1. Become informed of his or her rights as a patient in advance of, or when discontinuing, the
provision of care. The patient may appoint a representative to receive this information should
he or she so desire.
2. Exercise these rights without regard to sex or cultural, economic, educational or religious
background or the source of payment for care.
3. Considerate and respectful care, provided in a safe environment, free from all forms of abuse
4. Remain free from seclusion or restraints of any form that are not medically necessary or are
used as a means of coercion, discipline, convenience or retaliation by staff.
5. Patients have the right to appropriate assessment and management of pain.
6. Knowledge of the name of the physician who has primary responsibility for coordinating his/her
care and the names and professional relationships of other physicians and healthcare providers
who will see him/her.
7. Receive information from his/her physician about his/her illness, his/her course of treatment and
his/her prospects for recovery in terms that he/she can understand.
8. Receive as much information about any proposed treatment or procedures as you may need in
order to give informed consent or to refuse the course of treatment. Except in emergencies, this
information shall include a description of the procedure or treatment, the medically significant risks
involved in the treatment, alternative course of treatment or non-treatment and the risks involved
in each and to know the name of the person who will carry out the procedure or treatment.
9. Participate in the development and implementation of his or her plan of care and actively participate
in decisions regarding his/her medical care. To the extent permitted by law, this includes the right to
request or refuse treatment.
10. Formulate Advance Directives regarding his/her healthcare, and have hospital and practitioners
who provide care in the hospital compiled with these directives (to the extent provided by state laws
11. Have a family member or representative of his or her choice notified promptly of his or her
admission to the hospital.
12. Have his/her physician notified promptly of his/her admission to the hospital.
13. Full consideration of privacy concerning his/her medical care program. Case discussion,
consultation, examination and treatment are confidential and should be conducted discretely. The
patient has the right to be advised as to the treatment for the presence of any individual involved in
14. Confidential treatment of all communications and records pertaining to his/her care and his/her
stay in the hospital. His/her written permission will be obtained before his/her medical records can
be made available to anyone not directly concerned with his/her care.
15. Access information contained in his/her medical record within a reasonable time frame (usually
within 48 hours of request).
16. Reasonable responses to any reasonable request he/she may make for service.
17. Leave the hospital even against the advice of his/her physician.
18. Reasonable continuity of care and to know in advance the time and location of the appointments
well as the physician providing the care.
19. Be advised of the hospital grievance process, should he/she wish to communicate a concern
regarding the quality of care he/she receives or if he of she feels determined discharge date is
premature. Notification of the grievance process includes: whom to contact to file a grievance, and
that he or she will be provided with a written notice of grievance determination that contains the
name of the hospital contact person, the steps taken on his or her behalf to investigate the grievance,
the results of the grievance and the grievance completion date.
20. Be advised if hospital/personal physician to engage in or perform human experimentation affecting
his/her care or treatment. The patient has the right to refuse to participate in such research projects.
21. Be informed by his/her physician or a delegate of his/her physician of the continuing healthcare
requirements following his/her discharge from the hospital.
22. Examine and receive an explanation of his/her bill regardless of source of payment.
23. Know which hospital rules and policies apply to his/her conduct while a patient.
24. Have all patient’s rights apply to the person who may have legal responsibility to make decisions
regarding medical care on behalf of the patient.
25. All hospital personnel, medical staff members and contracted personnel performing patient care
activities shall observe these patient rights.
1. The care the patient receives depends partially on the patient himself. Therefore, in addition to
these rights, a patient has certain responsibilities as well. These responsibilities should be presented
to the patient in the spirit of mutual trust and respect.
2. The patient has the responsibility to provide accurate and complete information concerning his/her
present complaints, past illnesses and hospitalizations and other matters relating to his/her health.
3. The patient is responsible for making it known whether he/she clearly comprehends the course of
his/her medical treatment and what is expected of him/her.
4. The patient is responsible for keeping appointments and for notifying the hospital or physician when
he/she is unable to do so.
5. The patient is responsible for his/her actions should he/she refuse treatment or not follow his/her
6. The patient is responsible for assuring that the financial obligations of his/her hospital care are
fulfilled as promptly as possible.
7. The patient is responsible for following hospital policies and procedures.
8. The patient is responsible for being considerate of the rights of other patients and the hospital
9. The patient is responsible for being respectful of his/her personal property and that of other persons
in the hospital.
As an adult with the capacity to make your own decisions, you have the right to participate in decisions concerning your health care and medical treatment. Many people choose to indicate their wishes in an Advance Directive such as a Living Will or Power of Attorney. Use of these documents allows you to convey to your family and physicians your wishes concerning your medical treatment.
It is the policy of Adams Memorial Hospital to respect and honor your rights to the extent allowed by Indiana Law. Adams Memorial Hospital will not condition your treatment or discriminate against you in any way based on whether or not you have executed an Advanced Directive.
1. Obtain a copy and place it in the medical record. The Advance Directive is available to the patient
or healthcare representative for review upon request or if a review is required due to a change
in the patient’s condition.
2. Notify the patient’s physician of the existence of an Advance Directive.
3. Implement provisions of the Advance Directive based upon the attending physician’s orders.
4. Assist the patient in obtaining another physician if the attending physician, as a matter of conscience,
cannot implement the Advance Directive. (assuming the Advance Directive meets the Laws of Indiana)
This information often prompts additional questions regarding your legal rights. Since these questions affect you as well as your family, you are encouraged to discuss these matters with them. The Adams Memorial Hospital’s Social Service Department is available to discuss these matters with you and answer certain questions. However, use of Advance Directives has legal implications and our employees cannot provide legal advice; therefore you are encouraged to discuss these matters with your attorney.