PATIENTS BILL OF RIGHTS

PATIENT'S BILL OF RIGHTS
By: ROMMEL LUIS C. ISRAEL III

What is the patient bill of rights and
responsibilities?
The patient bill of rights and
responsibilities is a guide to make
sure every patient gets good quality
health care.
It contains rules for you or your
healthcare provider that should be
followed when you are getting
health care and treatment.
It also tells you how healthcare
providers may relate and care for
you as their patient.
They promote respect for patients
and providers, open dialog about
diagnosis, treatment, and fees, and
the delivery of effective patient
care.

Why a Bill of Rights for
Patients?
• Over the course of the past 40+ years, different
health and medical professional associations have
developed and adopted a Patients' Bill of Rights.
• The Patients' Bill of Rights establishes ethical
protocols for how medical and health professionals
should interact with patients.
• Even though physicians enjoyed god-like status, the
truth is that they perform a service—a paid
service—and those people who utilize those
services have a right to expect to be treated with
dignity and respect.

The AHA designed the Patient’s Bill of Rights to protect patients and
guarantee they get appropriate care.
These rights guard the patients from unlawful practices, such as
unnecessary treatments, overcharges, and a lack of transparency.
Other agencies, including the federal government, have also
designed bills of rights to protect individuals.

THE FILIPINO PATIENTS BILL
OF RIGHTS

1. Right to Appropriate Medical Care and Humane Treatment
Every person has a right to health and medical care corresponding to his state of health,
without any discrimination and within the limits of the resources, manpower and
competence available for health and medical care at the relevant time.
The patient has the right to appropriate health and medical care of good quality. In the
course of such, his human dignity, convictions, integrity, individual needs and culture shall
be respected.
If any person cannot immediately be given treatment that is medically necessary he shall,
depending on his state of health, either be directed to wait for care, or be referred or sent
for treatment elsewhere, where the appropriate care can be provided.

1. Right to Appropriate Medical Care and Humane Treatment
If the patient has to wait for care, he shall be informed of the reason
for the delay.
Patients in emergency shall be extended immediate medical care and
treatment without any deposit, pledge, mortgage or any form of
advance payment for treatment.

2. Right to
Informed
Consent
• The patient has a right to a clear, truthful
and substantial explanation, in a manner
and language understandable to the patient,
of all proposed procedures, whether
diagnostic, preventive, curative,
rehabilitative or therapeutic, wherein the
person who will perform the said procedure
shall provide his name and credentials to
the patient, possibilities of any risk of
mortality or serious side effects, problems
related to recuperation, and probability of
success and reasonable risks involved

2. Right to Informed Consent
Provided, That the patient will not be subjected to any procedure without his written informed consent, except in the following cases:
a) in emergency cases, when the patient is at imminent risk of physical injury, decline Of death if treatment is withheld orpostponed. In such
cases, the physician can perform any diagnostic or treatment procedure as good practice of medicine dictates without such consent;
b) when the health of the population is dependent on the adoption of a mass health program to control epidemic;
c) when the law makes it compulsory for everyone to submit a procedure;
d) When the patient is either a minor, or legally incompetent, in which case. a third party consent Is required;
e) when disclosure of material information to patient will jeopardize the success of treatment, in which case, third party disclosure and consent
shall be in order;
f) When the patient waives his right in writing.

Informed consent shall be obtained from
a patient concerned if he is of legal age
and of sound mind. In case the patient is
incapable of giving consent and a third
party consent is required. the following
persons, in the order of priority stated
hereunder, may give consent:
i. spouse; ii. son or daughter of legal age;
iii. either parent; iv. brother or sister of legal age, or v. guardian

If a patient is a minor, consent shall be obtained from his parents or legal
guardian.
If next of kin, parents or legal guardians refuse to give consent to a medical or
surgical procedure necessary to save the life or limb of a minor or a patient
incapable of giving consent, courts, upon the petition of the physician or any
person interested in the welfare of the patient, in a summary proceeding, may
issue an order giving consent.

3. Right to Privacy and Confidentiality
The privacy of the patients must be assured at all stages of his treatment.
The patient has the right to be free from unwarranted public exposure, except in the
following cases:
a) when his mental or physical condition is in controversy and the appropriate court, in its
discretion, order him to submit to a physical or mental examination by a physician;
b) when the public health and safety so demand; and c) when the patient waives this
right in writing.

3. Right to Privacy and Confidentiality
Any health care provider or practitioner involved in the treatment of a patient and all those who have
legitimate access to the patient's record is not authorized to divulge any information to a third party who
has no concern with the care and welfare of the patient without his consent, except:
a) when such disclosure will benefit public health and safety;
b) when it is in the interest of justice and upon the order of a competent court; and
c) when the patients waives in writing the confidential nature of such information; d) when it is needed
for continued medical treatment or advancement of medical science subject to de-identification of
patient and shared medical confidentiality for those who have access to the information.

3. Right to Privacy and
Confidentiality
• Informing the spouse or the family to the
first degree of the patient's medical
condition may be allowed; Provided That
the patient of legal age shall have the
right to choose on whom to inform. In
case the patient is not of legal age or is
mentally incapacitated, such information
shall be given to the parents, legal
guardian or his next of kin.

5. The Right to Choose Health
Care Provider and Facility

6. Right to Self-
Determination

6. Right to Self-
Determination
• Any person of legal age and of sound
mind may make an advance written
directive for physicians to administer
terminal care when he/she suffers from
the terminal phase of a terminal illness:
Provided That
a) he is informed of the medical
consequences of his choice;
b) he releases those involved in his care from
any obligation relative to the consequences
of his decision;
c) his decision will not prejudice public
health and safety.

9. Right to Leave
The patient has the right to leave hospital or any other health care institution
regardless of his physical condition: Provided. That
a) he/she is informed of the medical consequences of his/her decision
b) helshe releases those involved in his/her care from any obligation relative to
the consequences of his decision;
c) his/her decision will not prejudice public health and safety.

9. Right to Leave
The patient has the right to leave hospital or any other health care institution regardless of his
physical condition: Provided. That a) he/she is informed of the medical consequences of his/her
decisionl b) helshe releases those involved in his/her care from any obligation relative to the
consequences of his decision; c) hislher decision will not prejudice public health and safety.
No patient shaD be detained against hi$/her will in any health care institution on the sole basis of
his failure to fully settle his financial obligations. However, he/she shall only be allowed to leave
the hospital provided appropriate arrangements have been made to settle the unpaid bills:
Provided. further, That unpaid bills of patients shall be considered as loss income by the hospital
and health care provider/practitioner and shall be deducted from gross income as income loss
only on that particular year.

10. Right to Refuse Participation In Medical Research
The patient has the right to be advised if the health
care provider plans to involve him in medical research,
including but not limited to human experimentation
which may be performed only with the written
informed consent of the patient:
• Provided, That, an institutional review board or ethical review board
in accordance with the guidelines set in the Declaration of Helsinki be
established for research involving human experimentation:

10. Right to Refuse Participation In Medical Research
Provided, further, That the Department of Health shall safeguard
the continuing training and education of fUture health care
provider/practitioner to ensure the development of the health care
delivery in the country:
Provided, furthermore, That the patient involved in the human
experimentation shall be made aware of the provisions of the
Declaration of Helsinki and its respective guidelines.

11. Right to Correspondence
and to Receive Visitors

12. Right to Express
Grievances

13. Right to be Informed of His Rights
and Obligations as a Patient
• Every person has the right to be informed of his rights and obligations as a patient.
• The Department of Health, in coordination with heath care providers, professional and civic groups,
the media, health insurance corporations, people's organizations, local government organizations, shall
launch and sustain a nationwide information and education campaign to make known to people their
rights as patients, as declared in this Act Such rights and obligations of patients shall be posted in a
bulletin board conspicuously placed in a health care institution.
• It shall be the duty of health care institutions to inform of their rights as well as of the institution's
rules and regulations that apply to the conduct of the patient while in the care of such institution.

BRIEF HISTORY OF THE
PATIENT'S BILL OF RIGHTS

Patients' Bill of Rights was established in 1973 by the American Hospital Association (AHA).
It was then revised by the AHA in 1992 to include additional rights and better define the details
of all patients' rights.
In 1995 the Association of American Physicians and Surgeons, or AAPS, adopted its own Patient
Bill of Rights, termed "freedoms," that state the group's stand on protocols between physicians
and patients and also between physicians, patients, and health insurance plans.

Attempts by Sen John McCain, R-Ariz., and
others in both 2001 and 2003 to pass a
Bipartisan Patient Protection Act that
would give patients the right to sue health
care providers based on denied care died in
the Senate each time. A similar effort by
Sen. Barbara Boxer, D-Calif., in 2004 died in
committee.
In 2006 legislation was passed on the
federal level that health care insurers must
provide coverage of mental health services
to the same extent as services for physical
health. This coverage came into effect on
January 1, 2010

The Patient Protection and Affordable Care
Act
On March 23, 2010, the Patient Protection and Affordable Care Act was signed into
law by President Barack Obama. This legislation has been the topic of much debate,
both prior to its passage and since. Often referred to as "Obamacare," the Patient
Protection and Affordable Care Act is generally called simply the Affordable Care Act,
relegating the patient protection of the law into a dusty corner.
The Patient Protection and Affordable Care Act offers rights and protections to
patients not only in interactions with physicians and medical facilities but also with
health insurance providers

15 PATIENTS BILL OF RIGHTS
(By the American Hospital
Association)

You have the right to be treated fairly and respectfully.
You have the right to get information you can understand about your diagnosis, treatment, and prognosis from your
healthcare provider.
You have the right to discuss and ask for information about specific procedures and treatments, their risks, and the time
you will spend recovering. You also have the right to discuss other care options. You may lose this right if you’re in the
middle of an emergency and don’t have the ability to make sound decisions.
You have the right to know the identities of all of your healthcare providers, including students, residents, and other
trainees.
You have the right to know how much care may cost at the time of treatment and long term.

6. You have the right to make decisions about your care before and
during treatment and the right to refuse care. The hospital must
inform you of the medical consequences of refusing treatment. You
also have the right to other treatments provided by the hospital and
the right to transfer to another hospital.
7. You have the right to have an advance directive, such as a living will
or a power of attorney for healthcare. A hospital has the right to ask
for your advance directive, put it in your file, and honor its intent.
8. You have the right to privacy in medical exams, case discussions,
consultations, and treatments.

9. You have the right to expect that your communication and records
are treated as confidential by the hospital, except as the law permits
and requires in cases of suspected abuse or public health hazards. If
the hospital releases your information to another medical facility,
you have the right to expect the hospital to ask the medical facility to
keep your records confidential.
10. You have the right to review your medical records and to have
them explained or interpreted, except when restricted by law.
11. You have the right to expect that a hospital will respond reasonably to your
requests for care and services or transfer you to another facility that has
accepted a transfer request. You should also expect information and
explanation about the risks, benefits, and alternatives to a transfer.
12. You have the right to ask and be informed of any business relationships
between the hospital and educational institutions, other healthcare providers,
or payers that may influence your care and treatment.

13. You have the right to consent to or decline to participate in
research studies and to have the studies fully explained before you
give your consent. If you decide not to participate in research,
you’re still entitled to the most effective care that the hospital can
provide.
14. You have the right to expect reasonable continuity of care and to
be informed of other care options when hospital care is no longer
appropriate.
15. You have the right to be informed of hospital policies and practices
related to patient care, treatment, and responsibilities. You also
have the right to know who you can contact to resolve disputes,
grievances, and conflicts. And you have the right to know what the
hospital will charge for services and their payment methods.

Most Recent Additions to the
Patients' Bill of Rights

Insurance coverage will be available to people with pre-existing
medical conditions, including children age 19 or younger
The right to choose your own doctor within an insurance plan's network
of providers
Lifetime limits on coverage will be eliminated
Parents can keep their adult children up to age 26 on their health
insurance plans
Health insurance companies can no longer rescind coverage
retroactively for arbitrary reasons

You can obtain emergency services at a facility outside your network without
incurring out-of-network fees or charges
By the end of 2013, limits on annual health benefits will be eliminated
The health insurance company must spend at least 80 percent of your premium fees
for your health care, the not insurance company's overhead and administrative costs
Insurance companies will have to publicly announce and justify increases in
premiums
You have the right to ask your health insurance provider to reconsider a denial of
payment, termed an "internal appeal"

OTHER FEDERAL LAWS THAT
PROTECTS PATIENTS

The Emergency
Medical Treatment and
Labor Act (EMTALA)
• This law requires hospitals with dedicated emergency
departments to provide medical care to anyone who asks
for it regardless of their ability to pay or health insurance
status.

Fraud, waste, and abuse (FWA) laws
There are many fraud, waste,
and abuse laws designed to
protect patients. These laws are
aimed at keeping providers from
committing crimes, such as
billing for services that you
didn’t receive or using your
identity to treat someone else.
“Upcoding” is an example of an
illegal billing practice that often
goes undetected. It’s when a
provider sends your health plan
(or you, if you’re a cash payer)
false claims by using the wrong
codes. You’re the victim of
upcoding if you get billed for:
Treatment you didn’t get
More expensive treatment than
the treatment you were given
Treatment you didn’t need
Service that was included within
a grander scope of service
Treatment you got from an
unqualified or underqualified
employee

Health Insurance Portability
and Accountability Act
(HIPAA)

Pre-existing
conditions under
the Affordable
Care Act (ACA)
• This law under the ACA protects
you from being denied health
insurance or charged more if you
have a pre-existing condition — a
health problem you had before
the start date of your health
plan.

What can a
Patient do if he
believe his rights
have been
violated?
• One place to start is with the
hospital’s patient advocate —
sometimes referred to as a patient
representativeto help handle
complaints and grievances.
• They can help you navigate the process,
but keep in mind that they are hospital
employees. So if you feel as though you
need someone looking out for your best
interest, independent patient advocate
options are also available.
• Another option is to contact or file a
complaint with your state’s Department
of Health. They may want you to work it
out directly with the hospital first, but
they can step in if you’re unable to get a
resolution.

8 KEY AREAS RELATED
TO PATIENTS' RIGHTS
WITHIN THE MEDICAL
OFFICE:
AN EXPLANATION

THE RIGHT TO EMERGENCY TREATMENT
Healthcare professionals have a responsibility to provide medical treatment to any person with an emergency medical
condition.
Patients have the right to emergency medical treatment regardless of their ability to pay.
According to EMTALA or the Emergency Medical Treatment & Labor Act, an emergency medical condition is defined as "a
condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of
immediate medical attention could reasonably be expected to result in placing the individual's health [or the health of an
unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs."

THE RIGHT TO
RESPECT
The patient's right to respect, otherwise known as
nondiscrimination, is the right to be treated with
dignity and respect and is not to be discriminated
against for any reason regardless of sex, race, age,
national origin, ethnicity, religion, sexual
orientation, gender identity or expression, veteran
or military status, religion or any other basis
prohibited by federal, state, or local law.
This also means that patients have the right to be
treated humanely and never be subjected to
degrading treatment by any healthcare
professional.

THE RIGHT OF
INFORMED
CONSENT
The most important right that a patient has is the right
of informed consent. A patient should
only consent to medical treatment if they have sufficient
information about their diagnosis and all treatment
options available in terms he/she can understand.
Before a physician can begin any course of treatment,
the physician must make the patient aware of what he
plans to do.
For any course of treatment that is above routine
medical procedures, the physician must disclose as
much information as possible so the patient may make
an informed decision about his/her care.

THE RIGHT TO
REFUSE
TREATMENT
It's a given that patients have certain rights
including the right to medical treatment in
emergency situations, but they also have the
right to refuse medical treatment.
From an ethical perspective, physicians and
other healthcare professionals have the
responsibility or duty to protect the life and
health of a patient. However, ultimately, the
patient has the final decision regarding the
medical treatment they receive, even when it
means they choose to decline such treatment

THE RIGHT TO
CHOOSE
PROVIDERS
All patients have the right to choose the provider who
renders healthcare services to them.
This is typically in reference to patient referrals from
physicians and hospitals. Physicians and hospitals often
refer patients to specialists, home health care, long-term
facilities or other healthcare professionals for further care
outside of their expertise or ability to provide continuity of
care.
Many times physician or hospital relationships violate a
patients right to choose the provider of their choice.

THE RIGHT TO
PRIVACY
Patients have the right to decide to whom, when,
and to what extent their private individually
identifiable health information is disclosed.
This information includes but is not limited to
medical diagnosis, treatment plans, prescriptions,
health insurance information, genetic
information, clinical research records, and mental
health records.
For patients, a lack of privacy could lead to
personal embarrassment, public humiliation, and
discrimination.

THE RIGHT TO
APPEAL
Patients have the right to a fair review or appeal of any complaint
against physicians, hospitals, or any other healthcare provider.
The right to appeal includes complaints regarding:
• the adequacy of treatment
• the actions of healthcare personnel
• wait times
• operating hours
• billing and payment issues

Have healthy habits such as
exercising, not smoking, and
eating a healthy diet. Teach
your family about healthy
habits and work with them
to take care of their health.
Take care not to spread
disease to others.
01
Follow the treatment plan
given by your healthcare
provider. Ask your
healthcare provider
questions about your
condition, treatment, or
care.
02
Remember that medicines
may have unwanted side
effects and that there may
be risks with procedures and
treatments.
03

Carefully read and understand your health care plan. Know the
rules about getting tests and treatments for certain conditions.
This will help save time when you see healthcare providers. Pay
for your health care correctly and in a timely manner.
Show respect for other patients and healthcare
providers. Understand and care about other people that
are ill. Follow your healthcare provider's advice. Follow
the rules when you enter a health care building. Report
unusual activities to people who can help.

REFERENCES
• https://www.facebook.com/Drugscom. (2019). Patient Bill of Rights.
Drugs.com; Drugs.com. https://www.drugs.com/cg/patient-bill-of-
rights.html
• MAGNA CARTA OF PATIENTS RIGHTS AND OBLIGATIONS | Senate of the
Philippines Legislative Reference Bureau. (n.d.). Issuances-
Library.senate.gov.ph. Retrieved June 25, 2023, from https://issuances-
library.senate.gov.ph/subject/magna-carta-patients-rights-and-obligations
• Rn), O. R. for N. (Open. (n.d.). 3.3 Patient’s Bill of
Rights. Wtcs.pressbooks.pub.
https://wtcs.pressbooks.pub/nursingfundamentals/chapter/3-3-patients-
bill-of-rights/

REFERENCES
• Joy HIcks. (2018). A Patient’s Bill of Rights in the Medical Office.
Verywell Health. https://www.verywellhealth.com/patient-bill-of-
rights-2317484
• Woodard, L.L. (2022). Patients’ Bill of Rights in the United States.
[online] YouMeMindBody. Available at:
https://youmemindbody.com/health-care-industry/Patients-Bill-of-
Rights-in-the-United-
States#:~:text=The%20initial%20Patients%27%20Bill%20of%20Rights
%20was%20established [Accessed 25 Jun. 2023].

REFERENCES
• The Rights of a Filipino Patient. (n.d.). Healthy Pilipinas: Health
Information for All Filipinos. https://www.healthypilipinas.ph/news-
and-articles/the-rights-of-a-filipino-patient

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