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 Patient Rights Regulations

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Regulation on Patients' Rights Official Newspaper No: 01.08.1998 Official Newspaper No: 23420 SECTION ONE Objective, Scope, Basis, Definitions and Principles Objective Article 1- This Regulation; basis, a reflection on the human health care rights field, and especially in Turkey Constitution, other legislation and accepted in international legal texts "patient rights" of concretely demonstrate and health services are provided for all institutions and organizations and health institutions and organizations outside the health care given to cases.

In order to regulate the principles and procedures for ensuring that everyone can benefit from ine patient rights korunma, to be protected from violations of rights and, when necessary, to use legal safeguards as necessary.

Scope Article 2- This Regulation; all public and private institutions and organizations, health care institutions and organizations, all or other levels of participation in the service and all persons who have the right to benefit from the service.

Legal Basis Article 3- This Regulation; Article 33 of the Basic Law No. 3359 on Health Services and article 181 of the Decree Law no. 181 on the Organization and Duties of the Ministry of Health.

Definitions Article 4 – The terms mentioned in this Regulation; a) Ministry: Ministry of Health, b) Patient: Any person in need of health services, c) Personnel: All health professions participating in the provision of health services, regardless of whether the service is offered in public or private health institutions and institutions or free of charge. d) Health institutions and organizations: Except for those belonging to the Ministry of National Defense, all public and private institutions and organizations that provide health services, and all places where the tableland is exercised, e) Patients' rights: Persons who need to benefit from health services have the right to be human and because they are It expresses its rights guaranteed by its constitution, international agreements, laws and other legislation.

Principles Article 5- The following principles must be complied with in the provision of health services: a) It is always taken into account in every phase of the service that the right to live in a complete state of wellbeing is the most basic human right. b) The patient is treated humanely, knowing that everyone has the right to life, to protect and develop his / her material and spiritual existence, and that no authority or person is authorized to abolish this right. c) In the provision of health services, the patients' race, language, religion and denomination, gender, political thought, philosophical belief, economic and social status and other differences cannot be taken into consideration. Health services are planned and organized so that everyone can easily access them. d) Without the consent of the person, physical integrity and other personal rights shall not be affected without the consent of the medical requirements and the law. e) The person may not be subjected to medical research without his consent and without the permission of the Ministry. f) The privacy of the patient's private life and family life shall not be touched except with the conditions permitted by law and medical requirements.

CHAPTER TWO The Right to Benefit from Health Services The Right to Fairness and Fairness Beneficial Article 6 The patient has the right to benefit from health services according to the needs of the health services, including the activities for promoting healthy living and preventive health services within the framework of the principles of fairness and equity. This right includes all institutions and organizations providing health services and the responsibilities of the personnel involved in health care services in accordance with the principles of fairness and fairness.

Requesting Information Article 7- The patient may ask for information on how to benefit from health services. This right includes the right to learn which health institutions can be used according to the conditions, every kind of services and facilities provided by health institutions and organizations and the right to learn the health services provided in the institution applied. All health institutions and organizations shall establish a unit having sufficient technical equipment to inform the patient under the first paragraph; In this unit, in order to provide permanent and sufficient information to the patient and qualified personnel, and to ensure that the patient can reach the units he needs, he / she must take precautions such as having informative signs, brochures and signs in the appropriate places of the organization. Selecting and Changing the Health Organization Article 8- Patient; Provided that the procedures and conditions required by the legislation are complied with, it has the right to choose the health institution and institution and to benefit from the health service provided in the health institution it has chosen. The patient may change the healthcare institution provided that it is in accordance with the legislation set by the legislation. However, it is essential that the patient be clarified by the physician and that there is no medically objectionable change in the health institution in terms of life-threatening if the changing of the establishment will cause a life-threatening condition and the disease will become more severe. Apart from emergency cases, those who do not follow the referral chain, which is attached to any social security institution and which is stipulated by the legislation, will pay the difference between themselves. In cases where the patient is not medically beneficiary to stay in a health care facility or is required to be transferred to another health care provider, the situation shall be disclosed to the patient or to the persons specified in the second paragraph of Article 15.

Prior to the transfer, the required information is given to the health institution that is requested to be transported or considered medically appropriate, by the referring body or by the authorities designated by the legislation. In both cases it is essential to provide the service without interruption. Identification, Selection and Replacement of Personnel Article 9- In case of request, the patient is informed about the identities, duties and titles of the physicians and other personnel who provide or provide health services. The patient has the right to freely choose the personnel who will provide him / herself with the condition that the procedures specified in the legislation are complied with, to change the practitioner concerned with his / her treatment and to ask for consultation of other doctors. When the right to choose, change the staff and ask for consultation, the wage difference determined by the legislation shall be borne by the patient using these rights. Requesting the Determination of the Order of Priority Article 10- In cases where the health care institution has insufficient or limited opportunities to provide services, the patient has the right to request that the priority right be determined on the basis of medical criteria and can be objectively determined. The provisions of the relevant legislation shall be applied in order to determine the priority order for the emergency and forensic cases and the elderly and the disabled. Diagnosis, treatment and care appropriate to medical requirements Article 11- The patient has the right to be diagnosed, treated and maintained according to the requirements of modern medical information and technology. Diagnosis and treatment cannot be made contrary to the principles of the principles and the provisions of the legislation on medical treatment. Prohibition of intervention outside medical requirements Article 12- Nothing can be done or demanded without the aim of diagnosis, treatment or prevention, which may cause death or life threatening or violate body integrity or reduce mental or physical strength. Prohibition of Euthanasia Article 13- Euthanasia is prohibited. The right to life cannot be abandoned, regardless of the medical requirements, or in any way. No one's life can be terminated, including his own or anyone else's request. Medical Care Article 14- The personnel shows the medical care required by the patient's condition. Even if it is not possible to save the patient's life or maintain his health, it is imperative to try to reduce or relieve his suffering.

 

CHAPTER THREE The Right to Get Information Related to the Health Situation Requesting Information in General Article 15- The patient; has the right to ask for information orally or in writing about the medical condition, the medical procedures to be applied to them, their benefits and potential drawbacks, alternative medical intervention procedures, the possible consequences of the treatment if it is not accepted and the course of the disease and its consequences. Information about the state of health may be requested and obtained by the parent or legal guardian if the patient is young or is under incapacity. The patient may also authorize someone to obtain information about his / her health. If deemed necessary, certification of authority may be requested. The patient can also get information about his health status from another doctor who is interested in his treatment. Reviewing the Records Article 16- The patient can examine the file and records, which has information about his / her health status, directly or through his / her representative or legal representative and take a copy. These records can only be seen by those who are directly related to the patient's treatment. Requesting Correction of Records Article 17- Patient; may request incomplete, indefinite and erroneous medical and personal information to be completed, disclosed, corrected and brought into compliance with the final health status and personal status. This right includes the right to object to the reports on the patient's health status and to request a new report on the state of health in the same or other institutions and establishments. Procedures for giving information Article 18- Information is given by using an interpreter, if necessary, in a manner that the patient understands, without the use of medical terms as much as possible, without hesitation and doubt, and in accordance with the mental state of the patient. Information to be given Providing Illicit Information and Precautionary Measures to be Taken Article 19- It is permissible to keep the diagnosis in cases where the possibility of the disease is increased by making a bad effect on the patient's spiritual structure and the course and the outcome of the disease are grave. Whether the patient or relatives are informed about the patient's health status is at the discretion of the physician in accordance with the conditions specified in the above paragraph. A diagnosis without treatment can only be felt or reported by a physician and in a full reserve. In the event that the patient does not have a contrary request or the person to whom it will be announced is not determined in advance, such family of such a diagnosis shall be notified. Prohibition of Information Article 20- Except as required by the measures to be taken by the competent authorities according to the provisions of the relevant legislation and the nature of the disease; The patient may ask the patient or his family or relatives not to inform about his health. SECTION FOUR Protecting Patient Rights Respecting Privacy Article 21- It is essential to respect the privacy of the patient. The patient may explicitly demand protection of his privacy. Any medical intervention is performed by respecting the privacy of the patient. The right to privacy and to demand it; a) the patient's medical condition related to the conduct of medical assessments in privacy, b) the examination, diagnosis, treatment and other processes that require direct contact with the patient to be carried out in a reasonable privacy environment, c) medically not allowed to have a relative next to his relatives, d) (E) the absence of persons not directly involved in the treatment, not during the medical intervention; and e) failure to intervene in the patient's personal and family life unless the nature of the illness requires it; f) the confidentiality of the source of the health expenditure; The death incident does not give the right to deterioration of privacy In health institutions and institutions where training is provided, those who are not directly concerned with the treatment of the patient should be present during medical intervention; The patient's consent is also obtained for this in advance or during treatment. Medical Exclusion Without Consent Article 22- Except for the exceptions shown in the law, no one shall be subjected to medical treatment without his / her consent and not in accordance with his / her consent. The possible evidence of the offense committed by a person suspected of having committed or participated in a crime is considered to be in the body of the victim or the victim; it is up to the judge's decision to subject the defendant or the victim to medical practice in order to reveal these evidence. In case of delay, this can be done at the request of the public prosecutor.

Confidentiality of Information Article 23- Information obtained due to the provision of health services cannot be explained in any way, except as permitted by law. Even if it is based on the consent of the person, the disclosure of the information does not remove the legal responsibility for the disclosure of the information in case of giving up the personal rights completely, the transfer of these rights to others or the excessive limitation of such rights. The disclosure of information which may cause harm to the patient, without relying on a legally and morally valid and just cause, requires the civil and criminal liability of the personnel and others. In the activities carried out for research and training purposes, the identity information of the patient cannot be explained without his / her consent.

CHAPTER FIVE Patient Consent for Medical Intervention Patient Consent and Permission Article 24- Medical intervention requires consent of the patient. If the patient is young or interdicted, permission is taken from his / her parent or guardian. This condition is not required if the patient does not have a parent or guardian or is not present or has no patient's power of expression. In cases where it is medically necessary to intervene in cases where no consent is given by the legal representative, medical intervention can be made to the patient under custody and guardianship; Article 272 and Article 431 of the Turkish Civil Code is subject to the court decision. The permission requirement is not sought if the life or vital organs will be threatened if it is time-consuming to obtain permission from the legal representative or the court and there is no immediate response to the patient. The consent can be taken at any time, except in cases referred to in paragraph 3, and in urgent cases threatening life or vital organs. The withdrawal of consent means that the patient refuses treatment. The withdrawal of consent after intervening is subject to the condition that it is not medical. Refusal and Stopping Treatment Article 25- The responsibility for the negative consequences arising out of or in accordance with the law, except for the cases which are required by law; the patient has the right to refuse the treatment or to be stopped. In this case, the results of the non-application should be explained to the patient or his / her legal representatives or relatives and a written document indicating this should be obtained. The exercise of this right may not be used against the patient in the patient's application to the health institution again. Minority or Incarceration's Participation in Medical Intervention.

Article 26- Even if the consent of the legal representative is sufficient and sufficient, it is provided to the medical intervention by listening to the patient as young as possible or interdicted. Implementation of Unconventional Treatment Procedures Article 27- The classical treatment methods known as a result of clinical or laboratory examinations are fixed and will not benefit the patient. another treatment method may be applied. It is also essential that a method other than the conventional conventional method of treatment will be useful to the patient, and that this treatment will not be more unfavorable than conventional treatment methods. A previously untried medical treatment and intervention procedure can only be done if it is foreseen that it will not cause harm and save the patient. The provisions of Chapter 6 are reserved. Consent and Validity of Consent Article 28- The consent is not bound by any form except with the exceptions stipulated by the legislation. The consent taken against the law and morality shall be null and void and shall not be subject to intervention based on such consent. Consent to Receiving Organ and Tissue Article 29 - Organ and tissue that are under 18 years of age cannot be taken. These conditions are subject to the written conditions stipulated in Article 6 of the Law No. 2238 on the Collection, Storage and Transplantation of Organ and Tissue. Provisions of article 14 of the Law No. 2238 on the conservation of the bodies for scientific research are reserved. Family Planning Services and Termination of Pregnancy Article 30 - Medicines and instruments other than those determined by the Ministry, whether or not the consent of the person concerned is available, may not be used in family planning services. The termination of pregnancy is subject to the conditions stipulated in the Law No. 2827 on Population Planning. In the case of sterilization and termination of pregnancy, the consent of the spouse is also required if the patient is married. Scope of Consent Article 31- It is essential that the patient or his / her legal representative be informed about the subject and the results of the medical intervention while receiving the consent. The consent of the patient for the medical intervention to be applied also includes other medical procedures required by this intervention.

However, in the implementation of medical procedures, the utmost care is taken not to violate the rights set forth in this Regulation and other legislation.

CHAPTER SIX Medical Studies Consent in Medical Research Article 32- No one; No medical intervention can be made for experience, research or training purposes without the consent of the Ministry and without the consent of the Ministry. The medical benefit and benefit to society expected from medical research cannot be overestimated by the life of the volunteer and the protection of the integrity of the body. Medical research is carried out only by personnel who are competent in the field of research and who have sufficient medical knowledge and experience according to the legislation. The fact that the volunteer has consented to medical research does not remove the responsibility of the personnel involved in this research. Protection and Informing of the Volunteer Article 33- All the necessary measures are taken in order to prevent harm to the health and other personal rights of the volunteer. If the probable damages to the volunteer are not determined in advance; Even if there is voluntary consent, research cannot be done. Volunteer; The purpose of the investigation is to inform the procedure beforehand about the possible benefits and damages and the possibility that it may withdraw from participation in the research and that it may recover its consent at any stage of the research. Procedure for Receipt of Consent Article 34- The maximum care shall be taken to ensure that the consent of the volunteer, who has been sufficiently informed about the medical research, on the basis of its completely free will without any material or moral pressure. In medical research, consent is subject to the written form requirement. The Status of Minors and Mentally Imcompetent Article 35- Medical interventions for medical research purposes cannot be applied in any way to minors and Mentally Imcompetent without the benefit of themselves. Medical research on minors and Mentally Imcompetent on the condition of having their benefits depends on the consent of their parents or guardians. In cases where no consent is given by the legal representative, the second paragraph of Article 24 shall apply. Drug Use for Research purposes Article 36- Even if permission or license has been obtained in accordance with the special legislation, no medicines and compositions can be used for the purpose of medical research with the patient's consent and without the permission of the Ministry. The use of drugs and preparations in medical research is subject to the provisions of the Regulation on Pharmaceutical Research published in the Official Newspaper dated 29/11/1993 and numbered 21480.

CHAPTER SEVEN Other Rights Ensuring Security Article 37- Everyone has the right to expect to be safe in health institutions and organizations. All health institutions and organizations are obliged to take the necessary measures to protect and ensure the safety of life and property of patients and their relatives. The provisions of special legislation on the detention of prisoners and provisions in health institutions and organizations are reserved. Fulfillment of Religious Obligations and Benefit from Religious Services Article 38- Measures are taken in order to enable the health institutions and organizations to fulfill their religious obligations freely. In the event that they do not want to cause disruptions in the services of the institution, do not disturb the others, and ask the patients religiously and support them in a spiritual way provided that no medical intervention is carried out, the cleric who is in accordance with his religious beliefs is invited. For this purpose, appropriate time and place in health institutions and organizations are determined. For the patients with agony who are not able to testify and who have a religious belief and who are orphaned, a religious officer who is in accordance with his religious beliefs is called without requiring a demand. How and when these rights will be used and the measures to be taken will be regulated separately in the legislation that demonstrates the working principles and procedures of the health institution. Respect for Human Values and Visit Article 39- The patient has the right to benefit from health services in accordance with his/her personality values. All personnel involved in health services; patients, relatives and visitors should be friendly, polite, compassionate and behave in accordance with the legislation on health services and the provisions of this Regulation. In every stage of health services, patients are given necessary and sufficient information about the reasons of the waiting, if and when they are done, how and how they are done, and their physical and spiritual conditions. In health institutions and organizations, it is essential to provide all kinds of hygienic conditions that are worthy of human dignity, to eliminate noise and all other disturbing factors. If necessary, these issues can be made subject to the request by the patient.

 

Acceptance of patient visitors is carried out in accordance with the procedures and principles set by the institution or organization and in such a way that it does not cause any acts or attitudes that will disturb the peace and quiet of the patients and necessary measures are taken in this regard.

Accompanying Personnel Article 40- To assist the patient during the examination and treatment; to the extent required by the legislation and institution facilities and to the extent required by the medical condition of the patient; How and when to use this right and the measures to be taken in this regard are regulated separately in the legislation that shows the working principles and procedures of the health institution and its organization. Giving the Service Outside the Health Institution and Establishment Article 41- Patients can also benefit from the health services where they are: a) In the provision of preventive health services, b) In case of medical reasons, the health institution cannot be visited personally or in cases where it cannot be carried out, c) In extraordinary situations such as natural disasters. The procedures and principles regarding the delivery of the service outside the health institution shall be regulated separately by the Ministry.

 

CHAPTER EIGHT Liability and Legal Protection Procedures Application, Complaint and Right to Trial Article 42- The patients and the patients related to the patient have all kinds of applications, complaints and lawsuits within the framework of the legislation in case of violation of patient rights. Responsibility of Health Institutions and Institutions Article 43- In case of violation of patient rights, both material and moral damages can be filed against the institution and organization employing personnel. However, if the institution to be prosecuted against is a public institution and organization; a) According to Article 12 of the Administrative Procedure Code No. 2577; In the event of a violation of the right to an administrative operation, the persons concerned may open a full case of jurisdiction or abolition and full jurisdiction. b) Pursuant to the Article 13 of the same Law, the amount of compensation requested for material and non-pecuniary damage within a year from the date of learning of the damaging action is presented separately to the contracting entity and the legal order shall be lodged within the legal period within the must be opened. Responsibility of Civil Servant or Other Public Personnel Personnel Article 44- All or part of the responsibility for criminal, financial and detention of the personnel who prevents or otherwise violates the effective exercise of the rights of patients as shown in this Regulation may arise. Apart from the responsibilities mentioned in the first paragraph, administrative measures and sanctions to be imposed on the personnel by the institution and the organization employing personnel are reserved according to the situation of the violation. Article 45- The Procedures of the Determination of the Responsibility of Public Personnel Article 45- The acts of the personnel in public institutions and organizations that violate the rights of the patients, are determined by the governors or the personnel of the Ministry or the staff for directing, investigating and linking to the sanction if necessary. the inspector or surgeon shall be appointed by the inspector. Sanctions Concerning Public Personnel Article 46- Sanctions to be applied by a civil servant or other civil servant personnel and in any way in the event of a violation of their rights during the period of their duties are shown below: the disciplinary penalties foreseen by the competent supervisor or the board shall be duly appreciated. b) If the violation of rights also constitutes a criminal offense according to criminal law, about the civil servants, the Law on the Prosecution of Civil Servants, if the decision of the investigation is made according to the provisions of the law, the file is sent to the Prosecutor General's Office and the criminal case is opened and thus the staff the punishment of punishment is found appropriate to the verb. c) In accordance with the second paragraph of Article 40 of the Constitution, the fifth paragraph of Article 129 and Article 13 of the Civil Servants Law No. 657, and other relevant legislation, the legal responsibility of civil servants and other public officials cannot be carried out directly by a lawsuit filed against the civil servant.

 

The case can only be brought against the administration according to the procedure shown in Article 43. The legal responsibility of these personnel is due to the fact that a decision of compensation will be issued as a result of the lawsuit against the administration. After the compensation of the personnel of the public officials is compensated by the administration upon the decision of the court, the responsible personnel are discharged. d) While the public servants do their jobs outside the scope of their official duties, they shall be treated in accordance with Article 47 on the grounds of their acts. Liability of Non-Public Official Personnel Article 47- The sanctions to be applied in the event of any violation of the rights of the patient by the civil servant or other non-public official are as follows: a) Non-public personnel; Upon the complaint of the patient whose right has been violated, or upon the complaint made by the Ministry or other institutions and organizations in case of any other determination of these acts, the professional organizations which have been established according to the special laws of these institutions may be punished by disciplinary penalties by the councils of dignity. b) The legal responsibilities arising from violations of patient rights by non-public personnel may be brought forward directly or against the institutions or organizations operating them or against them and those who employ them. c) The application of criminal sanctions for non-public personnel on the basis of criminal acts according to the criminal law may be carried out by means of a complaint or complaint directly to the public prosecutor's offices according to the general provisions. CHAPTER III Final Provisions Duties of Institutions and Organizations Article 48- Authorities of health institutions and organizations; by making a list, sign or brochure, the "patient rights" shown in this Regulation, to help them to be used in accordance with the letter and spirit of the patient rights set out in this Regulation and other legislation, the health institution and its organization, patients, staff and visitors. and is obliged to take all necessary measures, including to keep them easily accessible and readable by them. Provisions Reserved Article 49- The special arrangements and limitations imposed by the intentions of national security, public order, public interest, general morality and general health and the provisions of the law are reserved. Enforcement Article 50- This Regulation shall enter into force on the date of its publication. Execution Article 51- The provisions of this Regulation are executed by the Health Minister.​