A patient is not just someone who is sick. He/she is first and foremost a person with rights and duties and the past quarter of a century has seen the emergence and rapid spread in Europe of the concept of "patients’ rights". In this context there is evidence that, increasingly, shared principles are being adopted in a number of countries which seem to be independent of the characteristics of a given country's health system.
Amongst current EU Member States to have adopted legislation on patient rights are: Finland (1992), The Netherlands (1994), Greece, Hungary, Lithuania, Latvia, Portugal (1997), Denmark (1998), Belgium, Estonia and France (2002) and Cyprus (2005).
At the international level, prominent examples of documents about patients’ rights include: the Declaration of March 1994 on the promotion of patients' rights in Europe which emerged from an initiative of the Worlds Health Organisation; the Council of Europe's 1997 Convention on Human Rights and Biomedicine. Despite its name, this Convention also deals with patients rights in general; and the "European Charter of Patients’ Rights", drafted under the auspices of an Italian-based NGO called the Active Citizenship Network.
These rights cover the entire aspect of patient care and treatment; Human Rights and Values, Information, Consent, Confidentiality and Privacy, Care and Treatment, Patient Safety and Application. As such they are not dissimilar to the concepts of Trust, Dignity, Information, Communication, Confidentiality and Competence which are encompassed in the ethical guidelines established by the Medical Council for doctors practicing in Ireland. Although long established these guidelines are dynamic, and acknowledged by the Council to be a continuous process in relation to their application to new situations. The rights are also not dissimilar to the provisions of the Code of Professional Conduct established by An Bord Altranais for nurses practicing in Ireland, the purpose of which is to provide a framework upon which nurses can base their professional decision making, promotion of high standards and acceptance of responsibilities.
In addressing this issue the Ombudsman makes a distinction between social and individual rights. Social rights in health care relate to the societal obligation undertaken, or otherwise enforced by Government and other public or private bodies, to make reasonable provision of health care for the whole population. Social rights are dependent on political, social, cultural and economic factors. They are enjoyed collectively and are relative to the level of development of society; they are also in a large measure subject to political priorities for development in our society.
By contrast, individual rights in patient care are more readily expressed in absolute terms and, when made operational, can be enforceable on behalf of an individual patient. It is not the intention of the Ombudsman to create new rights, but to distill those elements from the current thinking as outlined above, and adapt them in a statement of good practice for the health service in dealing with patients. It is the Ombudsman's intention to utilise this as a framework in the future examination of complaints in public healthcare. This Statement is outlined in point 8. The Ombudsman wants the public health service providers to be under no illusion but that she intends to see that the operation of this Statement becomes a living reality for patients.