Many a time, we see children spend days outside the ICU where their terminally-ill parent is admitted, only to receive the dead body after a few days. The patient’s relatives have a right to know about the condition of the patient, immediately after life-saving measures are instituted. They have a right to participate in the decision related to the treatment of their loved one, especially if it is an end of life situation. If there is no hope of the patient’s survival, he or she should be allowed to spend the last moments with loved ones. Medical intervention should be restricted to measures that ease the patient’s pain.
The pros and cons of using invasive life-support devices and the chances for cure have to be clearly explained to patients in understandable language. These devices should be used only if the brain is functioning. Today, any patient who has a breathing difficulty is put on a ventilator, irrespective of whether his/her condition is curable or not. It is highly unethical to use measures to prolong oxygenation after vital systems have stopped working spontaneously. Every human has a right to die with dignity.
Most countries have implemented the patient’s bill of rights. But, in India, there is no law to deal with patient’s rights, except some aspects of the Consumer Protection Act. In India, people have come to regard the ICU as a forbidden chamber and the only role of patients’ attendants is to bring medicines as requested by the ICU staff from time to time. They patiently wait outside hoping for the best, even in cases where the futility of life support is evident.
The rights of patients
The rights of patients and their relatives has to be legislated and awareness should be created in public fora.
- Every patient is entitled to quality healthcare and treatment consistent with available resources and accepted medical standards, regardless of caste, creed or religion.
- Every patient has the right to refuse treatment and to be informed of the consequences of his/her refusal.
- A patient has the right to respectful treatment. This means that a patient’s dignity is paramount to healthcare.
- A patient also has the right to privacy and confidentiality on matters concerning medical care.
- The nearest family members have a right to information in life-threatening circumstances.
- A patient has the right to information about doctors. This means that a right to know, at all times, the identity and professional credentials of the primary healthcare provider.
- Then a patient has the right to an explanation concerning his/her diagnosis, treatment, procedures, and prognosis of illness. These should be elucidated in a language and in terms which the patient is expected to understand. In cases where it is not medically advisable to give such information to the patient, the information should be provided to the family members.
- In case of emergencies, the information on the futility of treatment measures should be informed to the patient’s relatives as soon as possible before invasive life support measures need to be taken.
- The patient has a right to information, in non-clinical terms, on complications, risks, benefits, and alternative treatments and the chance of cure or benefit. This will help him/her take an informed decision on the treatment.
- The patient has the right of treatment in a safe environment.
- He or she has the right to be informed of the facilities, rules and regulations that relate to patient or visitor conduct.
- Patients are entitled to information about the mechanisms for the initiation, review, and resolution of patient complaints.
Every hospital should have a charter which shall identify the roles and responsibilities of hospital staff towards patients’ and families’ rights.