What are patient rights?

Before answering the question of what patient rights are, we find it useful to answer the questions of who is the patient and what should be understood from health care.

WHO IS THE PATIENT?

People who need to benefit from health services because they are not in a complete state of physical, mental and social well-being, and people who request health services for reasons such as aesthetic purposes, circumcision, or abortion even though there is no medical indication, can be defined as "patients". In the Patient Rights Regulation, a broad definition is made as "A person who needs to benefit from health services".

The concept of health services should be understood not only as health services for treatment purposes, but also as protective, preventive and rehabilitative health services.

CONCEPT OF PATIENT RIGHTS

The concept of patient rights consists of reflecting the universal, inalienable, unchangeable human rights that are believed to be inherent in people to the field of health. When human rights are categorized into 3 generations, the right to health is one of the 2nd Generation human rights, that is, social rights.

In the Patient Rights Regulation, the concept of Patient Rights; It is defined as "The rights of individuals who need to benefit from health services, just because they are human, and which are guaranteed by the Constitution of the Republic of Turkey, international agreements, laws and other legislation."

ENSURING PATIENTS' RIGHTS

We have stated that patient rights are in the social rights category among fundamental human rights. Social rights are services provided within the scope of a duty undertaken by states to ensure that their citizens benefit from their human rights. In accordance with the Social State Principle developed in the 19th century, it is the duty of the state to improve the welfare levels of societies and to prepare a legal basis for this.

In this context, TC. In Article 56 of the Constitution;

"Everyone has the right to live in a healthy and balanced environment.

It is the duty of the State and citizens to improve the environment, protect environmental health and prevent environmental pollution.

The State is to ensure that everyone lives their lives in physical and mental health; It organizes health institutions to plan and provide services from a single source in order to achieve cooperation by increasing savings and efficiency in human and material resources.

The state fulfills this duty by benefiting from and inspecting health and social institutions in the public and private sectors. General health insurance can be established by law in order to provide widespread health services."

In Article 4 of the Directive on the Execution of Health Services;

"Socialization of health services:

Based on the understanding that health services are a state duty, it is a form of organization and service that aims to improve the health level of the society by extending health services to the farthest places where citizens live, ensuring that everyone benefits from these services equitably, providing preventive and curative health services together, and ensuring the public's participation in health services."

It has been emphasized that providing health services is a duty of the state in our country, which is a social state of law.

HEALTH RIGHTS IN OUR COUNTRY

With the Patient Rights Regulation dated 1998 prepared by the Ministry of Health, health rights, which are accepted worldwide and rapidly developing through international declarations and agreements, have taken their place as the first legal regulation in our country's domestic legislation.

Article 1 of the Regulation states "This Regulation; It has been prepared with the aim of showing concretely the "patient rights", which are the reflection of fundamental human rights in the field of health services and accepted in the Constitution of the Republic of Turkey, other legislation and international legal texts, and to regulate the procedures and principles on how everyone can benefit from "patient rights" in a manner befitting human dignity, be protected from rights violations and, when necessary, actually use legal protection methods in all institutions and organizations where health services are provided and in cases where health services are provided outside health institutions and organizations.

WHAT ARE HEALTH RIGHTS?

The rights of patients who want to benefit from health services for various reasons are regulated in the Patient Rights Regulation. If everyone acts more consciously, knowing their legal rights, it will help increase the awareness of being able to seek their rights. Raising the awareness of patients and physicians about their health rights will lead to the patient-physician relationship becoming a more ideal relationship than the authoritarian physician or consultant physician approach and the "participatory" approach that is accepted today.

If we examine the patient rights regulated in our legislation under the headings;

RIGHT TO BENEFIT FROM HEALTH SERVICES

Article 6 of the Patient Rights Regulation regulates the right of patients to benefit from health services tailored to their needs within the framework of the principles of justice and equity. The right of patients to benefit from healthcare services also means the obligation of healthcare institutions and healthcare professionals to provide healthcare services in accordance with the principles of justice and equity.

RIGHT TO REQUEST INFORMATION

Article 7 of the Patient Rights Regulation regulates the right of patients to request information about the health services and facilities provided in health institutions and organizations and under what conditions they can benefit from these services. The right of patients to request information about health services refers to the obligation of health institutions and organizations to ensure that patients can easily exercise these rights and access the information they want (through the units they will establish and the personnel they will employ).

RIGHT TO CHOOSE AND CHANGE HEALTH CARE INSTITUTION

Article 8 of the Patient Rights Regulation regulates the patient's right to benefit from health services from the health institution of his choice, provided that he complies with the conditions stipulated by the law, and the right to change his current health institution by taking advantage of the referral system, subject to the conditions stipulated by the law.

While benefiting from health services, the patient may request to be transferred to another hospital. If this request is rejected by the healthcare institution or organization, the patient has the right to request the cancellation of the rejection of the referral request by filing a lawsuit in the administrative court.

As a matter of fact, in a decision of the Council of State dated 28.12.2005 regarding this issue;

"From the examination of the case file, the plaintiff, who works as a laboratory technician at the Ministry of Health... Training and Research Hospital, decided to refer her daughter to Ankara University Ibn-i Sina Hospital Headache Center as a result of the complaints continuing as a result of the treatment at the Ankara Hospital Neurology Clinic, which she enthusiastically went to, after there was no decrease in the pain of her daughter, who was treated for sinusitis in the said hospital due to her headache complaint" dated 27.5.2002. Upon the rejection of the application with the transaction dated 3.6.2002 and numbered 4817, stating that "the referral chain specified in the Circular No. 2002/24 of the General Directorate of Treatment Services of the Ministry of Health must be followed", it has been understood that the ongoing lawsuit has been opened with the request for the cancellation of the said transaction.

Since it is undisputed that the action in question has a "definitive and mandatory to be actionable" nature, regarding the plaintiff's daughter not being referred to Ankara University Ibn Sina Hospital, a decision should be made by entering into the merits of the dispute by carrying out notification procedures in accordance with Article 16 of Law No. 2577, but the decision of the Administrative Court to the contrary was not found to be legal."He ruled as follows.

RIGHT TO RECOGNIZE, SELECT AND CHANGE PERSONNEL

Article 9 of the Patient Rights Regulation regulates the patient's right to obtain information about the identity and titles of the physician or healthcare personnel who will provide healthcare services to him/her upon request, the patient's right to freely choose the personnel who will provide healthcare services to him/her, provided that it complies with the law, the right to change the physician involved in his treatment and to request the consultation of other physicians.

RIGHT TO REQUEST DETERMINATION OF PRIORITY ORDER

Article 10 of the Patient Rights Regulation regulates the patient's right to request that his/her priority right be determined objectively and based on medical criteria, in case the patient's health service request cannot be met on time due to insufficient or limited facilities of health institutions and organizations.

RIGHT TO DIAGNOSIS, TREATMENT AND CARE IN ACCORDANCE WITH MEDICAL REQUIREMENTS

Article 11 of the Patient Rights Regulation regulates the right of patients to request diagnosis and treatment in accordance with the requirements of modern medical knowledge and technology while benefiting from health services. Health institutions and organizations and all health personnel are obliged to provide the patient with a health service in accordance with the requirements of modern medicine and technology.

Article 12 - Nothing can be done or requested that may lead to death or life-threatening, violate body integrity, or reduce mental or physical strength without the purpose of diagnosis, treatment or protection.

RIGHT TO REVIEW RECORDS AND REQUEST CORRECTION OF RECORDS

Articles 16 and 17 of the Patient Rights Regulation regulate the right of the patient to examine and obtain a copy of the health file containing health records related to his/her own health status, directly or through his/her representative, and to request that incomplete, unclear and erroneous medical and personal information in the file records be completed, explained, corrected and adapted to his/her final health status and personal situation.

RIGHT TO REQUEST PROTECTION OF PRIVACY

Article 21 of the Patient Rights Regulation regulates that it is essential to respect patient privacy and the patient's right to openly request that privacy be protected. The patient has the right to demand that the information regarding his health condition be carried out confidentially, that the examination, diagnosis and treatment be carried out in an environment that will protect privacy, that a relative be present in case there is no medical problem, that he not be around people who are not directly related to his treatment, that the source of his health expenses be kept secret, and that the patient's personal and family life not be interfered with unless the nature of the disease requires it. The death of the patient does not eliminate the right to privacy.

RIGHT TO KEEP INFORMATION CONFIDENTIAL

Article 23 of the Patient Rights Regulation regulates the obligation that the personal information provided by the patient for benefiting from health services should not be kept confidential, except in cases permitted by law.

Even if it is based on the person's consent, disclosing information in cases that result in a complete waiver of personal rights, transfer of these rights to others, or excessive limitation does not remove the legal liability of the person disclosing them.

PATIENT'S CONSENT AND RIGHT TO LEAVE

Patient consent is required for medical interventions. Within the scope of Article 24 of the Patient Rights Regulation; Except for legal exceptions, it is regulated that no medical intervention should be performed without or without the patient's consent. Issues such as obtaining the patient's consent and written consent before medical intervention and the legal and criminal responsibilities that physicians may face in cases where it is not obtained are issues that need to be addressed on their own. In practice, since the subject of the majority of cases arising from medical malpractice is the failure to obtain or improperly obtain the patient's consent, this issue is explained in detail in our article titled Informed Consent.

RIGHT TO REFUSE OR STOP TREATMENT

Article 25 of the Patient Rights Regulation regulates the patient's right to refuse or request that the treatment planned or being applied to him/her be stopped.

RIGHT TO ENSURE SECURITY

Article 37 of the Patient Rights Regulation regulates the right of patients to be in safety in healthcare institutions and organizations and to request this. Health institutions and organizations are obliged to take security measures for the life and property safety of patients, visitors and companions.

In cases where healthcare institutions and organizations are not competent and qualified to protect the life and property safety of patients, companions and visitors, the patient's right to demand compensation may come to the fore.

In the decision of the Supreme Court of Appeals General Assembly on the subject dated 21.10.2009;

"… It is understood that Beytaş, the plaintiff's deceased, was brought to the defendant hospital by the plaintiffs on 25.05.2004, and in the psychiatric examination before he was admitted to the hospital, the deceased said that he was going to kill himself, the deceased's wife also stated that the patient tried to jump out of the window while he was at home, it was written that he was being treated for alcohol use, and the doctor who admitted him pointed out that the patient should be kept under close observation because he was having suicidal thoughts, and a form was prepared accordingly. He was kept in a single room at the defendant hospital throughout the night. It is understood that on 26.05.2004, after eating a group meal with other patients, the patient committed suicide by entering an empty room next to his room and using the TV antenna cable behind the wardrobe.

In terms of the concrete incident, it is understood that a specialist hospital personnel was not appointed to constantly accompany the patient, who should have been kept under close observation, to prevent his suicide, thus the defendant hospital did not properly fulfill the care service (debt-performance) considered within the scope of medical service. Such non-compliance with the debt appears as an "organizational defect" that is considered within the scope of the care service of the defendant hospital. It is mandatory to accept the existence of a proper causal link between the defendant hospital operator's non-compliance with the debt, which appears as an organizational defect, and the death that occurred as a result of the patient's suicide.

As stated in the legal legislation provisions quoted above, rooms appropriate to the patient's condition are allocated to the patient who will harm himself, and it is also stipulated that the rooms must be of a quality that will prevent the patient from being harmed. In this context, the presence of electrical switches and sockets in the rooms is prohibited. The defendant hospital operator also violated the mandatory legal rules binding him by not preventing the patient from seizing the television antenna cable, which should not have been at the scene. In addition, it is understood that he did not fulfill his duty to ensure the life safety of the patient, as stipulated in Article 37 of the Patient Rights Regulation, by not taking the necessary precautions in this regard. Thus, the defendant hospital operator, who not only failed to prevent the plaintiffs' deceased from committing suicide by not taking sufficient and qualified measures to prevent the patient's suicide, but also acted contrary to the mandatory legal rules in this regard, is free from any hesitation and is liable to compensate the plaintiffs for compensation."The verdict was established as follows.

THE RIGHT TO FULFILL RELIGIOUS OBLIGATIONS AND BENEFIT FROM RELIGIOUS SERVICES

Article 38 of the Patient Rights Regulation regulates the provision of opportunities for religious patients to fulfill their obligations within the limits of the possibilities of healthcare institutions and organizations.

RESPECT FOR HUMAN VALUES AND THE RIGHT TO VISIT

Article 39 of the Patient Rights Regulation regulates the patient's right to benefit from health services in a manner and environment appropriate to his/her personality values. All personnel working in health services; He/she must treat patients, their relatives and visitors in a friendly, courteous, compassionate manner and in accordance with the legislation regarding health services and the provisions of this Regulation. At every stage of health services, patients are given necessary and sufficient information about which procedure is done, why and how it is done, and if they are to be kept waiting, the reasons for the waiting, taking into account their physical and mental conditions. In health institutions and organizations, it is essential to provide all kinds of hygienic conditions worthy of human dignity and to eliminate noise and all other disturbing factors. When necessary, these issues can be requested by the patient. The admission of patient visitors is carried out in accordance with the procedures and principles determined by the institution or organization and in a way that does not cause any actions or attitudes that will disturb the peace and tranquility of the patients, and the necessary precautions are taken in this regard.

RIGHT TO HAVE A COMPANION

Patient Rights Regulation Article 40To assist the patient during examination and treatment; To the extent permitted by the legislation and the institution's facilities and required by the patient's health condition, a companion may be requested, subject to the approval of the physician responsible for the treatment. How and when to exercise this right and the measures to be taken in this regard are also regulated in the legislation showing the working procedures and principles of the health institution and organization.

RIGHT TO APPLY,COMPLAIN AND SUIT

Article 42 of the Patient Rights Regulation regulates the right of the patient and those related to the patient to make all kinds of applications, complaints and lawsuits within the framework of the legislation in case of violation of patient rights.

PATIENT RIGHTS BOARD AND RIGHT TO COMPLAIN

With the Patient Rights Directive published by the Ministry of Health in 2005;

It is aimed to ensure equal, high-quality and effective provision of health services by determining the principles and procedures regarding the planning, evaluation, implementation and supervision of patient rights practices in health institutions and organizations within the scope of the directive, so that everyone can benefit from "Patient Rights" in a manner befitting human dignity, be protected from rights violations and actually use legal protection methods when necessary.

Within the scope of this directive, "patient communication units" are established within healthcare institutions and organizations. Communication units have the duty of resolving problems related to patient rights. However, it is not possible to appeal to the patient rights board regarding malpractice claims. If no solution is provided through this unit, an application is made to the "Patient Rights Board" established within the province within the scope of the directive. This board decides on the applications within 30 days at the latest. Rights violation decisions made by the Board are notified to the relevant health institutions and organizations and relevant personnel.

VIOLATION OF PATIENT RIGHTS

HHY Article 43- In case of violation of patient rights, a lawsuit may be filed against the institution and organization employing the personnel for material or moral or both material and non-pecuniary damages. However, if the authority against which a lawsuit will be filed is a public institution or organization;

a) According to Article 12 of the Administrative Procedure Law No. 2577; In case the right is violated due to an administrative action, the relevant parties may directly file a full jurisdiction lawsuit or annulment and full jurisdiction lawsuits together, or they may first file an annulment lawsuit and file a full jurisdiction lawsuit within the filing period upon the decision of this case.

b) In accordance with Article 13 of the same Law, an application must be made to the administration, showing separately the amount of compensation requested as pecuniary and non-pecuniary damages, within one year from the date of learning of the damaging act, and if the request is rejected explicitly or implicitly, a lawsuit must be filed in the administrative judicial authorities within the legal period.

•When you encounter any violation of patient rights while benefiting from health services, it is recommended that you request information about your legal rights from a health law lawyer who specializes in patient rights.