Patient Rights - Kyrenia 2024 PDF

PATIENT RIGHTS Doç Dr Cemal Hüseyin Güvercin ◼ The physician-patient relationship is a special form of interpersonal relationship. ◼ The basic element in the physician-patient relationship is “trust”. ◼ The knowledge gap / asymmetry between the physician and the patient plays an...

PATIENT RIGHTS Doç Dr Cemal Hüseyin Güvercin ◼ The physician-patient relationship is a special form of interpersonal relationship. ◼ The basic element in the physician-patient relationship is “trust”. ◼ The knowledge gap / asymmetry between the physician and the patient plays an important role in this relationship. The goals of medicine  Paternalist Approach Patient-centered Approach Patient Rights ◼ Human right? ◼ Customer right? ◼ Consumer right? Patient Rights X Physician Rights Patient Rights Physician Rights  What does Hippocrates say? Right to be treated Service for the benefit of the patient No to euthanasia No to abortion Assistance from another physician when needed Respect for the patient and his body Keeping the Patient Secret The Origins of Patient Rights ◼ «Believe in our wisdom» ◼ «Trust our decisions» ◼ “The healer is always right” The Origins of Patient Rights ◼ Traditional Hippocratic understanding of medicine ◼ “Physicians may have the 'wiseness' to hide many things from their patients, many patients may choose the worse when the patient is informed.” ◼ Human rights, social democracy Patient Rights ◼ The traditional physician–patient relationship can be summarized as follows: ◼ Sick patients ask physicians to help them get better and physicians profess to be morally committed and technically competent to help the sick.  Conditions of Medical Intervention According to Islamic and Ottoman Law 1) The medical intervention is carried out by a health personnel who has sufficient knowledge and experience in accordance with the nature of the medical intervention. 2) Physician acting with the intention of treatment 3) Necessary and appropriate medical intervention according to the teaching/doctrine of the medical profession. 4) Permission of the patient, legal representative or judge Certificates of Consent in the Ottoman Empire ◼ It is registered in the Sharia Registries. The oldest informed consent document is registered in the 15th century. ◼ For more surgical interventions ◼ In the consent documents, the necessary conditions for the consent to the medical intervention are met with extreme care. ◼ Consent to medical intervention is obtained from people who have the capacity to give consent, and the patient is enlightened by taking the necessary precautions so that the patient's will is not harmed. ◼ In medical interventions to be performed on children, consent is obtained from the parent/guardian. The Origins of Patient Rights ◼ Historically, transition from paternalism to autonomy started in 1914, with a decision issued by the New York Court of Appeals in 1914 following the Schloendorff v. Society of New York Hospital, which stated that ◼ “Every human being of adult years and sound mind has a right to determine what shall be done with his own body” Justice Benjamin Cardozo  The Origins of Patient Rights ◼ Another reported event happened in 1976, with Karen Ann Quinlan – persistent vegetative state (PVS) on a ventilator; ◼ The New Jersey Supreme Court recognized the principle of a surrogate decision maker speaking for an incompetent patient. The Origins of Patient Rights ◼ 1947 Nurenberg Code volunteering ◼ 1957 In the USA, Attorney Paul G. Gebhard used the term "informed consent" for the first time. ◼ The “right to informed consent” was emphasized in a series of court decisions in the United States in 1972. The Origins of Patient Rights Patient’s Bill of Rights-1973 (AHA) ◼ Patient has the right to: 1. Considerate and respectful care 2. Obtain complete, current info on diagnosis, treatment and prognosis. 3. Receive necessary information to give consent 4. Have advance directives – DNR 5. Privacy concerning medical care 6. Confidentiality of all communications and records Patient’s Bill of Rights-1973 (AHA) 8. Reasonable response time to requests 9. Obtain info on relationship between hospital and other healthcare facilities 10. Be advised and right to refuse being part of research study 11. Reasonable continuity of care 12. Review medical records and examine bills 13. Informed of any/all hospital rules, regulations policies and resources to resolve disputes ◼ Where are the doctors while this is happening? Declaration of Lisbon-I,II,III on the Rights of the Patient,1981 WMA ◼ Right to good quality medical care ◼ Right to freedom of choice ◼ Right to self-determination ◼ Right to confidentiality ◼ Right to dignity, relief of suffering and human terminal care ◼ Right to religious assistance Declaration of Lisbon-I,II,III on the Rights of the Patient,1981 WMA ◼ Right to information ◼ Right to privacy ◼ Right to health education The Declaration on the Promotion of Patients' Rights in Europe, 1994 Amsterdam WHO ◼ right to respect of his or her person as a human being ◼ right to self-determination ◼ right to physical and mental integrity and to the security of his or her person ◼ right to respect for his or her privacy ◼ right to have his or her moral and cultural values and religious and philosophical convictions respected ◼ right to protection of health  Convention on Human Rights and Biomedicine The Oviedo 1997, EU ◼ Principles applicable to any medical act ◼ Key principles: ◼ Primacy of the human being ◼ Equity of access to health care ◼ Consent – Protection of persons not able to consent ◼ Protection of private life and right to information ◼ Principles applicable to new biomedical technologies: Genetics, Transplantation, Biomedical Research Convention on Human Rights and Biomedicine The Oviedo 1997, EU ◼ informed consent, ◼ respect for privacy, ◼ the right to information, ◼ the right to emergency medical care, ◼ scientific research standards, ◼ no genetic discrimination ◼ organ transplant European Charter of Patients’ Rights, Rome 2002 ◼ Right to Preventive Measures ◼ Right of Access ◼ Right to Information ◼ Right to Consent ◼ The Right to Free Choice ◼ Right to Privacy and Confidentiality ◼ Right to Respect of Patients’ Time European Charter of Patients’ Rights, Rome 2002 ◼ Right to the Observance of Quality Standards ◼ Right to Privacy and Confidentiality ◼ Right to Safety ◼ Right to Innovation ◼ Right to Avoid Unnecessary Suffering and Pain ◼ Right to Personalized Treatment ◼ Right to Complain ◼ Right to Compensation Patient Rights ◼ It is essential that patients’ rights and clinical ethics move in the same direction. The principles of ethics currently embraced by the medical profession include the following: ◼ (a) autonomy refers to respect for a person’s self-determination, alluding to a patient’s wishes regarding treatment choice; ◼ (b) beneficence means doing good to patients; Patient Rights ◼ (c) fidelity emphasizes faithfulness to a physician’s duties and obligations; ◼ (d) justice dictates that a physician’s decision on patient treatment is made fairly and impartially; and ◼ (e) utility implies that a physician’s actions should yield good results, achieving maximum benefits for the patient without wasting resources. Patient Rights ◼ What are the responsibilities of patients? The Responsibilities of Patients ◼ General responsibilities: Protecting one's own health, adopting a healthy lifestyle, ◼ Being respectful and attentive to healthcare workers ◼ Collaborating with healthcare professionals ◼ Informing health workers correctly ◼ To comply with the rules in health institutions ◼ To comply with the recommendations regarding the treatment Patient Rights ◼ Patient rights are in the 3rd generation human rights group. ◼ Patient rights are necessary for all of us. ◼ We physicians too…..  References ◼ Sağlık ve İnsan Hakları Üzerine 25 Soru - 25 Cevap. Toplum Sağlığı Araştırma ve Geliştirme Merkezi Derneği, 2007. ◼ Güvercin CH Türkiye'deki gelişimi açısından hasta hakları kavramı. Doktora Tezi. Ankara, 2007. ◼ Kuçuradi İ. https://oggito.com/icerikler/Ioanna-kucuradi-den- Insan-haklari-uzerine-21-alinti/40105 ◼ Dünya Tabipler Birliği Tıp Etiği El kitabı. TTB Yayınları 2015 ◼ Principles of Biomedical Ethics, Beauchamp and Childress, Oxford Univ. Press, 2012