Patient rights

from Wikipedia, the free encyclopedia

Under patients' rights means the rights of patients towards healing therapists, especially to physicians as well as to social services and other service providers in healthcare .

right

The most important rights include:

  • The right to self-determination : A medical measure may only be carried out with the will of the patient and consequently requires his consent , see informed consent and ability to consent
  • the right to information about the diagnosis , expected health development and therapy
  • the right to information about the likely costs of the treatment , which must be given in writing
  • The right to information : This is an explanation of the medical intervention that can be understood by laypeople, see medical information . This includes a correct presentation of the benefits and the chances of success as well as the risks and side effects of the planned medical measures. The essential circumstances must be clarified.
  • the right to careful treatment according to the so-called specialist standard (but not a "guarantee of success")
  • the right to confidentiality of the treatment , that the treating and caring persons treat the information and data that became known during treatment and care confidentially and not disclose it to third parties without authorization (medical confidentiality , § 203 StGB )
  • the right to documentation , in particular diagnosis and therapy.
  • the right to access to documents in the medical record .
  • the right to a second opinion with statutory health insurance (except in special forms of care)
  • the right to freely choose a doctor , including the right to change doctors (restricted in special forms of care and for dentures)
  • the right to free choice of hospital
  • the right to free choice of health insurance within the statutory health insurance

Country comparisons

Germany

Treatment and medical liability law has been codified in Germany in the German Civil Code (BGB) through the Patient Rights Act in Sections 630a to 630h BGB . A treatment contract arises with the treatment by doctors, dentists or practitioners from other health professions, such as psychotherapists, midwives and physiotherapists.

The treating person has to inform and educate the patient in several ways about the treatment, its risks and consequences (§§ 630c and 630e BGB). Information about the expected costs must be provided in writing.

Examinations, findings, diagnoses and therapies must be documented ( § 630f BGB). Upon request, the patient must be given immediate access to the patient's file; he can request copies or electronic transcripts against reimbursement of costs (§ 630g BGB).

In principle, the patient has the right to have his treatment carried out in accordance with the generally recognized professional standards (so-called specialist standard) that existed at the time of treatment (Section 630a (2) BGB).

If the doctor or another treating person violates his duty of care and thereby commits a so-called treatment error or if the information is incorrect, the patient can demand compensation and compensation for pain and suffering from the treating person , provided that he has suffered damage to his health as a result . Basically, the patient has to prove the breach of duty of care and the damage to health caused by it. In certain cases, which are now regulated in Section 630h of the German Civil Code (BGB), he will benefit from the simplification and relief of evidence.

In principle, treatment may only take place with the consent or - in emergencies - the presumed consent of the patient (Section 630d BGB). Treatment carried out without effective consent is, on the one hand, punishable as bodily harm and, on the other hand, constitutes an obligation to pay compensation. In the case of patients who are unable to give their consent, unless there is an authorized representative (power of attorney), a legal supervisor must be appointed who is then responsible for giving consent. If a legal supervisor is available, the supervisor must be informed.

Patients have the right, in case of their inability consent in a written living will establish binding if they agree their state of health or medical treatment or medical interventions in particular, is not imminent at the time when investigations or prohibit. This also or particularly applies to life-prolonging measures. The patient can order that life-prolonging measures are to be omitted under the conditions described by him, or that such measures, should they have already been taken, be reversed or broken off (so-called passive euthanasia). Both the treating physicians and the authorized representative or the supervisor are fundamentally bound by these orders. However, they are at liberty to turn to the responsible guardianship court in cases of doubt.

In exceptional cases, treatment can also take place against the patient's stated will, if z. B. Mentally ill pose an acute danger to themselves or others and treatment is necessary to avert the danger or danger. In Germany, the authorization for compulsory treatment is regulated in state laws ( PsychKG ). Another possibility for compulsory treatment is the care law according to the law regulating the consent under care law in a compulsory medical measure (compulsory treatment).

For patients who have statutory health insurance , the Social Security Code contains various provisions that are intended to protect patients. For example, hospitals must have a patient-oriented complaint management system in place. The health insurance companies must decide on applications for benefits within certain deadlines (Section 13 (3a) SGB V). They are intended to support the patient in the event of treatment errors (Section 66 SGB V).

Austria

In Austria, patient rights were first mentioned in a law in 1993 (in the Hospitals Act). From 1999 a list of patient rights was summarized in a "patient charter", which between 1999 and 2006 was gradually entered into 15a agreements between the federal government and the individual states . The rights listed in this patient charter cannot be sued directly in court by the patients themselves - rather, with these “Article 15a agreements”, the federal and state governments initially only undertake to guarantee these patient rights in their further legislative and administrative activities.

The general patient rights of the patient charter include (see Kalchschmied 2002 and Stemberger 2011):

  • The right to health care and equal access to treatment and care
  • The right to appropriate treatment
  • The right to respect for the dignity and integrity of patients
  • The right to self-determination
  • The right to adequate medical / therapeutic information

In every Austrian federal state there is an independent patient representative or patient advocate, which is available as a service facility for questions and complaints and offers legal support in the event of suspected medical errors (e.g. malpractice). In psychiatric departments, those affected who are accommodated against their will have a patient advocate working on the basis of the Accommodation Act , who represents them in relation to the psychiatric department and in proceedings under the Accommodation Act.

Great Britain

In the UK , the Mental Capacity Act 2005 has been regulating these issues since April 2007.

See also

literature

  • Arnd T. May: Autonomy and external control in medical decisions for those unable to consent. Münster 2000, ISBN 3-8258-4915-5 .
  • Kurt Pfänder: The rights of patients. 3. Edition. Zurich 2007, ISBN 978-3-907955-27-7 .
  • Christian Zehenter: patient guide . 2nd Edition. Munich 2002, ISBN 3-423-05662-2 .
  • Klaus Ulsenheimer : The development of case law to strengthen patient rights - do we need a patient charter? In: Festschrift 10 Years of the Working Group on Medical Law. Deutscher Anwaltverlag, Bonn 2008, ISBN 978-3-8240-1001-1 , pp. 121-135.
  • Dominik Kellner: The new patient rights law . In: Journal for the entire medical and health law (ZMGR), 2013, pp. 228–237.
  • Gertrud Kalchschmid (2002): Patients' rights . Innsbruck 2002: Tyrolean patient advocate.
  • Gerhard Stemberger : Patients' rights in psychotherapy , in: M. Kierein and A. Leitner (eds., 2011), Psychotherapie und Recht , Vienna: Facultas, pp. 202–229.

Web links

Germany

Austria