PATIENTS RIGHTS

Roberta C. Balbi Campos003923

Paper presented to Prof. Helena M.M. Pereira de Melo as requirement of Discipline of Health Law and Bioetics at Master Course.

Human Rights in Patient Care

First of all: why the utilization of the concept “human rights in patient

care” instead of “patient right”???

Human rights in patient care: refers to the application of general or

universal human rights principles to all stakeholders in the delivery of

health care services.

Patient right: refers to the specific rights of patients, in their

relationship in terms of health care.

Another important distinction which need to be made is between

"human rights in patient care" and "right to health", wherein the

concept of right to health encompasses one vast range of human rights

that fall outside the patient care delivery context, but nevertheless have

an important role in determining health outcomes.

RELEVANT CONCEPTS

"Patient”- means any individual receiving long- or short-term

inpatient care, emergency care, or outpatient care, and

residents of long-term care facilities.”

"Facility” - means hospitals, clinics, health maintenance

organizations, nursing homes, and other health care facilities

licensed, or subject to licensing, by the [state licensing

authority].

"Physician” - means any staff, attending, visiting, resident,

or

intern physician who cares for any patient in a licensed facility.

Human Rights in Patient Care in International Framework

- The Universal Declaration of Human Rights of 1948

“Whereas recognition of the inherent dignity and of the equal and inalienable rights of all

members of the human family is the foundation of freedom, justice and peace in the world,

(…)”.

Main dispositions are:

Article 3 - Right to life;

Article 5 - Prohibition on torture and cruel, inhuman, or degrading treatment;

Article 7 - Protection against discrimination;

Article 12 - Right to privacy;

Article 19 - Right to seek, receive, and impart information;

Article 25 – Right to medical care.

- International Covenant on Civil and Political Rights (ICCPR)

Relevant dispositions:

Article 2(1) - prohibition on discrimination;

Article 6 - right to life;

Article 7 - prohibition on torture;

Article 9 - right to liberty and security;

Article 10 - right to dignity for detainees;

Article 17 -right to privacy;

Article 19(2) - right to information;

Article 26 -equality before the law.

- International Covenant on Economic, Social and

Cultural Rights (ICESCR)

Main disposition:

Article 12 - right to highest attainable standard of health

*General Comment nº14 of the Committee on Economic, Social, and

Cultural Rights.

Other relevant dispositions include:

Article 2(1) - prohibition on discrimination;

Article 10(3) - protection of children;

Article 11 - adequate standard of living.

Other relevant treaties that also contains guarantees related to the protection of human rights in patient care.

Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW)

Convention for the Elimination of All Forms of Racial Discrimination (CERD)

Convention Against Torture and Other Forms of Cruel, Inhuman, or Degrading Treatment or Punishment (CAT)

Convention on the Rights of the Child (CRC) International Convention on the Protection of the Rights of All

Migrants Workers and Members of their Families (CMW)  Convention on the Rights of Persons with Disabilities (CRPD)

ADDITIONAL INTERNATIONAL DOCUMENTS

There is no binding force in those documents, they are consider as been

consensual, although they have a considerable political and moral force.

WHO Alma-Ata Declaration 1978

Charter on the Right to Health 2005 (International Union of Lawyers)

Declaration on the Rights of the Patients 2005 (revised) (World Medical

Association (WMA)

Declaration on Patient-Centred Healthcare 2007, International Alliance

of Patients’ Organizations (IAPO)

Jakarta Declaration on Leading Health Promotion into the 21st

Century (1997)

Position Statement: Nurses and Human Rights 1998, International

Council of Nurses (ICN)

EUROPE SYSTEM OF HUMAN RIGHTS IN PATIENT CARE

THE COUNCIL OF EUROPE

- The European Convention on the Protection of Human Rights and

Fundamental Freedoms

Relevant dispositions:

Article 2 - Right to life;

Article 3 - Protection against torture and cruel, inhuman or degrading

treatment;

Article 5 - Right to liberty and security of person

Article 6 - Access to a fair hearing;

Article 8 - Right to privacy;

Article 13 - Right to effective remedies;

Article 14 - Prohibition of discrimination.

- The European Social Charter

Relevant dispositions:

Article 11 - Right to protection of health;

Article 13 - Right to social and medical assistance;

Article 14 - Right to benefit from social welfare services;

Article 15 - Right of persons with disabilities to independence, social

integration and participation in the life of the community;

Article 16 - Right of the family to social, legal and economic protection;

Article 17 - Right of children and young persons to appropriate social, legal

and economic protection;

Article 19 - Right of migrant workers and their families to protection and

assistance)

Article 23 - Right of elderly persons to social protection.

- The Convention on Human Rights and Biomedicine

Relevant dispositions:

Equitable access to health care (Article 3)

Protection of consent (Chapter II, Articles 5-9)

Private life and right to information (Chapter III, Article 10)

Other relevant treaties that also contains guarantees related to the

protection of human rights in patient care.

European Convention for the Prevention of Torture and Inhuman or Degrading

Treatment or Punishment

Convention for the Protection of National Minorities 1995

Recommendation No. R (2000) 5 of the Committee of Ministers to member

states on the development of structures for citizen and patient participation in

the decision making process affecting health care

EUROPEAN UNION

- EU Charter of Fundamental Rights

Article 35 - right to health protection as the “right of access to preventive health care and the right to

benefit from medical treatment under the conditions established by national laws and practices,”

specifying that the EU must guarantee “a high level of protection of human health”.

Other relevant dispositions include:

Article 1 - the inviolability of human dignity;

Article 2 - the right to life;

Article 3 - the right to the integrity of the person;

Article 6 - the right to security;

Article 8 - the right to the protection of personal data;

Article 21 - the right to non-discrimination;

Article 24 - the rights of the child;

Article 25 - the rights of the elderly;

Article 34 - the right to social security and social assistance;

Article 37 - the right to environmental protection;

Article 38 - the right to consumer protection.

- EU Directive on Patients’ Rights in Cross Border Health Care

NON BINDING DOCUMENTS IN THE EUROPEAN SISTEM

- The European Charter of Patients’ Rights

1) Right to Preventive Measures

2) Right of Access

3) Right to Information

4) Right to Consent

5) Right to Free Choice

6) Right to Privacy and Confidentiality

7) Right to Respect of Patients’ Time

8) Right to the Observance of Quality Standards

9) Right to Safety

10) Right to Innovation

11) Right to Avoid Unnecessary Suffering and Pain

12) Right to Personalized Treatment

13) Right to Complain

14) Right to Compensation

- WHO: Declaration on the Promotion of Patients’ Rights in Europe

1) Human Rights and values in health care

2) Information

3) Consent

4) Confidentiality and privacy

5) Care and treatment

6) Application

7) Definitions

- The WHO Ljubljana Charter on Reforming Health Care 1996

1) Driven by values

2) Targeted on health

3) Centred on people

4) Focused on quality

5) Based on sound financing

6) Oriented towards primary health care

EUROPEAN CHARTER OF PATIENT´S RIGHTS

HUMAN RIGHTS OF GENERAL APPLICATION

Right to Preventive Measures Right to Health

Right to Access Right to Non-discrimination and Equality

Right to Information Right to Information

Right to Consent Right to Body Integrity; liberty and Security of person; freedom from torture, and cruel, inhuman

degrading treatment; Privacy; HealthRight to Free Choice

Right to Privacy and confidentiality Right to privacy

Right to Respect for Patient´s Time Right to Health

Right to Observance of Quality Standards Right to Health; life

Right to Safety Right to Health; life

Right to Innovation Right to Health; Benefits Of Scientific Progress

Right to Avoid Unnecessary Pain and Suffering Right to Health; freedom from torture, and cruel, inhuman degrading treatment

Right to Personalized Treatment Right to Health; Non-discrimination and Equality

Right to Complain; Compensation Right to a Remedy

How relate the European Charter of Patient´s Rights with the Human Rights of General Application

Possible violation of human rights in patient care?

A detention of a female drug user in a hospital without her consent, and

after giving birth of her child is denied her custody, is a violation of her

Right to Liberty and Security of the Person?

Baby is found dead in the trash inside of a box.

Baby found in the trash inside of a shoes box, but alive.

Possible violation of human rights?

When physicians imposes a drug user pregnant woman to undergo

with an abortion, would it be a violation of human right to body

integrity?

Baby of a woman who used crack during the pregnancy…

Possible violation of human rights?

Detain people without their consent, as they are assumed to lack the capacity to make decisions about their treatment and care, aiming to provide medical treatment for drug use… would it a violation of human right to liberty and body integrity???

Most of the time people do not accept treatment