Patient Rights and Responsibilities at the Facility

1. The procedure for implementing the rights and obligations of patients (their representatives) establishes the procedure for implementing the rights of patients and their representatives at the Alytus District Municipality Primary Health Care Center (hereinafter referred to as the Institution).

2. The purpose of this procedure is to ensure that patients' rights are implemented in the Institution.

3. The procedure has been prepared in accordance with the Law on Patients' Rights and Compensation for Damage to Health of the Republic of Lithuania, and the Order No. V-338 of the Minister of Health of the Republic of Lithuania dated April 29, 2008, "On the Approval of the Description of Minimum Quality Requirements for Personal Health Care Services."

4. The terms used in this procedure:

4.1. Patient – a person who uses the services provided by health care institutions, regardless of whether they are healthy or ill.

4.2. Patient's representative – a representative by law or a representative by proxy.

4.3. Patient's documents – medical history and other documents that record the patient's health condition, the types and methods of health care applied to them.

4.4. Diagnostic and treatment methodology – a document prepared by universities, research institutions, and professional medical associations, based on medical science and practice, which establishes general principles for diagnosing and treating health disorders and diseases.

4.5. Patient's request – a written request from an individual to a health care institution, asking for clarification, information, or desired documents.

4.6. Patient's complaint – a written request from an individual to a health care institution or a competent state institution, indicating that their rights or legitimate interests have been violated while providing health care services.

4.7. Damage to the patient's health – harm to the patient's health, injury, or death.

5.1. Every patient is provided with quality health care services, the indicators and content requirements of which are determined by the Minister of Health.

5.2. The patient has the right to conditions that do not degrade their dignity and honor, and to respectful treatment by health care professionals. Patients' rights in the Institution are not restricted based on their gender, age, race, citizenship, nationality, language, origin, social status, religion, beliefs, views, sexual orientation, genetic characteristics, disability, or any other circumstances not justified by law.

5.3. Every insured person has the right to receive free health care, compensated from the Compulsory Health Insurance Fund, in accordance with the Health Insurance Law and other legal acts. Emergency medical care must be provided to all patients immediately. In all other cases, uninsured patients pay the Institution according to the established rates.

5.4. The patient must be provided with scientifically based pain relief measures to prevent suffering due to their health disorders.

6.1. The Institution ensures conditions for patients that guarantee economic, communicative, and organizational accessibility of health care services and medical science principles, as well as compliance with medical ethics requirements, according to the patient's needs.

6.2. Emergency medical care is provided to the patient immediately, in accordance with the scope and procedure established by the Ministry of Health.

7.1. The patient has the right to choose a health care institution and a health care specialist. The procedure for selecting a health care specialist is established in the Institution's Internal Regulations.

7.2. The patient has the right to a second opinion from another specialist of the same professional qualification. When exercising this right, the patient's right to receive free health care may be limited in accordance with the procedure established by the Ministry of Health or its authorized institutions.

8. Right to information:

8.1. The patient has the right to receive information about the free and paid services provided by the Institution, their prices, and the possibilities of using them.

8.2. The patient has the right to receive information about the doctor and nursing staff providing health care services to them, indicating their name, surname, position, and professional qualification.

8.3. The patient is informed about the Institution's internal regulations.

8.4. The patient, upon presenting identification documents, has the right to receive information about their health condition, diagnosis, treatment or examination methods applied in the Institution or known to the doctor, possible risks, complications, side effects, treatment prognosis, and other circumstances that may affect the patient's decision to consent to or refuse the proposed treatment, as well as the consequences of refusing the proposed treatment. The information must be provided to the patient in a form they understand, explaining special medical terms.

8.5. The information specified in point 8.4 may not be provided to the patient only in cases where it would harm the patient's health or pose a threat to their life, or when the patient refuses this information. In such cases, the decision to limit the provision of information is made by the doctor providing health care services to the patient, noting it in the medical history.

8.6. Information about the health condition of a patient who cannot be considered capable of reasonably assessing their interests is provided to the patient's spouse, cohabitant (partner), parents (step-parents), and the patient's adult children upon their request. If the aforementioned persons are not available or it is not possible to contact them as quickly as necessary, information about the health condition of a patient who cannot be considered capable of reasonably assessing their interests is provided to one of the patient's adult siblings or one of the patient's adult grandchildren, or one of the patient's grandparents upon their request.

8.7. The patient has the right to receive copies of their medical history or other documents related to their illness, made at their expense. The doctor providing health care services to the patient must explain the meaning of the entries in the medical history to the patient. If the patient's request is justified, the doctor must correct, complete, delete, explain, and/or change inaccurate, incomplete, ambiguous data, or data unrelated to the diagnosis, treatment, or care. If the doctor does not agree with such a patient's request, the justification of the patient's request is decided by a council of doctors.

9.1. Information about the patient's health condition, diagnosis, treatment or examination methods applied in the Institution or known to the doctor, possible risks, complications, side effects, and treatment prognosis may not be provided to the patient against their will. The patient's refusal of information must be clearly expressed and confirmed by a signature.

9.2. The restrictions on providing information to the patient specified in point 9.1 do not apply if the patient's refusal to receive information may result in harmful consequences for the patient or other persons.

10.1. Upon the patient's request, their medical documents must be provided to them. The provision of medical documents to the patient may be restricted if the information contained therein would harm the patient's health or pose a threat to their life. The decision not to provide medical documents to the patient is made by the treating doctor. The decision not to provide medical documents and its reasons are noted in the medical documents.

10.2. The doctor providing health care services to the patient must explain the meaning of the entries in the patient's medical documents. If the patient's request is justified, inaccurate, incomplete, ambiguous data, or data unrelated to the diagnosis, treatment, or care, the health care specialist must correct, supplement, complete, delete, and/or change them within 15 working days. If the doctor does not agree with such a patient's request, the justification of the patient's request is decided by a council of doctors.

10.3. The specifics of the rights of patients with mental and behavioral disorders to access their medical documents are determined by the Law on Mental Health Care.

10.4. The representatives of a minor patient under the age of 16 have the right to access the minor's medical documents.

10.5. The patient has the right to receive certified copies of their medical history or other documents related to their illness, made at their expense. This right of the patient may be restricted only in accordance with the procedure established by the laws of the Republic of Lithuania.

11.1. The patient's private life is inviolable. Information about the patient's life facts may be collected only with the patient's consent and only if it is necessary for diagnosing, treating, or caring for the patient.

11.2. Data about the patient's presence in the Institution, their health condition, diagnostic, treatment, and care methods applied to them are recorded in the patient's medical documents of the established form and types. When determining the form, content, and use procedure of these documents, the patient's privacy is ensured.

11.3. Ensuring the patient's right to privacy, it must be guided by the principle that the patient's interests and well-being are more important than the interests of society. The application of this principle may be restricted in cases provided by law, when it is necessary for public security, crime prevention, public health, or the protection of the rights and freedoms of others.

11.4. All information about the patient's presence in the Institution, treatment, health condition, diagnosis, prognosis, and treatment, as well as all other personal information about the patient, is confidential even after the patient's death. The right to receive information after the patient's death is granted to heirs by will and by law, spouse (partner), parents, and children.

11.5. Confidential information may be provided to other persons only with the patient's written consent, which specifies the basis and purposes of providing such information, except in cases where the patient has specified in the medical documents a specific person who has the right to receive such information, as well as the scope and terms of providing such information.

11.6. The patient has the right to specify persons to whom confidential information may not be provided.

11.7. Confidential information may be provided to persons directly involved in treating or caring for the patient, or performing a health examination of the patient, without the patient's consent, in cases and to the extent necessary to protect the patient's interests.

11.8. If the patient is considered incapable of reasonably assessing their interests and there is no consent from the patient, confidential information may be provided to the patient's representative, spouse, cohabitant (partner), parents (step-parents), or adult children to the extent necessary to protect the patient's interests. If the aforementioned persons are not available or it is not possible to contact them as quickly as necessary, confidential information may be provided to one of the patient's adult siblings or one of the patient's adult grandchildren, or one of the patient's grandparents upon their request, to the extent necessary to protect the patient's interests.

11.9. At the patient's request, a third party may participate in the consultation if their participation is in line with the patient's will. The doctor must note the participation of a third party in the patient's examination/consultation in the medical history.

11.10. The patient has the right to remain only with the doctor if necessary.

12.1. The right to health care services without disclosing personal identity is granted to patients not younger than 16 years of age, in accordance with the Description of the Procedure for Providing Health Care Services When Personal Identity is Not Disclosed, approved by Order No. V-178 of the Minister of Health of the Republic of Lithuania dated March 4, 2010.

13.1. The patient cannot be included in biomedical research without their written consent. The procedure for including the patient in such research is determined by the Law on Ethics of Biomedical Research.

13.2. When including the patient in biomedical research and the educational process, it must be guided by the principle that the patient's interests and well-being are more important than scientific interests.

14.1. At the patient's request, a third party may participate in the consultation if their participation is in line with the patient's will. The third party participating during the patient's visit may be interpreters, caregivers, relatives, friends, other health care staff, students, residents.

14.2. The patient's consent for a third party to participate during the visit, as well as during internal/intimate examinations, is obtained verbally before the visit or examination begins.

14.3. The patient's refusal to allow a third party to participate is formalized in writing in the patient's medical history.

14.4. The doctor must note the participation of a third party in the patient's examination/consultation in the medical history.

15.1. The patient cannot be treated or provided with any other health care or nursing service against their will, unless otherwise provided by the laws of the Republic of Lithuania. If possible, the patient is offered alternative treatment or other health care services.

15.2. Emergency (first or urgent) medical care, when the patient is unconscious or for other reasons it is not possible to determine their will, and the patient's life or health is in danger, is provided without the patient's consent. Such care is also provided without the consent of the patient's representative if it cannot be obtained in time or if the representative refuses to give consent, and in the opinion of the doctor or nursing staff providing health care services to the patient, the provision of medical care is in the patient's interests. This must be noted in the patient's medical documents.

15.3. If the patient's legal representative refuses to give consent for treatment that is not urgent, and in the opinion of the treating doctor, the provision of medical care is in the patient's interests, the Lithuanian Medical Ethics Committee has the right to give consent for such treatment. The Institution's director or the doctor providing health care services to the patient applies to this committee.

15.4. The specifics of treating a patient suffering from a mental illness are determined by the Law on Mental Health Care of the Republic of Lithuania.

16.1. Every Patient has the right to emergency medical assistance, which is provided immediately by healthcare professionals. If the Institution is unable to provide appropriate emergency medical assistance to the Patient in a timely manner, it is ensured that the Patient is transferred to another healthcare institution as quickly as possible. The scope and procedure for providing emergency medical assistance are determined by the Ministry of Health of the Republic of Lithuania. When providing emergency medical assistance, the Institution follows the "Procedure for Providing Emergency Medical Assistance" approved by the Director of the Institution.

17.1. A Patient dissatisfied with healthcare services has the right to address the healthcare provider, the Director of the Institution regarding violated rights, conflicts with the Institution's employees, etc. Complaints are reviewed in the Institution in accordance with the Patient Complaint Review Procedure.

17.2. The Patient has the right to appeal the activities of the Institution to the Ministry of Health, other controlling institutions, or the court.

18.1. The Patient has the right to compensation for damages caused by the violation of their rights while receiving healthcare services.

19. The Patient must familiarize themselves with the Institution's internal rules and fulfill the obligations specified therein.

20. The Patient must take care of their health, use their rights honestly, not abuse them, cooperate with the Institution's specialists and employees.

21. The Patient, having registered for scheduled personal healthcare services, must arrive at the Institution at the specified time. If unable to arrive at the scheduled time, they must inform the Institution as soon as possible.

22. Patients wishing to receive healthcare services must present identity documents, except in cases of emergency healthcare.

23. The Patient must, to the best of their ability, provide healthcare professionals with information about their health, past illnesses, surgeries performed, medications used and currently being used, allergic reactions, genetic inheritance, and other known data necessary for the proper provision of healthcare services.

24. The Patient, having received information about the healthcare services assigned to them, must confirm their consent or refusal regarding the provision of these healthcare services in writing.

25. The Patient must follow the prescriptions and recommendations of healthcare professionals or refuse the assigned healthcare services in the prescribed manner. The Patient must inform healthcare professionals about any deviations from the prescriptions or the established regimen to which they have consented.

26. The Patient must behave respectfully and appropriately towards all employees of the healthcare institution and other patients.

27. The Patient must inform the registration office or other medical staff providing services about any changes in address and other contact details.

28. The Patient must maintain public order in the Institution's premises and territory: not make noise, not litter, not smoke, not consume alcohol, psychotropic or other mind-altering substances, except for the use of these substances for treatment purposes under the supervision of a healthcare professional, maintain personal hygiene, and so on.

29. If a Patient violates their obligations, thereby posing a threat to their own and other patients' health and lives, or hindering their ability to receive quality healthcare services, the provision of healthcare services may be terminated, except in cases where this would pose a danger to the Patient's life.

30.1. To bring cold and/or firearms into the Institution or its territory, or to bring (carry) animals.

30.2. To use a mobile phone during consultations with healthcare professionals and other diagnostic or treatment procedures.

30.3. To enter the Institution's service premises without authorization.

31. The Patient must take care of the Institution's property and is responsible for its damage or destruction in accordance with the procedure established by the legal acts of the Republic of Lithuania.