India’s Charter of Patients’ Rights
Patients’ Rights are a list of guarantees about the kind of medical
treatment people deserve as patients and human beings, in healthcare
settings. The World Health Organization (WHO) defines patients’
rights as those owed to the patient as a human being, by physicians
and by the state. Across the world, medical associations and
governments have formalised these rights in a codified bill called as
Charters of patient’s Rights.
In India, the National Human Rights Commission (NHRC) has
recognised the urgent need for such a Charter at the present juncture
and drafted a comprehensive “Charter of Patients’ Rights” in 2018,
containing 17 basic rights. Inspired by international charters and
guided by national legal provisions and constitutional obligations, this
Charter is expected to generate widespread public awareness and
educate citizens about the quality of care they should expect from
their healthcare providers. It also explains about the responsibilities
of patients and their caregivers, so that hospitals and doctors can
work optimally.
Following a concerted campaign and advocacy with the health
ministry by Jan Swasthya Abhiyan along with other Health Rights
networks and patients groups, the Union Ministry of Health and
Family Welfare (MoHFW) issued a letter on June 2, 2019 asking all
State governments to adopt a smaller set of 13 rights and
responsibilities for patients. Some key patients’ rights enunciated in
the NHRC were not included in this charter. Nevertheless, this set of
Do’s and Don’ts must be adopted and implemented by all state
governments.
17 Rights of Patients, as Tabled in India’s First Charter of Patients’ Rights 1. Right to Information
Right to Information
Physicians or their qualified assistants are required to provide adequate information about your illness, its diagnosis (provisional or confirmed, as it may be), proposed investigation and possible complications to the patient. If the patient is not in a state to understand this, the physician or their assistant is required to provide the information to the caretaker.
This has to be done in a simple language that the patient or caretaker will understand.
Apart from this, patients have the right to know the identity and professional status of every doctor and assistant as well as the primary doctor who is treating them. Information regarding costs of treatment needs to be given in writing.
Right to records and report
Patients or their respective caretakers have the right to access the originals or copies of case papers, indoor patient records and investigation reports. Investigation reports have to be made available to them within 24 hours of admission or 72 hours of discharge. The hospital is responsible for providing a discharge summary or a death summary, in the case of a death, to the caretakers or kin of the patient with original copies of investigations.
Right to emergency medical care
In an emergency situation, you can avail medical care in any government or private hospital. Under Article 21 of the Constitution, which ensures that every person has the right to life and personal liberty, you have the right to prompt emergency care by doctors without compromise on quality or safety and without having to pay full or an advanced fee to the hospital.
Right to informed consent
If a hospital decides upon carrying an invasive investigation or surgery or chemotherapy on a patient, they require to do so after completing an appropriate policy procedure. The doctor primarily in charge of a patient has to explain the risks, consequences and procedure of the investigation or surgery in detail and a simple language before providing the protocol consent form to the patient or to the responsible caretaker.
Right to confidentiality, human dignity and privacy
Now this one is a fairly known right, especially if you follow TV shows about hospitals or doctors. The code of ethics dictates doctors to hold information about the illness and treatment plan for the patient in strict confidentiality from everyone except the patient and their caretakers.
Unless it is an exceptional case where sharing this information is “in the interest of protecting other or due to public health considerations.” In the case of a female patient, she has the right to demand the presence of another woman if the medical practitioner checking or treating her is male. Having said this, the hospital is responsible for upholding the dignity of every patient, irrespective of their gender.
Right to non-discrimination
The above point brings us to the rights of a patient being upheld
without discrimination based on their illness, condition, HIV status or
on their gender, age, religion, caste, ethnicity, sexual orientation,
linguistic or geographical or social origins.
Based on the above characteristics, no person can be subjected to
discriminatory treatment, and the staff of the hospital is responsible
for ensuring this.
Right to safety and quality care according to standards
Here is a brief list of provisions that come under the list of quality care
standards-
- Safety and security.
- Cleanliness, infection control measures and sanitation facilities and
safe drinking water. - Healthcare that abides by the latest standards, norms and guidelines
under the National Accreditation Board for Hospitals (NABH). - To be attended to, treated and cared for in a professional manner
and with the principles of medical ethics. - Right to seek redressal by patient or caretakers.
Right to choose alternative treatment options if available
Hospital staff and doctors are responsible for clarifying all treatment
options to the patient/caretakers. After a thorough study of their
choices, the patient/caretakers can choose to opt for a treatment that
may or may not be the doctor’s primary recommendation. This also
means that once the patient/caretakers choose this alternative
treatment, they will shoulder the responsibility of its consequences
Right to a second opinion
Doctors and the hospital must respect your decision if you choose to
seek a second opinion from a doctor/hospital of your choice. They are
responsible for handing over all record documents and other relevant
information should you choose to approach a different doctor. The
hospital can neither stop you nor discourage you from going
elsewhere, only give a detailed explanation of the health condition and
repercussions in case of delay in treatment.
In case you choose to come back to the first hospital after getting your
second opinion, the hospital still cannot compromise on the quality of
healthcare services.
Right to transparency in rates, and care according to prescribed rates wherever relevant
As mentioned above, the patient has the right to have a written
account of the costs they will have to bear for the treatment they are
receiving. As evidence for this, hospitals are required to have printed
brochures and prominent display boards bearing the names and rates
of medical procedures that are available with them. Detailed
schedules of key rates need to be displayed in conspicuous places and
need to be in both, English as well as the local language.
Patients have the right to get medicines, devices and implants at rates
decided by the National Pharmaceutical Pricing Authority (NPPA) and
other relevant authorities. Patients have the right to receive health
care services that cost within the range prescribed by the Central and
State governments, at the time of receiving it.
Right to choose the source for obtaining medicines or tests
As a patient or a caretaker, you have the right to choose which
registered pharmacy you wish to buy your medical supplies from. This
also includes getting an investigation procedure (like a blood test, for
example) from any diagnostic centre or laboratory registered under
the National Accreditation Board for Laboratories (NABL).
Right to proper referral and transfer, which is free from perverse commercial influences
If a patient must be transferred from one healthcare centre to another,
a proper and detailed justification must be given to them/caretakers
along with various options of the new healthcare centre. They must
also be given a list of treatments/medicines that need to be continued
after the transfer. This step cannot be taken unless the patient or their
caretaker accept it.
Needless to say, these decisions cannot be influenced by reasons like
“kickbacks, commissions, incentives, or other perverse business
practices.”
Right to protection for patients involved in clinical trials
According to the MoHFW, “All clinical trials must be conducted in
compliance with the protocols and Good Clinical Practice Guidelines
issued by Services, Govt. of India as well as all applicable statutory
provisions of Amended Drugs and Cosmetics Act, 1940 and Rules,
1945 Central Drugs Standard Control Organisation, Directorate
General of Health.” These points include consent by the patient,
written prescription of drugs or intervention, privacy etc.
Right to protection of participants involved in biomedical and health research
In case a patient is involved in a biomedical or health research
procedure, their consent needs to be taken in a written format. Their
right to dignity, privacy and confidentiality needs to be upheld even
during the research. If the participant suffers direct physical,
psychological, social, legal or economic harm, they are eligible for
financial or other assistance by the hospital.
Whatever benefits the hospital gets from the research must be made
available to relevant individuals, communities and the general
population.
Right to be discharged, Right to receive the body of a deceased person from the hospital
“A patient has the right to be discharged and cannot be detained in a
hospital, on procedural grounds such as [a] dispute in payment of
hospital charges. Similarly, caretakers have the right to the dead body
of a patient who had been treated in a hospital, and the dead body
cannot be detailed on procedural grounds, including nonpayment/dispute regarding payment of hospital charges against
wishes of the caretakers,” says the MoHFW
Right to Patient Education
Here is a list of things that a patient needs to be informed about by the
hospital. These need to be addressed in the language that the
patient/caretaker understands.
- Major facts about their condition
- Healthy living practices
- Their rights and responsibilities
- Health insurance schemes relevant to them
- Relevant entitlements (for charitable hospitals)
- How to seek redressal of grievances
Right to be heard and seek redressal
Last but not the least, every patient has the right to address his
grievances and give feedback about the healthcare and treatment they
received at the hospital or from a particular doctor/assistant.
The MoHFW further adds, ” Patients and caregivers have the right to
seek redressal in case they are aggrieved, on account of infringement
of any of the above-mentioned rights in this charter. This may be done
by lodging a complaint with an official designated for this purpose by
the hospital/healthcare provider and further with an official
mechanism constituted by the government such as Patients’ rights
Tribunal Forum or Clinical establishments regulatory authority as the
case may be.
Orignal Source: https://www.thebetterindia.com/158829/patient-right-hospital-law/
Our Demand
Citizens groups, consumer organisations and health rights networks
across India should demand the implementation of the Patients’
Rights Charter in all hospitals.
The MoHFW should include the entire set of 17 patients’ rights, as
outlined in the NHRC Patient Rights Charter in the standards related
to Central Clinical Establishments Act (CEA); this would ensure that all
healthcare facilities in 11 states, which have adopted this Act, will
observe patients’ rights
