A framework of basic rights for patients in South Africa is provided by The National Health Act, 108 of 1996 (Health24, 2017). This is called the Patients’ rights charter that was issued in November 1999. This charter was created to ensure the realization of the right to access health services. This is a document of the state that obliges the Department of Health morally and legally to fulfill, protect, uphold and promote patients’ rights. This is a framework providing patients in South Africa with all their rights and responsibilities. One of the rights in the Patient Rights Charter states that citizens of South Africa have the right to emergency treatment as well as the right to participate in decision making regarding their health (Health24, 2017). Therefore, decisions regarding the patient’s health cannot only be taken by the health care professionals. The patient or members of the patient’s family is also part of the decision-making process.
While on clinical practice, I encountered a situation where a patients’ rights were violated. The patient had suffered a CVA two weeks ago and I have been treating him ever since. He was diagnosed with left hemiplegia and aphasia. His highest functional level was rolling in bed with assistance. Therefore, he needed maximal assistance with most tasks of daily living.
Last week the patient had a temperature spike and it was obvious that the patient was deteriorating. However, I continued with my physiotherapy session due to the patient still being stable and safe to treat. While busy with my session the dietitian walked in and said I should leave the patient alone due to him being on his “death bed”. The dietitian was denying the patients’ right to health care. However, I continued with my physiotherapy session due to the patient having a right to health care. The next day the patient got placed in a rehab facility where he will undergo further rehabilitation.
When looking at the bigger picture, decisions to stop or withhold treatment are common in the intensive care unit. This leads to the majority of deaths. It is straightforward to stop treatment when the health professionals and family agrees that the patient would not benefit from medical treatment. However, it becomes complicated when the health professionals and family disagrees on treatment that should or should not be given. This disagreement arose to the concept of futility. Futility can be described as medical inappropriate treatment. It is treatment that has low efficacy benefits to the patient and treatment that doctors believe should not be given (Wilkinson & Savulescu, 2011).
The National Health Act, 108 of 1996 is an important framework that should be followed by health professionals. The patients should know their rights to treatment as stated in the Patients’ Rights Charter. This will allow them to advocate for their rights if their rights are denied. In some cases, as mentioned above patients are unable or struggle to speak. Therefore, they cannot demand their rights and their health professionals should advocate for their patients’ rights and make sure that fellow employers do the same. However, this becomes difficult if there is a disagreement among the health professionals about the treatment.
Furthermore, there are still several other problems preventing realization of patient’s rights within South African public health sector. These several problems include under supply of medicine and hospital linen, unacceptable physical (buildings) environment and unsafe security arrangements, staff shortages, lack of a patient’s rights culture, ineffective and weak management and leadership and lastly lack of emphasis on patients’ responsibilities (Nevhutalu, 2016).
Therefore, it will always be a difficult decision if treatment should be continued or withdraw when a patient is on his “death bed”. Until the several problems have been solved, patient’s rights in South African public hospitals will not be carried out effectively. Steps need to be put in place to diminish the underlying causes that prevent realizations of patient’s rights. However, do you give futility treatment due to the patient having a right to treatment or do you allow the patient to die with dignity?
References
Health24. (2017, March 14). Know your rights and responsibilities. Retrieved from Health 24: https://www.health24.com/Medical/Cancer/Campaigning-for-cancer/Know-your-rights-and-responsibilities-20120721
Nevhutalu, H. K. (2016). Patients’ rights in South Africa’s public health system. 84-114 159-174.
Wilkinson, D., & Savulescu, J. (2011). Knowing when to stop: futility in the intensive care unit. Current opinion in anaesthesiology, 160-165.
3 thoughts on “Futility of patients’ rights”
Hi Megs,
This topic is very relevent and its true that the patients right should still be considered regardles of the situation, your topic overlaps with another ethical topic the meaning of life and death, maybe you can see what literature says about when is would be effective to stop treatment in the case stated above, even though the patient has the right to health care, it kind of leaves a large ambinguity so we don not really have an answer to when we should stop or if we should just oblige with the rights charter.
The structure seems to make sense and flow, your argument seems strong but make it stronger by adding what i said above and then counteract that and it will maybe enhance and make your claim stronger about the importance of the rights.
Good references
Correct these errors:
– responsibly_ responsibility
– citizens of South Africa have the right to emergency treatment as well as the right to participate in decisions making( decision making) regarding their health
– While on clinical practice, I encountered…
– and their health care takers should advocate for the..
– The rights as defined in the Patients’ rights charter are justiciable, consequently and have hard protection offered by law binding decisions of the South African courts
– However, there are still several problems preventing realisation of patient’s rights within South African public health sector.
– try using less “and”, replace them with commas.
Thank you for providing me with some insight Megan, ypur piece left me with more questions and is also helping me see the importance of rights and in the same breath apprecitating the importanance of making decisions on behalf of the patient but also giving me an apprecitation for my own life.
Thank you and all the best.
Sass x
Hi Megan
Thank you for your piece on patient rights. Your topic is relevant and relates to the content covered in class.
Patients rights should always be considered, however I find that during clinical practise we explain to patient what we are there for and ask them if it is okay for us to treat them, but we never tell them that they have the right to refuse treatment.
To improve your piece you can try and find literature on who makes the decision that the patient is on her death bed and when they should no longer receive treatment. You can also try and add the views of the OT and Speech therapist.
Try and think of the topic of meaning of life and death as it links to your topic.
Your references are more than adequate. The flow of you piece is good, I like that you did not use long sentences.
I suggest you start with a more interesting opening sentence to capture the readers attention.
Grammar
Paragraph 1: Line 5-Resposibly to responsibilities.
Line 6-Decisions making to decision making.
Paragraph 2: Line 1-“spiked a temperature” to had a temperature spike.
After clinical practice add a comma before I.
Your piece got me thinking of my own clinical experience as I treated a patient who I thought was not clinically well and deteriorating. I did not want to treat him, but still did because he had a right to refuse treatment. He refused treatment on a Monday, treated him on Tuesday and he died the Wednesday. I suggest you always do what you think is best for your patient as long as it goes hand in hand with their rights.
Thank you
Robert.
Hi Magen
I enjoyed reading your writing as it was highly informative. I have had similar experiences in the hospital in the sense that I have witnessed various patients who have had their rights violated and no one can advocate for them.
The content in the writing is relevant to the ethics module as human rights are fundamental when discussing morals and ethics. I like how you introduced the topic by giving a brief background followed by an experience which relates to your story. There are various sources that you have used in to support the statement that there are patients whose rights have been violated but you have not given enough reflection on the experience and as a result, your writing is mostly information about human right as appose to the reflection of the experience.
The ethical dilemma I have identified is that there is a compromise of patients rights in the hospital in order to spare resources. Although you have identified the reasons for this compromise I feel like you can expand on those ideas in order to highlight the ethical dilemma of the situation better.
References
In text and reference list looks fine
grammer and spelling
Make changes as indicated in the first two comments. Just correct the one mistake which was missed and change paragraph 2 sentence one discriminated → violated because discrimination means prejudice towards someone due t a characteristic that they have.
I hope my suggestions help you to improve your writing. Goodluck
kind regards
Mfundgo