Rights of international Patients
Right to information
Every patient has a right to adequate 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 language known to them.
Right to records and reports
Every patient or his caregiver has the right to access originals / copies of case papers, indoor patient records, investigation reports (during period of admission, preferably within 24 hours and after discharge, within 72 hours). This may be made available wherever applicable after paying appropriate fees for photocopying or allowed to be photocopied by patients at their cost.
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 a right to get Emergency Medical care.
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.It is the duty of the hospital management to ensure that all concerned doctors are properly instructed to seek informed consent, that an appropriate policy is adopted and that consent forms with protocol for seeking informed consent are provided for patients in an obligatory manner.
Right to confidentiality, human dignity and privacy
All patients have a right to privacy, and doctors have a duty to hold information about their health condition and treatment plan 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.
1) MCI Code of Ethics sections 2.2, 7.14 and 7.17.7 human dignity and privacy.
2) Annexure 8 of standards for Hospital level 1 by National Clinical Establishments Council set up as per Clinical Establishment Act 2010.
Right to second opinion
Every patient has the right to seek second opinion from an appropriate clinician of patients’ / caregivers’ choice. The hospital management has a duty to respect the patient’s right to second opinion, and should provide to the patients caregivers all necessary records and information required for seeking such opinion without any extra cost or delay.
Right to transparency in rates, and care according to prescribed rates wherever relevant.
Every patient and their caregivers have a right to information on the rates to be charged by the hospital for each type of service provided and facilities available.They have a right to receive an itemized detailed bill at the time of payment.
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 condition, religion, caste, ethnicity, gender, age, sexual orientation, linguistic or geographical /social origins.
Right to safety and quality care according to standards
Patients have a right to safety and security in the hospital premises.They have a right to be provided with care in an environment having requisite cleanliness,infection control measures, safe drinking water as per BIS/FSSAI Standards and sanitation facilities. The hospital management has a duty to ensure safety of all patients in its premises including clean premises and provision for infection control. Patients have a right to receive quality health care according to currently accepted standards, norms and standard guidelines as per National Accreditation Board for Hospitals (NABH) or Joint Commission International(JCI).
Right to choose alternative treatment options
If available Patients and their caregivers have a right to choose between alternative treatment / 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. In case a patient leaves a healthcare facility against medical advice on his / her own responsibility, then notwithstanding the impact that this may have on the patient’s further treatment and condition, this decision itself should not affect the observance of various rights mentioned in this charter.
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.
Similarly when a particular investigation is advised by a doctor or a hospital, the patient and his caregiver have a right to obtain this investigation from any registered diagnostic centre/laboratory having qualified personnel and accredited by National Accreditation Board for Laboratories (NABL).
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. When being transferred from one healthcare facility to another, the patient / caregiver must receive a complete explanation of the justification for the transfer, the alternative options for a transfer and it must be confirmed that the transfer is acceptable to the receiving facility.
1) Medical Council of India code of ethics section 3.6
2) World Health Organisation –Referral Notes
3) Various IPHS documents.
Right to protection for patients involved in clinical trials
Every person / patient who is approached to participate in a clinical trial has a right to due protection in this context. All clinical trials must be conducted in compliance with the protocols and Good Clinical Practice Guidelines issued by Central Drugs Standard Control Organisation, Directorate General of Health Services, Govt. of India as well as all applicable statutory provisions of Amended Drugs and Cosmetics Act, 1940 and Rules, 1945, including observance of the following provisions related to patients rights:
a) Participation of patients in clinical trials must always be based on informed consent, given after provision of all relevant information. The patient must be given a copy of the signed informed consent form, which provides him / her with a record containing basic information about the trial and also becomes documentary evidence to prove their participation in the trial.
b) A participant’s right to agree or decline consent to take part in a clinical trial must be respected and her/his refusal should not affect routine care.
c) The patient should also be informed in writing about the name of the drug / intervention that is undergoing trial along with dates, dose and duration of administration.
d) At all times, the privacy of a trial participant must be maintained and any information gathered from the participant must be kept strictly confidential.
e) Trial participants who suffer any adverse impact during their participation in a trial are entitled to free medical management of adverse events, irrespective of relatedness to the clinical trial, which should be given for as long as required or till such time as it is established that the injury is not related to the clinical trial. In addition, financial or other assistance must be given to compensate them for any impairment or disability. In case of death, their dependents have the right to compensation.
f) Ancillary care may be provided to clinical trial participants for non-study/trial related illnesses arising during the period of the trial. This could be in the form of medical care or reference to facilities, as may be appropriate.
g) Institutional mechanisms must be established to allow for insurance coverage of trial related or unrelated illnesses (ancillary care) and award of compensation wherever deemed necessary by the concerned Ethics Committee.
h) After the trial, participants should be assured of access to the best treatment methods that may have been proven by the study.
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 research participant and every research participant has a right to due protection in this context. Any research involving such participants should follow the National Ethical Guidelines for Biomedical and Health Research Involving Human Participants, 2017 laid down by Indian council for Medical Research and should be carried out with prior approval of the Ethics Committee.
Documented informed consent of the research participants should be taken. Additional safeguards should be taken in research involving vulnerable population. Right to dignity, right to privacy and confidentiality of individuals and communities should be protected.
Research participants who suffer any direct physical, psychological, social, legal or economic harm as a result of their participation are entitled, after due assessment, to financial or other assistance to compensate them equitably for any temporary or permanent impairment or disability.
The benefits accruing from research should be made accessible to individuals, communities and populations whenever relevant.
1) National Ethical Guidelines for Biomedical and Health Research Involving Human Participants, Indian Council of Medical Research, New Delhi, 2017
2) World Medical Assembly Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects available at www.wma.net/en/30publications/10policies/b3/17c.pdf
3) Drugs & Cosmetic Act, Rules 2016 on Clinical Trails
Right to take discharge of patient, or receive body of deceased from hospital
A patient has the right to take discharge and cannot be detained in a hospital, on procedural grounds such as 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 nonpayment/dispute regarding payment of hospital charges against wishes of the caretakers.
The hospital management has a duty to observe these rights and not to indulge in wrongful confinement of any patient, or dead body of patient, treated in the hospital under any circumstances.
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. The hospital management and treating physician have a duty to provide such education to each patient according to standard procedure in the language the patients understand and communicate in a simple and easy to understand manner.
1) The Consumer Protection Act, 1986
2) Standards for Hospital level 1 by National Clinical Establishments Council set up as per Clinical Establishment Act 2010
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.
Patients and caregivers have the right to seek redressal in case they are aggrieved, on account of infringement of any of the above mentioned rights in this charter. This may be done by lodging a complaint with an official designated for this purpose by the hospital / healthcare provider and further with an official mechanism constituted by the government such as Patients’ rights Tribunal Forum or Clinical establishments regulatory authority as the case may be. All complaints must be registered by providing a registration number and there should be a robust tracking and tracing mechanism to ascertain the status of the complaint resolution.
1) The Consumer Protection Act, 1986
2) NHS - Charter of Patient Rights and Responsibilities
1) Prohibition of wrongful confinement under Sec. 340-342 of IPC.
Statements of Mumbai High Court.
2) Consumer Protection Act 1986
Responsibilities of patients and caretakers
Along with promoting their rights, patients and caretakers should follow their responsibilities so that hospitals and doctors can perform their work satisfactorily.
1) Patients should provide all required health related information to their doctor, in response to the doctor’s queries without concealing any relevant information, so that diagnosis and treatment can be facilitated.
2) Patients should cooperate with the doctor during examination, diagnostic tests and treatment, and should follow doctor’s advice, while keeping in view their right to participate in decision making related to treatment.
3) Patients should follow all instructions regarding appointment time, cooperate with hospital staff and fellow patients, avoid creating disturbance to other patients, and maintain cleanliness in the hospital.
4) Patients should respect the dignity of the doctor and other hospital staff as human beings and as professionals. Whatever the grievance may be, patient / caregivers should not resort to violence in any form and damage or destroy any property of the hospital or the service provider.
5) The Patients should take responsibility for their actions based on choices made regarding treatment options, and in case they refuse treatment.