Its' from our personal experiences working with patients and especially Drug resistance TB patients in Odisha.

1. Bijayalaxmi Rautaray
Secretary, Sahayog
Patient Rights

2. Who is a patient?
 A person receiving or registered to receive medical
treatment of any form.
 ‘Patient’ the word comes from the Latin “patients,”
from “patior,” to suffer or bear. The patient who is
passive and has to bear suffering patiently and
tolerating all interventions from outside expert. Patient
doesn’t have a say. A patient needs to have patience.

3. Why discussion on patient rights?
 In our society doctors are treated alike God. And have
an unquestioning trust on them. But there have been
cases of medical negligence and/or malpractice due
to which the patients have suffered physically,
mentally, financially and emotionally. This is contrary
to patient rights.

4. Source of Patient rights.
 Patient’s right is the reflection of human rights. These rights exist
in international and regional treaties as well as the constitution of
our country. In India health is not a fundamental right. Its’ coming
under Right to life. In our country health is a state subject.
 First of patient is a citizen. Citizen has certain role in the
formation of a state. It is the prime duty of state to protect own
citizen’s life.

5. Patient rights’ in reality.
 Patients are always stands from the powerless group.
 In government hospital they are suffered from medical
negligence and private set up medical mal practice,
corruption.
 Being a patient or as family members when they felt
exhausted at one point and there is no grievance redressal
mechanism sometimes they beat, used foul language to
the service providers.

6. Contd….
 Now Government take measures to protect medical fraternity.
 A patient doesn’t have bargaining power.
 A patient never treated as a consumer.
 Patient has no rights. Its’ from our experiences in working with
MDR/XDR TB patients in Odisha that there are many instances
patient right are violated openly.

7. Right to Life
 Right to life-The state has to take step to protect patients life.
 On 1st January 2018 a TB patient name Gudi Nayak 20yrs died
in hospital.
 Her death was highlighted by media. She had taken expired anti-
TB medicines.
 In her case the treatment guideline deviated by District RNTCP.
No monitoring, no supervision, no DOTS or ADR management?
 But shockingly her file closed. Because death in TB is nothing
unusual.

8. Right to health
o States health care system available, accessible, acceptable
and of good quality. That means quality treatment services for
the patients. Government must provide essential medicines
regularly and uninterruptedly. But in communicable diseases
like TB core drugs stocks out sometimes for months together.
o There are certain underlying determinants of health like (food,
drinking water, sanitation, habitation). Which need to address
in quality care?

9. Right to non discrimination
 Patients health should not be a reason to treat differently from
others.
 As TB patients and especially a DR-TB patient always treated in
humanly. Very few times doctors have dialogue with DR-TB
patients about their health. They usually asked to their
attendants. Yes, occupational hazard is a concern and the
service providers need to be protected adequately. The patient
needs to know without proper protection the disease can infect to
the providers. But discriminating a patient without giving
information violates his rights.

10. Right to liberty/ freedom of
movement and arbitrary detention
 These things mostly witnessed in Private and corporate
hospitals. A woman who had tubectomy in a district hospital and
due doctors negligence she had some outside element in her
abdomen. Her husband was a contractual class IV employee in
an reputed organization. He had medical insurance with Rs.1,
00,000/- coverage.
 As per the advice insurance company they visit a corporate
hospital in Bhubaneswar. The estimate was Rs.70, 000/- . In
between the hospital found some more complications in her
body.

11. Contd…
 Without informing the patient they did whatever they choose to
did. In the meanwhile the bill came Rs.1 lakhs 35 thousands.
The insurance company denied to pay the money.
 The patient lie unattended and hospital detained them arbitrarily.
Without removing the stitches in a midnight they escaped from
the hospitals with the help of relatives. Till today she has been
suffering.

12. Right to science
 Every patient has the right to get benefit from new scientific
treatment, testing facilities available in the country.
 But this is not happening even in free treatment services like TB.
If a patient is not improving it needs timely revisit and review
treatment .
 If a patient is diagnostically negative but clinically have all
symptoms his comorbidites and allied disease need to review.
After completion of treatment follow up care needed. This is not
happening.
 In this way we lost two of our patient. One is at the last part of
treatment period and other patient one year after completion of
treatment.
 Even after treatment review and evaluations of the resistance of
drugs same drugs being taken by the patients. Neither he able
receive substitute drugs or new generation antibiotics.

13. Right to informed consent
 A patient should always have counseling before you make
a decision, and must have given time to think of questions
and receive answers.
 Its’ happening that many times without proper information
to woman arbitrarily after delivery tubectomy completed.
 Who gives the right to decide about the woman?
 Who are you to decide about the size of her family?

14. Right to information
 The patient has the right to know his/her disease, receive
counseling and all explanations that you need to agree to
any medical interventions.
 It means the patient has the right to know the names and
doses of any medicines and to understand all potential
side effects and other ways in which a medication may
affect own health and life. This is called treatment literacy.

15. Contd…
 The right to information also means that you should receive a
copy of your medical records or test reports if patient want so.
 In DR-TB patients cases unfortunately in maximum cases they
have not received a copy of their follow up test report.
 A XDR-TB patient his report from 3rd month to eight months all
six reports came as positive. Neither the patient had information
nor receives any treatment review but he blamed for his
conditions as a threat to public health.

16. Right to participation
 People affected by TB have the right to participate in
deciding health policies, from community level to national
level. For a person centered care the health authorities
need to involve the patient or receive their feedback. We
can’t generalize all patients.

17. In human or degrading treatment
 Unknown patients or patients without any attendant there is
provision to take care by government with attendant facilities,
free medicines, diagnosis, treatment and also rehabilitation but
this is not happening.
 Its’ due to lack of documents and prescription a pregnant tribal
woman denied admission in Saheed Laxman Naik Medical
college and delivered the baby outside a drainage. When she
lamented in labour pain doctors or nurses not looked after or
checked her condition because she didn’t have proper
documents.

18. Freedom of Association
 In communicable disease like TB right to
participation is much essential for TB prevention,
treatment and care.

19. Few photographs
Expired medicines took
life
In human treatment
SCB

20. Contd..
Core anti-TB drug stock
out
Refusal of doctor to
treat patient