Will a recent Doctors Syndicate endorsement of Egypt's first "Patients' Rights" document trigger more positive change for health care? Hala Sakr looks for answers Earlier this month, the Doctors' Syndicate gave its overwhelming approval and support to the "Document of Patients' Rights" recently issued by the New Kasr Al-Aini Teaching Hospital. The syndicate's council called for the document to be used as a "model" in all Egyptian hospitals. Although the document is not binding, it is meant to protect patients' rights regarding the medical care and services they receive in the hospital's in- and out- patient clinics and emergency units. The document has been reproduced on large posters that are now hanging on the New Kasr Al-Aini hospital's walls. Smaller posters are plastered on the doors of patients' rooms. Amongst the document's mandates are a patient's rights to receive round the clock medical services, to be informed of the different therapeutic options available, as well as the costs of any procedure they undertake. The document also requires that patients be asked for their consent regarding whatever treatment is provided, and that avenues for presenting complaints to the hospital be made available in case they feel any of their acknowledged rights have been breached. Doctors Syndicate chairman Hamdi El- Sayed said that the New Kasr Al-Aini hospital should "be thanked" for taking this initiative. The hospital is an independent unit affiliated to Cairo University's Kasr Al-Aini medical school, one of the oldest in the Middle East. The new unit opened in April 1996, and provides medical care for fees (whereas the original hospital is a public facility that offers free treatment). According to Said Rateb, the hospital's director general and professor of surgery at Cairo University, the new document is "symbolic" of the New Kasr Al-Aini's mission to be a centre of excellence that makes use of both top experts and the most advanced medical technology available to provide the highest standard of health care and medical education. "Part of our mission is to create and foster an awareness of basic concepts such as patients' rights," he told Al-Ahram Weekly. "We have to focus on our primary customers -- the patients." Although several earlier documents addressed more general issues related to medical ethics, the New Kasr Al-Aini document is "the first Egyptian document to specifically delineate patients' rights", Rateb said. The document is the outcome of almost a year of discussions and debate within the institution. A core group from the hospital's managerial team examined similar documents from different countries, using them to help set guidelines for the document's provisional draft, which was adapted to comply with various domestic considerations. The draft was then reviewed by the hospital's scientific committee -- which includes chairmen of different clinical departments -- before being given a final clearance by the board of directors. It was then released for more general discussions in different departments as well as amongst the hospital's medical and administrative employees. Some doctors were concerned that the new document might disturb the longstanding power dynamic within the medical profession, which has been, for the most part, heavily weighed to the doctor's advantage. They argued that such an official acknowledgement of patients' rights might eventually result in an increase in complaints. It might also catalyse a boom in Egypt's already flourishing medical malpractice litigation sphere, which would then force doctors to shy away from procedures that may hold risks, even if they are minor. Rateb, however, insisted that, "doctors should try and think like patients. If we simply follow proper and sound procedures, give our patients sufficient time, and engage in active, healthy and informative communication, there shouldn't be any problems. There would hardly be any space for negligence or negative consequences." Many in the medical profession think it is high time for someone to stand up for long- neglected patients' rights. "As of now, there is no organisation in Egypt that represents patients in any way," said Alaa Shukrallah of the Association for Health and Environmental Development (AHED). Although the new document might seem limited to just one hospital -- and not even one that offers the free services used by the vast majority of the population -- according to Shukrallah, it is definitely a "positive first step that should trigger a more concerted movement of all those concerned towards a wider acknowledgement of health as a basic human right, and the protection of patient's rights within the doctor-patient relationship".
