Understanding the Patient Bill of Rights
A patient bill of rights typically calls for fair care, provides health consumers with ways to address concerns, and advocates for patients to take an active role in their well-being. Understanding patient rights and expectations can help you practice nursing ethically.
Although these guidelines are commonly referred to as a “bill of rights,” this is a misnomer, since no single federal law includes an exhaustive list of rights for patients. Unlike the Constitution, the list of patient rights isn’t a single document, but an evolving set of mandates that have been issued by different organizations. As a subset of human rights, patient rights are closely linked with ethics and policy, which can change over time. Let’s explore how patient rights have evolved in the last several decades so you can better understand how to be a more effective and ethically minded nurse.
A Short History of the Patient Bill of Rights
The first patient bill of rights was released by the American Hospital Association (AHA) in 1973. This document encouraged healthcare facilities to treat patients with certain standards of care, including the first mandate on informed consent. This concept promoted patient autonomy, a radical change from the tradition of paternalism in medicine.
In 1996, the Health Insurance Portability and Accountability Act (HIPAA) created federally regulated privacy rights for patients. This law protected patient information, setting standards for how information can be handled and disposed of. It also outlined portability standards for insurance, so that consumers wouldn’t lose insurance when switching jobs. Health insurance providers, care providers, and clearinghouses are subject to the laws outlined by HIPAA.
With time, increased patient autonomy brought shared decision-making between patients and providers. The AHA updated its original bill of rights in 2003, promoting partnership between patients and care teams. This new Patient Care Partnership is a brochure that’s available in several languages and uses simple terminology, making it more accessible for patients.
The Affordable Care Act of 2010 brought new elements to the discourse around patient rights. It prohibited insurers from denying coverage due to preexisting conditions and allowed young adults to remain on their parents’ insurance plans until age 26. The ACA also introduced the Patient’s Bill of Rights, a set of protections aimed at ensuring fair treatment, transparency, and security in health coverage.
Today, many hospitals, health systems, and states have their own list of patient rights. Nursing homes, for example, are subject to care standards outlined by Medicare and Medicaid. As healthcare continues to evolve, these frameworks help ensure that patient voices remain central.
What’s Included in a Patient Bill of Rights?
Since there is no single law outlining rights for patients, this will depend on the facility you are in, your state, and other factors. In general, patients should be treated with respect, be informed about their care, and have the opportunity to make decisions for themselves. On the other side of care, healthcare professionals are entitled to a safe, non-hostile work environment.
Patients may need different rights depending on the clinical area. For an example of patients’ rights, check out the National Institutes of Health’s rights for patients participating in research:
- Safe, respectful, and considerate care, provided in a way that is consistent with the patient’s beliefs.
- All communications and records that pertain to a patient’s care will be treated confidentially.
- Patients must know the physician responsible for coordinating their care.
- Complete information about diagnosis, treatment, and prognosis must be communicated clearly in understandable terms.
- Patients must have complete information necessary for informed consent, including risks, descriptions of treatments, and alternatives. In case of emergency, there may be rare exceptions to this right.
- Patients have the right to routine care as related to research protocols.
- Patients will be advised of their appointment times and provider availability.
- Patients have the right to appropriate assessment and treatment for pain.
- Patients can refuse treatment or research participation at any time and be informed of the risks of doing so.
- Patients can be transferred to another facility if care is terminated.
- Patients’ summaries will be sent to their referring physician.
- Patients may request that other physicians or organizations receive medical updates.
7 Ways to Protect Patient Rights in Nursing
Since patient rights can seem like a moving target, how can you advocate for your patients to ensure that they get the care they need? Follow these tips:
- Read up on the patient bill of rights in your facility. Every healthcare setting may have a slightly different document that outlines what patients are entitled to during their care. Familiarizing yourself with your facility’s policy helps you recognize when a right is being overlooked and can give you confidence if you need to speak up.
- Listen to your patients. Patients may not use the language of “rights,” but if they express confusion, distress, or feel left out of decisions, slow down and ask questions. Listening actively and empathetically is one of the most powerful tools for upholding their patient dignity and autonomy.
- Practice medication rights. When you’re working too quickly, it’s easier to make a mistake. Slow down to practice the five rights of medication administration — right person, right drug, right dose, right route, right time.
- Educate your patients about their rights. Many patients don’t know what they’re entitled to. Take time to explain things like informed consent, the right to refuse treatment, or how to file a grievance if needed. Many facilities provide a printed list of patient rights for this purpose.
- Respect privacy and confidentiality. Be mindful of where and how you share sensitive information, even in casual conversation. Communicating with discretion helps you protect patient privacy and your nursing license.
- Watch for and report signs of abuse or neglect. Especially in vulnerable populations like the elderly or disabled, being alert to changes in behavior or unexplained injuries can help you protect patients’ safety. Reporting these concerns is also often a legal requirement.
- Support language access and cultural competency. Patients who speak limited English need access to medical interpreters to be informed about their care. Also, be aware of cultural differences that may affect how patients perceive illness, treatment, and authority figures in healthcare.
Patient Bill of Rights FAQ
What patient right is most often violated?
It’s difficult to provide a definitive answer, since many violations go unreported. When it comes to patient privacy rights, some of the most common HIPAA violations include snooping on patient records, denying patients access to healthcare records, and improperly disposing of confidential information.
What is an example of a patient rights violation?
A patient receiving a non-emergent procedure without being properly informed of the risks is a clear violation of informed consent. Another example would be if a nurse were discussing a patient in the hospital cafeteria, and the patient’s family overheard confidential information.
Can a nurse be arrested for violating patient rights?
Yes, criminal charges can be brought against nurses for abuse, neglect, or withholding treatment from a patient if a violation is serious enough. HIPAA confidentiality violations can also result in fines or loss of licensure rather than criminal prosecution.
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Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.