Patient Rights Flashcards
In what situation can nurses breach confidentiality?
Harm to others or themselves – Mental Health Act
Infectious diseases
Child abuse – Child and Family Services Act
Elder abuse
Patient’s Bill of Rights (Tommy Douglas Act [2003])
Every resident of Ontario has these rights.
Patient or Client Responsibilities
Treat others with respect
Disclose information important for safe care
Disclose concerns when they disagree with a plan of care
Notify health care providers if unable to keep appointments
Arrive on time, having followed instructions prior to procedures
Respect the needs of other persons
Obligations
An obligation is anything a person must do or refrain from doing in order to permit the full exercise of the rights of another.
The health care practitioner must also ensure that he or she acts in a professional manner and observes all applicable standards of practice.
Informed Consent
To exercise the right to informed consent, patients must be fully informed about their health condition, their prognosis, their treatment options, and the consequences and risks.
Right to Health Information and Teaching
Nurses are required to provide discharged patients (or substitute decision makers) with knowledge and skills to permit them to care for themselves.
Nurses are required to provide discharged patients (or substitute decision makers) with knowledge and skills to gain access to the health care system.
Communicating a Diagnosis
Communicating a diagnosis is a controlled act in Ontario.
A nurse would only be permitted to do so as the holder of an extended certificate (i.e. RN (EC))
When a diagnosis has not been communicated, the nurse should advocate for the patient’s right to be informed
Right to Confidentiality and Duty to Disclosure
The duty to disclose pertinent information may conflict with the obligation to provide care and prevent harm.
Statute law (Acts) requires many circumstances to disclose patient information and conditions.
The nurse must be aware of who/when/where to disclose the information (i.e. CAS, Public Health Unit, Unit Manager, Police, CNO).
Court Testimony
Provincial nursing statutes permit disclosure in the case of legal proceedings such as medical malpractice actions or there is a Coroner’s Inquest.
The nurse should, however, only disclose details relevant to the issues and the information related to their own care provision.
Ensuring Confidentiality in the Treatment Setting
Nurses should take care to prevent being overheard by others when discussing care with a colleague to ensure privacy when discussing problems with a client
Nurses should also take precautions not to disclose confidential information to colleagues, friends, or relatives who have no valid right to such details.
Personal Health Information Protection Act (2004)
All provinces and territories have enacted legislation which protects personal health information.
In Ontario, protected health information includes:
- Physical or mental health information (including patient and family histories).
- Identifying a provider of health care to the individual.
- Insurance, eligibility, or payment information
- Identifying an individual as a donor of any body part or substance.
- Identifying an individual’s substitute decision maker.
Right to Privacy
Nurses are obliged to ensure patient privacy during bathing, examinations, or procedures.
Nurses ensure that unauthorized persons do not view the patient.
Nurses ensure that pictures are not taken without permission, even if done for educational purposes.
Right to Respect
Health professionals have an obligation to treat all clients with respect and dignity.
Nurses who disregard clients’ privacy or fail to involve clients in decisions relevant to them are in violation of their ethical responsibilities.
Rights to be Discharged from a Health Care Facility
Patients have a right to leave a facility against medical advice (AMA).
They are asked to sign a waiver acknowledging that they have been advised against leaving.
Ultimately, it is the patient’s decision, not the health care team’s decision.
