Rights and obligations of the patient

CHARTER OF RIGHTS AND OBLIGATIONS OF THE PATIENT OF THE J. DIETL SPECIALIST HOSPITAL IN KRAKÓW


I. Patient’s right to health services.

  1.  Everyone has the right to protection of health.
  2. The patient has the right to health services suited to the requirements of current medical knowledge and aimed at preservation, saving, restoration and improvement of health provided by a physician, nurses and other medical personnel with appropriate care, in accordance with the principles of professional ethics.
  3. The patient has the right to equal access to health care services financed from public funds, and in situation of limited opportunities – to obtain appropriate health services, to the transparent, objective procedure based on medical criteria defining the order of accessing these services.
  4. The patient has the right to immediate obtaining health services due to the threat to health or life.
  5.  The patient has the right to demand that:
  • The physician providing health services to him/her consulted the case with another doctor or convened joint consultation.
  • The nurse providing health services to him/her consulted another nurse.
  1. The physician may refuse to convene a medical consultation or consult another physician, if he considers the request unfounded. The rule also applies to nurses.
  2. The patient has the right to free pharmaceuticals and medical supplies, if they are required by providing health services, as well as to alimentation suitable for patient’s health status.

 

II.  Patient’s right to information

  1. The Patient has the right to obtain intelligible information concerning his/her health condition, diagnosis, proposed and possible diagnostic and treatment methods, foreseeable consequences of their use or omission, and the results of treatment and prognosis.
  2. The patient has the right to information on the rights of patients, available in written form in public areas, and on the rules of limiting these rights.
  3. The patient has the right to information on the nature and scope of health services provided by the hospital and their price list in the case of full-paid benefits, and for outpatient services – on their exact hours and place, as well as the names of the persons providing these services.
  4. While in the hospital, the patient has the right to the possibility of identifying persons providing care of him/her, at least in terms of name, surname and professional status.
  5. The patient has the right to maintain the confidentiality of his/her personal information (in particular on the patient’s health status) by the hospital staff, including persons providing health benefits to the patient.
  6. Confidentiality does not apply if:
  1. The patient has the right not to be informed within the aforementioned range of information on his/her clear request.
  2. The patient has the right to indicate the person authorized to obtain information about his/her status of health and to receive patient’s medical records, as well as to refuse indicating such a person.
  3. The person authorized by the patient to receive information about the status of the patient’s health has the right to immediately receive information from  the attending physician or physician on duty about a sudden deterioration of the patient’s health status, causing a threat to life or about the death of the patient. The physician writes down the endorsement about the case in the medical records.
  4. The patient has the right to obtain intelligible information about his/her care and nursing procedures from the nurse.
  5. The patient has the right to be informed about the intention of the physician to withdraw from the patient’s treatment and to be informed by this physician about the possibility of obtaining health benefits from another physician or institution providing health services.

III.  Patient’s right to confidentiality of personal information

  • so are the regulations of separate law,
  •  the patient or his/her legal representative consents to disclosure of confidential information,
  • confidentiality may endanger the life or health of the patient or other persons,
  • it is necessary to provide indispensable information about the patient and related to the provision of health benefits to other persons performing medical profession and involving in providing these benefits.
  1. Persons exercising medical profession are also bound with confidentiality after the death of the patient.
  2. The patient has the right to respect for privacy and personal dignity, in particular during the provision of health services to him/her.
  3. The patient has the right to die in peace and dignity. In the terminal state the patient has the right to health care services providing relief in pain and other sufferings.
  4. While providing health services to the patient, he/she has the right to the presence of a close person. Lack of consent for the presence of a close relative or a friend may occur in the case of an epidemic emergency or due to the health safety of the patient.
  5. Persons within the hospital staff other than those directly providing health services to the patient may participate in providing these services only when it is necessary for their accomplishment. Participation and the presence of other persons, whose presence is not indispensable, requires the consent of the patient and of the person who provides a medical service.
  6. The patient has the right to express personally or by the legal representative the refusal to autopsy of his/her body, if it is not required by the binding law.
  7. The patient has the right to express the refusal to harvesting the cells, tissues and organs after his/her death, and to withdraw the objection at any time.
  8. The patient has the right to have access to medical documentation regarding his/her state of health and health care services provided. The hospital provides the medical records to the patient or his/her legal representative in accordance with the rules determined by separate regulation by the Director of the Hospital.
  9. After death of the patient the right to access his/her medical records belongs to the person authorized by the patient in the patient’s lifetime.
  10. At discharge from the hospital after termination of treatment, or discharge at patient’s own request, the patient has the right to obtain the original and one copy of the hospital discharge summary regarding hospital treatment with diagnosis given in Polish.
  11. Patient or his legal representative may object to opinion or medical certificate concerning his/her state of health issued by the physician, if the opinion or medical certificate affects patient’s rights or obligations resulting from the regulations.
  12. The objection shall be submitted to the medical committee operating by the Patient Ombudsman, by proxy of the Patient Ombudsman within 30  days from the date of issuing the opinion or the medical certificate by the physician adjudicating about patient’s state of health.
  13. The patient has the right to personal, telephone or correspondence contact with others, especially with members of the closest family, legal or de facto caretakers. In accordance with the rates established by the Hospital’s Directorate, a fee may be charged for realization of this right.

IV.  Patient’s right to consent to receiving health services

  1. The patient (or legal representative of completely incapacitated patient or patient incapable of informed consent) has the right to consent for receiving specific health services or to refuse such consent after being informed about the state of health, the proposed methods of diagnosis and treatment, foreseeable consequences of their application or omission.
  2. Consent or refusal may be expressed verbally or by such behavior, which clearly indicates the willingness (or lack of thereof) to submit to proposed services.
  3. In case of proposing diagnosis or treatment method causing an increased risk for the patient, the patient expresses the consent or refusal in the written form.
  4. Examination or providing the patient other health service without patient’s consent is permissible if the patient requires immediate medical attention, while, because of state of health or age he/she cannot give informed consent, and there is no possibility to contact with his/her legal representative or de facto caretaker.
  5. The patient has the right to consent or refuse to carry out examination, nursing or physiotherapy treatment by the trainees. Examination or medical procedure is performed by a trainee only in the presence of persons authorized to provide medical services. The patient has the right to obtain information about didactic lessons for medical students that are taught in the hospital.
  6. The patient has the right to participate in a medical experiment (clinical examination) after expressing written consent, after obtaining comprehensive information on its nature, significance, implications and risk related with the examination. The participant of an experiment may withdraw from the clinical trial at any time and without consequences for himself/herself.

V.  The right to respect for privacy and dignity of the patient

VI.  Patient’s right to medical records

VII.  Patient’s right to raise an objection against the opinion or medical certificate issued by the physician

VIII.  Patient’s right to respect for private and family life

patient has also the right to refuse contact with the persons mentioned above.

 

Patient’s right to personal contact may not:

  • disturb the normal functioning of the hospital (department),
  • hinder the provision of health services
  • violate the rights of other patients, especially the right to respect for privacy, peace and quiet.

Patient’s right to personal contact may be limited due to:

–        organizational capabilities of the Hospital (department),

–        occurrence of epidemical threat,

–        health safety of patients.

  1. The patient has the right to additional nursing care, understood as care beyond providing health services by hospital staff. This care can be performed by a close person or a person designated by the patient during hospitalization. For exercising additional nursing care by hospital personnel, a fee may be charged according to the rates established by the Hospital Directorate.

IX.  Patient’s right to pastoral care

  1. The patient has the right to pastoral care, including enabling participation in religious ceremonies organized in the hospital, the costs of which are borne by the hospital. The list of phone numbers and addresses of particular creeds’ clergymen is available in every ward.
  2. In the situation of deterioration of the patient’s status of health or life threat, the hospital enables the patient contact with the clergy of his religion, on request of the patient or his/her caretaker.
  3. The patient has the right to store valuables in the deposit in accordance with the principles determined by the separate regulation issued by the Director of the Hospital. The cost of execution of this right is borne by the hospital.
  4. If the patient (or a representative person) considers violation of above mentioned rights, he/she may:

X.  Patient’s right to store valuables in the depository

XI.  Patient’s right to complain

  • file a written or verbal complaint for intervention to the immediate superior of the person granting health services,
  • file a written or verbal complaint to the Hospital Director through the Plenipotentiary for the Rights of Patients appointed by the Director,
  • in the event of unsatisfactory effect of the complaint, ask for its consideration by the Department of Complaints and Applications of the Lesser Poland’s branch office of National Health Fund (Dział Skarg i Wniosków Małopolskiego Oddziału NFZ) or by the office of the Patient Ombudsman at the Ministry of Health,
  • if the violation of rights was related to the lack of proper diligence in performed medical practice, mistakes made in treatment or the proceedings contradictory to the principles of professional ethics – the patient may turn to the Screener for Professional Liability who operates at the Regional Medical Chamber, The Polish Chamber of Physicians and Dentists and Main Chamber of Nurses and Midwives.
  • file the motion to the Regional Commission for Evaluation of Medical Events to determine a medical event in the case of infecting the patient with a biological pathogen, bodily injury, patient health disorder resulting from the factors inconsistent with current medical knowledge, namely:
  1. diagnosis, if it resulted in wrong treatment or delayed suitable treatment contributing to the development of the disease,
  2.   treatment, including performing surgery,
  3.  application of therapeutic product or medical product/device.

In case of patient’s death, his/her heirs have the right to fail the motion. Detailed rules are specified in the Act of 6th November 2008 on the rights of the patient and the Patient Ombudsman.

If the infringement of personal interests took place or material harm has been done within the meaning of the Civil Code, as a result of actions or omission of the hospital or the person providing care over the patient, then one may bring a case before the court; when there is a suspicion that the event is related to the criminal act, the patient has the right to file the complain to the public prosecutor’s office.

XII. Specific rights and obligations of the patient demanding diagnostic imaging using ionizing radiation

  1. The patient requiring diagnostic imaging using ionizing radiation has the right to optimal protection by:
  • Limiting the number of projections, the time of exposure and radiation beam incident on the patient’s body to the value necessary to achieve the desired diagnostics information,
  • The use of personal shield against radiation, protecting patient’s body parts and organs not being under investigation, especially those located within the primary beam of the radiation, if it does not diminish diagnostics values of the result of the examination.
  • A pregnant woman has the right to maximum protection of the fetus against exposure to radiation through appropriate examination technique and the use of appropriate personal shields on the abdomen and pelvis parts (performing X-ray diagnostics examination in case of pregnant women is limited to the necessary cases, if they cannot be performed after delivery).
  • A pregnant woman has the right to written information about the types of threats to the embryo or fetus, and about the level of the risk of their occurrence.
  •  Persons present at the time of the examination in order to support the patient, have the right to information on how to proceed (for maximum protection against radiation) and on the risk of radiation.
  • In order to reduce the risk of complications the patient requiring diagnostics imaging using ionizing radiation is obliged to inform the person performing the examination on his/her state of health: pregnancy, allergies to medications, contrast agents and foods, medicines taken, claustrophobia, etc.
  • Women in their fertility period, subjected to interventional radiology in the case of unrecognized pregnancy are required to carry out a pregnancy test before performing the procedure.

XIII. Patient’s responsibilities

The patient is obliged to:

  1. Comply with applicable laws and regulations of the Hospital.
  2.  Hand the clothes and shoes to the hospital store at admission to the hospital.
  3. Comply with the daily schedule of the department where the patient is hospitalized.
  4.  Observe recommendations of the physician, nurses and other medical staff of the hospital.
  5. Not taking any medications nor undergoing any medical procedures without the prescription from attending physician or doctor on duty. Attending physician as well as the head physician of the department are responsible for the regular treatment process of the patients in a department.
  6. Keep a diet determined by patient’s attending physician and not serving food and beverages brought from the outside to other patients.
  7. Observe the hygiene / personal cleanliness in accordance with the degree of patient’s dexterity.
  8. Stay in designated areas at the time of the rounds, medical treatments and dressing and at meal times.
  9. Inform the nurse on duty about each departure from the department.
  10. The patient can stay outside the hospital only with the permission of the attending physician or the doctor on duty.
  11. Respect the rights of other patients, in particular the right to privacy and peace indispensable during treatment and rehabilitation.
  12. Adhere to the absolute prohibition of smoking, drinking alcohol and using intoxicants in the hospital area, where non-compliance can result in patient’s discharge from the hospital, provided that there is no risk that the discontinuance of the health services may result in direct threat to patient’s life or health.
  13. Respect the curfew in the department.
  14. Take care of hospital equipment and rooms.
  15.  Observe the principles of using the fire-fighting equipment.
  16. Use the hospital elevators in accordance to the safe use principles.
  17. Observe the prohibition of operating  medical, electrical and heating devices and equipment not intended for use by the patients.
  18.  Bear the costs associated with removal of damage caused by the fault of the patient.

Legal Basis

  1. The Constitution of Poland of  2 April 1997.
  2. The Act of 6 November 2008 on Patient`s Rights and the Ombudsman of Patient`s Rights.
  3. Act of 15 April 2011 on Healthcare Institutions Law.
  4. The Act of 27 August 2004 on healthcare services financed from public funds
  5. The Act of 5 December 1996 on the medical profession in place.
  6. The Act of 2 December 2009 on Medical Chambers
  7.  The Act of 15 July 2011 on nurse’s and midwife’s profession
  8. The Charter of 19 August 1994 on Rights for Persons with Disabilities
  9. The Act of 27 July 2001 on laboratory diagnosis
  10.  The Pharmaceutical Law Act of 6 September 2001
  11. Ustawa z dnia 1 lipca 2005 r. o pobieraniu, przechowywaniu i przeszczepianiu komórek, tkanek i narządów.
  12. The Act of 29th November 2000 on Atomic law
  13. The Personal Data Protection Act of 29 August 1997
  14. Regulation of the Minister of Health on the types and scope of medical documentation in health care centres and the manner in which it is processed dated 21 December 2010
  15. Medical Code of Ethics from 1991, amended in 2003.

the Nursing and Midwifery Code of Ethics of the Republic of Poland from 2003.