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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 Associatio
Enencourages 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 |
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