PATIENT'S BILL OF RIGHTS

Declaration of Rights

Sec. 4. The Rights of Patients. - The following rights of the patient shall be
respected by all those involved in his care:

(1) Right to Appropriate Medical Care and Humane Treatment. - Every
person has a right to health and medical care corresponding to his state of health, without any discrimination and within the limits of the resources, manpower and competence available for health and medical care at the relevant time.
The patient has the right to appropriate health and medical care of good quality.
In the course of such care, his human dignity, convictions, integrity, individual needs and culture shall be respected.
If any person cannot immediately be given treatment that is medically necessary he shall, depending on his state of health, either be directed to wait for care, or be referred or sent for treatment elsewhere, where the appropriate care can be provided. If the patient has to wait for care, he shall be informed of the reason for the delay.
Patients in emergency shall be extended immediate medical care and treatment
without any deposit, pledge, mortgage or any form of advance payment for treatment.


(2) Right to Informed Consent. - The patient has a right to a clear, truthful and substantial explanation, in a manner and language understandable to the patient, of all proposed procedures, whether diagnostic, preventive, curative, rehabilitative or therapeutic, wherein the person who will perform the said procedure shall provide his name and credentials to the patient, possibilities of any risk of mortality or serious side effects, problems related to recuperation, and probability of success and reasonable risks involved: Provided, That, the patient will not be subjected to any procedure without his written informed consent, except in the following cases:
a. in emergency cases, when the patient is at imminent risk of physical injury, decline or death if treatment is withheld or postponed. In such cases, the physician can perform any diagnostic or treatment procedure as good practice of medicine dictates without such consent;
b. when the health of the population is dependent on the adoption of a mass health program to control epidemic;
c. when the law makes it compulsory for everyone to submit to a procedure;
d. when the patient is either a minor, or legally incompetent, in which case, a third party consent is required;
e. when disclosure of material information to patient will jeopardize the success of treatment, in which case, third party disclosure and consent shall be in order;
f. when the patient waives his right in writing.
Informed consent shall be obtained from a patient concerned if he is of legal age and of sound mind. In case the patient is incapable of giving consent and a third party consent is required, the following persons, in the order of priority stated hereunder, may give consent:
i. spouse;
ii. son or daughter of legal age;
iii. either parent;
iv. brother or sister of legal age, or
v. guardian
If a patient is a minor, consent shall be obtained from his parents or legal guardian.
If next of kin, parents or legal guardians refuse to give consent to a medical or surgical procedure necessary to save the life or 1imb of a minor or a patient incapable of giving consent, courts, upon the petition of the physician or any person interested in the welfare of the patient, in a summary proceeding, may issue an order giving consent.

(3) Right To Privacy and Confidentiality. - The privacy of the patients must be
assured at all stages of his treatment. The patient has the right to be free from
unwarranted public exposure, except in the following cases:
a) when his mental or physical condition is in controversy and the appropriate court, in its discretion, orders him to submit to a physical or mental examination by a physician;
b) when the public health and safety so demand; and c) when the patient waives this right.
The patient has the right to demand that all information, communication and
records pertaining to his care be treated as confidential. Any health care provider or practitioner involved in the treatment of a patient and all those who have legitimate access to the patient's record is not authorized to divulge any information to a third party who has no concern with the care and welfare of the patient without his consent, except:
a) when such disclosure will benefit public health and safety;
b) when it is in the interest of justice and upon the order of a competent court; and c) when the patients waives in writing the confidential nature of such information; d) when it is needed for continued medical treatment or advancement of medical science subject to de-identification of patient and shared medical confidentiality for those who have access to the information.
Informing the spouse or the family to the first degree of the patient’s medical
condition may be allowed; Provided, That the patient of legal age shall have the right to choose on whom to inform. In case the patient is not of legal age or is mentally incapacitated, such information shall be given to the parents, legal guardian or his next of kin.

(4) Right to Information. - In the course of his/her treatment and hospital care,
the patient or his/her legal guardian has a right to be informed of the result of the
evaluation of the nature and extent of his/her disease, any other additional or further contemplated medical treatment on surgical procedure or procedures, including any other additional medicines to be administered and their generic counterpart including the possible complications and other pertinent facts, statistics or studies, regarding his/her illness, any change in the plan of care before the change is made, the person’s participation in the plan of care and necessary changes before its implementation, the extent to which payment maybe expected from Philhealth or any payor and any charges for which the patient maybe liable, the disciplines of health care practitioners who will furnish the care and the frequency of services that are proposed to be furnished.

The patient or his legal guardian has the right to examine and be given an itemized bill of the hospital and medical services rendered in the facility or by his/her physician and other health care providers, regardless of the manner and source of
payment. He is entitled to a thorough explanation of such bill.

The patient or his/her legal guardian has the right to be informed by the physician
or his/her delegate of his/her continuing health care requirements following discharge, including instructions about home medications, diet, physical activity and all other pertinent information to promote health and well-being.
At the end of his/her confinement, the patient is entitled to a brief, written
summary of the course of his/her illness which shall include at least the history, physical examination, diagnosis, medications, surgical procedure, ancillary and laboratory procedures, and the plan of further treatment, and which shall be provided by the attending physician. He/she is likewise entitled to the explanation of, and to view, the contents of the medical record of his/her confinement but with the presence of his/her attending physician or in the absence of the attending physician, the hospital’s representative.
Notwithstanding that he/she may not be able to settle his accounts by reason of
financial incapacity, he/she is entitled to reproduction, at his/her expense, the pertinent part or parts of the medical record the purpose or purposes of which he shall indicate in his/her written request for reproduction. The patient shall likewise be entitled to medical certificate, free of charge, with respect to his/her previous confinement.
The patient has likewise the right not to be informed, at his/her explicit request.

(5) The Right To Choose Health Care Provider and Facility. - The patient is
free to choose the health care provider to serve him as well as the facility except when he is under the care of a service facility or when public health and safety so demands or when the patient expressly or impliedly waives this right.
The patient has the right to discuss his condition with a consultant specialist, at
the patient’s request and expense. He also has the right to seek for a second opinion and subsequent opinions, if appropriate, from another health care provider/practitioner.

(6) Right to Self-Determination. - The patient has the right to avail himself/herself of any recommended diagnostic and treatment procedures. Any person of legal age and of sound mind may make an advance written directive for physicians to administer terminal care when he/she suffers from the terminal phase of a terminal illness: Provided, That
a) he is informed of the medical consequences of his choice;
b) he releases those involved in his care from any obligation relative to the consequences of his decision;
c) his decision will not prejudice public health and safety.

(7) Right to Religious Belief. - The patient has the right to refuse medical treatment or procedures which may be contrary to his religious beliefs, subject to the limitations described in the preceding subsection: Provided, That such a right shall not be imposed by parents upon their children who have not reached the legal age in a life threatening situation as determined by the attending physician or the medical director of the facility.

(8) Right to Medical Records. - The patient is entitled to a summary of his
medical history and condition, He has the right to view the contents of his medical
records, except psychiatric notes and other incriminatory information obtained about third parties, with the attending physician explaining contents thereof. At his expense and upon discharge of the patient, he may obtain from the health care institution a reproduction of the same record whether or not he has fully settled his financial obligation with the physician or institution concerned.
The health care institution shall safeguard the confidentiality of the medical records and to likewise ensure the integrity and authenticity of the medical records and shall keep the same within a reasonable time as may be determined by the Department of Health.
The health care institution shall issue a medical certificate to the patient upon request. Any other document that the patient may require for insurance claims shall also be made available to him within a reasonable period of time.

(9) Right to Leave. - The patient has the right to leave a hospital or any other health care institution regardless of his physical condition: Provided, That
a) he/she is informed of the medical consequences of his/her decision;
b) he/she releases those involved in his/her care from any obligation relative to the consequences of his decision;
c) his/her decision will not prejudice public health and safety.
No patient shall be detained against his/her will in any health care institution on the sole basis of his failure to fully settle is financial obligations. However, he/she shall only be allowed to leave the hospital provided appropriate arrangements have been made to settle the unpaid bills: Provided, farther, that unpaid bills of patients shall be considered as lost income by the hospital and health care provider/practitioner and shall be deducted from gross income as income loss for that particular year.

(10) Right to Refuse Participation in Medical Research. - The patient has the
right to be advised if the health care provider plans to involve him in medical research, including but not limited to human experimentation which may be performed only with the written informed consent of the patient. Provided, further, That, an institutional review board or ethical review board in accordance with the guidelines set in the Declaration of Helsinki be established for research involving human experimentation:
Provided, finally, That the Department of Health shall safeguard the continuing training and education of future health care provider/practitioner to ensure the development of the health care delivery in the country.

(11) Right to Correspondence and to Receive Visitors - The patient has the right
to communicate with relatives and other persons and to receive visitors subject to
reasonable limits prescribed by the rules and regulations of the health care institution.

(12) Right to Express Grievances. - The patient has the right to express
complaints and grievances about the care and services received without fear of
discrimination or reprisal and to know about the disposition of such complaints. The Secretary of Health, in consultation with health care providers, consumer groups and other concerned agencies shall establish a grievance system wherein patients may seek redress of their grievances. Such a system shall afford all parties concerned with the opportunity to settle amicably all grievances.

(13) Right to be Informed of His Rights and Obligations as a Patient. – Every person has the right to be informed of his rights and obligations as a patient. The Department of Health, in coordination with health care providers, professional and civic groups, the media, health insurance corporations, people’s organizations, local government organizations, shall launch and sustain a nationwide information and education campaign to make known to people their rights as patients, as declared in this Act. Such rights &d obligations of patients shall be posted in a bulletin board conspicuously placed in a health care institution.

It shall be the duty of health care institutions to inform patients of their rights as
well as the institution's rules and regulations that apply to the conduct of the patient while in the care of such institution.