Hospitals—When You Are a Patient
“When I checked into a hospital for the first time, I suddenly felt as if I had lost control of my life, as if I had become just another statistic.”—Marie G.
“I remember my first visit as a patient. I felt very vulnerable and unprotected.”—Paula L.
HAVE you ever been a patient in a hospital and experienced the above reactions? Whether you have or not, you must acknowledge that most people spend little time thinking about being a patient. Yet, that prospect may be a reality one day for you. In 1987, for example, reports show 1 hospital admission for every 7 persons in the United States. Such statistics vary throughout the world. Yet, as a prudent person, what preparations should you make for such an eventuality?
“The single most important way to protect your health is to make sure hospitalization is necessary,” comments Dr. Sidney Wolfe, director of the Public Citizen Health Research Group. No matter where you live, if you are sick, you have the right and the obligation to be informed as to the facts of your medical problem. Often your own doctor may be able to give you satisfactory answers.
But if there is any question, an independent second opinion is recommended. In some lands, insurance companies even require second opinions before they will pay on certain types of major surgery. And it is not unheard of to seek a third opinion to resolve differences on diagnosis and treatment. The fundamental point is: Whether there is one opinion or two or more, a wise patient takes time to determine for himself the need for and wisdom of the proposed treatment.
Of course, in an emergency situation, there may be no time to get various medical recommendations. The patient may even be unconscious, unable to speak or write when brought to the hospital. Sometimes doctors must act immediately, even before relatives can be located to determine the patient’s wishes or preferences. Such situations emphasize why forethought and planning are of utmost importance.*
For the patient who is one of Jehovah’s Witnesses, this involves carrying at all times a completed and current Medical Directive/Release Document. On this card the patient expresses beforehand his wishes about medical care and provides vital information so that medical personnel can contact relatives or others who know his wishes. While it cannot cover all possible situations, this important card serves as a legal document that speaks when you cannot.
It is also very helpful if, in an emergency, a close friend or relative familiar with your medical preferences and convictions can come to the hospital for your support. Whether that is immediately possible or not, an updated Medical Directive/Release Document may one day be a key to having your rights protected.
Even if a person is not a baptized minister of Jehovah’s Witnesses and does not have this document, he can prepare a similar written (preferably typewritten) statement. This ought to outline his wishes regarding medical treatment, state any limitations, and indicate who should be contacted in case of an emergency.
Filling Out Forms and Statements
Patient rights vary widely throughout the world. (See box, page 7.) In some countries these rights have increased dramatically in recent years; a doctor is not permitted to render any treatment without the patient’s consent, usually indicated in writing. This is one reason hospitals may have their own forms that they want you to sign. If such is the case where you live, the following should help.
You should very carefully read all forms before you sign them because your signature means that you agree to, consent to, whatever the form says. Let no one rush you into signing an admission form, or consent-for-treatment form, without your reading it carefully. If you do not agree with a portion of the standard form, cross out that part. Even if someone protests that it is the hospital’s form and that it cannot be altered, it is nevertheless a legal contract, and you cannot be required to sign anything that you do not agree with. Though not wanting to appear unreasonable, it is important that you do not compromise on this matter—you have the right to refuse to approve any portion of a form.
Especially regarding consent for surgery or any use of blood, check every paragraph carefully. Some of Jehovah’s Witnesses have been shocked at what they have found on a hospital form that was supposedly prepared just for them. Although at the outset it said that the patient’s wishes about blood would be respected, a later paragraph said something like, ‘In an emergency or if the doctor feels it is needed, he retains the right to transfuse blood.’ Furthermore, since God’s Word commands Christians to abstain from blood, it is a good practice to write “No Blood Transfusions” on all papers brought to you. (Acts 15:28, 29) That will make your position clear to all the staff. The fact is, a growing number of patients are refusing blood because they want to avoid the risk of contracting hepatitis, AIDS, or other lethal diseases.*
Patients in some countries have fewer rights than those outlined above. There are areas where the doctor is the law, and patients are more or less considered to be at his mercy. One doctor from a western country visited an African nation and observed: “I was not prepared, either, for the way that doctors and patients interacted . . . The patients themselves never spoke unless they were spoken to. They did not question their doctors.” Though such a custom could make it more difficult for the patient, the wise Christian would still—respectfully but firmly—insist that his basic human right to bodily integrity and to participate in discussions affecting his own health should be respected.
Talking With Medical Personnel
Your doctor should be your main advocate and source of information; hence, much may depend on how carefully you have chosen a physician. Notes one writer: “Recognize that doctors are like everyone else. They exhibit the full range of good and bad [that] the rest of us do. Most physicians try to do the best for their patients, but some are socialized [conditioned] into thinking they are entitled to make decisions for you. If a doctor’s beliefs or personality clash with yours, find another doctor.”
Try to get your questions answered fully and to your satisfaction before you consent to any treatment. (See box, page 8.) If you cannot understand something, do not be embarrassed to say so. Ask that the explanation be in plain, nonmedical language. It would also be tactful if at some point in the conversation with the doctor, you express sincere appreciation for his understanding your position that is based on your religious convictions.
Try to establish a friendly relationship with the hospital staff dealing with you, such as nurses, for they can and should be a big help in your care and recovery. When they bring medications or injections, make sure these are really for you. This is a step of practical wisdom, for despite the best intentions, mistakes are made.
The hospital staff probably will seem quite busy, but remember that most of them chose this line of work because they do care for people and genuinely want to help. You can cooperate with them if you try to express your needs or concerns clearly. No nurse (or anyone else on the staff) has the right to subject you to verbal abuse, such as: “You will die unless you accept this treatment.” Report any such abuse to the hospital administration as well as to relatives or to your minister; they may be in position to speak for you.
What if a Problem Arises?
There have been occasions when, in spite of applying all these points, patients find themselves in deep conflict with the medical system. Though such a circumstance is rare, what should you do if you suddenly find yourself in such a situation?
First, try not to panic. Usually this is a difficult time for all involved, with emotions running high. So your remaining calm, reasonable, and respectful can be a great asset. Second, consider and recruit all possible resources. The hospital may have a patient representative whom you can contact and from whom you can seek help.
Jehovah’s Witnesses make it a point to contact their congregation elders. These wise and experienced counselors can even assist in locating a cooperative facility if the situation is so serious as to require a transfer.* True Christians also remember to rely on the power of Jehovah God. In difficult situations there often is no single, all-encompassing answer, and on our own power, we may not know exactly where to turn. Many have found that when all that is humanly possible has been done, turning to God in prayer has resulted not only in comfort but also in unforeseen solutions.—1 Corinthians 10:13; Philippians 4:6, 7.
Hopefully, you will not have any of these problems, but it is good to plan ahead. Also remember that certain things are expected of you while you are staying in the hospital. The hospital is an excellent place to demonstrate such Christian qualities as patience, thankfulness for kindnesses shown, and especially gratitude to those who help you. A short follow-up letter to the hospital staff, or even a small treat given as an expression of appreciation, makes a lasting impression. Your hospital stay may provide you with an opportunity to give a witness by your own exemplary conduct, thereby contributing to the fine reputation that true Christians enjoy as patients.—1 Peter 2:12.
Long ago a Bible writer penned an inspired proverb that highlights the value of such forethought: “A prudent man sees danger and takes refuge, but the simple keep going and suffer for it.”—Proverbs 22:3, New International Version.
See How Can Blood Save Your Life? (1990), published by the Watchtower Bible and Tract Society of New York, Inc.
As explained in the article on page 12, Jehovah’s Witnesses have valuable sources of assistance in dealing with medical problems and hospital personnel.
[Box on page 5]
In Case You Should Be a Hospital Patient
□ 1. Carry updated Medical Directive/Release Document or written, signed statement of your wishes.
□ 2. Choose your doctor carefully.
□ 3. Make sure that the hospitalization is necessary.
□ 4. Read and fill out admittance forms carefully. If you are one of Jehovah’s Witnesses, promptly identify yourself as such.
□ 5. Bring the minimum of necessary personal items, such as a bathrobe, toiletries, and reading material.
□ 6. Leave at home any jewelry, most electrical appliances, and excess money.
[Box on page 7]
A Patient’s Bill of Rights
When a patient enters a hospital, he should not be overawed by the setting and think that he has become a nonentity. He has rights that most hospitals and staff are happy to respect. The following rights are condensed and based on a list of ten in the book How to Stay Out Of the Hospital, by Lila L. Anastas, R.N.*
The patient has the right to:
1. Considerate and respectful care by competent personnel.
2. Obtain from his physician complete and current information regarding his diagnosis, treatment, and prognosis in terms the patient can understand.
3. Receive from his physician information necessary to give informed consent prior to the start of any procedure and/or treatment. Where medically significant alternatives exist, the patient has the right to such information.
4. Refuse treatment to the extent permitted by the law.
5. Every consideration of privacy concerning his own medical-care program.
6. Expect that all communications and records pertaining to his care will be treated as confidential.
7. Expect that, within its capacity, a hospital must make reasonable response to the request of a patient for services or for transfer to another facility when medically permissible.
8. Obtain information as to any relationship of the hospital to other health-care and educational institutions as far as his care is concerned.
9. Be advised if the hospital proposes to engage in or perform human experimentation affecting his care or treatment.
10. Expect reasonable continuity of care and to know in advance what physicians are available and where.
The book The Rights of Patients—The Basic ACLU Guide to Patient Rights (an American Civil Liberties Union handbook) lists 25 rights in its “Model Patient Bill of Rights.”
[Box on page 8]
Patient Protection and Participation
“Just as no accused person should go to court without a lawyer, so no patient should enter a big-city hospital without a family member or close friend prepared to look after the patient’s interest and to speak up when necessary.”—June Bingham, The Washington Post, August 12, 1990.
“Throughout the ages the idea of patient participation in medical decisions has been alien to physicians’ thinking and practice. And patients have learned from bitter experience that asking too many probing questions may alienate them from us, since we too often resent such inquiries.
“Yet, the idea that we know what is in our patients’ interests and therefore can act on their behalf without inquiry, is so patently untrue that one can only marvel at the fervor with which that notion has been defended. . . .
“We can disagree with patients, even argue with them, even cajole them, but we must do all of this in the spirit of caring for them. Ultimately we must respect what patients want or do not want from us.”—Dr. Jay Katz, psychiatrist, professor at Yale University, The Medical Post, Canada.
“Patients are not infants and physicians are not parents. . . . Indeed, it seems strange to have to remind medical students, and physicians as well, that patients also bring to their encounters with doctors expectations . . . to be trusted and to trust themselves, to be allowed to stand on their own feet and not to have their dependence exploited, to be talked to and listened to, to be treated as equals and not to be ruled, to have their life style treated with respect, and to be allowed to live life in their own self-willed ways.”—The Silent World of Doctor and Patient, by Dr. Jay Katz.
“Service starts with our patient contact. Some 4 million patient interactions every day give American doctors the opportunity to demonstrate not only our competence, but also our genuine compassion, our caring, and our devotion to each individual patient we serve.”—James E. Davis, M.D., president of the American Medical Association.