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Rights and Obligations of Patients
(According to Act CLIV of 1997 on Health)
Right to Health Care
Section 6
Each patient shall have a right to receive, in an emergency, life-saving care, care to prevent serious or permanent impairment to health, as well as to have his pain controlled and his suffering relieved.
Section 7
(1) Each patient shall have a right, within the frameworks provided for by law, to
appropriate and continuously accessible health care justified by his health condition,
without any discrimination.
(2) Healthcare shall be considered appropriate if delivered in compliance with the
professional and ethical rules, and practice guidelines relating to the specific
healthcare service.
(3) Healthcare shall be considered to be continuously accessible if the operation of the
health care delivery is such as to enable its use 24 hours a day.
(4) Healthcare shall be considered free from discrimination if, in the course of
delivering healthcare services, patients are not discriminated against on grounds of their
social status, political views, origin, nationality, religion, gender, sexual preferences,
age, marital status, physical or mental disability, qualification or on any other grounds
not related to their state of health.
Section 8
(1) The patient shall have a right to choose his attending physician, with the
agreement of the healthcare provider of the level justified by his condition and, unless a
legal rule sets forth an exception, the physician so chosen, provided it is not precluded
by the professional contents of the health service justified by his condition, by the
urgency of care or the legal relationship serving as the basis for the use of the service.
(2) The right to choose a physician as in Subsection (1) may be exercised in accordance
with the rules of operation of the healthcare provider.
(3) A patient may initiate that he be examined by a second physician in connection with
any diagnosis made or therapy recommended by his attending physician, or regarding his
planned discharge from an in-patient institution or referral to another healthcare
provider.
Section 9
(1) If a patient cannot be given the necessary care warranted by his health condition
within the shortest possible period of time, the healthcare provider shall be obliged to
inform him of the healthcare provider where the specific healthcare service is available.
(2) The patient shall be placed on a waiting list, if
(3) If placed on a waiting list, the patient shall be informed of the reason for, and
expected duration of waiting, as well as of its possible consequences.
(4) The patients’ order on, and selection from the waiting list shall be based upon
unified, controllable and published professional criteria, in a manner justified by the
state of health of patients on the waiting list and without any discrimination. The
patients’ advocate shall also be entitled to verify compliance with these principles,
upon written authorization by the patient.
(5) The waiting list shall contain the medical and personal identification data of
patients waiting to receive the specific healthcare service, as well as the circumstances
justifying their selection.
The Right To Human Dignity
Section 10
(1) The patient's human dignity shall be respected in the course of health care.
(2) Unless otherwise provided by this Act, only the interventions necessary for the care
of the patient may be performed.
(3) In the course of health care, a patient may be restricted in exercising his rights
only for the period of time justified by his state of health, and to the extent and in the
way, as provided for by law.
(4) In the course of health care, the patient’s personal freedom may be restricted by
physical, chemical, biological or psychological methods or procedures exclusively in case
of emergency, or in the interest of protecting the life, physical safety and health of the
patient or others. Restriction of the patient may not be of a punitive nature and may only
last as long as the cause for which it was ordered exists.
(5) The application of restrictive methods or procedures shall be ordered by the
patient’s attending physician, unless otherwise provided by this Act. Prior to applying
such restrictive measures, or if it is not possible, within the shortest possible time
after the initiation of their application, the attending physician shall enter the
restrictive methods or procedures in the medical record, indicating precisely the reasons
for and the duration of application. In the absence of continuous medical supervision, in
exceptionally justified cases, a registered specialist nurse may also giver temporary
order for the restriction. The attending physician shall be informed of the restriction
without delay, and shall be required to approve it in writing within sixteen hours. In the
absence of such approval, the restriction must be discontinued. If restrictive methods and
measures are applied, the patient’s condition and physical needs shall be observed
regularly, in compliance with professional rules. The observation and the findings shall
be entered into the patient’s medical records.
(6) A patient may only be made to wait on grounds and for a duration which are reasonable.
(7) In the course of health care, for protection of his modesty, the patient's clothing
may only be removed for the necessary time and to the professionally justified extent. ó
The Right to Have Contact
Section 11
(1) The rights set out in Subsections (2) to (7) may be exercised by the patient
subject to the conditions existing in the in-patient institution, while respecting his
fellow-patients' rights, and ensuring the undisturbed and smooth delivery of patient care.
The detailed rules of the latter shall be defined in the regulations of the in-patient
institution, without restricting the content of these rights. The hospital regulations may
grant further rights, in addition to those set out in Subsections (2) to (7).
(2) In the course of his stay in an in-patient facility, the patient shall have a right to
keep contact with other persons, either in writing or verbally and to receive visitors.
The patient may forbid that the fact of his treatment or any other information related to
his treatment be disclosed to other persons. This may only be disregarded in the interest
of his care, at the request of his next of kin or a person obliged to care for him.
(3) A patient in a severe condition shall have a right to have the person designated by
him stay with him. For a legally incapable patient, the above person might be designated
by a person as defined in Subsections (1) and (2) of Section 16. For the purposes of this
subsection, a patient in a severe condition is one who, due to his condition, is
physically unable to look after himself, or whose pain cannot be controlled even with the
use of medication, or who is in a state of psychological crisis.
(4) A minor patient shall have a right to have his parent, legal representative, or a
person designated by him or by his legal representative stay with him.
(5) A woman in childbirth shall have a right to designate a person of age to stay with her
continuously during labor and delivery, and after delivery, to have her new-born baby
placed in the same room with her, provided it is not excluded by the mother’s or the
new-born baby's health condition.
(6) The patient shall have a right to keep contact with a representative of the church
corresponding to his religious beliefs and to freely engage in acts of worship.
(7) The patient shall have a right to use his own clothes and personal belongings, unless
otherwise provided by law.
The Right to Leave the Healthcare Facility
Section 12
(1) The patient shall have a right to leave the healthcare facility, unless he
threatens the physical safety or health of others by doing so. This right may only be
restricted in the cases defined by law.
(2) The patient shall inform his attending physician of his intention to leave, who shall
enter this fact in the patient's medical record.
(3) If the patient has left the healthcare facility without notification, the attending
physician shall enter this fact in the patient's medical record, furthermore, if required
by the patient's condition, he shall notify the competent authorities, or the legal
representative of a legally incapable patient or a patient with restricted disposing
capacity, that the patient has left the healthcare facility.
(4) The patient or his next of kin shall be informed of his planned discharge from the
healthcare facility in advance, possibly at least 24 hours prior to such planned
discharge.
(5) In the case of a legally incapable patient, the right defined in Subsection (1) may be
exercised with the agreement of the legal representative.
The Right to Information
Section 13
(1) The patient shall have a right to complete information provided in an
individualized form.
(2) The patient shall have a right to receive detailed information on:
(3) The patient has a right to pose additional questions during information and
subsequently.
(4) The patient shall have a right to be informed of the results or eventual failure, or
unexpected outcomes and their reasons, after an examination or intervention has been
performed in the course of his care.
(5) The legally incapable patient or a patient with reduced disposing capacity shall also
have a right to information corresponding to his age and mental state.
(6) The patient shall have a right to know the identity, qualifications and professional
status of those directly providing services.
(7) The conditions necessary for the assertion of the rights to information shall be
provided by the agency running the healthcare facility.
(8) The patient shall have a right to be informed in a way which is comprehensible for
him, with regard to his or her age, education, knowledge, state of mind and his wish
expressed on the matter. If necessary and if possible, the services of an interpreter or a
sign language interpreter shall be supplied for the provision of information.
Section 14
(1) A patient with full disposing capacity may waive the right of being informed,
except in cases when he must be aware of the nature of his illness in order not to
endanger the health of others. If an intervention takes place at the patient's initiative
and not for therapeutic purposes, such waiver of the right of being informed shall only be
valid in writing.
(2) The patient with full disposing capacity shall have a right to designate a person in
writing or in any other credible manner who is to be informed in his stead.
(3) The patient shall have a right to be informed even in cases where his consent is not
otherwise a condition for initiating medical care.
The Right to Self-determination
Section 15
(1) The patient shall have a right to self-determination, which may only be restricted
in the cases and in the ways defined by law.
(2) Within the framework of exercising the right of self-determination, the patient is
free to decide whether he wishes to use health care services, and which procedures to
consent to or to refuse in the course of using such services, taking into account the
restrictions set out in Section 20.
(3) The patient shall have a right to be involved in the decisions concerning his
examination and treatment. Apart from the exceptions defined in this Act, the performance
of any health care procedure shall be subject to the patient’s consent thereto granted
on the basis of appropriate information, free from deceit, threats and pressure
(hereinafter referred to as ‘informed consent’).
(4) A patient may give his consent as in Subsection (3) verbally, in writing or through
implied behavior, unless otherwise provided by this Act.
(5) Invasive procedures shall be subject to the patient’s written consent, or if the
patient is not capable of this , to his declaration made verbally, or in some other way,
in the joint presence of two witnesses.
(6) A patient may, at any time, withdraw his consent given to the performance of a
procedure. If, however, the patient withdraws his consent without good cause, he may be
obliged to reimburse any justified costs that will have incurred as a result of such
withdrawal.
Section 16
(1) Unless otherwise provided by this Act, a person with full disposing capacity may,
in a statement incorporated into a public deed, into a fully conclusive private deed, or,
in the case of inability to write, a declaration made in the joint presence of two
witnesses,
a) name the person with full disposing capacity who shall be entitled to exercise the
right to consent and refuse in his stead, and who is to be informed in line with Section
13,
b) exclude any of the persons defined in Subsection (2) from exercising the right of
consent and refusal in his lieu, or from obtaining information, as defined in Section 13,
by or without naming a person as in paragraph a).
(2) If a patient has no, or limited disposing capacity, and there is no person entitled
to make a statement on the basis of Paragraph a) Subsection (1), the following persons, in
the order indicated below, shall be entitled to exercise the right of consent and refusal
within the limits set out in Subsection (4), subject to the provisions of Paragraph b) of
Subsection (1):
a) the patient's legal representative, in the absence thereof
b) the following individuals with full disposing capacity and sharing household with the
patient:
(3) In the event of contrary statements made by the individuals qualified in the same line to make statement, the decision that is likely to impact upon the patient's state of health most favorably shall be taken into account.
(4) The statement of the persons defined in Subsection (2) shall be made exclusively following the provision of information, as in Section 13, and it may refer to giving consent to invasive procedures recommended by the attending physician. However, such a declaration – with the exception of the case defined in Subsection (3) of Section 20– apart from the intervention may not unfavorably affect the patient’s state of health, and in particular may not lead to serious or lasting impairment to the health. The patient shall be informed of such statements immediately after he regains his full disposing capacity.
(5) In making decisions on the health care to be provided, the opinion of a patient with no disposing capacity or with limited disposing capacity shall be taken into account to the extent professionally possible also in cases where the right of consent and refusal is exercised by the person defined in Subsection (2).
Section 17
(1) The patient's consent shall be assumed to be given if the patient is unable to make
a statement of consent as a result of his health condition and
a) obtaining a declaration from the person defined in Paragraph a) of Subsection (1) of
Section 16 would result in delay;
b) in the case of invasive interventions, if obtaining a declaration from the person
defined in, Paragraph a) of Subsection (1) of Section 16 or Subsection (2) of Section 16
would result in delay and the delayed performance of the intervention would lead to a
serious or lasting impairment of the patient’s state of health.
(2) The patient’s consent shall not be required if failure to carry out the given
intervention or action
a) would seriously endanger the health or physical safety of others, including also the
foetus beyond the 24th week of pregnancy, furthermore
b) if the patient’s life is in direct danger – also taking into account Sections 20
– 23.
Section 18
(1) If, in the course of an invasive intervention, an extension thereof becomes
necessary which was not foreseeable, in the absence of a consent to such extension –
with the exception of the case defined in Subsection (2) – it may only be carried out if
a) warranted by a state of emergency, or
b) failure to do so would impose a disproportionately serious burden on the patient.
(2) If the extension of the intervention defined in Subsection (1) would lead to the loss
of an organ or a part of the body or to the complete loss of the function thereof, in the
absence of consent to such extension, the intervention may only be extended if the
patient’s life is in direct danger or in the case defined in Paragraph b) of Subsection
(1).
Section 19
(1) The patient's written consent shall be required to the utilization of any of his
cells, cell components, tissues, organs and body parts removed while alive in connection
with an intervention for any purpose not related to the patient's provision. The patient's
consent shall not be required for the destruction of these materials in the usual manner.
(2) (7)
Within the boundaries of this Act, the patient shall have the right to provide for any
interventions regarding his corpse in the event of his death. According to the provisions
of this Act, the patient may prohibit the removal of any organ and tissue from his corpse
for the purposes of treatment, research or education.
The Right to Refuse Healthcare
Section 20
(1) In consideration of the provisions set out in Subsections (2) – (3) and excepting
the cases defined in Subsection (6), a patient with full disposing capacity shall have the
right to refuse healthcare, unless its lack would endanger the lives or physical safety of
others.
(2) A patient shall be required to refuse the provision of any care, the absence of which
would be likely to result in serious or permanent impairment of his health, in a public
deed or in a fully conclusive private deed, or in the case of inability to write, in the
joint presence of two witnesses. In the latter case, the refusal must be recorded in the
patient’s medical record and certified with the signatures of the witnesses.
(3) Life-supporting or life-saving interventions may only be refused, thereby allowing the
illness to follow its natural course, if the patient suffers from a serious illness which,
according to the current state of medical science, will lead to death within a short
period of time even with adequate health care, and is incurable. The refusal of
life-supporting or life-saving interventions may be made in keeping with the formal
requirements set out in subsection (2).
(4) Refusal as defined in Subsection (3) shall only be valid if a committee composed of
three physicians has examined the patient and made a unanimous, written statement to the
effect that the patient took his or her decision in full cognizance of its consequences,
and the conditions defined in Subsection (3) have been satisfied, furthermore if on the
third day following such statement by the medical committee the patient declared
repeatedly the intention of refusal in the presence of two witnesses. If the patient does
not consent to the examination of the medical committee, his or her statement regarding
refusal of medical treatment may not be taken into consideration.
(5) Members of the committee defined in Subsection (5) shall be the patient's attending
physician, one board-certified doctor specializing in the field corresponding to the
nature of the illness who is not involved in the treatment of the patient, and one
board-certified psychiatrist.
(6) A female patient may not refuse a life-supporting or life-saving intervention if she
is pregnant and is considered to able to carry the pregnancy to term.
(7) In the event of refusal as defined in Subsections (2) to (3), an attempt shall be made
to identify the reasons underlying the patient's decision through personal interviews and
to alter the decision. In the course of this , in addition to the information defined in
Section 13, the patient shall be informed once again of the consequences of failure to
carry out the intervention.
(8) A patient may withdraw his or her statement regarding refusal at any time and without
any restriction upon the form thereof.
Section 21
(1) In the case of a patient with no disposing capacity or with limited disposing
capacity, healthcare as defined in Subsection (2) of Section 20 may not be refused.
(2) If in the case of a patient with no disposing capacity or limited disposing capacity,
healthcare as in Subsection (3) of Section 20 has been refused, the healthcare provider
shall institute proceedings for obtaining the required consent from the court. The
attending physician shall be required to deliver all medical care necessitated by the
patient's condition until the court passes its final and absolute decision. In the case of
a direct threat to life, it shall not be required to obtain a substitute statement by the
court for the required interventions to be carried out.
(3) An attending physician, in the interest of satisfying his or her obligation defined in
Subsection (2) may use the police force, if necessary.
(4) In the course of the proceedings to substitute the statement defined in Subsection
(2), the court shall proceed in out-of-court proceedings, without delay. Such proceedings
shall be exempt from charges. Unless it otherwise follows from this Act or from the
out-of-court nature of the proceedings, the provisions of Act III of 1952 on Civil
Proceedings shall apply, as appropriate.
Section 22
(1) A person with full disposing capacity may refuse in a public deed, for the event of
his eventual subsequent incapacity,
a) certain examinations and interventions defined in Subsection (1) of Section 20,
b) interventions defined in Subsection (3) of Section 20, and
c) certain life-supporting or life-saving interventions if he has an incurable disease and
as a consequence of the disease is unable to care for himself physically or suffers pain
that cannot be eased with appropriate therapy.
(2) A person with full disposing capacity may name in a public deed, for the event of his
eventual subsequent incapacity, the person with full disposing capacity who shall be
entitled to exercise the right defined in Subsection (1) in his stead.
(3) The statement defined in Subsections (1) – (2) shall be valid if a board-certified
psychiatrist has confirmed in a medical opinion, given not more than one month earlier,
that the person had made the decision in full awareness of its consequences. The statement
shall be renewed every two years, and may, at any time, be withdrawn, regardless of the
patient’s disposing capacity and without formal requirements.
(4) In the case of a declaration of refusal of a medical intervention made by a person
with full disposing capacity in keeping with Subsection (2), the committee defined in
Subsection (4) of Section 20 shall make a declaration on
a) whether the conditions set out in Subsection (1) exist, and
b) whether the person defined in Subsection (2) has made the decision in cognizance of its
consequences.
Section 23
(1) An intervention as defined in Subsection (3) of Section 20 may only be terminated
or dispensed with if the will of the patient to that effect can be established clearly and
convincingly. In case of doubt, the patient’s declaration made ulteriorly and personally
must be taken into account; in the absence of such declaration, the patient’s consent to
the life-supporting or life-saving intervention must be assumed.
(2) In the course of refusing healthcare, a patient, or the person defined in Subsection
(2) of Section 22 must not be forced by any means to alter his decision. Even in the case
of refusal of an intervention set forth in Subsection (3) of Section 20, a patient shall
have the right to receive healthcare intended to ease his sufferings and reduce pain.
The Right to Become Acquainted With the Medical Record
Section 24
(1) A patient shall have the right to become acquainted with the data contained in the
medical record prepared on him or her, and shall have the right to request information on
his or her health care data, with regard to the contents of Section 135.
(2) The health care provider shall dispose of the medical record, while the patient shall
dispose of the data contained therein.
(3) The patient shall have the right to
a) be informed of the management of the data related to the medical treatment,
b) become acquainted with the health care data relating to him,
c) gain access to the medical record and to receive copies thereof at his own expense,
d) be given a discharge summary upon discharge from the healthcare institution (Section
137),
e) receive a written summary or abridged opinion of his health data for justified
purposes, at his own expense.
(4) A patient shall have the right to initiate completion or correction of the medical
record relating to him, that he deems to be inaccurate or incomplete, which shall be
entered in the medical record by the attending physician, or by another person handling
such data, together with his professional opinion. The erroneous health care data may not
be deleted following the entry thereof, and shall be corrected in such a way that the data
entered originally can be established.
(5) If the medical record prepared of a patient also contains information concerning
another person’s right to confidentiality, the right of inspection and other right set
forth in subsection (3) may only be exercised in respect of the part thereof relating to
the patient.
(6) The right to inspect the medical record of a person with no disposing capacity shall
be exercised by a person as defined in Subsections (1) and (2) of Section 16.
(7) In the course of health care delivered for his current condition, a patient shall have
the right to give written authorization to a person designated by him to inspect the
medical record relating to him and to have copies made thereof.
(8) Following the conclusion of the patient's medical treatment, only the person being
authorized by the patient in a fully conclusive private deed shall have the right to
inspect the medical record and to have a copy made thereof.
(9) During a patient’s lifetime, or following his death, the spouse, a lineal kin, a
sibling or common law spouse shall have the right to become acquainted with the health
care data, upon written request, if
27. such health data is required in order to
27. identify a reason that might influence the life or health of the spouse, a lineal kin,
a sibling or common law spouse, or
28. provide healthcare to the persons set forth in Subparagraph aa); and
b) there are no other ways to become acquainted with such health data or to establish them
by inference.
(10) In the case set forth in Subsection (9), only those health data may be learnt that
are directly related to the reason defined in Paragraph a) of Subsection (9). Information
on the health data shall be provided by the patient’s attending physician, or the
director of medical services of the healthcare provider, in keeping with the requirements
on the provision of medical information, if necessary, based on consultation with the
attending physician of the claimant.
(11) In the case of a patient’s death, his legal representative, close relative, or heir
shall have the right, upon written request, to become acquainted with health data that is,
or may be, related to the cause of death, and data that is related to the medical
treatment preceding death, furthermore to inspect the medical record and to be provided by
copies thereof, at his own cost.
(12) The detailed rules of handling and protecting healthcare and
related personal data shall be established by a separate law.
The Right to Professional Secrecy
Section 25
(1) A patient shall have the right to have persons involved in his health care disclose
his health care and personal data which they might learn in the course of delivering such
care (hereinafter: ‘medical secret’) to those entitled thereto and to have them handle
such data confidentially.
(2) A patient shall have the right to make a statement as to who are to receive
information on his illness and the expected outcome thereof and who are to be excluded
from becoming partially or fully acquainted with his health care data.
(3) The health care data of the patient concerned shall be disclosed even in the absence
of his consent thereto when
a) ordered by law,
b) required in order to protect the lives, physical safety and health of others.
(4) Health care data, the lack of which may lead to the deterioration of the patient's
state of health may be disclosed to a person in charge of a patient's further nursing and
continuing care, without the consent of the patient concerned.
(5) A patient shall have the right to have only those persons present during the course of
his examination and medical treatment whose involvement is necessary in delivering such
care, furthermore those persons to whose presence he has consented, unless otherwise
provided by law.
(6) A patient shall have the right to have his examination and treatment take place under
circumstances whereby it cannot be seen or heard by others without his consent, unless
this is unavoidable due to an emergency or critical situation.
(7) A patient shall have the right to name the person who may be notified of his admission
to an inpatient healthcare institution and the development of his state of health, and he
shall have the right to exclude any person therefrom. The inpatient healthcare institution
must inform the person named by the patient of his admission and any change in his
placement, as well of any significant change in the patient’s state of health.
Obligations of the Patient
Section 26
(1) When using a health care service, the patient shall respect and observe the legal
rules relating thereto and the institutional order.
(2) If allowed by his state of health, a patient shall cooperate with the health care
workers involved in his care according to his abilities and knowledge, as follows:
a) inform them of all details necessary for a diagnosis, the preparation of an adequate
treatment plan and for carrying out the required interventions, in particular, of his
history of illnesses, medical treatment, medicinal drug use or use of paramedicines, and
his health damaging risk factors,
b) inform them of every detail in connection with his illness which may endanger the lives
or physical safety of others, in particular, of any communicable diseases, and of
illnesses and conditions disqualifying him from pursuing an occupation,
c) in the case of communicable diseases set forth in the relevant decree of the Minister
of Health, name the persons from whom he may have contracted the communicable disease and
whom he may have infected,
d) inform them of all former legal statements that he might have made in connection with
health care,
e) comply with the instructions received from them in connection with the medical
treatment,
f) observe the house rules of the health care institution,
g) make the co-payment as provided for by law,
h) show credible proof of his personal data as required by law.
Section 27
(1) In the course of exercising their rights, the patient and his relatives shall
respect the rights of other patients.
(2) The exercise of the rights of a patient and his relatives may not violate the rights
of health care workers stipulated by law.
(3) The method of exercising patients' rights shall be regulated by the house rules of the
institution, within the boundaries of this Act.