Your Rights as a Patient: Consent, Privacy and Respectful Care
On Human Rights Day, a plain guide to your rights in healthcare: what informed consent means, who can see your records, asking for a chaperone or a second opinion, and how to complain in the UK, Nigeria and Kenya.
TL;DR: You have the right to be treated with dignity, to be told what a test or treatment involves, and to say yes or no before anyone examines or treats you. Your health information should be kept confidential. You can ask for a chaperone or a female clinician for intimate examinations, ask to stop at any time, and ask for a second opinion. In the UK, PALS and the NHS complaints process can help if care goes wrong. Nigeria has a Patients' Bill of Rights, and Kenya's Constitution guarantees a right to health care.
Many of us were raised to be "good patients". You sit quietly, you do not question the doctor, and you say thank you even when you left more confused than you arrived. In some clinics in Lagos or Nairobi, and in some busy NHS wards too, that habit gets tested: an examination that starts before anyone explains it, a comment about your weight in front of a waiting room, a midwife who shouts. December 10 is Human Rights Day, and health is part of that conversation. Here is what you are entitled to, and what you can do when it does not happen.
What is respectful care?
Respectful care means being treated with dignity, privacy and kindness, being given information, and being involved in decisions about your body. The World Health Organization says every woman has the right to dignified, respectful health care, and that disrespectful and abusive treatment during childbirth violates women's rights to life, health, bodily integrity and freedom from discrimination.
This is not a rare problem. A WHO-led study in Ghana, Guinea, Myanmar and Nigeria found that 42 percent of women experienced physical or verbal abuse, stigma or discrimination during childbirth in health facilities, and 14 percent experienced physical abuse, most often being slapped, hit or punched. It also found high rates of caesarean sections, episiotomies and vaginal examinations carried out without consent. Younger, less-educated women were most at risk.
The WHO's guideline on care during labour puts woman-centred, human rights-based care at its heart. If you are expecting, our list of questions to ask at antenatal appointments can help you start those conversations early.
What does informed consent mean?
It means you give permission, freely and with full information, before any examination, test or treatment. The NHS explains that for consent to be valid it must be voluntary, informed, and given by someone with the capacity to decide.
In practice, that means:
- Voluntary: the decision is yours, without pressure from staff, friends or family.
- Informed: you are told what the treatment involves, its benefits and risks, any reasonable alternatives, and what happens if you do nothing.
- Capacity: you understand the information and can use it to decide.
Consent can be spoken, written on a form, or shown by actions, such as holding out your arm for a blood test, as long as you understand what is about to happen. The NHS also says that if an adult with capacity refuses a treatment, that decision must be respected, even if refusing could lead to their death or the death of their unborn child.
Consent is also ongoing. For cervical screening, the NHS says plainly that you are in control and can ask to stop at any time. The same principle applies to other examinations: you can say "please stop" or "please explain first", and a good clinician will listen.
Who can see my health information?
Your health information should stay between you and the people caring for you. The NHS Constitution says you have the right to privacy and confidentiality, to expect the NHS to keep your information safe and secure, to be told how your information is used, and to ask that it is not used beyond your own care and treatment. It also gives you the right to see your own health records and have factual mistakes corrected.
Confidentiality matters a great deal when family is close by. A relative may come with you to an appointment, but that does not mean they are entitled to hear everything. You can ask to speak to the clinician alone. If you are worried about who can see your data in health apps, our post on femtech privacy for African women explains what to look for.
Can I ask for a chaperone or a female doctor?
Yes. For intimate examinations, such as a vaginal or breast examination, you can ask for someone else to be in the room. The NHS tells people going for a colposcopy to let the clinic know if they would like a chaperone, either someone they know or a nurse or member of staff. For a pelvic examination about womb symptoms, the NHS notes that you can ask for a female doctor or nurse.
If no chaperone or female clinician is available, you can ask to rebook. If you have experienced sexual violence or trauma, you can say so, or simply say that you need things to go slowly. Our guide to your first gynaecologist appointment walks through what usually happens.
Can I get a second opinion?
You can ask for one. If you are unsure about a diagnosis or a recommended treatment, especially surgery, it is reasonable to ask your doctor to refer you to someone else, or to say you would like time to think. Write down what you were told and what you are unsure about, so the second clinician can see the full picture. Asking does not make you difficult. It makes you careful.
This is where preparation helps. Our post on how to talk to your gynaecologist so you are not dismissed has scripts for pushing back politely and asking for a referral.
How do I complain if care goes wrong?
Start by raising the problem with the service, if you feel able to. Many issues can be sorted out quickly that way. If not, there are formal routes.
In the UK (England): you have the right to complain about any aspect of NHS care, and every NHS service must have its own complaints procedure. You can complain to the provider, such as your GP surgery or hospital, or to the body that pays for the service, usually your local integrated care board, but not both. The Patient Advice and Liaison Service (PALS), found in most hospitals, offers free, confidential help and can often resolve problems informally. A free NHS complaints advocate can help you write a complaint letter and come to meetings with you, and your local Healthwatch can tell you who provides advocacy in your area.
In Nigeria: the Patients' Bill of Rights was launched at the State House in Abuja in 2018, developed with the Federal Competition and Consumer Protection Commission and the Nigerian Medical Association to set out patients' rights and privileges in care. The FCCPC is the agency behind it, so it is a place to start if you feel your rights as a patient have been ignored.
In Kenya: Article 43 of the Constitution of Kenya says every person has the right to the highest attainable standard of health, including reproductive health care. Complaints about doctors and health facilities can be made to the Kenya Medical Practitioners and Dentists Council, which runs a public complaints service.
Wherever you are, write things down as soon as you can: the date, the names or roles of staff, what was said and done, and how it affected you. Clear notes make any complaint easier to follow.
Speaking up is part of your care
Knowing your rights does not mean going into every appointment ready for a fight. It means you can relax a little, because you know what to expect and what to do if something goes wrong.
Asele can help you arrive prepared. Cycle tracking and symptom logging give you a record of what has been happening, and the Health Brief turns it into a clear pre-visit summary you can hand to your doctor, so the conversation starts from your story. Amara can help you plan your questions in Yoruba, Hausa, Igbo, Swahili, French or English. Find us at Asele.
This post is education, not legal or medical advice. Rules differ between countries and health systems, so check with your local health service or a patient advocate about your situation.
References
- World Health Organization. The prevention and elimination of disrespect and abuse during facility-based childbirth. 2014. who.int
- World Health Organization. New evidence shows significant mistreatment of women during childbirth. 2019. who.int
- World Health Organization. WHO recommendations: intrapartum care for a positive childbirth experience. 2018. who.int
- NHS. Consent to treatment. nhs.uk
- Department of Health and Social Care. The NHS Constitution for England. gov.uk
- NHS. What happens at a colposcopy. nhs.uk
- NHS. What happens at your cervical screening appointment. nhs.uk
- NHS. How to complain to the NHS. nhs.uk
- NHS. What is PALS (Patient Advice and Liaison Service)? nhs.uk
- Federal Competition and Consumer Protection Commission (Nigeria). Patients' Bill of Rights launch. fccpc.gov.ng
- Constitution of Kenya, 2010, Article 43. kenyalaw.org
- Kenya Medical Practitioners and Dentists Council. kmpdc.go.ke
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