The Hungarian Constitution declares that every individual has the right to physical and mental health. Patient rights include all the rights that apply to patients during their medical treatment. Beside patient rights, the patients have responsibilities toward the medical facility as well.
The purpose of patient rights is to decrease patients’ vulnerability, and to provide answer to the question of what the medical provider is responsible for during the medical treatment.
Based on previous experiences, it can be concluded that patients have a greater compliance during their medical treatment if they are familiar with their rights and responsibilities, thereby increasing the efficacy of the medical treatment. You can read further details about the patient rights and responsibilities in the Act CLIV. of 1997, or you can contact the medical provider and the designated patient representative.
The act about the health care includes the following patient rights:
- Right to access health care
- Right to be treated with respect
- Right to have visitors
- Right to leave the medical service provider facility
- Right to make informed consent
- Right to make decisions about medical treatment
- Right to refuse medical treatment
- Right to access medical records
- Right to privacy and confidentiality
Right to have access to health care
The right to have access to health care means that every patient has the right to equal access to continuous medical treatment that is appropriate for their condition. The right to access to health care also means that every patient has the right to life-saving interventions, or medical services targeting to prevent the development of permanent health damage and pain management procedures in order to alleviating the patient’s pain and suffering.
The right to access to health care is proper, if the applying professional and ethical rules and directives are complied. Medical service needs to be continuously available, and it has to be provided at the appropriate level of the health care system that the patient’s condition requires (e.g. in the form of in- our outpatient services).
Patients also have the right to be informed if a certain medical service provider cannot provide them the appropriate level of care within the earliest time required by their condition, and also need to be informed about which medical service provider can ensure them the necessary service.
Further rights within the rights to have access to health care:
Right to choose the health care provider: patients have the right to choose their medical service provider facility appropriate for their health condition – if no exceptions are applied by law, and the chosen health care provider / physician gives consent, if their health condition, an emergency or their health insurance related legal relationship do not indicate otherwise. Choosing the health care provider physician, however, must comply with the regulations of the medical service provider. By choosing the health care provider physician, the patient has the right to choose whom they can communicate with, complying with the type of the medical service and complying with the patient’s condition.
Requesting a secondary medical opinion: beside the abovementioned rights, patients have the right to request for a secondary medical opinion with every diagnosis established or every treatment suggested, or with every referral issued by a physician or a hospital discharge initiated by a health care provider.
Right to be treated with respect
The right to be treated with respect means that during the medical service, patients should be treated with respect and their personal dignity must always be recognized. Additionally, it also means that only those interventions can be implemented that are necessary for their treatment. With regard to their personal dignity, patients’ clothes can only be removed to the extent and time that is necessary for the intervention, with the consent of the patient, if possible.
Patients can be kept on hold if professionally indicated and necessary.
Patients’ rights can be restricted if indicated, to an extent set out in legal act. Restrictive measures can be indicated by the treating physician, except at inpatient hospital wards, where there is no constant medical supervision. At inpatient wards restrictive measures can be indicated by the nurse specialist, after the notification and the approval of the designated medical supervisor. If the doctor approves the indicated restrictive measures, the doctor has to review the legal indication of the restriction at specific, legally determined time intervals. The restrictive measures can be only applied until the indication stands. If the restrictive measures are indicated in the case of patients with psychiatric disease, the designated patient representative must be immediately notified.
Right to have visitors
Exercising the rights to have visitors always depend on the given circumstances at the inpatient department that are regulated within the department’s policy. Exercising these rights are only possible if the rights of other patients are also treated with respect, and until it does not cause disruption in the medical services provided for the patients at the medical facility.
This right involves that the patients have the right to have visitors (relatives and other visitors) and also to ban certain people from visiting them during their hospital stay. The patient has the right to keep the information regarding their hospital stay and their treatment personal. Deviation from this right is only permitted if it is indicated by the patient’s medical treatment, in that case, information can be given only to their close relatives or to their legal guardian.
Critically ill patients have the right to have a designated person around. The person can be designated either by the patient or (in case of incapacitated patients) the legal guardian. Critically ill patients are those who are unable to provide their own basic needs.
Minors have the right to have their parent or their legal guardian around, or another person designated by them. Pregnant women who are giving birth also has the right to have a designated person around during their labor and the delivery, and to have their babies around after birth, if it is not indicated otherwise by medical professional reasons.
Patients also have the right to exercise their religious beliefs freely and to meet religious people during they hospitalization.
Right to leave the facility
The patient can leave the medical service provider facility if their leaving does not pose a threat to other people’s wellbeing. When the patient decides to leave, especially when it is not medically advised, the treating physician has to make a note in the patient’s medical record whether the patient has notified them about their intention for leaving or they left without notifying the doctor.
If patients who lack decision-making capacity, patients with limited capacity or patients with limited capacity in regard to their patient rights leave the facility without indicating their leaving intention to their treating physician, the facility notifies the legal guardian.
Additionally, the patients or their relatives have to be notified 24 hours before the patients’ hospital discharge.
Right to make informed consent
The right to make informed consent means that the patient has the right get all the information related to their care in a personalized, plain language (considering the patient’s age, educational background, knowledge, emotional state, wishes) that is necessary for them to make a choice or a decision on their care. If needed, the patient has also to right to receive this information with the cooperation of an interpreter or a sign-language interpreter.
Information regarding informed consent includes, but is not limited to the followings:
- their health condition and the doctor’s opinion;
- the indicated procedures and interventions and their advantages, risks, date and also their treatment choices, including being able to request or refuse treatment;
- the process and the possible outcome of the care;
- further interventions, alternative therapeutic options and methods;
- recommended lifestyle;
- test results.
The patient has the right to:
- get to know the name, qualification and position of those who are taking care of them;
- ask questions during and after being informed;
- designate a person who can be informed by the doctor;
- ban people from being informed.
Patients who lack decision-making capacity, minors with limited capacity and patients with limited capacity in regard to any subject have the right to receive information about their health condition and their care at the appropriate level (considering their age and mental state).
Before the examination, the doctor has to inform the patient (if they do not lack decision-making capacity) about the charge of the examination and the following care, if the result of the examination does not indicate emergency and the examination and the care are not covered by the social security insurance.
Patients with capacity to act can waive their right to be informed, however, if the patient requested and intervention, waiving is only valid in a form of a written statement.
It is also important to note that patient information leaflets do not supplement information given in person. Patients have the right to consult on the information regarding their status and care.
Right to make decisions about medical treatment
Patients have the right to make decisions freely about their care, including requesting or refusing therapy. Patients with capacity to act can also appoint another person with capacity to act in a legal declaration made in advance who has the right to exercise the right to give consent to or refuse a treatment. In this declaration patients can also ban any of their relatives from exercising this right.
If the patient lacks capacity to act and there is no appointed representative, then according to the health act, the following order prevails in exercising the right to giving consent or refusing therapy: legal representative, spouse/partner living in the same house, child, parent, sibling, grandparent, grandchild.
If the abovementioned people’s statements are opposing, the option favoring the patients’ health condition the best has to be chosen.
The patient does not have to give consent if:
- the patient is in a life-threatening situation;
- cancellation of the intervention poses a threat to other’s health;
- the consent of the appointed representative is delayed and the delay of the intervention leads to severe or a permanent health damage;
- during invasive procedures (that invade the patient’s body) it is necessary to extend the operation – this case is also regarded as an emergency.
Patient can give their consent in oral or written form or in an agreement expressed by conduct, and they can withdraw their consent anytime.
Written statement is necessary:
- before invasive and surgical interventions;
- the utilization of their removed cells, tissues, organs or body parts if their utilization is not related to their care.
Patients can withdraw their consent at any time. If their withdrawal lacks a well-founded cause, the patients are obliged to pay for the necessary emerging charges related to the intervention.
Right to refuse medical treatment
Patients with capacity to act have the right to refuse medical treatment, except if the refusal poses a threat to other’s health. If possible, the reasons behind the refusal need to be investigated, and the patient always needs to be informed about the consequences of the refusal. The treating physician has to try to convince, but must not force the patient to change their decision.
If the refusal of the therapy would lead to severe or permanent health damage of the patient’s health condition, the therapy can only be refused in a notarized deed or in a private document providing conclusive evidence, or (if the patient is illiterate) the withdrawal is legally binding if taken in the presence of two witnesses. This right does not apply to patients with limited or no legal capacity.
Lifesaving and life-supporting care can only be refused after an examination of a three-member committee (psychiatrist, specialist and treating physician). In such cases, the committee must uniformly declare in a written statement that the patient made their decision after being informed of the consequences and the patient suffers from a serious, incurable illness that leads to death in a short period of time. The patient has to repeat their statement in the presence of the two witnesses three days after the examination.
Patients cannot refuse the treatment if they are pregnant, and the pregnancy will foreseeably terminate in a healthy, normal delivery. For minors, GP and GP Pediatrician services and health-visitor care cannot be refused.
The refusal declaration can be withdrawn at any time, without any consequences.
Patients with capacity to act can make declarations in advance about refusal of medical treatment and their legal representative (in case they lose their legal capacity) in a form of a notarized deed (so-called “advance directive”).
Right to access medical records
Based on the right to have access to medical records the patient is entitled to:
- being informed about their medical data management;
- being informed about their test results and medical data;
- receive a hospital discharge document on their hospital discharge;
- after outpatient care, receiving an outpatient medical record;
- the patient has the right to ask for a modification in their medical record if some data is missing or incorrect in their chart.
Additionally, patients have the right to take a look into their medical records, ask for an excerpt or a copy of them, and receive a copy (the first copy is free of charge, all other replicas are needed to be paid for based on the regulations of the medical facility),
If the patient is deceased, their legal representative, close relative and their heir (based on a written request) are entitled to get to know the cause of death, the medical treatment the patient received before death during their hospital stay and to take a look into the patient’s medical records. They are also entitled to ask for an excerpt or a copy and receive a copy (the first copy is free of charge, all other replicas are needed to be paid for based on the regulations of the medical facility).
The patient’s spouse, lineal descendants, siblings or life partner are entitled to get to know the patient’s medical records while the patient is alive or after their death, if the patient’s medical record and test results influence these individuals and descendants’ health condition and their medical care and if these medical data are otherwise not achievable.
The health act enables the medical restriction of rights to patients’ access to their medical records in case of psychiatric patients, if access to their medical records would supposedly threaten the patients’ recovery or violate privacy rights of another person. The patient representative and the patient’s legal or appointed representative must be informed about the restriction.
Access to medical records is also possible via the EESZT (National eHealth Infrastructure, in Hungarian: Elektronikus Egészségügyi Szolgáltatási Tér) in electronic form.
Right to privacy and confidentiality
Based on the right to privacy and confidentiality, the patient is entitled to the confidential handling of their medical data by those participating in their care.
The patient has the right to:
- decide on whom can be informed about their condition and whom can be banned from receiving information;
- be surrounded by only those people who participate in their medical care;
- privacy during their examination and treatment – meaning that without their consent, people who do not participate in their care cannot be around them during their care, unless it is impossible because of an emergency;
- appoint a person who can be informed about their hospitalization and about the course of their disease, and they also have the right to ban any person from receiving confidential information about their medical status.
The appointed individual has to be informed by the medical facility about the patient’s localization within the hospital and about any significant change in the patient’s condition.
Information regarding the patients’ condition and further nursing care must be provided to the individuals taking care of the patients without the patients’ consent, if the absence of providing this information would lead to damage to the patients’ health.
Patient responsibilities
Patients (as far as their medical condition enables them) have the legal responsibility to cooperate with the medical team participating in their medical care, they have to:
- inform them about their relevant medical history, regarding their previous illnesses, medications and medical treatments, risk factors;
- inform them about everything regarding their own health that might threaten other people’s life or physical health, especially about infectious diseases and other diseases and conditions disqualifying them from certain occupations;
- inform them about any previous legal declarations related to their health;
- comply with the recommended medical therapy;
- comply with the department’s policy;
- pay the legally determined service fee;
- verify their personal data.
The patients and their relatives have to respect other patients’ rights and the policies of the medical service provider facility, and they must not violate the rights of the medical employees.
For further information on exercising patient rights and on patient representatives, read the applying article: Enforcing patient rights
