Your Rights and Responsibilities

Patient Bill of Rights

You have the right to:

  1. Considerate and respectful care, and to be made comfortable. You have the right to have your cultural, psychosocial, spiritual and personal values, beliefs and preferences respected.
  2. Have a family member (or other representative of your choosing) and your own physician notified promptly of your admission to the hospital.
  3. Know the name of the physician who has primary responsibility for coordinating your care and the names and professional relationships of other physicians and non-physicians and other organizations who will see you, as well as the right to know of any reasons for any proposed change in professional staff responsible for your care and the right to decline service by students.
  4. Receive information about your health status, diagnosis, prognosis, course of treatment, prospects for recovery and outcomes of care (including unanticipated outcomes) in terms you can understand. You have the right to effective communication and participate in the development and implementation of your plan of care. You have the right to participate in ethical questions that arise in the course of your care, including issues of conflict resolution, withholding resuscitative services, and foregoing or withdrawing life-sustaining treatment.
  5. Make decisions regarding medical care and receive as much information about any proposed treatment of procedure as you may need in order to give informed consent or to refuse a course of treatment. Except in emergencies, this information shall include a description of the procedure or treatment, the medically significant risks involved, alternate courses of treatment or non-treatment and the risks involved in each, and the name of the person who will carry out the procedure or treatment.
  6. Request or refuse treatment, to the extent permitted by law. However, you do not have the right to demand inappropriate or medically unnecessary treatment or services. You have the right to leave the hospital even against the advice of physicians, to the extent permitted by law.
  7. Be advised if the hospital/personal physician proposes to engage in or perform human experimentation/research affecting your care or treatment. You have the right to refuse to participate in such research projects.
  8. Reasonable responses to any reasonable requests made for service.
  9. Appropriate assessment and management of your pain, information about pain, pain relief measures and to participate in pain management decisions. You may request or reject the use of any or all modalities to relieve the pain, including opiate medication, if you suffer from severe chronic intractable pain. The doctor may refuse to prescribe the opiate medication, but if so, must inform you that there are physicians who specialize in the treatment of severe chronic pain with methods that include the use of opiates.
  10. Formulate advance directives regarding decisions at the end of life in accordance with Federal and State Patient Self-Determination Act. This includes designation of a decision maker if you become incapable of understanding a proposed treatment or become unable to communicate your wishes regarding care. Hospital staff and practitioners who provide care in the hospital shall comply with these directives. All patients’ rights apply to the person who has legal responsibility to make decisions regarding medical care on your behalf, without coercion, discrimination or retaliation. The patient’s family has the right of informed consent of donation of organs and tissues.
  11. Have personal privacy respected. Case discussion, consultation, examination and treatment are confidential and should be conducted discreetly. You have the right to be told the reason of the presence of any individual. You have the right to have visitors leave prior to an examination and when treatment issues are being discussed. Privacy curtains will be used in semi-private rooms.
  12. Confidential treatment of all communications and records pertaining to your care and stay in the hospital. You will receive a separate “Notice of Privacy Practices” that explains your privacy rights in detail and how we may use and disclose your protected health information. You have the right to access information contained in your medical record within a reasonable amount of time.
  13. Receive care in a safe setting, free from mental, physical, sexual or verbal neglect, exploitation, retaliation, discrimination, coercion, or harassment. You have the right to access protective and advocacy services including notifying government agencies or neglect or abuse. You also have the right to be informed, when appropriate, of patient rights in advance of furnishing or discontinuing patient care whenever possible as allowed under state law.
  14. Be free from chemical, physical restraints and/or seclusion of any form used as a means of coercion, discipline, convenience or retaliation by staff.
  15. Reasonable continuity of care and to know in advance the time and location of appointments as well as the identity of the persons providing the care.
  16. Be informed by the physician, or delegate of the physician, of continuing health care requirements and options following discharge from the hospital. You have the right to be involved in the development and implementation of your discharge plan. Upon your request, a friend or family member may be provided with this information also.
  17. Know which hospital rules and policies apply to your conduct while a patient.
  18. Designate visitors of your choosing, if you have decision-making capacity, whether or not the visitor is related by blood or marriage, unless:

    No visitors are allowed

    The facility reasonably determines that the presence of a particular visitor would endanger the health or safety of a patient, a member of the health facility staff or other visitor to the health facility, or would significantly disrupt the operations of the facility.

    You have told the health facility staff that you no longer want a particular person to visit.

    However, a health facility may establish reasonable restrictions upon visitation, including restrictions upon the hours of visitation and number of visitors.

  19. Have your wishes considered, if you lack decision-making capacity, for the purposes of determining who may visit. The method of that consideration will be disclosed in the hospital policy on visitation. At a minimum, the hospital shall include any persons living in your household.
  20. Examine and receive an explanation of the hospital’s bill regardless of the source of payment within a reasonable period of time.
  21. Exercise these rights without regard to sex, economic status, educational background, race, color, religion, ancestry, national origin, disability, handicap, medical condition, sexual orientation, ethnicity, age or marital status or the source of payment for care.
  22. Know the reasons for his/her transfer either within or outside the facility.
  23. Be informed of the source of the facility reimbursement of his/her services, and of any limitations which may be placed upon his/her care.
  24. File a grievance/complaint. If you want to file a grievance/complaint with this hospital, you may do so by writing or calling: ADMINISTRATION OF THIS HOSPITAL.
  25. File a complaint with the State Department of Public Health regardless of whether you use the hospital’s grievance process. The State Department of Public Health phone number and address is: 7575 Metropolitan Drive, Ste. 211, San Diego, CA 92108. Phone: (619) 688-6190.

Patient Responsibilities

So that you may contribute effectively to your health care, you have, as a patient or patient’s representative, the following responsibilities:

  1. Be honest and as accurate as possible when asked for information about your medical history and everything that happens to you as a patient.
  2. Participate actively in agreed-upon decisions regarding your health.
  3. Notify your doctor or nurse if you have any concern about your care and if you notice, or think you notice, or perceive any changes in your health.
  4. Ask promptly for clarification if you do not understand what is asked of you, or why it is asked.
  5. Let your doctor or nurse know if you are concerned about a treatment, or if you feel you cannot, or will not, follow a certain treatment plan and to be responsible for the consequences if you refuse treatment, or do not follow instructions.
  6. Examine your bill and ask any questions you may have regarding the charges or methods of payment, and for assuring that the financial obligations of your health care are fulfilled as promptly as possible.
  7. Follow hospital rules and regulations affecting patient care and conduct, to be considerate of other patients and hospital staff and their property, and for assisting in controlling the noise and number of your visitors.
  8. Provide the hospital with a copy of any advance directives you may have executed.
  9. Contribute to a safe environment of care, therefore the following is prohibited:
  • Possession of weapons, dangerous objects, alcohol, illegal drugs and drugs not prescribed by the patient’s physician.
  • Visiting while under the influence of drugs and/or alcohol.

The hospital’s obligation to provide a safe environment for patient care must override the patient’s right to privacy.

Patient Safety

In our efforts to support patient safety and reduce mistakes, we encourage patients to ask questions regarding all aspects of their medical care. Being involved in every decision about your health care can lead to a better outcome for you.

  1. Be involved with your health care. The single most important way you can help optimize your care and help to prevent errors is to be an active member of your health care team. ASK QUESTIONS! Actively participate in every decision about your health care from start to finish.
  2. Make sure all of your doctors and nurses know about any medications you are taking—including prescriptions, over-the-counter medication, and dietary supplements such as vitamins and herbs. Just because it is herbal or natural does not mean it is safe. Tell your doctor and nurse about any allergies or adverse reactions that you have had to medication(s) or food products.
  3. Be sure to ask for information about your medication when it is prescribed and when your nurse gives it to you. Make sure that caregivers give you information in terms that you can understand. If you do not understand any information IT IS OK TO ASK! Questions you want to ask include: What is the medication(s) for? How am I supposed to take it, and for how long? What side effects may occur? What do I do if they occur? Is this medication safe to take with other medications or dietary supplements? What foods, drinks, or activities should I avoid while taking this medication?
  4. Ask why a test or treatment is needed and how it may help you. Be informed.
  5. When you have any type of surgery, ASK for information about your surgery in terms that you can understand. Who will be assisting with my surgery? What is involved? How long will it take? What are the risks involved? How long with my recovery be? What are the expected outcomes?
  6. If you are having surgery, make sure that you, your doctor, and your surgeon all agree and are clear on exactly what will be done. Be involved in marking the correct site of your surgery with the word, “YES.”
  7. Ask if you have questions or concerns. Do not be afraid to ask questions of anyone who is involved in your care. Ask your doctor or nurse about results of all tests performed, your condition, and treatment during your hospital stay.
  8. Provide all health professionals involved in your care with accurate information about yourself. This is especially important if you have many health problems.
  9. Upon discharge from the hospital, ask your doctors and nurses to explain the treatment plan you will need to follow at home.
  10. If you will be taking medications after discharge from the hospital, you will be given instructions along with a list of medications. To promote medication safety, it is highly recommended that you keep a current list of your medications in your wallet or purse so you can share this information with your doctors, retail pharmacist and if you are re-admitted with your health care provider.
  11. Ask a family member or friend to be here with you to be your advocate and ask questions if you can’t. Even if you think you don’t need help now, you might need it later. Ask about an Advance Directive if you do not have one. If you do, be sure to give a copy to your primary physician and the hospital.
  12. Practicing good hand washing is the single most important thing we can all do to stop the spread of infection. It is a healthy habit for anyone, whether you are in the hospital, at work or at home. Encourage your visitors to wash their hands and practice good hand-washing yourself. If you do not see the health care provider washing their hands with soap and water or using the waterless alcohol hand sanitizer when entering your room to provide care, remember, IT IS OK TO ASK! Be an active participant in the hand washing process. It only takes a few simple words to help encourage this healthy habit.

Simply say:

“Excuse me, did you wash your hands?”
“I saw that you washed your hands. Thank you!”
Communication about all aspects of your care, treatment and services is an important part of our culture of safety.

Your Right to Make Decisions about Medical Treatment

You have the right to make health care decisions and how you can plan now for your medical care if you are unable to speak for yourself in the future.

A federal law requires us to give you this information. We hope this information will help increase your control over your medical treatment.

Who Decides About Treatment
Your doctors will give you information and advice about treatment. You have the right to choose. You can say “Yes” to treatments you want. You can say “No” to any treatment that you don’t want—even if the treatment might keep you alive longer.

How do I Know What I Want?
Your doctor must tell you about your medical condition and about what different treatments and pain management alternatives can do for you. Many treatments have “side effects.” Your doctor must offer you information about problems that medical treatment is likely to cause you.

Often, more than one treatment might help you and people have different ideas about which is best. Your doctor can tell you which treatments are available to you, but your doctor can’t choose for you. That choice is yours to make and depends on what is important for you.

Can Other People Help with my Decisions?
Yes. Patients often turn to their relatives and close friends for help in making medical decisions. These people can help you think about the choices you face. You can ask the doctors and nurses to talk with your relatives and friends. They can ask the doctors and nurses questions for you.

Can I Choose a Relative of Friend to Make Health Care Decisions for Me?
Yes. You may tell your doctor that you want someone else to make health care decisions for you. Ask the doctor to list that person as your health care “surrogate” in your medical record. The surrogate’s control over your medical decisions is effective only during treatment for your current illness or injury or, if you are in a medical facility, until you leave the facility.

What if I Become too Sick to Make my Own Health Care Decisions?
If you haven’t named a surrogate, your doctor will ask your closest available relative or friend to help decide what is best for you. Most of the time that works. But sometimes everyone doesn’t agree about what to do. That’s why it is helpful if you can say in advance what you want to happen if you can’t speak for yourself.

Do I Have to Wait Until I am Sick to Express my Wishes About Health Care?
No. In fact, it is better to choose before you get very sick or have to go to the hospital, nursing home, or other health care facility. You can use an Advance Health Care Directive to say who you want to speak for you and what kind of treatments you want. These documents are called “advance” because you prepare one before health care decisions need to be made. They are called “directives” because they state who will speak on your behalf and what should be done.

In California, the part of an advance directive you can sue to appoint an agent to make health care decisions is called a Power of Attorney for Health Care. The part where you can express what you want done is called an Individual Health Care Instruction.

Who Can Make an Advance Directive?
You can if you are 18 years or older and are capable of making your own medical decisions. You do not need a lawyer.

Who Can I Name as my Agent?
You can choose an adult relative or any other person you trust to speak for you when medical decisions must be made.

When Does my Agent Begin Making my Medical Decisions?
Usually, a health care agent will make decisions only after you lose the ability to make them yourself. But, if you wish, you can state in the Power of Attorney for Health Care that you want the agent to begin decisions immediately.

How Does my Agent Know What I Would Want?
After you choose your agent, talk to that person about what you want. Sometimes treatment decisions are hard to make, and it truly helps if your agent knows what you want. You can also write your wishes down in your advance directive.

What if I don’t want to Name an Agent?
You can still write your wishes in your advance directive, without naming an agent. You can say that you want to have your life continued as long as possible. Or you can say that you would not want treatment to continue your life. Also, you can express your wishes about the use of pain relief or any other type of medical treatment.

Even if you have not filled out a written Individual Health Care Instruction, you can discuss your wishes with your doctor, and ask your doctor to list those wishes in your medical record. Or you can discuss your wishes with your family members or friends. But it will probably be easier to follow your wishes if you write them down.

What if I Change my Mind?
You can change or cancel your advance directive at any time as long as you can communicate your wishes. To change the person you want to make your health care decisions, you must sign a statement or tell the doctor in charge of your care.

What Happens When Someone Else Makes Decisions About my Treatment?
The same rules apply to anyone who makes health care decisions on your behalf—a health care agent, a surrogate whose name you gave to your doctor, or a person appointed by a court to make decisions for you. All are required to follow your Health Care Instructions or, if none, your general wishes about treatment, including stopping treatment. If your treatment wishes are not known, the surrogate must try to determine what is in your best interest.

The people providing your health care must follow the decisions of your agent or surrogate unless a requested treatment would be bad medical practice or ineffective in helping you. If this causes disagreement that cannot be worked out, the provider must make a reasonable effort to find another health care provider to take over your treatment.

Will I still be Treated if I don’t Make an Advance Directive?
Absolutely. You will still get medical treatment. We just want you to know that if you become too sick to make decisions, someone else will have to make them for you.

To implement Public Law 101-508, the California Consortium on Patient Self-Determination Prepared this brochure in 1991; it was revised in 2000 by the California Department of Health Services, with input from members of the consortium and other interested parties to reject changes in state law.

Remember That…
A Power of Attorney for Health Care lets you name an agent to make decisions for you. Your agent can make most medical decisions—not just those about life sustaining treatment—when you can’t speak for yourself. You can also let your agent make decisions earlier, if you wish.

You can create and Individual Health Care Instruction by writing down your wishes about health care or by talking with your doctor and asking the doctor to record your wishes in your medical file. If you know when you would or would not want certain types of treatment, an Instruction provides a good way to make your wishes clear to your doctor and to anyone else who may be involved in deciding about treatment on your behalf.

These two types of Advance Healthcare Directives may be used together of separately.

How Can I get More Information About making and Advance Directive?
Ask your doctor, nurse, social worker, or health care provider to get more information for you. You can have a lawyer write an advance directive for you, or you can complete an advance directive by filling in the blanks on a form.