Practicing patients’ rights in Iran: a review of evidence

Protection of patients' rights is critical in improving healthcare quality, and hence this study aimed at reviewing patient rights’ practices in healthcare organizations of Iran. Using systematic search, this review was conducted based on Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Several keywords, including "patient rights", "patient bills of rights" and "patients rights’ charter" were searched bilingually in the databases of SID, Magiran, PubMed, Scopus, and Web of Science from 2010 to 2021, and then, following a three-tier screening using the Critical Appraisal Skills Program (CASP) checklists, 76 articles were extracted. The degree of compliance with the Patients' Rights Charter (PRC) in healthcare organizations was 60.88% on average. As to the observance of the PRC dimensions, respectively, the highest and lowest scores were related to the "right to privacy and confidentiality" (70.16%) and "right to access an efficient complaining system" (53.01 %). Respect for patients' rights in organizations was assessed at a moderate level, and some aspects of patients' rights should be attended to immediately. Therefore, discrepancies in the dimensions of patients' rights and their implementation by organizations should be on the agenda of healthcare managers and policymakers.

Comparative pharmacoeconomic analysis of the use of erythropoiesis-stimulating drugs for the treatment of anemia in cancer patients

Introduction. Currently, a number of pharmacoeconomic studies describing use of erythropoietin stimulating agent (ESA) in cancer patients with anemia have been published, however, most of the publications on this topic are foreign. At the same time, there are practically no studies comparing the economic efficiency of various ESA preparations with each other. Some of works by foreign colleagues reflect that the clinical efficacy of using ESA namely the degree of increase in Hb, significantly depends on the patient’s body weight: the higher the weight, the greater the dose of EPO is required for a single administration and a course of therapy.Aim. Сomparative pharmacoeconomic analysis of epoetin alfa usage for the treatment of anemia in adult cancer patients with weight 80 kg.Materials and methods. The following drugs were selected for comparative analysis: epoetin alfa, epoetin beta, darbepoetin. Clinical efficacy was assessed in terms of the rate of in Hb level increase. Pharmacoeconomic analysis was carried out using the cost-effectiveness method (CEA).Results. Тhe usage of epoetin alfa 12,000 IU for 8 weeks therapy course in cancer patients weighting over 80 kg had a better cost-effectiveness ratio compared to epoetin alfa (10,000 IU, 30,000 IU, 40,000 IU) and darbepoetin, giving way in price only to the cheapest epoetin beta which can be administered 4 injections simultaneously. Its the infringement of patients rights to avoid additional pain. Its the infringement of patients rights to avoid additional pain. At the 16th week of therapy, the usage of epoetin alfa 12,000 IU had an advantage over all ESA.Conclusions. Тhe usage of russian epoetin alfa 12,000 IU for the treatment of anemia in adult cancer patients weighing over 80 kg approximately in real clinical practice in Russian Federation is an economically justified approach to the medical care organization.

Civil Unions (Non – Registered Partnerships) and Patients’ Rights: Problematics and the Future Perspective

Unlike the institution of matrimonial law, which has developed over several hundred years and thus has a solid legal basis, the legal framework for non-registered partnerships is a relatively recent legal phenomenon, which therefore also means that the legal framework in those countries where it is applied is not uniform and there are significant differences between different legal systems. The legal framework of non-registered partnerships is influenced by the traditions, history, culture, religion, and other factors of the country and its population. With the development of non-registered partnerships, new challenges are emerging in various fields, including healthcare in terms of ensuring patients’ rights. This results in a situation where there is a lack of regulation in society to protect all families, regardless of whether the family is based on a registered or non-registered partnership. The purpose of the article is to clarify the role, and importance, as well as crucial problematics of non-registered partnerships from the patients’ point of view. The methodological basis of the research includes general theoretical principles of scientific knowledge. This knowledge provides various aspects in the study of non-registered partnerships and the patients’ rights in healthcare. The scientific novelty is to identify the essence and importance of the fundamental rights of each person and to clarify the legal problematics of the non-registered partnership institution that influence patients’ rights in the decision-making process.

Focus group findings on clinicians’ perceived barriers and facilitators to giving rights information to involuntary psychiatrics patients in British Columbia, Canada

Background In British Columbia, Canada, clinicians are responsible for giving information about rights to patients involuntarily hospitalized under the Mental Health Act. But a survey commissioned by the Ministry of Health and an investigation by the BC Office of the Ombudsperson found that patients were not consistently receiving rights information. Methods Focus groups were used to probe clinicians’ perceived barriers and facilitators to giving patients rights information. Focus group transcripts were thematically analyzed, and the themes were coded using the Theoretical Domains Framework to identify interventions that could encourage clinicians to consistently give patients complete rights information. Results Eighty-one psychiatric clinicians participated. Analysis identified these barriers: (a) clinicians receive inadequate training on the Mental Health Act and rights notification; (b) newly admitted patients might not be receptive to new information; (c) the tool used to communicate rights to patients is inadequate; (d) many patients don’t speak English; (e) clinicians have competing priorities during the admission process; (f) clinicians face pressure from other staff to give incomplete information; (g) the clinical workflow doesn’t facilitate follow-up and accountability; and (h) staff don’t receive enough support from their employer. The following facilitators were identified: (a) a team approach allows clinicians to share knowledge about the Mental Health Act and rights notification, (b) having one person take responsibility for rights information clarifies roles and increases accountability, (c) accreditation reminds clinicians of the importance of giving patients rights information, and (d) checklists remind clinicians of their rights-notification responsibilities. Conclusions These interventions may help clinicians give rights information more consistently: (a) training about the Mental Health Act and rights notification, (b) an accessible legal resource for clinicians and patients, (c) regular group sessions about rights for patients, (d) an improved rights-communication tool, in multiple languages, and (e) checklists, reminders, and accountability and feedback systems.

Philosophy, Law, and Ethics of Handling COVID-19 Pandemic in Indonesia

BACKGROUND: During the pandemic, COVID-19 spread very quickly between people. Thus, the patients’ rights to obtain treatment do not have to decrease the protection of the public. The perspectives of ethics, law, and justice prioritize the rights of the public as stated in the principle “Salus Populi Suprema Lex Esto” (Public safety is the highest law as regulated in the law). METHODS: This research employs the statute approach with comprehensive, all-inclusive, and systematic manners to the ratio legis of the Health Law. It also uses the philosophy approach. RESULTS: In Indonesia, the regulatory handling of the COVID-19 pandemic is based on the Law on Infectious Disease Outbreak. During the COVID-19 pandemic, the quick spread of this disease causes many fatalities. Thus, individual rights of patients must be ruled out to prioritize public rights. CONCLUSION: The legal perspective upholds the “Salus Populi Suprema Lex Esto” principle, namely, public safety is the highest law was the core of philosophy, law and ethics handling covid 19 pandemic.

Reporting violations of European Charter of Patients’ Rights: analysis of patient complaints in Croatia

Background The European Charter of Patients' Rights (ECPR) presents basic patients' rights in health care. We analysed the characteristics of patients' complaints about their rights submitted through the official complaints system and to a non-governmental organization in Croatia. Methods The official system for patients’complaints in Croatia does not have a common pathway but offers different modes for addressing patient complaints. In this cross-sectional study, we analysed the reports about patients’ complaints from the official regional committees sent to the Ministry of Health. We also analysed the complaints received by the Croatian Association for the Protection of Patient’s Rights (CAPR) and mapped them to the ECPR. Results The aggregated official data from the Ministry of Health in 2017 and 2018 covered only 289 individual complaints from 10 out of 21 counties. Complaints were most frequently related to secondary and tertiary healthcare institutions and details were not provided. CAPR received a total of 440 letters, out of which 207 contained 301 complaints about violations of patients’ rights in 2017–2018. The most common complaint was the Right of Access to health care (35.3%) from the ECPR, followed by the Right to Information (29.9%) and the Right to Safety (21.7%). The fewest complaints were about the Right to Complain (1.9%), Right to Innovation (1.4%), Right to Compensation (1.4%), and Right to Preventive Measures (1.0%). Conclusions Reporting and dealing with patients’ complaints about violations of their patients’ rights does not appear to be effective in a system with parallel but uncoordinated complaints pathways. Mapping patient's complaints to the ECPR is a useful tool to assess the perception of patients’ rights and to plan actions to improve the complaints system for effective health care.

Seclusion Management in an Acute In-Patient Unit

<p>Trends in modern day mental health facilities have been towards the least restrictive environment with emphasis on patients’ rights, but these rights have to be balanced against the safety of both the patients themselves and anyone else in the immediate environment. One way of restricting a person’s movement is through the use of seclusion, a means of isolating a person in a locked room with minimal stimulus and from where that person cannot freely exit. This study was developed to explore the use of seclusion in an acute in-patient unit for people with mental illnesses. Investigation into this issue was considered important due to an identified large increase in seclusion use over the previous two years. The study used a qualitative research methodology with a descriptive and interpretive approach. Data collection included a retrospective file audit of patients who had been secluded over the past seven years, and one-to-one staff interviews. I also included some personal reflections of seclusion events. The principle reason for using seclusion was violence and aggression in the context of mental illness. It was also used for people who were at risk of, or who had previously absconded from the unit. A recovery approach and the use of the strengths model was fundamental to nurses’ way of working with patients in the unit. Nurses believed that the strengths process should be adapted to the person’s level of acuity and to their ability to engage in this approach in a real and tangible way. Seclusion continues to be a clinical management option in the unit that is the subject of this study. It is used when a person is so unwell that they cannot be managed in any other identified way. However, in many circumstances there are other options that could be explored so that the utmost consideration is given to the dignity, privacy and safety of that person.</p>

Seclusion Management in an Acute In-Patient Unit

<p>Trends in modern day mental health facilities have been towards the least restrictive environment with emphasis on patients’ rights, but these rights have to be balanced against the safety of both the patients themselves and anyone else in the immediate environment. One way of restricting a person’s movement is through the use of seclusion, a means of isolating a person in a locked room with minimal stimulus and from where that person cannot freely exit. This study was developed to explore the use of seclusion in an acute in-patient unit for people with mental illnesses. Investigation into this issue was considered important due to an identified large increase in seclusion use over the previous two years. The study used a qualitative research methodology with a descriptive and interpretive approach. Data collection included a retrospective file audit of patients who had been secluded over the past seven years, and one-to-one staff interviews. I also included some personal reflections of seclusion events. The principle reason for using seclusion was violence and aggression in the context of mental illness. It was also used for people who were at risk of, or who had previously absconded from the unit. A recovery approach and the use of the strengths model was fundamental to nurses’ way of working with patients in the unit. Nurses believed that the strengths process should be adapted to the person’s level of acuity and to their ability to engage in this approach in a real and tangible way. Seclusion continues to be a clinical management option in the unit that is the subject of this study. It is used when a person is so unwell that they cannot be managed in any other identified way. However, in many circumstances there are other options that could be explored so that the utmost consideration is given to the dignity, privacy and safety of that person.</p>

Human Rights during the COVID-19 Pandemic in Hungary with Special Regard to the Right to Have Contact

In Hungary, the government declared a state of danger in March 2020 as a consequence of the COVID-19 pandemic. The state of danger was lifted in June, but epidemological preparedness and state of medical crisis were declared by a government decree. In November 2020, the state of danger was declared for the second time, while epidemological preparedness was maintained. In February 2021, the state of danger was declared again. The list of the legal rules which changed and have been continuously changing because of the COVID-19 pandemic since March 2020 is extremly long and the new provision or the modifications have been heavily influencing the population's everyday life. The aim of this paper is to overview primarily the restrictions affecting human rights with special regard to the right to have contact as one of the patients' rights. Important issues of the parent-child contact affected by the COVID-19 pandemic is discussed, as well.