Monday, May 23, 2016


Patients' Bill of Rights

 
There are few times that we are more vulnerable than when we, or our loved ones, are admitted to a hospital.  New York State mandates a specific list of rights with such basic items as the right to receive treatment without discrimination, and the right to considerate and respectful care. In the context of illness, it is difficult know what our rights are, let alone assert them.  We are at the mercy of hospital staff who, we can only hope, take the title “caregiver” seriously.  We sign multiple pages on admission as they are placed in front of us, at the time when all we want, is to feel better.  Among those pages is that “Patient bill of Rights.”  It is hardly a time that we are going to stop and analyze what those rights are.  In any event New York Public Health law mandates the following rights for every patient.

 

As a patient in a hospital in New York State, you have the right, consistent with law, to:

  1. Understand and use these rights. If for any reason you do not understand or you need help, the hospital MUST provide assistance, including an interpreter.
  2. Receive treatment without discrimination as to race, color, religion, sex, national origin, disability, sexual orientation, source of payment, or age.
  3. Receive considerate and respectful care in a clean and safe environment free of unnecessary restraints.
  4. Receive emergency care if you need it.
  5. Be informed of the name and position of the doctor who will be in charge of your care in the hospital.
  6. Know the names, positions and functions of any hospital staff involved in your care and refuse their treatment, examination or observation.
  7. A no smoking room.
  8. Receive complete information about your diagnosis, treatment and prognosis.
  9. Receive all the information that you need to give informed consent for any proposed procedure or treatment. This information shall include the possible risks and benefits of the procedure or treatment.
  10. Receive all the information you need to give informed consent for an order not to resuscitate. You also have the right to designate an individual to give this consent for you if you are too ill to do so. If you would like additional information, please ask for a copy of the pamphlet "Deciding About Health Care — A Guide for Patients and Families."
  11. Refuse treatment and be told what effect this may have on your health.
  12. Refuse to take part in research. In deciding whether or not to participate, you have the right to a full explanation.
  13. Privacy while in the hospital and confidentiality of all information and records regarding your care.
  14. Participate in all decisions about your treatment and discharge from the hospital. The hospital must provide you with a written discharge plan and written description of how you can appeal your discharge.
  15. Review your medical record without charge. Obtain a copy of your medical record for which the hospital can charge a reasonable fee. You cannot be denied a copy solely because you cannot afford to pay.
  16. Receive an itemized bill and explanation of all charges.
  17. Complain without fear of reprisals about the care and services you are receiving and to have the hospital respond to you and if you request it, a written response. If you are not satisfied with the hospital's response, you can complain to the New York State Health Department. The hospital must provide you with the State Health Department telephone number.
  18. Authorize those family members and other adults who will be given priority to visit consistent with your ability to receive visitors.
  19. Make known your wishes in regard to anatomical gifts. You may document your wishes in your health care proxy or on a donor card, available from the hospital.

 

But at a basic level, your rights go far beyond those enumerated one liners.  There are national standards that require doctors, nurses and other staff to maintain minimum levels of care.  These standards apply to all patients.  Those rights include:

 

  • Medical Records: Today, all hospitals should be using electronic records, but that doesn’t change the fact that patients should have access to their record.  Hospitalized patients should be offered their medical record daily and be shown how to make entries into their record and correct any misinformation. Hospital should provide a CD with the record at minimal cost, upon request of the patient or the patient’s representative.
  • Evidence-based care: Diagnosis and treatment shall be according to federal healthcare guidelines or according to peer-reviewed guidelines published by expert organizations for the medical condition of the patient. If the physician determines that a deviation from guidelines is needed, then the patient must be told that her care should deviate from guidelines and given an explanation for the deviation.
  • Therapeutic Drugs: No patient shall be prescribed a medication for off-label purposes without being informed that the drug prescribed has not been approved by the FDA for the patient’s medical condition. The rationale for prescribing the off-label drug and the risk associated with this must be revealed to the patient and documented. The patient shall be told how to report adverse effects of any prescription drug to the FDA.
  • Physician Competency: Patients have the right to be told the competency status of their physician before they are treated. This status shall include completion of state mandated CME, board-certification status, maintenance of board certification, rehabilitation from drug abuse, and any other factors that bear on the physician’s competency.  This also means that patient’s in a teaching hospital have the right to refuse treatment by medical students, and interns who are merely “learning” rather than contributing to the care. 
  • Costs: Patients shall know the ordinary costs of the diagnosis and treatment that they are going to receive before they agree to a diagnostic plan or treatment plan. Treatment found to be against guidelines without the patient’s consent does not have to be paid for.  Patients are entitled to itemized bills detailing all treatment.
  • Adverse Events: If an unanticipated adverse event occurs during diagnosis or treatment, the patient has a right to a full accounting of what happened and how the hospital intends to prevent similar adverse events in the future. If the adverse event was caused by a medical error, then the patient has a right to just compensation. Falsification of medical records after an adverse event constitutes tampering with evidence.
  • Duty to Warn: Patients shall know the hospital’s infection rate and morbidity and mortality associated with planned invasive procedures. The patient shall be warned of any lifestyle activity that threatens their health. They shall be given guidance on management of that activity.
  • Informed Consent: The patient shall give their informed consent for invasive procedures according to guidelines published by the American Medical Association. Fear shall never be used to elicit consent for invasive procedures. Invasion of another person’s body without genuine informed consent is improper and the patient has a right to be compensated.
  • Right to an Advocate: Research (Gittell, High Performance Healthcare) has shown that while in the hospital the main one to integrate the care of a patient is the patient’s advocate. All hospital patients must have the right to an advocate.

 

At The Sanders Firm, we have decades of experience protecting patients. If you or a loved one have been injured due to substandard hospital care call 516-741-5252 or email us at tgoralski@thesandersfirm.com for a free consultation. 

 

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