Patient Rights | AMA-Code

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Patient-Physician Relationships

Opinion 1.1.3

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The health and well-being of patients depends on a collaborative effort between patient and physician in a mutually respectful alliance. Patients contribute to this alliance when they fulfill responsibilities they have, to seek care and to be candid with their physicians.

Physicians can best contribute to a mutually respectful alliance with patients by serving as their patients’ advocates and by respecting patients’ rights. These include the right:

1. To courtesy, respect, dignity, and timely, responsive attention to his or her needs.
2. To receive information from their physicians and to have opportunity to discuss the benefits, risks, and costs of appropriate treatment alternatives, including the risks, benefits and costs of forgoing treatment. Patients should be able to expect that their physicians will provide guidance about what they consider the optimal course of action for the patient based on the physician’s objective professional judgment.
3. To ask questions about their health status or recommended treatment when they do not fully understand what has been described and to have their questions answered.
4. To make decisions about the care the physician recommends and to have those decisions respected. A patient who has decision-making capacity may accept or refuse any recommended medical intervention.
5. To have the physician and other staff respect the patient’s privacy and confidentiality.
6. To obtain copies or summaries of their medical records.
7. To obtain a second opinion.
8. To be advised of any conflicts of interest their physician may have in respect to their care.
9. To continuity of care. Patients should be able to expect that their physician will cooperate in coordinating medically indicated care with other health care professionals, and that the physician will not discontinue treating them when further treatment is medically indicated without giving them sufficient notice and reasonable assistance in making alternative arrangements for care.

AMA Principles of Medical Ethics: I, IV, V, VIII, IX

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Council Reports

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Ethics Cases & Legal Briefs

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  Must Physicians Disclose Personal Health Information to Patients?

Related Opinions

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Opinion 1.1.7

Preserving opportunity for physicians to act (or to refrain from acting) in accordance with the dictates of conscience is important for preserving the integrity of the medical profession as well as the integrity of the individual physician; Physicians’ freedom to act according to conscience is not unlimited; They are expected to provide care in emergencies, honor patients’ informed decisions to refuse life-sustaining treatment, respect basic civil liberties and not discriminate against patients on the basis of arbitrary characteristics.

Opinion 2.1.1

Informed consent to medical treatment is fundamental in both ethics and law. Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care.

Opinion 3.1.1

Respecting patient privacy is a fundamental expression of respect for patient autonomy and a prerequisite for trust. Patient privacy includes personal space (physical privacy), personal data (informational privacy), personal choices, including cultural and religious affiliations (decisional privacy), and personal relationships with family members and other intimates (associational privacy). Physicians must seek to protect patient privacy in all settings to the greatest extent possible.

Opinion 3.2.1

Physicians have an ethical obligation to preserve the confidentiality of information gathered in association with the care of the patient. With rare exceptions, patients are entitled to decide whether and to whom their personal health information is disclosed.

Opinion 5.2

Advance directives are tools that give patients of all ages and health status the opportunity to express their values, goals for care, and treatment preferences to guide future decisions about health care. Advance directives also allow patients to identify whom they want to make decisions on their behalf when they cannot do so themselves. However, an advance directive never takes precedence over the contemporaneous wishes of a patient who has decision-making capacity.

Opinion 5.3

A patient who has decision-making capacity appropriate to the decision at hand has the right to decline or halt any medical intervention even when that decision is expected to lead to his or her death, When a patient lacks appropriate capacity, the patient’s surrogate may halt or decline any intervention. There is no ethical difference between withholding and withdrawing treatment. When an intervention no longer helps to achieve the patient’s goals for care or desired quality of life, it is ethically appropriate for physicians to withdraw it.

Opinion 10.7

Ethics committees offer assistance in addressing ethical issues that arise in patient care and facilitate sound decision making that respects participants’ values, concerns, and interests. Ethics committees may also assist in ethics-related educational programming and policy development within their institutions.

Opinion 10.7.1

The goal of ethics consultation is to support informed, deliberative decision making on the part of patients, families, physicians, and the health care team. By helping to clarify ethical issues and values, facilitating discussion, and providing expertise and educational resources, ethics consultants promote respect for the values, needs, and interests of all participants, especially when there is disagreement or uncertainty about treatment decisions.

Opinion 11.1.4

Physicians individually and collectively have an ethical responsibility to ensure that all persons have access to needed care regardless of their economic means.

Your Rights as a Hospital Patient in New York State

• “Your Rights as a Hospital Patient in New York State” is also available as a printable PDF. This document is also available in the following languages:
  Spanish, Russian, Chinese, Korean, Haitian Creole, Italian

Keep this booklet for reference. Review it carefully and share the information with your family and friends involved in your care.

The state and federal governments require that all hospital patients in New York State be given certain information and materials when admitted to a hospital. This booklet collects that information in one place, explains the rights of each hospital patient and contains advice for the patients on how best to get assistance.

The booklet is divided into two sections:

• The first section of this booklet explains the rights of each hospital patient in New York State. It also contains a Glossary to help understand terms commonly used in the hospital.
• The second section provides documents the law requires the hospital to provide to each patient while in a hospital in New York State.

• About Your Rights
• About Your Special Needs
• Concerns/Problems/Complaints About Your Hospital Care
• If You Think You Are Being Asked to Leave the Hospital Too Soon
• You Have the Right to File a Complaint About:
  • Doctors or Physician Assistants
  • Other Health Care Professionals

• Questions or Complaints About Your Hospital Bill or Health Insurance
• Access to Your Medical Records
• Glossary
• Regulations and Information
• Patients’ Bill of Rights
• An Important Message Regarding Your Rights as a Hospital Inpatient (for patients not covered by Medicare)
• Admission Notice for Medicare Patients
• Important Message from Medicare
• Deciding About Health Care: A Guide for Patients and Families
  • Introduction
  • Adult Patients Who Have the Ability to Make Informed Decisions
  • Advance Directives/Health Care Proxies
  • Health Care Decision-Making in Hospitals and Nursing Homes
  • Decisions to Withhold or Withdraw Life-Sustaining Treatment in Hospitals and Nursing Homes
  • Decision-Making Standards for Legal Guardians and Surrogates
  • Resolving Disputes in Hospitals and Nursing Homes
  • DNR Orders Outside the Hospital or Nursing Home
  • Health Care Proxy

• Letter from the New York State Department of Health (SPARCS data collection system)
• Maternity Information
• Domestic Violence: Notice for Prenatal and Maternity Patients
• Domestic Violence: Victim’s Rights Notice
• Parents’ Bill of Rights

Rights and obligations of the patient | City Clinical Hospital.

F.I. Inozemtseva

When applying for
medical care and its receipt the patient has the right to:

• respectful and humane treatment by medical workers and
  other persons involved in the provision of medical care;
• information about his last name, first name, patronymic, position and qualifications
  the attending physician and other persons directly involved in providing him
  medical care;
• examination, treatment, under the program of state guarantees
  free provision of medical care to citizens, and being in an institution
  health care in conditions corresponding to sanitary and hygienic and
  anti-epidemic requirements;
• transfer to another attending physician with the permission of the head of the organization
  health care (its structural subdivision) with the consent of another doctor;
• refusal to provide (termination) of medical care, from hospitalization, for
  with the exception of cases provided for by legislative acts;
• filing a complaint with the officials of the healthcare institution, in
  which he is receiving medical assistance, as well as to officials
  government agencies or to the court;
• confidentiality of information about the fact of his
  seeking medical care, health status, diagnosis and other information,
  obtained during examination and treatment, except for the cases provided for by
  legislative acts;
• receiving, in a form accessible to him, complete information about the state of his
  health, the methods of diagnosis and treatment used, as well as the choice of persons
  to whom information about the state of his health can be transferred;
• for additional medical and other services based on the program of paid
  medical services.

THE PATIENT IS OBLIGED:

• to comply with the rules of internal regulations and behavior for patients;
• observe the rules of personal hygiene;
• take care of the property of the institution;
• treat medical workers and other persons involved in the provision of medical care with respect;
• treat other patients with respect, respect the queue, let people through who are entitled to extraordinary services in accordance with the Legislation of the Russian Federation;
• provide the person providing medical care with reliable information known to him about his state of health, including contraindications to the use of medicines, previous and hereditary diseases;
• comply with medical orders;
• cooperate with the doctor at all stages of medical care;
• comply with sanitary and hygienic standards: to be in hospital departments in change of shoes and clothes;
• comply with the rules for the prohibition of smoking, drinking alcohol;
• strictly observe the internal regulations.

RIGHTS AND OBLIGATIONS OF EMPLOYEES

Employees must comply with the rules of medical ethics and deontology, in
fully fulfill their professional duties (in accordance with
job descriptions), prevent the dissemination of confidential and
personal information about patients (except as provided in
current legislation).

Employees are strictly prohibited from using the services of patients or their
relatives for personal purposes.

At 22:00, medical personnel on duty must close the entrances to the departments.

The Procedure for resolving conflict situations between the hospital and patient

In the case of conflict situations, the patient (his legal representative) has the right to directly contact the hospital administration or the duty administrator according to the schedule of citizens’ admission or to contact the hospital administration in writing.

In person
citizen presents a document proving his identity.

The content of the oral appeal is recorded in the citizen’s personal reception card. If the facts and circumstances stated in the oral appeal are obvious and do not require additional verification, the response to the appeal with the consent of the citizen can be given orally during a personal reception, which is recorded in the citizen’s personal reception card. In other cases, a written response is given on the merits of the questions raised in the appeal.

Written appeal, accepted during a personal reception, is subject to registration and consideration in the prescribed manner.

If the circulation contains
issues, the solution of which is not within the competence of an official, to a citizen
clarification is given where and in what order he should apply.

A citizen in his written application must indicate either the name of the institution to which he sends a written application, or the last name, first name, patronymic of the relevant official, or the position of the relevant person, as well as his last name, first name, patronymic (the latter – if any) , the postal address to which the response should be sent, notification of redirection of the appeal, sets out the essence of the proposal, application or complaint, puts a personal signature and date.

If necessary, in support of his arguments, the citizen shall attach documents and materials or their copies to the written application.

A written appeal received by the hospital administration is considered within 30 days from the date of its registration in the manner prescribed by the Federal Law.

The response to a written appeal received by the hospital administration is sent to the postal address indicated in the appeal.

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In accordance with the Federal Law of November 21, 2011 No. 323-FZ “On the fundamentals of the health of citizens in the Russian Federation”

Article 19. Right to medical care

1. Everyone has the right to medical care.

2. Everyone has the right to medical care in a guaranteed volume, provided free of charge in accordance with the program of state guarantees of free provision of medical care to citizens, as well as to receive paid medical services and other services, including in accordance with a voluntary medical insurance contract.

3. The right to medical care for foreign citizens residing and staying on the territory of the Russian Federation is established by the legislation of the Russian Federation and the relevant international treaties of the Russian Federation. Stateless persons permanently residing in the Russian Federation enjoy the right to medical care on an equal footing with citizens of the Russian Federation, unless otherwise provided by international treaties of the Russian Federation.

4. The procedure for rendering medical assistance to foreign citizens is determined by the Government of the Russian Federation.

5. The patient is entitled to:

1) the choice of a doctor and the choice of a medical organization in accordance with this Federal Law;

2) prevention, diagnosis, treatment, medical rehabilitation in medical organizations in conditions that meet sanitary and hygienic requirements;

3) obtaining advice from medical specialists;

4) relief of pain associated with the disease and (or) medical intervention, available methods and drugs;

5) obtaining information about their rights and obligations, the state of their health, the choice of persons to whom, in the interests of the patient, information about the state of his health can be transferred;

6) receiving therapeutic nutrition in the case of a patient being treated in a hospital;

7) protection of information constituting a medical secret;

8) refusal of medical intervention;

9) compensation for harm caused to health during the provision of medical care to him;

10) admission to him of a lawyer or legal representative to protect his rights;

11) the admission of a clergyman to him, and in the case of a patient being treated in a hospital, to the provision of conditions for the performance of religious rites, which can be carried out in a hospital, including the provision of a separate room, if this does not violate the internal regulations of the medical organization.

Principles of health protection in Russia.
Article 4. Basic principles of health care

The basic principles of health care are:

1) observance of the rights of citizens in the field of health protection and provision of state guarantees related to these rights;

2) priority of the patient’s interests in the provision of medical care;

3) the priority of protecting the health of children;

4) social protection of citizens in case of loss of health;

5) the responsibility of public authorities and local governments, officials of organizations for ensuring the rights of citizens in the field of health care;

6) availability and quality of medical care;

7) inadmissibility of refusal to provide medical care;

8) the priority of prevention in the field of health protection;

9) observance of medical secrecy.

Article 5

1. Measures for the protection of health should be carried out on the basis of the recognition, observance and protection of the rights of citizens and in accordance with the generally recognized principles and norms of international law.

2. The state provides citizens with health protection regardless of gender, race, age, nationality, language, presence of diseases, conditions, origin, property and official status, place of residence, attitude to religion, beliefs, membership in public associations and other circumstances.

3. The state guarantees citizens protection from any form of discrimination caused by the presence of any diseases.

Medical assistance provided free of charge within the framework of state guarantees.
It is necessary to consider the territorial program of state guarantees for 2016 approved by the Decree of the Government of Khanty-Mansi Autonomous Okrug – Yugra dated December 25, 2015 No. 492p and not the program of state guarantees for the provision of free medical care to citizens of the Russian Federation for 2008, approved by Decree N 286 of the Government of the Russian Federation of May 15, 2007 .

How are patients identified who can receive expensive and high-tech medical care free of charge?

The territorial program of state guarantees for 2016 approved by the Decree of the Government of Khanty-Mansi Autonomous Okrug – Yugra dated December 25, 2015 No. 492p

How can I get information about my health status?

Section 22 Health Information

1. Everyone has the right to receive in an accessible form information available in a medical organization about their state of health, including information about the results of a medical examination, the presence of a disease, the diagnosis and prognosis of the development of the disease, methods of providing medical care related to them. risk, possible types of medical intervention, its consequences and results of medical care.

2. Information about the state of health is provided to the patient by the attending physician or other medical professionals who are directly involved in the medical examination and treatment. In relation to persons under the age established in Part 2 of Article 54 of this Federal Law, and citizens recognized as legally incompetent, information on the state of health is provided to their legal representatives.

3. Information about the state of health cannot be provided to the patient against his will. In the event of an unfavorable prognosis for the development of the disease, information should be communicated in a delicate form to a citizen or his spouse, one of his close relatives (children, parents, adopted children, adoptive parents, siblings, grandchildren, grandfathers, grandmothers), if the patient has not forbidden inform them about it and (or) has not identified another person to whom such information should be transferred.

4. The patient or his legal representative has the right to directly get acquainted with the medical documentation reflecting the state of his health, in the manner established by the authorized federal executive body, and receive advice from other specialists on the basis of such documentation.

(as amended by the Federal Law
dated November 25, 2013 N 317-FZ)

5. The patient or his legal representative has the right, on the basis of a written application, to receive medical documents reflecting the state of health, their copies and extracts from medical documents. The grounds, procedure and terms for the provision of medical documents (their copies) and extracts from them are established by the authorized federal executive body.

What kind of health impact information is every citizen entitled to receive?

Article 23. Information on factors affecting health

Citizens have the right to receive reliable and timely information about factors that contribute to the preservation of health or have a harmful effect on it, including information about the sanitary and epidemiological well-being of the area of ​​residence, the state of the environment, rational nutrition, the quality and safety of industrial and technical products, food products, goods for personal and household needs, the potential danger to human health of the work performed and the services provided. Such information is provided by public authorities and local governments in accordance with their powers, as well as organizations in the manner prescribed by the legislation of the Russian Federation.