Patient’s Rights In Practice Essay

In the field of healthcare, patients have several rights they can or should utilize in order to receive the maximum benefit out of the treatment they receive. The patient should be thoroughly evaluated and one should make sure that all their rights and responsibilities are respected. However, we should also be aware that there is more than just accepting the rights and responsibilities of the patient. The decision made by the healthcare professionals should be legal and ethical in every sense. In my study, I present a case of a 14-year old girl (let’s name her Sara) who was presented to the hospital when she was found with cramps. Unfortunately, upon ultrasound scanning, it was revealed that she was pregnant. The pregnancy was ectopic. She was obviously hesitating to reveal this to her mother and she planned to undergo the surgery by signing the legal consent herself. However, the girl being underage, consent is definitely an issue as one has to be 18 years old or more to sign the legal consent. There are pros and cons of the issue here that will be discussed elaborately based on several evident journals supporting my arguments. As stated earlier, it is absolutely essential to make the patient aware of his or her rights and in our case, Sara is negligent regarding her rights as she is underage (14 years old). How has she really utilized her rights and what rights she didn’t utilize that could have benefited her? The first right that Sara had utilized correctly was the right to use the free hospital services as a public patient. The second right that can be applied in Sara’s case is her right to be treated with respect, dignity and consideration without taking into consideration of her age, gender, religion or culture. The third right that can be applied is the right to information where she can choose either to be a private patient or a public patient. The fourth right that is applicable in Sara’s case is her right to treatment based on how unwell she is. The fifth right that fits into Sara’s description is her right to participate in making her own decisions regarding the healthcare. Sara also has the right to learn more information about her treatment and risks in her own way so that it is easy for her to understand. This can be regarded as her sixth right. Her right to give permission for the treatment can be her seventh right and Sara’s eighth right is her right to keep her information confidential and private (Queensland Health Public Patient’s Charter, 2002). While all her rights have been outlined above thoroughly, let’s look into each and elaborate into each concept by supporting the arguments as well with examples. Each right mentioned above conforms with her age and her right to treatment. In the first right, she gains access to free health services from the hospital which is absolutely vital as she is a resident and under the program she is insured in, she is entitled for benefits. The second right is her right to treatment irrespective of her age and other attributes. Obviously, Sara is underage and by no means does her current age status deprive her from receiving the right medical treatment. The third right that has been explained above is her right to be a public or a private patient. She can pay her own bills or have Medicare pay for her. Since she is underage, this right will apply but as a public patient as private patient right makes no sense in her case as she is not earning (or her financial dispositions have not been displayed). Sara’s fourth right is her right to treatment based on her condition diagnosed, which again, fits into her category. Her right to treatment here is a surgery for her ectopic pregnancy and that should be done at the right time. The suggestion given by the health professionals is accurate and therefore, she can proceed with the treatment whenever she wishes (Queensland Health Public Patient’s Charter, 2002). Sara’s fifth right is to choose the kind of healthcare treatment she wants to proceed with. Obviously, in her case, we see that she is negligent regarding this right. However, the healthcare professionals such as the nurses or physicians may advice her (only) regarding her options. Sara’s sixth right, as entitled, is to learn more information about the treatment in her own way. In her case, it would be a simplified language (and not in medical terms) to explain what has actually happened to her and what she has to do for her ectopic pregnancy. Sara’s seventh right is her right to give permission for the treatment. She can refuse or accept to perform the surgery but as in her case, a surgery is absolutely essential as she has an ectopic pregnancy but if she refuses to do so, the healthcare professionals or physicians cannot force her into changing her decision and granting them the permission to pursue with the surgery. And finally, Sara has the right to keep her information confidential. Since she doesn’t want her mother to know about her pregnancy, any information about her pregnancy and surgery should be kept strictly confidential unless absolutely necessary to reveal, only by the patient’s permission (Queensland Health Public Patient’s Charter, 2002. All the patients have their own rights and thus they should be respected as well as taken care of without any sense of hostility towards them. Sara’s first right, as stated, is her right to use free hospital services as a public patient and accordingly, she has utilized her first right. Medicare was first introduced in Australia in the year 1984. Under the public sector of health financing, it has two vital functions, one of them being to cover the cost of public hospital care and other of medical physicians or practitioners. As quoted by the article below, â€Å"Under Medicare, all permanent Australian residents are entitled to free public hospital care when choosing to be public patients. Doctors who are appointed in the hospitals provide their medical treatment. State and territory governments provide public hospital services and work closely with the federal government and professional bodies to ensure that quality of care and appropriate standards are maintained†¦ Medicare also meets the bulk of costs for all out-of-hospital services such as general practitioner and specialist consultations. † (Australia Now, n. d. ). As per the quote above, Sara must have been insured under Medicare which is how she was able to proceed for the surgery or even gain access for the check-up where she was diagnosed for ectopic pregnancy. As the ICN code of ethics for nurses states in its preamble, Inherent in nursing is respect for human rights, including cultural rights, the right to life and choice, to dignity and to be treated with respect. Nursing care is respectful of and unrestricted by considerations of age, colour, creed, culture, disability or illness, gender, sexual orientation, nationality, politics, race or social status† (ICN code of ethics, 2005). Ethically and legally, Sara has utilized her rights and therefore, it is ethical and perfectly legal for the healthcare practitioners such as doctors or nurses to treat her in the way she should be treated. As the right and regulation itself states, there is no discrimination based on any attribute in terms of treatment or providing healthcare services. Her third right, as implied, is her right to be a public or private patient. In Sara’s case, there is hardly any choice as she cannot choose to be a private patient (because if you are a private patient, you pay your own bills and if you are a public patient, they can have Medicare to cover your costs). Regarding the healthcare services in Australia, there is absolutely no fee limit that is charged by the doctors and therefore, one has to be extremely careful when making such choices. However, Dr. Stephen Duckett states, â€Å"There is, however, a government-set fee schedule. Doctors can bill patients or send their bills directly to the government insurance authority, the Health Insurance Commission (HIC). If sent to the HIC, the payment is 85% of the government-set fee for out-of-hospital expenses and 75% of the government set fee for in-hospital services; the money is paid directly to the doctor, and the doctor is not allowed to charge the patient an additional fee. About 75% of family physician services are directly billed to the HIC. If a doctor bills the patient directly, the patient then applies for the rebate of the government set fee† (Duckett, 2004). Sara’s fourth right, as outlined previously, is her right for appropriate treatment for the diagnosed condition, which in her case, is ectopic pregnancy. According to Megan-Jane Johnstone, the patients have the right to appropriate case and thus she states in her book, â€Å"Bioethics: a nursing perspective†, â€Å"The right to have access to appropriate care is a second sense in which a right to health care can be claimed. This sense raises important questions concerning the cultural relativity or ethno-specificity of care and its ability to accommodate people’s personal preferences, health beliefs, health values and health practices. Failing to provide health care in an appropriate manner can have disastrous consequences (clinically, legally and morally)† (Johnston, 1999). Therefore, as stated by Megan-Jane, failing to provide inappropriate healthcare may lead to serious consequences and even lawsuits (when taking this in a legal perspective). The fifth right is Sara’s right is to choose the kind of healthcare treatment she wants to pursue with. The healthcare practitioners can only advise her on this matter and cannot force her to choose a particular kind of treatment. As suggested by her ultrasound test reports, Sara is diagnosed with ectopic pregnancy. In her case, the rights are her law. The law protects her rights. Since Sara has no option at all, she plans to proceed with the surgery of her ectopic pregnancy. According to code of ethics for nurses in Australia, as stated below, Nursing care is based on the development of a therapeutic relationship and the implementation and evaluation of therapeutic processes. Therapeutic processes include health promotion and education, counseling, nursing interventions and empowerment of individuals, families or groups to exercise maximum choice in relation to their health care† (ANMC, 2002). Sara’s sixth right states that the healthcare professionals should make her understand of her situation as well as treatment options in an easy-to-understand language. Ethically, it is the right thing to do as the healthcare professionals should make their patients aware of their health condition, its consequences and the treatment options in the easiest manner. In Sara’s case, we see that at a very young age, she is a patient with ectopic pregnancy and nothing except surgery can save her life from being ruined. According to Mary Ellen Trail Ross, â€Å"Nurses must frequently make arduous decisions when faced with ethical dilemmas that occur in clinical practice. Utilizing ethical principles for analyzing and reflecting on the issues may ease this difficult task. In addition, the nurse involved may experience less anxiety and uncertainty over whether or not the correct decision was made† (Ross, 1993). We have observed that the healthcare professionals (in Sara’s case) have respected her rights and have advised her for the most safest and viable option. The role of nurse is taken seriously in this regard as she is the one who takes extreme care in such delicate cases. Sara’s seventh right is her right to give or ask permission for the treatment. Before any treatment is initiated, her complete permission has to be sought. But here involves a complexity. Sara is underage and they should have legal consent from their guardians before performing or prescribing any medical treatment. Judith M. Cassells and Barbara K. Redman emphasize on the ethical dilemmas when concerning the informed consent. In the practice, a nurse should take into account the moral aspects of nursing care when arriving on any decision (Cassells & Redman, 1988). Applying values in order to come into a decision mostly works and therefore, Sara has been given the option for the surgery. According to her right, she can utilize her free will and sign on the legal consent form without any questions from the healthcare provider as her right entails her to do so. However, a legal consent from her guardian would have done her more good as it is essentially vital for someone who is close to her (as in relations) to be by her when this surgery would take place. Ethically and legally, what Sara is doing and has gone through the surgery is right but morally speaking, the presence of someone close would have helped the patient in a great way. Lastly, Sara has her right for privacy. Legally, yes. Ethically- the hospital, the hospital staff as well as the doctors and nurses are not allowed to reveal either. The information serves in the best interest of the patient and without the written consent of the patient, no information is revealed to any person, even if the person inquiring is a close relative. Geoffrey Hunt in his book, â€Å"Ethical issues in nursing† has stressed on maintaining the privacy as it helps in proper management of records and helps the patient be at ease regarding his or her health information (Hunt, 1994). While all her rights have been served and the ethical aspect of every right having been discussed, we have seen how the public patient charter issued by Queensland government helped in making public aware of their rights. The rights stated therein are the laws and the ethics involved stated here are from a nursing perspective. Marie T. Hilliard in her journal article, â€Å"Nursing, Ethics and Professional roles† states that there has always been a growing concern over the ethical codes and practice where nurses are involved but today, immense information has been highlighted for the public as well as the medical professionals in order to understand their practice, their laws as well as their ethics (Hilliard, 1990). Overall, the public charter has highlighted on the responsibilities and rights of the patient in a way that they are able to utilize it with full knowledge and are able to gain the maximum benefit out of it. Reference http://unpan1.un.org/intradoc/groups/public/documents/APCITY/UNPAN016276.pdf http://icn.ch/icncode.pdf