All patients are provided with the best possible service commensurate with medical knowledge and available technology. These services are provided while duly respecting the human dignity and autonomy of each patient, without any distinction on the basis of social class, sexual orientation or philosophical conviction.
Care with a view to preventing, treating and alleviating physical and psychological pain forms an integral part of the patient's treatment.
The patient personally chooses a healthcare practitioner and can reconsider that choice at all times.
In some cases the law or circumstances peculiar to the healthcare can restrict that freedom of choice (e.g. mandatory admission of a person with a mental illness and where there is only one specialist in a hospital).
On the other hand, every healthcare practitioner can refuse to provide a patient with services for personal or practitioner reasons, except in cases of emergency.
If the healthcare practitioner stops providing treatment, (s)he must guarantee continuity of care.
The healthcare practitioner provides the patient with all the information necessary to gain an understanding of his/her health condition (i.e. the diagnosis) and its probable evolution.
The healthcare practitioner also indicates recommended future behaviour (e.g. there are certain pregnancy-related risks).
How is the patient informed?
The healthcare practitioner orally communicates the information to the patient in clear language that is adjusted to the patient.
The patient can also request that this information be confirmed in writing.
The patient can have a confidant assist him/her or can request that this information be communicated to such person. Where appropriate, the healthcare practitioner makes a note in the health records of the identity of the confidant and of the fact that the information was communicated to or in the presence of this person.
The confidant: a family member, friend, other patient or any other person designated by the patient to assist him/her in obtaining information on his/her state of health, the perusal of his/her health records or obtaining a copy of his/her health records, and in lodging a complaint.
The patient does not wish to receive the information
The healthcare practitioner respects the patient's wish not to be informed, except if this entails a serious health risk for the patient or for third parties (e.g. infectious disease).
The information poses a serious threat to the patient’s health
A healthcare practitioner can withhold certain information from a patient in exceptional cases and temporarily if (s)he is of the opinion that the information in question would seriously harm the patient’s health at that point in time.
In such cases the healthcare practitioner must do the following:
· consult another healthcare practitioner;
· make a note of the reasons for his/her decision in the health records;
· communicate the sensitive information to any confidant designated by the patient.
Before starting treatment, a healthcare practitioner attending to a patient must obtain such patient's voluntary and informed consent for the treatment.
This means that the healthcare practitioner must have adequately informed the patient of the characteristics of the intervention, i.e.:
· the purpose of the intervention, degree of urgency, duration, side-effects, risks, aftercare, etc.;
· the cost price (fees, non-refundable medical expenses, supplements, etc.);
· possible alternatives.
If it is impossible to procure the consent of the patient or that of his representative (e.g. in the case of an emergency), the healthcare practitioner provides all the necessary treatment and states this in the health records.
How does the patient give consent?
The patient agrees orally or the healthcare practitioner concludes from the patient's behavior that the latter gives his/her consent for the intervention.
The patient can grant conditional consent (e.g. terminating chemotherapy if this does not work).
On condition that there is mutual consent, the patient and the healthcare practitioner can agree to set out the consent in writing and add it to the health records.
If the patient withdraws or refuses consent
The healthcare practitioner respects the withdrawal or refusal of the patient’s consent as long as the patient has not revoked this decision.
However, the healthcare practitioner continues to provide a quality service (e.g. continues to provide essential physical care for a patient who refuses food and water).
The patient or practitioner can request that the withdrawal or consent refusal be stated in the health records.
If the patient is in a state of health that prevents him/her from expressing his/her will (e.g. in a coma or in the case of a degenerative mental disorder) the healthcare practitioner must respect the prior declaration of will that the patient drew up at the point in time that (s)he was still able to exercise his/her rights.
Such a prior statement of will:
· may contain the notice that the patient refuses to give his/her consent for a certain intervention;
· is preferably drawn up in the presence of a third party (e.g. a healthcare practitioner) to avoid divergent interpretations;
· is not limited in time, unless the patient revokes this at a moment that (s)he is capable of exercising his/her rights.
The patient is informed by the healthcare practitioner if (s)he has an insurance coverage or another form of protection related to his/her professional liability, as well as if (s)he is insured or registered (in particular via the visa which (s)he received from the minister competent for Public Health, his/her registration in the Belgian National Service for Medical and Disablement Insurance or the Belgian Medical Association).
The healthcare practitioner duly keeps the health records up to date for each patient, which (s)he (the healthcare practitioner) keeps in a safe place.
If the patient chooses to have another healthcare practitioner, (s)he can request that his/her health records be transferred to guarantee continuity of care.
How can the patient examine his/her record?
The patient can ask (orally or in writing) the healthcare practitioner to peruse his/her health records.
The patient can designate a confidant (whether or not a healthcare practitioner) in writing, who can peruse the records with him/her or in his/her place. The patient’s request and the identity of the confidant are added to the health records.
The healthcare practitioner has 15 days as of the date on which this request is received to present the records to the patient, with the exception of the following:
· the healthcare practitioner’s personal notes;
· data relating to third persons;
· the data in respect of which the healthcare practitioner is exceptionally of the opinion that they can have a serious adverse effect on the patient’s health at that moment; in this case only a healthcare practitioner designated by the patient can peruse the records, including the personal notes.
How can the patient obtain a copy of his/her records?
The patient can request a copy of his/her health records under the same conditions as for perusal.
The copy is marked “strictly personal and confidential”.
The healthcare practitioner does not provide a copy if he avails of elements indicating that the patient is under pressure to communicate the information in question to third parties (e.g. employer or insurance company).
Access to the records by the deceased patient’s next of kin
After the patient has passed away, the partner and relatives to the second degree included ((grand)parents, (grand)children, brothers and sisters) can indirectly consult the health records through the intervention of a healthcare practitioner and on the following conditions:
· the patient may not have objected to such perusal during his/her lifetime;
· reasons must be given for the request for perusal and the reasons must be sufficiently serious to grant an exception to the deceased’s right to privacy (e.g. suspicion of a medical error, tracing family antecedent);
· the right to perusal is limited to those data related to the reasons provided by the family members.
Subject to the patient’s consent, only the persons whose presence is professionally justified may be present during treatment or an examination.
No information whatsoever on the patient’s state of health can be communicated to third persons, unless this is expressly provided for by law.
A person can lodge a complaint with a local ombudsman or Federal Ombudsman Service when (s)he is of the opinion that one of his/her rights as a patient has been infringed. The person concerned can have a confidant whom (s)he has designated assist him/her in this matter.