Written By Ramesh Adhikari
Professionally reviewed by Manish Raj Kharel, Advocate, Partner, AHN Legal
In recent decades, the discourse on patient rights has become a critical facet of modern healthcare practices globally. Acknowledging the significance of informed and empowered patients, the World Medical Association’s Declaration of Lisbon on the Rights of the Patient, adopted in 1981 and subsequently amended, outlines fundamental principles that guide patient-physician relationships. This declaration, alongside the Nepal Medical Council’s Code of Ethics and Professional Conduct, forms a foundational framework for understanding and advocating patient rights.
Patient Rights: A Global Perspective
The WMA Declaration articulates several key patient rights principles applicable on a global scale. The right to medical care of good quality ensures that every individual, without discrimination, is entitled to appropriate medical care. Physicians are obligated to provide care guided by clinical and ethical judgments, free from external influences, thereby upholding the patient’s best interests. Quality assurance is paramount, reinforcing the responsibility of healthcare providers, particularly physicians, in ensuring the quality of medical services.
Patient autonomy is underscored through the right to freedom of choice, enabling individuals to select and change their physicians and healthcare institutions. Seeking a second opinion at any stage is not only a right but a critical component of patient empowerment.
The principle of self-determination emphasizes a patient’s right to make free decisions about themselves, extending to the right to refuse participation in research or medical teaching. Even when unconscious, patients maintain rights, with informed consent playing a crucial role, especially in cases where a legally entitled representative is not immediately available.
For legally incompetent patients, the consent of a representative is required, but the patient’s involvement in decision-making remains essential, respecting their capacity for rational decisions.
Confidentiality of patient information is a global standard, and information sharing should strictly adhere to explicit consent or legal provisions. Patients also have the right to access information about themselves, ensuring transparency and understanding of their health status.
Health education is recognized as a patient right, emphasizing the importance of informed decision-making about personal health and available services. This aligns with the notion that patients are not mere recipients of healthcare but active participants in their well-being.
The right to dignity ensures that patients’ privacy and cultural values are respected throughout their medical care journey. This extends to humane terminal care, emphasizing the importance of providing comfort during the dying process.
Patient Rights in Nepal: Bridging the Gap
While the global principles set by the WMA Declaration provide a robust foundation, the application of patient rights in Nepal requires a context-specific approach. The Nepal Medical Council’s Code of Ethics and Professional Conduct aligns with many of these principles, emphasizing patient dignity, privacy, and the right to quality healthcare. However, challenges persist in translating these principles into effective practices, especially in a rapidly evolving healthcare landscape.
Current Landscape in Nepal
Nepal faces unique challenges in healthcare delivery, including resource constraints, uneven distribution of healthcare facilities, and varying levels of awareness among the population. The recent surge in COVID-19 cases has further highlighted the strain on Nepal’s healthcare system, necessitating a re evaluation of patient rights and healthcare practices.
In Nepal, patients are entitled to basic rights such as the right to quality healthcare, informed consent, and confidentiality. The Nepal Medical Council emphasizes the importance of maintaining medical records and respecting patient confidentiality. However, awareness among patients about these rights remains a critical issue.
Empowering Nepalese Patients: A Call to Action
Empowering patients in Nepal requires a multifaceted approach involving healthcare providers, policymakers, and the community. A comprehensive awareness campaign about patient rights, including the right to information, informed consent, and confidentiality, is essential.
Global Best Practices and Legal Frameworks
Several advanced countries have implemented robust legal frameworks to safeguard patient rights. In the United States, the Health Insurance Portability and Accountability Act (HIPAA) ensures the privacy and security of patients’ health information. The Affordable Care Act (ACA) emphasizes patient-centered care, aiming to enhance the quality of healthcare services.
Similarly, the United Kingdom’s National Health Service (NHS) Constitution enshrines patient rights, including the right to make decisions about one’s healthcare and the right to be treated with dignity and respect. Australia’s Charter of Healthcare Rights outlines the fundamental rights of patients, fostering a culture of shared decision-making between healthcare providers and patients.
Public Awareness Campaigns: Launching targeted awareness campaigns to educate the Nepalese population about their rights and expectations in healthcare.
Legal Reforms: Continuous review and reform of existing laws to align with global best practices, ensuring the protection of patient rights.
Healthcare Provider Training: Integrating patient rights education into the training curriculum for healthcare providers, emphasizing communication skills, empathy, and patient-centric care.
Patient Advocacy Groups: Facilitating the establishment of patient advocacy groups to represent patient interests, provide support, and contribute to policy discussions.
Accessible Information: Ensuring that healthcare information is easily accessible, comprehensible, and available in multiple languages to cater to Nepal’s diverse population.
Collaboration with International Organizations: Establishing collaborations with international healthcare organizations to exchange best practices and learnings for the improvement of patient rights in Nepal.
Empowering Nepalese patients requires a concerted effort from all stakeholders in the healthcare ecosystem. By aligning national practices with global principles, addressing gaps in awareness, and implementing best practices observed in advanced countries, Nepal can build a patient-centric healthcare system that upholds the rights and expectations of its citizens. The journey toward patient empowerment is not only a legal and ethical imperative but a collective responsibility to ensure the well-being of the nation’s population.
REFERENCES
World Medical Association. (2015). WMA Declaration of Lisbon on the Rights of the Patient. Adopted by the 34th World Medical Assembly, Lisbon, Portugal, September/October 1981, and amended by the 47th WMA General Assembly, Bali, Indonesia, September 1995, and editorially revised by the 171st WMA Council Session, Santiago, Chile, October 2005, and reaffirmed by the 200th WMA Council Session, Oslo, Norway, April 2015.
Nepal Medical Council. (2017). Code of Ethics & Professional Conduct. Nepal Medical Council.
U.S. Department of Health and Human Services. Health Insurance Portability and Accountability Act (HIPAA). Retrieved from https://www.hhs.gov/hipaa/index.html
The National Archives. (2010). The Constitution of the United States: A Transcription. Retrieved from https://www.archives.gov/founding-docs/constitution-transcript
National Health Service. (2015). The NHS Constitution for England. Retrieved from https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england
Australian Commission on Safety and Quality in Health Care. (2008). Charter of Healthcare Rights. Retrieved from https://www.safetyandquality.gov.au/publications/charter-healthcare-rights