Your Rights as a Patient

You and your physician should be equal partners.

For years, most Americans held medical professionals in high esteem, treating them with the reverence and awe older cultures reserved for priests and wise men. Some medical doctors have done little to discourage this worshipful attitude. They prescribed treatments and performed operations with little concern for obtaining the patient's input beforehand. When they succeeded, the success was all theirs; when they failed, the problem was fate.

Today, the sense that physicians are miracle workers has eroded somewhat, but most of us are still overwhelmed and intimidated by health care and those who provide it. We schedule appointments with doctors who then keep us waiting for hours past the original appointment time. Before we even see the doctor, we fill out reams of forms and answer endless questions from receptionists, medical assistants and office nurses, only to have the doctor finally appear, glance at our chart and ask "So what seems to be the problem?" We submit to tests without any real explanation of what they are intended to reveal, pay big laboratory bills, and in some cases never even learn what, if anything, those tests revealed.

You don't have to take it. As a patient, you have clearly defined legal rights which give you the power to deal with physicians not as a passive supplicant subject to those who provide medical treatment but as an equal partner in managing, maintaining, and improving your health. Let's take a look at those rights and how they help you.

First, you have the right to be fully informed about any medical condition you have and to receive a full and clear explanation of any treatment or surgical procedure your doctor proposes and give your consent before it takes place. This is the legal doctrine known as "informed consent."

Under this doctrine, you must be told what condition you are suffering from, the treatment or procedure that the doctor proposes, the benefits you can reasonably expect if you agree to the treatment, as well as the potential risks involved. You also have the right to know about alternative treatments that may be available, and have an explanation from the doctor as to why he believes that the treatment he recommends is better. Finally, you have the right to know what the probability of success is if you decide to follow the doctor's recommendations.

All of this must be explained to you in as plain a manner as possible, describing all the details of the treatment as specifically as possible, and the doctor must answer any and all questions you have before he obtains your consent. If he fails to do so, he can be charged with battery, or sued for negligence.

Unfortunately, many doctors still resent being questioned by their patient about a proposed course of treatment. They may try to shrug away your concerns about possible complications or your desire for information about alternative forms of treatment. Some doctors even become quite indignant and try to intimidate the patient into "following doctor's orders." Don't let this happen to you. If you don't understand the doctor's diagnosis, ask him to explain it again. If you don't understand why he proposes a particular course of treatment and discourages your consideration of some other procedure, ask him to explain it again. If he tells you that the risks are very small, ask him to be more specific about just how small they are. And don't feel pressured into giving your consent until you've had an opportunity to consider everything you've learned and make a rational decision.

If necessary, take the time to talk with family members, or to get a second opinion. In fact, many health insurers now will pay for a second opinion in order to avoid paying for surgery that the second doctor deems unnecessary. Some Health Maintenance Organizations (HMOs) actually require a second or even a third opinion, for the same reason.

While taking the time to get a second opinion won't be possible in an emergency (for example, your appendix has ruptured and immediate surgery is required), emergencies make up only a small part of the medical treatment most of us receive. Remember, you have the legal right to be fully informed before giving consent to any treatment or procedure your doctor suggests.

Of course, a doctor has the right to refuse to treat a patient (unless he is an emergency room physician), provided that his refusal isn't due to an illegal act of discrimination. If you disagree with your doctor about the manner in which he wants to treat your medical condition, he can legally refuse to provide you with any more services, but only after you have found another doctor, or when enough time has passed in which you could have found one.

In general, anyone over the age of 18 is considered capable of giving consent for his or her own medical treatment, unless mentally incompetent and unable to understand the consequences of giving consent, or when under the influence of drugs or alcohol. For persons under 18, the parent or legal guardian must give consent for treatment before it can take place. In some cases, however, such as treatment for drug or alcohol problems, pregnancy or sexually transmitted diseases, or for purposes of obtaining contraceptives, state laws often permit minors to obtain medical treatment without parental consent.

This leads to one of the more curious situations in modern America. If your 12 year-old daughter falls on the playground at school and skins her knee, you'll probably be called to school to give your consent before she can be bandaged by the school nurse, because the law considers her incapable of giving informed consent to her own treatment. But if the same child wants to obtain birth control pills, you will never know about it from the physicians who prescribe them and the pharmacists who supply them to her, because the law prohibits them from telling you.