RH Bill: What you deserve.

Everytime I register for a fun-run, I usually check the beneficiary and the stuff that comes with the race pack. I make sure that everything is complete e.g. race bib, timing chip, singlet and route map. It doesn’t end there. Some seasoned runners also check if the distance they ran is exactly what they registered for. There was one running event that got so many complaints from the 10-km runners because the route was only 8.9 km. I guess it is a natural reaction for people if they did not get what they deserve or even paid for.
I remember during my clerkship year in medical school, that the residents and consultants are the “gods” in the hospital. Since we are rotating in the charity ward, patients have little choice but to listen to what the doctors have to say. As clerks, we just carry out the orders given to us. I told myself that one day I will be a consultant too and give orders for my patients.
I took my residency training in a private hospital and I thought this is my opportunity to call the shots. However, this was already the time when there is already a paradigm shift with regards patient care. The hospital was espousing a different model in patient care and that is putting the patient on center stage. I didn’t quite get the meaning at first until I gradually imbibed the culture. It is a must that we explain whatever the patient must know and lay down options for them to choose. The patient is involved in the decision making regarding their health. I also came to realize that they deserve such information and care because they paid for such services. It is the patient who is in the center of our care and not the doctors. This concept was further emphasized when the hospital applied for an international accreditation. It was my senior year in training when the accreditors came to evaluate the hospital. I was assigned to review a patient chart with the accreditor. It was random and the chart is a minor surgical case – newborn circumcision. The accreditor asked about the contents of the informed consent which we make the authorized person to sign. She asked if it contains the complications of the procedure, type of anesthetic used, etc. To my surprise, it was a general statement only. She asked me if I am in the position of the signatory, would I be satisfied with the informed consent. It was a learning experience for all of us. A dramatic change happened and the hospital has to revise all the consent forms indicating all important things that can potentially happen in any procedure no matter how trivial it is. It was even a policy that the consent forms be given to the patient days before any procedure for them to read and fully comprehend the risks involved in the procedure that they will undergo.
It did not end there. We were taught the value of explaining to the patient the possible options available and its corresponding benefits. We are discouraged to withhold information with the intention of convincing the patient to agree with our plans. Simply put, we are empowering our patients to have an informed decision. Now, the hospital espouses a new brand of patient care – making “patients as partners”. I believe every health institution has their own brand of care and it all boils down to giving what the patients rightfully deserve, whether in a private or public sector. All these advocacies are consistent with the Medicine Code of Ethics, particularly in Section 1, which bounds the physician to secure for their patients all possible benefits that may depend upon his professional skill and care.
The Reproductive Health Bill, which was tainted by so many allegations and accusations, is a non-issue for me. It is a 14-page Bill and easy to read. It speaks of the universal basic human right to reproductive health and the right to make free and informed choices – same guiding principles which I was taught in my training and consistent with the Medicine Code of Ethics. It simply highlights what each Filipino couple deserves, regardless of religion or economic status. Unfortunately, most of the people who benefit from such right are the people who can afford and has adequate understanding of and access to information. The consequence for those who lack access to reproductive health information and services, particularly the poor sector, suffer from complications of pregnancy such as bleeding, preeclampsia, unsafe abortion, etc., which is translated to 11 deaths per day. However, we still see patients who obtain incomplete and inaccurate information pertaining to reproductive health. There are discrepancies on the content of information disseminated particularly by lay people leading to more misconceptions. Family planning services are not uniformly distributed and it is banned in some areas depriving couples, particularly women, these basic services that they deserve. Despite the very slow decline in our maternal mortality rate, admittedly not reaching our MDG 5 target in 2015, we don’t have a unified approach to improve maternal health. We also have to bear in mind that the Philippines is a signatory to international treatise which addresses reproductive health and women’s rights such as the ICPD, CEDAW and recently the MDG.
Patients in private institutions have the right to demand the services that they paid for. Even as petty as being short-changed for a 10 km run, it is their right because they deserve it. Just the same, I think every Filipino deserves the right to free access of reproductive health information and services because the country is duty bound to uphold the common good of the Filipino and be faithful to our international commitments.