Behavioral health facilities must make patient rights a priority from every point of patient care from contact and communication to administrative tasks to active care. Patient rights are an ethical obligation, and failure to meet this obligation can result in severe sanctions such as legal actions and regulatory penalties. Therefore, it is not only important for facility owners and direct care providers to be aware of what constitutes a violation of patient rights and how to avoid these violations, but also for everyone who works for the organization to be properly informed and trained on this issue.
Abuse
Abuse of patients includes a wide range of financial, emotional, physical, and sexual abuse, as well as neglect and infringements on the patients’ dignity. Specific examples of abuse in a healthcare setting include:
- Threatening or belittling;
- Physical attacks such as slapping, pushing, pinching, or shaking;
- Unnecessary or overly-aggressive restraint (physical or chemical);
- Physical or social isolation;
- Mocking or humiliation;
- Failure to provide necessities such as food, water, or medication;
- Waiting too long to change soiled bandages, clothes, or bedpans;
- Neglecting regular maintenance duties or calls for help;
- Unwelcome physical contact unrelated to care;
- Taking photos or videos that damage the patient’s privacy or dignity.
Providers should be aware of major signs of patient abuse including sudden behavioral changes and anxiety or signs of insufficient care such as weight loss, unhygienic conditions, bruises, or bedsores. It is also important to take note if more problems or complaints occur during a particular caregiver’s shift.
Inadequate Care
Severe inadequate care can constitute neglect, but there are many other ways healthcare systems and caregivers can fall below the mark on care. These issues can damage the quality of life of patients and pave the way for more serious infractions. Such issues include:
- Delaying scheduled tasks such as bathing, changing bedding, and administering medications;
- Failing to properly monitor patients with conditions that may result in injury without supervision;
- Not providing patients with enough social or emotional enrichment through indifference or isolation.
Scheduled care tasks should be strictly enforced and facilities should always make an effort to improve on the conditions of their treatment centers and their staff’s handling of patients.
Lack of Informed Consent
Because healthcare sometimes requires the sharing of highly sensitive information, the necessity for invasive procedures, and the discernment of important patient health insights, informed consent is paramount on many fronts.
This means that the patient is fully and appropriately informed of important information, standard procedures, and the options available to them. It also requires that the patient or the legally-appointed person in charge of their medical decisions gets to make the choices about their care and further actions are not taken without their consent, with some exceptions for emergency responses in which prepared instructions from the patient are not available. Examples of lack of informed consent include:
- Failing to inform patients of results or potential risks;
- Failing to fully describe a procedure or the follow-up care;
- Failing to properly characterize the probability of risks;
- Failing to inform the patient of all possible options;
- Coercing a patient into a procedure;
- Asking for consent while a patient’s judgement is impaired;
- Not providing a patient with proper translation services if needed;
- Not disclosing financial stake related to treatment options;
- Sharing information without patient consent;
- Conducting unapproved actions or procedures;
- Misrepresenting your experience level in a field or with a specific procedure.
Ensuring patient privacy is another important element of maintaining informed consent.
Privacy Violations
Healthcare facilities store and share substantial quantities of highly sensitive personal information, and therefore must take serious steps to protect that information. Many of the standards for information privacy are outlined by regulations such as HIPAA. Examples of privacy violations include:
- Unauthorized access of patient records;
- Use of unsecured information sharing or storage platforms;
- Failure to disclose a data breach;
- Disclosure to third parties without permission;
- Taking or sharing photos or videos of patients without permission;
- Improper disposal of records;
- Unsecured devices.
Secure communication channels should begin at the decision to record the information, and remain secure at every point of movement or storage thereafter, even following disposal. Primarily, privacy violations can be avoided through employee training, client education, ongoing monitoring, and implementation of technologies such as EHR.
Violations of Personal Rights
The personal rights that people are granted in their-day-to day lives must also be respected, protected, and advocated for in a healthcare setting. Examples of personal rights violations include:
- Discrimination;
- Restriction of freedom;
- Violation of autonomy;
- Breach of privacy.
Violations of personal rights can be avoided by ensuring that all employees are well-versed in personal rights and understand their duties as it pertains to upholding them.
In short, behavioral healthcare facilities should strive for impeccability rather than acceptability when it comes to creating and maintaining standards.
