At one point in Edgar Allan Poe’s Narrative ofArthur Gordon Pym of Nantucket, Pym, who has stowed away in the hold of a whalingvessel, believes he has been abandoned and that the hold will be his tomb. He expresses sensations of “extreme horror and dismay,” and “the most gloomy imaginings, in which the dreadful deaths of thirst, famine, suffocation, and premature interment, crowded in as the prominent disasters to be encountered.” It is probably uncommon for hospitalized patients to feel as gloomy as Pym. Nevertheless, installed in a strange institution, separated from friends and family, forced to wear a degrading costume, confined to bed, and attended to by a variety of strangers who may or may not keep the patient informed of what they are doing, the average patient is intimidated and disoriented. Such an atmosphere encourages dependence and discourages the assertion of individual rights. The movement for enhanced patients’ rights is based on two premises: (I) citizens possess certain rights that are not automatically forfeited by entering into a relationship with a physician or health care facility; and (2) most physicians and health care facilities fail to recogmze these rights, fail to provide for their protection or assertion, and limit their exercise without recourse.’ The primary argument against patients’ rights is that patients have “needs” and defining these needs in terms of rights leads to the creation of an unhealthy adversary relationship.z It is not, however, the creation of rights, but the disregard of them, that produces adversaries. When care provider and patient work together in an atmosphere of mutual trust and understanding, the articulation of rights can only enhance their relationship. Many issues cannot be resolved entirely within the provider-patient relationship, however. F’roviders not only have formal relationships with their patients but also have relationships with other providers, health care institutions, and numerous governmental agencies. A provider’s relationship with these institutions and individuals is often a very complex one, and providers often find themselves confused and therefore submissive in cases where they do not understand their own rights or those of their patients.