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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 patientsí 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 patientsí 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 patientís 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 patientís 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 patientís condition and physical needs shall be observed regularly, in compliance with professional rules. The observation and the findings shall be entered into the patientís 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. ů

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 motherís 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 patientís consent thereto granted on the basis of appropriate information, free from deceit, threats and pressure (hereinafter referred to as Ďinformed consentí).
(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 patientís 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 Ė with the exception of the case defined in Subsection (3) of Section 20Ė apart from the intervention may not unfavorably affect the patientís 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 patientís state of health.

(2) The patientís 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 patientís life is in direct danger Ė also taking into account Sections 20 Ė 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 Ė with the exception of the case defined in Subsection (2) Ė 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 patientís 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) Ė (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 patientís 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) Ė (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 patientís 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 patientís declaration made ulteriorly and personally must be taken into account; in the absence of such declaration, the patientís 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 personís 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 patientís 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 patientís 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 patientís 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: Ďmedical secretí) 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 patientís 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.

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