Navigation Links
Concept of patients' charters 'inadequate'
Date:12/7/2007

The concept of patients charters is inadequate and should be replaced with charters of health responsibilities, argues an expert in this weeks BMJ.

But even these raise ethical tensions, says Harald Schmidt, a research associate at LSE Health.

The British Medical Association (BMA) recently called for a charter setting out the responsibilities patients have within the National Health Service and what patients can expect from the NHS.

Although it lacked detail, it raised questions about the scope, specificity, and status of such a charter, says Schmidt. So he assessed how health responsibility initiatives in three countries have dealt with these questions and looks at the ethical tensions raised.

He examined the 2005 Scottish NHS patients charter: The NHS and You; book V of the 1988 German Sozialgesetzbuch (social security code), revised in 2007; and the Medicaid member agreement, implemented in West Virginia, United States, in 2007.

These documents all apply to publicly funded health programmes but set out responsibilities with varying degrees of specificity, legal status, and enforceability.

The documents all contain explicit health maintenance obligations, such as Look after your own health and have a healthy lifestyle (Scottish charter) and I will do my best to stay healthy (Medicaid agreement).

But Schmidt warns that, while it is easy to make appeals not to risk health, it is far more complicated to decide whether and to what extent people should be held responsible when things go wrong, especially when expensive treatment is required.

He urges clarity about such decisions, especially for documents with a binding status.

The documents also emphasise obligations to contribute to fair and efficient use of healthcare resources, but these may give rise to several problems, he adds.

For example, appeals to only use emergency services in a real emergency may lead people to not request treatment when they need it, or with delay, which may result in poorer overall health and higher costs for the healthcare system.

Similarly, emphasising the need to keep (or cancel) appointments may be unfair for patients who may have good reasons for missing appointments.

With rising healthcare costs, higher burdens of chronic diseases, and increasing evidence about the contribution of genetic and behavioural factors to disease, the issue of personal responsibility for health is here to stay, says Schmidt. There have already been concerns about the decision of some primary care trusts to require, for example, patients to lose weight or stop smoking before routine surgery.

The BMAs proposal for a health responsibility charter, and similar initiatives towards spelling out rights and responsibilities as part of Lord Darzis current review of the NHS, offer unique opportunities to clarify which types of responsibilities are compatible with the ethos of the NHS, and which ones are not, he concludes.


'/>"/>
Contact: Emma Dickinson
edickinson@bmj.com
44-020-738-36529
BMJ-British Medical Journal
Source:Eurekalert

Related medicine news :

1. LUNA Pure Prevention Survey Confirms Breast Cancer Misconceptions
2. Misconceptions About Bipolar Disorder Explained, From the Harvard Health Letter
3. Fluctuating eye pressure associated with visual field deterioration in glaucoma patients
4. Comparison of obstetric outcomes between on-call and patients own obstetricians
5. Vision restoration therapy shown to improve brain activity in brain injured patients
6. Diabetes appears to increase risk of death for patients with acute coronary syndromes
7. Ambulatory oxygen rarely a benefit in COPD patients without resting hypoxemia
8. Restricting Blood Flow May Help Heart Bypass Patients
9. Patients with Medicaid and those lacking insurance have higher risk of advanced laryngeal cancer
10. Study provides hope that some transplant patients could live free of antirejection drugs
11. Study provides hope that some transplant patients could live free of anti-rejection drugs
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... TopConsumerReviews.com recently awarded their highest five-star rating to ... of individuals in the United States and Canada wear eyeglasses. Once considered to be ... vision and make a fashion statement. Even celebrities use glasses as a way of ...
(Date:6/26/2016)... , ... June 26, 2016 , ... On June 10-11, ... of the 2016 Cereal Festival and World’s Longest Breakfast Table in Battle Creek, MI, ... the city’s history as home to some of the world’s leading providers of cereal ...
(Date:6/26/2016)... , ... June 26, 2016 , ... PawPaws brand ... new product that was developed to enhance the health of felines. The formula is ... The two main herbs in the PawPaws Cat Kidney Support Supplement Soft ...
(Date:6/26/2016)... Lake Orion, Clarkston, Michigan (PRWEB) , ... June ... ... direction with respect to fertility once they have been diagnosed with endometriosis. These ... tolerable intercourse but they also require a comprehensive approach that can help for ...
(Date:6/25/2016)... ... June 25, 2016 , ... Austin residents seeking Mohs surgery services, ... Mohs Surgery and to Dr. Russell Peckham for medical and surgical dermatology. , Dr. ... skin cancer. The selective fellowship in Mohs Micrographic Surgery completed by Dr. Dorsey was ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Research and Markets has announced the addition of the ... to 2022" report to their offering. ... financial data derived from varied research sources to present unique ... on the market during the next five years, including a ... markets, regional and country level analysis. The report provides a ...
(Date:6/23/2016)... , June 23, 2016 Research and ... News Issue 52" report to their offering. ... influenza treatment creates a favourable commercial environment for MedImmune to ... patient base that will serve to drive considerable growth for ... would serve to cap sales considerably, but development is still ...
(Date:6/23/2016)... Calif. , June 23, 2016 ... CST on Thursday, July 7, 2016 , , , , ... ) , , , , EXPERT PANELISTS:  , , ... Naik; Senior Industry Analyst, Christi Bird; Senior Industry Analyst, Divyaa Ravishankar ... The global pharmaceutical industry is witnessing an exceptional ...
Breaking Medicine Technology: