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The Right to Health and Patients‘ Rights: Population-based Assessment

The Right to Health and Patients‘ Rights: Population-based Assessment. Anne Brunner 1,2 , Manfred Wildner 1,3 1 Bavarian Public Health Research Center 2 Catholic University Eichstätt 3 Ludwig-Maximilians-University Munich. The Human Rights Context. §.

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The Right to Health and Patients‘ Rights: Population-based Assessment

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  1. The Right to Health and Patients‘ Rights: Population-based Assessment Anne Brunner1,2, Manfred Wildner1,3 1Bavarian Public Health Research Center 2Catholic University Eichstätt 3Ludwig-Maximilians-University Munich

  2. The Human Rights Context § I. Nuremberg Code for Physicians(Doctors‘ Trials ar Nuremberg 1946/47) II. International Human Rights Treaties 1948 Universal Declaration of Human Rights 1950 European Convention on Human Rights and Fundamental Freedoms 1961 European Social Charter 1966 International Covenant on Civil and Political Rights 1966 International Covenant on Economic, Social and Cultural Rights 2000 Charter of Human Rights of the European Union (Nice Treaty) III. National (Constitutional) Law

  3. Patients‘ Rights and Human Rights ICESCR ICPCR U D H R PR Nuremberg Code 1946/47

  4. Patient Orientation 1991 Patients‘ Charter (GB) 1994 Amsterdam Consultation (WHO) „Declaration on the Promotion of Patients‘ Rights in Europe“ 1996 Ljubljana Charta „Reforming Health Care“ 1997 Gothenburg Consultation (WHO) 1999 Gesundheitsministerkonferenz Trier„Patientenrechte in Deutschland heute“

  5. Declaration on the Promotion of Patients‘ Rights in Europe(WHO 1994) • Human Rights and values in health care • Information • Consent • Confidentiality and privacy • Care and treatment • Application

  6. Status of patients‘ rights: where is the evidence?

  7. Study Design MSD Sharp & Dohme Research Grant on Health Targets in Europe 2000 • Citizens‘ perspective • Household sample (CATI) • Four German-speaking cities Munich, Dresden, Vienna (A), Berne (CH)

  8. Methods • Computer assisted telephone interview • 15 minutes • Netto-Response Rate • 43%-60% • Dimensions • Demography (17) • Health Status (SF 12) • Human Rights Status (19) • Patients‘ Rights Status (30) • Response categories • Yes/No • Don‘t know • No answer

  9. Example Q: My privacy is adequately respected by doctors and other health care providers A: Agree – don‘t agree – don‘t know

  10. Demography • Munich (127) • Dresden (124) • Vienna (125) • Berne (126) • Female 57%-70% • Native German tongue 86%-98% • Age 25-78 years (mean 49)

  11. Munich

  12. Munich: Human rights and values Access to care and prevention

  13. Munich: Information rights Information about health services Information during inpatient care

  14. Munich: Consent

  15. Munich: Confidentiality and privacy

  16. Munich: Care and treatment Humane terminal care Transition between institutions or sectors Continuous health care coordination

  17. Munich: Application Information and advice on the rights as a patient Successful protest *

  18. Dresden: Human rights and values Access to care and prevention

  19. Dresden: Information rights Information about health services Right not to be informed Information during inpatient care

  20. Dresden: Consent

  21. Dresden: Confidentiality and privacy Access to own medical files

  22. Dresden: Care and treatment Humane terminal care Transition between institutions or sectors

  23. Dresden: Application Information and advice on the rights as a patient Successful protest *

  24. Vienna: Human rights and values

  25. Vienna: Information rights Information about health services Right not to be informed Information during inpatient care

  26. Vienna: Consent

  27. Vienna: Confidentiality and privacy Access to own medical files

  28. Vienna: Care and treatment Humane terminal care Transition between institutions or sectors

  29. Vienna: Application Information and advice on the rights as a patient Successful protest *

  30. Berne: Human rights and values

  31. Berne: Information rights Right not to be informed Information during inpatient care

  32. Berne: Consent

  33. Berne: Confidentiality and privacy

  34. Berne: Care and treatment Humane terminal care

  35. Berne: Application

  36. Diagnosis: High fulfillment • Dignity • Humanity • Confidentiality • Autonomy • Free choice • Contact to family and friends

  37. Diagnosis: Low fulfillment • Information rights (various) • Hospital/sectoral transition • Humane terminal care

  38. Perspective Research, monitoring and evaluation of patients‘ rights fulfillment

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