International patient rights are among the most important issues that health tourism players are required to comply with. Many of these laws are common in the countries where health tourists are visiting. In this section, we will examine the laws and rights of international patients in Iran
Right to access information
Every patient has the right to have sufficient and complete information about the nature of the disease, cause, provisional/confirmed diagnosis, recommendations and possible complications of their treatment in a language that is completely relevant to them (the patient),
Right to access medical records and documents and reports
The patient or his/her companion has the right to access the original/copy of the case files, patient records, treatment reports (during the hospitalization, within 24 to 72 hours after discharge)
Right to emergency medical care
All hospitals, whether in the public or private sector, have a duty to provide basic emergency medical care and injured persons have the right to receive immediate medical care
Right to informed consent
- Every patient has the right to fully and fully complete informed consent forms before any potentially dangerous test/treatment (e.g. invasive research/surgery/chemotherapy) that carries certain risks. And consent forms with appropriate protocols and in the patient's language should be provided to patients on a mandatory basis to obtain informed consent.
Right to confidentiality, human dignity and privacy
All patients have the right to privacy and doctors have a duty to keep information about their health status and treatment plan confidential. Except in special circumstances and in the interest of protecting the patient or others or due to public health considerations
Right to a second opinion (requesting a second doctor's opinion)
Every patient has the right to request a second opinion from a specialist of their choice. Hospital management has a duty to respect the patient's right to a second opinion and to provide the patient's companions with the necessary records and information without any additional costs or delays
Right to transparency in rates, and care according to the established rates
Every patient and their companions have the right to be fully informed about the rates that the hospital charges for each type of service provided and the facilities available in it. They have the right to receive full and detailed information on all matters at the time of payment.
Right to non-discrimination
Every patient has the right to be treated without discrimination based on their illness or condition, including HIV status or other health-related conditions, religion, nationality, ethnicity, gender, age, sexual orientation, linguistic or geographical and social origins.
Right to safety and quality care as per standards
Patients in hospitals have the right to safety and security. They have the right to receive necessary care in an environment that has adequate cleanliness, infection control measures, safe drinking water as per BIS/FSSAI standards and sanitation.
Hospital management has the duty to ensure the safety of all patients in the hospital premises including cleanliness and infection control related matters
Patients have the right to receive quality healthcare services in accordance with accepted standards, norms and guidelines, as per the National Accreditation Assessment
Right to choose alternative treatment options
Patients and their companions have the right to choose between alternative treatment options after considering all aspects of the existing situation
This section covers cases where the patient refuses care after considering all available options, accepting responsibility for the consequences of doing so. If the patient leaves the treatment center against medical advice (despite the effects that this may have on the patient's treatment and condition), this personal decision of the patient should not affect the observance of the various rights mentioned in this Charter
The right to choose the provider, to receive medication or to undergo a test
When any medication is prescribed by the doctor or hospital, the patient or his/her companion has the right to choose the pharmacy (authorized and registered). Similarly, when the doctor recommends that diagnostic measures be performed, the patient and his/her companion have the right to receive the diagnostic services of their choice from any registered diagnostic center/laboratory with a national accreditation license.
Right to appropriate referral and transfer, free from harmful effects
A patient has the right to continuity of care and the right to be properly admitted to the first treatment facility or any other place where he/she sought treatment
When transferring from one treatment facility to another, the patient/his/her companion must receive a full explanation of the reason for the transfer and the alternative options for transfer and must confirm that all necessary procedures for transfer and admission to the new facility have been completed
Right to protection of patients subject to clinical trials
Any person/patient subject to clinical trials has the right to receive appropriate care. All clinical trials must be conducted in accordance with the protocols and guidelines issued by the relevant organizations. This section includes the following:
- Patients’ participation in clinical trials should always be based on informed consent and after receiving all relevant information. The patient should be given a copy of the signed informed consent form, which contains the basic information about the clinical trial.
- The patient’s right to agree or refuse (to participate in a clinical trial) should be respected and his refusal should not affect routine care.
- The patient has the right to be informed in writing about the name of the drug/pharmacological intervention along with the date, dose and duration of administration during the trial.
- At all times, the patient’s privacy during the trial session should be maintained and any information collected from him should be kept confidential.
- If the patient suffers any adverse effects during the clinical trial, regardless of their connection to the clinical trial, he has the right to be monitored by a forensic physician until it is determined that the harm is not related to the clinical trial. In addition, financial or other assistance should be provided to compensate for damages and disabilities. In the event of death, the patient's relatives have the right to compensation.
- Institutional mechanisms should be established to cover insurance for diseases related or unrelated to clinical trials (ancillary care) and to grant compensation by the relevant ethics committee.
- After the trial, the patient should be assured of access to the best possible treatment methods.
Right to protection of participants in medical and health research
Every patient participating in medical research should be identified as a research participant and every participant in this research has the right to appropriate protection in this regard.
Documented informed consent should be obtained from research participants. In research involving vulnerable populations, additional safeguards should be taken. The rights to dignity, privacy and confidentiality of individuals and communities should be protected.
Research participants are at risk of any direct physical, mental, emotional, social, legal or economic harm as a result of their participation and may, after appropriate assessment, benefit from financial or other relevant assistance to ensure that they have the right to fair compensation for any temporary or permanent impairment or disability suffered by the patient.
The benefits of research should be made available to individuals and communities, where appropriate.
Right to Discharge or Receive the Body of a Deceased from the Hospital
A patient has the right to be discharged and cannot be forcibly detained in the hospital for reasons such as a dispute over payment of hospital fees (non-discharge).
Similarly, a patient's guardian has a legal right to the deceased and the patient's body cannot be held in the hospital due to hospital processes such as non-payment or financial disputes related to treatment.
Hospital management has a duty to respect these rights and refrain from forcibly detaining a patient (non-discharge) or detaining a deceased person who is being treated in the hospital under any circumstances.
Right to patient education
The patient has the right to receive the necessary education about the main facts regarding his/her condition and healthy lifestyle, the insurance services that officially support the patient's rights, and the procedure for possible complaints.
The hospital director and the attending physician have the duty to provide this education to each patient according to standard procedures in a language that patients understand and communicate in a simple and easy way.
The right to be heard and to compensation
The patient and his/her companion have the right to express their feedback in various cases or to declare a possible complaint about the health care they have received from the doctor or the hospital.
Due to the violation of any of the rights mentioned in this Charter, the patients and their companions have the right to request compensation.
This may be done by filing a complaint with an official authority designated by the hospital/healthcare provider for this purpose (such as the Patients’ Rights Tribunal or the Clinical Institutions Regulatory Authority).
All complaints should be registered with a unique tracking number and there should be a robust tracking mechanism to determine the status of the complaint.
Patient and Legal Guardian Responsibilities
In addition to upholding their rights, patients and their legal guardians/companions must also comply with their responsibilities so that hospitals and doctors can do their job fully and satisfactorily:
- Patients should provide their doctor with all health-related information in response to the doctor's questions without withholding any relevant information, in order to facilitate diagnosis and treatment.
- Patients should cooperate with the doctor during examinations, diagnostic tests and treatment, and should follow the doctor's recommendations while respecting their right to participate in treatment decisions.
- Patients should follow all instructions regarding appointment times, cooperate with hospital staff and other patients, avoid disturbing other patients, and maintain cleanliness in the hospital.
- Patients should respect the dignity of the doctor and other hospital staff as human beings and as professionals. Whatever the complaint, the patient/companion should not resort to violence in any way and cause harm or destroy the property of the hospital or the service provider.
- Patients should take responsibility for their actions based on the choices made regarding treatment options in the event of refusal of treatment.
