- The desirable enjoyment of health services is the patient’s right. (Get optimal health services)
- The information should be favorably and adequately provided to the patients. (Quality of information provided to service recipients)
- The patient’s right of choice and voluntary decision-making on receiving health services must be respected. (Choose and decide freely)
- The delivery of health services should be on the basis of respect for the patient’s privacy, i.e. right to have privacy, and the observance of medical confidentiality. (Patient privacy)
- Availability of an efficient grievance redressal system is the patient’s right.( Access to the grievance redressal system)
- The desirable enjoyment of health services is the patient’s right.
- It should be shaped based on the veracity, impartiality, courtesy along with kindness;
- It should be tailored to human dignity yet considering respect for values, and cultural and religious beliefs;
- It should be away from any prejudice; i.e. lack of discrimination on the basis of ethnicity, culture, religion, type of disease, and gender;
- It should be in accordance with state-of-the-art (up-to-date) knowledge;
- It should be based on the superiority of patient interests;
- In conjunction with the distribution of health resources, it should be based on justice and treatment priorities of patients;
- It should be based on the harmony of the constituent parts of care, containing prevention, detection, treatment, and rehabilitation;
- It should be associated with the supply of all basic and essential welfare facilities and away from the imposition of unnecessary suffering and restrictions;
- It should pay special attention to the rights of vulnerable groups in society, including children, pregnant women, the elderly, psychopaths, prisoners, the mentally and physically disabled persons, and the people without caretakers/attendants;
- It should be conducted in the quickest possible time with respect to the patient’s time;
- It should be done with regard to variables like language, age, and gender of service recipients;
- It should be carried out in urgent care (emergency care) without considering its finance.
- In non-urgent (elective) cases, it should be specified in accordance with the rules;
- In the event that the delivery of proper services in urgent and emergency care is not feasible, the ground for moving the patient to the equipped unit/ward needs to be prepared after providing the essential services and detailed explanations;
- In the last stages of life, while the patient’s illness is in an irreversible condition and the patient’s imminent demise (imminent death) is conceivable, it should be delivered with the aim of maintaining his/her comfort. The mean of comfort is the alleviation of the patient’s pain and suffering, the consideration of the psychological, social, spiritual, and emotional requirements of him/her and his/her family at the point of death (in the agony of death). The dying patient has the right to be accompanied by the person he/she wants in the last moments of his/her life.
- Agony is referred to as the incurable and irreversible illness condition in which impending death is unavoidable.
- The information should be favorably and adequately provided to the patients.
2-1) The information content should embrace the following items:
- Provisions of the Charter of patient rights at the admission time;
- Rules and foreseeable expenses of the hospital, comprising medical and non-medical services, insurance rules, and introduction of support systems at the admission time;
- The name, responsibility, and professional rating of the medical department members in charge of providing care, including physicians, nurses, and students, and their professional connection together;
- Diagnostic and therapeutic methods and the weaknesses and strengths (pros and cons) of any approach and its probable outcomes, disease diagnosis;
- Prognosis and its complications and all impressive information in the patient’s decision-making process;
- The way of access to the attending physician and primary members of the medical department during treatment;
- All measures with a research nature;
- Presenting necessary education for continuing treatment
2-2) The way in which information should be presented is as follows:
- Tailored to the patient’s situation, including anxiety and pain, and his/her individual features such as language, education, and perception, information must be available to him/her at the right time, unless:
Delayed treatment initiation resulting from giving the above information may cause harm to the patient; (After taking the necessary action, information transfer has to be carried out in this case at the first best time). The patient refuses to do so despite being aware of the right to receive information, in which case the patient’s request should be respected unless the patient’s lack of information puts him/her or other persons at the exposure of serious risk;
- 2. The patient can have accessibility to all the information registered in his/her clinical record and get its image and demand the modification of the mistakes included in it.
- The patient’s right of choice and voluntary decision-making on receiving health services must be respected.
3-1) The scope of choice and decision-making embodies the following items:
Choosing the attending physician and the health care service provider center within the framework of the criteria; selecting and asking for the second physician’s view as a consultant; attendance or lack of attendance in any research ensuring that his/her decision-making will not influence the continuousness and mode of receiving health services; accepting or rejecting the offered therapies after the knowledge of the possible complications caused by its acceptance or rejection, except in cases of suicide or cases in which refusing treatment puts someone else exposing to serious risk; expression of the patient’s previous opinion in conjunction with future therapeutic measures while the patient is eligible for the capacity of decision making is recorded and taken into account by health care providers and patient’s alternative decision-maker as a guide to medical actions at the time of lacking decision-making capacity in compliance with legal standards.
3-2) The circumstances of choice and decision-making embrace the following items:
The patient’s choice and decision-making should be independently and knowingly based on receiving adequate and detailed information (referred to in the second paragraph); after rendering the information, the required and enough time should be given to the patient for decision-making and choices.
- The delivery of health services should be on the basis of respect for the patient’s privacy, i.e. right to have privacy, and the observance of medical confidentiality.
- Observing the medical confidentiality in connection with all information associated with the patient is imperative, except in cases where the law has made an exception for it;
- In all care stages, including diagnostic and therapeutic, the patients’ privacy needs to be respected. To this end, all the required facilities to guarantee the privacy of the patient need to be provided; the patient and treatment team and authorized persons on behalf of the patient and persons deemed to be permitted by law can only access information; the patient is entitled to be accompanied by a trusted person in the diagnostic procedures like examinations. The companionship of one of the child’s parents in all stages of treatment is the right of the child unless this matter is in opposition to medical necessities.
- Availability of an efficient grievance redressal system is the patient’s right.
- In the case of a claim indicating the infringement of his/her rights which is the subject of this Charter, any patient is entitled to complain to the competent authorities without causing any disruption to the quality of receiving health services; patients have the right to be informed of the grievance redressal and the consequences of their complaint; harm due to the health care providers’ mistakes must be compensated in the shortest possible time after consideration and proof in accordance with the rules.
- In implementing this Charter’s provisions, the exercise of all patient rights listed in this Charter will be undertaken by the alternative legal decision-maker in the event that the patient lacks the capacity to make decisions for any reason. Nevertheless, if the alternative decision-maker prevents the patient from being treated contrary to the physician’s opinion, the physician can appeal the decision through the relevant authorities.
If a patient lacks adequate capacity for decision-making yet can adopt wise decisions in some parts of the process of treatment, his/her decision has to be esteemed.