Declaration of Lisbon on the Rights of the Patient 1981

World Medical
Association

PRINCIPLES

1. Right to
medical care of good quality

A. Every person is entitled
without discrimination to appropriate medical care.

B. Every patient has the right
to be cared for by a physician whom he/she knows to be free to make clinical
and ethical judgments without any outside interference.

C. The patient shall always be
treated in accordance with his/her best interests. The treatment applied shall
be in accordance with generally approved medical principles.

D. Quality assurance always should be a part
of health care. Physicians, in particular, should accept responsibility for
being guardians of the quality of medical services.

E. In circumstances where a choice must be
made between potential patients for a particular treatment, which is in limited
supply, all such patients are entitled to a fair selection procedure for that
treatment. That choice must be based on medical criteria and made without
discrimination.

F. The patient has the right of
continuity of health care. The physician has an obligation to cooperate in the
coordination of medically indicated care with other health care providers
treating the patient. The physician may not discontinue treatment of a patient
as long as further treatment is medically indicated, without giving the patient
reasonable assistance and sufficient opportunity to make alternative
arrangements for care.

 

2. Right to
freedom of choice

A. The patient has the right
to choose freely and change his/her physician and hospital or health service
institution, regardless of whether they are based in the private or public
sector.

B. The patient has
the right to ask for the opinion of another physician at any stage.

 

3. Right to
self-determination

A. The patient has the right to
self-determination, to make free decisions regarding himself/herself. The
physician will inform the patient of the consequences of his/her decisions.

B. A mentally competent adult
patient has the right to give or withhold consent to any diagnostic procedure
or therapy. The patient has the right to the information necessary to make
his/her decisions. The patient should understand clearly what is the purpose of
any test or treatment, what the results would imply, and what would be the
implications of withholding consent.

C. The patient has the right to
refuse to participate in research or the teaching of medicine.

 

4. The
unconscious patient

A. If the patient is
unconscious or otherwise unable to express his/her will, informed consent must
be obtained whenever possible, from a legally entitled representative where
legally relevant.

B. If a legally entitled
representative is not available, but a medical intervention is urgently needed,
consent of the patient may be presumed, unless it is obvious and beyond any
doubt on the basis of the patient’s previous firm expression or conviction that
he/she would refuse consent to the intervention in that situation.

C. However, physicians should
always try to save the life of a patient unconscious due to a suicide attempt.

 

5. The legally
incompetent patient

A. If a patient is a minor or
otherwise legally incompetent the consent of a legally entitled representative,
where legally relevant, is required. Nevertheless the patient must be involved
in the decision making to the fullest extent allowed by his/her capacity.

B. If the legally incompetent
patient can make rational decisions, his/her decisions must be respected, and
he/she has the right to forbid the disclosure of information to his/her legally
entitled representative.

C. If the patient’s legally
entitled representative, or a person authorized by the patient, forbids
treatment which is, in the opinion of the physician, in the patient’s best
interest, the physician should challenge this decision in the relevant legal or
other institution. In case of emergency, the physician will act in the
patient’s best interest.

 

6. Procedures
against the patient’s will

Diagnostic
procedures or treatment against the patient’s will can be carried out only in
exceptional cases, if specifically permitted by law and conforming to the
principles of medical ethics

 

7. Right to
information

A. The patient has the right to
receive information about himself/herself recorded in any of his/her medical
records, and to be fully informed about his/her health status including the
medical facts about his/her condition. However, confidential information in the
patient’s records about a third party should not be given to the patient
without the consent of that third party.

B. Exceptionally, information
may be withheld from the patient when there is good reason to believe that this
information would create a serious hazard to his/her life or health.

C. Information must be given in
a way appropriate to the local culture and in such a way that the patient can
understand.

D. The patient has the right
not to be informed on his/her explicit request, unless required for the
protection of another person’s life.

E. The patient has the right to
choose who, if anyone, should be informed on his/her behalf.

 

8. Right to
confidentiality

A. All identifiable information
about a patient’s health status, medical condition, diagnosis, prognosis and
treatment and all other information of a personal kind, must be kept confidential,
even after death. Exceptionally, descendants may have a right of access to
information that would inform them of their health risks.

B. Confidential information can
only be disclosed if the patient gives explicit consent or if expressly
provided for in the law. Information can be disclosed to other health care
providers only on a strictly “need to know” basis unless the patient
has given explicit consent.

C. All identifiable patient
data must be protected. The protection of the data must be appropriate to the
manner of its storage. Human substances from which identifiable data can be
derived must be likewise protected.

 

9. Right to
Health Education

Every
person has the right to health education that will assist him/her in making
informed choices about personal health and about the available health services.
The education should include information about healthy lifestyles and about
methods of prevention and early detection of illnesses. The personal
responsibility of everybody for his/her own health should be stressed.
Physicians have an obligation to participate actively in educational efforts.

 

10. Right to
dignity

A. The patient’s dignity and
right to privacy shall be respected at all times in medical care and teaching,
as shall his/her culture and values.

B. The patient is entitled to
relief of his/her suffering according to the current state of knowledge.

C. The patient is entitled to
humane terminal care and to be provided with all available assistance in making
dying as dignified and comfortable as possible.

 

11. Right to
religious assistance

The
patient has the right to receive or to decline spiritual and moral comfort
including the help of a minister of his/her chosen religion.

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