Patient privacy

Dr Asma Khan 

 

Since the day when I visited my doctor colleague admitted for planned surgery, I started passionately thinking about dignity of a patient. She surprised me when she said she was not getting operated in a hospital where she was working.  "I don't know how much will anyone care to maintain my privacy during my surgery. I will not know to what extent I will be exposed once I am under anaesthesia." 

Once operated in another hospital, she said, she wouldn’t come across people who have seen her while she was unconscious and under scalpel.

This was great solace to her.

Being a doctor herself she was concerned about her exposure and was very well aware that very little would be done to maintain her privacy and dignity.

As doctor she knew operation theatres so well. In operation theatres there is unrestricted movement of housekeeping personnel, company representatives, who bring implants and other expensive equipment’s to hospital. Exposing patients to required limits is necessary for performing procedures. But unrestricted movement of people in and out of the theatre not only present exposed patients to non-medical professionals while they are being prepared for surgery but also increases risk of infection due to human traffic inside theatres.

She found comfort in this thought that by getting operated in an unknown place she won't be facing people who might have seen her exposed on the operation table.

This is situation in private hospitals where people pay huge sums to get treatment. One can imagine what might be happening in government hospitals.

Doctors and nurses are not ignorant about theory of medical ethics. And they all take oath to protect their patients. But then this oath also remains mere oath like all other oaths in this country. A colleague cited an incident of a operation theatre where a patient was getting operated and media people were inside the theatre during the procedure setting up their cameras and other instruments for an upcoming conference.

A junior colleague shared her experience over coffee. She was told not to take indecent behaviour happening around her seriously because that might put her at risk of being unsafe in hospital during her night duty. In such an atmosphere where a doctor is advised to overlook attacks on her dignity and respect, how can you guarantee dignity of a patient  under anaesthesia. In hospitals where male employees of the hospital treat female doctors and nursing staff disrespectfully, can one expect that female patients would be treated with dignity when they are in most vulnerable position.

In a study done in Denmark patients reported crying when their dress was changed in presence of other patients in sharing ward. In India patients  are exposed and examined before everyone. And procedures are performed without any concern about what patients must be going through and how they would be struggling to hide an embarrassment resulting from unconcerned behavior of medical professionals.

It has been observed that patients absorb several incidents during hospital admission as part of medical treatment. They compromise with their dignity fearing if they would raise such an issue either they would be construed as arrogant egoists or they would be ridiculed. They also fear raising voice would compromise their medical treatment.

I always thought after home, hospital is a safe place. A place where sufferings are mitigated and patients step out with hope and optimism of having new life ahead. But over the years I have realised that hospital can be as nightmarish as taking risk of boarding passenger bus in late evening.

A case of Aruna Shanbaug, who was raped in King Edward Memorial Hospital, Mumbai by a grade IV employee of the same hospital, is open example. She suffered for more than 35 years due to hypoxic brain injury forcing her to be a living corpse all her life.

We also come across news of patients or staff getting molested in hospital premises. Such incidences happen because untrained staff have unrestricted access to exposed patients in operation theatres and wards. Doctors or nurses don't restrict entry of untrained and unwarranted staff into theatres and they also don’t voice concern regarding presence of unauthorized people around exposed patients. It is strange that in places like hospitals those who are out to attack dignity and respect of a patient have sense of impunity that no one would touch them.

Nursing staff does not raise their voice because they are scared that once they would take on nuisance element they will have to face harassment. Like road rowdies hospital goons have also this sense of security that no one is going to take on them. They continue to "visually" molest patients without fear and at times they move beyond the “visual molestation.” Time has come when dignity of an individual in the hospitals, in operations theatres, should be talked about.

Time has come that we should talk about dignity of patient under scalpel more loudly.