BEHAVIORAL SCIENCES - Universitatea de Medicină şi Farmacie
BEHAVIORAL SCIENCES - Universitatea de Medicină şi Farmacie BEHAVIORAL SCIENCES - Universitatea de Medicină şi Farmacie
ecame enshrined in the research and treatment codes of democratic nations. There have been major changes in the doctor-patient relationship over the past decades; both from patients' and doctors' point of view. There is, indeed, some evidence that changes in society and health care have resulted in real changes in what people expect from their doctors and in how doctors view patients. Many patients want more information than they are given. Many also say that they want to take an active part in decisions about their treatment, in the light of its chances of success and any side effects. Concepts like 'patient empowerment', 'informed consent', 'shared decision making' and 'consumerism' have been introduced to label this transformation of the patient role from that of passive dependency to active autonomy. According to the literature, the traditional paternalistic model is no longer the only, nor the preferred doctor-patient relationship model. There is a wide consensus that a model based on a more equal doctor-patient relationship is both beneficial for patients and more in keeping with current ethical views. Today, most procedures in a hospital are preceded by explanations and discussions at the patient's bedside that make clear all the risks and benefits of the procedure. The consent conversation must be conducted by an MD, and the patient must be able to understand what he or she is being asked to agree to. Reflecting the importance of informed consent in modern health care, an opinion from the current AMA Code of Ethics, on "Fundamental Elements of the Patient-Physician Relationship" states: "The patient has the right to make decisions regarding the health care that is recommended by his or her physician. Accordingly, patients may accept or refuse any recommended medical treatment". As a physician, the doctor-patient relationship greatly impacts the approach to education, motivation, and negotiation of treatment plans. In literature are described the following four models of the physician-patient relationship: Paternalistic - The physician is parental, recommending what he/she feels is best for the patient. The patient chooses whether or not to follow the recommendations. Informative - This is a "consumer" model of care. The physician provides information about all available treatment choices in as 65
accurate and as unbiased a manner as possible. The patient chooses from the available options. Interpretive - In this model, the patient is not expected to simply choose among available options because he/she lacks medical training. Instead, the physician tries to understand or interpret the patient’s general values and preferences. The physician then recommends the treatment option which is most consistent with the patient’s values. Deliberative - In this model, part of the physician’s role is to promote health by influencing the patient’s health-related choices, using non-coercive approaches to motivate the patient. All these model of doctor- patient interaction occur within the limits of professional sets of norms designed to guide the behavior in medical context. One of such a set of norm is A U.S. Patient's Bill of Rights is a statement of the rights to which patients are entitled as recipients of medical care. Typically, a statement articulates the positive rights which doctors and hospitals ought to provide patients, thereby providing information, offering fair treatment, and granting them autonomy over medical decisions. Shrewsbury Surgery Center PATIENT BILL OF RIGHTS 1.Information Disclosure. Consumers have the right to receive accurate, easily understood information and some require assistance in making informed health care decisions about their health plans, professionals, and facilities. 2.Choice of Providers and Plans. Consumers have the right to a choice of health care providers that is sufficient to ensure access to appropriate high-quality health care. 3.Access to Emergency Services. Consumers have the right to access emergency health care services when and where the need arises. Health plans should provide payment when a consumer presents to an emergency department with acute symptoms of sufficient severity -including severe pain -- such that a "prudent layperson" could reasonably expect the absence of medical attention to result in placing that consumer's health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part. 4.Participation in Treatment Decisions. Consumers have the right and responsibility to fully participate in all decisions related to their health care. Consumers who are unable to fully participate in treatment 66
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accurate and as unbiased a manner as possible. The patient chooses from<br />
the available options.<br />
Interpretive - In this mo<strong>de</strong>l, the patient is not expected to<br />
simply choose among available options because he/she lacks medical<br />
training. Instead, the physician tries to un<strong>de</strong>rstand or interpret the patient’s<br />
general values and preferences. The physician then recommends the<br />
treatment option which is most consistent with the patient’s values.<br />
Deliberative - In this mo<strong>de</strong>l, part of the physician’s role is to<br />
promote health by influencing the patient’s health-related choices, using<br />
non-coercive approaches to motivate the patient.<br />
All these mo<strong>de</strong>l of doctor- patient interaction occur within the<br />
limits of professional sets of norms <strong>de</strong>signed to gui<strong>de</strong> the behavior in<br />
medical context. One of such a set of norm is A U.S. Patient's Bill of<br />
Rights is a statement of the rights to which patients are entitled as<br />
recipients of medical care. Typically, a statement articulates the positive<br />
rights which doctors and hospitals ought to provi<strong>de</strong> patients, thereby<br />
providing information, offering fair treatment, and granting them<br />
autonomy over medical <strong>de</strong>cisions.<br />
Shrewsbury Surgery Center PATIENT BILL OF RIGHTS<br />
1.Information Disclosure. Consumers have the right to receive<br />
accurate, easily un<strong>de</strong>rstood information and some require assistance in<br />
making informed health care <strong>de</strong>cisions about their health plans,<br />
professionals, and facilities.<br />
2.Choice of Provi<strong>de</strong>rs and Plans. Consumers have the right to a<br />
choice of health care provi<strong>de</strong>rs that is sufficient to ensure access to<br />
appropriate high-quality health care.<br />
3.Access to Emergency Services. Consumers have the right to<br />
access emergency health care services when and where the need arises.<br />
Health plans should provi<strong>de</strong> payment when a consumer presents to an<br />
emergency <strong>de</strong>partment with acute symptoms of sufficient severity -including<br />
severe pain -- such that a "pru<strong>de</strong>nt layperson" could reasonably<br />
expect the absence of medical attention to result in placing that<br />
consumer's health in serious jeopardy, serious impairment to bodily<br />
functions, or serious dysfunction of any bodily organ or part.<br />
4.Participation in Treatment Decisions. Consumers have the right<br />
and responsibility to fully participate in all <strong>de</strong>cisions related to their<br />
health care. Consumers who are unable to fully participate in treatment<br />
66