The Moral Issue of Patient’s Rights

MEVELLE L. ASUNCION

 Woman became pregnant by accident rather than by

design justifies her decision t0 abort the fetus by appealing to her right to privacy and self determination. The fetus, however, also has the right to life. How much weight do we assign to these conflicting rights? Which rights takes precedence?
 Discuss autonomy, utility, situationism, and

naturalism principles

 Patient’s rights
 The

moral and inviolable power vested in him as a person to do, hold or demand something on his own.
Right to informed consent Right to informed decision Right to informed choice

 Types of Patient’s Rights
1. 2.

3.

Four major elements of informed consent
 Competence  One has made adecision  One has the capacity to justify one’s choice  One does not justify one’s choice but does so in reasonable manner

 Disclosure
 Comprehension  Voluntariness

Right to refuse treatment
 Right to die

 Freedom of choice

Limitations of Patient’s rights
 2 methods of obtaining informed consent  Written consent  Verbal consent  In emergency cases the types of patient need not

require informed consent
  

Comatose obtunded patient Blind or illiterate patients Underaged patients Language barriers

Rights of Patients
Right to considerate and respectful care The patient has the right to obtain from his physician complete current information concerning his diagnosis, treatment, and prognosis in terms that the patient can be reasonably expected to understand 3. The patient has the right to receive from his physician information necessary to give informed consent prior to the start of any procedure and/or treatment 4. The patient has the right to refuse treatment to the extent permitted by law and to be informed of the medical consequences of his action 5. Right ot every consideration of his privacy concerning his medical care program
1. 2.

6. The patient has the right ot expect all communications and records to his care should be treated as confidential 7. The patient has the right ot expect that, within its capacity, the hospital must provide a reasonable response to his her request for services 8. Right to obtain info regarding any relationship of his hospital to tother health care and educational institutions insofar as his care is concerned 9. The patient has the right to be advised if the hospital proposes to engage in or perform human experimentation affecting his/her care of treatment. Right to refuse to participate in such research projects

10. The patient has the right to expect reasonable 11. The patient has the right to examine and receive an explanation of the hospital bill, regardless of source of payment 12. Patient has the right to know the hospital rules and regulations apply to his her conduct as a patient.

CASE HISTORY
 A 26 years old male patient with a HIV (+) test refuses to believe his

diagnosis and does not accept to undertake any complementary studies (e.g. CD4+ T cell count, levels of HIV RNA in serum plasma, etc.) and treatment. Five years later, the patient had to be admitted to the Intensive Care Unit for the treatment of respiratory failure secondary to Pneumocystis Carini pneumonia. He had CD4+ T cell count <50, a severe nutritional compromise and skin lesions compatible with Kaposi’s sarcoma. The patient refused antiretroviral therapy. Nevertheless, his mother insistently requested the attending physician to begin the therapy even against the patient’s wishes. The physician refused to do so. One week later, because of his family’s persistence, the patient changed his mind and accepted treatment. The opportunistic pathologies evolved favorably, so that the patient could be discharged from the hospital one month later. He now accepts regular control of the antiretroviral therapy and is progressively improving his general and nutritional conditions.

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