By Prarthana Mitra
In a country where most knowledge about a patient’s rights comes from television shows, the Indian government recently published the first-ever Charter of Patients’ Rights, in cognizance of certain basic rights for those seeking medical help during times of crises.
Listing 17 important points of concern, ranging from insurance to access and accountability, this Charter released by the Ministry of Health and Family Welfare is expected to alleviate anxiety and financial burdens for patients in the near future. More importantly, it educates each citizen of their rights while seeking consultancy from a doctor or admittance to the hospital.
Here are the crucial rights, laid down by the Constitution and outlined in the Charter.
Right to Information
Physicians are required to provide adequate information regarding the patient’s illness, diagnosis, possible complications, costs of treatment (in writing), and their own qualifications to the patient. They must also provide the information to the respective caretaker if the patient is not in a position to understand or act on these recommendations.
Right to records and reports
Patients or their caretakers ought to be able to access the original case history, indoor patient records, besides furnishing them with investigation reports within 24 hours of admission or 72 hours of discharge.
The hospital must additionally provide a discharge summary or a death summary to the patient’s caretaker or kin along with original copies of investigations.
Right to emergency medical care
In cases of medical emergencies, prompt medical care without advance payments or compromise in quality and safety will be available at all government or private hospitals under Article 21 of the Constitution, which ensures right to life and personal liberty for all.
Right to informed consent
Doctors have to first explain the risks, consequences and the procedure in detailed jargon-free terms, before any invasive investigation, surgery or chemotherapy. Then, hospitals are required to get a protocol consent form signed by the patient party.
Right to confidentiality
Doctor-patient confidentiality holds all information about the illness and treatment strictly between the two parties unless exceptional circumstances deem this information to be “in the interest of protecting other or due to public health considerations.”
Female patients can demand the presence of another woman if she is being treated by a male medical practitioner. The dignity of every patient, irrespective of their gender, must be preserved.
Right to non-discrimination
Access to medical aid and care cannot be withheld on the basis of illness, gender, age, religion, ethnicity, sexual orientation, linguistic, geographical or caste-based discrimination.
Right to safety and quality care according to standards
Basic quality care standards of hospitals include safety, security, cleanliness, infection control measures, sanitation facilities and safe drinking water.
Healthcare must be provided at par with the latest standards, norms and guidelines under the National Accreditation Board for Hospitals (NABH). While attending, treating and caring for patients, professional principles and medical ethics must be followed.
Right to choose alternative treatment options
Hospitals and doctors are responsible for explaining the pros and cons of all treatment options, which is ultimately the patient’s choice. The onus is on the patient to shoulder the consequences of their choice.
Right to a second opinion
Every patient is entitled to a second opinion from a doctor/hospital of their choice. Doctors originally in charge must turn in all case files and relevant information that constitute case history to the patient, and must not discourage them from seeking a second opinion in any way. In case they come back after getting the second opinion, the first hospital/doctor cannot compromise on the quality of healthcare services.
Right to transparency in rates
Hospitals must be upfront about costs and rates of treatment in their brochures and notice boards, and display detailed schedules of key rates in prominent places both in English and vernacular languages.
Patients should be able to avail medicines, devices and implants at rates decided by the National Pharmaceutical Pricing Authority (NPPA) and access health care services within the cost range prescribed by the Central and State governments.
Right to choose the source for obtaining medicines or tests
Patients cannot b coerced to purchase medical supplies or get tests done at a particular pharmacy or laboratory. It is their choice to make, and they may settle for any diagnostic centre or laboratory registered under the National Accreditation Board for Laboratories (NABL).
Right to proper referral and transfer, without perverse commercial motives
If a patient must be transferred from one healthcare centre/professional to another, a proper and detailed justification must be provided to them/caretakers along with the differences between the two, which treatments/medicines need to be continued. This step cannot be taken unless the patient or their caretaker accept it, the Charter clarifies. Nor should such decisions be influenced by “kickbacks, commissions, incentives, or other perverse business practices.”
Right to protection from 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.” The patient has to consent to undergo the trial.
Right to protection in the case of biomedical research
For participants of biomedical or health research procedures, written consent is key. Their right to dignity, privacy and confidentiality must be preserved during the research, and should they suffer direct physical, psychological, social, legal or economic harm, the hospital is liable to offer financial or medical compensation.
Positive results of the research, if any, must be made available to the general population.
Right to be discharged
A patient has the right to be discharged whenever they want. They cannot be detained in a hospital on procedural grounds such as a dispute in payment of hospital charges, says the MoHFW.
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 non-payment/dispute regarding payment of hospital charges against wishes of the caretakers,” according to the Charter.
Right to Patient Education
A patient needs to be informed about major facts about their condition, healthy living practices, their rights and responsibilities, health insurance schemes relevant to them, relevant entitlements (for charitable hospitals), and how to seek redressal of grievances.
Right to be heard and seek redressal
Patients have the right to address their grievances regarding the healthcare service or treatment they received, and give feedback.
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” by 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.
Prarthana Mitra is a staff writer at Qrius
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