UNITS 4:3-4:4 Patients’ Rights and Legal Directives for Health Care

Objective List at least six rights of the patient who is receiving health care

Introduction Have you ever heard the saying “The customer is always right? Is the patient always right? Why or Why Not?

Patients’ Rights Patients’ rights are factors of care that patients can expect to receive Federal and state legislation requires agencies to have written policies concerning patients’ rights All personnel must respect ad honor these rights

American Hospital Association has affirmed a “Patients Bill of Rights” stating that the patient has the right to: Considerate and respectful care Obtain complete current information concerning his or her diagnosis, treatment and prognosis (expected outcomes) Receive information necessary to give his or her informed consent prior to the start of any procedure or treatment Have advanced directives for health care and/or refuse treatment to the extend permitted under law Privacy concerning his or her medical care program Confidential treatment of all communications and records Reasonable response to his or her request for services Obtain information regarding any relationship of the hospital to other health care and educational institutions Be advised of and have the right to refuse to participate in any research project Expect reasonable continuity of care Review medical records and examine the bill and receive an explanation of all charges Be informed of any hospital rules, regulations, and/or policies

Long Term Care Bill of Rights Residents in long term care guaranteed certain rights under federal law Established by the Omnibus Budget Reconciliation Act (OBRA) of 1987 Every long term care facility must inform a resident or guardian of these rights, and a copy must be posted in the facility

Long Term Care Bill of Rights Often called a “Resident’s Bill of Rights” and states, in part, that a resident has a right to:  Free choice regarding the physician, treatment, care and participation in research  Freedom from abuse and chemical or physical restraints  Privacy and confidentiality of personal and clinical records  Accommodations of needs and choice regarding activities, schedules, and health care  Voice grievances without fear of retaliation or discrimination  Organize and participate in family resident groups and in social, religious, and community activities  Manage personal funds and use personal possessions  Unlimited access to immediate family or relatives and to share a room with his or her spouse if both are residents  Remain in facility and not be transferred or discharged except for medical reasons the welfare of the resident or others, failure to pay, or if the facility cannot meet the resident’s needs or ceases to operate  Information r/t medical benefits, medical records, survey results and deficiencies of the facility, and advocacy groups including the ombudsman program

Bills of Rights States have adopted these rights and added additional ones Check your state law to obtain rights established Failure to follow and grant rights can lead to job loss, fines, and even imprisonment

Advanced Directives for Health Care Also known as legal directives Legal documents that allow individuals to state what medical treatment they want or do not want in the event that they become incapable and unable to express their wishes Two main directives include a Living Will and a Durable Power of Attorney (POA) for health care

Living Wills Documents that allow individuals to state what measures should or should not be taken to prolong life when their condition is terminal Must be signed when individual is competent and witnessed by two adults who cannot benefit from death Most states now have laws that allow the withholding of life-sustaining procedures and honor living wills

Living Wills Continued Frequently result in DNR (do not resuscitate) order for a terminally ill individual  Cardiopulmonary resuscitation (CPR) is not performed when the patient stops breathing  Patient is allowed to die with peace and dignity  Extremely difficult for health care workers to honor  Important to remember that many individuals believe that the quality of life is important and a life on support systems has no meaning or purpose for them

Durable Power of Attorney for Health Care or Designation of Health Care Surrogate Document that permits an individual (known as a principal) to appoint another person (known as agent) to make any decisions regarding health care if the principal is unable to make decisions Includes providing or withholding specific medical or surgical procedures, hiring or dismissing health care providers, spending or withholding funds for health care, and having access to medical records Usually give POAs to spouses or adult children, can be given to any qualified adult Must be signed by the principal, agent, and one or two adult witnesses

Patient Self Determination Act (PSDA) Federal law that went into effect in 1990 Requires that ALL health care facilities receiving any type of federal aid comply with the following requirements:  Inform every adult, both orally and in writing, of their right under state law to make decisions concerning medical care, including right to refuse  Provide information and assistance in preparing advance directives  Document any advance directives on patient’s records  Have written statements to implement the patient’s rights in the decision making process  Affirm that there will be no discrimination or affect on care due to advance directives  Educate the staff on the medical and legal issues of advance directives Patients are informed of their rights and have the opportunity to determine the care they will receive

Wrapping It Up…. Health care workers must be aware of an honor advance directives In addition, health care workers should give serious consideration to preparing their own advance directives

Quick Review Other agencies, states, and organizations have created statements on patients’ rights All make patients aware of their rights and protect rights By observing rights, health care worker assures patient’s safety, privacy and well being and provides quality care Advance directives for health care must also be recognized and respected by health care workers

Check for Understanding… What are six rights of a patient receiving health care? What is the difference between a living will and advanced directives?

Apply What You Know… Considering what you know about patient rights, you are going to create a living will and a set of advanced directives Must be “legal” and appear to be legit and professional Be creative