Helge Garåsen The Trondheim Model - NSDM

trust between the patient and health services while having respect for the individual patient’s
life, integrity and human worth.
The patient is entitled to emergency medical services and is entitled to receive necessary
health care from the municipal health service and to receive necessary health care from the
specialist health service. The health service must give anyone who applies for, or who needs
health care, the medical- and care-related information he will need in order to safeguard his
rights.
The right to health care only applies if the patient can be expected to benefit from the health
care, and if the costs are reasonable compared to the expected effect that can be gained from
the proposed medical measures.
The patient is entitled to participate in the implementation of his medical care. This includes
the patient’s right to choose between available and medically sound methods of examination
and treatment. Participation must be adapted to the individual patient’s ability to give and
receive information. If the patient is not capable of giving an informed consent, the patient’s
next of kin is entitled to participate on behalf of the patient. However, it is the clinicians that
make the final decisions.
Both the Swedish and Norwegian acts stress that care must, as far as possible, be conducted
and designed in consultation with the patient. However, the Swedish system is still
characterised by professional paternalism (55).
2.4 Where do the patients want to get care?
A study from Denmark (57) compared the older patients’ ADL statuses with where they were
living prior to, and after, being hospitalised. In this study the authors concluded that older
people with a high ability to cope with daily and social activities wanted to stay in their own
homes and have control over their own future. Leland, in his master’s thesis from 2001,
discussed if the possibility, and ability, to live in a person’s own home is an important value
by itself, worth fighting for and if it by itself strengthens older people’s ability to cope (58),
i.e. an important factor according to Antonovsky’s theories about sense of coherence (SOC)
(59).
27