Ethical Implications of Protecting Patient and Family Rights

07 February, 2017

What is the Standard of Care? Have you or a loved one been harmed during medical care? The concept of the standard of care has evolved over the years and will continue to change as legal theory in this area develops. Unless modified, it is now a settled principle of law that a medical practitioner (Surgeons, Physicians, interventionists, and other medical professionals) and the duty owed by a doctor towards his patient, in the words of the Honorable Court is to “bring to his task a reasonable degree of skill and knowledge” and to exercise “a reasonable degree of care” (Indian J Ul).The degree of care is a variable and depends on the circumstances. Failure to perform Surgery or manage patient properly, the consequences of such error can be devastating to the victims and their families. Medical errors rank behind heart disease and cancer as the third leading cause of death in the U.S.  Virtually most of the medical errors are preventable and surgical mistakes are the most shocking of medical malpractice claims. If we can clarify for the public and lawmakers how big a problem these errors are we would hope it would lead to more resources toward patient safety. Surgeons /interventionists are required to obtain informed consent from patients and document it in patients record  file the risks, benefits alternatives of  his/her plan of care were  explained to patient or relatives and have agreed and signed. Signing the consent does not amount to waiver of right to complain later if the patient or his /her relative are convinced of medical negligence, they have still a right to file a complaint. Patients and their families have rights.(PFR). That's right. Typically notice of patient family rights/responsibilities  are displayed conspicuously in bilingual language near the main entrance to the hospital, the emergency department entrance and at all the registration areas of the hospital. The purpose is to provide this information in advance of providing or discontinuing care to assure all stake holders about the organizational policy of adherence to the standards of respecting the individual rights of all persons that come to this facility for care. The list is too big and varies from one set up to another tailored depending upon local conditions. Typically, state things such as to have nondiscriminatory access to treatment to the extent that they are available and medically necessary, regardless of gender, race, color, religion, creed, mental or physical disability, disease process, national origin or source of payment for care in a safe and supportive environment, free of exploitation, abuse or harassment. Certain  organization allow  you have the right to request a second opinion regarding your treatment and to request the names of other physicians able to provide such a second opinion.Also,to complain about treatment or care, have your complaints registered, reviewed and resolved, through hospital quality department or  grievance  cells if possible, without compromising your care or access to service.  There are many more rights than that which is stated here, but one right you do have that is not displayed explicitly   in these  signage’s  is the right you have to hold medical professionals civilly liable for harm caused by their negligence. 

Often, patients or their families do not realize their specific rights at the time of their care because those rights are either not needed or included in requisite papers that patients need to sign during admission process but gain importance medico legally especially when things go wrong unexpectedly. 

We go to the hospital for treatment, there is an expectation, a trust  that your care providers will, at the very least, "do no harm." While medical community owe a duty to not harm their patients, either by errors of omission or commission it is known that medical services carry a risk of complications there has to be zero tolerance for negligence. An estimated 100,000 hospital patients die every year as a direct result of medical malpractice or medical negligence involving surgical mistakes by surgeons and other health care professionals in operating rooms. Sometimes things do not go as planned and during my experience of investigating malpractice cases I found it's  not always practitioner's  fault while  reading too much on media hype.

Sadly true, any healthcare professional who commits malpractice causing harm to a patient exploits the consent (waiver) obtained preoperatively which protects the practitioner when he or she is not at fault. However, if the results of  medical management, intervention or surgery are not satisfactory to patient or their family  has resulted in harm because the practitioner  failed to exercise the appropriate level of care and safety  when prescribing or performing any intervention/surgery/or medication  , or didn’t possess requisite qualification, competence ,skills and privileges the waiver does not apply and the patient may complain  for medical malpractice. The patient, too, has an equal right to present his /her case. The Medical liability rules and laws applicable may differ from country to country or every state takes guidance from its medical councils. Doctors need not practice defensive medicine and can feel free that if they have acted within the accepted limits of internationally recognized evidence based protocol or purview even if an outcome has been undesired or unsatisfactory despite all precautions, usually they will not be held liable. Our friends in legal profession can educate us better on this issue.

 Lately, there is a growing awareness regarding patient's rights, in our land and If you or a family member were injured due to medical malpractice or nursing home negligence, many advocate law groups.NGOs  are eager to  be  on your side to take it to consumer court. So,it is important for Medical practitioner to know what constitutes medical negligence. Generally, the term negligence is defined as the absence or lack of care that a reasonable person should have taken in the circumstances of the case.  This is what real patients (i.e. those patients who are really sick) expect from their treating Doctor  is that they make correct diagnosis and treat  them with the evidence based best clinical practice guidelines, in order to cure them, or at least in order to alleviate  their sufferings.

While medical professionals all over globe are considered being among the best human talent in the world, there are exceptions. Bad Doctors do exist and bad things can happen while receiving medical care, and medical errors can result in serious injury or death. What does not cost money –is protection of patient and family rights in our healthcare syswtem? Patients want assurance on their quality and safety concerns. Who can do what, and where?