The pandemic has changed our concept of time. Most of us by now have lost track of time wondering which day of week it is, which month and what time of the day we are in.  It feels as if time has come to a standstill. The pandemic is the absolutely perfect example of VUCA world – Volatile, Uncertain, Complex and Ambiguous.

We all are going through the COVID-19 pandemic; we are living through is scary, depressing yet a life-changing experiences. This pandemic is worst then world wars, terrorist’s attacks or the Great Depression. It’s bigger than a lot of previous social shifts, not only because of its tragic outcomes, but also because it is distressing so many of us at once and changing every aspect of life from our professional work, income, health, social life everything.

Because of the risk of viral transmission, many people are dying apart from their loved ones, and many others are mourning lonely without their friends and relatives for sharing their grief. It’s distressing to feel helpless to not go to see your near and dear ones suffering Corona… I experienced the agony when my sisters were admitted in hospital for Corona and I couldn’t reach out to assist them in this crucial time. I am so thankful to God that both my sisters have recovered and have returned back to their home. I could visit them only after two months because of the restriction on traveling from one district to another.   

Pandemic has created only chaos; the media constantly gives out news of number of deaths due to Corona, numbers of new additions of Corona patients and numbers of recovery of Corona. Countless people are anguished for losing their jobs, not being able to manage their basic daily expenses, worried about their children’s education, unable to pay their loan instalments…..in short  plans for the future have gone topsy-turvy. It’s only feeling of uncertainty all the while. Over and above all while we fear for our near and dear ones’ health and comfort.

The point is we all learn to live with adversities. When adversity hits us, we start to ask questions. The tougher it hits us, the deeper our questions become. Sometimes, those questions end up being unexpected gifts that take us on higher levels, where our souls demand us to go. Sometimes we tend to run away from these difficult questions, and sometimes we are left with no choice but to fight.

George A. Bonanno is a professor of clinical psychology at Teachers College, Columbia University, U.S.A. He is responsible for introducing the provocative idea of our mind’s agility to tackle loss and trauma. He is known as a pioneering researcher in the field of grief and trauma.

In situations as the present pandemic which is very difficult for people, George Bonanno says that people will get through it, probably the same way that people have gotten through other kinds of losses. They will just need to be a little more creative about it. Based on decades of research, Bonanno calls grief a “natural adaptive reaction” it is a painful but necessary mental recalibration to accommodate a new absence, new loss, new beginning.

Anything this big creates the opportunity for new thinking. If the size of the crisis is associated with the amount of new learning it can generate new opportunities. Our brilliance will be magnified many-fold when we emerge in the new normal. New and expanded points of view are generally a good thing. In fact, the roots of the word “emergency” come from the Latin “emergere” meaning to rise up or out.

Socrates said “The secret of change is to focus all of your energy, not on fighting the old, but on building the new.”

This phase will also  pass.

The film stars get large fan following; fans always surround their favourite stars wherever they see them. The fans feel like touching the stars, take selfies with them, take their autograph etc. Now there is no logic in this why should people follow the film starts, singers and models but the obsession sometimes crosses the boundaries. Some fans become too excited and they go to any extent and end up injuring the celebs they claim to love.

Bollywood actress Katrina Kaif was attacked by a mob of fans on her way back from promoting her movie Tees Maar Khan.The crazy fans trying to touch her and number increased to an extent when there was no control of the security personnel. But her co-star macho man Akshay Kumar came to damsel’s rescue and made a shield around Katrina with his arms, and saved her from further harassment. In another incident On her way back from the unveiling of the Diwali special edition of a magazine, Deepika was mobbed by fans who tried to touch her inappropriately and refused to let her go. Thankfully, with the help of her security, Deepika fled the scene.

While good looks can give some advantages in some walks of life, they also come with drawbacks. While there are of course some definite perks, it turns out that the bubble of beauty can make certain aspects of life much more difficult. Beautiful girls and also boys get chased by the wrong people. Some men, who fall for a beautiful woman and get dejected by her go to extent of murdering her, rape her or even attack her with acid and what not. Young school going teenage girls get chased by elderly men.

R.J.Malishka

Seeking attention habitually, to be desperate to gain notice is an obsessive behaviour. It is a psychological disorder. Most affluent people have similar traits of behaviour such as buying styles or life style choices. They spend tons of money on buying luxury cars, sports cars, private planes and golf resorts. They would also be keen on spending tons of money on engagements wedding, partying, exotic travels etc. They simply like to show off. Wealthy people like to indulge in some conspicuous behavior to seek attention from others. If you show off, it may make you famous or infamous, depending upon your intention, situation, circumstances and background.

Rich people face threats and worst consequence; their children become lazy, incompetent, non-self-reliant adults, they are worried about kids getting kidnapped, we see many high profile kidnapping cases. They are susceptible to lawsuits; where there is money, there are lawsuits. Strangers, family members and friends ask for money.   Slowly, they don’t trust people around them.

So if you are successful, you will find many enemies. You will find envious, bitter, jealous, suspicious, distrustful people around you.  Unwanted attention costs peace of mind.

At times when we need genuine attention, we don’t get it. Therefore it is called slippery. A crisis is a situation that poses an immediate risk to health, life, environment, property, career, bank balance, an important relation etc. Most emergencies require urgent intervention to prevent a worsening of the situation, although in some situations, mitigation may not be possible. Situations like these – when you rush your near and dear one to hospital, and you need attention from the hospitals staff and doctor; when you need to catch a flight, you are late, the staff at the airport does not pay attention to you; when you need to go to reach your destination at the earliest and the roads are crowded; when you try to tell your teacher/professor that you have not committed a mistake he/she does not pay attention to you; when you need to urgently withdraw cash from bank and the queue is big nobody is ready to pay attention; you are giving a presentation and people are not giving enough attention, these and in many other crisis situations  when you need attention most, you don’t get it.

The fact is we are living in a world where human attention as a scarce commodity. The phrase ‘to pay attention’ has a connotation of giving something of yourself to another. Typically, paying is normally associated with money, so we don’t need to specify anything when money is paid. But to pay attention is still giving your time, your concentration, your mind to another person.  And ultimately attention is the key to everything related to our lives.

As it is, many people are afraid of hospitals; they relate hospital with sickness and death, some people find their fear so deeply rooted that they feel threatened and overwhelmed when they need to go to a hospital. It’s a common sentiment for so many number of years that medical practice means the physicians make decisions for their patients. This mistaken view has gradually been displaced by the fact that a patient has sovereignty and rights in decision making about his well being and the entire process of getting cured. He can thus share his views and with the doctors. In the recent years we see a sea change in doctor-patient relationships; they are very different now than they were just a few decades ago. However, conflicts still abound as the medical community and those it serves struggle to define their respective roles.

Patients’ rights differ in different countries and in different jurisdictions which often depend upon existing cultural and social standards. Different models of the patient-physician relationship usually represent the citizen-state relationship, and these standards shape   particular rights to which patients are entitled. In North America and Europe, for instance, there are at least four models which depict this relationship: the paternalistic model, the informative model, the interpretive model, and the deliberative model. Each of these suggests different professional obligations of the physician toward the patient. For example, in the paternalistic model, the best interests of the patient as judged by the clinical expert are valued above the provision of comprehensive medical information and decision-making power to the patient. As in the informative model, by contrast, sees the patient as a consumer who is in the best position to judge what is in her own interest, and thus views the doctor as chiefly a provider of information. There continues to be enormous debate about how best to envisage this relationship, but there is also growing international consensus that all patients have a fundamental right to privacy, to the confidentiality of their medical information, to consent to or to refuse treatment, and to be informed about relevant risk to them of medical procedures.

Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit multispecialty academic medical center that combines clinical and hospital care with research and education. Cleveland Clinic was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. U.S.News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Do you know, about 2,000 full-time salaried physicians and researchers and 7,600 nurses at Cleveland Clinic represent more than 100 medical specialties and subspecialties? In addition to its main campus, Cleveland Clinic operates from nine regional hospitals in Northeast Ohio, Cleveland Clinic Florida, Lou Ruvo Center for Brain Health in Las Vegas and Cleveland Clinic Canada. Millions of patients from so many countries in the world visit Cleveland for different ailments. Cleveland Clinic has set benchmarking in patient’s and patient’s family’s experience in the hospital. It constantly reviews opportunities to improve the patient experience. By monitoring real-time patient feedback, individual departments are able to review their results and prioritize patient experience improvement objectives. We have examples of Cleveland Clinic for the best medical practices.

Right of information: Please be aware that as a patient you have right to have information regarding risks, alternatives, and success rates. The information must be presented to you in language which you understand. As a patients or close relative of patient, you have a right to have description of the recommended treatment or procedure. Also, you can seek description of the risks and benefits, particularly exploring the risk of serious bodily disability or death. You can ask questions to seek information of alternative treatments and the risks and benefits of trying out the alternatives. You must get to know from the physician the probable results if no treatment is undertaken. The probability of success and a definition of what the doctor means by success; yes, you must ask questions to gauge the so called success elements. Ask questions to know length and challenges of healing. And, you are free to ask any other information generally provided by the physician.

Patient’s consent: Please understand that doctors do not have the right to touch or treat a patient without the patient’s approval because the patient is the one who must subsist with the consequences and deal with any discomfort caused by treatment. A doctor can be held liable for committing a series if the doctor touches the patient without first obtaining the patient’s consent. Consent must be voluntary, competent, and well informed. Voluntary means that, when the patient gives consent, he or she is free from extreme pressure and is not intoxicated or under the influence of medication and that the doctor has not coerced the patient into giving consent. The law presumes that an adult is competent, but competency may be an issue in numerous instances. Competence is typically only challenged when a patient disagrees with a doctor’s recommended treatment or refuses treatment altogether. If an individual understands the information presented regarding treatment, she or he is competent to consent to or refuse treatment.

Medical practice is not free from legal, moral, and ethical questions. Hippocratic Oath is one of the oldest binding documents in history, the Oath written by Hippocrates is still held sacred by physicians: to treat the ill to the best of one’s ability, to preserve a patient’s privacy, to teach the secrets of medicine to the next generation, and so on.

Emergency: In an emergency situation, a patient has a right to treatment, regardless of his ability to pay. If a situation is likely to cause death, serious injury, or disability if not attended to promptly, it is an emergency. Cardiac arrest, heavy bleeding, profound shock, severe head injuries, and acute psychotic states are some examples of emergencies. Less obvious situations can also be emergencies: broken bones, fever, and cuts requiring stitches may also require immediate treatment. Please understand that both public and private hospitals have a duty to administer medical care to a person experiencing an emergency. If a hospital has emergency facilities, it is legally required to provide appropriate treatment to a person experiencing an emergency. If the hospital is unable to provide emergency services, it must provide a referral for appropriate treatment. Hospitals cannot refuse to treat forthcoming patients on the basis of race, religion, or national origin, or refuse to treat someone with HIV or AIDS.

However, there is no universal right to be admitted to a hospital in a nonemergency situation. In nonemergency cases, admission rights depend largely on the specific hospital, but basing admission on ability to pay is severely limited by statutes, regulations, and judicial decisions.

Medical Experimentation: medical progress and medical experimentation have always gone hand in hand, but patients’ rights have sometimes been ignored in the process. Sometimes patients are completely unaware of the experimentation. Experimentation has also taken place in settings in which individuals may have extreme difficulty asserting their rights, such as in prisons, mental institutions, the military, and residences for the mentally disabled. Legitimate experimentation requires informed consent that may be withdrawn at any time by the patient.

Every state has enacted advance medical directive legislation, but the laws differ widely. Advance medical directives are documents that are made at a time when a person has full decision-making capabilities and are used to direct medical care in the future when this capacity is lost. Many statutes are narrowly drawn and specify that they apply only to illnesses when death is imminent rather than illnesses requiring long-term life support, such as in end-stage lung, heart, or kidney failure; multiple sclerosis; paraplegia; and persistent vegetative state.

Right to die: A number of cases have addressed the right to refuse life-sustaining medical treatment. Broadly speaking, under certain circumstances a person may have a right to refuse life-sustaining medical treatment or to have life-sustaining treatment withdrawn. On the one side in these cases is the patient’s interest in autonomy, privacy, and bodily integrity. This side must be balanced against the state’s traditional interests in the preservation of life, prevention of suicide, protection of dependents, and the protection of the integrity of the medical profession.

Confidentiality: confidentiality between a doctor and patient means that a doctor has the express or implied duty not to disclose information received from the patient to anyone not directly involved with the patient’s care. Confidentiality is important so that healthcare providers have knowledge of all facts, regardless of how personal or embarrassing, that might have a bearing on a patient’s health. Patients must feel that it is safe to communicate such information freely. Although this theory drives doctor-patient confidentiality, the reality is that many people have routine and legitimate access to a patient’s records. A hospital patient might have several doctors, nurses, and support personnel on every shift, and a patient might also see a therapist, nutritionist, or pharmacologist, to name a few. The law requires some confidential information to be reported to authorities. For example, birth and death certificates must be filed; child abuse cases must be reported; and infectious, contagious, or communicable diseases must be reported. In addition, confidential information may also be disclosed pursuant to a judicial proceeding or to notify a person to whom a patient may pose a danger.

Human Rights: The Universal Declaration of Human Rights has been instrumental in preserving the notion of human dignity in international law, providing a legal and moral grounding for improved standards of care on the basis of our basic responsibilities towards each other as members of the “human family”, and giving important guidance on critical social, legal and ethical issues. But there remains a great deal of work to be done to clarify the relationship between human rights and right to health, including patient rights. Recognizing this challenge, the United Nations Commission on Human Rights (UNHCR) has designated a Special Forum to provide it with a report that examines and clarifies the broader relationship between human rights and the right to health. This report has great importance for the World Health Organization, whose mission is to ensure “health for all”.

How much information is considered adequate? Reasonable physician standard: this standard allows the physician to determine what information is appropriate to disclose. However, this standard is often insufficient, since most research shows that the typically physicians tell the patient very little. Reasonable patient standard: what would the average patient need to know in order to be an informed participant in the decision? This standard focuses on considering what a typical patient would need to know in order to understand the decision at hand. And, lastly the subjective standard: what would this particular patient need to know and understand in order to make an informed decision? This standard is the most challenging to incorporate into practice, since it requires tailoring information to each patient.

I want to conclude my article with this beautiful quote of Albert Schweitzer – the medical missionary in Africa “Each patient carries his own doctor inside him. They come to us now knowing this truth. We are at our best when we give the doctor who resides within each patient a chance to go to work” I think, this quote sums up our rights as patients.