Asst. Prof., Dept. of Medical Ethics Alfarabi Medical college, Riyadh Dr. Ghaiath M. A. Hussein Saudi Commission for Health Specialties Professionalism and Ethics Education for Residents (PEER) Patients’ Rights ى ض ر م ل ا وق ق ح
Asst. Prof., Dept. of Medical EthicsAlfarabi Medical college, Riyadh
Dr. Ghaiath M. A. Hussein
Saudi Commission for Health SpecialtiesProfessionalism and Ethics Education for Residents (PEER)
Patients’ Rightsالمرضى حقوق
Ethical basis for patients’ rightsDefinition and classification of patient rightsPatient’s Right related to
Treatment Access to care Choice of care Participation in decision making Privacy and Confidentiality Seek for 2nd opinion or referral Compassionate Palliative and EOL care
Outline
Before we start…where are we?
Patient
Doctor
Lab./X-ray
Social worker
Nurse
Manager
Educator
Doctors Are NOT the focus of the healthcare
Islamic Guidance behind care...1. Relieved patients from some religious commitments خففت عنهم
:التكاليف الدينيةساء فلم تج�دوا ماء فتيمموا * )وإن كنتم مرضى أو على سفر أو جاء أحد منكم من الغآئط أو المستم الن
با ( صعيدا طي
ر من القرآن علم أن سيكون منكم مرضى( سورة المزمل 20 * )فاقرؤوا ما تيسام أخر( سورة البقرة هر فليصمه ومن كان مريضا أو على سفر فعدة من أي 185 * ) فمن شهد منكم الش
أسه ففدية من صيام أو صدقة أو نسك( سورة البقرة .196 * ) فمن كان منكم مريضا أو به أذى من رذين ال يجدون ما ينفقون حرج ( سورة التوبة يس على الضعفاء وال على المرضى وال على ال 91 * }ل
2. Visiting them is a duty (on everybody, not only doctors) جعلتعيادتهم حقا واجبا .
3. Referred to their health, mental, and social requirements نبهتعلى مسائل يحتاجونها: صحيا ونفسيا واجتماعيا .
Patients’ Rights on who?
State (MOH)
Providers
Family Community
Patient’s RightRights directly related to Treatment
Receive treatment Consent to treatment ( accept or refuse ) Privacy Confidentiality Compassionate End of Life ( EOL ) Care
Right Not directly related to treatment Respect Safety Protection for Physical assault ( specially vulnerable ) Spiritual care Participation in research studies
Saudi Commission for Health Specialties
PATIENT’S BILL OF RIGHTS AND RESPONSIBILITIES (KSA)
http://www.moh.gov.sa/en/HealthAwareness/EducationalContent/HealthTips/Pages/Tips-2011-1-29-001.aspx
Rights of Patients & Their Families1. Knowing Patient and Family
Rights and Responsibilities2. Getting Health Care3. Privacy and Confidentiality4. Safety and Protection5. Respect and Appreciation6. Participation in the
Healthcare Plan7. Refuse Treatment8. Participation in Research
Studies9. Organ and Tissues Donation
Policies and Procedures10. Health Insurance and
Financial Policy11. Clear and Comprehensive
Declaration Forms12. Complaints and Suggestions
Policies and Procedures• Child Patient Rights• Elderly Patient Rights• Psychiatric Patient Rights• Special Needs Patient Rights
Treatment-Related Rights
• Access to care• Choice of Care• Participation in decision making• Privacy & Confidentiality• Seek 2nd Opinion/Referral• Compassionate Palliative & EOL care• Complaints and Suggestions Policies and
Procedures
Saudi Commission for Health Specialties
1- Access to Care
Patients have the right to have access to healthcare that meets their needs at the time they need it at a cost they can afford.
Patients should not be denied access to care they need or discriminated against based on their colour, race, belief, disability, etc.
This includes their right to transport to hospital in case of emergency (Ambulance).
2- Choice of Care
These include: Receiving timely emergency care Treatment and rehabilitation Be seen of their doctor (of choice) Provision for special needs Counseling Palliative care Health information (education)
3- Participation in decision-making
Receive Relevant Information
Diagnosis
Treatment
Prognosis
Post-Discharge Care
Hospital policies
Consent to Treatment
Relevant facts explained
Patients are free from undue
influence
Patients assign Substitute decision
maker (SDM)
Right to Refuse Treatment
Relevant alternatives explained
Risks explained, and consent taken
Informed Consent to TreatmentCAPACITY VOLUNTARINESS DISCLOSURE
• The patients has the ability to:
• Understand medical information • Appreciate the risks• Memorize the information•Communicate the decision
• Freedom from undue influence:• Financial• Social pressure•Physical restraint
• Information:•Diagnosis• Possible prognosis• Benefits and risk of treatment• Expected outcome• In a language understood by the patient
Saudi Commission for Health Specialties
4- Continued care, Seeking 2nd opinion & Referral The patients have the right to:
Receive uninterrupted care from his/her doctor. To be referred to other health care providers when necessary. Receive a second opinion when the patient or
his/her doctor requests one. The second opinion must be provided by a
qualified health care professional within the same organization.
Saudi Commission for Health Specialties
5- Compassionate EOL CareThe patient have the right to:
Have her physical pain assessed and managed Have Advance Directive Plan (Living Will) Assign a family member to be the SDM Have her/his emotional and spiritual needs
addressed
Ethical quiz: what to draw the line between “allowing your patient to die” and “helping your patient to die?”
Saudi Commission for Health Specialties
6- Appeal and Complaint SubmissionThe patient have the right to:
Be told on how to process her problems or complaints
Voice his/her concerns about the care she/he receives
Ask questions and express concerns about hospital health care and services, without fear of reprisal
Have his/her complaint responded to in a timely and satisfactory manner
Saudi Commission for Health Specialties
Additional Rights for special groupsChildren Elderly
• Examined by specialized team.
• Appropriate environment
• Assign a companion • Report any violence
against children to the concerned authority.
• Avoid isolating the patient unless it's medically necessary.
• Meet their special needs in the health facility.
• Provide needed health and treatment services to the patient.
• Facilitate making appointments and having their medical reports
Saudi Commission for Health Specialties
Additional Rights for special groupsPsychiatric Special Needs Patient • Protect psychiatric patients
from harm.• Ensure the patient’s freedom
of movement and shouldn’t isolate him/her unless it’s medically necessary.
• Allocating mental health clinics• Provide suitable education and
rehabilitation methods
• Respect the patient’s dignity, independency in addition to his/her personal decisions.
• Provide specialized equipments and tools for special needs patients.
• Assist the patient in moving • Provide suitable aisles and
bathrooms.• Allocate parking spaces for
special needs patients.
Saudi Commission for Health Specialties
Key messages Make sure you and your patients know their rights Train your colleagues on patient’s rights Knowing and providing these rights protects you professionally
and legally Patient rights guide you to achieve your ethical and
professional goals of availing the best service to your patients Rights are rights! They are required by LAW, needed for
accreditation, and not gifts that you may or may not give.