It appears you don`t have a PDF plugin for this browser. No biggie

● JOURNAL
OF PUBLIC
HEALTH,
NURSING
AND MEDICAL
RESCUE
●RESCUE
No. 3/2015
(9-11) ●
●
● JOURNAL
OF PUBLIC
HEALTH,
NURSING
ANDAND
MEDICAL
RESCUE
● No.3/2015
● JOURNAL
OF
PUBLIC
HEALTH,
NURSING
MEDICAL
● 2/2014
●
9
Patients’ rights to information in contemporary
healthcare system
(Prawa pacjenta do informacji we współczesnej ochronie zdrowia)
G Majkowska A-F
Abstract – Apart from beneficial effects for patients, progress
made in medical knowledge and new diagnostics technologies
brought numerous hazards against which they should be protected.
Patients’ rights are stipulated in numerous legal acts whose provisions impose certain obligations on participants of the healthcare
sector. They are particularly important from the legal, psychological, moral and social perspective. Rights protect patients’ autonomy and set medical personnel the direction of their actions according to regulations.
The medical procedures performed on patients require their consent, which unavoidably entails the necessity of providing them
with the information concerning their health condition. The right
to information sets the boundaries for medical intervention and
consent for the initiation of medical proceedings.
The broad impact of information on patients gives rise to various
disagreements on the extent to which they should be informed
which arise among legal practitioners, ethicists and physicians.
Doctors have the duty to inform patients about their health,
whereas in the case of nurses and midwives, the patient or their
medical representative has the right to obtain the information to
the extent necessary to provide medical care.
The scope of information must be reliable and understandable for
patients, depending on the type of a disease, patient’s condition
and sort of medical intervention.
The right to information plays a crucial role in the patient’s or
their statutory representative’s decision-making process as regards granting the consent for medical procedures. Patients find
making the decision a dubious, complicated, difficult and riskladen matter. The medical personnel’s duty is to provide the information about the patient’s health condition within
an extent specific to a given profession and in such a way that an
authorised person could grant a voluntary consent for specific
medical procedures.
Key words - patient’s rights, information.
Streszczenie – Postęp w zakresie wiedzy medycznej oraz nowych
technologii diagnostycznych i terapeutycznych obok
swych dobroczynnych dla pacjenta skutków, przyniósł zagrożenie
przed którymi pacjent powinien być chroniony.
Prawa pacjenta są zawarte w wielu aktach prawnych, w których
zawarte przepisy nakładają obowiązki na osoby uczestniczące w
udzielaniu świadczeń zdrowotnych. Są one szczególnie istotne z
punktu widzenia prawnego, psychologicznego, medycznego,
etycznego, moralnego i społecznego. Prawa tworzą ochronę autonomii pacjenta a personelowi medycznemu wyznaczają kierunek działania zgodny z przepisami prawa.
Wykonywane procedury medyczne u pacjenta wymagają zgody
pacjenta, co jest nierozerwalnie związane z poinformowaniem go
o stanie zdrowia. Prawo do informacji stanowi element wyznaczenia granic medycznej ingerencji i przyzwolenia na podjęcie
postępowania medycznego.
Szeroki wpływ informacji na pacjenta w różnych aspektach powoduje spory wśród praktyków prawa, etyków, medyków na temat granic zakresu informowania pacjenta.
Lekarz ma obowiązek informowanie pacjenta o stanie zdrowia, w
przypadku pielęgniarek i położnych pacjent lub jego przestawiciel
ustawowy ma prawo do uzyskania informacji o stanie zdrowia
pacjenta w zakresie koniecznym do sprawowania opieki pielęgnacyjnej.
Zakres informacji dla pacjenta musi być zrozumiały i rzetelny
uzależniony od rodzaju choroby, stanu pacjenta oraz rodzaju
interwencji medycznej.
Prawo do informacji odgrywa fundamentalne znaczenie w procesie decyzyjnym pacjenta lub jego przedstawiciela ustawowego w
zakresie udzielania zgody na procedury medyczne. Podjęcie decyzji jest dla pacjenta złożone, trudne, obarczone niepewności i
ryzykiem. Zadaniem personelu medycznego jest przedstawienie
informacji o stanie zdrowia pacjenta
w zakresie typowym dla
dane profesji, w taki sposób aby uprawniona osoba mogła wyrazić uświadomioną zgodę na określone świadczenia medyczne.
Słowa kluczowe - prawa pacjenta, informacja.
Author Affiliations:
Collegium Masoviense - College of Health Sciences
Provincial Hospital Complex in Skierniewice
Authors’ contributions to the article:
A. The idea and the planning of the study
B. Gathering and listing data
C. The data analysis and interpretation
D. Writing the article
E. Critical review of the article
F. Final approval of the article
● JOURNAL
OF PUBLIC
HEALTH,
NURSING
ANDAND
MEDICAL
RESCUE
● No.3/2015
● JOURNAL
OF PUBLIC
HEALTH,
NURSING
MEDICAL
RESCUE
● 2/2014 ●
●
Correspondence to:
Grazyna Majkowska, Collegium Masoviense - College of Health
Sciences, Żyrardów, G. Narutowicza 35 Str., PL-96-300 Żyrardów, Poland, e-mail: [email protected]
Accepted for publication: July 10, 2015.
I. PATIENT’S RIGHTS
he patient’s rights are reconfirmed in legal provisions
and impose certain obligations on the persons providing medical services. The rights protect the patient’s
autonomy and define for the medical personnel the right
direction of their activities [1].
The medical procedures performed on patients require
their consent, which unavoidably entails the necessity of
providing them with information about their health condition. The right to information is an element of determining
limits of medical intervention and consent to start a medical
procedure [2].
The paper aims to underline the importance of the patient’s rights to information with the consideration for the
duty to provide information by the nurse.
The patient has the right to information about his or her
health, examination results, diagnosis and future prognoses.
It should be remembered that the right to information is a
patient’s right – it is he or she that decides what information about their health and to whom it can be provided.
They also have the right to abstain from authorising anyone
or can waive the right to information. The patient under 16
years of age has the right to information within the scope
necessary for appropriate delivery of medical services [3].
There have been cases where the patient told the
doctor that he or she fully trusted him and therefore, waives
his or her right to information. Such state of affairs is confirmed by the provision included in Art. 9.4 of the Act on
the Patient’s rights in line with which the patient can demand the doctor not provide them with information [2].
The patient’s decision not to use the right to information
is not ultimate. The patient may at any time change his or
her mind and demand the information to be disclosed.
An important issue remains whether the patient may demand the information be partially limited, e.g. with regard
to the risk associated with a medical procedure or its prognosis. The patient manages his or her right to information,
both in the subject-related sense, by authorising specific
persons to receive information, and in the object-related
T
10
sense with reference to the type and scope of the information provided. Patients may at their own discretion demand specific information and ask for passing over some
other in silence [4].
Another important question relates to whether the right
not to inform at all or partially does not get limited at the
cost of protecting other values. The literature discusses the
circumstances under which respect for the patient’s autonomy must give way to other ethical concerns, e.g. health
security of another person. In this case, the patient may not
waive the right to information even if he or she is a particular virus or bacteria carrier which may be transmitted to
other person [3].
In accordance with the Nursing and Midwifery Act, the
patient has the right to obtain information about the patient’s health condition within the scope necessary to provide nursing care. A nurse delivers health services through
individually rendered preventive, diagnostics, treatment
and rehabilitation benefits. Thus, by delivering health services individually, she is obliged to provide information
herself and cannot send patients away to the doctor [4].
The information delivered to a patient or his or her authorised person is a very important point of reference in the
situation they are currently in. Knowledge forms the basis
for action as far as granting or refusing consent for specific
medical procedures is concerned, as well as in the case
where the nurse provides information about the patient’s
participation in nursing services. Taking into consideration
the importance of informing the relatives, the doctor and
nurse should share the news in a recipient-friendly manner.
The information must be clear, transparent and understandable, as well as adjusted to recipients’ perceptive capabilities without any professional and strange terminology.
Failure to provide the patient with the information or doing it in an unsuitable way is a self-contained prerequisite
for liability. In accordance with the Supreme Court’s jurisdiction approach, if a dispute emerges in this respect, the
burden of proof rests on a person responsible for disclosing
information or on a medical establishment. The main evidence used to prove that the information has been provided
are records in medical documentation together with the
patient’s signatures [5].
The right to information is an inalienable human right
which is guaranteed by law. The extensive case law of
courts proves that the scope of provided information is not
entirely clear-cut. Courts underline and accept that the patient needs reliable information to be able to make a conscious and well-thought decision [6].
● JOURNAL
OF PUBLIC
HEALTH,
NURSING
ANDAND
MEDICAL
RESCUE
● No.3/2015
● JOURNAL
OF PUBLIC
HEALTH,
NURSING
MEDICAL
RESCUE
● 2/2014 ●
●
II.
THE SCOPE OF PROVIDED INFORMATION
The scope of provided information depends on the type
of disease, the patient’s condition and type of medical intervention. Medical staff duty analysis with regard to the
patient and his or her right to information in correlation
with the court case laws indicates how much there is still to
be done as regards the compliance with the patient’s rights
[5]. The solution to this problem may include increasing
the number of trainings organised for medical personnel.
Compliance with the fixed legal order as to the provision of
information secures the patient’s interests and protects the
medical personnel against claims for the breach of patient’s
rights and infringement of his or her goods.
III.
REFERENCES
[1] Karkowska D. Ustawa o prawach pacjenta i Rzeczniku Praw
Pacjenta –komentarz. Warszawa; Wolters Kluwer Polska Sp. Z
o.o. 2012.
[2] Ustawa z dnia 6 listopada 2008 r. o prawach pacjenta i Rzeczniku Praw Pacjenta
[3] Nestorowicz M. Prawo medyczne. Toruń; Wyd. TNOiK 2007.
[4] Karkowska D.. Prawo medyczne dla pielęgniarek. Warszawa;
Wyda. Lex 2013.
[5] Śliwka M.. Prawa pacjenta w prawie polskim na tle porównawczym. Toruń; Wyd. TNOiK 2010.
[6] Wyrok Sądu Najwyższego z dnia 12 czerwca 2008r. sygn. akt III
CSK16/08.
11