Standing up for patients’ rights

There is an increasing emphasis around the world on a rights-based approach to health and education and some European countries have gone as far as to adopt legislation on patients’ rights. The World Health Organisation made a declaration on patients rights in 1994 and the Council of Europe issued a Convention on Human Rights and Biomedicine 1997, which dealt with patients’ rights in general.

However, the clearest language and commitment to patients’ rights now in Ireland is found in the Ombudsman’s Statement of Good Practice for the Public Health Service in Dealing with Patients.

This document divides patients’ rights into two broad categories – basic human rights as applied to healthcare settings, whether as an outpatient or an inpatient, and patient rights surrounding treatment and care.

The Ombudsman sets out five human rights. These are the right to be respected as a human being; the right to have your physical and mental integrity respected; the right to feel safe and secure; the right to have your privacy respected and the right to have your moral, cultural, religious and philosophical convictions respected.

In some ways, it could be argued these five basic human rights are breached quite often. Yet the Ombudsman stresses they are used as a framework in the examination of public complaints about the public health services in Ireland.

In terms of the treatment and care of patients, the Ombudsman sets out five other rights.

The first of these is a patient’s right to information about the available health services. “Every patient has the right to be fully informed about their health status, including the medical facts about their condition, the proposed medical procedures – its potential risks and benefits – and alternatives to these procedures, including the effect of non-treatment.” Every patient also has the right to choose, who, if anyone, should be informed on their behalf. And, they have the right to request and be given a summary of their diagnosis, treatment and care on discharge from hospital.

Consent

The second patient right relates to consent. “Every patient has a right to refuse or halt a medical intervention – but the implications of refusing or halting such an intervention must be carefully explained to the patient.” Patients must give their consent to the presence of medical professionals in training attending alongside other medical personnel. And, patients must also give their consent before partaking in clinical trials or scientific research.

The patient’s right to confidentiality and privacy about their medical condition, diagnosis, prognosis and treatment is identified as the third patient right. All identifiable patient data must be protected and patients have the right to access their medical files, technical records and any other files relating to their diagnosis, treatment and care.

Another patient right is to a quality of care that is marked by high professional standards and a humane relationship between the patient and healthcare providers. This patient right overlaps with the basic human right to be treated with dignity in relation to diagnosis, treatment and care and respect regarding the patient’s cultural, religious or moral values. It also incorporates a patient’s right to humane terminal care and the right to die with dignity.

And, finally, is the patient’s right to safety. This incorporates the right to be free from harm caused by failures in service delivery, medical malpractice and errors. When availing of health services, each patient has the right to expect that such services and treatments meet high safety standards and that the risks are monitored on a continuous basis.

The Ombudsman also notes the importance of the right to expect that healthcare staff who report existing risks to their superiors and/or peers will be protected from possible adverse consequences. “A blame-free, non punitive culture encourages individuals to report errors and truly learn from their mistakes while also supporting organisations to better understand those errors and make improvements.”

Adapted from the Ombudsman’s Statement of Good Practice for the Public Health Service in Dealing with Patients. See also www.ombudsman.gov.ie