Rights and obligations

Sometimes, in the long course of a physician’s education, it’s easy to forget what is common knowledge and what isn’t. Doctors spend most of their time in hospitals, with a language understood only by those in the same field. Things we consider common knowledge may not be as accessible to others.

In the week since my last column, my colleagues in the profession and I have been inundated, on the one hand, by support; and, on the other hand, by so much noise from those who would tell us and allied health professionals how to do our jobs. Things that we thought of as common sense, like the importance of patient-physician privacy, are foreign concepts to some.

To close our minds to all criticism of our profession would be useless; we can all cry out against doctor-shaming, but so much of the outcry is a pity-party begging the public to make excuses for bad behavior. No, my 36 hours awake doesn’t justify my rudeness both to patients or to other health professionals. No, the number of teenage pregnancies doesn’t excuse my judgmental and petty behavior toward the next pregnant 14-year-old who comes to the emergency room.

The inhumane hours, the frustrations of the healthcare system, and the poorly educated layman—all these can explain, but not excuse, jadedness, irritability and clerical errors.

On the other hand, though, healthcare workers really are at a unique position of being the frontliners in an industry where there are so many imperfections of a grave nature, and where lives literally hang in the balance. Yet, most of the powers that be are nameless before the public, and we are the easy targets, blamed both for personal errors and systemic ones. Our errors are magnified, our job descriptions made fluid.

Nurses, for example, get blamed even for malfunctioning air conditioners and—as previously mentioned here—are even asked to do Starbucks coffee runs. Healthcare, as I’ve mentioned, is a perpetual balance of trying to give patients what they need while not dismissing outright what they want, now that instantaneous and personalized gratification is the norm. We know our obligations to patients and the community and we fulfill them, with due consideration to how patients come to us in sincere need.

We as doctors know our rights, and since it appears that the community at large may not, then let us take this opportunity to name them: among several others, we have the right to refuse to provide treatment (in nonemergency situations and without resorting to neglect or abandonment); the right to refuse participation in treatments; the right to be paid; and the right to set up guidelines and boundaries for our relationships with our patients.

We have the right to ask for information to assist us in the performance of our duty, and thus demand honesty from those we treat. We have the right to provide sound treatment: For example, we have the right to see patients according to the (much-belabored) concept of triage, which the layperson may not fully understand. Furthermore, in the same way that we protect patients’ privacy, we have the right to expect our privacy to be protected, too; the fact that we are in a service profession is not a free-for-all and does not give any man on the street the right to film us at work in the performance of our duties, no more than a priest hearing a confession or a lawyer handling a client interview may be filmed.

We must fight for the right to be treated as professionals, and as people. The public mistakes us if it believes that we want to be treated as gods. We have the right to basic respect, just like every patient who walks into the ward or the ER.

More than ever, the principles supporting the bill of the Magna Carta of Patient’s Rights and Obligations should be emphasized, because the protection of physicians’ rights and patient’s obligations ultimately safeguards the welfare of patients. The relationship between a patient and a healthcare provider is a two-way street. Respect is not “earned”; it is disrespect which is earned, because respect is the baseline, the default, the minimum, on both sides.

kchuarivera@gmail.com