Healthcare: Patient's responsibilities and their rights

For this reason, I am often called upon to recommend a ‘good’ doctor who can be relied on to be competent and, if necessary, take the right decisions on the patient’s behalf. This is not so much an indifferent attitude as a need for empowerment as patients feel at a disadvantage when ill or in need of healthcare. There is also the underserved majority of patients that just turn up at the clinic or hospital and hope for the best.

The concept of patient’s rights emerges from the principle of autonomy and self-determination enshrined as the right to life in the constitution. With special reference to the doctor-patient equation, it recognises the vulnerability of the patient and seeks to mitigate this inequality. On one hand, standards of ethical practice and behaviour are prescribed for the doctor and on the other hand, patient rights are described to ensure that the patient can have some say in his treatment options and health plan. This ensures that the patient’s physical, emotional and psychological integrity is upheld and respected.

Although the World Medical Association has outlined the declaration of patients rights, many countries and individual health organisations under its umbrella also define their own charter of patient rights with special reference to prevailing needs, as in rights of mental health patients.

The most important rights of the patient are: The Right to appropriate medical care of a good standard without discrimination; this implies that a patient must have a fair chance at access to healthcare even in countries like India where resources are limited.

Government hospitals attempt to close this gap in resource but vast rural and tribal areas do not even have a primary health centre; the right to be treated with respect and dignity; the right to be informed about the medical condition in order to make an informed decision; the right to choose a physician and ask for a second opinion; patients’ right to be represented when their autonomy is compromised; the right to refuse treatment.

The wise patient will also realise that the entitlement to rights is accompanied by responsibilities too. In order to get the best care and ensure successful medical outcomes it is important to adhere to these patient responsibilities.

Honesty

The patient needs to be completely honest with his physician and comply with the treatment plan and preventive care instructions. For his good, this candid attitude should also extend to doctors approached for a second opinion.

Patients should participate in health decisions, understanding risk and side effects of drugs or therapy before making an informed choice. Patients are advised to avoid self-medications and recommendations from unqualified well wishers or the internet. This is specially challenging for doctors in India where alternative or indigenous medical practice co-exists and patients hesitate to share this history of use of native therapies with the physician.

Another responsibility of the patient, although this seems obvious, is to be courteous and respectful with the healthcare team and make the required payments when due.

Irresponsible behaviour in this area undermines the doctor-patient relationship and trust.

Patients with infectious diseases must strictly follow quarantine and treatment instructions to avoid placing others and the medical team at risk.

It is expected that patients take responsibility for their health, complying with lifestyle changes if needed and maintaining their health with preventive care.
India lags behind in appreciation and exercise of patient rights as compared to the West.

This may partly be on account of the lower levels of literacy and awareness, with the most underserved patients content to have any kind of healthcare at all. Another reason could be that patients in a hospital are often treated by many doctors and lose the personalised care experience.

Many large hospitals have excellent patient charters in their manuals but not much is done to spread this message. All this can quickly change if there is a concerted effort to promote awareness in hospitals, clinics and through the ongoing community health programmes.