2.4.2. The patient has the right to consent or refuse to participate in proposed research studies or clinical trials affecting care and treatment and to have those studies fully explained prior to consent.

2.4.3. Any refusal to participate will not compromise a patient's access to other medical center services.

2.4.4. Patients have a right to address any concern they may have about a clinical trial that they have are participating to the chairperson of the Institutional research review and ethics committee ( Prof. MB Raghu at 24762002, ext:432)

2.5.Surrogate decision maker:
The patient has the right to designate a surrogate decision-maker within legal parameters.

2.6. Ethical Concerns/Care at the End of Life
2.6.1.There are times when ethical questions about medical care and treatment options pose dilemmas for patients, families, physician and staff. Ethical issues that could arise in the course of care include conflict resolution, withholding resuscitative services, foregoing or withdrawing of life sustaining treatment. SRMC has established Medical center Ethics Committees to provide consults/advice upon request regarding issues mentioned above.

2.6.2.The chairperson of the multidisciplinary ethics committee is available for consultation and
may be reached at: ____ (day) or _________(night)

2.7. Right to organ donation and anatomic gift
2.7.1. The patient has the right to make a donation of his/ her body or parts there-of for transplantation in as such the donation conforms to the Indian transplantation of human organs (THO) act 1994.

2.7.2.The patient also has the right to make a gift of his/her body or parts thereof upon death for medical education or research in as such the donation conforms to the Indian anatomic gift act (year)

2.7.3. The patient and their family have the right to be provided with the appropriate information and counseling to support their choices with regard to organ donation.

2.8. Treatment Privacy (PFR 1 .3)
2.8.1The patient has the right to every consideration of privacy and may exclude family members from his/her health care decisions.

2.8.2.Care discussions, consultations, examinations, procedures and treatments shall be conducted in a way to respect each patient's privacy.

2.9. Personal Privacy
2.9.1The personal privacy of each patient will be respected by the institution in as much as it is possible without compromise to their safety and clinical care.

2.10. Confidentiality
2.10.1. The patient has the right to confidentiality of all communications and records about his/her care. •
2.10.2. The patient has the right to be informed of the medical center's confidentiality practices as required by law.
2.10.3. Medical records and all other information will be kept confidential unless disclosure is required by law, written consent, or allowed within the limits of the law.

2.11. Communication
2.11.1. The patient has the right to be informed of any restrictions of communications, (i.e., phones, visitors, etc.).

2.11.1. Restrictions will be determined with the patient's participation. Hearing, speech- impaired patients and patients who require interpreters have the right to effective communication assistance.

2.12. Participation in Care Planning
2.12.1.The patient has the right to:
2.12.1.1. make informed decisions regarding his/her care
2.12.1.2. be told of his/her health status
2.12.1.3. be a part of care planning and treatment
2.12.1.4. request a second opinion from another physician or health care provider as long it is in conformation with the policies of the medical center
2.12.1.5. decide if family members will participate in his/her care
2.12.1.6. be involved in ethical questions that arise regarding his/her care and to refuse treatment to the extent permitted by law
2.12.1.7. choose a decision-maker in the event that the patient is incapable of under standing a proposed treatment or procedure or is unable to communicate his/her wishes regarding care


2.13.Respect of cultural and religious beliefs
2.13.1 The patient has a right to continue to exercise his cultural and religious beliefs in as much it is exercised in respect to the beliefs and values of others
2.13.2 The patient has the right to expect that the health care team will respect his/her religious beliefs and personal value systems with regard to care and be informed about the alternatives to the proposed care if these are in conflict to his/ her beliefs. (PFR1.2.1)
2.13.3 The patient has the right to request priestly/ pastoral services and access to places of prayer/ meditation/ worship that exist in the institution


2.14. Managing Pain Effectively
2.14.1. The patient has the right to be involved in pain management decisions and to receive aggressive and appropriate pain management when indicated.
2.14.2. The patient has a right to information about pain and pain relief measures.
2.14.3. The pain management should optimize the comfort of the patient throughout his/her treatment.

2.15. Protective Services
2.15.1.1.The patient has the right to be free from all forms of abuse or harassment.

2.16. Restraints
2.16.1. The patient has the right to be free from restraints of any form that are not medically necessary. They are not used as a means of coercion, discipline, convenience or retaliation by staff.

2.17. Secure Environment
2.17.1. The patient has the right to a safe environment. This includes reasonable measures for the management of infection, emergency preparedness, safe medical equipment, facility security and reasonable care to promote a safe and violent free environment.

2.18. Transfers
2.18.1. The patient has the right to expect that the medical center will provide the health services within the standard of care.
2.18.2. Treatment, referral or transfer may be recommended. If transfer is recommended or requested, the patient will be informed of risks, benefits and alternatives.
2.18.3. The patient will not be transferred to another institution unless that institution agrees to accept the patient.

2.19. Discharge Planning
2.19.2. The patient or his/her designated representative has the right to be told of realistic care alternatives when medical center care is no longer appropriate.

2.20. Billing Explanation
2.20.1. The patient has the right
2.20.1.1. To be informed of services and related charges available in or through the facility
2.20.1.2. To receive an itemized bill, regardless of source of payment
2.20.1.3. To a detailed billing explanation.
2.20.2. The patient may question charges associated with procedures and with billing and will be advised of the availability of financial assistance if appropriate.

2.21.Complaints and Grievances
The patient has the right to be informed of available resources for resolving disputes, grievances and conflicts within the institution.

3. PATIENT RESPONSIBILITIES:
3.1. Health care delivery is enhanced by the involvement of the patient as appropriate to his/her condition as a partner in the health care process.

3.1.1. Health care providers are entitled to reasonable and responsible behaviors on the part of patients and their families.

3.2. Providing Information
3.2.1. The patient is responsible for providing, to the best of his or her knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications, and other matters relating to his or her health.

3.2.2. The patient and family are responsible for reporting perceived risks in their care and unexpected changes in the patient's condition.

3.2.3. The patient and family help the organization improve its understanding of the patient's environment by providing feed back about service needs and expectations.

3.3. Participation in Health Care Decisions
3.3.1. The patient has the responsibility to participate in decisions about his/her health care and to participate in the development and implementation of their plan of care.

3.3.2. Patients are also responsible for asking questions when they do not understand what they have been told about their care or what they are expected to do.

4.  Safety of Possessions (PFR 1.4)
4.1.1. Patients are strongly discouraged from bringing valuables to the institution during hospitalization

4.1.2. In the event of the inevitability of carrying valuables or cash in excess of Rs.5000/ - it is contingent on the patient to inform the administration and avail the use of a safe storage that will be provided for the patient upon request.

4 .1.3. If a patient is brought in a position wherein he or she cannot assume responsibility for their valuables, the institution will secure the valuables until such time that the patient can claim it or the next of kin can claim it upon production of sufficient proof of the relationship.

4.1.4. In as much as that the institution will make every effort to protect and safeguard patient's valuables, it will not assume responsibility for the loss of valuables that have not be secured under its custody.

4.1.5. All thefts and losses may be reported to the security office by calling extension 250

4.2. Following instructions
4.2.1 The patient and family are responsible for following the care, service, or treatment plan developed.

4.2.2 They should express any concerns they have about their ability to follow and comply with the proposed care plan or course of treatment.

4.2.3 Every effort is made to adapt the plan to the patient's specific needs and limitations. When such adaptations to the treatment plan are not recommended, the patient and family are responsible for understanding the consequences of the treatment alternatives and not following the proposed course.

4.3.Accepting Consequences
4.3.1. The patient and family are responsible for the outcomes if they do not follow the care, service, or treatment plan.

4.4.Showing Respect and Consideration
4.4.1.  Patients are responsible for being considerate of other patients, helping to control noise and disturbances and following smoking policies.

4.4.2. Patients are also responsible for being considerate of the organizations rules concerning patient care including respect for personnel and property.

4.5.Meeting Financial Commitments
The patient and family are responsible for promptly meeting any financial obligation agreed to with the organization.

APPROVED ON THIS THE­­­­­­­­­­­­­­­­­­­­­­­ 2 nd OF JUNE ­­ 2004.
CHAIRPERSON
MEDICAL STAFF EXECUTIVE COMMITTEE

CHIEF EXECUTIVE DIRECTOR