ROJoson PEP Talk: Basic Rights in Patient Empowerment

Empowerment
objective - for
laypeople to have
an understanding
of the BASIC
RIGHTS in Patient
Empowerment.
Basic Rights in
Patient
Empowerment

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.

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

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.

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

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.

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.

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.”

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Basic Rights in
Patient
Empowerment
•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.

Basic Rights in
Patient
Empowerment
•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.

Basic Rights in
Patient
Empowerment
•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.

Basic Rights in
Patient
Empowerment
•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.

Basic Rights in
Patient
Empowerment
•Know the professional bill or policy of charging
prior to medical consultation.
•Complain about the care and services provided
without fear of reprisal.

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.)

Basic Rights in
Patient
Empowerment
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).

Basic Rights in
Patient
Empowerment
Clinics
to:
•Have respect and dignity without
discrimination.
•Have participation in care decisions with their
physicians and other health care professionals.

Basic Rights in
Patient
Empowerment
Clinics
to:
•Have informed consent and informed refusal
without prejudice to continuing health care.
•Have second opinion from alternate health care
professionals of choice.

Basic Rights in
Patient
Empowerment
Clinics
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.

Basic Rights in
Patient
Empowerment
Clinics
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.

Basic Rights in
Patient
Empowerment
Clinics
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.

Basic Rights in
Patient
Empowerment
Clinics
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.

Basic Rights in
Patient
Empowerment
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.

Basic Rights in
Patient
Empowerment
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.

Basic Rights in
Patient
Empowerment
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.

Basic Rights in
Patient
Empowerment
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.

Basic Rights in
Patient
Empowerment
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.

Basic Rights in
Patient
Empowerment
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

Basic Rights in
Patient
Empowerment
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.

Basic Rights in
Patient
Empowerment
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.

Basic Rights in
Patient
Empowerment
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.

Basic Rights in
Patient
Empowerment
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.

ROJoson PEP Talk: Basic Rights in Patient Empowerment

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