One of your principal medical rights is to informed consent. That is, you have a right to an explanation of any treatment or procedure before it is performed on you, an explanation of the risks of that treatment or procedure, and an explanation of the alternatives to that treatment or procedure. "Treatment or procedure" means any drugs, any tests or surgeries—anything that involves something foreign entering your body. "Risks" means material risks, that is, anything that can reasonably be expected to happen. Your doctor is not necessarily obligated to inform you of an improbable risk, a one-in-a-million chance. Informed consent also means that you can refuse any treatment or procedure. Anyone who attempts the treatment or procedure without your consent—assuming you are mentally competent to give consent—can be sued on grounds of assault. You also have the right to refuse medication. Your right to refuse food and water is still a matter of legal argument. Your right to refuse treatments, procedures, or medication can be overruled only if you are incompetent. Incompetent means that you are unable to comprehend what you have been told and are unable to make decisions. In principle, the courts, guided by the advice of the physician, decide when someone is incompetent. In practice, the court system takes a long time, and competence is decided by two concurring physicians, one of whom is your physician-of-record. You can request treatments, procedures, or medication, but you cannot demand them. You have a right to see your medical records. Your medical records are, however, the property of the hospital. As such, the hospital can dictate under what circumstances and in whose presence you can see your medical records. You have a right to copy your medical records. You may not remove the records from the hospital without the hospital's consent. Hospitals, as public accommodations, cannot refuse to treat you on the grounds that you have HIV infection. Some hospitals, however, limit the kinds of treatment they offer and can refuse to treat anyone who requires services they do not offer. Any Health Maintenance Organization (HMO) to which you belong has a legal contract with you that outlines the rights and obligations of both parties. In a hospital, you can request to be assigned another physician. The hospital is obliged to grant your request. Some states have laws that prohibit a physician from refusing patients on the basis of race, sex, creed, color, or disability. In most states, HIV infection is defined as a disability. However, many physicians do not consider themselves competent to care for people with HIV infection and will refuse care—rightly—on this basis. Others are simply too busy to accept new patients. The first time you see a private physician, he or she can refuse to treat you. If you have previously been accepted as a patient by that physician for other medical conditions and the two of you have an ongoing relationship, she or he can still refuse to treat you, but cannot abandon you. Not abandoning you means that your physician must help you find another physician who can provide the care needed. Similar rules apply to dental care. Many dentists are uncomfortable caring for people with HIV infection. The ethics of dental practice dictate that the dentist is obliged to provide continuing care to established patients, or at least refer them to another dentist who can provide more specialized care. A Note on Lawsuits-The right to file lawsuits is a right no one can take away from you. But lawsuits often take years to settle. Some people decide not to file a suit because they do not want to take the time. Others decide not to file because their HIV status would then become public record. Many people go ahead and fight and win suits.*201\191\2*
