International Perspectives on Patients' Rights
Makela, Carole J., Journal of Family and Consumer Sciences
Health care is a dynamic issue. Dr. Gro Harlem Brundtland, Director-General of the World Health Organization stated "We have no choice: the well-being of future generations depends on how we act today" (2002, p. 17). In High Noon: 20 Global Problems, 20 Years to Solve Them, the author concluded, "Never have there been such massive opportunities for improving the human condition. Yet never has there been such uncertainty about our ability to grasp these opportunities" (Rischard, 2002, p. 199). These messages apply whether we look globally, nationally, or locally to the health of families and individuals.
In the United States, efforts at enacting health reform and patients' rights have languished in Congress. Policy action in the states has been piecemeal and often targeted at a single issue (e.g., insurance coverage of mental illness). Individuals and families are often faced with complex health decisions as to lifestyle choices, treatment, care, and payment with limited information. Other countries have enacted comprehensive legislation or adopted charters as the basis for consumer rights and responsibilities related to health care. Rights empower consumers to take action and to make changes that improve the quality of life. They provide a benchmark of expectation and empowerment in attaining health care. Responsibilities, though less often delineated with rights, clarify consumers' roles in striving for and attaining an optimal state of health.
Reviewing patients' rights initiatives adopted in other countries provides information for health care consumers in any country, as well as strengthening the foundation for advocacy for a coherent "bill of rights." Despite the diversity of the U.S. health care system as compared to the more nationalistic systems in many countries, there is much to learn from other countries.
The rights initiatives developed by Consumers International, the World Health Organization, The World Medical Association, and the European Union as well as eight countries representing every continent were reviewed in depth in a 2002 presentation, "A comparative analysis of patients' rights: An international perspective," given by M.E. Rider & CJ. Makela. The Consumer Rights, first advocated by President Kennedy and subsequently expanded, were used as the framework to examine the various rights documents. The following examples from the initiatives were chosen to illustrate the potential for motivating consumer expectations, policy advocacy, and public awareness and to identify deficiencies in current practices.
1. Right to adequate, equitable health care: Equal access to public health services; non-discrimination (world/regional organizations model initiatives).
2. Right to information: Informed consent is provided for all treatments (Israel).
3. Right to choice: Treatment alternatives, benefits, risks, and consequences as well as lack of treatment options are made known to patients (Iceland). …