Health & Fitness

Complex nature of patient-doctor rights

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Summary

  • In the chapter, you have the guarantee to the attainment of the highest possible standard of healthcare.
  • In this regard, if the State is for some reason, unable to give this to you, the onus is on it to explain why.
  • The same Constitution also provides for your right to life, human dignity, and privacy.

"How far do patients' rights go in terms of choosing a preferred mode of treatment? I have a phobia for injectables but my doctor keeps insisting on that for a nagging wound on my lower leg following an accident last year.

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Chapter four of the Kenya Constitution (2010) is a good place to start in answer to your question.

In the chapter, you have the guarantee to attainment of the highest possible standard of healthcare. In this regard, if the State is for some reason, unable to give this to you, the onus is on it to explain why.

The same Constitution also provides for your right to life, human dignity, and privacy. It is perhaps in this regard you might feel that your doctor is infringing on your rights by insisting that you must have an injection to enable him give you the “highest attainable standard of health care”. This is where sometimes rights begin to show conflict.

My understanding is that every right we enjoy comes with a reciprocal responsibility and that although our rights are fundamental in that they are not granted by the generosity of the State, they are not absolute in the sense that the rights come to an end if they infringe on those of another citizen.

Your doctor has taken the Hippocratic oath that requires of him to ensure that he saves and promotes your life, as a fundamental requirement of ethical practice. He is further required by his registering body to ensure that he keeps up with the most modern methods of healthcare delivery.

Given all the foregoing, it must be clear that you and your doctor are required to treat each other with respect, always maintaining the very clear rights and responsibilities that have brought you together. Put another way, you and your doctor must agree on the best way forward!

Just so that you know, many cases where doctors are sued by their patients come about precisely in instances such as yours in which a well-meaning doctor, fails to explain to the patient why a certain procedure is necessary.

Even if the intention of the doctor is right and noble, it must receive the full understanding and consent of the patient who has the right to his own autonomy and respect for what happens to his body. If the doctor forces you to have the injection, you will in most probability sue him for assault.

In such an instance, the duty of explaining what the procedure is and what benefits/potential complications might be, rests on the doctor. Your doctor must, therefore, give you adequate opportunity to explore other options of care, including seeking an alternative opinion to the care he proposes.

In the past, doctors have acted as though their patients have neither knowledge nor rights, but this attitude happily belongs to the dark past.

That, however, is the easy part. In your case, you tell us that you had an accident but do not tell us the extent of the injuries that you sustained. You also do not tell us if the fear you now have of injections existed prior to the accident or is the result of the trauma of the accident.

Unknown to you perhaps, the doctor has made the determination that you now have complications from the head injury that you suffered and that you, in addition have signs of Post-Traumatic Stress Disorder (PTSD), which is a condition that could manifest with the kind of fear that you now seem to have.

It is possible that the doctor plans to ensure that he deals with the leg wound that is an immediate threat to your life, before he sends you for evaluation by a mental health expert.

Just to complicate your life further, it is possible that the accident has led to a measure of memory loss and indeed the doctor has explained all these things to you and your family, but the extent of the memory loss is such that you have forgotten the explanation. We simply do not know enough.

In clinical practice, each person is different, and each patient/doctor relationship is unique.

A few years ago, the highest court in the UK found against a psychiatrist who had ‘respected’ the rights of his patient, who did not want to be given treatment in hospital against his will.

The harm that came to the patient later was attributed to the doctor who failed to exercise due care in ensuring that the patient received the care he needed.

In this case, the respect of the patient’s rights had come to haunt the doctor!