What rights do you have as a patient?

What does the Health Services Act say?

The Health Services and Conditions of ProvisionAct is a key standard in the area of patients’ rights – it tells us what they entail, what health service providers have to ensure in this respect and how to proceed if rights are violated or not respected in any way. It also sets out the obligations of health service providers towards the administrative authorities and how they obtain their authorisation. It regulates the legal form of patient organisations. It also enshrines specific legal institutes such as the previously expressed wishes.

Right to consent to health services

The initial rule enshrined in the Act states that “health services may be provided to a patient only with his or her free and informed consent, unless otherwise provided by law.” What is meant by this? After all, everyone knows that, for example, patients in a very serious condition, such as victims of road accidents, do not give any consent. Here, however, two opposing principles meet.

The primary one is the need to obtain the patient’s consent. No one can give you medication, draw blood or perform surgery without your consent. Generally, verbal consent is sufficient, but in some cases it is only an implicit expression of will, that is, for example, you nod when a prescription for medication is written, or at least you do not protest in any way. Written consent is required if a piece of legislation so provides or if the provider so determines in view of the nature of the health services provided. Typically this will apply to any surgery or hospitalisation. In this context, service providers should inform the patient of all risks associated with the procedure. This will also save them from many complaints and lawsuits in the event that any of the admitted risks occur.

The second principle is, of course, the possibility of providing emergency care without consent, either where the patient’s state of health does not permit consent or where the treatment is for a serious mental disorder and failure to treat it would in all likelihood result in serious damage to the patient’s health.

Typically, these are the sudden and acute conditions already mentioned, which are immediately life-threatening or may lead to a serious threat to health. In such a situation, treatment is initiated immediately, whether it takes the form of resuscitation, surgery or another procedure for which the patient does not give consent.

Other health services may be provided without consent if the Public Health Protection Act so provides. This includes, for example, health services intended to prevent the spread of infectious diseases (typically HIV).

Other permissible situations in which a patient may be hospitalised without consent are the existence of a final court order, isolation or quarantine under the Public Health Protection Act, or an examination ordered under the Criminal Procedure Code or the Code of Civil Procedure. Also, the protection of society when the patient poses an immediate and serious threat to himself or herself or to his or her surroundings and shows signs of mental disorder or is under the strong influence of an addictive substance takes precedence over the patient’s consent. The clients of alcohol detention centres know this.

Reversals – the right to refuse treatment

A reversal is a written statement that the patient refuses to consent to treatment. It can occur in a situation that is not so urgent that health care would be provided without consent. The patient is then given information about the most appropriate course of action – for example, hospitalisation and surgery. However, the patient himself will assess the situation by refusing the procedure and, for example, leaving the hospital. The reason for this may be, for example, to choose another health facility, another (alternative) treatment, or to refuse treatment altogether if the patient does not consider it to be beneficial for him or her.

The right to information on health status

Directly related to the first principle is the right to be informed about one’s health. He or she should receive full information in a form that is also appropriate to his or her knowledge, i.e. not just a medical report written in abbreviations and Latin. In particular, unusual or less common procedures should be explained to patients in a detailed and comprehensible manner. Despite their initial consent, patients may later disagree with the treatment at any time.

However, there are also patients who do not want to know information about their condition. For example, if they are at risk of advanced cancer and do not want to hear an unfavourable prognosis. In this case, they can opt out of having their health information given, or they can specify to whom it should be given (for example, to their spouse or children). However, a record of such action must be made in the medical record. Of course, a waiver of information can always be revoked. It shall only be disregarded if the information is information that the patient is suffering from an infectious disease or other disease which may endanger the health or life of others.

A specific situation is permitted by law where the patient is a minor or has limited capacity and there is a suspicion that the person caring for him or her is involved in abuse, mistreatment or endangering his or her healthy development. In such a case, full information about the patient’s medical condition may be withheld on the assumption that providing this information could put the patient at risk.

Right to privacy

The patient should be allowed both to be examined and to be given information about his/her condition in a private setting appropriate to the capabilities of the health care facility. A large proportion of examinations involve varying degrees of disclosure to the patient, and it is undoubtedly the patient’s right not to be allowed to enter the surgery or be observed from the corridor in such situations. Related to the right to privacy is the confidentiality of the information given. It is absolutely essential that information about health is not disclosed to other patients or persons who are not involved in the treatment, especially if the information is sensitive. Protection of information must also be ensured when dealing with paper or electronic files.

The right to prohibit the disclosure of health information to others

The disclosure of health information to others is typically addressed in situations where a patient is entering hospitalisation or planning surgery and further developments in their condition are expected. After surgery, there is usually a period of several hours (sometimes days) when the patient is unable to communicate with others, either because their physical condition does not allow it or because they lack the means of communication (mobile phone). Nevertheless, his/her relatives would like to know that the operation was successful and with what result. However, it cannot be said that they (with the exception of the legal representatives) have the right to do so. It is up to the patient to decide in advance how he or she wishes to express himself or herself. For example, they may express a complete prohibition on giving information about their health to any person, even to those close to them. Or, for example, limit this possibility to offspring, spouses, parents, etc. In such a case, the medical staff must fully respect the choice and not disclose anything to other persons, even if they are close family members.

Right to visit

The possibility to be visited by their relatives during hospitalisation is probably an issue for most patients. It has to be said that fewer and fewer patients encounter this requirement. In this respect , however, it is crucial how the ward is set up, whether the hygiene conditions and the organisation of the ward allow this possibility. Mutual respect is in order, also with regard to other patients, the nature of the illness or injury of the patient being visited, strict hygiene measures, etc.