CLIENTS RIGHTS AND RESPONSIBILITIES

A. The World Medical Association Declaration on the Rights of the Patient

PREAMBLE

The relationship between physicians, their patients and broader society has undergone significant
changes in recent times. While a physician should always act according to his/her conscience,
and always in the best interests of the patient, equal effort must be made to guarantee patient
autonomy and justice. The following Declaration represents some of the principal rights of the
patient that the medical profession endorses and promotes. Physicians and other persons or
bodies involve in the provision of health care have a joint responsibility to recognize and uphold
these rights. Whenever legislation, government action or any other administration or institution
denies patients these rights, physicians should pursue appropriate means to assure or to restore
them.

1. Right to medical care of good quality

a. Every person is entitled without discrimination to appropriate medical care.
b. Every patient has the right to be cared for by a physician whom he/she knows to
be free to make clinical and ethical judgments without any outside interference.
c.The patient shall always be treated in accordance with his/her best interests. The
treatment applied shall be in accordance with generally approved medical principles.
d. Quality assurance should always be a part of health care. Physicians, in particular,
should accept responsibility for being guardians of the quality of medical services.
e.In circumstances where a choice must be made between potential patients for a
particular treatment that is in limited supply, all such patients are entitled to a fair
selection procedure for the treatment. That choice must be based on medical criteria and
made without discrimination.

2. The patient has the right to continuity of health care

a. The physician has an obligation to cooperate in the coordination of medically indicated
care with other health care providers treating the patient.
b. The physician may not discontinue treatment of a patient as long as further
treatment is medically indicated, without giving the patient reasonable assistance and
sufficient opportunity to make alternative arrangements for care.

3. Right to information
a.The patient has the right to receive information about himself/herself recorded in any of
his/her medical records, and to be fully informed about his/her health status including
the medical facts about his/her condition.
b. However, confidential information in the patients record
about the third party should not be given to the patient without the consent of that third
party.
 c.Exceptionally, information may be withheld from patient when there is good reason to
believe that this information would create a serious hazard to his/her life or health.\
d. Information should be given in a way appropriate to the
patients culture and in such a way that the patient can understand.
e.The patient has the right not to be informed on his/her explicit request, unless required
for the protection of another persons life.
f. The patient has the right to choose who, if anyone should be informed on his/her behalf.

4. Right to freedom of choice

a. The patient has the right to choose freely and change his/her physician and hospital or
health service institution, regardless of whether they are based in the private or public
sector.
b. The patient has the right to ask for
the opinion of another physician at any stage.

5. Right to self determination

a.The patient has the right to self-determination, to make free decisions regarding
himself/herself. The physician will inform the patient of the consequences of his/her
decisions.
b. A mentally competent adult
patient has the right to give or withhold consent to any diagnostic procedure or therapy.
The patient has the right to the information necessary to make his/ her decisions. The
patient should understand clearly what is the purpose of any test or treatment, what the
results would imply, and what would be the implications of withholding consent.
c.The patient has the right to refuse to participate in research or the teaching of medicine.
d. The procedure against the
patients will. Diagnostic procedures or treatment against the patients will can be carried
out only in exceptional cases, if specifically permitted by law and conforming to the
principles of medical ethics.

6. Right to confidentiality
a.All deniable information about a patients health status, medical condition, diagnosis,
prognosis and treatment and all other information of a personal kind must be kept
confidential, even after death. Exceptionally, descendants may have a right of access to
information that would inform them of their health risks.
b. Confidential information can only be disclosed if
the patient gives explicit consent or if expressly provided for in the law. Information can
be disclosed to other health care providers only on a strictly need to know basis unless
the patient has a given explicit consent.
c.All identifiable patient data must be protected. The protection of the data must be
appropriate to the manner of its storage. Human substances from which identifiable data
can be derived must be likewise protected.

7. Right to dignity
a.The patients dignity and right to privacy shall be respected at all times in medical care
and teaching as shall his/her culture and values.
 b. The patient is entitled to relief of his/her suffering according to the current state of
knowledge.
c.The patient is entitled to humane terminal care and to be provided with all available
assistance in making dying as dignified and comfortable as possible.
8. Right to Health Education
a.Every person has the right to health education that will assist him/her in making
informed choices about personal health and about the available health services. The
education should include information about healthy lifestyles and about methods of
prevention and early detection of illness.
b. The personal responsibility of everybody for his/her own health should be
stressed. Physicians have an obligation to participate actively in educational efforts.

9. The unconscious patient

a. If the patient is unconscious or otherwise unable to express his/her will, informed
consent must be obtained whenever possible, from a legally entitled representative.
b. If a legally entitled representative is not available, but a medical intervention is
urgently needed, consent of the patient may be presumed, unless it is obvious and
beyond any doubt on then basis of the patients previous firm expression or eviction
that he/she would refuse consent to the intervention in that situation.
c.However, physicians should always try to save the life of a patient unconscious due to a
suicide attempt.

10. The legally incompetent patient

a.If a patient is a minor or otherwise legally incompetent, the consent of a legally entitled
representative is required in some jurisdictions. Nevertheless the patient must be involved
in the decision-making to the fullest extent allowed by his/her capacity.
b. If the legally incompetent patient can make rational decisions, his/her decisions
must be respected, and he/she has the right to forbid the disclosure of information to
his/her legally entitled representative.
c.If the patients legally entitled representative, or a person authorized by the patient,
forbids treatment which is, in the opinion of the physician, in the patients best interest,
the physician should challenge this decision in the relevant legal or other institution. In
case of emergency, the physician will act in the patients best interest.

11. Right to religious assistance

The patient has the right to receive or to decline spiritual and moral comfort including the
help of a minister of his/her chosen religion.
B. The declaration of Rights Philippine Constitution

1. The patient has the right to considerate and respectful care irrespective of socio-economic
status.

2. The patient has the right to obtain form his physician complete information concerning his
diagnosis, treatment and prognosis in terms the patient can reasonably be expected to
understand. When it is not medically advisable to give such information to the patient, the
information should be made available to an appropriate person in his behalf. He has the right
to know by name or in person, the medical team responsible in coordinating his care.

3. The patient has the right to receive from his physician information necessary to give
informed consent prior to the start of any procedure and/or treatment. Except in emergencies,
such information for informed consent should include but not necessarily limited to the
specific procedure and or treatment, the medically significant risks involved, and the
probable duration or incapacitation. When medically significant alternative for care or
treatment exist, or when the patient requests information concerning medical alternatives, the
patient has the right to such information. The patient has also the right to know the name of
the person responsible for the procedure and/or treatment.

4. The patient has the right to refuse treatment/life giving measures, to the extent permitted by
law, and to be informed of the medical consequences of his action.

5. The patient has the right to every consideration of his privacy concerning his own medical
care program. Case discussion, consultation, examination and treatment are confidential and
should be conducted discreetly. Those not directly involved in his care must have the
permission of the patient to be present.

6. The patient has the right to expect that all communications and records pertaining to his care
should be treated as confidential.

7. The patient has the right that within its capacity, a hospital must make reasonable response to
the request of patient for services. The hospital must provide evaluation, service and/or
referral as indicated by the urgency of care. When medically permissible a patient may be
transferred to another facility only after he has received complete information concerning the
needs and alternatives to such transfer. The institution to which the patient is to be transferred
must first have accepted the patient for transfer.
8. The patient has the right to obtain information as to any relationship of the hospital to other
health care and educational institutions in so far as his care is concerned. The patient has the
right to obtain as to the existence of any professional relationship among individuals, by
name that is treating him.

9. The patient has the right to be advised if the hospital proposes to engage in or perform human
experimentation affecting his care or treatment. The patient has the right to refuse or
participate in such research project.

10. The patient has the right to expect reasonable continuity of care; he has the right to know in
advance what appointment times the physicians are available and where. The patient has the
right to expect that the hospital will provide a mechanism whereby he is informed by his
physician or a delegate of the physician of the patients continuing health care requirements
following discharge.

11. The patient has the right to examine and receive an explanation of his bill regardless of
source of payment.

12. The patient has the right to know what hospital rules and regulation apply to his conduct as
a patient.
C. The Patients Charter for Tuberculosis Care

The Patients Charter for Tuberculosis Care (the Charter) outlines the rights and responsibilities
of people with Tuberculosis (TB). It empowers people with the disease and their communities
through knowledge of disease. Initiated and developer by patients form around the world, the
Charter makes the relationship with healthcare providers a mutually beneficial one.

The Charter sets out the ways in which patients, communities, health care providers, both private
and public, and government can work together as partners in a positive and open relationship, to
improve standards of TB care and enhance the effectiveness of the ,healthcare process. It allows
all parties to be held more accountable to each other, fostering mutual interaction and a positive
partnership.

Developed in tandem with the International Standards for Tuberculosis Care to promote a
patient-centered approach, the Charter adheres to the principles on health and human rights of
the United Nations, UNESCO, WHO and the Council of Europe , as well as other local and
national charters ad conventions.

The Charter embodies the principle of Greater Involvement of People with TB (GIPT). This
affirms that the empowerment of people with the disease is the catalyst for effective
collaboration with healthcare providers and authorities, and is essential to victory in the fight to
stop TB. The Charter, the first global patient-power standard for care, is a cooperative tool,
forged from a common cause, for the entire TB community.

1. Care
My patients have the right to free and equitable access to TB care, from diagnosis to
completion of treatment, regardless of resources, race, gender, age, language, legal status,
religious beliefs, sexual orientation, and culture and health status. They have the right to
receive medical advice and treatment that full meet the new International Standards for
Tuberculosis Care, centering on patients needs including those MDR-TB or TB-HIV co
infections, and preventive treatment for young children and others considered to be high risk.
They have the right to benefit from proactive health sector community outreach, education
and prevention campaigns as part of comprehensive healthcare programs.
2. Dignity
My patients have the right to be treated with respect and dignity, including the delivery of
services, without stigma, prejudice or discrimination by healthcare providers and authorities.
They have the right to high-quality healthcare in a dignified environment, with moral support
from family, friend and the community.

3. Information
My patients have the right to information about the availability of healthcare services for TB,
and the responsibilities, engagements and direct or indirect costs involved. They have the right
to receive a timely, concise and clear description of the medical condition, with diagnosis,
prognosis (an opinion as to the likely future course of the illness) and treatment proposed,
with communication of common risks and appropriate alternatives. They have the right to
know the names and dosages of any medications or interventions to be prescribed, its normal
actions and potential side effects, and its possible impact on other conditions or treatments.
They have the right to access to medical information relating to their condition and treatment
and to have a copy of medical records if requested by them or a person they authorize. They
have the right to meet, share experiences with peers and other patients and to voluntary
counseling at any time from diagnosis to completion of treatment.

4. Choice
My patients have the right to a second medical option, with access to past and medical records.
They have the right to accept or refuse surgical interventions if chemotherapy is possible and to
be informed of the likely medical statutory consequence within the context of a communicable
disease. They have the right to choose whether or on to take part in research programs without
compromising care.

5. Confidence
My patients have the right to respect for personal privacy, dignity, religious beliefs and culture.
They have the right to confidentiality relating to the medical condition, with information
released to other authorities contingent upon their consent.

6. Justice
My patients have the right to make a complaint through channels provided for this purpose by
the health authority and to have any complaint dealt with promptly and fairly. They have the
right to appeal to higher authority if the above is not respected and to be informed in writing of
the outcome.

7. Organization
My patients have the right to join, or to establish, organizations of people with or affected by
TB, and to seek support for the development of these clubs and community-based associations
through healthcare providers, authorities and civil society. They have the right to participate as
stakeholders in the development, implementation, monitoring and evaluation of TB policies
and programs with local, national and .international health authorities.

8. Security
 My patients have the right to job security after diagnosis or appropriate rehabilitation upon
completion of treatment. They have the right to nutritional security or food supplements if
needed to meet treatment requirements.

9. Share Information
My patients have the responsibility to provide as much as information as possible to healthcare
providers about present health, past illnesses, any allergies and any other relevant details. They
have the responsibility to provide information to healthcare providers about contacts with
immediate family, friends, and others who may be vulnerable to TB or who may have been
infected.

10. Follow Treatment

My patients have the responsibility to follow the prescribed and agreed treatment regimen and
to conscientiously comply with the instructions given to protect their health and that of others.
They have the responsibility to inform healthcare providers of any difficulties or problems in
following treatment, or if any part of treatment is not clearly understood.

11. Contribute to Community Health

My patients have the responsibility to contribute to community well-being by encouraging
others to seek medical advice if they exhibit symptoms of TB. They have the responsibility to
show consideration for the rights of other patients and healthcare providers, understanding that
this is the dignified basis and respectful foundation of the TB community.

12. Show Solidarity

My patients have the moral responsibility to show solidarity with other patients, marching
together towards cure. They have the moral responsibility to share information and knowledge
gained during treatment, and to share this expertise with others in the community, making
empowerment contagious. They have the moral responsibility to join in efforts to make this
community free of TB.
 CHILDRENS RIGHTS

The Philippine Child Survival Strategy Adopts and supports the

CHILD 21 vision for every Filipino child to be:

1. born healthy and well, with an inherent right to life,

endowed with human dignity;
2. happy, loved and nurtured by a strong, stable and
God-loving family;
3. living in peaceful, progressive, gender-fair, and
child-friendly society;
4. growing safe in a healthy environment and ecology;
5. free and protected by a responsive and enabling
environment;
6. reaching her/his full potential with right
opportunities and accessible resources;
7. imbued with Filipino values steeped in her/his
indigenous cultural heritage;
8. assertive of his/her rights as well as those of others;
and
9. actively participating in decision-making and
governance, in harmony and in solidarity with
other, in sustaining the Filipino nation.
D. Sexual and Reproductive Health Rights

1. The Right to Life. No womans life should be put at risk by reason of pregnancy, gender or
lack of access to health information and services. This also includes having safe and
satisfying sex life.
2. The Right to Liberty and Security of the Persons. Recognizes that no woman should be
subjected to forced pregnancy, forced sterilization or forced abortion.
3. The Right to Equality, and to be Free from all Forms of Discrimination. Recognizes
freedom from discrimination because of ones sexuality and reproductive life choices.
4. The Right to Privacy. All sexual and reproductive health care services should be
confidential in terms of physical set-up, information given or shared to clients, and access to
records or reports.
5. The Right to Freedom of Thought. Freedom from restrictive interpretation of religious
texts, beliefs, principles and customs as tools to curtail freedom of thought on sexual and
reproductive health care and other issues.
6. The Right to Information and Education. Access to full information on the benefits, risks
and effectiveness of all methods of fertility regulation, in order that all decisions taken are
made on the basis of full, free and informed consent.
7. The Right to Choose Whether or Not to Marry and to Found and Plan a Family. The
right of persons to protection against a requirement to marry without his/her consent. It also
includes the right of individuals to choose to remain single without discrimination and
coercion.
8. The Right to Decide Whether or When to Have Children. The right of persons to decide
and responsibly the number of children and spacing of their children and to have access to
related information and education.
9. The Right to Health care and Health Protection . The right of clients to the highest
possible quality of health care, and the right to be free from harmful traditional health
practices.
10. The Right to Benefits of Scientific Progress. The right of sexual and reproductive
health service of clients to avail of the new reproductive health technologies that are safe,
effective and acceptable.
11. The Right to Freedom of Assembly and Political Participation. The right of all
persons to seek to influence communities and government to prioritize sexual and
reproductive health and rights.
12. The Right to be Free from torture and Ill-Treatment. The right of women, man and
young people to protection from violence, sexual exploitation and abuse.
13. The Right to Development. The right of all individuals to access development
opportunities and benefits, especially in decision-making processes that affects his/her life.

SEXUAL AND REPRODUCTIVE HEALTH RIGHTS

1. The Right to Life.
2. The Right to Liberty and Security of the Persons.
3. The Right to Equality, and to be Free from all
Forms of Discrimination.
4. The Right to Privacy.
5. The Right to Freedom of Thought
6. The Right to Information and Education.
7. The Right to Choose Whether or Not to Marry and
to Found and Plan a Family.
8. The Right to Decide Whether or When to Have
Children
9. The Right to Health care and Health Protection.
10. The Right to Benefits of Scientific Progress
11. The Right to Freedom of Assembly and Political
Participation.
12. The Right to be Free from torture and Ill-
Treatment
13. The Right to Development.