Rights of patients
Tuesday, 18 May 2010
Maswood Alam Khan
HUMAN Rights and Peace for Bangladesh, a rights group, on Saturday asked the ministry of health and the accreditation body of medical practitioners to display within a week the rights of the patients on signboards to be put up at prominent places and locations of all the hospitals, clinics and doctors' chambers in conformity with a High Court verdict delivered on November 8, 2008. It is shocking that a legal notice had to be issued by the rights group as the concerned medical bodies, authorities and individuals have failed in more than a year and a half to implement the High Court directive. How the doctors and the allied medical professionals could dare ignore the court order is not understandable.
Bangladesh perhaps is one of the few backward countries in the world where the doctors reign supreme and the patients are at the mercy of the medical professionals. Not a single instance can be cited in Bangladesh where a physician for his or her negligence in discharging professional duties and responsibilities was ever awarded a major punishment by any court of law. Like policemen or armed men the medical professionals are also feared by all and sundry because everybody, who is now a patient or who may become a patient in the near or a distant future, are scared of doctors and dare not join issues with them, lest they fall prey to their wrath. The omnipotence of the physicians and the silence of the government and the civic society on the faults and blunders committed by the medical practitioners are responsible for the grim picture of corruption and inefficiency we find in the sanatoriums and clinics, especially in the public-funded hospitals and health centres --- like any other public institutions that are all gripped by a kind of terrorism.
Giving medications safely and timely is a noble task the doctors and the caregivers are expected to do it perfectly. The accuracy standard, according to world health authority, is expressed as 'The Five Rights of Medication Safety', that is, Right Patient, Right Drug, Right Dose, Right Route, and Right Time.
The most important right a patient should have is the right to feel confident in the hands of the caregivers, who include not only doctors and nurses but also other caregivers like dieticians, therapists, counselors, cleaners, laundrymen and a variety of other professionals engaged in hospital administration, so that a strong and friendly bond between patients and their healthcare providers is established. Unfortunately, this is the area where people in Bangladesh are mostly neglected. Doctors and other healthcare professionals in our country maintain a kind of stony silence in their demeanour and keep up a sort of stoicism. They perhaps believe that wise health professionals should not allow themselves to be friendly with the patients. Just the reverse is true in India, our next-door neighbour, where a patient before even getting any medications gets cured almost to an extent of 50 per cent immediately after s/he meets a doctor who always wears a smiling look on his/her face in tireless efforts to inject doses of confidence into patients' psyche.
I don't know whether there is a special course in the curricula of medical science in the name of 'enigmatic handwriting' where students of medicine are categorically instructed to write prescriptions in cipher or in the most unintelligible fashions so that a patient or a commoner can never decipher the names of the prescribed medicines and instructions written in scribbles and scrawls that are understandable only to salesmen of designated drug stores. A nurse on duty in an American hospital was surprised when I repeatedly enquired whether the medical advice meant for me was written by a doctor or not. As the nurse asked me why I had the suspicion, I said: 'The prescription is so legibly handwritten that I can't believe that it can be from a doctor's hand'. The American nurse laughed uproariously when I explained to her how our doctors in Bangladesh pen the prescriptions in cryptic styles.
As a patient one should have the right to accurate and easily understood information about medications, health services, health care professionals and health care facilities. If a patient speaks another language, has a physical or mental disability, or just doesn't understand something, help must be given so that s/he can make her informed healthcare decisions. A patient should have the right to know his/her treatment options and take part in decision-making about his/her care. Parents, guardians, family members, or others that the patient chooses should have the right to speak for the patient if s/he cannot make his/her own decisions.
In a developed country, if a patient, even if s/he is a pauper, has a severe pain, an injury, or a sudden illness that makes him or her believe that his or her health is in danger, s/he has the constitutional right to be screened and stabilised using emergency services of any public or private hospital or clinic nearby without having to pay a single farthing if the patient is genuinely incapable to defray the expenses of the emergency medical services. But a patient in our country cannot enter the emergency section even of a state-owned hospital without greasing the palms of the gatekeepers and without stashing cash into the wallets of the caregivers, let alone an entry to a private clinic which is off limits to the poor.
I don't know exactly what rights were specifically mentioned in the verdict given by the High Court as to the rights of patients to be mentioned in the signboards in all the healthcare facilities. Whatever the rights we as patients in Bangladesh have according to law of the land, the exercise for realising those rights would be fruitless if our doctors and other medical professionals do not change their old-fashioned mindset. Unless and until our medical professionals are imbued with a missionary zeal to serve the frail and fragile sections of humanity with dedication and commitment, the corrupt practices of lining pockets by prescribing more medicines than are actually required by the patients, sending patients to diagnostic centres for unnecessary check-ups, aggravating diseases with a greed to fatten the medical bills, luring patients through unscrupulous middlemen posted at bus terminals and railway stations, issuing false certificates as to diseases and fabricated postmortem reports as to causes of deaths etc. will remain rampant.
What is actually needed is a draconian purge that should remove the dishonest elements not only from the health sector, but also from other public sectors where the crooked and the corrupt are deemed the kingmakers and where the dedicated and the incorruptible are deemed the lunatic.
.....................................................
E-mail : maswood@hotmail.com
HUMAN Rights and Peace for Bangladesh, a rights group, on Saturday asked the ministry of health and the accreditation body of medical practitioners to display within a week the rights of the patients on signboards to be put up at prominent places and locations of all the hospitals, clinics and doctors' chambers in conformity with a High Court verdict delivered on November 8, 2008. It is shocking that a legal notice had to be issued by the rights group as the concerned medical bodies, authorities and individuals have failed in more than a year and a half to implement the High Court directive. How the doctors and the allied medical professionals could dare ignore the court order is not understandable.
Bangladesh perhaps is one of the few backward countries in the world where the doctors reign supreme and the patients are at the mercy of the medical professionals. Not a single instance can be cited in Bangladesh where a physician for his or her negligence in discharging professional duties and responsibilities was ever awarded a major punishment by any court of law. Like policemen or armed men the medical professionals are also feared by all and sundry because everybody, who is now a patient or who may become a patient in the near or a distant future, are scared of doctors and dare not join issues with them, lest they fall prey to their wrath. The omnipotence of the physicians and the silence of the government and the civic society on the faults and blunders committed by the medical practitioners are responsible for the grim picture of corruption and inefficiency we find in the sanatoriums and clinics, especially in the public-funded hospitals and health centres --- like any other public institutions that are all gripped by a kind of terrorism.
Giving medications safely and timely is a noble task the doctors and the caregivers are expected to do it perfectly. The accuracy standard, according to world health authority, is expressed as 'The Five Rights of Medication Safety', that is, Right Patient, Right Drug, Right Dose, Right Route, and Right Time.
The most important right a patient should have is the right to feel confident in the hands of the caregivers, who include not only doctors and nurses but also other caregivers like dieticians, therapists, counselors, cleaners, laundrymen and a variety of other professionals engaged in hospital administration, so that a strong and friendly bond between patients and their healthcare providers is established. Unfortunately, this is the area where people in Bangladesh are mostly neglected. Doctors and other healthcare professionals in our country maintain a kind of stony silence in their demeanour and keep up a sort of stoicism. They perhaps believe that wise health professionals should not allow themselves to be friendly with the patients. Just the reverse is true in India, our next-door neighbour, where a patient before even getting any medications gets cured almost to an extent of 50 per cent immediately after s/he meets a doctor who always wears a smiling look on his/her face in tireless efforts to inject doses of confidence into patients' psyche.
I don't know whether there is a special course in the curricula of medical science in the name of 'enigmatic handwriting' where students of medicine are categorically instructed to write prescriptions in cipher or in the most unintelligible fashions so that a patient or a commoner can never decipher the names of the prescribed medicines and instructions written in scribbles and scrawls that are understandable only to salesmen of designated drug stores. A nurse on duty in an American hospital was surprised when I repeatedly enquired whether the medical advice meant for me was written by a doctor or not. As the nurse asked me why I had the suspicion, I said: 'The prescription is so legibly handwritten that I can't believe that it can be from a doctor's hand'. The American nurse laughed uproariously when I explained to her how our doctors in Bangladesh pen the prescriptions in cryptic styles.
As a patient one should have the right to accurate and easily understood information about medications, health services, health care professionals and health care facilities. If a patient speaks another language, has a physical or mental disability, or just doesn't understand something, help must be given so that s/he can make her informed healthcare decisions. A patient should have the right to know his/her treatment options and take part in decision-making about his/her care. Parents, guardians, family members, or others that the patient chooses should have the right to speak for the patient if s/he cannot make his/her own decisions.
In a developed country, if a patient, even if s/he is a pauper, has a severe pain, an injury, or a sudden illness that makes him or her believe that his or her health is in danger, s/he has the constitutional right to be screened and stabilised using emergency services of any public or private hospital or clinic nearby without having to pay a single farthing if the patient is genuinely incapable to defray the expenses of the emergency medical services. But a patient in our country cannot enter the emergency section even of a state-owned hospital without greasing the palms of the gatekeepers and without stashing cash into the wallets of the caregivers, let alone an entry to a private clinic which is off limits to the poor.
I don't know exactly what rights were specifically mentioned in the verdict given by the High Court as to the rights of patients to be mentioned in the signboards in all the healthcare facilities. Whatever the rights we as patients in Bangladesh have according to law of the land, the exercise for realising those rights would be fruitless if our doctors and other medical professionals do not change their old-fashioned mindset. Unless and until our medical professionals are imbued with a missionary zeal to serve the frail and fragile sections of humanity with dedication and commitment, the corrupt practices of lining pockets by prescribing more medicines than are actually required by the patients, sending patients to diagnostic centres for unnecessary check-ups, aggravating diseases with a greed to fatten the medical bills, luring patients through unscrupulous middlemen posted at bus terminals and railway stations, issuing false certificates as to diseases and fabricated postmortem reports as to causes of deaths etc. will remain rampant.
What is actually needed is a draconian purge that should remove the dishonest elements not only from the health sector, but also from other public sectors where the crooked and the corrupt are deemed the kingmakers and where the dedicated and the incorruptible are deemed the lunatic.
.....................................................
E-mail : maswood@hotmail.com