病人的权利和责任(Patient Rights & Responsibilities)
网友问：“到ER看急诊或住院时必须签署那么多的同意书（informed consent）才能得到治疗或手术，感觉像是给自己签下了生死状任由宰割、不能自主了。医院的医护人员该不会强行把病人五花大绑在手术台上动刀吧？病人到底有哪些正当、合法的权利可以拒绝治疗、自行出院而自我保护、不受伤害呢？” 这一篇就介绍病人的权利和责任（Patient Rights & Responsibilities）。
每个州都有非常具体的法律条文来维护民众的就医权利。请访问或致电各州的卫生署（Health Department）的网址或问讯处，取得最准确的当地条文。以下以纽约州为例。PATIENTS' BILL OF RIGHTS（病人的人权法案）
As a patient in a hospital in New York State, you have the right, consistent with law, to:
1. Understand and use these rights. If for any reason you do not understand or you need help, the hospital must provide assistance, including an interpreter.
2. Receive treatment without discrimination as to race, color, religion, sex, national origin, disability, sexual orientation, or source of payment.
3.Receive considerate and respectful care in a clean and safe environment free of unnecessary restraints.
4. Receive emergency care if you need it.
5. Be informed of the name and position of the doctor who will be in charge of your care in the hospital.
6.Know the names, positions, and functions of any hospital staff involved in your care and refuse their treatment, examination or observation.
7. A no smoking room.
8. Receive complete information about your diagnosis, treatment and prognosis.
9. Receive all the information that you need to give informed consent for any proposed procedure or treatment. This informatiom shall include the possible risks and benefits of the procedure or treatment.
10. Receive all the information you need to give informed consent for an order not to resuscitate. You also have the right to designate an individual to give this consent for you if you are too ill to do so. If you would like additional information, please ask for a copy of the pamphlet " Do Not Resuscitate Orders - A Guide for Patients and Families."
11. Refuse treatment and be told what effect this may have on your health.
12. Refuse to take part in research. In deciding whether or not to participate, you have the right to a full explanation.
13. Privacy while in the hospital and confidentiality of all information and records regarding your care.
14. Participate in all decisions about your treatment and discharge from the hospital . The hospital must provide you with a written discharge plan and written description of how you can appeal your discharge.
15. Receive your medical record without charge and obtain a copy of your medical record for which the hospital can charge a resonable fee. You cannot be denied a copy solely because you cannot affored to pay.
16. Receive an itemized bill and explanation of all charges.
17. Complain without fear of reprisals about the care and services you are receiving and to have the hospital respond to you and if you request it, a written response. If you are not satisfied with the hospital's response, you can complain to the New York State Health Department. The hospital must provide you with the Health Department telephone number.
18. Authorize those family members and other adults who will be given priority to visit consistent with your ability to receive visitors.
19. Make known your wishes in regard to anatomical gifts. You may document your wishes in your health care proxy or on a donor card, available from the hospital.
In addition to the New York State rights listed above, each patient at ____Hospital has the right to understand and participate in decisions regarding the management of his or her pain.
（the Fifth Vital Sign
A patient has the responsibility to:
1. Provide, to the best of his/her knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications and other matters relating to his/her health.
2. Report changes in their condition to the responsible practitioner.
3. Make it known if they clearly understand a contemplated course of action and what is expected of them, to ask any questions they may have, and to follow the treatment plan recommended by the practitioner primarily responsible for their care. This may include following the instructions of nurses and allied health personnel as they carry out the coordinated plan of care and implement the responsible practitioner's orders; and as they enforce the applicable hospital rules and regulations.
4. Keep appointments and, when unable to do so for any reason, notify the practitioner or the hospital.
5. Accept the results of his/her own actions if he/she refuses treatment or dose not follow the practitioner's instructions. （接受他/她拒绝治疗或不按照医生指示的自我行为的结果。）
6. Assure that the financial obligations of their health care are fulfilled as promptly as possible.
7. Follow hospital rules and regulations affecting patient care and conduct.
8. Be considerate of the rights of other patients and hospital personnel, and assist in the control of noise, smoking, and the number of visitors.
9. Be respectful of the property of other persons and of the hospital.
10. Keep all personal property in appropriate containers, as the hospital is not responsible for your personal things.
简单地说，神志清醒的病人有权拒绝服药、手术等治疗措施；有权要求换主治医生（Attending Physician)；有权要求提前出院(leave against medical advice
)。但您必须签署相关文件，为自我行为和可能的后果负责。下面是一份文件的格式：INFORMED REFUSAL OF TREATMENT / RELEASE OF RESPONSIBILITY
I understand that ____Hospital has offered:O
to examine me (the patient) to determine whether I am suffering from an emergency medical condition;O
to provide necessary treatment to care for and stabilize my condition;O
to provide medically appropriate transfer to another facility capable and/or willing to provide care that is not available at this facility;O
to arrange for transfer by ambulance or aircraft;O
to perform/provide the following therapies/procedures deemed appropriate for my condition:
The physician(s) and /or licensed healthcare professional(s) have informed me that the benefits that might reasonably be expected from the offered services are:
__________________________________________________________________________________________I understand that my refusal may result in a worsening of my known condition and any conditons currently unknown, and could pose a threat to my life, my health, and my medical safety including death or permanent disability. I hereby:
O refuse the offered services O acknowledge my decision to leave against medical advice.
I have read this document in its entirety, and I fully understand it. I release ____ Hospital , the attending physician and all____hospital healthcare providers and employees from all responsibility and resultant ill effects.
Patient Date Administrative - check all that apply:
Refused informed discussion O
Left against madical advice O
Left without signing form
Witness (Physicion/Healthcare Provider) Date
When a patient is a minor or lacks capacity to give
consent, signature of person authorized to give
consent for treatment:
Name of Authorized Representative Relationship to Patient但有例外：
3. 美国看病常识(4)---Advance Directives(预先指示)
4. 美国看病常识(3)---有哪些同意书和文件要签?**今天（09/30/2010）补加一个《中国医学院毕业并在美行医的医生名录》链接，方便查找美国各州行医的各科中国医生，请点击： http://physician.cmgforum.net/