A patient is any individual who seeks to get examined, treated and obtain an opinion on any health condition, from medical facilitators. These facilitators include doctors, nurses, hospitals, nursing homes, dispensaries, insurance companies, and third-party administrators.
When a patient is undergoing treatment or examination, there are certain formalities, rules, and conditions that the medical caregiver requires them to read, understand and agree, usually presented in the form of an agreement.
The patient or their relative/attendant is required to agree to the same and mark their signatures on it.
These terms and conditions come from the side of the medical facilitator and are put up to safeguard the hospital/medical staff. At such a time of adversity, patients often do not know what are their rights in the capacity of a patient.
The Ministry of Health and Family Welfare released a charter to educate and create awareness among the common man, to avoid exploitation and ignorance with respect to patient rights.
This article only aims at further clarifying the charter so that all patients are sensitized towards what all they have a right to, as a patient
Right to Emergency Medical Care
Every patient has the right to seek medical care in case of an emergency, which is typically treated in the emergency section of any hospital. This emergency care includes availing of the facility of an ambulance.
Ambulances are provided by private hospitals and also by the government, which transports them to any nearby hospital of choice. There is no requirement to pay any advance fees for availing the ambulance, which is fully equipped with all equipment and trained personnel.
Right to Non-Discrimination
In a country like India, which has a history of observing discrimination on the basis of different criteria such as age, gender, color, caste, social segment, and financial background, it can be common to spot denial to the disadvantaged.
However, the first Fundamental Right in India grants “Right to Equality” as the basic fundamental right that is applicable all. As an extension of the same, all citizens of India have the right to be treated fairly to seek medical help, regardless of their gender, caste, creed, color, social and financial status.
Right to Information
The introduction of the Right to Information Act, 2005 was a landmark development in the information-seeking process for any citizen of the country.
This act enabled citizens to seek any information from any public authority, by filing an RTI application, to which the answer must be furnished within 30 days.
Further to the coming into force of this act, this could also be made applicable to patients in terms of getting information related to their treatment such as :
- Cost of treatment.
- The type of treatment as the way forward.
- Competencies and qualifications of the doctor/ team of doctors treating the patient.
- Further investigation and possible complexities must be communicated to the patient or their caretaker.
Right to records and reports
Investigation and medical history trail are important arms of seeking medical help. Each patient reserves the right to access his or her records of treatment and the reports of the investigation done in relevance to the treatment.
The medical caregivers cannot deny it on any ambiguous grounds and are bound to furnish the same to the patient/caretaker.
Additionally, it has been recently held by Bombay High Court that prescribing medicines without the diagnosis ( tests ) is “culpable negligence”.
Right to Transparency in rates
Medical treatment has a lot of hidden costs involved. Usually, the patient/family of the patient comes to receive treatment with a different impression in mind, and when the invoices are handed over to them for final payment, it presents exorbitantly high amounts – not anymore though.
Now every patient has the right to know the cost of treatment, tests, taxes, and consultation charges. For conveying with clarity to the patients, health centers are required to display conspicuously on billboards and common spaces, the different rates for:
- Seeking treatment
- Medical investigation
- Getting diagnosis done
- Purchasing medicines
- Any other services provided
Such information must be conveyed in English and Hindi/local language.
Right to the second opinion-
Medical emergencies call for calculated risks only. With a variety of specialists available to consult, any patient holds the right to seek the second opinion from another doctor to ensure they are following the correct line of treatment.
The primary doctor cannot deny pursuing the treatment in case they find out that their patient has referred to another doctor or health center to make a firm decision.
Right to choose alternative treatment/medicine
India is a country where there are a plethora of options available, to access medical care from different routes. Apart from mainstream medicine, the options available range from homeopathy to naturopathy and Ayurveda.
In fact, the government itself promotes alternative medicine lines abbreviated as ‘AYUSH’, which stands for Ayurveda, Yoga, Unani, Siddha, and Homeopathy. Every patient has the right to choose any or more than one of these to treat themselves. Medical care isn’t limited to just allopathy and surgery.
Right to safety and quality care
With the increasing population in the country, there may be concerns of hygiene and cleanliness at hospitals and clinics. To give the patient fraternity utmost care, every patient has the right to access healthcare in its most hygienic and sanitized conditions.
Additionally, every patient is entitled to receive medical care that is at par with quality control standards of safety and security, patient grievance redressal, professional and objective behavior by the staff, safe and clean water.
In addition to the above, patients also have the right to obtain healthcare that stands true to the standards of the National Accreditation Board for Hospitals ( NABH ).
Right to informed consent
This right also comes in the extension of the Fundamental Right to Information. Surgical procedures, radiations, and therapies have their own set of side-effects and repercussions.
Medical staff must inform the same to the patient or the caretakers and seek written consent as part of the policy. Such risks must be explained in simple language on a consent form, and it must be ensured that the caretakers understand the following as part of “Informed Consent”:
|§ Type of treatment|
|§ Purpose of treatment|
|§ Risks and benefits of the treatment|
|§ Procedure of treatment|
|§ Scope of procedure – whether minor/major|
|§ Side effects – possible and intended|
Further, the patient’s rights with respect to consent are as follows:
|§ Right to ask questions with respect to any aspect of the treatment|
|§ Freedom from fraud, force, deception, coercion, duress or other forms of restraint|
|§ Right to refuse without affecting the patient’s future route of treatment|
As per the Indian Contract Act, consent goes hand in hand with competency, while entering into a contract. No person can enter into a valid contract, if either of consent or competency are missing.
A person isn’t competent to enter into a valid contract if any of the following situations hold true :
- Mental illness or retardation
- Unstable mental status
- Influence of alcohol or drugs/ intoxication
- Minor status, i.e. not attained the minimum age of 18
If patients are incompetent as per the circumstances mentioned above, their competent caretaker or attorney can take a decision on their behalf.
Right to confidentiality and privacy
Patient data and diagnosis must be guarded by bounds of confidentiality and their privacy must be respected at every cost. The doctors do not have any right to release private data about medical conditions of their patients, unless required by law.
This is a part of doctors’ code of conduct and ethics to maintain confidentiality about treatment procedures with everyone apart from the patient and their attendants.
Women should also know that if a male doctor is examining them or performing a procedure, she has the right to have another woman in her proximity during such examination or treatment.
There are certain exceptions that are subject to confidentiality. Certain cases require the information to be revealed to third parties. These are:
- Patients in a condition of harming themselves or others.
- Cases of child abuse. In case a health centre/doctor does not report child abuse, that person becomes subject to prosecution, in case the child suffers injuries or wounds due to the abuse.
- Certain communicable diseases, gunshot and knife wounds. In case a medical caregiver gets information of the above, they are supposed to the police as it is a criminal issue.
Right to choose the source of medication
Patients have the right to choose the chemist or medical store from where they procure medicines for treatment. Patients cannot be subject to force or other restraint by any medical caregiver for their preference of store to make such purchases that are related to their treatment.
The same also holds true for choosing the diagnostic lab for their medical investigations.
Right to proper referral and transfer
In situations where patients are transferred from one health centre to another, for purposes of obtaining advanced facilities or more specific treatment, they reserve the right to be carefully referred to another medical facilitator with detailed condition of the patient, diagnosis, medical record and medication to be communicated to the new place of treatment. This is only executed when the patient or their caretakers agree to such a transfer or referral.
Right to protection to patients in clinical trials
The charter specifically mentions the guidelines which must be adhered to, that involve patients in clinical trial. These are the Good Clinical Practice Guidelines and protocols issued by the Govt. of India. These guidelines lay stress on written prescriptions, consent seeking and respecting of privacy of patients.
Right to patient education
Patients have the right to educate themselves in the best interest of their health condition. At the time of discharge, hospitals are duty-bound to furnish to their patients, a list of all such details that aid in the condition betterment for the patient. These include the present condition of the patient, medication to be continued and its patter, rights and duties, habits and practices to improve health, grievance redressal system, follow-up schedule.
Right to seek redressal and being heard
This is an arm of the fundamental right to “constitutional remedies”. Every citizen has the right to be heard in the courts of law and to claim a solution to their issues. Patients too, have the right to get their problems addressed in the applicable jurisdiction and claim damages, if any.
Right to be discharged & Right to receive the body of the patient (for caretakers)
If there’s a conflict about non-payment of hospital dues, a patient cannot be denied discharge. This is unfair to the condition of the patient.
Similarly, in case a patient passes away in the midst of treatment at any health center, his caretakers have the right to receive the body of the deceased, and cannot be denied on account of non-payment of dues.
Right to protection of biomedical research participants
For the purpose of research, clinical data is often collected from patients. However, their identity is to be kept confidential, even if the results are used for conducting trials and coming to conclusions. Their privacy and dignity should be of utmost importance to such researchers and research laboratories.