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The Patient’s Bill of Rights

Despite being much ballyhooed, particularly during the Clinton-Gore years, the Patient’s Bill of Rights really isn’t a bill of rights at all. Instead, what it amounts to is a set of aspirational standards, first adopted by the American Hospital Association in 1973. However, before we launch into an examination of the Patient’s Bill of Rights, it might be useful first to understand what the plain old vanilla Bill of Rights is, thus facilitating comparison to whatever degree that may prove helpful.The Bill of Rights is, simply, the first ten Amendments to the United States Constitution. See, that was easy. Among these rights you may count freedom of religion, freedom of speech and of the press, the right to peaceable assembly and the right to petition the government for the redress of grievances. Included, too, are the right to bear arms, the right to be secure from unreasonable searches and seizures, the right to remain silent when charges are leveled against you, protections against double jeopardy and the right to due process of law. Included, too, are the right to trial by a jury of one’s peers, the right to a speedy trial, protections against cruel and unusual punishment, and a handful of less publicized protections. These amount, simply, to the fundament of our Constitutionally protected personal freedoms. Largely, they amount to protections from governmental interference, despotism, zealotry and unwarranted intrusion.The Patient’s Bill of Rights, while having a certain associative cache, has less to do than protecting one against an overly-concentrated or overly-aggressive government and more to do with fundamental dignity when vulnerable owing to a medical condition.First adopted by the American Hospital Association in 1973, the Patient’s Bill of Rights was revised in October 1992. Among the highlights are the right to considerate and respectful care, and the right to obtain from physicians and other direct care-givers relevant, current, and understandable information about one’s diagnosis, treatment, and prognosis. Except in emergencies when the patient lacks the ability to make decisions and the need for treatment is urgent, the patient is entitled to a chance to discuss and request information related to the specific procedures and/or treatments available, the risks involved, the possible length of recovery, and the medically reasonable alternatives to existing treatments along with their accompanying risks and benefits. The patient has the right to know the identity of physicians, nurses, and others involved in his or her care, as well as when those involved are students, residents, or other trainees. The patient also has the right to know the immediate and long-term financial significance of treatment choices. The patient has the right to make decisions about the plan of care before and during the course of treatment and to refuse a recommended treatment or plan of care if it is permitted by law and hospital policy. The patient also has the right to be informed of the medical consequences of this action. The patient has the right to have an advance directive (such as a living will, health care proxy, or durable power of attorney for health care) concerning treatment or designating a surrogate decision-maker and to expect that the hospital will honor that directive as permitted by law and hospital policy. Health care institutions must advise the patient of his or her rights under state law and hospital policy to make informed medical choices, must ask if the patient has an advance directive, and must include that information in patient records. The patient has the right to know about any hospital policy that may keep it from carrying out a legally valid advance directive. The patient has the right to privacy. The patient has the right to review his or her medical records and to have the information explained or interpreted as necessary, except when restricted by law. The patient has the right to ask and be told of the existence of any business relationship among the hospital, educational institutions, other health care providers, and/or payers that may influence the patient’s treatment and care. The patient has the right to consent to or decline participation in proposed research studies or human experimentation and to have those studies fully explained before he or she consent. A patient who declines to participate in research or experimentation is still entitled to the most effective care that the hospital can otherwise provide. The patient has the right to expect reasonable continuity of care and to be informed by physicians and other care-givers of available and realistic patient care options when hospital care is no longer appropriate. The patient has the right to be informed of hospital policies and practices that relate to patient care treatment, and responsibilities. The patient has the right to be informed of available resources for resolving disputes, grievances, and conflicts, such as ethics committees, patient representatives, or other mechanisms available in the institution. The patient has the right to be informed of the hospital’s charges for services and available payment methods. In turn, the patient has certain responsibilities. These include, the responsibility to provide information about past illnesses, hospitalizations, medications, and other health-related matters. While not yet falling with the hammer blow of the Constitutional Bill of Rights, the Patient’s Bill of Rights is a step in the direction of greater patient control, better health care practitioner responsibility and full sensitivity and accountability by those who at time literally hold our lives in their hands.Rohn K. Robbins is an attorney licensed before the Bars of Colorado and California who practices in the Vail Valley. He is a member of the Colorado State Bar Association Legal Ethics Committee and is a former adjunct professor of law. Mr. Robbins lectures for Continuing Legal Education for attorneys in the areas of real estate, business law and legal ethics. He may be heard on Wednesday nights at 7 p.m. on KZYR radio (97.7 FM) as host of “Community Focus”. Mr. Robbins may be reached at 926-4461 or at his e-mail address: robbins@colorado.net


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