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 Patients’ Rights

Current Projects Social Accountability of Private Healthcare Sector

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

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.

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.

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.

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. 

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.

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.

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.

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  

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.

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.   

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).

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 theircare taker accept it.

Needless to say, these decisions cannot be influenced by reasons like “kickbacks, commissions, incentives, or other perverse business practices.”

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.

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.

“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

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

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