Medical Ethics and Professionalism – Extended Notes – Patient and Healthcare Provider Rights

Medical Ethics and Professionalism – Extended Notes – Patient and Healthcare Provider Rights

Patient Rights

Learning Objectives

• Define the terms right, patient, culture and values
• Identify rights of the patient/client
• Identify the culture and values that influence comprehensive health
• care
• Demonstrate the application of the patient rights when providing
• medical service
• Sub-Enabling Outcome : Describe rights of
• patients and health care providers in the

provision of health care services

Related Tasks

• a) Define the term patient’s rights
• b) Identify patient rights
• c) Describe providers rights in the provision of health services
• d) Describe how to meet patients’ rights in the provision of health
• services
• e) Describe approaches to uphold human rights in health services
• Explanation of Patient Rights

‘What are patient rights?’

• Patient rights encompass legal and ethical issues in the providerpatient relationship and
• include person's right to privacy; the right to quality medical care
• without prejudice; the right to make informed decisions about care
• and treatment options, and the right to refuse treatment.
• Many issues comprise the rights of patients in the medical system,
• including
• a person's ability to sue a health care provider; access to emergency
• and specialty care, diagnostic testing, and

prescription of medication without prejudice; confidentiality and protection of patient’s medical information; and continuity of care.Select this paragraph to edit

• Besides basic rights of care and privacy, is the education of patients
• concerning what to expect of their health care facility and its
• providers.
• Recognition of Patient Rights
• The right of individuals to be treated with respect and dignity.
• The rights of the individual to life, liberty, and security.
• The right of individuals to have their religious and cultural identity
• respected.
• The right to a competent professional and quality care.
• The right to an appropriate standard of care to meet individual
• needs.
• The right to privacy and confidentiality, which includes access to
• medical records upon request.
• The right to personal safety self-determination.
• The right to be recognized as human beings who are social beings
• with social needs.
• The right to participate in the development and implementation of
• the plan of care.
• The right to be informed about condition, treatment options, and the
• possible results and side effects of treatment.
• The right to refuse treatment in accordance with the law, and receive
• information about the consequences of refusal.
• The right to quality health care without discrimination because of
• race, creed, gender, religion, national origin, or source of payment.
• The right to know the identity of the person treating the patient, as
• well as any relationship between professionals and agencies involved
• in the treatment.
• The right to informed consent for all procedures, including the
• medical records by the patient or by the patient's legally authorized
• representative and hospital charges.
• The right to consultation and communication freely without fear.
• The right to complain or compliment without the fear of
• compromising access to quality care.
• Together with these rights the patient has a responsibility to follow
• the plan of care agreed upon, and providing relevant, complete and
• accurate health information.
• The patient is further responsible for consequences of refusal of
• treatment, of not following the rules and regulations of a hospital,
• and of not being considerate of others‘ rights.
• Meeting Patient Rights in the
• Provision of Health Services
• ‘How can patient rights be met in the health facility during provision of
• health services?’
• In accordance to patient rights health care providers have the
• obligation to adhere to these patients rights.
• Each provider has to adhere to ethical code of practice and has
• responsibilities for provision of quality of care as guided below.
• The Right of Individuals to be Treated
• with Respect and Dignity
• Health providers should promote an environment that engenders
• mutual respect including respect for the dignity and rights of all
• concerned.
• The Rights of the Individual to Life,
• Liberty and Security
• Promote emotional security, provide physical security, and enable
• religious and spiritual security for patients while in hospital care.
• Assure patients that their independence will be encouraged.
• Provide mechanisms that enable patients and staff to offer feedback
• or make complaints without fear of revenge to quality care.
• Provide and promote a safe working environment for patients and all
• staff.
• Respect and protect rights of staff to freedom of association,
• (including the right to choose whether or not to join an employee
• association).
• The Right of Individuals to Have Their
• Religious and Cultural Identity
• Respected
• Provide care in an environment that supports the cultural and
• language needs of residents and their families.
• Provide food and drink which meet the needs for reasonable
• personal, cultural and religious preferences.
• Provide ease of access to spiritual advisers and a place (not
• necessarily a dedicated place) for religious observances appropriate
• to the wishes of the patient.
• The Right of Competent Individuals to
• Self-determination
• Promote an environment that provides patients with opportunities
• for self-development and that maximise their potential for well-being,
• especially patients who stay for long time in the hospital.
• Respect the right of patients to their reasonable choices of care
• provision.
• Encourage patients to take responsibility for their actions and
• choices.
• Provide access to independent social, legal or other advice and help,

which are relevant to patient care.

• Develop protocols, within the law, to assist patients with selfmedication for this type of care.
• The Right to an Appropriate Standard
• of Care to Meet Individual Needs
• Act in the best interests of patients in determining, particularly
• before admission, whether or not the hospital has the capability of
• providing them with care appropriate to their needs.
• Provide food, drink, care and support to the standard appropriate to
• the needs of patients in order to maintain optimal health and wellbeing.
• Develop ways of consulting with residents and their families or
• representatives on all aspects of the provision of care.
• Provide appropriately qualified staff and staffing levels necessary for the
• safe, efficient and effective delivery of care, treatment, support and
• protection and encouraging them to maintain and upgrade their
• qualifications by providing opportunities for education and training,
• including awareness of appropriate ethical standards.
• Ensure the safety of patients in relation to medication provision, making
• sure that patients get right drug, right dose, and right route at right time.
• Promote risk reduction programs and foster a culture among staff where
• mistakes and adverse events are identified, reported without blame,
• discussed and corrected, by putting in place appropriate communication
• and management structures.
• Encourage all professionals to comply with the ethical standards of
• the profession and that of the hospital.
• Provide the buildings, fittings and furnishings necessary to provide
• the optimal standard of care for patients, having regard to the right to
• make a fair profit or surplus, after meeting all legal and ethical
• obligations.
• The Right to Privacy and
• Confidentiality
• Providers should promote an environment that supports the privacy
• and confidentiality of residents, families, and staff.
• The Recognition that Human Beings
• are Social Beings with Social Needs
• Enable patients to meet their social needs whenever possible.
• Enable ease access for families and friend to visit the patient
• following hospital regulations and policies.
• Recognize the needs of patients for social contact and provide

opportunities for social interaction.

Key Points

• Patient rights encompass legal and ethical issues in the medical care
• provider-patient relationship, including person’s right to privacy.
• Patient rights also include the right to quality medical care the right
• to make informed decisions about care, treatment option and the
• right to refuse treatment.
• The health care providers have the obligation to meet these rights
• through practicing professionally using the ethical code of practice.
• Evaluation
• What are patient rights?
• How can we meet patient rights?

References

• Beauchamp, T.L. and Childress, J. (2001). Principles of Biomedical Ethics (5th ed.). New York: Oxford University

Press.

• Burkhardt, Margareth A. & Nathaniel, A.K. (2007) Ethics and Issues in Contemporary Nursing. (3rd ed.) New

York: Thomson.

• Devettere, R.J. (1995). Practical Decision Making in Health care Ethics: Cases and Concepts. Washington DC:
• Georgetown.
• Furrow, D. (2005). Ethics: Key Concepts in Philosophy. New York, Continuum
• International Ethics Guidelines for Biomedical Research Involving Human Subject, CIOMS, Geneva, 1993.
• Mason, J.K., McCall Smith R.A. & Laurie, G.T. (1999). Law and Medical Ethics. London: Butterworths
• Mellish, J.M. & Paton, F. (1999). An Introduction to the Ethics of Nursing. Capetown: Heinemenn.
• Tanzania National Health Research Forum (2001). Guidelines on Ethics for Health Research in Tanzania.
• World Medical Association (2009). Medical Ethics Manual (2nd ed.). France: World Medical Association.
• Rights of the Health Care
• Provider
• Define the terms right, health provider
• Identify health provider’s rights
• Describe guidelines on health and safety programs for health
• providers
• Identify responsible stakeholders for health provider safety
• Describe compensation rights for health providers injured at work
• Definition of Terms
• Health care provider
• Right
• Health care provider: A person who has acquired the expert
• knowledge base in health matters, decision-making skills and clinical
• competencies for practical practice,
• the characteristics of which are shaped by context and/or country
• which he/she is legally allowed to practice.
• Right: Is a privilege or fundamental power to which an individual is
• entitled unless is revoked by law or given up voluntarily.
• Also is defined as social, economical or privileges to which some has to claim
• legally or morally.
• Rights of the Health Care Provider
• Health providers are falling ill, incurring workplace injuries, and
• suffering from exposure to workplace hazards. As a result, the global
• community is losing critical members of the healthcare team,
• compounding the already existing staff crisis.
• This needless attrition seriously impairs the fulfilment of the United
• Nations Millennium Development Goals (MDGs) and affects the
• ability to meet primary health care needs. These challenges can be
• effectively resolved if health providers’ rights are respected.
• The International Labour Organization (ILO) acknowledged the need
• for safe and health workplaces 30 years ago (ILO convention 157).
• This shows that the health practitioner has the right to remain safe
• from hazards/injuries happening in the course of their employment.
• You will work in small groups to discuss and list rights of health care
• provider. Record your answers. One group will present their
• responses and other will share in the discussion.
• Basic human rights of all Tanzanians are provided in the Constitution
• of the United Republic of Tanzania.
• Together with these rights, the health care provider has the right to:
• Recognition of their competence and potential as well as respect for their
• human action
• Health providers have the right to opportunities for professional
• advancement
• Practice in an environment that allows them to act in accordance with
• professional standards and authorized scopes of practice
• Work in an environment that supports and facilitates ethical practice in
• accordance with Code of Professional Conduct
• Negotiate the condition of their employment, either as individuals or
• collectively in all practice setting
• Work in an environment that is safe to herself/himself and to her/his patients
• Fair compensation for her/his work consistent with their knowledge,
• experience and professional responsibility
• Freely advocate for themselves and their patients/clients
• Get rest, leisure time and family life
• Compensation for injuries happening in the course of their work

Activity: Case Study

• Clinician X is working in a rural health centre for 6 years. He feels that
• in order to execute high quality care, he needs to advance himself
• further by enrolling in a degree program. He applies to the university
• and is granted admission. He wrote a letter to the employer in order
• to be released for his studies.
• The employer reads the letter, bangs the table and says ‘What is this?
• Nonsense! A clinical officer for a degree? No way’! He calls the
• clinician and tells him that permission is not granted for him to go for
• the studies.
• Questions
• What right has the clinician been denied?
• What further action should the clinician take to get his right?
• What is the best way of dealing with such an employer?

Key Points

• Right is a privilege or fundamental power to which an individual is
• entitled unless is revoked by law or given up voluntarily.
• Health care providers have right to; recognition, professional
• advancement, better enabling environment, negotiation, fair
• compensation and time for rest and family
• Evaluation
• Please mention the different rights of health providers.
• Can a volunteer explain the guidelines on health and safety programs
• for health providers?
• Can someone please identify responsible stakeholders for health

provider safety?