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The Patient's Rights Law

Original Language Title: Pacientu tiesību likums

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The Saeima has adopted and the President promulgated the following laws: law on patient rights article 1. The terms used in the law (1) the terms used in the Act comply with the Act of treatment used terms, if this law provides otherwise.
(2) the Act is used in the following terms: 1) the treating doctor-medical person who drives a patient's treatment, the patient's treatment of adopted decisions, the overall responsibility for all of the patient's treatment, focus, continuity, quality, and results;
2) informed consent — consent to medical treatment of a patient, which he gives orally, in writing or by such actions that clearly confirms the consent, in addition, give it freely, on the basis of the treatment of personal information in a timely manner for the purpose of treatment, the risks, consequences and methods to be used;
3) clinical training — according to an approved education program performed medical education or qualifications of the acquiring person training medical institution to which the rights are granted in accordance with the regulations;
4) medical documents — any writing, radiodiagnostisk movies, or in electronic form recorded information about the patient, his State of health, disease diagnosis and prognosis, prevention, diagnostic and treatment methods, as well as diagnostic and therapeutic results.
5) health care services — services that the health care provided to the patient under medical treatment of a person of a certain objective. 2. article. The purpose of the Act, the Act aims to promote the friendly relationship between the patient and health care provider, contributing to the patient's active participation in their own health care, as well as to provide him a chance to exercise and defend their rights and interests. 3. article. General provisions (1) the rights of the Patient under this Act, in so far as other laws unless otherwise specified.
(2) provide the patient's rights, prohibited different treatment depending on the person's race, ethnic origin, colour, sex, age, disability, health, religious, political or other belief, national or social origin, property or marital status or other circumstances. Different treatment includes the person's direct or indirect discrimination, harassment or an instruction to discriminate.
(3) the difference in treatment in relation to any of the second part of this article, the conditions that permitted only if it is objectively justified by a legitimate aim, which is to achieve the means chosen are proportionate.
(4) it is prohibited to punish patients or otherwise directly or indirectly creating conditions favourable to him, if the patient defends their rights.
(5) the patient and his relatives are entitled to spiritual care, which according to the chaplain and religious organisations the laws regulating provides hospital's chaplain.
(6) health care against the will of the patient is not allowed, unless the law provides otherwise. 4. article. Right to information (1) the patient's right to information about health care services and health care billing services. This information is publicly available.
(2) the patient's right to know the treating doctor and other health care treatment of individuals involved in the process of first name, last name, job title, profession, specialty and qualification.
(3) the patient is entitled to receive from the referring physician information on their health status, including for disease diagnosis, treatment, and rehabilitation of the investigation plan projections and the effects of the disease also produced functional limitations, prevention opportunities, as well as right after treatment carried out in the framework of investigations and surgical or other invasive interventions to obtain information on the results of treatment of unforeseen outcomes and reasons.
(4) the patient's right to information about treatment from his other physicians engaged in medical treatment of persons according to their competence.
(5) Information to be provided to the patient in an intelligible form, explaining medical terms, and taking into account the patient's age, maturity and experience.
(6) the patient's right after treatment or one of its stage of completion (for example, if you sign out of the medical establishment) receive information about treatment services provided to him and the reasons for the completion of treatment, as well as the diagnostic study and functional assessments (extracts, transcripts and copies), instructions and recommendations regarding further treatment and social services, and if applicable to the patient's State of health, get a referral to another hospital for treatment.
(7) patient information may not be provided only if the doctor has in its possession or the fact that information is vulnerable to the patient or another person's life or health.
(8) the patient's right to refuse to receive the information referred to in this article. His refusal he expressed orally, in writing or by such actions that clearly certify it. 5. article. The right to medical treatment (1) each person the treatment prescribed by law are entitled to appropriate health treatments.
(2) the patient's right to kind treatment, high quality and qualified treatment, regardless of the nature and severity of the disease.
(3) a patient has the right to their own family and other persons to aid in healing.
(4) the patient has the right to timely medical treatment. The medical establishment in which the patient is approached, provides information about the receipt of treatment options and deadlines, as well as other medical institutions where you can receive the appropriate medical treatment.
(5) the patient is entitled to receive from all those involved in the treatment of his medical treatments using the authorities.
(6) if the medical treatment is limited or allowed more types of treatment, the patient has a right to a doctor's professional choice, based on the evidence-based medical criteria.
(7) the patient has the right to a treatment that is carried out only in the presence of the persons who are directly involved in the treatment. The patient can accept the presence of another person during treatment or invite other persons, if it does not interfere with treatment.
(8) if the patient has stopped treatment and left the hospital, for their actions without informing the treating doctor or hospital, it indicates his medical record. If the patient is a minor or a person of their State of health or age are not able to take care of itself, the medical institution shall immediately inform the patient's legal representative, but if not, a spouse or next of kin, but if not, well, family courts. The medical establishment shall immediately inform the competent authorities if their State of health, endanger other people's health or safety.
(9) the patient has the right to medical treatment at home if his State of health and living conditions in the permit. 6. article. Consent to medical treatment or the abandonment of its (1) Treatment is permitted if the patient has given informed consent to it. The patient has the right to informed consent before going to ask questions and get answers.
(2) Informed consent expressed in writing, if requested by the patient or the treating doctor.
(3) If the notified consent given in writing, the patient confirms with his signature, indicating the date and time. Written consent to add his medical document.
(4) the patient's right to refuse medical treatment prior to its launch, from the methods used in, not giving up treatment altogether, or to opt out of the medical treatment.
(5) your treating doctor inform the patient of the fourth paragraph of this article, that the possible consequences of the decision. After treating a doctor's receipt of the information supplied with your signature confirms the decision to refuse medical treatment or on the suspension or waiver of the methods to be used in the treatment, indicating that the appropriate information is received. If the patient does not change its decision, the referring physician has a duty to encourage him to visit another doctor.
(6) if the patient refuses to acknowledge in writing off, call your treating doctor and the two adult witnesses who are having with your signature certifies that the patient is accepted in part four of this article, the above decision.
(7) if authorized by another person (hereinafter referred to as the authorised person of the patient) for him to accept treatment or medicine generally used method of treatment or refuse, in whole or in treatment methods, as well as receive information in accordance with article 4 of this law, shall inform the patient of the treatment of such authorisation. 7. article. Another person the right to accept or refuse medical treatment from the

(1) if the patient of their State of health or age could not decide on treatment, the right to take the decision to consent to the treatment or medicine generally used method or the abandonment of the treatment as a whole or the methods to be used in treatment is the patient's spouse, but if not, age and legal capacity, closer Kinsman in the following order: the patient's children, parents, brother or sister of the patient, the patient's grandparents, grandchildren of the patient.
(2) the patient's spouse, relative or close the patient's authorized representative, as well as the legal representative of the patient, if the patient is in the custody or guardianship (hereinafter referred to as the person who represents the patient) when making a decision about treatment or abandonment of the patient expressed above, comply with the will for treatment.
(3) If the patient's relatives, who have the same rights to decide the location of the patient, cannot agree to consent to the treatment, the most favourable treatment that affect the patient's health status, adopt the doctor konsilij.
(4) your treating doctor will explain to the person that represents the patient, what consequences can lead to the decision to refuse treatment. Following receipt of the person representing the patient, with his signature in the document approved by the medical decision to refuse medical treatment or on the suspension or waiver of the methods to be used in the treatment, indicating that the appropriate information is received.
(5) If a person who represents the patient refuses to accept the decision of the patient's treatment, but doctors believe that treatment is in the interest of the patient, the treatment takes the doctor konsilij.
(6) If a person who represents the patient refuses to acknowledge in writing off, call your treating doctor and the two adult witnesses in a lawsuit that the undersigned, certify that the person who represents the patient has taken that decision. Add patient medical waiver documents.
(7) if the patient is not indicated by the person entitled him to agree to or refuse treatment and the patient does not have a spouse, next of kin or legal representative or the patient is denied in writing to the spouse or closest relatives to take his place, the most favourable treatment that affect the patient's health status, adopt the doctor konsilij.
(8) in cases where the delay threatens the patient's life, and it is not possible to get the same patient or persons representing the patients consent, treatment of persons within their competence, shall take immediate measures, investigation, treatment, including surgical or other invasive interventions. In such cases, investigation and treatment plan is approved and adopted the decision konsilij the doctor, except in the case of first or be provided emergency medical help.
(9) the surgical or other invasive interventions during the treating physician without the consent of the patient has the right to carry out a previously unscheduled treatment if the patient provided emergency medical assistance, or if the treatment does not occur because of the much bigger damage his health. 8. article. The right to choose the doctor and hospital patients have the right to choose the doctor and hospital. 9. article. Entitled to consult medical documents (1) the patient shall have the right to consult their medical documents. He has the right to request and receive extracts, transcripts and copies of relevant medical institution approved price list, with the exception of natural persons, the data protection act. Extracts, transcripts and copies the patient receives three working days from the date of submission of the application.
(2) the patient's right to information about his medical record includes the use of information in accordance with this Act and the individual in the data protection act.
(3) a patient may require the treating doctor made additions or edits medical record if he reasonably believes that the information is inaccurate or incorrect. Making corrections in the documents, medical treatment of the person shall ensure the conservation of the information incorrect, respectively, specifying or supplementing it and inform the treating doctor.
(4) If the patient's medical record is information about another person's sensitive data or information supplied by a third party, but asked them not to disclose to a patient, the patient's right to consult medical documents provided so far as this does not prejudice the right of a third party. 10. article. Patient data protection (1) the information relating to an identified or identifiable patient, is protected in accordance with the individual data protection laws regulating.
(2) information for the patient may be made only with his written consent or in cases provided for in this Act.
(3) the first paragraph of this article, information cannot be disclosed after the patient's death.
(4) information for the patient after his death to disclose this law article 7 referred to persons, if: 1) the provision of information can affect their life or health or to facilitate health services;
2) the information is relevant to a patient's cause of death or medical treatment before his death.
(5) upon written request and the head of the hospital's written authorization of the patient information not later than 10 working days after receipt of the request the following persons and institutions: 1) medical institutions — medical objectives;
2) data state inspection, in order to check the processing of personal data in compliance with the requirements of the law;
3) national labour inspectorate — accidents at work and occupational diseases investigation and accounting;
4 health inspection —) health care and integrity inspection quality control;
5) health and capacity of the National Commission of physician expertise — disability expertise;
6 the Court, the public prosecutor's Office) to the police, the national child protection officers, family courts, the national probation service, the Ombudsman, as well as the pre-trial investigation authority, statutory functions;
7) health economic centre-public health and health care for the generation of statistical information and analysis;
8) settlement center of health, health services administration;
9) national armed forces reserve accounting departments — reserve soldiers and reservists health situation;
10) Association of the Latvian Office of the vehicle "to insurance companies that perform vehicle insurance against civil liability in respect of a road traffic accident caused by the injured party for damages.
(6) the minor patient's legal representative is entitled to information on the patient's State of health, except for article 13 of this law. Minor patient's legal representative shall not provide information if the disclosure of such information might harm the interests of the patient. The doctor records the decisions made in the patient's medical record and inform the family courts.
(7) medical record fixed patient data can be used in the study, one of the following conditions: 1) after the information can not be analysed directly or indirectly identify the patient;
2) patient agreed in writing that the information about him is used in a particular study.
(8) medical record fixed patient data can be used in the study, not subject to the conditions mentioned in the seventh paragraph, if the following conditions occur simultaneously: 1) research is carried out in the public interest;
2) competent administrative authority of the cabinet order has authorized use of patient data in the study;
3 the patient in advance and in writing) not restricted the transfer of his data the researcher;
4) with proportionate means it is not possible to obtain a patient's consent;
5) public health benefits of the study right is commensurate with the rights to privacy restrictions.
(9) of this article, the seventh and the eighth part of the information referred to in the medical establishment needs the study provides, making of it a check medical record. 11. article. Patient participation in clinical trials (1) patient involved in the clinical trial, approved pursuant to the procedure set out in laws and regulations for the clinical studies if they have received a written consent and informed clinical research performed at the following conditions: 1) the foreseeable risks been assessed in relation to the patient, as well as the forecast of another existing or next patient benefits;
2) there is no alternative to that of comparable effect can be obtained by other means;
3) healing benefits, as well as the benefits of public health justifies the risks that could threaten the patient.

(2) if the patient is unable to express his will, the right to accept his involvement in clinical research is the patient's spouse or closest relatives that their agreement confirmed in writing this law article 7, first paragraph, the procedure laid down in the first subparagraph of paragraph 2 and to the following conditions: 1) clinical trial results can make a real and direct benefit to the patient's health;
2) is not possible with patients who are able to express your will, to conduct a study that would give comparable effects;
3) a patient has expressed opposition to his involvement in clinical research.
(3) if the patient is in the custody or under the auspices, of the written consent of his involvement in the clinical trial, while the first paragraph of this article, paragraph 2 and the second subparagraph of point 1 and 2 of the said conditions, gives the patient's legal representative, subject to his will. The consent of the minor patient participation in clinical studies in the collectable article 13 of this law in the order listed.
(4) before entering the clinical trial patient provides information about the clinical trials, its purpose, methods, duration, expected benefits, risks, and clinical conditions of the study, as well as on the right at any time to refuse from participation in the clinical trial and for other rights.
(5) if the patient is unable to express his will, then, in the fourth paragraph of this article, this information shall be provided to the person who has given consent to patient participation in clinical research.
(6) the patient or, if he is unable to express his will, the person who has given consent to the patient's involvement in the study, patients have the right to opt out of participation in a clinical trial, as well as any time to stop participating in it. Refusal to participate or participation in cessation should not adversely affect the medical treatment person's subsequent treatment of the patient.
(7) the clinical trials information for patients allowed to use if the patient or, if he is unable to express his will, from the person who has the consent of the patient's involvement in the study, received the appropriate consent and patient anonymity are guaranteed. 12. article. Patient participation in clinical training (1) If the medical establishment or the medical person who provides patient treatment, involved in the process of clinical training, patient inform.
(2) the patient or, if he is unable to express his will, the person who has given consent to the treatment, the patient has the right to refuse to participate in the process of clinical training, as well as any time to stop participating in it. Refusal to participate or participation in cessation should not adversely affect the medical treatment person's subsequent treatment of the patient.
(3) training in the clinical process information about patients allowed to use if the patient or, if he is unable to express his will, from the person who has the consent of the patient's involvement in training, received the consent and are guaranteed the protection of patient data or his anonymity. 13. article. Minor patient rights (1) the minor patient (up to 14 years of age) the acceptable treatment, if his legal representative is informed about it and gave his consent. Minor patient has the right to be heard and according to their age and maturity to participate in the treatment-related decision making.
(2) a minor patient (from 14 years of age) is allowed if the treatment received his consent, with the exception of this law article 7 of the eighth.
(3) if the minor patient (from 14 years of age) refuses to give his consent to the treatment, but doctors believe that treatment is the patient's best interest, the consent to the treatment given to the minor patient's legal representative.
(4) a minor patient has the right to obtain from the treatment of a person for his age and maturity to understand information. 14. article. The jurisdiction of the family courts (1) If a minor patient's legal representative refuses to give his consent to the commencement of treatment or legal representatives could not agree on the initiation of treatment, or the doctor is not aware of the minor's legal representatives of patient location, but he considered that medical treatment is the patient's best interest, permission for treatment, based on the physician's submission, motivated within three working days after submission of this doctor, motivated, you can give the family courts except this article in cases referred to in the second subparagraph.
(2) if the doctor considers that the interests of the minor patient's need to start treatment immediately, but the patient's legal representative refuses to give his consent or statutory representatives could not agree on the initiation of treatment, or the doctor is not aware of the minor's legal representatives of patient location, the decision on the initiation of the treatment takes the doctor konsilij. Doctor konsilij in three working days of the decision taken shall inform the family courts after the jurisdiction laid down in this article.
(3) the permission of a minor patient treatment gives the municipal family courts, where the area declared the patient both parents or guardian.
(4) If a minor patient's parents ' place of residence declared various municipal administrative territory, his treatment of the family courts, which give the area declared place of residence to which the older the patient lives.
(5) If the minor's parents or legal guardian of the patient is not declared, the permission of residence in his treatment of the municipal family courts, given that in this area the patient's parent or guardian actually living.
(6) If the minor patient founded a separate custody of one parent, she gives permission for treatment, which fosters activities in the area of residence of the parents declared that the individual under the aegis of this patient is in.
(7) If a minor's parents are not known to the patient or the patient is a foundling, his treatment of the family courts, which give the area the patient is found. 15. article. Patient responsibilities (1) the patient is obliged to take care of your health.
(2) where a patient's State of health allows it, he must actively engage in treatment and their capabilities and the limits of knowledge give the treating physician: 1) required medical treatment;
2) about their diseases, which can endanger other people's lives or health;
3 the following consents in advance) and denials for treatment;
4) on treatment during the last health changes.
(3) the patient is bound by the hospital's internal rules and the treatment of personal guidance.
(4) a Person registering for the medical institution or receiving medical treatment, after treatment at the request of the person presented identity documents, except when the patient gave emergency medical assistance and of their State of health, he is not able to produce such a document. Patient identity documents presented as soon as possible.
(5) the patient is obliged to pay for the health care services in the order laid down in the law on health care organization and financing.
(6) in exercising their rights, the patient and the person representing the patient is obliged to respect the rights of other patients.
(7) in the fourth subparagraph of this article shall not apply to arrested or convicted for the patient. The Cabinet of Ministers shall determine any prison shall inform the treatment outside the prisons, arrested or convicted for the patient, who was placed in the medical institution, as well as on the treatment in prison. 16. article. The right to compensation (1) the patient's right to reimbursement for his life or health, as well as damages for moral injury, which by its actions or inaction contributed to the institution of the medical treatment person's treatment.
(2) of the medical risk to the patient of the Fund are entitled to reimbursement for: 1) his life or damage — the extent of damage, but not exceeding 100 000 lats;
2) he suffered moral injury, the extent of damage, but not more than 5000 lats.
(3) the cabinet shall determine any charge from the risk fund of treatment for the patient's life or health, as well as damages for moral injury and procedures assessed patient harm, shall decide on the remuneration and the costs of remuneration of medical cost risk fund.
(4) the patient shall have the right to receive remuneration from the risk fund treatment for his life or health, as well as damages for moral injury, regardless of whether the medical establishment has taken the risk of treatment in the payment of contributions.
(5) the patient about his life or damage, as well as moral damage compensation of medical risk fund request not later than two years from the date of discovery of the damage, but not later than within a period of three years from the date of the breach. Article 17. Medical risk fund

(1) the medical risk fund creates the risk of treatment charges and recourse in order to recover the funds. Medical risk fund, storage and administration procedures established by the Cabinet of Ministers.
(2) the medical risks of the Fund holder and organizer is a health centre in the settlement. Health Center settlement decision and the actual action on this law, as provided for in article 16 of the therapeutic risk remuneration to be paid to the Fund's patient may be challenged in the Ministry of health. The Ministry of health decision may appeal to the Court of Justice of the administrative procedure law.
(3) the payment risk of treatment each year conduct treatment services. The risk of treatment and payment arrangements for payment shall be determined by the Cabinet of Ministers. Medical risk fund revenue and expenditure shall be included in the annual State budget in the General individual subprogrammes.
(4) the medical risk fund be used only to satisfy the claims of the patient about his life or damage, as well as moral damages. The balance of this Fund shall be used for the payment of compensation to patients in subsequent financial years.
(5) If the medical establishment has not taken the risk of treatment in the payment of contributions, the health center has a right of settlement from the hospital's recovery all the consideration paid to the patient. 18. article. Rights and statutory interests of advocacy (1) in this Act the rights or interests arising from them for defending a person can use all provided by law enforcement mechanisms, including in the law courts.
(2) if the right or interest advocacy takes place within the framework of the administrative procedure, the relevant administrative provisions and actual action, where this Act provides otherwise, may challenge the health inspection. Health inspection decision may appeal to the Court.
(3) in this Act or resulting from them with therapeutic approaches for the protection of the interests of the legal person specified in the order no later than two years from the date of the infringement or interest is entitled to submit a complaint to the health inspection of the statutory and the required activities. The answer to the complaint regarding the application within the time limit prescribed by law or, in the case of administrative procedure initiated, together with the adoption of the decision in the process. The person who made the complaint will be informed of the initiation of the administrative procedure. The transitional provision of article 16 of this law, the second, third, fourth, fifth, and article 17 shall enter into force on January 1, 2012. Article 16 of this law the remuneration provided for in the second subparagraph shall be paid from July 1, 2012, for the damage suffered by the patient after January 1, 2012. Informative reference to European Union directives, the law includes provisions deriving from Council of 29 June 2000, Directive 2000/43/EC implementing the principle of equal treatment between persons irrespective of racial or ethnic origin. The law shall enter into force on March 1, 2010.
The Parliament adopted the law of 17 December. President Valdis Zatlers in Riga V 2009 December 30