In Cyprus,patients enjoy various rights under the Safeguarding and Protection of Patients' Rights Act of 2004,which is in force since April 2005. This Act establishes the rights of patients regarding health care, as well as the control mechanism for securing these rights.
The primary and fundamental right enjoyable by all individuals is the right to health care and treatment. Every patient has a right to enjoy uninterrupted and good quality care, which should always be provided within reasonable timedepending on the patient’s needs. This right prevents any medical institution or health care provider from refusing to provide the required medical care to a patient. On the contrary,the 2004 Act provides that health services should be constantly available and accessible. Therefore, medical institutions and health care providers have an obligation to act in the best possible manner and provide good quality care to every patient.
All patients are entitled to equal treatment with respect to the provision of health care. Health care should equally be provided to all patients without discrimination. In cases where a choice it be made between two or more patients in order to provide a specific health service,the choice must be made fairly and be based on objective scientific criteria without discriminating between patients.
Furthermore,every patient has the right to be treated with dignity; hence providing health care should be done so with appropriate respect for the cultural values of each patient,until the final stage of his life.
An important requirement set by the 2004 Act for the provision of health care is the patient's consent. Each patient, after complete medical information,must give written or oral consent, provided that the patient’s oral consent will be put in writing as soon as possible. The medical information must be given by the health care provider at an appropriate time and in a comprehensible manner, so that the patient understands the information given in order to be able to choose freely and independently.
The 2004 Act,indicating the importance of the patient's consent,provides for only three exceptional situations where health care can be provided without the consent of the patient.
The first exception to the rule is cases where it is necessary to provide immediate health care and the patient, due to his mental or physical stateis unable to express his will and to give his consent. In situations such as thisit is presumed that the patient consents,unless it is evident from previously expressed wishes that he would have refused to give consent.
The second exception issituations wherea person was appointed or should be appointed to act on the patient’s behalfdue to the patient’s state, and the consent of that is required but cannot be obtained in time. When an emergency occurs is situations such as these,health care is providedunless it is obvious under the circumstances that consent would be withheld.
The third exception applies to minors who, according to the law,do not have the capacity to consent. In cases regarding minors,health care can be provided only with the consent of the parent or guardian, unless there is an emergency and the consent of the parent or guardian cannot be obtained in time.
An equally important right,inherent to the requirement for consent,is the patients’ right to information. Every patient has a right to a complete medical information that includes: a) the diagnosis and prognosis of the patient's medical condition,b) the purpose,benefits and likelihood of success of the proposed treatment,c) the risks and side effects of the proposed treatment,and d) the likelihood of success and the risks of the various forms of treatment or non- treatment.
Each patient, according to the 2004 Act, maywaive in writing his right to information,or choose someone else to be informed on his behalf.
The only exception provided by the 2004 Actto the patients’ right to information,in cases where he has not waived that right,is in exceptional situations where there are grounds to believe that the information given would likely cause severe mental or physical harm to the patient. In this case the information that is not provided to the patient must be given to his relatives.
Everyone have a right to privacy.Thus, the 2004 Act explicitly prohibits any intrusion on the patients’ right toprivate and family life, and imposes an obligation to health care providers to show the appropriate respect when providing health care. Any violation to this right can only occur with the consent of the patient,or when deemed necessary for the diagnosis,treatment or care of the patient.
Another right that is inherent to the right to privacy is the patients’ right to confidentiality. The right to confidentiality provides for all information regarding the patient’s medical condition,diagnosis,prognosis and treatment,and any other personal data to be kept confidential even after the patient’s death.
The only situations where the medical institution or health care provider can disclose medical information to third parties are: a) with the written consent of the patient,b) when the disclosure is made for treatment purposes by another health care provider,c) for purposes of processing and archiving information or for opinion purposes,d) when there is a legal obligation to do so,e) for purposes of publication in medical journals or for research or teaching purposes,or f) when the Medical Council decides that the concealment of information might cause serious harm to the health or integrity of other people or that disclosure of information is in the public interest. In any case,the 2004 Act provides for the protection of information and data that may reveal the identity of the patient.
Patients have a right to receive, if they wish, second medical opinionand to select and change the medical institution or health care provider. For this reasonthe 2004 Act gives to patients the right to access their medical records and the powerto obtain information that is stored within them, eitherdirectly or indirectly through an agent. Furthermore,patients can obtain a copy of their medical file,and make corrections,or delete information,or even require the lock of their files due to inaccuracies or deficiencies.
Therefore,the health care provider must keep medical records stating the patient’s and health care provider’s information,the previous medical history of the patient,as well as medical information regarding the patient’s treatment and the diagnosis of his medical condition.
The patient’s right to access his medical records can only be limited when the information is likely to cause serious harm to his health,or disclose information about third parties, or even when it involvesgenetic information.
In addition to the patients’rights, the 2004 Act provides for a control mechanism for the proper enforcement of these rights. According to the 2004 Act,each State hospital must have a person responsible for safeguarding the rights of patients (the 'Patients’ Rights Officer). This person has a duty to provide advice and assistance to patients for the purpose of safeguarding their rights,to receive and handle complaints of patients that must be handled immediately or refer the complaints to the Complaints Examination Committee,and to guide and inform the medical,paramedical,nursing and administrative staff of the hospital about matters concerning the 2004 Act.
The Complaints Examination Committee examines complaints referred by the Patients’ Rights Officer and issues a decision within 15 days from the referral of the complaint in question. Also, it considers on appeal complaints by patients who were not satisfied by the decision of the Patients' Rights Officer and issues a decision within a month.
In respect to complaints concerning private hospitals,the Complaints Examination Committee considers at first instance the patients’ complaints and reaches a decision within 48 hours,and on appeal issuing a decision within one month.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought on your specific circumstances.
For further information, please contact Pariana Demetriou.