โ Scribed by Joseph Margolis
No coin nor oath required. For personal study only.
The details of an adequate patients' bill of rights are obviously quarrelsome and extremely difficult to formulate with precision. The recent effort at a model bill of patient rights, by Professor Annas and Dr. Joseph Healey, may well be the most comprehensive and coherent version that we are likely to have for some time.1 It may, therefore, be more useful to step back and consider what we are doing in formulating such a bill of rights -why, and with what justification -than to tinker with the terms of their particular version or of any other. Or, at any rate, it may be useful to generalize before reviewing any details. There are, of course, a good many similar efforts in other areas, for instance, the various manuals published by the American Civil Liberties Union for inmates in American prisons or for those inducted into the armed services; or Nicholas Kittrie's attempt at a model bill of rights for patients in mental institutions, particularly those confined by law. 2 The larger issue may, in fact, afford us a better grasp of the details of competing bills, although to make a gain here is to retreat to conceptual issues.
The fundamental notion of a right is that of entitlement regarding one's own behavior and regarding a justified and coordinate claim obligating another. This is not a non-controversial definition by any means. Annas and Healy, for example, mention Holland's definition of a right as a specimen of at least one sort of theory: "a capacity residing in one man of controlling, with the assent and assistance of the State, the actions of others. ''3 But Holland's definition is defective in at least three critical respects that decisively bear on our present question. First of all, it defines rights in terms that require the participation of the state; but we may suppose that a model bill of patients' rights would be desirable if the hospital community would subscribe to it even if it should prove difficult or imiaossible to have it embodied in Federal statutes or comprehensively throughout the fifty States.
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