The right to receive treatment without any discrimination - Charter of Patients’ Rights - Seeker's Thoughts

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The right to receive treatment without any discrimination - Charter of Patients’ Rights

“Patient Rights” - The Concept
The Jan Swasthya Abhiyan, a national platform working on health and health care services, urged the Ministry of Health to immediately implement the charter of patients Rights and ensure the inclusion of the entire range of patients rights without any dilution.
What is the Charter of Patients Rights?
In August 2018, the Ministry of Health and Family welfare announced its plans to implement this Charter, which was plaved in the public domain for inviting comments up to 30th September, 2018. Although nearly 4 months have elapsed since this declaration of intent, there seems to have been no further progress on finalisation and adoption of the charter.
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What is the current status of patient rights in india?
Government of india has enacted the Clinical Establishments (Registration and Regulations) Act in 2010 and niotified the Clinical Establishemnts ( Central Government) Rules, 2012. The act and the rules provide for the following.
-         Registration and regulations of clinical Establishment including those in the private sector (includes both allopathic and AYUSH systems of medicine, Therapeutic, diagnostic establishmenst)
-         All such clinical establishment are required to meet the following norms.
-         Minimum standards of facilities and services
-         Minimum requirement of personnel, maintenance of records and reports.
-         Displaying of rates at a conspicuous place.
-         Follow standard Treatment Guidlines issues by the Central/state governments.
-         Charge rates for each type of procedure and service within the range of rates as determined from time to time.

Need of Charter of Patients’ Rights:
Right to non-discrimination is an important right. Every patient has the right to receive treatment without any discrimination based on his or her illness or conditions, including HIV status or other health condition, religion, caste, ethnicity or sexual orientation.
The charter assumes significance as india does not have dedicated regular like other countries. Existing regulations in the interest or patients and  governing healthcare delivery system are still on the anvil.
The draft Charter of Patients’ Rights:
It has been prepared by the National Human Rights Commission.
The draft charter includes 17 rights with description, inspired by international charters and guided by national level provison, with the objective or consolidating these into a single document.
The proposed charter draws upon all the existing relevant provisions, thereby mking them publicly known in a coherent manner.
Right to Information: Every patient has a right to adequate & relevant information about the nature, cause of illness, provisional/confirmed diagnosis, proposed investigations and management, and possible complications to be explained at their level of understanding in language known to them. 

Patients and their caretakers also have a right to know the identity and professional status of various care providers who are providing service to him/her.

Right to records and reports: Every patient or his caregiver has the right to access originals/copies of case papers, indoor patient records, investigation reports (during period of admission, preferably within 24 hours and after discharge, within 72 hours). This should be made available after paying appropriate fees for photocopying or allowed to be photocopied by patients at their cost.

Right to Emergency Medical Care: As per Supreme Court, all hospitals both in the government and in the private sector are duty bound to provide basic Emergency Medical Care, and injured persons have a right to get Emergency Medical Care.
 Such care must be initiated without demanding payment/advance and basic care should be provided to the patient irrespective of paying capacity.

Right to informed consent: Every patient has a right that informed consent must be sought prior to any potentially hazardous test/treatment (e.g. invasive investigation/surgery/chemotherapy) which carries certain risks.

Right to confidentiality, human dignity and privacy: All patients have a right to privacy, and doctors have a duty to hold information about their health condition and treatment plan in strict confidentiality, unless it is essential in specific circumstances to communicate such information in the interest of protecting other or due to public health considerations.

Right to second opinion: Every patient has the right to seek second opinion from an appropriate clinician of patients’ or caregivers’ choice. The hospital management has a duty to respect the patient’s right to second opinion, and should provide to the patient’s caregivers all necessary records and information required for seeking such opinion without any extra cost or delay.

Right to transparency in rates and care as per prescribed rates: Every patient and their caregivers have a right to information on the rates to be charged by the hospital for each type of service provided and facilities available on a prominent display board and a brochure. They have a right to receive an itemized detailed bill at the time of payment. 
It would be the duty of the to display key rates at a conspicuous place in local as well as English language, and to make available the detailed schedule of rates in a booklet form to all patients/caregivers.

Right to non-discrimination: Every patient has the right to receive treatment without any discrimination based on his or her illnesses or conditions, including HIV status or other health condition, religion, caste, ethnicity, gender, age, sexual orientation, linguistic or geographical/social origins.

Right to safety and quality care according to standards: Patients have a right to safety and security in the hospital premises. They have a right to be provided with care in an environment having requisite cleanliness, infection control measures, safe drinking water as per BIS/FSSAI Standards and sanitation facilities.

Right to choose alternative treatment options if available: Patients and their caregivers have a right to choose between alternative treatment/management options, if these are available, after considering all aspects of the situation. This includes the option of the patient refusing care after considering all available options, with responsibility for consequences being borne by the patient and his/her caregivers.

Right to choose source for obtaining medicines or tests: When any medicine is prescribed by a doctor or a hospital, the patients and their caregivers have the right to choose any registered pharmacy of their choice to purchase them. Similarly, when a particular investigation is advised by a doctor or a hospital, the patient and his caregiver have a right to obtain this investigation from any registered diagnostic centre/laboratory having qualified personnel and accredited by National Accreditation Board for Laboratories (NABL).

Right to proper referral and transfer, which is free from perverse commercial influences: A patient has the right to continuity of care, and the right to be duly registered at the first healthcare facility where treatment has been sought, as well as at any subsequent facilities where care is sought.4

Right to protection for patients involved in clinical trials: Every person/patient who is approached to participate in a clinical trial has a right to due protection. All clinical trials must be conducted in compliance with the protocols and good clinical practice guidelines issued by Central Drugs Standard Control Organisation and other applicable provisions.

Right to protection of participants involved in biomedical and health research: Every patient who is taking part in biomedical research shall be referred to as research participant and every research participant has a right to due protection. Any research involving such participants should follow the National Ethical Guidelines for Biomedical and Health Research involving Human participants.

Right to take discharge of patient, or receive body of deceased from hospital: A patient has the right to take discharge and cannot be detained in a hospital, on procedural grounds such as dispute in payment of hospital charges. Similarly, caretakers have the right to the dead body of a patient who had been treated in a hospital and the dead body cannot be detailed on procedural grounds, including nonpayment/dispute regarding payment of hospital charges against wishes of the caretakers.

Right to Patient Education: Patients have the right to receive education about major facts relevant to his/her condition and healthy living practices, their rights and responsibilities, officially supported health insurance schemes relevant to the patient, relevant entitlements in case of charitable hospitals, and how to seek redressal of grievances in the language the patients understand or seek the education.

Right to be heard and seek redressal: Every patient and their caregivers have the right to give feedback, make comments, or lodge complaints about the health care they are receiving or had received from a doctor or hospital. This includes the right to be given information and advice on how to give feedback, make comments, or make a complaint in a simple and user-friendly manner.

Patients and caregivers have the right to seek redressal in case they are aggrieved, on account of infringement of any of the above mentioned rights in this charter. 

This may be done by lodging a complaint with an official designated for this purpose by the hospital and further with an official mechanism constituted by the government.

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