The Importance of Knowing Your Rights as a Medical Patient

Having worked as a Patient Advocate in both an outpatient facility and within a hospital, it was eye-opening to me how many patients and their families have issues that need to be addressed on a daily basis. Some of the problems patients or their families bring to the attention of the patient advocate are easy to solve, such as food that comes to the room cold, or heating or air conditioning problems. Some issues, however, are not so mundane, and can affect the overall care and feeling of security on the part of the hospital patient. Because of the state of health care today, with doctors having a large patient load, and a shortage of nurses nationwide, it is particularly important that all patients, but particularly seniors, understand their rights as patients, and exercise those rights.

Judging from some of the elders in my family, who are generally informed and "with it", there is still the perception of the doctor as being all-knowing, and there is fear of questioning the doctor on important issues of care and medication. Today, medical information is open to patients, and it is important that you educate yourself about your condition, and ask questions about your tests, treatment, and your medication. Following are guidelines for outpatients and hospital patients to ensure that you receive the best care possible.

WHILE YOU ARE IN THE HOSPITAL

There is a "Patient's Bill of Rights" that should be given to every patient in the hospital. This "Bill of Rights" was adopted by the American Hospital Association in 1973 and updated in 1992. There are several "rights" of patients listed in this piece, but the first two mentioned are perhaps the most important in terms of a patient's getting appropriate care. The first statement is: "The patient has the right to considerate and respectful care." The second statement in the Bill of Rights states that, "The patient has the right and is encouraged to obtain from physicians and other direct caregivers relevant, current, and understandable information about his or her diagnosis, treatment, and prognosis." With knowledge of these rights, every hospital patient should feel confident that they are receiving appropriate care, should have access to their physician, and should understand their condition and the reason for treatment.
(Visit http://www.library.dal.ca/kellogg/Bioethics/codes/rights.htm - to see a sample of the entire Bill of Rights.)

In addition to respectful care and treatment, seniors, and others who may not be so senior, need to be aware of completing an "Advance Directive." The Bill of Rights mentions the Advance Directive as another important patient right. The Advance Directive is a form that would be completed by the patient, indicating what measures should be taken should the patient be unconscious, or otherwise unable to speak his or her wishes. In the Directive, the patient would assign a health proxy, a relative, friend or other acquaintance who will carry out the wishes of the patient if the patient becomes unable to speak. For example, the patient may not wish to be resuscitated if they are unconscious and there is no hope for recovery, or treatment would unnecessarily prolong the suffering of a dying patient. The patient would indicate in the Advance Directive what his or her wishes are with respect to resuscitation, intubation and hydration, and would name his or her health proxy.
(Visit: http://www.library/dal.ca/kellogg/bioethics/codes/rights/htm for a sample of the Patient's Bill of Rights)

When you are admitted to the hospital, you should be asked if have an Advance Directive, and if so, is it on file with the hospital. If you don't have one, you should be given a blank Advance Directive form to complete.

You can also complete an out-of-hospital Advance Directive form. Your doctor's office should be able to provide this to you for completion, and your completed form would be kept in your file, as well as a copy made for your health proxy.

WHAT YOU SHOULD DO IF YOU ARE NOT SATISFIED THAT YOUR "RIGHTS" ARE BEING HONORED

Hospitals are busier than ever, and the need to be vigilant as a hospital patient and / or caregiver, is more important than ever. Therefore, if you as a patient do not feel you are getting answers to your questions, or understand your condition, or you are not seeing the doctor every day, you need to speak up.
These are steps you should take:

- Make sure you know the name of the Admitting physician, if it is not the same person as your primary doctor

- If you are not seeing the Admitting physician every day with an update on your condition, you or a family member should ask how to make contact with that physician.

- If you are uncomfortable with any treatment proposal or medication, mention this to your physician as soon as possible

- If you are uncomfortable with the nursing care, you or a family member should ask to speak to the Nurse Manager or Nursing Administrator.

- If you have tried to make contact with your doctor and your efforts fail, or if you are still not satisfied with your care in general, contact the Patient Advocate, or Patient Representative. The Patient Advocate will help to bridge the gap between patient and doctor, or patient and nursing staff and assist you in getting the comfort you need about your care and treatment.

WHEN IN THE DOCTOR'S OFFICE

Although patients will not receive a Patient's Bill of Rights in the doctor's office, they still deserve to receive appropriate treatment in a considerate and respectful manner. Therefore, if you are uncomfortable with your doctor, or about his care and treatment, know that you have the right to ask questions, or even seek a second opinion, or change doctors if that is necessary.

In fact, if you are facing any type of life threatening illness, you should always seek a second opinion about treatment, even if you are very comfortable with your doctor and what he has proposed as treatment. There are so many advances in medicine today, but not every doctor may know about latest treatments, nor does every hospital provide state of the art treatment. Therefore, it is essential to investigate your condition and potential treatments, and know where you can go to receive the very best treatment.

You should also know that you have the right to your medical records, including the right to receive medical test results. Every doctor's office should give a copy of whatever test result you wish without any question.

SENIORS - TAKE SOMEONE WITH YOU TO THE DOCTOR / HOSPITAL

Seniors are savvy people today, but it is very difficult for many of them to keep up with the latest treatments. Many seniors do not have a computer, so it is not easy for many of them to research their conditions or possible treatments. Therefore, if you are a senior, place some reliance on your children, or other, younger family members to go to the doctor with you, particularly if it will involve a discussion of a serious condition. Even as a young person, when I was diagnosed with breast cancer, I was told I could bring two relatives or friends to the first doctor's visit. This is to ensure that if I didn't hear everything because of the complexity or seriousness of the discussion, one of my relatives could pick up what I missed. As young and aware as I was, I still missed a few things that my husband and mother-in-law picked up.

Above all, don't be frightened of members of the medical profession. Treat them with respect, but also make sure they treat you with respect. Your health and well-being is in their hands, and you and your health care provider need to have a comfortable and trusting relationship to ensure your ultimate good health.