“The rights of every man are diminished when the rights of one man are threatened.” – John F. Kennedy (“A quote by John F. Kennedy”, 2019)

Everyone is entitled to human rights and with that comes the responsibility to respect the rights of the next person in an ideal world. But in reality, we are both the distrespecter and the disrespected. To protect our rights and the rights of others we first need to be able to define human rights and know what it consists of. To justify these rights we need to know what is right and wrong, and to know what is right and wrong we need to have a set of morals in place, which varies from person to person.

As a fourth year physiotherapy student I do clinical rotations at various hospitals throughout the year and  I have to work under qualified physiotherapist who are meant to  guide me in the right direction.

There are many incidents in which the human rights have been violated to some extent of both mine and the patients’. I will highlight a few just to make some examples.

According to the National Patient’s Charter, every patient has the right to refuse treatment verbally or in writing (“Here’s What You Need to Know About the Patients’ Rights Charter”, 2015). But is this really true? There have been many occasions where my patient has refused to be treated mostly because of extreme pain and not feeling like participating. I do my part to try to encourage them and inform them about the benefits of what I’m trying to do but they still refuse. I’m very understanding and empathetic by nature and accept their refusal, but when reporting back to the clinician they always say that I need to see the patient and get them out of bed so that they can be discharged because of the lack of bed space. This is very common in the public government hospitals.  I took a deeper look into the whole reasoning behind where this pressure comes from and gave it some thought. The physiotherapist is pressured by the doctor to get the patient mobilising as independently as possible. The patient is given to me as the student to treat but remains the responsibility of the clinician. The pressure of getting patients out of hospital comes from the lack of bed space in our public hospitals, leading to premature discharge, which often leads to readmission due to secondary complications. I am currently working in a surgical ward, and the rate of patients being readmitted for sepsis or falling is shocking. We are creating bed space but for the same patients to fill those beds again. But, in essence, the patient does not actually have the right to say no. For me as a student this is  also a learning experience and I feel that I cannot learn as much when all we have to do is get the patient up to get them out and is this really what physiotherapy is about?

Another incident is where patients are referred for chest physiotherapy when their TB status has not yet been confirmed. The patient became my responsibility to treat and was referred for mobilisation for a neck of femur fracture, chest physiotherapy and a sputum sample.  Because the patient was placed in the surgical ward and all the staff was working in close proximity with him, I did not think I would have to wear a mask. I did my physiotherapy session with him and used some manual techniques but as soon as i was done  the doctor confirmed his physiotherapy status to be positive for pulmonary TB. According to what we have been taught, manual techniques should not be done for patients with active TB, and according to literature, it is not contraindicated but should be done with caution as long as it is discussed with the team and moderate pressure is used to minimise risk of complications (Moses, Ricketts, Ricketts & Hart, 2016). Presentations such as haemoptysis and cavities should be taken into consideration when deciding how to treat these patients(Moses, Ricketts, Ricketts & Hart, 2016). My concern is that the patient had been put at risk because he received treatment which would be a precaution but was not known at the time, the patients around him as well as myself and the other medical staff which have been working with him had their health put at risk. In this scenario everyone’s rights has been infringed in some way or another. This has happened several times when I was working with a patient. I have gotten annoyed that this has happened to me but then I started wearing a mask with every patient I treat. I have safeguarded myself but the patients around the affected patient in the ward are at risk and there have been cases where the patients acquired pulmonary TB in the hospital from patients around them in this specific hospital. Their rights to safe health care have been disrespected and we cannot expect every patient to wear a mask in the wards. What could possibly be done is that the queried patient go to the TB ward, and wear a mask until their status is confirmed. But first we need to get to the solution as to why patients are only being diagnosed with TB after they have spent a few days in the ward, which is enough time to spread the infection, especially when people have weakened immune systems around them.

Here’s What You Need to Know About the Patients’ Rights Charter. (2015, January 23). Retrieved May 23, 2019, from https://www.westerncape.gov.za/general-publication/heres-what-you-need-know-about-patients’-rights-charter

Moses, R., Ricketts, H., Ricketts, W., & Hart, N. (2016). Mechanical airway clearance in patients with pulmonary tuberculosis: is it indicated, contraindicated or used with caution?. Physiotherapy, 102, e195-e196. doi: 10.1016/j.physio.2016.10.237