Hospice patients have rights under both state and federal law.
In the United States, every patient has rights -- whether they are newly born or at the end of their days. Every state has laws governing patients' rights and many, including California, include special provisions clarifying how these rights extend and apply to hospice patients. Medicare takes hospice patient rights a step further and gives them federal recognition -- mandating that patients receiving end-of-life treatment have the same and sometimes more rights than states give. Regardless of which level of government supports them, hospice patient rights are designed to promote dignity and choice.
Right to Participate
Patients have the right to make decisions and participate in choosing the course of their treatment. Medical service providers have an obligation to inform the patient about the patient's options including what they entail and the ramifications of each choice. Providers can make their recommendations, but the patient has the ultimate authority and has the right to know anything and everything about his care.
Right to Refuse
Despite life threatening or the painful consequences of not receiving treatment, patients have the right to refuse. While physicians and nurses normally have an obligation to sustain life, in the case of hospice treatment clinicians are released from their ethical obligation if the patient refuses care. Similarly, family members and even spouses' wishes do not supersede the patient's rights unless the patient has given power of attorney and is deemed incapable of making decisions about her care.
Pain Management
Unfortunately, terminal illness usually comes with tremendous pain. Patients have the right to pain management -- namely medication. Medicare regulations are very clear that patients have the right to whatever amount of medication is necessary to adequately treat their pain.
Choice of Physician
At the end of life, patients have the right to select their own physician. Hospice services do not have the right to force their favored physicians upon a patient. Of course, for Medicare patients, the physician has to be a Medicare participating provider.
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