Please complete the following REVIEW QUESTIONS

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CHAPTER 15

Patient Rights and Responsibilities

Learning Objectives

Describe the rights and responsibilities of patients.

Discuss the importance of understanding patient responsibilities.

Life or Death: Right to Choose

Jehovah’s Witness, in Stamford Hospital v. Nelly E. Vega, executed a release requesting that no blood or its derivatives be administered during her hospitalization.

Hospital filed a complaint requesting the court issue an injunction.

Connecticut Supreme Court determined hospital had no common law right or obligation to thrust unwanted medical care on a patient.

Patient Rights (1 of 8)

Know one’s rights.

Patient’s bill of rights

Explanation of rights

Know caregivers.

Ask questions.

Patient Rights (2 of 8)

Admission

Discrimination prohibited

Government facilities

Emergency care

Assessments and reassessments

Participate in care decisions.

Informed consent

Patient Rights (3 of 8)

Right to treatment

Right to refuse treatment

Pain management

Quality care

Appoint a surrogate decision maker

Patient Rights (4 of 8)

Have special needs addressed

Advance directives

Compassionate care

Confidentiality

Patient Rights (5 of 8)

Discharge orders

Privacy and HIPAA

Disclosures permitted without patient authorization

Limitations on disclosures

Patient advocate

Ethics consultation

Chaplaincy services

Patient Rights (6 of 8)

Discharge orders

News: Don’t Leave the Hospital Until You Know What Comes Next

Discharge or detainment

Release from hospital contraindicated transfer

Failure to override physician’s discharge order

Patient Rights (7 of 8)

Transfer

Access medical records

Hospital’s adverse events

Third-party relationships

Patient education

Patient Rights (8 of 8)

Transparency and hospital charges

Failure to disclose insurance applicants’ HIV status

Transparency not so transparent

Patient Responsibilities

Patient Responsibilities: Historical Perspective (1 of 4)

Cornwall General Hospital’s Rules for Patients (posted in 1897)

1. Patients on admission to the Hospital must have a bath, unless orders to the contrary are given by the Attending Medical Attendant . . .

6. Patients must be quiet and exemplary in their behaviour and conform strictly to the rules and regulations of the Hospital, and carry out all orders and prescriptions of the various officers of the establishment . . .

Patient Responsibilities: Historical Perspective (2 of 4)

8. No male patient shall, under any pretense whatever, enter the apartments or wards for the females, nor shall a female patient enter the apartments or wards for males, without express orders from the Medical Attendant or Lady Superintendent . . .

10. Every patient shall retire to bed at 9 p.m. from First May to First November, and at 8 p.m. from November to May; and those who are able shall rise at 6 a.m. in the Summer and 7 a.m. in the Winter . . .

11. Such patients as are able, in the opinion of the physicians and surgeons, shall assist in nursing others, or in such services as the Lady Superintendent may require . . .

Patient Responsibilities: Historical Perspective (3 of 4)

13. Patients must not take away bottles, labels or appliances when leaving the Hospital.

14. No patients shall enter into the basement story, operating theater, or any of the officers’ or attendants’ rooms, except by permission of an officer of the Hospital ...

Patient Responsibilities: Historical Perspective (4 of 4)

17. Any patient bringing spirituous liquors into the Hospital or the grounds, or found intoxicated, will be discharged.

18. Whenever patients misbehave or violate any of the standing rules of the Hospital, the Attending Physician may remove or discharge them, as provided by clauses 91 and 93 of Rules for Medical Staff.

Patient Responsibilities: Contemporary Perspective (1 of 4)

Practice a healthy lifestyle.

Maintain current medical records.

Keep appointments.

Provide full disclosure of medical history.

Accurately describe symptoms.

Patient Responsibilities: Contemporary Perspective (2 of 4)

Disclose information.

Communicate care preferences.

Stay informed.

Report unexpected changes in health status.

Adhere to agreed upon treatment plan.

Patient Responsibilities: Contemporary Perspective (3 of 4)

Avoid self-administration of medications.

Actively participate in care.

Comply with hospital policy.

Treat providers with respect.

Understand medicine has limits.

Patient Responsibilities: Contemporary Perspective (4 of 4)

Ask questions.

“What is this medication for?”

“What diet am I on?”

“Since you are going to change my dressing, did you wash your hands?”

Tips for Patients: Help Prevent Medical Errors (1 of 7)

Medications

Inform your doctors about medicine you are taking.

Bring your medicines and supplements to doctor visits.

Inform your doctor about any allergies and adverse reactions you have had to medicines.

Make sure you can read your doctor’s prescription order.

Tips for Patients: Help Prevent Medical Errors (2 of 7)

Medications (cont.)

Ask for information about your medicines in terms you understand—both when your medicines are prescribed and when you pick them up.

When you pick up your medicine from the pharmacy, ask: “Is this the medicine that my doctor prescribed?”

Make queries about any questions and directions on your medicine labels; don’t be afraid to ask.

Tips for Patients: Help Prevent Medical Errors (3 of 7)

Medications (cont.)

Ask your pharmacist for the best device to measure your liquid medicine.

Ask for written information about the side effects your medicine could cause.

Tips for Patients: Help Prevent Medical Errors (4 of 7)

Hospital stays

If you are in a hospital, consider asking all healthcare workers who will touch you whether they have washed their hands.

When you are being discharged from the hospital, ask your doctor to explain the treatment plan you will follow at home.

Tips for Patients: Help Prevent Medical Errors (5 of 7)

Surgery

If you are having surgery, make sure that you, your doctor, and your surgeon all agree on exactly what will be done.

If you have a choice, choose a hospital where many patients have had the procedure or surgery you need.

Tips for Patients: Help Prevent Medical Errors (6 of 7)

Other steps

Speak up if you have questions or concerns.

Make sure that someone, such as your primary care doctor, coordinates your care.

Make sure doctors have your health information.

Tips for Patients: Help Prevent Medical Errors (7 of 7)

Other steps (cont.)

Ask a family member or friend to go to appointments with you.

Know that “more” is not always better.

If you have a test, do not assume that no news is good news—be sure to follow up.

Learn about your condition and treatments by asking your doctor, nurses, and other reliable sources.

Review Questions

Describe the rights and responsibilities of patients as reviewed in this chapter.

Why should caregivers consider themselves as patient advocates?

Describe what patients can do to help prevent medical errors.

Please complete the following REVIEW QUESTIONS

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