Mofid Children's Hospital

Patient's Rights Charter in IRAN

All citizens are committed to maintain and respect human dignity. This fact is more important when individuals are suffering from illness. Therefore, providing healthcare must be based on justice and observing human dignity and patient's rights. The charter has been adjusted regarding dignity, Islamic-Iranian values, and it is also based upon the principle of equal intrinsic dignity for all recipients of health services. The charter aims to maintain, enhance, and consolidate human relations between the recipients and providers of health services.

Chapter 1: Every individual has the right to receive appropriate health care services.

Providing healthcare must be based on:

1-1) Respecting human dignity, cultural values, and religious beliefs;

1-2) Loyalty, equity, politeness and in association with kindness;

1-3) Freedom from any discrimination based on ethnicity, culture, religion, disease or gender;

1-4) Up-to-date knowledge;

1-5) Priority of patients' interest;

1-6) Justice and therapeutic priorities of patients in terms of health resource allocation;

1-7) Coordination of all aspects of care including prevention, diagnosis, treatment and rehabilitation;

1-8) Avoidance of causing unnecessary pain, suffering and limitation. This must be along with providing all basic and necessary welfare needs;

1-9) Focus on vulnerable groups of the society including children, pregnant women, elderly, mental patients, prisoners, mental and physical handicaps, and abandoned children;

1-10) Timely responses to patients' needs;

1-11) Considering certain variables such as language, age, and gender of health care recipients;

1-12) Ignoring medical costs in case of emergency;

in none emergency cases it must be based on predefined standards;

1-13) Trying to transfer the patient to a more specialized center, if necessary, and services are not available;

1-14) Bringing comfort to terminally ill patients nearing death. Comfort refers to decreasing patients' suffering and pain, to observe their (patients and their families) mental, social, spiritual and moral requirements at the time of death. Dying patients are entitled to be accompanied by a person of their choice.

 Chapter 2: Every individual has the right to receive a sufficient amount of desired information.

2-1) The information must contain the following:

2-1-1) Patient’s rights charter upon reception;

2-1-2) Standards and predictable costs of hospitalization including medical and non-medical services, insurance standards, and introduction to supportive systems upon reception;

2-1-3) Name, professional position, and the responsibilities of the members of the medical team in charge of the patient including, physician, nurse, student and their professional relations to each other;

2-1-4) Diagnostic and therapeutic techniques as well as advantages and disadvantages of each technique, its probable risks, side effects, diagnosis, prognosis methods and any information which might affect patients' decision;

2-1-5) How to reach the physician in charge and main members of the medical team during treatment;

2-1-6) All interventions which are conducted with the purpose of research;

2-1-7) Necessary information for treatment follow up.

2-2) Information must be offered in the following manner:

2-2 -1) Information must be provided at a proper time with consideration of patient’s condition. i.e., anxiety, pain, language, education, and comprehension,

Unless:

 - Postponing treatment in order to offer abovementioned information might harm the patient; in this case, information must be released at the proper time after taking necessary steps.

- Patient refuses to receive information despite knowing that they have the right to be informed. This refusal must be accepted if it does not cause serious harm to the patients or others.

2-2-2) Patients are entitled to access all their recorded medical information, receive their copies, and request corrections if necessary.

 Chapter 3: Every individual has the right to a free choice and decision about receiving healthcare services:

3-1) The scope of individual choice is:

3-1-1) To choose their physician and healthcare center according to current regulations;

3-1-2) To choose to receive advice from a consultant;

3-1-3) Voluntary participation in research ensuring their decision will never affect their ongoing care;

3-1-4) To accept or to reject proposed treatments after being informed about the medical consequences of their decisions, except in cases of suicide or harm to

others;

3-1-5) Patients' advance directives for times when they are incompetent.

3-2) Provisions for individual choice and decision making are:

3-2-1) Patients must make decisions freely and based on sufficient information as mentioned in chapter 2;

3-2-2) Patients must have been given enough time for decision making.

Chapter 4: Every individual has the right to privacy and confidentiality.

4-1) Observing patients' confidentiality is compulsory unless stated in regulations;

4-2) Patients' privacy must be respected at all times, and preparing all requirements to secure such right is necessary;

4-3) Only patients, people authorized by the patient, the law, and the medical team can have access to the information;

4-4) Patients are entitled to enjoy companionship of a person they wish, during diagnostic procedures such as physical examination. Parents can accompany their child during all treatment stages unless there is a medical restriction.

 Chapter 5: Every individual has the right to access an efficient complaint system

5-1) Every individual has the right to report violations to their rights (subject of the charter) to authority without jeopardizing the quality of the healthcare they receive.

5-2) Every individual has the right to be informed about the result of their complaint.

5-3) Any harm caused by healthcare providers must be dealt with according to the existing regulations as soon as possible.

If the patient is not able to make decisions for any reason, all patients’ rights mentioned in this charter apply to the surrogate decision maker. However, if the surrogate decision maker is opposed to treatment, against the physician's advice, the physician can demand intervention from related authorities.

If the patient lacks sufficient capacity to make decisions, but can participate in some parts of decision making reasonably, their decision must be respected.