Patient Autonomy
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A patient is any recipient of
health care Health care, or healthcare, is the improvement or maintenance of health via the preventive healthcare, prevention, diagnosis, therapy, treatment, wikt:amelioration, amelioration or cure of disease, illness, injury, and other disability, physic ...
services that are performed by
healthcare professionals A health professional, healthcare professional (HCP), or healthcare worker (sometimes abbreviated as HCW) is a provider of health care treatment and advice based on formal training and experience. The field includes those who work as a nurse, physi ...
. The patient is most often
ill ILL, or Ill, or ill may refer to: Places * Ill (France), a river in Alsace, France, tributary of the Rhine * Ill (Vorarlberg), a river in Vorarlberg, Austria, tributary of the Rhine * Ill (Saarland), a river of Saarland, Germany, tributary o ...
or injured and in need of treatment by a
physician A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the Medical education, study, Med ...
,
nurse Nursing is a health care profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alle ...
,
optometrist Optometry is the healthcare practice concerned with examining the eyes for visual defects, prescribing corrective lenses, and detecting eye abnormalities. In the United States and Canada, optometrists are those that hold a post-baccalaureate f ...
,
dentist A dentist, also known as a dental doctor, dental physician, dental surgeon, is a health care professional who specializes in dentistry, the branch of medicine focused on the teeth, gums, and mouth. The dentist's supporting team aids in provi ...
,
veterinarian A veterinarian (vet) or veterinary surgeon is a medical professional who practices veterinary medicine. They manage a wide range of health conditions and injuries in non-human animals. Along with this, veterinarians also play a role in animal r ...
, or other
health care provider A health care provider is an individual health professional or a health facility organization licensed to provide health care diagnosis and treatment services including medication, surgery and medical devices. Health care providers often rece ...
.


Etymology

The word
patient A patient is any recipient of health care services that are performed by Health professional, healthcare professionals. The patient is most often Disease, ill or Major trauma, injured and in need of therapy, treatment by a physician, nurse, op ...
originally meant 'one who suffers'. This English noun comes from the
Latin Latin ( or ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken by the Latins (Italic tribe), Latins in Latium (now known as Lazio), the lower Tiber area aroun ...
word , the
present participle In linguistics, a participle (; abbr. ) is a nonfinite verb form that has some of the characteristics and functions of both verbs and adjectives. More narrowly, ''participle'' has been defined as "a word derived from a verb and used as an adject ...
of the
deponent verb In linguistics, a deponent verb is a verb that is active in meaning but takes its form from a different voice, most commonly the middle or passive. A deponent verb has no active forms. Languages with deponent verbs ''This list may not be exh ...
, , meaning , and akin to the
Greek Greek may refer to: Anything of, from, or related to Greece, a country in Southern Europe: *Greeks, an ethnic group *Greek language, a branch of the Indo-European language family **Proto-Greek language, the assumed last common ancestor of all kno ...
verb ( ) and its cognate noun (). This language has been construed as meaning that the role of patients is to passively accept and tolerate the suffering and treatments prescribed by the healthcare providers, without engaging in
shared decision-making Shared decision-making in medicine (SDM) is a process in which both the patient and physician contribute to the medical decision-making process and agree on treatment decisions. Health care providers explain treatments and alternatives to p ...
about their care.


Outpatients and inpatients

An outpatient (or out-patient) is a patient who attends an outpatient clinic with no plan to stay beyond the duration of the visit. Even if the patient will not be formally admitted with a note as an outpatient, their attendance is still registered, and the provider will usually give a note explaining the reason for the
visit Visit refer as go to see and spend time with socially. Visit may refer to: *State visit, a formal visit by a head of state to a foreign country *Conjugal visit, in which a prisoner is permitted to spend several hours or days in private with a visit ...
,
test Test(s), testing, or TEST may refer to: * Test (assessment), an educational assessment intended to measure the respondents' knowledge or other abilities Arts and entertainment * ''Test'' (2013 film), an American film * ''Test'' (2014 film) ...
s, or procedure/
surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...
, which should include the names and titles of the participating personnel, the patient's name and
date of birth A birthday is the anniversary of the birth of a person or figuratively of an institution. Birthdays of people are celebrated in numerous cultures, often with birthday gifts, birthday cards, a birthday party, or a rite of passage. Many religi ...
, signature of
informed consent Informed consent is an applied ethics principle that a person must have sufficient information and understanding before making decisions about accepting risk. Pertinent information may include risks and benefits of treatments, alternative treatme ...
, estimated pre-and post-service time for
history History is the systematic study of the past, focusing primarily on the Human history, human past. As an academic discipline, it analyses and interprets evidence to construct narratives about what happened and explain why it happened. Some t ...
and
exam An examination (exam or evaluation) or test is an educational assessment intended to measure a test-taker's knowledge, skill, aptitude, physical fitness, or classification in many other topics (e.g., beliefs). A test may be administered verba ...
(before and after), any
anesthesia Anesthesia (American English) or anaesthesia (British English) is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prev ...
,
medication Medication (also called medicament, medicine, pharmaceutical drug, medicinal product, medicinal drug or simply drug) is a drug used to medical diagnosis, diagnose, cure, treat, or preventive medicine, prevent disease. Drug therapy (pharmaco ...
s or future treatment plans needed, and estimated time of discharge absent any (further) complications. Treatment provided in this fashion is called
ambulatory care Ambulatory care or outpatient care is Health care, medical care provided on an outpatient basis, including diagnosis, observation, consultation, treatment, intervention, and rehabilitation services. This care can include advanced medical technolog ...
. Sometimes surgery is performed without the need for a formal hospital admission or an overnight stay, and this is called
outpatient surgery Outpatient surgery, also known as ambulatory surgery, day surgery, day case surgery, or same-day surgery, is surgery that does not require an overnight hospital stay.The International Association for Ambulatory Surgery (IAAS) would not consider al ...
or day surgery, which has many benefits including lowered healthcare cost, reducing the amount of medication prescribed, and using the physician's or surgeon's time more efficiently. Outpatient surgery is suited best for more healthy patients undergoing minor or intermediate procedures (limited urinary-tract,
eye An eye is a sensory organ that allows an organism to perceive visual information. It detects light and converts it into electro-chemical impulses in neurons (neurones). It is part of an organism's visual system. In higher organisms, the ey ...
, or
ear, nose, and throat Otorhinolaryngology ( , abbreviated ORL and also known as otolaryngology, otolaryngology–head and neck surgery (ORL–H&N or OHNS), or ear, nose, and throat (ENT)) is a surgical subspecialty within medicine that deals with the surgical an ...
procedures and procedures involving superficial skin and the extremities). More procedures are being performed in a
surgeon In medicine, a surgeon is a medical doctor who performs surgery. Even though there are different traditions in different times and places, a modern surgeon is a licensed physician and received the same medical training as physicians before spec ...
's office, termed ''office-based surgery'', rather than in a hospital-based
operating room Operation or Operations may refer to: Arts, entertainment and media * ''Operation'' (game), a battery-operated board game that challenges dexterity * Operation (music), a term used in musical set theory * ''Operations'' (magazine), Multi-Man ...
. An inpatient (or in-patient), on the other hand, is "admitted" to stay in a hospital overnight or for an indeterminate time, usually, several days or weeks, though in some extreme cases, such as with
coma A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to Nociception, respond normally to Pain, painful stimuli, light, or sound, lacks a normal Circadian rhythm, sleep-wake cycle and does not initiate ...
or
persistent vegetative state A vegetative state (VS) or post-coma unresponsiveness (PCU) is a disorder of consciousness in which patients with severe brain damage are in a state of partial arousal rather than true awareness. After four weeks in a vegetative state, the patie ...
, patients can stay in hospitals for years, sometimes until
death Death is the end of life; the irreversible cessation of all biological functions that sustain a living organism. Death eventually and inevitably occurs in all organisms. The remains of a former organism normally begin to decompose sh ...
. Treatment provided in this fashion is called
inpatient care Inpatient care is the care of patients whose condition requires admission to a hospital. Progress in modern medicine and the advent of comprehensive out-patient clinics ensure that patients are only admitted to a hospital when they are extremel ...
. The admission to the hospital involves the production of an admission note. The leaving of the hospital is officially termed ''discharge'', and involves a corresponding
discharge note Inpatient care is the care of patients whose condition requires admission to a hospital. Progress in modern medicine and the advent of comprehensive out-patient clinics ensure that patients are only admitted to a hospital when they are extremel ...
, and sometimes an assessment process to consider ongoing needs. In the
English National Health Service The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the ...
this may take the form of "Discharge to Assess" - where the assessment takes place after the patient has gone home. Misdiagnosis is the leading cause of
medical error A medical error is a preventable adverse effect of care (" iatrogenesis"), whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete diagnosis or treatment of a disease, injury, syndrome, behavior, ...
in outpatient facilities. When the U.S.
Institute of Medicine The National Academy of Medicine (NAM), known as the Institute of Medicine (IoM) until 2015, is an American nonprofit, non-governmental organization. The National Academy of Medicine is a part of the National Academies of Sciences, Engineerin ...
's groundbreaking 1999 report, '' To Err Is Human'', found up to 98,000 hospital patients die from preventable medical errors in the U.S. each year, early efforts focused on inpatient safety. While patient safety efforts have focused on inpatient hospital settings for more than a decade, medical errors are even more likely to happen in a
doctor's office A doctor's office in American English, a doctor's surgery in British English, or a doctor's practice, is a medical facility in which one or more medical doctors, usually general practitioners (GP), receive and treat patients. Description Doct ...
or outpatient clinic or center.


Day patient

A day patient (or day-patient) is a patient who is using the full range of services of a hospital or clinic but is not expected to stay the night. The term was originally used by
psychiatric hospital A psychiatric hospital, also known as a mental health hospital, a behavioral health hospital, or an asylum is a specialized medical facility that focuses on the treatment of severe Mental disorder, mental disorders. These institutions cater t ...
services using of this patient type to care for people needing support to make the transition from in-patient to out-patient care. However, the term is now also heavily used for people attending hospitals for day surgery.


Alternative terminology

Because of concerns such as
dignity Dignity is a human's contentment attained by satisfying physiological needs and a need in development. The content of contemporary dignity is derived in the new natural law theory as a distinct human good. As an extension of the Enlightenment- ...
,
human rights Human rights are universally recognized Morality, moral principles or Social norm, norms that establish standards of human behavior and are often protected by both Municipal law, national and international laws. These rights are considered ...
and
political correctness "Political correctness" (adjectivally "politically correct"; commonly abbreviated to P.C.) is a term used to describe language, policies, or measures that are intended to avoid offense or disadvantage to members of particular groups in society. ...
, the term "patient" is not always used to refer to a person receiving health care. Other terms that are sometimes used include health consumer, healthcare consumer, customer or client. However, such terminology may be offensive to those receiving
public health care Publicly funded healthcare is a form of health care financing designed to meet the cost of all or most healthcare needs from a publicly managed fund. Usually this is under some form of democratic accountability, the right of access to which are se ...
, as it implies a business relationship. In
veterinary medicine Veterinary medicine is the branch of medicine that deals with the prevention, management, medical diagnosis, diagnosis, and treatment of disease, disorder, and injury in non-human animals. The scope of veterinary medicine is wide, covering all a ...
, the client is the owner or guardian of the patient. These may be used by governmental agencies,
insurance companies Insurance is a means of protection from financial loss in which, in exchange for a fee, a party agrees to compensate another party in the event of a certain loss, damage, or injury. It is a form of risk management, primarily used to protect ...
, patient groups, or health care facilities. Individuals who use or have used
psychiatric Psychiatry is the medical specialty devoted to the diagnosis, treatment, and prevention of deleterious mental conditions. These include matters related to cognition, perceptions, mood, emotion, and behavior. Initial psychiatric assessment of ...
services may alternatively refer to themselves as consumers, users, or survivors. In
nursing home A nursing home is a facility for the residential care of older people, senior citizens, or disabled people. Nursing homes may also be referred to as care homes, skilled nursing facilities (SNF), or long-term care facilities. Often, these terms ...
s and
assisted living An assisted living residence or assisted living facility (ALF) is a housing facility for people with disabilities or for adults who cannot or who choose not to live independently. The term is popular in the United States. Still, the setting i ...
facilities, the term resident is generally used in lieu of ''patient''. Similarly, those receiving
home health care Homecare (home care, in-home care, care at home), also known as domiciliary care, personal care, community care, or social care, is health care or supportive care provided in the individual home where the patient or client is living, generally focu ...
are called ''clients''.


Patient-centered healthcare

The
doctor–patient relationship The doctor–patient relationship is a central part of health care and the practice of medicine. A doctor–patient relationship is formed when a doctor attends to a patient's medical needs and is usually through consent. This relationship is bui ...
has sometimes been characterized as silencing the voice of patients. It is now widely agreed that putting patients at the centre of healthcare by trying to provide a consistent, informative and respectful service to patients will improve both outcomes and patient satisfaction. When patients are not at the centre of healthcare, when institutional procedures and targets eclipse local concerns, then patient neglect is possible. Incidents, such as the
Stafford Hospital scandal The Stafford Hospital scandal concerns poor care and high mortality rates amongst patients at the Stafford Hospital, Stafford, England, during the first decade of the 21st century. The hospital was run by the Mid Staffordshire NHS Foundation Tr ...
, Winterbourne View hospital abuse scandal and the Veterans Health Administration controversy of 2014 have shown the dangers of prioritizing cost control over the patient experience. Investigations into these and other scandals have recommended that healthcare systems put patient experience at the center, and especially that patients themselves are heard loud and clear within health services. There are many reasons for why health services should listen more to patients. Patients spend more time in healthcare services than regulators or quality controllers, and can recognize problems such as service delays, poor hygiene, and poor conduct. Patients are particularly good at identifying soft problems, such as attitudes, communication, and 'caring neglect', that are difficult to capture with institutional monitoring. One important way in which patients can be placed at the centre of healthcare is for health services to be more open about patient complaints. Each year many hundreds of thousands of patients complain about the care they have received, and these complaints contain valuable information for any health services which want to learn about and improve patient experience.


See also

*
Casualty Casualty may refer to: *Casualty (person), a person who is killed or rendered unfit for service in a war or natural disaster **Civilian casualty, a non-combatant killed or injured in warfare * The emergency department of a hospital, also known as ...
*
e-Patient An e-patient is a health consumer who participates fully in their own medical care, primarily by gathering information about medical conditions that impact them and their families, using the Internet and other digital tools. The term encompasses th ...
*
Mature minor doctrine The mature minor doctrine is a rule of law found in the United States and Canada accepting that an unemancipated minor patient may possess the maturity to choose or reject a particular health care treatment, sometimes without the knowledge or ...
* Nurse-client relationship *
Patient abuse Patient abuse or patient neglect is any action or failure to act which causes unreasonable suffering, misery or harm to the patient. Elder abuse is classified as patient abuse of those older than 60 and forms a large proportion of patient abuse. ...
*
Patient advocacy Patient advocacy is a process in health care concerned with advocacy for patients, survivors, and caregivers. The patient advocate may be an individual or an organization, concerned with healthcare standards or with one specific group of disor ...
* Patient empowerment * Patients' Bill of Rights * Radiological protection of patients * Therapeutic inertia *
Virtual patient The term virtual patient is used to describe interactive computer simulations used in health care education to train students on clinical processes such as making diagnoses and therapeutic decisions. Virtual patients attempt to combine modern tech ...
* Patient UK


References


External links

*
a peer-reviewed article published in the British Medical Journal's (BMJ) first issue dedicated to patients in its 160-year history *
review article with views on the meaning of the words "good doctor" vs. "good patient"
"Time Magazine's Dr. Scott Haig Proves that Patients Need to Be Googlers!" – Mary Shomons response
to the Time Magazine articl

{{Authority control Medical terminology