Where appropriate, AfMA will propose additional policies or declarations that support its objectives.

Proposed AfMA Statement (of Pilanesberg) on Health Information to and Communication with Patients

PREAMBLE

The relationship between physicians, their patients and broader society has undergone significant changes in recent times. This is especially due to the development of new information channels such as the Internet, the growing health care needs of patients and the limited resources available in health care systems worldwide to satisfy those needs. Despite these challenges physicians should always act in the best interests of their patient. In addition, all efforts should be made to facilitate respectful communication within the patient-physician relationship and to ensure that patients are fully informed about their health, illnesses and the availability of treatments.

The following statement represents some of the principal rights of the patient which physicians support and will promote. Whenever legislation, government action or any other administration or institution denies patients these rights, physicians and physician organizations should pursue appropriate means to assure or to restore them.

PRINCIPLES

1. Right to Dignity and Respect

   The patient's right to be treated with dignity and respect and the ethical imperative for physicians to always serve the best interest of their patients will act as guiding principle in optimizing health information and communication practices in health care. Physicians should pay specific attention to the unique needs, preferences and values of their patients.

2. Right to Information

   All patients have a fundamental and legitimate right of access to accurate, relevant and comprehensive information to enable them to make informed decisions about healthcare treatment and living with their condition. The patient has the right to choose who, if anyone, should be informed on his/her behalf.

3. Quality of Information

   Information to patients should be easily accessible, timely, accurate, clear, relevant, and reliable and based on evidence or best practice. Information must be presented in an appropriate format, according to health literacy principles, considering the individual's condition, language, age, understanding, abilities and culture. Patients need to understand their condition and be able to receive information on genetic and hereditary factors, where relevant. Care should be taken that information is provided about the best available management of the disease and of all available treatments. In addition, everyone should have access to accurate, reliable and transparent information on scientific research, pharmaceutical and medical device care and technological innovations.

4. Communication of Information

   Health professionals need to be trained and possess the knowledge and skills to communicate, manage and provide information in the most effective manner to their patients. They need to assist patients in accessing, managing and utilizing information.

5. Responsible Use of Technology

   Information should be made available using a variety of information and communication technologies and should be presented in accordance with recognized or agreed quality standards. This is especially true in the provision of information via the Internet, where the responsible use of only evidence-based, accurate information should be encouraged.

6. Communication of Risks and Benefits

   Risks and benefits of healthcare interventions and options should be explained to patients and, where appropriate, to their families and carers. This should specifically include awareness of the risks and benefits of prescription medicines and the importance of reporting and managing possible side effects.

7. Right to Health Education and Focus on Prevention

   Every person has the right to health education that should include information about healthy lifestyles, elimination of risk-taking activities and about methods of prevention and early detection of illnesses. The personal responsibility of everybody for his/her own health should be stressed. Health professionals have an obligation to participate actively in these educational efforts.

8. Research on Health Information and Communication

   Health professionals should be encouraged to conduct research and contribute to the evidence base regarding the impact of informed patients on health outcomes and health professional practice.

9. Right to confidentiality

   All identifiable information about a patient's health status, medical conditions, diagnosis, prognosis and treatment and all other information of a personal kind must be kept confidential, even after death. Exceptionally, descendants may have a right of access to information that would inform them of their health risks. Confidential information can only be disclosed if the patient gives explicit consent or if expressly provided for in the law.

10. Partnerships to Improve Health Information and Communication

    Health professionals should work in partnership with each other and all interested groups, especially patient representative organizations, to ensure that patients and the public have access to appropriate information about health and health services.

4.10.2006