Improvement of human rights in patient care in Republic of Macedonia

Abstract

The rights of patients are based on the general human rights and are an important segment in the process of "Europeanization" of the Republic of Macedonia. The main goal of this study was to analyze the legislative framework of human rights in the health care in the Republic of Macedonia and its implementation in practice. Material and methods: The study was designed as a descriptive-analytical cross sectional study, in which a public health approach, an information-analytical method and evidence synthesis method were applied for the analysis of the relevant legislation. A survey was conducted on a representative stratified sample of patients in the Polog Region in the period from October to November 2017 in the Clinical Hospital Tetovo and the General Hospital Gostivar. Results: The legal system of the Republic of Macedonia was analyzed and compared with 6 transition countries, which had undergone a series of substantial reforms in recent years. The legislative framework in the Republic of Macedonia is a comprehensive frame for protection of patients’ rights, with which the patient is guaranteed legal rights in the process of treatment, respect and protection of his/her personality and integrity. The implementation of patients' rights in practice in this paper was analyzed by implementation of two rights of patients: the right on information about the recommended medical interventions and the right to accept and reject certain medical intervention. 85.2% of the interviewed patients had information on the right to information about the recommended medical interventions, and 14.8% didn’t have. 72.1% of the interviewed patients had personal experience for this right, and 27.9% didn’t have. Regarding the right to accept and reject certain medical intervention, 77% of the interviewed patients had information on this right, while 23% didn’t have. Personal experience was significantly smaller with this right, i.e. only 32.8% of the interviewed patients had personal experience, and 67.2% didn’t have. These differences were significant for both rights, for information and for personal experience. Conclusions: The human rights in the health care in the Republic of Macedonia are reflected in the national legislation, which is harmonized with the European and international legislation. However, it is necessary to improve the implementation of patients' rights in practice by raising the citizens' awareness about the knowledge of patients' rights and encouraging medical staff to respect the rights of patients and their compulsory application in practice.