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ROJoson PEP Talk: Basic Rights in Patient Empowerment

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ROJoson PEP Talk: Basic Rights in Patient Empowerment

  1. 1. Empowerment objective - for laypeople to have an understanding of the BASIC RIGHTS in Patient Empowerment. Basic Rights in Patient Empowerment
  2. 2. Empowerment objective - for laypeople to have an understanding of the BASIC RIGHTS in Patient Empowerment. Basic Rights in Patient Empowerment I have a Patient Empowerment Program in which I like to empower the lay people or patients to take control in the management of their health.
  3. 3. Empowerment objective - for laypeople to have an understanding of the BASIC RIGHTS in Patient Empowerment. Basic Rights in Patient Empowerment I launched this PEP TALK on May 15, 2021 with MODULE on COVID19. 2nd Module: PATIENT EMPOWERMENT 3rd Module: PATIENT MANAGEMENT PROCESS 4th Module RIGHTS IN PATIENT EMPOWERMENT
  4. 4. Empowerment objective - for laypeople to have an understanding of the BASIC RIGHTS in Patient Empowerment. Basic Rights in Patient Empowerment What I have in mind in my PEP TALK which may run for 3 years is to empower at least 30 persons, with my family members and my patients as a priority. This is my key performance indicator. I hope you will be in my group of 30.
  5. 5. Empowerment objective - for laypeople to have an understanding of the BASIC RIGHTS in Patient Empowerment. Basic Rights in Patient Empowerment 4th Module RIGHTS IN PATIENT EMPOWERMENT 2 Parts • Basic Rights • Patient Autonomy and Advance Directive
  6. 6. Empowerment objective - for laypeople to have an understanding of the BASIC RIGHTS in Patient Empowerment. Basic Rights in Patient Empowerment My PEP TALK today is entitled: Basic Rights in Patient Empowerment.
  7. 7. Basic Rights in Patient Empowerment The World Health Organization (WHO) defines patient empowerment as the process through which people gain greater control over decisions and actions affecting their health.
  8. 8. Basic Rights in Patient Empowerment World Health Organization (WHO) has identified four components as being fundamental to the process of patient empowerment: •Understanding of their role •Sufficient knowledge to be able to engage their healthcare providers •Patient skills •Presence of facilitating environment In the WHO definition, rights in patient empowerment can be subsumed at the very least under “understanding of their role.”
  9. 9. Basic Rights in Patient Empowerment In a Community of Inquiry or survey that I conducted in June 2021 among 55 Filipino respondents, we agree that patient empowerment can be translated in Filipino as PAGPAPALAKAS NG PASYENTE with the following 4 strategies (K4): • KAALAMAN (knowledge and understanding) • KAKAYANAN (capability) • KARAPATAN (rights) • KAPANGYARIHAN (self-determination). KARAPATAN means rights in patient empowerment.
  10. 10. Basic Rights in Patient Empowerment Before I go to the rights in patient empowerment, let me remind everybody that everyone has the right to health, which is part of human rights. Right to health means the states or countries have the legal obligation to promote the health of their citizens.
  11. 11. Basic Rights in Patient Empowerment The right to health has 2 components: freedom and entitlement. Freedom includes rights to control one’s health and body, including sexual and reproductive freedom and freedom from interference such as non-consensual medical treatment and experimentation. Entitlement includes access to adequate health care facilities and services.
  12. 12. Basic Rights in Patient Empowerment So, rights in patient empowerment emanate from this human right on health, specifically on the freedom or right to gain greater control over decisions and actions affecting the health of laypeople or patients. Every person has the right to make his own choices with regards to his health and health care.
  13. 13. Basic Rights in Patient Empowerment Patient autonomy means the right of competent adults to make informed decisions about their own medical care. The principle underlies the requirement to seek the consent or informed agreement of the patient before any investigation or treatment takes place. In the medical world, one of the principal ethical principles that has been established and being observed and practiced is patient autonomy.
  14. 14. Basic Rights in Patient Empowerment So, the foremost right in patient empowerment is for everybody, physicians or health care providers and even relatives included, to respect patient autonomy. Again, to repeat, patient autonomy is the right of all competent adults to make informed decisions about their own medical care.
  15. 15. Basic Rights in Patient Empowerment There are 2 keywords or phrases in the definition of patient autonomy: “competent adults” and “informed decisions.” “Competent adults” means conscious, coherent and discerning adults. “Informed decisions” means a permission or no permission is granted by the competent adults after proper understanding of the purpose; options with benefit, risk, cost and availability data analysis; and consequences of procedures to be undertaken. These 2 components or requirements must be fulfilled for patient autonomy to be ethically and legally binding.
  16. 16. Basic Rights in Patient Empowerment Patient autonomy should be observed when a patient is being managed by a physician in whatever setting, such as when consulting at the clinic, at the outpatient departments or inside the hospital as a confined patient. Patient autonomy should also be respected when being managed by relatives or significant others.
  17. 17. Basic Rights in Patient Empowerment When being managed by a physician, patient autonomy should be respected before any paraclinical laboratory diagnostic procedure and/or treatment procedure take place.
  18. 18. Basic Rights in Patient Empowerment After the patient is properly advised, respecting patient autonomy can end up either in informed refusal or informed consent. With informed refusal, no paraclinical laboratory diagnostic procedure and/or treatment procedure are executed. With informed consent, the agreed paraclinical laboratory diagnostic procedure and/or treatment procedure are executed.
  19. 19. Basic Rights in Patient Empowerment To repeat, before informed refusal and informed consent are decided upon, the patient must have proper understanding of the purpose; options with benefit, risk, cost and availability data analysis; and consequences of procedures to be undertaken.
  20. 20. Basic Rights in Patient Empowerment In medical practice, exercising patient autonomy is prominently seen in situations where terminally-ill patients have to decide whether to have life- sustaining treatment or not. Whatever their decisions, the physicians will have to abide, thereby respecting patient autonomy.
  21. 21. Basic Rights in Patient Empowerment When being managed by relatives or significant others especially during terminally-ill stage, the wish and decision of the competent-adult patients should be respected as part of their right to autonomy.
  22. 22. Basic Rights in Patient Empowerment Aside from patient autonomy, the other rights in patient empowerment will include entitlements from physicians managing them and from hospitals and clinics serving them. The laypeople or patients should know these entitlements so that they can demand as part of their strategies to gain greater control on decisions and actions affecting their health, particularly in terms of being recipients of quality and safe services.
  23. 23. Basic Rights in Patient Empowerment In my presentation of the other rights in patient empowerment, I will categorize them into • Patient’s Entitlements from Physicians and • Patients’ Entitlements from Hospitals and Clinics. However, let me say that there will be overlaps with some similarities in both categories. Note also that I don’t guarantee that I will be able to list all.
  24. 24. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients are entitled to: •Choose a physician they want to manage them and corollary to this, change a physician anytime, without having to justify their decisions. •Have a second opinion from another physician and from other physicians with no limit and without having to justify their decisions.
  25. 25. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients are entitled to: •Have quality services (patient-centered compassionate care; equitable care with dignity and no discrimination; effective, efficient and timely services; holistic, well-integrated and well-coordinated services, etc.) •Have safe medical care with no undue harms being inflicted on them.
  26. 26. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients are entitled to: •Have right to information related to their health concerns (on diagnosis; paraclinical diagnostic procedures and results; treatment; prognosis; etc.) •Have participation in care decisions with their physicians. •Have informed consent and informed refusal without prejudice to continuing health care.
  27. 27. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients are entitled to: •Have medical records of their medical consultations such as physician’s notes and tape recordings of interactions. •Keep their medical records from other physicians and other hospitals and clinics and for physicians not to get and keep them without giving back or giving a copy to the patients.
  28. 28. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients are entitled to: •Have no undue long waiting time for medical consultation (as much as possible there is an appointment time for the consultation and if physicians not able to comply, they should forewarn or advise the patients). •Have privacy and confidentiality of the medical consultation.
  29. 29. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients are entitled to: •Know the professional bill or policy of charging prior to medical consultation. •Complain about the care and services provided without fear of reprisal.
  30. 30. Basic Rights in Patient Empowerment Patients’ Entitlements from Hospitals and Clinics (Note: There are posters entitled Patients’ Rights and Responsibilities in hospitals and clinics as required by the Department of Health. These vary from hospitals to hospitals, not uniform. Below are my listings.)
  31. 31. Basic Rights in Patient Empowerment Patients’ Entitlements from Hospitals and Clinics All patients in hospitals and clinics are entitled to: •Choose a hospital and/or clinic they want to serve them and corollary to this, change anytime, without having to justify their decisions. •Have quality and safe health care in accordance with generally approved medical and hospital principles (should have Patient Safety Program and Safe Hospital Initiative).
  32. 32. Basic Rights in Patient Empowerment Patients’ Entitlements from Hospitals and Clinics All patients in hospitals and clinics are entitled to: •Have respect and dignity without discrimination. •Have participation in care decisions with their physicians and other health care professionals.
  33. 33. Basic Rights in Patient Empowerment Patients’ Entitlements from Hospitals and Clinics All patients in hospitals and clinics are entitled to: •Have informed consent and informed refusal without prejudice to continuing health care. •Have second opinion from alternate health care professionals of choice.
  34. 34. Basic Rights in Patient Empowerment Patients’ Entitlements from Hospitals and Clinics All patients in hospitals and clinics are entitled to: •Be asked for consent for additional procedures to be done on them not included in the initial prescription of their attending physicians. •Be asked for consent or refusal to allow additional physicians to manage them beside their attending physicians.
  35. 35. Basic Rights in Patient Empowerment Patients’ Entitlements from Hospitals and Clinics All patients in hospitals and clinics are entitled to: •Have privacy and confidentiality of personal information subject to applicable laws. •Have right to Information related to their health concerns and services being done to them. •Have right to medical records.
  36. 36. Basic Rights in Patient Empowerment Patients’ Entitlements from Hospitals and Clinics All patients in hospitals and clinics are entitled to: •Avail of benefits and privileges in accordance with government regulations. •Be billed accurately (patients have to monitor the medications and procedures done). •Complain about the care and services provided without fear of reprisal.
  37. 37. Basic Rights in Patient Empowerment Patients’ Entitlements from Hospitals and Clinics All patients in hospitals and clinics are entitled to: •Be discharged from institution upon their request and after settlement of accounts. •Be treated at the Department of Emergency Medicine without initial deposit. •Refuse participation in medical research.
  38. 38. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients’ Entitlements from Hospitals and Clinics Above, I have presented lists of Patient’s Entitlements from Physicians and Patients’ Entitlements from Hospitals and Clinics. As I said, there could be more that I may have missed. I will update once I recognize the missing ones.
  39. 39. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients’ Entitlements from Hospitals and Clinics I use the word “entitlement” to mean patients having a legal or ethical right to have or obtain something from the physicians, hospitals and clinics. At the same, they have the right to expect physicians, hospitals and clinics to act in a certain way that will promote and facilitate quality and safe services to them.
  40. 40. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients’ Entitlements from Hospitals and Clinics Knowing these entitlements will enable the patients to look for them, not to say, demand, which redound to patient empowerment, which is gaining greater control on decisions and actions affecting their health.
  41. 41. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients’ Entitlements from Hospitals and Clinics However, let me say, that patients should be proactive aside from expectation of these entitlements and rights which may not flow naturally or smoothly to them.
  42. 42. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients’ Entitlements from Hospitals and Clinics • They carry a responsibility to make them happen. • They should ask and, if needed, they should demand if they are not being given the entitlements. • They have recourses if the rights and entitlements are not afforded them and worst, are in violations.
  43. 43. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients’ Entitlements from Hospitals and Clinics Here are some recourses that patients can do: •Remind •Change physicians, hospitals and clinics as indicated •Give feedback and hope for improvement of services •File a complaint and hope for improvement of services
  44. 44. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients’ Entitlements from Hospitals and Clinics Complaints can be filed with the hospital and clinic administration and/or with external monitoring agencies like the Professional Regulation Commission and/or with the courts of law.
  45. 45. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients’ Entitlements from Hospitals and Clinics The best promoting and facilitating measure in seeking and getting the rights in patient empowerment to enable patients to gain greater control over decisions and actions affecting their health is to look around now, as early as now, for the right physician, right hospital and right clinic. Once found, place them in a list of hotline numbers in the house.
  46. 46. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients’ Entitlements from Hospitals and Clinics In case a physician, hospital or clinic is tested to be undesirable, change right away. Remember the first right after patient autonomy is that everybody can choose his physician, hospital or clinic anytime without having to justify.
  47. 47. Basic Rights in Patient Empowerment Patients’ Entitlements from Physicians Patients’ Entitlements from Hospitals and Clinics So, there you are – the rights in patient empowerment. Maximize your knowledge (KAALAMAN) on these rights. Maximize your capability (KAKAYANAN) in seeking for and implementing these rights. Lastly, maximize your self-determination (KAPANGYARIHAN) in using the rights in gaining greater control over decisions and actions affecting your health.
  48. 48. Empowerment objective - for laypeople to have an understanding of the BASIC RIGHTS in Patient Empowerment. Basic Rights in Patient Empowerment

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