Dignity: First casualty in hospitals

Case 1: A 15-year-old dies in hospital after a road accident. His parents complain that he was not put into the intensive-care ward. Case 2: An operation scheduled to be performed by a particular surgeon is postponed by the director of the clinic and the issue develops into a personal dispute. The patient wonders whether the decision benefited his health. Case 3: The staff in an outpatients’ clinic behave contemptuously toward a foreign patient and her escort. These everyday incidents impinge on patients’ rights to healthcare and dignity. Some cases end up in court and others – just a few dozen – at the committee for the protection of patients’ rights, which operates at the Health Ministry. Professor Vassilis Golematis, currently chairman of the committee, has started visiting hospitals to investigate complaints, improve communications among doctors, nurses, administrative staff and patients, and promote institutions for the protection of patients’ rights. «The committee is an independent service set up in 1997 to protect people who go to hospital for examinations or treatment and who confront problems that impinge on their rights,» Golematis told Kathimerini. «It is an institution which is being set up around the world to get the message across to health professionals that patients are entitled to proper treatment and good behavior, to the protection of their dignity and personality. «Although some complaints are referred to the public prosecutor, we are not as interested in the legal side as in getting across the message and establishing new perceptions and attitudes in hospitals.» Golematis believes patients have to be assertive to protect themselves. «I’ve always told my students that patients are ill even when they’re wrong. But 80 percent of the complaints that patients have made to the committee seem reasonable and well-founded.» Correct information and communication between patients and doctors is also the best way to avoid malpractice claims of the type that have mushroomed in some other countries, such as the United States. It is as important to protect the dignity of patients as it is to protect their health. For example, the poor infrastructure of many Greek hospitals is no excuse for leaving elderly patients naked in full view in examining rooms or for failing to put up screens in wards. This arises from a lack of sensitivity, which gives patients the impression they have left their personality and dignity at the door of the hospital. «Nearly all the complaints that have been made to the committee concern matters of behavior, poor information and delayed examinations,» said Golematis. Professor, what conclusions have you drawn from studying these cases? That we need to give patients more time. As health professionals, we have a duty to explain to them exactly what surgical procedure will be followed if they are going to be operated on and the patient will decide whether to go ahead. If the patient changes his or her mind the next day, he or she is entitled to leave the hospital. This summer I dealt with the case of a patient who had advanced cancer of the rectum. It was a borderline decision whether to perform a colostomy, which entails a functional disability. I advised the patient, who decided not to have the operation. «I lived with dignity and I want to die with dignity,» he said. «I don’t want to live like that.» We heard that you and other members of the committee visit hospitals to investigate complaints. Have there been many cases since the patients’ rights committee was formed? No, I’m afraid not. The previous chairmen of the committee, who were all attorneys, resigned one after the other, perhaps because most of the the cases were of a medical nature. It takes a personal viewpoint, hard work and persistence. And the different opinions on the same subject have to be brought together in an on-site investigation. It’s very interesting that most of the complaints and court cases concern the behavior of health professionals. We have to change our mentality. Some patients can be bad-tempered and illness can make them behave badly. Doctors have to take the time to explain things to them. They must respect patients’ personalities and not speak to them scornfully. I firmly believe that by regular visits to hospitals and on-site investigations into specific complaints, we will get the message across to doctors and staff and be able to restore patients’ trust.