Shalev Carmel, Freiman Efrat
Unit for Health Rights and Ethics, Gertner Institute for Health Policy Research, Tel Hashomer, Israel.
Med Law. 2002;21(3):521-39.
Israel enacted the Patient Rights Law in 1996. The Law embodies a movement from paternalism to autonomy in doctor-patient relations. The following year, law students at the Israeli Centre for Academic Studies participated in a clinical seminar designed to measure internalisation ofthe Law, through personal interviews with hospitalized patients. The seminar can be adapted for medical students. The methodology is taken from human rights field work. The objective is to use patient rights as indicators of quality of care in medical settings. Students studied the text and principles of the Law in light of personal testimonies taken from relatives and friends. They developed an open-structured questionnaire, and were trained in interviewing with due respect for the patients' dignity and privacy, and the need to obtain their free and informed consent to the interview. The interviews were conducted in Hadassah Hospital, Jerusalem, after receiving approval of the Helsinki Committee. The findings, though in no way statistically valid, are nonetheless interesting. Students received training in listening and advocacy skills. The approach is conciliatory rather than adversarial. The thesis is that respect for patient rights is an efficient tool for quality control, risk management, conflict resolution and prevention of litigation.
以色列于1996年颁布了《患者权利法》。该法律体现了医患关系从家长式作风向自主权的转变。次年,以色列学术研究中心的法律专业学生参加了一个临床研讨会,旨在通过对住院患者进行个人访谈来衡量该法律的内化程度。该研讨会可适用于医学生。其方法取自人权实地工作。目的是将患者权利用作医疗环境中护理质量的指标。学生们根据从亲戚和朋友那里获得的个人证词来研究该法律的文本和原则。他们编制了一份开放式问卷,并接受培训,在访谈中充分尊重患者的尊严和隐私,以及获得患者对访谈的自由和知情同意的必要性。在获得赫尔辛基委员会的批准后,访谈在耶路撒冷的哈达萨医院进行。研究结果虽然在统计学上没有效力,但仍然很有趣。学生们接受了倾听和宣传技巧的培训。这种方法是和解性的而非对抗性的。其论点是,尊重患者权利是质量控制、风险管理、冲突解决和预防诉讼的有效工具。