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American Hospital Association
MANAGEMENT ADVISORY
A Patient's Bill of Rights
A Patient's Bill of Rights
was first adopted by the
American Hospital
Association in 1973.
This revision was approved by the AHA Board
of Trustees on October 21, 1992.
Introduction
Effective health care requires collaboration between patients and physicians
and other health care professionals. Open and honest communication, respect
for personal and professional values, and sensitivity to differences are integral
to optimal patient care. As the setting for the provision of health services,
hospitals must provide a foundation for understanding and respecting the rights
and responsibilities of patients, their families, physicians, and other caregivers.
Hospitals must ensure a health care ethic that respects the role of patients
in decision making about treatment choices and other aspects of their care.
Hospitals must be sensitive to cultural, racial, linguistic, religious, age,
gender, and other differences as well as the needs of persons with disabilities.
The American Hospital Association presents A Patient's Bill of Rights with
the expectation that it will contribute to more effective patient care and be
supported by the hospital on behalf of the institution, its medical staff, employees,
and patients. The American Hospital Association encourages health care institutions
to tailor this bill of rights to their patient community by translating and/or
simplifying the language of this bill of rights as may be necessary to ensure
that patients and their families understand their rights and responsibilities.
Bill of Rights
These rights can be exercised on the patient's behalf by a designated surrogate
or proxy decision maker if the patient lacks decision-making capacity, is legally
incompetent, or is a minor.
- The patient has the right to considerate and respectful care.
- The patient has the right to and is encouraged to obtain from physicians
and other direct caregivers relevant, current, and understandable information
concerning diagnosis, treatment, and prognosis.
Except in emergencies when the patient lacks decision-making capacity and the
need for treatment is urgent, the patient is entitled to the opportunity to
discuss and request information related to the specific procedures and/or treatments,
the risks involved, the possible length of recuperation, and the medically reasonable
alternatives and their accompanying risks and benefits.
Patients have the right to know the identity of physicians, nurses, and others
involved in their care, as well as when those involved are students, residents,
or other trainees. The patient also has the right to know the immediate and
long-term financial implications of treatment choices, insofar as they are known.
- The patient has the right to make decisions about the plan of care prior
to and during the course of treatment and to refuse a recommended treatment
or plan of care to the extent permitted by law and hospital policy and to
be informed of the medical consequences of this action. In case of such refusal,
the patient is entitled to other appropriate care and services that the hospital
provides or transfer to another hospital. The hospital should notify patients
of any policy that might affect patient choice within the institution.
- The patient has the right to have an advance directive (such as a living
will, health care proxy, or durable power of attorney for health care) concerning
treatment or designating a surrogate decision maker with the expectation that
the hospital will honor the intent of that directive to the extent permitted
by law and hospital policy.
Health care institutions must advise patients of their rights under state
law and hospital policy to make informed medical choices, ask if the patient
has an advance directive, and include that information in patient records.
The patient has the right to timely information about hospital policy that
may limit its ability to implement fully a legally valid advance directive.
- The patient has the right to every consideration of privacy. Case discussion,
consultation, examination, and treatment should be conducted so as to protect
each patient's privacy.
- The patient has the right to expect that all communications and records
pertaining to his/her care will be treated as confidential by the hospital,
except in cases such as suspected abuse and public health hazards when reporting
is permitted or required by law. The patient has the right to expect that
the hospital will emphasize the confidentiality of this information when it
releases it to any other parties entitled to review information in these records.
- The patient has the right to review the records pertaining to his/her medical
care and to have the information explained or interpreted as necessary, except
when restricted by law.
- The patient has the right to expect that, within its capacity and policies,
a hospital will make reasonable response to the request of a patient for appropriate
and medically indicated care and services. The hospital must provide evaluation,
service, and/or referral as indicated by the urgency of the case. When medically
appropriate and legally permissible, or when a patient has so requested, a
patient may be transferred to another facility. The institution to which the
patient is to be transferred must first have accepted the patient for transfer.
The patient must also have the benefit of complete information and explanation
concerning the need for, risks, benefits, and alternatives to such a transfer.
- The patient has the right to ask and be informed of the existence of business
relationships among the hospital, educational institutions, other health care
providers, or payers that may influence the patient's treatment and care.
- The patient has the right to consent to or decline to participate in proposed
research studies or human experimentation affecting care and treatment
or requiring direct patient involvement, and to have those studies fully explained
prior to consent. A patient who declines to participate in research or experimentation
is entitled to the most effective care that the hospital can otherwise provide.
- The patient has the right to expect reasonable continuity of care when appropriate
and to be informed by physicians and other caregivers of available and realistic
patient care options when hospital care is no longer appropriate.
- The patient has the right to be informed of hospital policies and practices
that relate to patient care, treatment, and responsibilities. The patient
has the right to be informed of available resources for resolving disputes,
grievances, and conflicts, such as ethics committees, patient representatives,
or other mechanisms available in the institution. The patient has the right
to be informed of the hospital's charges for services and available payment
methods.
The collaborative nature of health care requires that patients, or their families/surrogates,
participate in their care. The effectiveness of care and patient satisfaction
with the course of treatment depend, in part, on the patient fulfilling certain
responsibilities. Patients are responsible for providing information about past
illnesses, hospitalizations, medications, and other matters related to health
status. To participate effectively in decision making, patients must be encouraged
to take responsibility for requesting additional information or clarification
about their health status or treatment when they do not fully understand information
and instructions. Patients are also responsible for ensuring that the health
care institution has a copy of their written advance directive if they have
one. Patients are responsible for informing their physicians and other caregivers
if they anticipate problems in following prescribed treatment.
Patients should also be aware of the hospital's obligation to be reasonably
efficient and equitable in providing care to other patients and the community.
The hospital's rules and regulations are designed to help the hospital meet
this obligation. Patients and their families are responsible for making reasonable
accommodations to the needs of the hospital, other patients, medical staff,
and hospital employees. Patients are responsible for providing necessary information
for insurance claims and for working with the hospital to make payment arrangements,
when necessary.
A person's health depends on much more than health care services. Patients
are responsible for recognizing the impact of their life-style on their personal
health.
Conclusion
Hospitals have many functions to perform, including the enhancement of health
status, health promotion, and the prevention and treatment of injury and disease;
the immediate and ongoing care and rehabilitation of patients; the education
of health professionals, patients, and the community; and research. All these
activities must be conducted with an overriding concern for the values and dignity
of patients.
© 1992 by the American Hospital Association, One North
Franklin Street, Chicago, IL 60606.
Printed in the U.S.A. All rights reserved. Catalog no. 157759.
Copyright 1998, American Hospital Association