Abstract

At one time or the other in our lives, we all play the role of a patient. Do you passively submit to all the instructions from your doctor? Or, do you question him as to how safe are the medicines given to you, whether you really need that expensive MRI? You have a right to seek clarifications from your doctor on the treatment prescribed for you, and also when hospitalised. Be aware and use it judiciously, advises Advocate Anju D Aggarwal.

In 1981 the World Medical Association adopted a statement on the rights of a patient. Recognising the practical, ethical or legal difficulties, a doctor should always act according to his/her conscience and always in the best interests of the patient. You, as a patient, are entitled to these rights:

• To receive the best medical care for your problem regardless of race, religion, national origin or the source of payment for your care. You have the right to prompt life-saving treatment in an emergency without discrimination on account of economic status. Your individuality will be respected and differences in cultural and educational background taken into account. When you raise a query, you will be listened to and receive an appropriate and helpful response.
• To know about the nature of your illness, the cost, duration, benefits from the treatment, the risk involved and the precautions to be taken once the treatment is over.
• Get advice about all aspects of self-care and drug use including side-effects, if any, of the medicines prescribed, and the precautions that can aid recovery.
• To select your doctor and treatment. To say “yes” or “no” to the recommended treatment, and ask for medical consultation or a second opinion, if you so desire.
• To confidentiality. The public, in general, cannot force a doctor to reveal the details of a patient’s illness; only a court can do so, or a doctor can reveal the nature of a patient’s illness to the prescribed statutory authorities (e.g. where the disease is of a communicable nature). The personal privacy of each patient should be respected by the doctor/institution without compromise to safety and clinical care.
• To be informed of any restrictions of communications (i.e., phones, visitors, etc.). If you are hearing or speech- impaired, or require interpreters, you should be given effective assistance.
• Your religious beliefs and personal value systems with regard to care should be respected and you should be informed about the alternatives if these are in conflict to your beliefs. You can request priestly/pastoral services and access to places of prayer/ meditation/worship that exist in the institution.
• To be free from all forms of abuse or harassment, and from restraints of any form not medically necessary. They should not be used as a means of coercion, discipline, convenience or retaliation by staff. You are entitled to a safe environment. This includes reasonable measures for the management of infection, emergency preparedness, safe medical equipment, facility security and reasonable care to promote a safe and violent-free environment.
• To a detailed billing explanation. You may question charges associated with procedures and with billing and will be advised of the availability of financial assistance, if needed.
• To be informed of available resources for resolving disputes, grievances and conflicts within the institution.
• To make a donation of your body parts for transplantation or gift your body or parts for medical education or research at the end of life.

Doctor’s Role

A doctor has to convince and obtain your consent before beginning the treatment. This, in modern concept, is called the theory of ‘informed consent’. He is not supposed to reveal to you if you’re suffering from a dreaded disease like leukaemia (unless you specifically ask for the info) because this will cause a lot of unwarranted anxiety. Your relatives can be informed about the nature of the disease. He can only advise you, not coerce you into accepting his advice for a treatment. He should not obstruct your desire to consult experts in other branches of medicine such as homeopathy, ayurveda and acupuncture for treatment.

In the Hospital

Most hospitals stock medicines. If these are adulterated or spurious, the hospital will be equally liable for the payment of compensation under the Consumer Protection Act. Many hospitals also serve food to patients. In case it is substandard, or you fall ill after taking it, the hospital authorities will be liable to pay you compensation.

You have the right to leave the hospital even if your doctor advises against it. But the hospital will not be responsible for any harm this may cause you and you will be asked to sign a “Discharge Against Medical Advice” Form.

Care at the End of Life

There are times when ethical questions about medical care and treatment options pose dilemmas for patients, families, physician and staff. These issues include conflict resolution, withholding resuscitative services, foregoing or withdrawing of life sustaining treatment. You have the right to pass on in dignity.

You Also Have Some Responsibilities!

As a patient, you have two obligations: you’re responsible for providing, to the best of your knowledge, accurate and complete information about present complaints, past illnesses, hospitalisations, medications, and other matters relating to your health. Secondly, comply with the doctor’s instructions in the best possible manner -- for instance, if you are instructed to stop smoking, stop drinking or to exercise, follow the advice faithfully. You and your family should report perceived risks in the care and unexpected changes in your condition.

Show respect and consideration to other patients, personnel and property; help control noise and disturbances and follow smoking and visitor policies.

Protected by the Law

The Medical Council of India, a statutory organisation, set-up under the Indian Medical Council Act, 1956, has the power to regulate and control the medical profession. An enactment that has helped the patients to enforce their rights is the Consumer Protection Act (CPA), 1986.

Under the CPA, a person is a consumer if the services have been hired for a consideration, but does not include any service free of charge or under a contract of personal service. Complaints under the CPA are to be resolved within three months of the receipt of the notice by the opposite party in case it does not require a laboratory analysis, and within five months if it requires an analysis.

It is via the three-tier redressal machiney -- the district forum, the state commission and the national commission -- that you as a consumer can get redressal. If your claim for compensation is within Rs 20 lakhs, you must approach the District Forum. If it is between Rs 20 lakhs and Rs one crore, then go to the State Commission and if above Rs one crore, then the National Commission must be approached. A provision of appeal also exists for both parties.

Addresses of the district forums and the state commission can be obtained from the office of the national commission which is as follows: The Registrar, National Consumer Disputes Redressal Commission, ‘A’ Wing, 5th floor, Janpath Bhawan, New Delhi -- 110 001.

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