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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 Anne Brunner1,2, Manfred Wildner1,3 1Bavarian Public Health Research Center 2Catholic University Eichstätt 3Ludwig-Maximilians-University Munich
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
Patients‘ Rights and Human Rights ICESCR ICPCR U D H R PR Nuremberg Code 1946/47
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“
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
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)
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
Example Q: My privacy is adequately respected by doctors and other health care providers A: Agree – don‘t agree – don‘t know
Demography • Munich (127) • Dresden (124) • Vienna (125) • Berne (126) • Female 57%-70% • Native German tongue 86%-98% • Age 25-78 years (mean 49)
Munich: Human rights and values Access to care and prevention
Munich: Information rights Information about health services Information during inpatient care
Munich: Care and treatment Humane terminal care Transition between institutions or sectors Continuous health care coordination
Munich: Application Information and advice on the rights as a patient Successful protest *
Dresden: Human rights and values Access to care and prevention
Dresden: Information rights Information about health services Right not to be informed Information during inpatient care
Dresden: Confidentiality and privacy Access to own medical files
Dresden: Care and treatment Humane terminal care Transition between institutions or sectors
Dresden: Application Information and advice on the rights as a patient Successful protest *
Vienna: Information rights Information about health services Right not to be informed Information during inpatient care
Vienna: Confidentiality and privacy Access to own medical files
Vienna: Care and treatment Humane terminal care Transition between institutions or sectors
Vienna: Application Information and advice on the rights as a patient Successful protest *
Berne: Information rights Right not to be informed Information during inpatient care
Berne: Care and treatment Humane terminal care
Diagnosis: High fulfillment • Dignity • Humanity • Confidentiality • Autonomy • Free choice • Contact to family and friends
Diagnosis: Low fulfillment • Information rights (various) • Hospital/sectoral transition • Humane terminal care
Perspective Research, monitoring and evaluation of patients‘ rights fulfillment