Your Rights and Responsibilities

The United Nations Charter: recognizes the inherent dignity and the equal and inalienable rights of all members of the human family as the foundation of freedom, justice and peace in the world,

Key articles that relate to those affected by pain are:

1. All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.
   • Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, color, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. Furthermore, no distinction shall be made on the basis of the political, jurisdictional or international status of the country or territory to which a person belongs, whether it be independent, trust, non-self-governing or under any other limitation of sovereignty.
2. Everyone has the right to life, liberty and security of person.
3. No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.
4. Everyone has the right to recognition everywhere as a person before the law.
   • All are equal before the law and are entitled without any discrimination to equal protection of the law. All are entitled to equal protection against any discrimination in violation of this Declaration and against any incitement to such discrimination.
   • Everyone has the right to an effective remedy by the competent national tribunals for acts violating the fundamental rights granted him by the constitution or by law.
5. No one shall be subjected to arbitrary arrest, detention or exile.
   • Everyone is entitled in full equality to a fair and public hearing by an independent and impartial tribunal, in the determination of his rights and obligations and of any criminal charge against him.
6. No one shall be subjected to arbitrary interference with his privacy, family, home or correspondence, nor to attacks upon his honor and reputation.Everyone has the right to the protection of the law against such interference or attacks.
7. No one shall be arbitrarily deprived of his property.
8. Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers.
9. Everyone has the right to freedom of peaceful assembly and association.
   • No one may be compelled to belong to an association.
10. Everyone has the right to take part in the government of his country, directly or through freely chosen representatives
    • Everyone has the right of equal access to public service in his country.
11. Everyone, as a member of society, has the right to social security and is entitled to realization, through national effort and international co-operation and in accordance with the organization and resources of each State, of the economic, social and cultural rights indispensable for his dignity and the free development of his personality.
12. Everyone has the right to work, to free choice of employment, to just and favorable conditions of work and to protection against unemployment
    • Everyone has the right to rest and leisure, including reasonable limitation of working hours and periodic holidays with pay.
13. Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control
14. Everyone has the right to education
15. Everyone has the right freely to participate in the cultural life of the community, to enjoy the arts and to share in scientific advancement and its benefits.

 Excerpts from the Universal Declaration of Human Rights

United Nations Charter, http://www.un.org/en/documents/udhr/index.shtml: Accessed on February 19, 2013

Adopted by the US Advisory Commission on Consumer Protection and Quality in the Health Care Industry in 1998.

This bill of rights applies to health care delivery systems, insurance plans offered to federal employees, other health insurance plans have also adopted including Medicare and Medicaid. The bill of rights addresses 8 key areas:

1. Patient information
   You have the right to accurate and easily-understood information about your health plan, health care professionals, and health care facilities. If you speak another language, have a physical or mental disability, or just don’t understand something, help should be given so you can make informed health care decisions.
2. Choice of health care providers and insurance plans
   You have the right to choose health care providers who can give you high-quality health care when you need it.
3. Access to emergency services
   If you have severe pain, an injury, or sudden illness that makes you believe your health is in danger, you have the right to be screened and stabilized using emergency services. You should be able to use these services whenever and wherever you need them, even if they’re out of your network, without needing to wait for authorization and without any financial penalty.
4. Being involved in your health care—treatment decisions
   You have the right to know your treatment options and take part in decisions about your care. You have the right to ask about the pros and cons of any treatment, including no treatment at all. As long as you are able to make sound decisions, you have the right to refuse any test or treatment, even if it means you might have a bad health outcome as a result. You can also legally choose who can speak for you if you cannot make your own decisions.
5. Respect and non-discrimination
   You have a right to considerate, respectful care from your doctors, health plan representatives, and other health care providers that does not discriminate against you based on race, ethnicity, national origin, religion, sex, age, mental or physical disability, sexual orientation, genetic information, or source of payment.
6. Protection of Confidentiality (privacy) of health information
   You have the right to talk privately with health care providers and have your health care information protected. You also have the right to read and copy your own medical record. You have the right to ask that your doctor change your record if it’s not correct, relevant, or complete.
7. Process for Complaints and appeals
   You have the right to a fair, fast, and objective review of any complaint you have against your health plan, doctors, hospitals, or other health care personnel. This includes complaints about waiting times, operating hours, the actions of health care personnel, and the adequacy of health care facilities.
8. Consumer responsibilities
   In a health care system that protects consumer or patients’ rights, patients should expect to take on some responsibilities. For example, as a patient you must:

• Tell your health care providers about any medicines you are taking, and about health conditions and medical or surgical problems in the past or present.
• Ask questions or request further information from health care providers if you do not completely understand health information and instructions.
• Take responsibility for your lifestyles to help improve your own health (for instance, following a treatment plan, exercising, and not using tobacco).
• Treat health care workers and other patients with respect
• Try to pay your medical bills
• Follow the rules and benefits of their health plan coverage
• Be involved in your care as this increases the chance of the best possible outcomes and helps support a high quality, cost-conscious health care system.

Healthcare.gov

http://www.healthcare.gov/law/index.html:Accessed Feb 19, 2013

In 2010, a new Patient’s Bill of Rights was created along with the Affordable Care Act. This bill of rights was designed to give new protections in dealing with insurance companies. The new rights will:

• Prevent insurance companies from canceling a policy if the policyholder gets sick.
  • At a time when American’s need health insurance most, insurance companies have used loopholes such as mistaken information on an application to cancel a policy and leave the patient high and dry with no coverage.
• Stop insurance companies from denying coverage to children with pre-existing conditions. In September, this ban becomes effective for children.
  • In 2014, the provision extends to ban this discrimination for all Americans.
• Prohibit setting lifetime limits on insurance policies issued or renewed after September 23, 2010.
  • As Americans renew or purchase insurance policies in the future, they will no longer have to be concerned with having their coverage cap out if they have catastrophic level expenses and need their coverage the most.
• Phase out dollar limits on coverage over the next three years. In addition to lifetime caps, many policies have annual limits which can be devastating to those with high medical costs each year.
  • These limits will be eliminated completely by 2013.
• Allow patients to designate any available participating primary care physician as their provider.
  • This eliminates the need for referrals to see a physician such as an OB-GYN.
• Remove insurance company barriers to receiving emergency care and prevents them from charging patients more because the facility or physicians are out-of-network.
  • Allows patients to seek emergency care anywhere without having to pay higher co-pays or deductibles. It also eliminates the need for prior approval for this care.

Suite 101.com
http://suite101.com/article/new-patients-bill-of-rights-a259874: Accessed on Feb 19, 3013

Issued: 2010

Patient’s Bill of Rights

Another person chosen by the patient can exercise these rights on the patient’s behalf. A proxy decision maker can exercise these rights if the patient lacks decision-making ability, is legally incompetent, or is a minor.

• The patient has the right to considerate and respectful care.
• The patient has the right to and is encouraged to obtain from doctors and other direct caregivers appropriate, current, and understandable information about diagnosis, treatment, and prognosis. Except in emergencies when the patient lacks decision-making ability and the need for treatment is urgent, the patient is entitled to the chance to discuss and request information about the specific procedures and/or treatments, the risks involved, the possible length of recuperation, and the medically reasonable alternatives and their risks and benefits. Patients have the right to know the identity of doctors, nurses, and others involved in their care, as well as when those involved are students, patients, or other trainees. The patient also has the right to know the immediate and long-term financial implications of treatment choices, insofar as they are known.
• The patient has the right to make decisions about the plan of care before and during treatment. The patient has the right to refuse a recommended treatment or plan of care to the extent allowed by law and hospital policy and to be informed of the medical consequences of this action. In case of refusal, the patient is entitled to other appropriate care and services that the hospital provides or transfers to another hospital. The hospital should notify patients of any policy that might affect patient choice within the institution.
• The patient has the right to have an advance directive (such as a living will, health care proxy, or durable power of attorney for health care) concerning treatment or designating a surrogate decision maker with the expectation that the hospital will honor the intent of that directive to the extent permitted by law and hospital policy. Health care institutions must tell patients of their rights under state law and hospital policy to make informed medical choices, ask if the patient has an advance directive, and include that information in patient records. The patient has the right to timely information about hospital policy that may limit its ability to implement fully a legally valid advance directive.
• The patient has the right to every consideration of privacy. Case discussion, consultation, examination, and treatment should be conducted so as to protect each patient’s privacy.
• The patient has the right to expect that all communications and records related to his/her care will be treated as confidential by the hospital, except in cases such as suspected abuse and public health hazards when reporting is permitted or required by law. The patient has the right to expect that the hospital will stress the confidentiality of this information when it releases it to any other parties entitled to review information in these records.
• The patient has the right to review the records about his/her care and to have the information explained or interpreted as necessary, except when restricted by law.
• The patient has the right to expect that, within its capacity and policies, a hospital will make reasonable response to a patient’s request for appropriate and medically indicated care and services. The hospital must provide evaluation, service, and/or referral as indicated by the urgency of the case. When medically appropriate and legally permitted, or when a patient has requested, a patient may be transferred to another facility. The institution to which the patient is to be transferred must first have accepted the patient for transfer. The patient must also have the benefit of complete information and explanation concerning the need for, risks, benefits, and alternatives to such a transfer.
• The patient has the right to ask and be informed of business relationships among the hospital, educational institutions, other health care providers, or payers that may influence the patient’s treatment and care.
• The patient has the right to consent to or decline to take part in research studies or human experimentation affecting care and treatment or requiring direct patient involvement, and to have those studies fully explained prior to consent. A patient who declines to take part in research or experimentation is entitled to the most effective care that the hospital can otherwise provide.
• The patient has the right to expect reasonable continuity of care when appropriate and to be informed by doctors and other caregivers of available and realistic patient care options when hospital care is no longer appropriate.
• The patient has the right to be informed of hospital policies and practices that relate to patient care treatment, and responsibilities. The patient has the right to be informed of available resources for resolving disputes, grievances, and conflicts, such as ethics committees, patient representatives, or other mechanisms available in the institution. The patient has the right to be informed of the hospital’s charges for services and available payment methods.

Patient Responsibilities

The partnership nature of health care requires that patients, or their families/surrogates, take part in their care. The effectiveness of care and patient satisfaction with the treatment depends, in part, on the patient fulfilling certain responsibilities. The following are patient responsibilities:

• Patients are responsible for providing information about past illnesses, hospitalizations, medications, and other matters related to health status. To participate effectively in decision making, patients are take responsible for asking for additional information or explanation about their health status or treatment when they do not fully understand information and instructions.
• Patients are also responsible for ensuring that the health care institution has a copy of their written advance directive if they have one.
• Patients are responsible for telling their doctors and other caregivers if they expect problems in following prescribed treatment.
• Patients should be aware of the hospital’s duty to be reasonably efficient and fair in providing care to other patients and the community. The hospital’s rules and regulations are intended to help the hospital meet this responsibility. Patients and their families are responsible for making reasonable accommodations to the needs of the hospital, other patients, medical staff, and hospital employees.
• Patients are responsible for giving necessary information for insurance claims and for working with the hospital to make payment arrangements, when necessary.
• A person’s health depends on much more than health care services. Patients are responsible for recognizing the impact of their lifestyle on their personal health.

Adapted from the American Hospital Association: www.aha.org

http://mhcc.maryland.gov/consumerinfo/hospitalguide/patients/consumer_help/bill_of_rights.htm: Accessed on Feb 19, 2013

Issued: 2012

Accredited hospitals, nursing homes and other health care facilities are required to assess and treat pain under the quality standards set by the Joint Commission (in effect since 2001).

While the law and private medical practices do not always recognize the rights and responsibilities for pain care, these should be expected and honored in order to achieve quality care. As a person with pain-

You have a responsibility to:

• Promptly report when it pain occurs particularly when new onset or change in character of any pre-existing pain
• Seek quality pain care that :
  • Identifies and corrects the cause, when possible
  • Lessens the pain intensity and frequency
  • Improves your ability to function in everyday activities
  • Presents with side effects that are minimal and tolerable
  • Person-Centered and Integrative.
• Expect a physical examination, review of your medical records and a pain assessment during your medical evaluation
• Be open and honest about  your health history–including current or past history of conditions that may challenge your pain treatment, such as:
  • Substance Abuse or Addictive Disease
  • Mental Health Disorders
  • Sleep Apnea
  • Respiratory Disease
  • Medication Sensitivities
• Talk with your heath care provider about your pain, the possible cause(s), and treatment options available along with the benefits, risks and cost of each choice.
• Participate actively about how to manage your pain and take the needed time to make decisions about your pain care that best suits your goals and values.
• Refuse a particular type of treatment, if you so choose and share your reasons why.
• Commit to hard work with your health care team, to achieve better control of your pain, wellness and healing.

You have a right to:

• Be treated without stigma, bias or prejudice when you report pain or current/past pain treatment
• Have your pain appropriately assessed and treated effectively as well as promptly.
• Ask questions and be informed about your pain care options—that is person-centered and integrative in nature.
• Get clear and prompt answers to your questions.
• Be treated respectfully when you have concerns about or refuse recommended treatment for your pain without retribution or retaliation.
• Have a trusted family member, friend or pain advocate attend to serve as witness, coach and support during your medical evaluations and treatment, if you so choose.
• Have your pain reassessed regularly and your treatment plan adjusted if your pain has not been eased or you are experiencing intolerable side effects.
• Be assisted, in a non-judgment fashion, with a referral for a second opinion, a pain specialist (if you are not seeing one) or other specialists depending on your pain condition, if unrelieved pain and disruption in function persists.

Modified version

Pain Care Bill of Rights: First published by the American Pain Foundation, 1998

MDJunction.com: http://www.mdjunction.com/forums/trigeminal-neuralgia-discussions/general-support/424035-pain-care-bill-of-rights: Accessed Feb 19, 2013

See The Pain Community User Guidelines to learn about your rights and responsibilities in our online community.

© 2013, Association of Fundraising Professionals (AFP), all rights reserved. Reprinted with permission from the Association of Fundraising Professionals.

Philanthropy is based on voluntary action for the common good. It is a tradition of giving and sharing that is primary to the quality of life. To ensure that philanthropy merits the respect and trust of the general public, and that donors and prospective donors can have full confidence in the nonprofit organizations and causes they are asked to support, we declare that all donors have these rights:

• To be informed of the organization’s mission, of the way the organization intends to use donated resources, and of its capacity to use donations effectively for their intended purposes.
• To be informed of the identity of those serving on the organization’s governing board, and to expect the board to exercise prudent judgment in its stewardship responsibilities.
• To have access to the organization’s most recent financial statements.
• To be assured their gifts will be used for the purposes for which they were given.
• To receive appropriate acknowledgement and recognition.
• To be assured that information about their donation is handled with respect and with confidentiality to the extent provided by law.
• To expect that all relationships with individuals representing organizations of interest to the donor will be professional in nature.
• To be informed whether those seeking donations are volunteers, employees of the organization or hired solicitors.
• To have the opportunity for their names to be deleted from mailing lists that an organization may intend to share.
• To feel free to ask questions when making a donation and to receive prompt, truthful and forthright answers.

Association of Fundraising Professionals

http://www.afpnet.org/ethics/enforcementdetail.cfm?itemnumber=3359