Do patients have duties?

Abstract

The notion of patients’ duties has received periodic scholarly attention but remains overwhelmed by attention to the duties of healthcare professionals. In a previous paper the author argued that patients in publicly funded healthcare systems have a duty to participate in clinical research, arising from their debt to previous patients. Here the author proposes a greatly extended range of patients’ duties grounding their moral force distinctively in the interests of contemporary and future patients, since medical treatment offered to one patient is always liable to be an opportunity cost (however justifiable) in terms of medical treatment needed by other patients. This generates both negative and positive duties. Ten duties—enjoining obligations ranging from participation in healthcare schemes to promoting one’s own earliest recovery from illness—are proposed. The characteristics of these duties, including their basis, moral force, extent and enforceability, are considered. They are tested against a range of objections—principled, societal, epistemological and practical—and found to survive. Finally, the paper suggests that these duties could be thought to reinforce a regrettably adversarial characteristic, shared with rights-based approaches, and that a preferable alternative might be sought through the (here unexplored) notion of a “virtuous patient” contributing to a problem-solving partnership with the clinician. However, in defining and giving content to that partnership, there is a clear role for most, if not all, of the proposed duties; their value thus extends beyond the adversarial context in which they might first be thought to arise.

How do queuing concepts and tools help to efficiently manage hospitals when the patients are impatient? A demonstration

“…See Buhaug (2002), Preater (2002), Propper et al (2002), Sternberg (2006), and Kennedy et al (2004) for details on issues connected to waiting time in hospitals. Evans (2007) mentions a list of duties for the patients. The patient flow is indicative of efficiency of hospital operation.…”

“…The demand for patients care in developing nations is perpetually higher than the capacity to serve the patients. The patients are obligated to discharge their duties [Evans, 2007]. The patient's duties are of paramount importance especially in limited healthcare resources.…”

Telecare and self-management: opportunity to change the paradigm?

“…If the data show that something is wrong, the patient will receive a call or electronic message. In interviews with patients using such a system some reported feeling safe and secure because as long as they did not receive a telephone call, they knew they were all right 16 17…”

“…Second, on a normative level compliance has recently been promoted as a moral good—it has even been argued that patients have a duty to comply with medical prescriptions and regimens17 18 19 The main argument is derived from the principle of justice vi. Because the society shares the medical costs, patients have a duty to do everything in their power to reduce these costs, and therefore they should be compliant, the argument goes.…”

Parents as equal partners in the paediatric cystic fibrosis multidisciplinary team

“…For longitudinal care such as paediatric CF, this is the framework required. 27 The standard system for CF paediatric teams should be to consider the parent as inclusive and aim for partnership with parents, collaboration for treatment decisions, shared treatment goals and health outcomes, recognition of family pressures, and consider family and child quality of life parameters as valid. Returning again to Patient A (Box 1), perhaps the best outcome would be:…”