. This is regarded as a fundamental patient right. Informed consent requires the patient to understand the following:

What the doctor intends to do
Whether the doctor’s recommendation is for a minor procedure or major surgery
The treatment’s nature and purpose
The intended effects versus the potential side effects
The dangers and anticipated benefits
All reasonable alternatives, including potential risks and benefits.
Voluntary consent, which is closely related to informed consent, indicates that the patient understands these concepts; patient rights include the following:

Freedom from force, fraud, deception, duress, overreaching, or any other form of secondary constraint or coercion
The right to refuse or withdraw from treatment without affecting the patient’s future healthcare.
The right to ask questions and negotiate treatment aspects
To give voluntary and informed consent, a patient must be competent. As a result, competent consent entails the ability to make and stand by an informed, freely made decision. Competence is frequently confused with capacity in clinical practice. The ability of a patient to make decisions about accepting healthcare recommendations is referred to as decision-making capacity. A patient must understand the options, the consequences of the various options, and the costs and benefits of these consequences by relating them to personal values and priorities in order to have adequate decision-making capacity.

Some factors may render a patient temporarily or permanently incapable of providing competent consent. The following are some examples:

Illness or retardation of the mind
Intoxication from alcohol or drugs
Changes in mental state
Brain damage
Being too young to make legal decisions about health care
Patients who are deemed incompetent (usually by two independent physicians or, in some cases, by a legal decree) can have others legally authorized to make medical decisions for them.

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According to law and ethics, the doctor-patient interaction should be kept private. The physician should never reveal confidential information unless the patient specifically requests that it be disclosed to others or unless required by law. If information must be released, it should be done so in the form of an official signed document.

Certain exceptions to confidentiality exist due to legal, ethical, and social considerations.

When patients are in danger of physically harming another person or themselves, the physician has a legal obligation to protect the potential victim and notify law enforcement authorities.
All cases of child abuse in the United States and Canada must be reported to the district attorney’s office and/or child protective services. This includes both suspected and confirmed child abuse cases. Failure to report child abuse and neglect by health care personnel may result in criminal prosecution under the Child Abuse and Prevention Act of 1974. Failure to report child abuse may also result in civil malpractice charges if the child suffers injury or death as a result of the abuse not being reported. This is another special case in which patient confidentiality does not exist. Doctors who reasonably suspect child abuse and report it are not liable if Child Protective Services later determines that no abuse occurred. This law is now also applicable to elderly patients, thanks to new amendments.
Aside from child and elderly abuse, certain aspects of confidentiality do not apply in cases involving communicable diseases, gunshot wounds, and knife wounds associated with illegal or criminal activity.
The issue of minors creates a unique situation in terms of confidentiality. The laws differ from one state to the next. Most states consider anyone under the age of 18 to be a minor.
An exception is made for emancipated minors who are considered self-sufficient because they are married or have children of their own. In terms of medical care, emancipated minors are typically treated as adults.
Mature minors are those who live with their parents but are self-sufficient and independent. In some states, a mature minor may be treated as an adult in terms of medical treatment. Minors can consent to treatment for contraception, drug and alcohol problems, psychiatric conditions, pregnancy, abortion, and sexually transmitted diseases (STDs, venereal diseases) without their parents’ knowledge in various states and situations. It is best for doctors and patients to be familiar with the laws of the state in which the medical situation is to be assessed and treated.

The Right to Medical Care
Most people agree that everyone deserves the basic right to healthcare, but how far that right extends has been at the center of America’s healthcare debate; even with the Supreme Court upholding the current new federal healthcare laws, the debate continues, and the new laws may be repealed. Inequities in access to healthcare are widespread within the current social structure. Because of numerous inequities in healthcare, which frequently involve factors such as race, socioeconomic status, and gender, politicians have attempted to change the healthcare system for many years and are likely to continue intervening and changing these “patient rights.”

America’s health-care system is a patchwork of healthcare programs and insurance that includes, among other things, private health insurance, HMOs, Medicaid, and Medicare. However, according to 2010 census data, more than 49 million Americans are uninsured, and the government has been forced to pass various laws in order for America’s health care system to provide more equal care.

The Consolidated Omnibus Budget Reconciliation Act is an example of such a law (COBRA). The COBRA regulations are federal legislation that requires patients seeking medical attention at emergency facilities to be evaluated. If an emergency care facility refuses to provide care, both the facility and the health care providers are held accountable. These regulations prohibit health-care facilities from refusing necessary care to people who do not have money or health insurance.

The COBRA laws, as well as the more recent Emergency Medical Treatment and Active Labor Act (EMTALA), refer to federal laws governing patient screening and transfer. All emergency departments and Medicare-participating hospitals are required to do the following:
A qualified provider should conduct an appropriate medical screening examination to determine whether an emergency condition exists.
Provide additional examination and treatment to stabilize the patient, and arrange a transfer if necessary and appropriate.
Consider patients in labor who are unstable for transfer under special circumstances (see below).
All emergency departments and Medicare-participating hospitals are required by EMTALA to screen anyone who is in active labor or seeking emergency care. If such a screening reveals the presence of an emergency medical condition, such as severe pain, a serious threat to life or limb, or active labor, the hospital must provide stabilizing treatment to the best of its ability.
COBRA provisions allow for the continuation of coverage through the workplace in order to provide continuing health insurance for the recently unemployed. Many federal and civil lawsuits have recently been filed and won or lost against HMOs for failing to provide needed care as a result of the drive to reduce health care costs. The outcome of such lawsuits is sometimes unclear, but the quality of care provided is on the minds of all who seek medical attention.

After consenting to provide medical care, the doctor has the obligation to continue a patient’s healthcare until the patient no longer requires treatment for the illness. If the doctor intends to withdraw care, he or she must notify the patient and transfer care to another acceptable doctor. For ending the relationship with the patient without appropriate referral, transfer, or discharge, the doctors may be charged with negligent abandonment. Although doctors are free to choose which patients to treat, doctors should provide the best possible care for patients who require emergency first-aid treatment.

Adults, Parents, and Children have the right to refuse care.
Along with the right to adequate and appropriate healthcare, competent adult patients have the right to refuse health care (it is recommended that the patient document that they clearly understand the risks and benefits of their decision), but exceptions do occur.

Patients with altered mental status due to alcohol, drugs, brain injury, or medical or psychiatric illness may be unable to make competent decisions; in this case, the patient may require the appointment of a person legally authorized to make medical decisions.
Although laws have established the right of an adult to refuse life-sustaining treatment, they do not allow parents or guardians to deny children necessary medical care.
The United States Supreme Court ruled in the case of Prince v. Massachusetts: “The freedom to practice religion does not include the freedom to expose the community or a child to communicable disease, or to subject the latter to illness or death. Parents are free to become martyrs as well. However, this does not imply that they are free, in similar circumstances, to make martyrs of their children before they reach the age of full and legal discretion.” To avoid counter-charges of assault and battery by the parents or child, legal counsel and Child Protective Services should be sought and informed about these occurrences.

Medical Legal Principles
One way to look at patients’ rights is to consider the legal consequences that occur when their rights are violated. Torts, which are defined as civil injustices that can be used to file a lawsuit, are frequently involved in medical injury and malpractice claims. The majority of medical malpractice claims in the United States are based on negligence. A plaintiff and a defendant are involved in a civil negligence claim.

In order to prevail in court, the plaintiff (in this case, the patient) must establish four elements of medical malpractice: (1) a prior duty, (2) a breach of duty, (3) damage, and (4) immediate cause

The phrase “duty to treat” implies that a licensed physician agrees to practice medicine and accepts a patient for medical treatment. A physician-patient relationship is formed, and a contract to provide care is formed. Given current medical knowledge and available resources, the physician owes each patient the duty to possess and bring to bear on the patient’s behalf that degree of knowledge, skill, and care that reasonable and careful practitioners exercise under similar circumstances.
Once a duty to treat has been established, the plaintiff must demonstrate a breach of duty. A breach of duty may exist when a health professional fails to meet the minimum standards of his or her specialty. Under the same or similar circumstances, the physician is expected to act professionally in accordance with the standard of care expected of a similarly trained, reasonable, and careful professional. Unfortunately, the “standard of care” shifts over time and is not always clearly defined in many cases.
After establishing that a duty to treat exists and that a breach of duty occurred, the plaintiff must establish that damage occurred. Personal loss, injury, or deterioration as a result of the physician’s negligence is evidence of damage. Negligence cannot be established in the absence of damage. Physical and mental disability, pain and suffering, loss of income, present and future medical expenses, and death may all be considered damages.
Causation is the last aspect of negligence. If there is a duty to treat and the standard of care is not met, the plaintiff must show that the defendant’s breach of duty caused the plaintiff’s damage.
All four of these components must exist in the opinion of a judge or jury that decides the outcome in order for the plaintiff to prove the physician’s negligence.

Discuss how health care providers can ensure that patients’ rights are respected and protected.

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