What are patient rights in healthcare?
According to the American Hospital Association, all patients have the following rights:
- Privacy
- Confidentiality
- Respect and dignity
- Select and choose their doctor or doctors
- Transparency of their medical condition and treatments (have all the information needed to make a decision → informed consent)
- Autonomous decisions about medical care (including to refuse treatments)
- Complete freedom from abuse and neglect
- Competent and compassionate care
- Manage and control finances and personal property
- Religious freedom
- Social freedom
- Accurate bills for care and services
- Express complaints and concerns and have them addressed
Nurses’ role and responsibilities around patient rights include:
- Respect patient rights
- Evaluate patient rights (directly or indirectly)
- Educate staff and patients about patient rights and responsibilities
- Ensure that this knowledge is applied and integrated into staff practice and patients are exercising their rights
- Plan, implement, and evaluate educational activities about patient rights
History of patient rights
Formalized in 1948, the universal declaration of human rights recognizes the inherent dignity and the equal and unalienable rights of all humans. On this basis of the concept, the notion of patient rights was developed.
Patient right to refusal
The patient self-determination act upholds a person’s right to make decisions about current and future treatments. This includes the free choice to not accept treatment or care.
Patient rights to change doctors
Patients’ right to choose their doctors emphasizes the principle of autonomy in healthcare. It means that patients have the freedom and authority to select a medical professional they trust and are comfortable with for their care, without coercion or external pressures.
Pain management patient rights
Patients have the right to comprehensive pain management, which includes timely assessment of pain, receiving clear information about potential treatments, and participating in pain-related decisions. They should be provided with effective pain relief measures, be it through medications, alternative therapies, or other interventions. Patients also have the right to voice if their pain is not adequately managed and to seek a second opinion if they feel their pain management needs aren’t being met. Proper pain management respects the dignity and autonomy of the patient, ensuring their comfort and quality of life.
Patient rights in medical billing errors
Based on the patients’ right to accurate billing, healthcare providers and insurers are obligated to rectify any errors. Patients have the right to an explanation of their bills (transparency) and can dispute their bill if they find any inaccuracies. Last but not least, patients’ billing and medical records are private (right to privacy).
What is HIPAA?
The health insurance portability and accountability act (HIPAA) is a U.S. federal law that supports and upholds clients’ rights to confidentiality and the privacy of their medical information.
Types of consent
There are three ways how consent can be given:
- Explicit consent: written consent to a surgical procedure
- Implicit consent: consenting to receiving care by letting themselves be admitted to a hospital
- Opt-out consent: when patient does not refuse treatment
Managing patient expectations
According to patient rights policies, what expectations may a patient have?
Table: Potential expectations/requests patients have of nurses and patients rights that justify them
| Patient expectation/request | Based on which patient right |
| Getting an explanation of a procedure before it is performed | Informed consent |
| Acceptance of cultural practices | Respect and dignity |
| Talking in a separate room about their condition | Privacy and confidentiality |
| Asking for a translator | Informed consent, transparency |
| Explanation of a charge | Transparency and accurate billing |
| Not wanting to take a specific medication | Right to refusal, right to be involved in decisions about care |
| Wanting to see medical records | Transparency |
Unrealistic patient expectations
Nurses may encounter a range of unrealistic patient expectations, often due to misconceptions, lack of medical knowledge, or heightened emotions.
Here are some examples and how you as a nurse can address them:
- Instant relief or cure: provide education, set realistic timelines
- Personal attention at all times: acknowledge the patient’s feelings and educate them about nurses’ responsibilities, set realistic expectations about wait times
- Getting unavailable treatments: clearly explain reasons and educate on alternatives
Examples of patient rights violations
- Discussing a patient’s diagnosis in the elevator with a colleague → breach of confidentiality
- Performing a biopsy during an unrelated surgery → failure to obtain informed consent
- Dismissing a patient’s complaints about severe side effects from a medication → not addressing patient complaints
- Providing substandard care and dismissing concerns of a transgender patient due to personal biases → discrimination
- Administering a medication when patient has stated desire to stop taking it → denial of the right to refuse treatment
What are patient responsibilities?
Patient responsibilities refer to the behaviors and actions expected of patients to ensure effective care for them. These responsibilities often mirror patient rights. Here are a few examples:
- Complying with treatment
- Fulfilling financial obligations
- Keeping appointments
- Providing accurate and complete information
- Accepting consequences (e.g., refusing treatment)
