Regulations on the Rights and Responsibilities of Patients

Regulations on the Rights and Responsibilities of Patients at the Multispecialty Hospital 12/14 Gąsiorowskiego Street, 05-510 Konstancin-Jeziorna Tel: 22 703 00 00, www.ckr.pl, find us on Facebook Regulations on the Rights and Responsibilities of Patients2 Chapter I. PATIENT’S RIGHTS Section 1 Patient’s right to healthcare services. I

1. The patient has the right to healthcare services that correspond to the requirements of current medical knowledge.
2. In situations where there are limited possibilities to provide appropriate healthcare services, the patient has the right to a transparent, objective procedure based on medical criteria that determines the order of access to these services.
3. The patient has the right to demand that the healthcare provider:
   1. consult another physician or convene a medical council;
   2. consult another nurse (if applicable).
4. The physician may refuse to convene a medical council or seek the opinion of another physician if they consider the patient’s request to be unfounded.
5. The nurse may refuse to seek the opinion of another nurse if they consider the patient’s request to be unfounded.
6. The request mentioned in point 3, as well as the refusals mentioned in points 4 and 5, shall be recorded in the medical documentation. II
7. The patient has the right to immediate provision of healthcare services in case of a threat to their health or life. III The patient has the right to healthcare services provided with due care under conditions that meet the professional and sanitary requirements specified by the applicable laws. When providing healthcare services, medical professionals abide by the ethical principles defined by the relevant professional associations. Section 2 Patient’s right to information. I
8. The patient has the right to information about their health condition.
9. The patient, including a minor who has reached the age of 16 or their legal representative, has the right to receive accessible information from the physician regarding the patient’s health condition, diagnosis, proposed and possible diagnostic and therapeutic methods, foreseeable consequences of their application or omission, treatment outcomes, and prognosis.

The patient or their legal representative has the right to give consent for the information mentioned in point 2 to be provided to other individuals. 4. The patient has the right to request that the physician does not provide them with the information mentioned in point 2.

5. After receiving the information mentioned in point 2, the patient has the right to express their opinion to the physician regarding this matter.
6. In exceptional situations, if the prognosis is unfavorable for the patient, the physician may limit the information about the health condition and prognosis if, in the physician’s assessment, it is in the patient’s best interest. However, upon the patient’s request, the physician is obliged to provide the requested information in its entirety.
7. A minor patient who has not reached the age of 16 has the right to receive from the physician the information mentioned in point 2, to the extent and in the form necessary for the proper course of the diagnostic or therapeutic process.
8. The patient, including a minor who has reached the age of 16 or their legal representative, has the right to receive accessible information from the nurse regarding their care and nursing procedures. II In the case referred to in Article 38(1) of the Act of 5 December 1996 on the Medical Profession and the Dentist’s Profession, the patient, their legal representative, or de facto guardian have the right to receive sufficiently early information about the intention of the physician to withdraw from treating the patient and to indicate the possibility of obtaining healthcare services from another physician or healthcare provider.

III

1. The patient has the right to information about the patient’s rights specified in the Act of 6 November 2008 on Patient Rights and the Patient Ombudsman (Journal of Laws of 2009 No. 52, item 417), as well as in separate regulations, taking into account the limitations of these rights specified in those regulations. Information about these rights is included in this Regulation. This Regulation is posted in a publicly accessible place in each Hospital Ward.
2. In the case of a patient who is unable to move, this Regulation is made available in a manner that allows the patient to become acquainted with it in the room where the patient stays.

IV The patient has the right to information about the type and scope of healthcare services provided by the Center, including preventive health programs financed from public funds, implemented by this entity. This information is made available in writing by placing it in their premises in a publicly accessible place.

Section 3 Patient’s right to confidentiality of related information.

I The patient has the right to confidentiality of information related to the patient, obtained in connection with the exercise of the medical profession, by persons performing medical professions, including those providing healthcare services.

II

1. In order to fulfill the right mentioned in point I, persons performing medical professions are obliged to maintain the confidentiality of information related to the patient, in particular regarding the patient’s health condition.
2. The principle specified in point I does not apply in the case where:

1. separate laws stipulate otherwise;
2. maintaining confidentiality may pose a danger to the life or health of the patient or other persons;
3. the patient or their legal representative gives consent to the disclosure of confidentiality;
4. there is a need to provide necessary information about the patient related to the provision of healthcare services to other persons performing medical professions involved in providing these services.
5. Persons performing medical professions providing healthcare services, except in cases specified in point 2, sub-points 1-3, are also bound by confidentiality after the patient’s death.

Section 4 –  Patient’s right to give consent to receive healthcare services.

The rules contained in this section apply to giving consent for the provision of healthcare services or refusing such consent, unless provisions of other laws, other than the Act of 6 November 2008 on Patient Rights and the Patient Ombudsman, state otherwise.

II The patient has the right to give consent for specific healthcare services or refuse such consent, after receiving information specified in Section 2.

III

1. The patient, including a minor who has reached the age of 16, has the right to give consent for examinations or other healthcare services by a doctor.
2. The legal representative of a minor patient, a fully incapacitated person, or a person incapable of giving informed consent has the right to give consent as mentioned in point 1. In the absence of a legal representative, a de facto guardian may exercise this right regarding the examination.
3. A minor patient who has reached the age of 16, a fully incapacitated person, or a mentally ill or intellectually disabled patient who possesses sufficient understanding has the right to object to receiving healthcare services, despite the consent of the legal representative or de facto guardian. In such a case, permission from the guardianship court is required.
4. Consent and objection as mentioned in points 1-3 may be expressed orally or through behavior by the individuals listed in these provisions, which clearly indicates their willingness or unwillingness to undergo the proposed medical procedures.

IV

1. In the case of a surgical procedure or the use of treatment or diagnostic methods posing increased risks to the patient, the consent mentioned in point III, sub-point 1, must be given in writing. The provisions of point III, sub-points 2 and 3, apply to giving consent and objection.
2. Before giving consent as specified in point 1, the patient has the right to receive the information mentioned in Section 2, point I, sub-point 2.
3. The rules contained in point III, sub-points 2-4, apply accordingly.

V

The rules for conducting examinations or providing other healthcare services by a doctor despite the absence of consent or in the face of objection, as mentioned in points III and IV, are determined by the provisions of Article 33 and Article 34(6) of the Act of 5 December 1996 on the Medical and Dental Professions.

Chapter 5 Right to Respect for Privacy and Dignity of the Patient.

I

1. The patient has the right to respect for privacy and dignity, particularly during the provision of healthcare services.
2. The right to respect for dignity also includes the right to die in peace and dignity. A patient in a terminal state has the right to healthcare services that provide relief from pain and other suffering.

II

1. A close person may be present during the provision of healthcare services.
2. A healthcare professional providing healthcare services to a patient may refuse the presence of a close person during the provision of healthcare services in the event of a likelihood of an epidemic threat or for the health safety of the patient. The refusal should be documented in the medical records.

III

1. In order to uphold the right mentioned in point I, subpoint 1, a healthcare professional has the obligation to act in a manner that ensures respect for the patient’s privacy and dignity.
2. Healthcare professionals other than those providing healthcare services participate in the provision of such services only when necessary due to the nature of the service. Participation and the presence of other individuals require the patient’s consent. In the case of a minor patient, a completely incapacitated patient, or a patient incapable of giving informed consent, the consent of their legal representative and the healthcare professional providing the healthcare service is required.

Chapter 6 – Patient’s Right to Medical Documentation.

I

1. The patient has the right to access medical documentation concerning their health status and provided healthcare services.
2. The data contained in medical documentation is subject to protection as specified in this law and separate regulations.

II

1. In order to uphold the right mentioned in point I, subpoint 1, the Hospital is obliged to keep and provide access to medical documentation in the manner specified in this chapter and ensure the protection of the data contained in this documentation.
2. Doctors and nurses are authorized to obtain and process the data contained in medical documentation, as mentioned in point III.

III Medical documentation includes at least:

1. Patient identification allowing for the determination of their identity: a) Last name and first name(s) b) Date of birth c) Gender designation d) Residential address e) Personal Identification Number (PESEL), if assigned, and in the case of individuals without a PESEL number, the type and number of the identity document f) In the case of a minor patient, a completely incapacitated patient, or a patient incapable of giving informed consent: the last name and first name(s) of their legal representative and their residential address
2. Identification of the healthcare provider indicating the organizational unit in which the healthcare services were provided
3. Description of the patient’s health condition or provided healthcare services
4. Date of preparation

IV

1. The Hospital provides access to medical documentation to the patient or their legal representative or a person authorized by the patient.
2. After the patient’s death, the right to access medical documentation belongs to a person authorized by the patient during their lifetime.

The hospital provides access to medical documentation to:

1. Entities providing healthcare services, if the documentation is necessary to ensure the continuity of healthcare services.
2. Public authorities, the National Health Fund, medical professional bodies, as well as national and provincial consultants, to the extent necessary for them to perform their tasks, particularly in terms of control and supervision.
3. The relevant Minister of Health, courts, including disciplinary courts, public prosecutors, forensic doctors, and professional liability ombudsmen, in connection with ongoing proceedings.
4. Authorized entities and institutions under separate laws if the examination was carried out at their request.
5. Pension authorities and disability assessment teams, in connection with proceedings conducted by them.
6. Entities managing medical service registers, to the extent necessary for registry management.
7. Insurance institutions, with the patient’s consent.
8. Doctors and nurses involved in the accreditation procedure in healthcare, to the extent necessary for its conduct based on healthcare accreditation regulations.

Regulations on Patients’ Rights and Obligations10 4. Medical documentation may also be made available to higher education institutions or research and development units for scientific purposes without disclosing the name and other data enabling the identification of the person to whom the documentation pertains.

V

1. Medical documentation is made available in the following ways:

1. For viewing at the hospital premises.
2. By preparing extracts, copies, or duplicates of the documentation.
3. By issuing the original with a receipt of acceptance and subject to return after use, if the authorized body or entity requests the provision of the original documentation.

VI

1. The hospital charges a fee for providing medical documentation as specified in point IV, subpoint 2. 3
2. The fee amounts are as follows:

1. For one page of an extract or duplicate of medical documentation – 0.002% of the average salary in the previous quarter, starting from the first day of the following month after the announcement by the President of the Central Statistical Office in the Official Journal of the Republic of Poland “Monitor Polski” based on Article 20, point 2 of the Act of December 17, 1998, on pensions and disability benefits from the Social Insurance Fund.
2. For one page of a copy of medical documentation – 0.0002% of the average salary referred to in subpoint 1.
3. For the preparation of an extract, duplicate, or copy of medical documentation on an electronic data carrier, if the facility maintains electronic medical records – 0.002% of the average salary referred to in subpoint 1.

VII

1. The hospital keeps medical documentation for a period of 20 years from the end of the calendar year in which the last entry was made, with the following exceptions:

1. Medical documentation in the case of a patient’s death resulting from bodily injury or poisoning, which is kept for a period of 30 years from the end of the calendar year in which the death occurred.
2. X-ray images kept separately from medical documentation, which are stored for a period of 10 years from the end of the calendar year in which the image was taken.
3. Referrals for examinations or doctor’s orders, which are kept for a period of 5 years from the end of the calendar year in which the service covered by the referral or order was provided.
4. After the expiration of the periods mentioned in point 1, the hospital destroys medical documentation in a manner that prevents the identification of the patient to whom it pertained.

Section 7 – Patient’s right to object to a physician’s opinion or decision.

1. The patient or their legal representative may object to the opinion or ruling issued by a doctor if it affects the patient’s rights or obligations under the law.
2. The objection should be submitted to the Medical Committee operating under the Patient Rights Ombudsman, through the Patient Rights Ombudsman, within 30 days from the date of the doctor’s opinion or ruling on the patient’s health condition.
3. The objection must be justified, including specifying the legal provision from which the rights or obligations referred to in point 1 arise.
4. If the requirements specified in point 3 are not met, the objection will be returned to the person who submitted it.
5. Based on the medical documentation and, if necessary, after examining the patient, the Medical Committee issues a ruling immediately, no later than 30 days from the date of the objection.
6. The Medical Committee issues the ruling by an absolute majority vote in the presence of the full composition of the committee.
7. There is no right of appeal against the decision of the Medical Committee.
8. The provisions of the Administrative Procedure Code do not apply to proceedings before the Medical Committee.
9. The rules specified in points 1-8 do not apply to appellate proceedings on opinions and rulings regulated by laws other than the Act of November 6, 2008, on patient rights and the Patient Rights Ombudsman.

Section 8 Patient’s Right to Respect for Private and Family Life

I

1. The patient in the Hospital has the right to personal, telephone, or written contact with other people.
2. The patient has the right to refuse contact with the persons mentioned in point 1.

II

1. The patient has the right to additional care.
2. Additional care, as referred to in point 1, means care that does not involve providing healthcare services.
3. A patient who would like to avail themselves of additional care shall submit a declaration to the Ward Nurse in the Ward where they are staying, indicating the person who will provide such care and the duration for which it will be provided during hospitalization. If the patient is unable to submit such a declaration, it may be submitted by their legal representative or de facto guardian.
4. The type of activities that may be undertaken with regard to the patient as part of additional care requires prior agreement with the attending physician or the ward duty doctor.

III

1. The patient bears the costs of implementing the rights referred to in point I, sub-point 1, and point II, sub-point 1, if the implementation of these rights results in costs incurred by the Hospital.
2. The amount of the fee compensating the costs referred to in point 1 shall be determined by the Management Board of the Company, taking into account the actual costs of implementing the rights referred to in point I, sub-point 1, and point II, sub-point 1.
3. Information on the amount of the fee referred to in point 2 and the method of its determination is public and made available on the notice board at the Hospital’s registered office.

Section 9 Patient’s Right to Pastoral Care

I The patient in the Hospital has the right to pastoral care.

II In the event of a deterioration of the patient’s health or a threat to life, the Hospital is obliged to enable the patient to have contact with a clergyman of their denomination.

III The Hospital bears the costs of implementing the patient’s rights referred to in point I and II, unless provisions of laws other than the Act on patient rights and the Patient Rights Ombudsman stipulate otherwise.

Section 10 Patient’s Right to Store Valuables in a Deposit

The patient in the Hospital has the right to store valuables in a deposit.

12. Observe the prohibition on bringing and consuming alcoholic beverages and other psychoactive substances.
13. Observe the prohibition on staying on the premises of the Center after consuming alcohol or psychoactive substances.
14. Observe the prohibition on smoking tobacco on the premises of the Center.
15. Observe the prohibition on engaging in gambling activities on the premises of the Center.
16. Observe the prohibition on using telephones that are the property of the Center.
17. Observe the prohibition on bringing television, radio, or other equipment to the Hospital without obtaining prior consent from the attending physician.
18. Observe the prohibition on using personal television, radio, etc., without obtaining prior consent from other patients in the same hospital room and the attending physician.
19. A patient may be discharged from the Hospital if they significantly disrupt the order or provision of healthcare services, and there is no fear that refusal or cessation of services may directly endanger their life, health, or the life or health of others (Article 29, Section 1, Point 3 of the Act on Medical Activity).

If the patient believes that their right to healthcare protection is not being satisfied to their satisfaction, they may submit an application or complaint to:

SECTION FOR COMPLAINTS AND APPLICATIONS AT THE NATIONAL HEALTH FUND DEPARTMENTS Mazovian Regional Branch of the National Health Fund Complaints and Applications Department ul. Chałubińskiego 8 00-613 Warsaw tel. (22) 480 43 43 email: skargi@nfz-warszawa.pl website: www.nfz-warszawa.pl

OFFICE OF THE PATIENT’S OMBUDSMAN Patient’s Ombudsman: Krystyna Barbara Kozłowska ul. Młynarska 46 01-171 Warsaw National toll-free helpline: 800-190-590 (available Monday to Friday from 9:00 am to 9:00 pm) website: www.bpp.gov.pl

REGIONAL COMMISSION FOR ADJUDICATING MEDICAL EVENTS IN WARSAW Mazovian Voivodeship Office pl. Bankowy 3/5 00-950 Warsaw tel. (22) 695-67-08 (22) 695-69-00 (22) 695-62-41 fax. (22) 695-69-01 email: zdarzeniamedyczne@mazowieckie.pl