The advent of the “patient rights” movement and associated legislation is a relatively recent phenomenon, having first taken root in the early 1990s. However, as of January 2006, a divided and partisan U.S. Congress was still grappling with various provisions for a federal Patients’ Rights Law, and none appeared likely in the foreseeable future. Part of the delay was due to the 2004 U.S. Supreme Court decision in Aetna v. Davila, which severely limited patients’ rights to sue their HMOs in state courts. (The Court held that the federal Employee Retirement Income Security Act [ERISA] preempted state laws in this area.) The decision impacted and invalidated provisions in at least ten state patients’ rights laws.
Notwithstanding, all states have enacted some form of health care law addressing “patient rights.” The problem remains that there is no uniformity of laws, and the scope of rights afforded patients varies greatly from state to state.
The term “patient” generally refers to a person who is receiving medical treatment and/or who is under medical care. Certain vulnerabilities attach to the status of patient. For this reason, certain laws have been passed at both the national and state levels to protect people’s interests which otherwise might be compromised by medical, social, governmental, and/or financial entities. These protective provisions may be in the form of passive guarantees, or they may spring into effect as a result of some affirmative act on an individual’s part, such as the execution of a legal document, like a Patient Directive or Durable Power of Attorney (see below).
Generally speaking, the rights of a patient fall into a few main categories: the right to autonomy and self-determination (which includes the related right to withhold or grant informed consent), the right to privacy concerning medical information, and the right to receive treatment (not be refused treatment). Some hospitals refer to these collectively as a “Patient Bill of Rights,” but there is no such “bill of rights” document per se, excepting a generally accepted (but not mandated) model version prepared by the American Medical Association and frequently used by hospitals.