Hostname: page-component-848d4c4894-wg55d Total loading time: 0 Render date: 2024-05-05T06:55:29.651Z Has data issue: false hasContentIssue false
  • English
  • Français

The Emerging Stowaway: Patients' Rights in the 1980s

Published online by Cambridge University Press:  27 April 2021

George J. Annas
Get access Rights & Permissions [Opens in a new window]

Extract

At one point in Edgar Allan Poe’s Narrative of Arthur Gordon Pym of Nantucket, Pym, who has stowed away in the hold of a whaling vessel, believes he has been abandoned and that the hold will be his tomb. He expressed sensations of “extreme horror and dismay,” and “the most gloomy imagining, in which the dreadful deaths of thirst, famine, suffocation, and premature interment, crowded in as the prominent disasters to be encountered.”

It is probably uncommon for hospitalized patients to feel as gloomy as Pym. Nevertheless, installed in a strange institution, separated from friends and family, forced to wear a degrading costume, confined to bed, and attended to by a variety of strangers who may or may not keep the patient informed of what they are doing, the average patient is intimidated and disoriented. Such an environment encourages dependence and discourages the assertion of individual rights.

As the physician-director of Boston’s Beth Israel Hospital has warned: “today’s hospital stands increasingly to become a jungle, whose pathways to the uninitiated are poorly marked and fraught with danger. . . .”

Type
Article
Information
Law, Medicine and Healthcare , Volume 10 , Issue 1 , February 1982 , pp. 32 - 46
Copyright
Copyright © American Society of Law, Medicine and Ethics 1982

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rabkin, M., quoted in Annas, G.J., The Hospital: A Patient Rights Wasteland. Civil Liberties Review (Fall 1974) at 11.Google Scholar
See generally Annas, C.J., The Rights of Hospital Patients (Avon Books, New York) (1975).Google Scholar
Margolis, E.G., Conceptual Aspects of a Patient's Bill of Rights, Connecticut Medicine Supplement 43:9 (October 1979). See also Ladd, , Legalism and Medical Ethics, in Davis, Hoffmaster, Shorten, , eds., Contemporary Issues in Biomedical Ethics (Humana Press, New Jersey) (1978).Google Scholar
Examples of patient abuse based on providers’ misunderstanding of the law after the Saikewicz case in Massachusetts are cited in Annas, G.J., Reconciling Quinlan and Saikewicz: Decision Making for the Terminally Ill Incompetent, American Journal of Law & Medicine 4(4):367, 387 (Winter 1979).Google ScholarPubMed
Rawls, J., A Theory of Justice (Harvard Univ. Press, Cambridge, Mass.) (1971).Google Scholar
Dworkin, R., Taking Rights Seriously (Harvard Univ. Press, Cambridge, Mass.) (1977).Google Scholar
Id. at 205.Google Scholar
Reprinted in Annas, , supra note 1, at 25-27.Google Scholar
Altman, J.H., Patterns Who See Their Medical Record, New England Journal of Medicine 302(3):169 (January 17, 1980).Google Scholar
Lipsett, D., Editorial. New England Journal of Medicine 302(3): 167 (January 17, 1980).Google Scholar
Burt, R.. Taking Care of Strangers: The Rule of Law in Doctor-Patient Relations (Free Press, New York) (1979) at 43.Google Scholar
Stevens, D.P. Stagg, R. MacKay, I., What Happens When Hospitalised Patients See Their Own Records. Annals of Internal Medicine 86:474, 476 (1977). For a more complete discussion of this issue, including additional studies of patients given routine access to their records, see Annas, G.J. Glantz, L.H. Katz, B.F., The Rights of Doctors, Nurses and Allied Health Professionals (Avon Books, New York) (1981) at 159-61.Google Scholar
Golodetz, A. Ruess, J. Milhous, R., The Right to Knew Giving the Patient His Medical Record, Archives of Physical Medicine and Rehabilitation 57:78, 80 (1976). Experience under the new record access regulation enacted by the Massachusetts Board of Registration in Medicine indicates that patients want access to their records for a variety of reasons, In the period from October 13, 1978 (when the regulation went into effect) to January 31, 1980, the Board received more phone calls from consumers asking about the medical records regulation (approximately ten per month) than about any other single issue dealt with by the Board. There were also 33 formal complaints filed concerning record access during this period. Of this number, almost half (16) needed help from the Board to get their physician to forward a copy of their records directly to another physician. Of the remaining 17, six needed information for insurance purposes, six wanted to personally review the records for various reasons, one alleged negligence, one wanted the record sent to a school nurse, one was moving to another state, one wanted a second opinion, and one wanted her contact lens prescription. (Statistics compiled by Judy Miller, a student at Boston College Law School.)Google Scholar
See. e.g., Laforet, E.G., The Fiction of Informed Consent. Journal of the American Medical Association 235:1579 (April 12, 1976).Google ScholarPubMed
Cassileth, B.R., Informed Consent—Why Are its Goals Imperfectly Realized? New England Journal of Medicine 302(16):896 (April 17, 1980).Google ScholarPubMed
See generally chapter on Informed Consent in Annas, G.J. Glantz, L.H. Katz, B.F., The Rights of Doctors, Nurses and Allied Health Professionals (Avon Books, New York) (1981); and Annas, G.J. Glantz, L.H. Katz, B.F., Informed Consent to Human Experimentation: The Subject's Dilemma (Ballinger, Cambridge, Mass.) (1977). See also Rennie, D., Informed Consent by “Well-Nigh Abject” Adults. New England Journal of Medicine 302(16):916 (April 17, 1980). “I suggest that the physician accept far more than simply the duty to improve consent forms…. They should accept education of the patient through the process of consent as a worthwhile therapeutic goal. To deny the possibility of informed consent is to ensure that it will never be achieved—an attitude that is immoral and … illegal.” Id. at 918.Google Scholar
Thomas, L., On Magic in Medicine. New England Journal of Medicine 299:461, 462 (August 31, 1978).Google ScholarPubMed
Lear, M.L., Heartsounds (Simon & Schuster, New York) (1980) at 47.Google Scholar
Annas, G.J., The Care of Private Patients in Teaching Hospitals: Legal Implications. Bulletin of New York Academy of Medicine 56(4):403–11 (May 1980).Google ScholarPubMed