Doctors have many duties toward their patients. Their responsibilities cover their own actions, as well as orders they give to their assistants, such as nurses, medical students and residents. Here are the doctor’s obligations toward patients.
Diagnosing and Treating the Patient
In legal terms, doctors have an obligation of means toward their patients, not an obligation of result. This means that they have to take appropriate steps available to make the right diagnosis, provide treatment and follow-up on their patients’ progress.
Doctors must base their actions on up-to-date scientific information and use recognized treatments in the right way.
They must treat their patients attentively and conscientiously.
Doctors must recognize their own limits: in case of doubt, they must get information from other people or refer patients to specialists.
The duty to treat patients includes the duty to
- prescribe the right medication,
- tell patients about the advantages, disadvantages, risks and alternatives regarding a proposed treatment or operation, and
- provide adequate follow-up to the patient within a reasonable amount of time.
For example, after a treatment, a doctor must provide the medical follow-up required by the patient’s state of health, or at least make sure that a colleague or other professional follows up.
Informing the Patient
Doctors must give their patients all the information they need to make free and informed decisions. For example, doctors must tell their patients about the following:
- nature, goal and seriousness of the treatment
- risks of the treatment
- other treatment options
The doctor’s duty to provide information also includes answering patients’ questions.
The doctor’s duty is toward the patients themselves, the people who make decisions on behalf of patients, or the parents of children under the age of 14.
Doctors must explain the chances of success and the risk of failure of the suggested treatment, keeping in mind the patient’s specific condition.
Doctors must also inform their patients about the possible negative effects of a treatment. However, it is impossible for a doctor to talk about all the possible risks; doctors must tell their patients about the foreseeable risks, in other words, the risks that are most likely to occur. Doctors must also tell patients about any rare risk that could have serious consequences.
The extent of the duty to provide information depends on the circumstances and the patient in question.
For some types of treatments, doctors are required to give more complete and specific information about the risks. This is the case, for example, with purely experimental treatments as well as treatments that are not aimed at curing an illness or injury, like some types of plastic surgery. In these cases, doctors must tell patients about all possible and rare risks.
Obtaining the Patient’s Free and Informed Consent
The reason behind the duty of doctors to provide information to patients is to give patients all the information they need to make free and informed decisions with full knowledge of the facts about the treatment and care offered. When a patient agrees to treatment or care, this is called consent.
The duty to get the consent of patients is a continuous process. This is why patients must be kept informed about any new information about their states of health and the treatments they are receiving.
Doctors have a duty to respect their patients’ confidentiality. This is sometimes called the duty of professional secrecy.
This duty covers both the information patients tell their doctors and any facts doctors discover about their patients as part of the doctor-patient relationship.
Professional secrecy belongs to the patient, not the doctor. Doctors cannot reveal what their patients tell them, unless their patients waive the confidentiality of the information or if the law allows it. For example, the Public Health Act says that certain diseases must be reported to public health agencies.
Also, doctors can reveal some confidential information when they have very strong reasons to do so related to the health or safety of the patient or people close to the patient.