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Rights of patient

Code of the Republic of Kazakhstan
“On public health and healthcare system”

(with amendments and additions as of 24.06.2021)

Chapter 12. RIGHTS AND OBLIGATIONS OF INDIVIDUALS IN THE FIELD OF HEALTHCARE

Article 76. Guarantee of rights in the field of healthcare

1. The state guarantees to citizens of the Republic of Kazakhstan are as follows:

1) equal access to medical assistance;

2) good quality of medical assistance;

3) good quality of drug provision;

4) availability, efficacy and safety of medicines;

5) carrying out measures for the prevention of diseases, the formation of a healthy lifestyle and healthy nutrition;

6) freedom of reproductive choice, protection of reproductive health and observance of reproductive rights;

7) sanitary-epidemiological welfare.

2. The Republic of Kazakhstan guarantees the citizens of the Republic of Kazakhstan protection from any forms of discrimination and stigmatization due to the presence of any diseases and conditions.

 

Article 77. Rights of citizens of the Republic of Kazakhstan

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

1) guaranteed volume of free medical care;

2) medicines and medical products within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance;

3) free choice of a physician and a medical facility;

4) medical nutrition in the event of a patient’s treatment in a hospital;

5) additional medical assistance in excess of the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance at the expense of their own funds, funds of organizations, the system of voluntary medical insurance and other sources in accordance with the legislation of the Republic of Kazakhstan;

6) medical and other services on a paid basis;

7) medical assistance provided outside the Republic of Kazakhstan at the expense of budgetary funds, given indications, in the manner prescribed by the authorized body;

8) receipt and submission of relevant documents certifying the fact of temporary disability, in accordance with the legislation of the Republic of Kazakhstan;

9) free and regular receipt from state bodies, organizations and an attending physician, within their competence, of reliable information on methods of prevention, diagnosis, treatment of the disease and medical rehabilitation, clinical trials, factors affecting health, including the state of the environment, working conditions, life and recreation, healthy diet and food safety;

10) receive information from state bodies, independent expert organizations and entities in the field of distribution of medicines and medical products on the safety, efficacy and good quality of medicines and medical products sold;

11) the protection of information falling under medical confidentiality;

12) compensation for harm caused to health in the provision of medical assistance in accordance with the legislation of the Republic of Kazakhstan;

13) protect their rights and legitimate interests in the field of health protection in accordance with the legislation of the Republic of Kazakhstan;

14) appeal against actions (inaction) of healthcare professionals and pharmaceutical workers in the manner prescribed by the laws of the Republic of Kazakhstan;

15) petition higher authorities for involving independent experts in case of disagreement with the findings of state medical examination;

16) voluntary declaration of will about the opportunity to act as a donor;

17) declaration of will of consent or refusal to remove their tissues (parts of tissue) and (or) organs (parts of an organ) after death for the purpose of transplantation in the manner prescribed by this Code;

18) give informed consent or refusal for treatment and other medical interventions, including preventive vaccinations;

19) co-payment;

20) pain relief in the treatment of chronic incurable diseases;

21) get information in an intelligible form on the state of health, including information on the results of medical examination, diagnosis and prognosis of the disease, methods of providing medical care, associated risk, possible types of medical intervention, its consequences and the results of providing medical assistance;

22) get reliable and timely information on factors that contribute to the preservation of health or have a negative impact on them, including information on the prevention of diseases, sanitary-epidemiological welfare, the state of the environment, the potential danger to human health from the work performed and services provided, rational nutritional standards, quality and safety of products, goods and services;

23) other rights in accordance with the laws of the Republic of Kazakhstan.

2. Women have the right to decide on their motherhood and free choice of modern methods of preventing unwanted pregnancy for the purposes of family planning and protecting their health.

The right of citizens to maternity protection is exercised through:

1) medical examinations, dynamic observation and health improvement of women of reproductive age;

2) medical treatment of common diseases that directly affect the reproductive health of women and the health of the child when admitted to a hospital for the care of a sick child.

 

Article 79. Rights of citizens of the Republic of Kazakhstan and a family in the field of protection of reproductive rights

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

1) free reproductive choice;

2) receive services for reproductive health and family planning;

3) get reliable and complete information on the state of their reproductive health;

4) infertility treatment, also with the use of modern assisted reproductive methods and technologies, which are permitted in the Republic of Kazakhstan;

5) prevent unwanted pregnancy;

6) safe motherhood;

7) the donation of germ cells, tissue of reproductive organs;

8) the use and free choice of contraception methods;

9) surgical sterilization;

10) artificial abortion;

11) protect their reproductive rights;

12) free decision-making regarding the number of children and the time of their birth within and out of wedlock, the intervals between births necessary to maintain the health of the mother and child;

13) store germ cells, tissue of reproductive organs, embryos in accordance with the procedure established by the legislation of the Republic of Kazakhstan.

2. When exercising their reproductive rights, citizens are obliged to observe the rights, freedoms and legal interests of other persons.

3. Given medical indications, citizens have the right to consultations on family planning, the presence of socially significant diseases and diseases that pose a danger to others, on the medical and psychological aspects of family and marriage relations, as well as to medical genetic and other consultations and examinations in medical facilities in order to prevent possible hereditary and congenital diseases in descendants.

4. The child’s father or another family member is granted the right, given the woman’s consent and taking into account the state of her health, to be present at the birth of the child, except for cases of operative delivery, provided that obstetrics organizations (individual delivery rooms) have appropriate conditions and the father or another family member has no infectious diseases. This right is exercised free of charge.

5. HIV-infected citizens of the Republic of Kazakhstan have the right to adopt children on an equal basis with other citizens of the Republic of Kazakhstan in accordance with the legislation of the Republic of Kazakhstan.

6. HIV-infected citizens of the Republic of Kazakhstan have the right to use assisted reproductive methods and technologies in accordance with the legislation of the Republic of Kazakhstan.

 

Article 80. Obligations of citizens of the Republic of Kazakhstan

Citizens of the Republic of Kazakhstan are obliged to:

1) take care of their health, bear joint responsibility for the preservation and strengthening of individual and public health;

2) pay contributions for compulsory social health insurance in accordance with the Law of the Republic of Kazakhstan “On Compulsory Social Health Insurance”;

3) take preventive medical examinations, screening tests;

4) follow the prescriptions of healthcare professionals related to individual and public health;

5) take part in the process of managing their own health, including in programs for managing chronic diseases, if any, be interested in getting information on the disease and methods of its treatment, possible risks and complications;

6) inform healthcare professionals on individual characteristics of their body;

7) observe precautions to protect their own health and the health of others, take examination and treatment at the request of public health entities, inform medical personnel on the presence of infectious and other diseases that pose a danger to others;

8) comply with the legislation of the Republic of Kazakhstan in the field of healthcare.

In case of evasion of examination and treatment, citizens of the Republic of Kazakhstan, sick with diseases that pose a danger to others, except for HIV infection, are subject to forcible examination and treatment in accordance with this Code and the laws of the Republic of Kazakhstan.

 

Article 81. Rights and obligations of pregnant women and mothers in the field of health protection

1. Motherhood in the Republic of Kazakhstan is protected and encouraged by the state.

2. Citizens have the right to support breastfeeding, including protection and promotion of breastfeeding, inter alia:

1) the protection of the rights of pregnant and nursing women is aimed at ensuring conditions for the preparation and implementation of breastfeeding (maternity leave, additional breaks from work to feed infants, part-time work, services on a priority basis in medical facilities, use of the services provided by parenting rooms, etc.);

2) informing the population on the benefits of exclusive breastfeeding for children under six months of age and on continuing breastfeeding with healthy complementary foods for up to two years or more.

3. Pregnant women have the right to:

1) health protection and assistance during pregnancy, during and after childbirth, including premature one, determined by the international live birth and stillbirth criteria, using methods permitted in the Republic of Kazakhstan;

2) medical assistance during pregnancy, during and after childbirth;

3) examination, treatment and medical intervention during pregnancy only with their consent or that of a legal representative, except for cases when delay in examination, treatment and medical intervention threatens the life of a woman and a child (fetus), when a decision to carry out examination, treatment and medical intervention is made by a doctor or a medical case conference;

4) observe a work schedule, maternity leave, unpaid leave to care for a child until the child reaches the age of three, and working conditions for pregnant women and nursing mothers in accordance with the labor legislation of the Republic of Kazakhstan;

5) qualified support provided to nursing mothers (parents), counseling by healthcare professionals trained in lactation, methods of exclusive breastfeeding and complementary feeding;

6) support for the practice of breastfeeding, which is implemented by child-friendly medical facilities;

7) time for medical examination and registration as pregnant within twelve weeks of gestation, which is granted by an employer together with protecting job, securing position and preserving average salary;

8) other guarantees and incentives in accordance with the laws of the Republic of Kazakhstan.

4. Pregnant women are obliged to:

1) within twelve weeks of gestation, register as pregnant at the place of registration for receiving medical assistance within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance;

2) follow the doctor’s recommendations during pregnancy, during and after childbirth.

5. If a woman with contraindications for pregnancy plans a pregnancy, she assumes full responsibility for all health risks to herself and the fetus during pregnancy and up to forty-two calendar days of childbirth.

 

Article 82. Obligations of individual entrepreneurs and legal entities for their employees’ health protection

1. In accordance with their activities, individual entrepreneurs and legal entities are obliged:

1) to take sanitary-antiepidemic and sanitary-preventive measures;

2) to comply with regulatory legal acts in the field of sanitary-epidemiological welfare of the population, as well as acts of officials exercising state control and supervision in the field of sanitary-epidemiological welfare of the population;

3) to ensure the safety and goof quality of works performed, services provided and products during their production, transportation, storage and sale to the population, disposal and destruction;

4) to perform production control;

5) to promptly inform the state body for the sanitary-epidemiological welfare of the population on emergencies, suspension of production, breakdowns in technological processes that pose a threat to the sanitary-epidemiological welfare of the population, in cases of mass and group infectious and parasitic, occupational diseases and poisoning;

6) to promptly inform the state body for the distribution of medicines and medical products on the identification of side effects of medicines and medical products;

7) to arrange hygienic training for employees belonging to the decreed population group;

8) to provide officials of the state body for the sanitary-epidemiological welfare of the population with the opportunity to take samples of products, raw materials, goods, production environment for laboratory research within their competence;

9) to bar from working persons without a document certifying their medical examination, hygienic training, and also those with infectious, parasitic diseases and carriers of pathogens of infectious, parasitic diseases, persons with contraindications to work in harmful and (or) hazardous working conditions identified by public health entities, except for those infected with HIV;

10) to prohibit the sale of goods, products, raw materials which are found to be inconsistent with regulatory legal acts in the field of sanitary-epidemiological welfare of the population, and also to make a decision on the possibility of their use or disposal;

11) to submit accounting and reporting documentation relating to the sanitary-epidemiological welfare of the population for inspection to the state body for the sanitary-epidemiological welfare of the population;

12) to suspend entrepreneurial and (or) other activities if they pose a threat to the life or health of the population;

13) to ensure unhindered access of officials exercising state control and supervision in the field of sanitary-epidemiological welfare of the population to facilities in order to check their compliance with regulatory legal acts in the field of sanitary-epidemiological welfare of the population;

14) at their own expense, to carry out disinfection, disinfection and deratization according to epidemiological indications and prescriptions, decisions of officials of the state body for the sanitary-epidemiological welfare of the population;

15) to pay deductions and (or) contributions for compulsory social health insurance in accordance with the Law of the Republic of Kazakhstan “On Compulsory Social Health Insurance”.

2. The employer shall create favorable conditions for health promotion and disease prevention among employees.

 

Article 83. Rights and obligations of kandasses, foreigners, stateless persons and other persons

1. Kandasses, refugees, as well as foreigners and stateless persons permanently residing in the Republic of Kazakhstan, have the right to receive a guaranteed volume of free medical care on an equal basis with citizens of the Republic of Kazakhstan.

2. Foreigners and stateless persons temporarily staying in the Republic of Kazakhstan, asylum seekers have the right to receive a guaranteed volume of free medical care for diseases that pose a danger to others, according to the list and in the amount determined by the authorized body unless otherwise provided for by laws of the Republic of Kazakhstan or international treaties ratified by the Republic of Kazakhstan.

 3. Kandasses, refugees and asylum seekers, foreigners and stateless persons staying in the Republic of Kazakhstan bear the same responsibilities in the field of healthcare as the citizens of the Republic of Kazakhstan.

 

Article 134. Rights of patients

1. In addition to the rights specified in Chapter 12 of this Code, the patient has the right to:

1) respectful attitude in the process of prevention, diagnosis, treatment, respect for his/her cultural and personal values;

2) receive medical assistance in accordance with the priority determined solely on the basis of medical criteria, without the influence of any discriminatory factors;

3) select, replace a doctor or a medical facility providing medical assistance within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance, except for cases of emergency and urgent assistance;

4) be informed by a medical facility about audio and (or) video surveillance and recording;

5) be relieved of suffering to the extent enabled by the current level of medical technologies;

6) obtain information (data on possible risks and benefits, proposed and alternative methods of treatment, information on possible consequences of refusing treatment, information on the diagnosis, prognosis and treatment plan in an intelligible form, and also explanation of the reasons for discharging him/her home or transferring to another medical facility), and an independent opinion on the state of his/her health, and a consultation;

7) obtain information on his/her rights and obligations, the services provided, the cost of paid services and the amount of co-payment, the procedure for their provision with account of their accessibility for persons with visual and (or) hearing impairments; the prescribed medicinal product; healthcare professionals providing medical services to him/her;

8) refuse to participate in the educational process, and also to refuse third parties to be present at medical and diagnostic procedures;

9) other rights provided for by the laws of the Republic of Kazakhstan.

2. Information on the patient’s rights is placed on visual outreach boards of medical facilities.

3. Medical assistance is provided after obtaining the patient’s informed consent to receive medical assistance. The informed consent of the patient during invasive interventions is drawn up in the form approved by the authorized body.

4. The patient can choose a person who shall be informed about the state of his/her health. With account of the state of the patient’s health, information thereon can be hidden from the patient and communicated to the patient’s spouse, close relatives or legal representatives.

5. Patients’ rights are protected by state bodies, healthcare organizations, public associations within their competence.


Article 135. Obligations of patients

1. In addition to the obligations specified in Chapter 12 of this Code, the patient is obliged:

1) to take measures to preserve and strengthen his/her health;

2) to show respect and tact in communication with healthcare professionals;

3) to provide a physician with all the information necessary for the diagnosis and treatment of the disease; after giving consent to medical intervention, to strictly follow the prescriptions of healthcare professionals;

4) to comply with internal regulations and take good care of the property of a medical facility, to cooperate with medical personnel when receiving medical assistance;

5) to promptly inform healthcare professionals on changes in his/her state of health in the process of diagnosis and treatment, as well as in cases of diseases that pose a danger to others, or suspicion of them;

6) not to commit acts that violate the rights of other patients;

7) to fulfill other obligations provided for by the laws of the Republic of Kazakhstan.

2. The obligations of patients specified in subparagraphs 2), 3) and 5) of paragraph 1 of this article apply to parents or other persons who care for a sick child in a hospital.

 

Article 136. Right to refuse medical assistance

1. The patient or his/her legal representative has the right to refuse medical assistance, except for the cases specified in Article 137 of this Code.

2. If medical assistance is denied, a healthcare professional explains possible consequences to the patient or his/her legal representative in an intelligible form.

3. Refusal of medical assistance with an indication of possible consequences is entered in medical records, also in electronic format, and signed by the patient or his/her legal representative, as well as by a healthcare professional.

If the patient or his/her legal representative refuses to sign their denial of medical assistance, it is necessary to make an appropriate entry in medical records, also in electronic format, which is signed by the healthcare professional.

4. If legal representatives of a minor or an incapacitated person refuse medical assistance necessary to save their lives, a medical facility has the right to apply to the guardianship and custody body and (or) the court to protect their interests.

 

Article 137. Provision of medical assistance without the patient’s consent

1. The provision of medical assistance without the consent of the patient is allowed in relation to persons:

1) who are in a state of shock, in a comatose state, when they are unable to express their will;

2) with diseases that pose a danger to others;

3) with severe mental disorders (diseases);

4) with mental disorders (diseases) who committed a socially dangerous act.

2. Consent to the provision of medical assistance in relation to minors, except for the cases provided for by paragraph 2 of Article 78 of this Code, and consent for persons declared incapacitated by the court shall be given by their legal representatives.

3. The decision on the provision of medical assistance without consent in relation to the persons specified in paragraph 1 of this article shall be made by a case conference, and if it is impossible to gather required specialists - by a healthcare professional with subsequent notification of officials of a medical facility.

4. Medical assistance is provided without the consent of the patient until the grounds provided for in paragraph 1 of this article disappear.

 

Article 273. Secrecy of medical worker

1. Personal medical data, information on event of seeking medical advice, state of health of a person, diagnosis of his disease and other details, obtained during examination and (or) treatment constitute secrecy of medical worker.

2. It is not allowed to disclose details constituting secrecy of medical worker, by persons, to whom they become known during training, performance of professional duties, official and other obligations, except for cases specified in paragraphs 3 and 4 of this article.

3. With informed consent of a patient or his legal representative, it is allowed to convey information, constituting secrecy of medical worker, for conduction of research activities, use of such information in educational process.

4. Provision of information, constituting secrecy of medical worker, without consent of a person is allowed in following cases:

1) for the purposes of examination and treatment of a person, incapable due to his state to express own will, in case of absence of a legal representative;

2) under the threat of disease distribution, constituting a danger to the public, including in donation of blood, its components, transplantation of organs (part of an organ) and (or) tissues (part of tissue);

3) upon request from bodies of inquiry and preliminary investigation, prosecutor, attorney and (or) court due to conduction of investigation or judicial proceedings;

4) in delivery of medical services to a minor child or incompetent person to notify his legal representative;

5) if there are grounds to suppose that damage to health of a citizen of the Republic of Kazakhstan is caused as a result of unlawful acts;

6) in case of disclosure of mental deviations and propensity towards sexual violence of a person;

7) in exercising state control of quality of delivery of medical services (aid), monitoring of contractual obligations on quality and scope of medical services;

8) in conduction of inspections by public prosecution bodies in accordance with the procedures, established by the Law of the Republic of Kazakhstan "On Prosecutor's Office";

9) upon request of special state bodies for the purposes of solution of tasks of counterintelligence activities.

5. The following shall not be considered as disclosure of secrecy of medical worker:

1) transmission for storage of a backup copy of electronic information resource to an integrated platform for standby storage of electronic information resources in accordance with the procedures and within the terms, established by an authorized body in the field of maintenance of information security, except for cases, when such electronic information resources contain information, related to intelligence, counterintelligence activities and guard activities on maintenance of safety of protected persons and facilities, transmission whereof is implemented in accordance with the laws of the Republic of Kazakhstan on state secrets;

2) exchange of information using information and communication technology for the purposes of delivery of medical services and to maintenance of operation of law enforcement and special state bodies.

6. It is not allowed to connect electronic information resources, containing personal medical data of individuals, to telecommunication networks, which connect them to other databases, without consent of individuals when using personal medical data, relating their private life, except for cases, related to donation of blood and its components, organs (part of an organ) and (or) tissues (part of tissue), as well as requests from law enforcement, special state bodies on presentation of information in the form of an electronic document, constituting medical secrecy, on state of persons with mental, behavioural disorders (diseases), related to substance use.

7. Cases, when data on health of a patient become available due to reasons beyond the control of a medical worker, shall not be considered as violation of secrecy of medical worker.