Patients' Rights and Responsibilities in Canada

Patients' Rights and Responsibilities

• Patients have rights regarding their medical treatment.
• Rights in Canada fall into four main categories:
  • Full Disclosure: Patients have the right to be fully informed about their medical condition, treatment options, risks, and the qualifications of their healthcare provider.
  • Privacy: Patients have a right to privacy regarding their health information. Healthcare professionals must keep all information confidential. Access to health records is restricted to public health services for treatment purposes.
  • Access: Patients have access to copies of their personal health records and the right to a second opinion on their diagnosis and treatment.
  • Consent to Medical Treatment: Patients have the right to accept or reject medical interventions. Consent must be voluntary and the patient must be legally competent (mature minor ~16 years old and mentally stable). The patient must receive proper information about the nature and consequences of the treatment before consent. "Medical interventions" requiring informed consent include physical exams, blood tests, injections (vaccines or other drugs), and exposure to radiation for diagnosis. Patients who cannot consent (minors, unconscious patients, or those admitted for psychiatric treatment) may undergo necessary interventions to save their life or prevent harm.
• Patient Responsibilities:
  • Providing accurate and complete information about their medical history, complaints, medications, pain, and other relevant health details.
  • Following the treatment plan recommended by their healthcare team.
  • Accepting consequences if they refuse treatment or do not follow instructions from the healthcare team.
  • Following rules and regulations set by Health Canada and Saskatchewan Health.

Ethical Decision Making

• When dealing with a health issue and competing treatment options, practitioners must consider ethical factors.

  • Autonomy: The patient has the right to make their own decisions. Practitioners should provide full information to help the patient come to their own conclusions, even if the decision seems medically wrong. Implications for the practitioner include consulting with the patient to fully disclose risks/dangers, obtaining informed consent, and maintaining confidentiality.

  • Beneficence and Non-Maleficence: The moral obligation is to provide the most benefit to patients with minimal harm (a 'do no harm' principle). Implications for the practitioner include ensuring their skills and training benefit the patient, recognizing and weighing the benefits and risks of treatment, and avoiding choices without moral justification. For example, a practitioner should consider the possible benefits and harms by comparing mast ectomy treatment for a 29 year old patient vs. a 75 year old patient.

  • Justice (Fairness): The practitioner must operate fairly within the ethical framework of healthcare. Implications include obeying laws set by Health Canada, avoiding decisions without a moral basis, avoiding punishing patients (withholding antibiotics from a smoker, for example), and preventing resource waste by considering treatment costs that have similar outcomes.

Case Study - Resolving Ethical Dilemmas

• Mr. Jones, a tax accountant, has melanoma and his dermatologist wants to remove it immediately, but Mr. Jones wants to delay surgery due to his busy work schedule. Key questions include:
  • What patient's rights does this situation fall under, and why? (Right of Refusal)
  • What is the dermatologist's next course of action regarding Mr. Jones's decision? (Full Disclosure, discuss consequences of delaying treatment, but without coercion.)
• The practitioner should honor the patient's right of refusal, but provide information about the potential consequences of delaying treatment. This includes possible harms from delaying treatment. The practitioner must be impartial while addressing the patient's autonomy, beneficence, and maintaining justice in the provision of healthcare.