Patients Physical Incompetence Essay

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Patients Physical Incompetence Essay

The four weeks at the Mumbai hospital helped me hone up my professional and personal skills. The first learning came from the environment itself. Although there were many cultural and professional differences, it was not difficult for me to adjust as I knew the local language. What was truly astonishing though was that while the other therapists were friendly and helpful they would not interact with me when others were around. I wonder whether it was a bias against gender or their reputation would be at stake if they were seen talking to a male physiotherapist. It could also be my nationality and background that disturbed them. Most of them could communicate in English although Hindi was the preferred language. Patients Physical Incompetence Essay. Nevertheless, I did find them friendly, which conveys that humanity is above caste, creed, and religion; it is the person that is important and not the nationality.
On the professional front, I found that the plinths (beds) within the department were wooden and the height could not be adjusted according to the patient’s or therapist’s requirements. I often had to use a stool to step up. What was even more shocking was the manual handling techniques that were used to move the patients. The patient was picked up by the ward boys by putting their hands under the armpit of the patients. This was something truly ridiculous and then the chair on which the patient was seated would be pushed around by the ward boy from one place to another. The wheelchairs were fitted with brakes but the patients had to use them without the brakes. Irrespective of the presence of a physiotherapist, the department should have the basic pieces of equipment and standard facilities (Physiosa, n.d.). It is impractical and expensive.

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Patient rights are those basic rule of conduct between patients and medical caregivers as well as the institutions and people that support them. A patient is anyone who has requested to be evaluated by or who is being evaluated by any healthcare professional. Medical caregivers include hospitals, healthcare personnel, as well as insurance agencies or any payors of medical-related costs. This is a broad definition, but there are other slightly more specific definitions. For example, a legal definition is as follows; patient rights is general statement adopted by most healthcare professionals, covering such matters as access to care, patient dignity, confidentiality, and consent to treatment.

No matter what definition is used, most patients and doctors are finding that many of the details of patient rights have changed and are continuing to change over time. This article is designed to give the reader a basic introduction to patient rights. Patients Physical Incompetence Essay.

Often, people do not realize their specific rights at the time of their care because those rights are either not clearly defined or included in a bundle of papers that patients need to sign during registration. Some basic rights are that all patients that seek care at an emergency department have the right to a screening exam and patients that cannot afford to pay are not turned away. The details of these rights are detailed in the Emergency Medical Treatment and Active Labor Act (EMTALA) laws in the U.S. In addition, many people think that patient rights are only applicable between themselves and their doctor. This is not the situation; as stated in the first definition, patient rights can be extensive and exist between many people and institutions. Most notably, they can exist between patients, any medical caregiver, hospitals, laboratories, insurers and even secretarial help and housekeepers that may have access to patients or their medical records.

It is not possible in this article to list all of patient’s rights. However, most written rights that doctors and hospital personnel have patients read (and sign) are abbreviated statements that are summaries of all or parts of the American Medical Association (AMA) Code of Medical Ethics. Many of these patient rights have been written into state or federal laws and if violated, may result in fines or even prison time.

This article will focus on the doctor patient relationship and present areas of greatest concerns. Readers should understand that in most instances, when the word “doctor” is used, the reader may substitute many other names such as nurse, caregiver, hospital, insurer, doctor’s office personnel and many others. A patient’s rights in relation to their doctors occur at many different levels, and in all specialties. As stated above, the American Medical Association (AMA) outlines fundamental elements of the doctor-patient relationship in their Code of Medical Ethics. These rights include the following in the 2012-2013 book (568 pages!) and have the various topics covered in great detail:

1.00 – Introduction
2.00 – Opinions on Social Policy Issues
3.00 – Opinions on Interprofessional Relations
4.00 – Opinions on Hospital Relations
5.00 – Opinions on Confidentiality, Advertising, and Communications Media Relations
6.00 – Opinions on Fees and Charges
7.00 – Opinions on Physician Records
8.00 – Opinions on Practice Matters
9.00 – Opinions on Professional Rights and Responsibilities
10.00 – Opinions on the Patient-Physician Relationship
According to the AMA, physicians should also serve as advocates for patients and promote the basic patient rights. Patients Physical Incompetence Essay.

Communication
Open and honest communication is an integral part of the doctor-patient relationship. The AMA’s Code of Medical Ethics clearly states that it is a fundamental ethical requirement that a physician should at all times deal honestly and openly with patients. Patients have a right to know their past and present medical status and to be free of any mistaken beliefs concerning their conditions. Situations occasionally occur in which a patient suffers significant medical complications that may have resulted from the physician’s mistake or judgment. In these situations, the physician is ethically required to inform the patient of all the facts necessary to ensure understanding of what has occurred. Only through full disclosure is a patient able to make informed decisions regarding future medical care.

Past patient surveys have found that virtually all patients desired some acknowledgment of even minor errors. For both moderate and severe mistakes, patients were significantly more likely to consider legal action if the physician did not disclose the error. Findings such as these reinforce the importance of open communication between physician and patient.

Informed Consent
Part of communication in medicine involves informed consent for treatment and procedures. This is considered a basic patient right. Informed consent involves the patient’s understanding of the following:

What the doctor is proposing to do
Whether the doctor’s proposal is a minor procedure or major surgery
The nature and purpose of the treatment
Intended effects versus possible side effects
The risks and anticipated benefits involved
All reasonable alternatives including risks and possible benefits.
Closely associated with informed consent, voluntary consent means that the patient understands these concepts; the patient rights include the following:

Freedom from force, fraud, deceit, duress, overreaching or other ulterior form of constraint or coercion
The right to refuse or withdraw without influencing the patient’s future healthcare
The right to ask questions and to negotiate aspects of treatment
A patient must be competent in order to give voluntary and informed consent. Patients Physical Incompetence Essay. Thus, competent consent involves the ability to make and stand by an informed, freely made decision. In clinical practice, competence is often equated with capacity. Decision-making capacity refers to a patient’s ability to make decisions about accepting healthcare recommendations. To have adequate decision-making capacity, a patient must understand the options, the consequences associated with the various options, and the costs and benefits of these consequences by relating them to personal values and priorities.

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Some factors may make a patient incapable of providing competent consent either temporarily or permanently. Examples include the following:

Mental illness or mental retardation
Alcohol or drug intoxication
Altered mental status
Brain injury
Being too young to legally make decisions concerning health care
Patients that are judged incompetent (often determined by two independent physicians or in some instances, by a legal decree) can have others legally permitted to make medical decisions for the patient.

Confidentiality
Law and ethics state that the doctor-patient interaction should remain confidential. The physician should never reveal confidential information unless the patient wants this information disclosed to others, or unless required to do so by law. If the release of information is warranted, information should be released in the form of an official signed document.

Confidentiality is subject to certain exceptions because of legal, ethical, and social considerations.

When patients are at risk of physically harming another person, or if those patients are at risk of harming themselves, the physician has the legal obligation to protect the potential victim and notify law enforcement authorities.
All U.S. states and Canadian provinces require all cases of child abuse to be reported to the district attorney’s office and/or child protective services. This includes suspected and confirmed cases of child abuse. Failure of health care personnel to report child abuse and neglect may result in criminal prosecution under the Child Abuse and Prevention Act of 1974. Failure to report child abuse may also result in civil prosecution for malpractice if the child suffers injury or death because the abuse was not reported. This is another special case in which patient confidentiality does not exist. Doctors that reasonably suspect child abuse and report it are not liable if Child Protective Services ultimately find there was no abuse. Patients Physical Incompetence Essay. New changes also extends this law to elderly patients.
In addition to child and elderly abuse, certain aspects relating to confidentiality does not apply to cases involving some specific communicable diseases, gunshot wounds, and knife wounds that are related to illegal or criminal activity.
The subject of minors creates a special situation regarding confidentiality. The laws vary from state to state. Most states regard a person younger than 18 years as a minor.
An exception is made for emancipated minors, who are considered self-reliant because, for example, they are married or have children themselves. Emancipated minors are usually regarded as adults in reference to their medical care.
Minors who live with their parents but are self-reliant and independent are considered mature minors. In some states, a mature minor may be considered an adult regarding medical treatment. In various states and depending on the situation, minors can consent to treatment for contraception, drug and alcohol problems, psychiatric conditions, pregnancy, abortion, and sexually transmitted diseases (STDs, venereal diseases) without the knowledge of their parents. It is best for doctors and patients to know the laws that pertain to the State where the medical situation is to be assessed and treated. Patients Physical Incompetence Essay.