Rights of patient

RIGHTS AND RESPONSIBILITIES OF PATIENT

Code of the Republic of Kazakhstan dated 18 September 2009 No. 193-IV
“On Public Health and Health Care System”
(Wording with amendments as of 19.05.2015)


Article 88. Rights of citizens

1. Citizens of the Republic of Kazakhstan shall have the right to

1) the guaranteed amount of free medical care in accordance with the list, approved by the Government of the Republic of Kazakhstan;

2) provision of drugs and medical devices within the framework of the guaranteed amount of free medical care, including provision of the certain categories of people with certain diseases (statuses) with free or the reduced-price drugs and specialized medical products on an outpatient basis in accordance with the list, approved by the authorized body;

3) free choice of a medical organization, qualitative and timely medical assistance;

4) additional medical services in addition to the guaranteed amount of free medical care at the expense of own funds, the organizations’ funds, the system of voluntary insurance and other not-prohibited sources;

5) receive medical care abroad at the expense of budget funds, when clinically indicated, in the order defined by the authorized body;

6) compensation for the harm caused to the health by wrong assignment and use of drugs, medical devices and medical equipment by medical staff

7) certification of temporary disability with the issuance of a temporary disability leave or a temporary disability certificate;

8) receive free of charge reliable information on prevention, diagnosis, treatment and rehabilitation methods, clinical studies, factors affecting health, including the environment, working conditions, living and recreation, healthy food and food safety, including conclusions of healthcare-epidemiological expertise from the state bodies, organizations and attending physician within their competence;

9) receive information on safety, efficacy and quality of sold drugs, medical devices and medical equipment from the state bodies, independent expert organizations and subjects, involved in circulation of drugs, medical devices and medical equipment;

10) appeal actions (or inaction) of medical and pharmaceutical personnel in healthcare organization, higher authority and (or) in a judicial procedure;

11) an application for attracting independent experts in case of disagreement with the findings of the state medical expertise;

12) free expression of will about possibility of recuperation of his or her tissues (part of tissue) and (or) organs (parts of organs) after the death for transplantation purpose ;

2. A woman has the right to resolve an issue on motherhood and the free choice of modern methods of unwanted pregnancy prevention for family planning and protection of her health.

The right of citizens to protection of maternity shall be provided by:

1) conduct of medical examinations within the framework of the guaranteed amount of free medical care, dynamic observation and health improvement of women of reproductive age;

2) medical treatment for health purposes of major diseases, directly affecting women's reproductive health and child’s health, when being hospitalized for care for a sick child.

Working hours, maternity leave and working conditions of pregnant women and nursing mothers shall be established in accordance with the labor legislation of the Republic of Kazakhstan.

3. People with gender identity disorders, except for those with mental disorders (diseases) shall have the right to change their sex.

The rules of medical examination and sex change operations for persons with gender identity disorders shall be established by the authorized body.

4. The citizens, whose freedom is limited, and those, serving a sentence in prison, placed in special institutions, shall receive the medical care in accordance with the procedure established by correctional system’s bodies with the approval of the authorized body.

These persons shall enjoy all the above rights of the citizens of the Republic of Kazakhstan when receiving medical care.

5. Foreigners and stateless persons residing in the territory of the Republic of Kazakhstan shall have the right to receive the guaranteed amount of free medical care in acute diseases posing threat to others, in compliance with the list established by the authorized body unless otherwise stipulated by the international treaties ratified by the Republic of Kazakhstan.

5-1. Refugees and asylum seekers shall be provided with prevention, diagnostic and medical treatment services having maximum proven efficiency, in accordance with the procedure and to the extent established by the authorized body.


Article 90. Responsibilities of citizens, individual entrepreneurs and legal entities

1. Citizens shall be obliged to:

1) preserve their health;

2) observe the regime existing in healthcare organizations;

3) undergo preventive medical examinations in accordance with the legislation of the Republic of Kazakhstan in the area of healthcare;

4) observe instructions of medical workers, bodies and healthcare organizations related to the individual and public health;

5) observe precautions to protect their own health and the health of others, to pass examination and treatment on demand of healthcare organizations, to inform medical staff about his or her disease in case of infectious diseases and the diseases posing threat to others.

In case of evasion from medical examination and treatment, the citizens with diseases posing threat to others shall be subject to enforced examination and treatment in accordance with this Code and other laws of the Republic of Kazakhstan.

The grounds and procedure for sending the citizens with diseases posing threat to others, to enforced treatment shall be regulated by this Code;

6) observe the legislation of the Republic of Kazakhstan in the area of healthcare.

2. Pregnant women up to twelve weeks of pregnancy must get registered in healthcare organization.

3. Foreigners and stateless persons residing in the territory of the Republic of Kazakhstan shall have the same duties in the area of healthcare as the citizens of the Republic of Kazakhstan.

4. In accordance with their activities, the individual entrepreneurs and legal entities shall:

1) take sanitary and anti-epidemic measures and sanitary preventive arrangements;

2) comply with requirements of regulations in the area of healthcare and epidemiological welfare of people and hygienic standards, as well as reports and healthcare-epidemiological conclusions of officials exercising the state healthcare and epidemiological control and supervision;

3) ensure safety and quality of performed works, rendered services and products in its production, transportation, storage and sale to people;

4) conduct the production control in accordance with the legislation of the Republic of Kazakhstan;

5) promptly inform the state healthcare and epidemiological services on emergencies, suspension of productions, violations of technological processes, that pose a threat to the healthcare and epidemiological welfare of people, in cases of mass and group infectious and parasitic, occupational diseases and poisoning;

6) promptly inform the authorized body on any side-effects of drugs and medical devices in case of detection thereof;

7) ensure sanitary training of employees working in the service sector, which poses a threat of infecting others with the infectious and parasitic diseases;  

8) allow officials of state healthcare and epidemiological services to conduct sampling of products, raw materials, goods, work environment for laboratory testing in accordance with their competence;

9) bar from working any persons without certificate of passing medical examination, sanitary training and to suspend from work those with infectious and parasitic diseases and carriers of agents of infectious and parasitic diseases detected by public health organizations;

10) bar from selling goods, products, raw materials if they are found non-compliant with the requirements of regulations in the area of healthcare and epidemiological welfare of people and sanitary standards, and to make a decision on their use or disposal;

11) paragraph is excluded (see footnote).

12) submit records and reporting documentation on healthcare and epidemiological welfare of people to the state healthcare and epidemiological services for review;

13) suspend business and (or) any other activity in case if they pose threat to life or health of people;

14) ensure unhindered access of officials exercising the state healthcare and epidemiological supervision to the objects in order to verify their compliance with the regulations in the area of healthcare and epidemiological welfare of people and sanitary standards;

15) conduct at their own expense disinfection, disinfestation and deratization activities upon epidemiological indications and instructions, and decrees of officials of healthcare and epidemiological services;

16) submit complete and reliable information about medicaments sold by them.


Article 91. Rights of patients

1. In addition to the rights specified in Article 88 of this Code, a patient shall have the rights to:

1) a decent treatment during diagnostics, medical treatment and care, respect for his cultural and personal values;

2) a medical care in order of priority determined solely on the basis of medical criteria, without the influence of any discriminatory factors;

3) a choice, replacement of a physician or a medical organization, including a foreign physician carrying out the activity in healthcare organizations of the Republic of Kazakhstan that provide medical care within the framework of the guaranteed amount of free medical care;

3-1) notification of that fact that audio and (or) video monitoring and recording is conducted in a medical organization;

4) support of his family, relatives and friends, and attendants of religious communities;

5) relief of suffering to the extent to which it is made possible by the existing level of medical technologies;

6) receive an independent opinion on his health status and holding a consilium;

7) other rights provided by the laws of the Republic of Kazakhstan.

2. A patient shall have the right to be informed of his rights and responsibilities, provided services, the cost of paid services, as well as the procedure of their provision. Information on the patient's rights must be placed on visual propaganda billboards in medical organizations.

When being hospitalized, a patient shall be provided with information about the names and professional status of those who shall provide him with medical services, and the internal rules of the medical organization.

3. Medical assistance shall be provided after the oral or written informed voluntary consent of a patient. The written voluntary consent of the patient in case of invasive interventions shall be executed in the form approved by the authorized body.

4. When receiving medical care a patient shall have the right to be fully informed about his health status, including information about eventual risks and benefits of the proposed and alternative treatments, information about the possible consequences of refusal of treatment, information on diagnosis, prognosis and plan of remedial measures in the form accessible for the patient, and the explanation of any reasons of his discharge from the hospital or transfer to another medical institution.

5. A patient may appoint a person to whom the information on his health status should be provided. The patient's refusal of acquisition of information shall be executed in a written form and included in the medical record.

6. Information may be withheld from the patient in the cases only where strong evidence suggests that the provision of medical information would not just provide any benefit but cause serious harm to the patient. In this case, this information shall be reported to the spouse of the patient, his near relatives or legal representatives.

7. Patients receiving medical care in conditions of clinical sites of educational institutions in the area of healthcare shall have the right to refuse participation in the teaching process, and presence of third persons during diagnostic and treatment manipulations.

8. The patients’ rights shall be protected by healthcare bodies and organizations, and by non-governmental organizations within the limits of their competence.

9. When receiving medical care a patient shall have the right to be fully informed about prescribed drugs.

10. Citizens entering into marriage shall have the right to medical and medicogenetic examination.


Article 92. Responsibilities of patients

1. In addition to responsibilities specified in Article 90 of this Code, the patient shall be obliged to:

1) take measures to preserve and strengthen his health;

2) show respect and tact in interpersonal relations with medical workers;

3) provide doctor with all information required for diagnosis and treatment of disease; after giving consent for medical intervention to comply strictly with all instructions of attending physician;

4) observe the internal rules and take good care of the property of medical organization, to cooperate with the medical staff when receiving medical care;

5) promptly inform medical staff about any change in his health status during the diagnosis and treatment, and in case of any disease posing threat to others, or any assumption thereof;

6) not commit any acts violating the rights of other patients;

7) fulfill other responsibilities envisaged by the laws of the Republic of Kazakhstan;

8) comply with all instructions made when receiving medical care and drug treatment in outpatient facilities according to contract signed with healthcare organization.

2. Responsibilities of patients specified in subparagraphs 2) - 4) of paragraph 1 of this Article shall extend to parents or other persons, who immediately care for a sick child in an inpatient healthcare facility .


Article 93. Right to refuse medical assistance

1. A patient or his legal representative shall have the right to refuse medical assistance, except for the cases provided for in Article 94 of this Code.

2. In case of refusal of medical assistance the patient or his legal representative shall be informed about any eventual consequences in the form accessible for them.

3. Refusal of medical assistance stating any eventual consequences shall be recorded in medical documents and signed by the patient or his legal representative, and a medical worker.

In case of refusal to sign by the patient or his legal representative the refusal of medical assistance, the respective record about this shall be made in medical documents and signed by a medical worker.

4. In case when legal representatives of a minor child or an incompetent person refuse medical assistance required to save the life of those persons, the medical organization may apply to the guardianship and wardship authority and (or) to the court to protect their interests.


Article 94. Provision of medical assistance without the consent of citizens

1. Medical assistance without the consent of citizens shall be allowed with respect to persons:

1) being in a state of shock, coma which precludes them from expressing their will;

2) suffering from diseases posing threat to others;

3) suffering from severe mental disorders (diseases);

4) suffering from mental disorders (diseases) and having committed socially dangerous act.

2. The consent for medical assistance with respect to minors and citizens declared legally incompetent by court shall be given by their legal representatives. In the absence of legal representatives, a decision on medical assistance shall be taken by a concilium, and if it is impossible to put together the concilium immediately by a medical professional with the notification of officials of the medical organization and legal representatives.

3. Provision of medical assistance without the consent of the citizens shall continue until disappearance of grounds envisaged by paragraph 1 of this Article.


Article 95. Medical secrecy

1. Information about seeking medical assistance, the health status of a citizen, his diagnosis and other information, received during his examination and (or) treatment, shall be the medical secrecy.

2. Disclosure of information belonging to medical secrecy by persons , to whom it became known during training, fulfillment of professional, service and other responsibilities shall not be allowed, except for the cases defined by paragraphs 3 and 4 of this Article.

3. With the consent of the patient or his legal representative, the information belonging to medical secrecy may be transferred to other individuals and (or) legal entities for the benefit of examination and treatment of the patient, for conduct of scientific researches, use of that information in teaching process and for other purposes.

4. Presentation of information belonging to medical secrecy without the consent of the patient or his legal representative shall be allowed in the following cases:

1) for the purposes of examination and treatment of a citizen, who is unable to express his will because of his condition;

2) in the event of imminence of disease distribution, which poses threat to others, including in case of donation of blood and its components;

3) at the request of bodies of inquiry and preliminary investigation, public prosecutor, lawyer, and (or) court in connection with conduct of investigation or prosecution;
4) when providing medical assistance to a minor or an incompetent person to inform his legal representatives;

5) if there is an evidence that the injury caused to the citizen is a result of illegal acts.
5. Without the permission of natural persons (patients), no collection and processing of personal data touching upon their private life shall be allowed for the purpose of formation of electronic information resources containing personal data of natural persons (patients), except for cases related to the donation of blood and its components.

No connection of electronic information resources containing personal data of natural persons (patients) to any networks linking with other databases shall be allowed without the permission of natural persons (patients), in the process of use of their personal data touching upon their private life, except for cases related to the donation of blood and its components.