Take second opinion before surgery in India –
Before you say yes to an operation, you should discuss the following questions with your operating surgeon:
- Indications for the operation?
- How is the operation expected to improve my health or quality of life?
- Are there likely to be any side effects from the operation?
- Alternative forms of treatment ?
- Likely fallout if I don’t have the operation?
Taking an additional opinion has always been a part of good medical practice, and a competent surgeon should not be insulted if you decide to get further second opinion before undergoing a surgical procedure. If you do want a second opinion, here are some things to remember:
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If, after discussing these questions with your surgeon, you feel confident that a surgical procedure is the best treatment for your condition, you probably don’t need a second opinion.
But if you are not so sure — you have doubts about whether the operation should be performed, or if the doctor recommending the operation is not a qualified surgeon, you may want to seek a second opinion consultation.
1. Seek Qualified Advice
A consultation is not worth much unless it is given by someone with the knowledge of and expertise in treating your condition. Always seek consultation from a surgeon who is a qualified surgical specialist. A good way to judge a surgeon’s expertise is by having a look at his /her qualifications and the hospitals where they are associated.
If you are unsure of a surgeon’s qualifications, contact your family doctor, your local or state medical society, the hospital where the surgeon practices, or the surgical department of the nearest medical school.
2. The Decision Is Yours
Remember, the final decision will be yours. It’s a decision that should be made with all the facts, so don’t hesitate to discuss with your surgeon any questions or concerns you may have.Feel free to ask all your doubts and concerns. Taking a well informed decision before embarking on a surgical journey is almost like completing 50 % of the work before actually starting the work.
Its important to know that according to a study done at John Hopkins, 33% of the patients have a change of diagnosis and surgery after a second opinion re evaluation patients symptoms.
The Ministry of Health and Family Welfare, Government of India has proposed a ‘Charter of Patient Rights’ to be implemented by state governments.
What is a ‘Charter of Patient Rights’?
A patient is entitled to a certain amount of protection to be ensured by physicians, healthcare providers, and the state, which have been codified in various societies and countries in the form of Charters of Patient’s Rights.
Legal documents on patient’s rights
In India, there are various legal provisions related to patient’s rights which are scattered across different legal documents, such as:
- The Constitution of India, Article 21
- Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002
- The Consumer Protection Act 1986
- Drugs and Cosmetic Act 1940
- Clinical Establishment Act 2010 etc.
Why is there a need for this draft?
- This document will act as a guidance document for the union and state governments to formulate concrete mechanisms so that the rights of the patients are given adequate protection. Also, operational mechanisms are set up to make these rights functional and enforceable by law.
- Another objective of this charter is to generate widespread public awareness and educate citizens regarding what they should expect from their governments and health care providers about the kind of treatment they deserve as patients and human beings, in healthcare settings.
What is the situation of patient’s rights in India?
India does not have a dedicated regulator like other countries.
Some states have adopted the national Clinical Establishments Act 2010, while other states have enacted their own state-level legislation like the Nursing Homes Act to regulate hospitals, and a few other states are in the process of adopting/developing such regulations.
The charter defines 17 rights of a patient listed below:
1. Right to Information
- Every patient has a right to adequate and relevant information about the nature, cause of illness, provisional/confirmed diagnosis, proposed investigations and management, and possible complications to be explained at their level of understanding in a language known to them
- Patients and their designated caretakers also have a right to know the professional status of various care providers who are providing service to the patient.
2. Right to Records and Reports
- Every patient or his caregiver has the right to access originals/copies of case papers, indoor patient records, and investigation reports (during a period of admission, preferably within 24 hours and after discharge, within 72 hours)
- This should be made available after paying appropriate fees for photocopying or allowed to be photocopied by patients at their cost.
3. Right to Emergency Medical Care
- As per Supreme Court, all hospitals both in the government and in the private sector are duty bound to provide basic emergency medical care, and injured persons have the right to get emergency medical care
- Such care must be initiated without demanding payment/advance, and basic care should be provided to the patient irrespective of paying capacity.
4. Right to Informed Consent
- Every patient has a right that informed consent must be sought prior to any potentially hazardous test/treatment (e.g. invasive investigation/surgery/chemotherapy) which carries certain risks
- The doctor may proceed only if consent has been given in writing by the patient/caregiver or in the manner explained under the Drugs and Cosmetic Act Rules 2016 on informed consent.
5. Right to Confidentiality, Human dignity, and Privacy
- All patients have the right to privacy, and doctors have a duty to hold information about their health conditions and treatment plans in strict confidentiality unless it is essential in specific circumstances to communicate such information in the interest of protecting other or due to public health considerations
- Female patients have the right to a presence of another female person during physical examination by a male practitioner.
6. Right to Second Opinion
- Every patient has the right to seek the second opinion from an appropriate clinician of patients’ or caregivers’ choice. The hospital management has a duty to respect the patient’s right to second opinion and should provide to the patient’s caregivers all necessary records and information required for seeking such opinion without any extra cost or delay
- Any kind discriminatory practice adopted by the hospital or the service providers will be deemed as Human Rights’ violation.
7. Right to Transparency in Rates and Care As Per Prescribed Rates
- Every patient and their caregivers have the right to information on the rates to be charged by the hospital for each type of service provided and facilities available on a prominent display board and a brochure. They have the right to receive an itemized detailed bill at the time of payment
- It would be the duty of the to display key rates at a conspicuous place in local as well as the English language and to make available the detailed schedule of rates in a booklet form to all patients/caregivers.
8. Right to Non-Discrimination
Every patient has the right to receive treatment without any discrimination based on his or her illnesses or conditions, including HIV status or other health conditions, religion, caste, ethnicity, gender, age, sexual orientation, linguistic or geographical/social origins.
9. Right to Safety and Quality Care According to Standards
Patients have a right to safety and security in the hospital premises. They have the right to be provided with care in an environment having requisite cleanliness, infection control measures, and safe drinking water as per BIS/FSSAI Standards and sanitation facilities.
10. Right to Choose Alternative Treatment Options if Available
- Patients and their caregivers have the right to choose between alternative treatment and management options, if these are available, after considering all aspects of the situation
- This includes the option of the patient refusing care after considering all available options, with responsibility for consequences being borne by the patient and his/her caregivers.
11. Right to Choose Source for Obtaining Medicines or Tests
- When any medicine is prescribed by a doctor or a hospital, the patients and their caregivers have the right to choose any registered pharmacy of their choice to purchase them
- Similarly, when a particular investigation is advised by a doctor or a hospital, the patient and his caregiver have the right to obtain this investigation from any registered diagnostic centre/laboratory having qualified personnel and accredited by National Accreditation Board for Laboratories (NABL).
12. Right to Proper Referral and Transfer, which is free from perverse commercial influences
A patient has the right to continuity of care, and the right to be duly registered at the first healthcare facility where treatment has been sought, as well as at any subsequent facilities where care is sought.
13. Right to protection for patients involved in clinical trials
- Every person/patient who is approached to participate in a clinical trial has the right to due protection
- All clinical trials must be conducted in compliance with the protocols and good clinical practice guidelines issued by the Central Drugs Standard Control Organisation and other applicable provisions.
14. Right to Protection of Participants Involved in Biomedical and Health Research
- Every patient who is taking part in biomedical research shall be referred to as a research participant and every research participant has a right to due protection
- Any research involving such participants should follow the National Ethical Guidelines for Biomedical and Health Research involving human participants
15. Right to Take Discharge of Patient, or Receive Body of Deceased from Hospital
- A patient has the right to take the discharge and cannot be detained in a hospital, on procedural grounds such as a dispute in payment of hospital charges
- Similarly, caretakers have the right to the dead body of a patient who had been treated in a hospital and the dead body cannot be detailed on procedural grounds, including non-payment/dispute, regarding payment of hospital charges against wishes of the caretakers.
16. Right to Patient Education
Patients have the right to receive education about major facts relevant to his/her condition and healthy living practices, their rights and responsibilities, officially supported health insurance schemes relevant to the patient, relevant entitlements in case of charitable hospitals, and how to seek redressal of grievances in the language the patients understand or seek the education.
17. Right to be heard and seek redressal
Every patient and their caregivers have the right to give feedback, make comments or lodge complaints about the health care they are receiving or had received from a doctor or hospital. This includes the right to be given information and advice on how to give feedback, make comments, or make a complaint in a simple and user-friendly manner.
(Source: The Ministry of Health and Family Welfare)
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