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When a Right is No Longer a Right

by Kathleen Heren, Rhode Island's Long-term Care Ombudsman

Kathleen Heren

I am certain you have been following the story of the governor mandating health care workers to be vaccinated before October. I have given this a great deal of thought for a very long time. One of their arguments is “I have the right to refuse what I put into my body.” Our office lives and breathes standing up for residents receiving long-term care services and their rights. I even teach resident rights to employees of long-term care facilities. The Bill of Rights is a mandated class that all long-term care workers, which includes all departments, are obligated to attend. One of the questions I start my lecture with is asking “Do you all know what a right is?” The employees who have attended this class each year all respond with “It’s a resident’s right to do anything they want.” When I tell them they are incorrect, they look at me dumbfounded. My definition of a right depends on two very important factors; first, does a person understand the consequences of exercising their right, and second; will their decision affect other people’s rights. A person’s ability to make decisions is not either/or. It rests on the two conditions I first explained.

To get into the weeds a little more, here are some examples. I have spoken to many residents who tell the staff they no longer wish to receive dialysis (a life-sustaining treatment). The staff panic and ask for an ombudsman to speak to the resident. Our role is to listen to the resident then try to explain the consequences of their decision. If they respond by telling me they do not wish to continue living like they are, I will support them in carrying out their decision. As you can imagine many families become very upset and tell us “they are the Power of Attorney for Health Care.” We then remind them they only have the right to make decisions when the resident can no longer make them. If I have doubts, I will ask the physician to order an evaluation with a mental health worker. I don’t want our office to be a party to a suicide wish.