Доверяете ли Вы врачам???

It has long been recognized that successful medical care requires an ongoing collaborative effort between patients and physicians. Physician and patient are bound in a partnership that requires both individuals to take an active role in the healing process. Such a partnership does not imply that both partners have identical responsibilities or equal power. While physicians have the responsibility to provide health care services to patients to the best of their ability, patients have the responsibility to communicate openly, to participate in decisions about the diagnostic and treatment recommendations, and to comply with the agreed-upon treatment program.

Like patients’ rights, patients’ responsibilities are derived from the principle of autonomy. The principle of patient autonomy holds that an individual’s physical, emotional, and psychological integrity should be respected and upheld. This principle also recognizes the human capacity to self-govern and choose a course of action from among different alternative options. Autonomous, competent patients assert some control over the decisions which direct their health care. With that exercise of self-governance and free choice comes a number of responsibilities.

(1) Good communication is essential to a successful patient-physician relationship. To the extent possible, patients have a responsibility to be truthful and to express their concerns clearly to their physicians.

(2) Patients have a responsibility to provide a complete medical history, to the extent possible, including information about past illnesses, medications, hospitalizations, family history of illness, and other matters relating to present health.

(3) Patients have a responsibility to request information or clarification about their health status or treatment when they do not fully understand what has been described.

(4) Once patients and physicians agree upon the goals of therapy and a treatment plan, patients have a responsibility to cooperate with that treatment plan and to keep their agreed-upon appointments. Compliance with physician instructions is often essential to public and individual safety. Patients also have a responsibility to disclose whether previously agreed upon treatments are being followed and to indicate when they would like to reconsider the treatment plan.

(5) Patients generally have a responsibility to meet their financial obligations with regard to medical care or to discuss financial hardships with their physicians. Patients should be cognizant of the costs associated with using a limited resource like health care and try to use medical resources judiciously.

(6) Patients should discuss end-of-life decisions with their physicians and make their wishes known. Such a discussion might also include writing an advance directive.

(7) Patients should be committed to health maintenance through health-enhancing behavior. Illness can often be prevented by a healthy lifestyle, and patients should take personal responsibility when they are able to avert the development of disease.

( Patients should also have an active interest in the effects of their conduct on others and refrain from behavior that unreasonably places the health of others at risk. Patients should inquire as to the means and likelihood of infectious disease transmission and act upon that information which can best prevent further transmission.

(9) Participation in medical education is to the mutual benefit of patients and the health care system. Patients are encouraged to participate in medical education by accepting care, under appropriate supervision, from medical students, residents, and other trainees. Consistent with the process of informed consent, the patient or the patient’s surrogate decision maker is always free to refuse care from any member of the health care team.

(10) Patients should discuss organ donation with their physicians and, if donation is desired, make applicable provisions. Patients who are part of an organ allocation system and await needed transplant should not try to go outside of or manipulate the system. A fair system of allocation should be answered with public trust and an awareness of limited resources.

(11) Patients should not initiate or participate in fraudulent health care and should report illegal or unethical behavior by physicians and other providers to the appropriate medical societies, licensing boards, or law enforcement authorities. (I, IV, VI)

Principles of Patients Rights' and Responsibilities was developed and Approved by the National Health Council Board of Directors, January 1995 1 (Directors 1995)

ALL PATIENTS, TO THE EXTENT CAPABLE, HAVE THE RESPONSIBILITY TO:

(It is recognized that patients may suffer significant physical and/or mental conditions which may limit their ability to fulfill these responsibilities.)
PURSUE HEALTHY LIFESTYLES.
Patients should pursue lifestyles known to promote positive health results, such as proper diet and nutrition, adequate rest, and regular exercise. Simultaneously, they should avoid behaviors known to be detrimental to one's health, such as smoking, excessive alcohol consumption, and drug abuse.
BECOME KNOWLEDGEABLE ABOUT THEIR HEALTH PLANS.
Patients should read and become familiar with the terms, coverage provisions, rules, and restrictions of their health plans. They should not be hesitant to inquire with appropriate sources when additional information or clarification is needed about these matters.
ACTIVELY PARTICIPATE IN DECISIONS ABOUT THEIR HEALTH CARE.
Patients should seek, when recommended for their age group, an annual medical examination and be present at all other scheduled health care appointments. They should provide accurate information to providers regarding their medical and personal histories, and current symptoms and conditions. They should ask questions of providers to determine the potential risks, benefits, and costs of treatment alternatives. Where appropriate, this should include information about the availability and accessibility of experimental treatments and clinical trials. Additionally, patients should also seek and read literature about their conditions and weigh all pertinent factors in making informed decisions about their care.
COOPERATE ON MUTUALLY ACCEPTED COURSES OF TREATMENT.
Patients should cooperate fully with providers in complying with mutually accepted treatment regimens and regularly reporting on treatment progress. If serious side effects, complications, or worsening of the condition occur, they should notify their providers promptly. They should also inform providers of other medications and treatments they are pursuing simultaneously.
1 National Health Council Board of Directors. “Principles of Patients Rights' and Responsibilities,” (National Health Council Principle, 1995) Washington D.C.

Maintaining Your Rights as a Patient

By Trisha Torrey
Updated April 08, 2010

In a discussion of patients' rights, it's also important to review patients' responsibilities. Just as we have rights as American citizens (the right to vote, for example), we have corresponding responsibilities that help maintain those rights (the responsibility of going to the polls to vote.) The same is true for our medical care.

Maintaining Healthy Habits

That proverbial ounce of prevention is most definitely more effective and efficient that the corresponding pound of cure. Making healthy food choices, getting plenty of exercise, resolving stress, getting enough sleep, moderating alcohol consumption, and refraining from smoking are those good habits we are all familiar with -- and most of us need to work on.
Being Respectful to Providers

Just as it's a patient's right to expect respect, it is the patient's responsibility to show respect in return. This is not to suggest that patients need to be so respectful that they are afraid to ask questions or request clarification on issues regarding their health. Rather, it's a recognition that commanding respect means giving it in return -- on both sides of the patient/provider equation.
Being Honest With Providers

As an empowered patient, you recognize that being totally honest with your practitioner is imperative. This means sharing all information about your habits and health, as holding back can mean not getting the care that you need.
Complying with Treatment Plans

Since you and your doctor will have worked together to agree on a treatment plan, it only makes sense to comply with that plan. Not doing so works against the good care you've put effort into securing.
Preparing for Emergencies

For those who have medical challenges and/or take prescription drugs to maintain their health, it is important to be prepared for medical emergencies. If you find yourself in an emergency room, you'll want to be sure hospital personnel know about the treatments you are already receiving, or the cautions needed for effective treatment.
Reading Behind the Headlines

We see news every day about some new study that changes the way we see certain diseases or conditions. Sometimes the headlines don't tell the whole story. As an empowered patient, you know to look behind those headlines to find out if they apply to you.
Making Decisions Responsibly

In the face of a frightening diagnosis, or a scary treatment option, it's difficult to leave our emotions out of our decisions. We need to make sure our decisions about our care are based on solid evidence and proven procedures, rather than wishful thinking.
Understanding Prescription Drugs and Their Possible Effects

There are so many possibilities for drug-related medical errors that we need to take responsibility for double-checking all prescriptions, then comparing them to the drug the pharmacist delivers to us. This is a safety question that all empowered patients must address.
To learn more about potential side effects of a drug you're on, visit About.com's Drug Finder.
Meeting Financial Obligations

Patients have the right to choose their insurance or other means for paying for their healthcare, and that right is balanced by the responsibility of taking care of those payments or corresponding financial obligations. There is no question that medical costs can become difficult and cumbersome, but they do need to be dealt with responsibly.
Reporting Fraud and Wrongdoing

We've all heard of medical payment fraud, whether it's through taking advantage of Medicare laws or billing for services not rendered through public or private medical payment assistance. These violations serve to line the pockets of those who don't deserve that extra money, while forcing all citizens to pay out of their own pockets in the form of higher premiums, copays, coinsurance or Medicare taxes. It is the responsibility of patients who become aware of such fraudulent activity to report it to those who can stop it.
Avoiding Putting Others at Risk

At one extreme, we see and hear news reports about a tuberculosis patient who travels the world, potentially infecting someone else, or about a person with AIDS who passes on his disease intentionally.
At the other extreme, we send our kids to school, knowing they are running a mild fever or coughing and sneezing from an upper respiratory problem. Not to be forgotten is the dangerous workplace, or the highway bridge that is unsafe, or the playground built on a toxic waste dump.

In the United States, we have an obligation not to harm others either through intentional or unintentional means. It's our responsibility to act in such a way that we keep others from being infected or injured. In some cases, there are laws that speak to this responsibility, warranting eventual arrest or a lawsuit. In others, it's simply common sense or even the golden rule.

Of course, all these responsibilities help us maintain our rights as patients in the United States. You might also be surprised to learn what healthcare rights we do not have in the United States.