Exploring patient participation in reducing health-care-related safety risks

The 2005 United States act on patient safety and quality improvement (18) aims
to strike an appropriate balance between encouraging the reporting of valuable
information that will be used to save lives and safeguarding individuals’ ability to access
necessary information, enabling them to seek judicial redress when appropriate. As the
Congressional Record notes:
[The act] would assure doctors and other health professionals that if they voluntarily report
information to expert patient safety organizations, that information will be used for health care
quality improvement efforts and will be kept privileged and confidential. This protection will
encourage health care professionals to report and will result in the creation of valuable new
information that can be used to identify best practices for eliminating errors and improving
patient outcomes. We believe the bill will also help reduce the number of lawsuits resulting
from medical errors. Information from medical records and other existing data sources will
continue to be available for injured plaintiffs to pursue their claims in court, just as that
information is available today (19).
Patients’ rights in the area of patient safety
In general terms, the relationship between legal rights and patient safety has been clearly
summarized by WHO (WHO Regional Office for Europe, unpublished data, 2009):
The fulfilment of the right to health (a human and patient right) involves all health care actors:
patients/consumers, governments and health care providers/stakeholders in rendering it concrete.
All binding and non-binding international documents revised emphasize that international
frameworks and policy instruments should be used to protect the fundamental human rights
including patients’ rights. In the quest towards strengthening political commitment of Member
States, the WHO Declaration on the promotion of patients’ rights in Europe and the European
Charter of Patients’ Rights, seek to render the right to health concrete, applicable and appropriate
to the current transitory situation in health services across the region. Work towards a common
European framework for action and international instruments for realizing national policies
in the field of patients’ rights recorded substantial progress according to reported data. Most
of the European [Member States] have national dedicated policies and charters addressing
patient rights. The implementation of local instruments as juridical legislation or extra juridical
organisms (e.g. national or regional ombudsman) have to be encouraged and promoted to render
effective the patient/consumer protection. The right to safety is a key point in the implementation
of the right to health. Promoting patient safety is strictly connected with the development of
consumer empowerment, and involvement in the process of health promotion and care, including
participation in the policy-making process. It is expected to support the active partnership needed
in the process of improving safety, quality and efficiency of health service delivery.
Patients’ rights have been identified and elaborated in international documents and
guidelines, national legislation, case law and deontological codes over decades. A
number are relevant to patient safety. They can be separated into categories according to
the level at which a right can best be exercised (for instance, collectively or individually)
or based on their orientation (substantive or procedural). Such categorizations may be
helpful in clarifying the content and legal strength of the rights in question, but not all
patients’ rights fit into a specific category, and some might belong to more than one. For
that reason, the rights mentioned in the following sections are not categorized. They
Patients’ rights and patient safety
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