Raising Women’s Voices

Testimony Before the President’s Council on Bioethics: Protecting Patients’ Rights

Posted in Uncategorized by raisingwomensvoices on September 12, 2008

by Lois Uttley on September 12, 2008 – 8:00am

Recently, a great deal of public attention and public policy has been focused on protecting the religious and ethical beliefs of health providers. As your council discusses this issue, I urge you to consider another imperative – protecting the rights of patients to receive accurate medical information and needed treatment in a timely manner. In a pluralistic society such as we have in the United States, public policy must carefully balance the needs and rights of all affected parties.

Let’s use an example to make this discussion very concrete:

A 19-year-old rape victim – let’s call her Sally — is brought to a hospital emergency department by the police. The physician who treats her numerous injuries – Let’s call him Dr. Brown — omits any mention of the potential to prevent pregnancy from the rape by using emergency contraception, because he does not approve of it for religious reasons. Many hours later, Sally leaves the hospital without being informed about emergency contraception, or offered the medication. A friend takes her back to the college dorm where they live and Sally, exhausted, falls asleep for 24 hours. Because emergency contraception is the most effective when taken shortly after unprotected intercourse, Sally’s opportunity to prevent pregnancy has now been greatly diminished.

What has just happened? Is this proper medical care? What are Sally’s rights? What are Dr. Brown’s? And, how should they be properly balanced?
The patient’s rights

Let’s start with Sally. After all, the patient is supposed to be the focus of what the health professions now refer to as “patient-centered care.” According to the Institute of Medicine, “patient-centered care is defined as health care that establishes a partnership among practitioners, patients and their families (when appropriate) to ensure that decisions respect patients’ wants, needs and preferences and solicit patients’ input on the education and support they need to make decisions and participate in their own care.”

One of the central tenets of patients’ rights and “patient-centered care” is the right to informed consent. For a patient to make an informed decision about medical treatment, he or she must have knowledge of all potential treatment options, and their risks and benefits. In this case, the rape victim has not been informed about an important potential treatment option – use of emergency contraception to prevent pregnancy. As it happens, Sally is one of the millions of American women of reproductive age who are not aware of EC. So, Sally has had no opportunity to consider this option or use her own moral, ethical or religious perspectives to decide whether she wishes to risk the chance of bearing the child of a rapist. Further, she has had no chance to discuss with her physician the potential medical complications of an unplanned pregnancy, in view of her existing medical conditions, which include diabetes.

How could this violation of patients’ rights be corrected? The simplest method would be to require all hospital emergency department personnel, including Dr. Brown, to always offer EC to rape victims who are of reproductive age…

For the full article, please visit: http://www.rhrealitycheck.org/blog/2008/09/11/testimony-before-presidents-council-bioethics-protecting-patients-rights

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