In March 2009, ACRI intervened before newly appointed Deputy Health Minister Ya’acov Litzman (serving as the de facto Health Minister) demanding he clarify regulations on the right of mentally ill patients to access information concerning their health condition and previous medical records. At present, during admission to a psychiatric ward, patients are asked to sign a consent waiver, which states that a doctor has the right to allow or deny them access to information regarding their condition – at the doctor’s discretion.
This clause stands in contradiction to the 1996 Patient’s Rights Bill, according to which a patient is entitled to full disclosure of information regarding his or her health, unless the doctor believes disclosure of information risks causing severe harm to the patient’s mental or physical condition or to those of another individual. In such circumstances, the doctor must appeal to the Ethics Committee, which is authorized to make a final decision. The law states that a patient holds the right to appear in person before the Ethics Committee.
Since the standard consent waiver a patient is requested to sign when admitted to a psychiatric ward was formulated in 1992, four years before the Patient’s Rights Bill was passed, it therefore overlooks this crucial matter. This discrepancy in law is particularly important in light of unfortunate trends within the psychiatric system to ignore the rights of the mentally ill. ACRI’s experience in representing the mentally ill shows that psychiatric institutions do not consider full disclosure of information to mentally ill patients a norm, but rather an exception to the rule. Mentally ill patients and their families are often presented with conditions and limitations, such as disclosure of selected records alone or a demand that the information be presented to a doctor or lawyer representing the patient.
In a previous Supreme Court petition submitted by ACRI on behalf of a woman whose request to review all her past medical files kept at a psychiatric hospital were refused, the court ruled in favor of the plaintiff. The judges accepted ACRI’s claim that the 1996 law should be fully implemented when dealing with the rights of the mentally ill. “The only exception to the rule in the case of a mentally ill patient”, the Court wrote, “is that a doctor is allowed to withhold information when the doctor is concerned severe harm or danger might be caused by the patient to another person”. The court instructed the case be brought to the Ethics Committee, as stated in the Patient’s Rights Bill, for a final decision.
In the intervention before the Health Minister, ACRI demanded that the waiver would explicitly include the considerations according to which the doctor is allowed to deny a patient access to information about his or her medical condition. The form, ACRI wrote, should also state that such a decision is dependent on a ruling of the Ethics Committee, and that the patient holds the right to present his or her case to the committee before the committee makes its decision.
