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.