Patients’ rights

Main Law of Lithuania, Article 53 of the Constitution of Republic of Lithuania, regulates that the state takes care of people’s health and guarantees medical assistance and services in the event of illness of a person. This constitutional provision is concretized and the rights of patients are enforced through the laws and by-laws. The main laws governing the legal health relationship and ensuring the rights of patients are Civil Code of the Republic of Lithuania, Law on Health System of the Republic of Lithuania, the Law on Health Care Institutions of the Republic of Lithuania and special law – the Law on the Rights of Patients and Compensation for the Damage to Their Health of the Republic of Lithuania. By-laws adopted by the executive bodies regulate the realization and implementation procedures of some of the patients’ rights provided for in the laws.

The principles of the Law on the Rights of Patients and Compensation for the Damage to Their Health of the Republic of Lithuania define and detail the following basic rights of patients:

1. Right to High Quality Health Care Services. 

Each patient must be provided with high-quality health care: health care to be provided in accordance with the health care standards and other laws and to be ensured by the people with medical licence or other licence of appropriate practice to work in health care institutions and ensured by their civil liability for the damage to patients. 

2. Right to Choose a Health Care Institution and a Health Care Professional. 

The patient shall have the right in accordance with the procedure established by legal acts to choose a health care institution and a health care professional, as well as to the right to the opinion of other professional of the same professional qualification. 

3. Right to Information.

According to the procedure established by the head of a health care institution, the patient shall have the right to receive information about health care services provided in health care institutions, their prices and possibilities to access them, as well as the patient shall have the right to receive information about the health care professional providing health care services to him: his name, surname, professional duties and information concerning his professional qualification.

The patient, upon presentation of the documents confirming his identity, shall be entitled to receive information about his state of health, diagnosis, methods of treatment or examination applied in the health care institution or alternatives known to the doctor, potential risks, complications, side-effects, prognosis of the treatment and other circumstances that may have an effect on the acceptance or rejection by the patient of the proposed treatment, as well as about the consequences of rejecting the proposed treatment. The doctor must give the patient this information in a comprehensible form, taking into account his age and state of health, explaining special medical terms.

The patient should be informed about the decision to discharge him from the hospital or send him to another health care institution and the continuity of further health care and should confirm it by signature.

4. Right not to Know. 

Information about the patient’s state of health, diagnosis, methods of treatment or examination applied in the health care institution or alternatives known to the doctor, potential risks, complications, side-effects, prognosis of the treatment may not be communicated to the patient against his will. The patient must explicitly express his refusal of information and confirm it by signature. 

5. Right of Access to Entries in one’s Medical Records.

The patient, at his request, must be provided with his medical records or copies thereof, as well as 2 diagnosis and treatment descriptions must be issued to him. The health care professional must, within his competence, explain to the patient the meaning of the entries in his medical records. If the patient’s request is reasonable; the health care professional must within 15 working days correct, supplement, complete, delete and/or amend the data that is inaccurate, incomplete, ambiguous or the data that is irrelevant to the diagnosis, treatment or nursing. Any dispute between the health care professional and the patient concerning the correction of, supplement to, completion, deletion of and/or amendment to entries in the patient’s medical records shall be settled by the head of the health care institution.

6. Right to Privacy. 

In health care institutions, the data about the patient’s stay in a health care institution, his state of health, as well as the diagnostic, therapeutic and nursing measures taken shall be entered in the medical records of the established form and types. Any information about the patient’s stay in a health care institution, his treatment, state of health, diagnosis, prognoses and treatment, as well as any other personal information about the patient shall be considered confidential even after the death of the patient. After the patient’s death, his testamentary and statutory heirs, spouse (partner), parents and children shall be entitled to receive information. Confidential information may be disclosed to other persons only subject to the patient’s written consent specifying the grounds for disclosing such information and the purposes of its use, except in cases when the patient has specified by his signature in the medical documents which particular person is entitled to receive such information, as well as the scope of information and the terms of its provision. The patient shall be entitled to specify the persons to whom confidential information may not be disclosed.

7. Right to Anonymous Health Care. 

8. Right of Participation in Biomedical Research and Training Process. 

A patient may not be involved in biomedical research without his written consent. The patient who does not agree to take part in the teaching process or objects to the information about him being used for scientific and educational purposes shall make it known in writing. 

9. Right to Complain. 

Mechanism for Submission of Complaints and Protection of Rights

The patient (or his representative) who believes that his rights have been violated shall have the right to lodge a complaint to the health care institution in which, in his opinion, his rights have been violated. Only complaints which are signed by the patient, have the patient’s name and surname, his actual place of residence and contact details indicated, as well as the crux of the complaint set out shall be investigated. Where a complaint is lodged by the patient’s representative, the name and surname of the representative, his place of residence, the document confirming representation and the patient on whose behalf the complaint is made shall be specified. Illegible complaints that do not meet the requirements set in this paragraph shall be returned to the patient stating the reasons for the return. In the complaint, the patient must present the document confirming his identity. When such a complaint is sent by post or courier, it must be accompanied by a copy of the document confirming the applicant’s identity certified by a notary or the advocate representing the patient. The patient’s representative, when requesting such information, shall present the identity document and the document confirming representation. The patient shall be entitled to lodge a complaint not later than within one year after he becomes aware that his rights have been violated but not later than within three years after the date of the violation of his rights. Patients shall have the right to apply to state institutions (officials appointed by the Ministry of health of the Republic of Lithuania, State Health Care Accreditation Agency under the Ministry of Health, The National Health Insurance Fund under the Ministry of Health, Lithuanian Medical Ethics Committee, Public Health Centres in the counties) hearing patients’ complaints only if they are not satisfied with the investigation of complaints in the health care institution in which, in their opinion, their rights have been violated. Upon receiving the patient’s complaint, the health care institution must investigate it and notify the patient in writing of the results of the investigation not later than within 20 working days. Patients shall have the right to appeal, in accordance with the procedure established by laws, against decisions of state institutions hearing patients’ complaints.

The patient shall also have the right to complain to the Lithuanian Dental Chamber, municipal doctor, 3 medical ethics committee of the health care institution.

Hearing of patient complaints at the State Health Care Accreditation Agency under the Ministry of Health shall be regulated by the Description of the Procedure for the Examination of Complaints made by the Patients at the State Health Care Accreditation Agency under the Ministry of Health.

9. Right to the Compensation for the Damages

The patient shall have the right to compensation for the damages caused in violation of his rights during the provision of health care services. The conditions and procedures for the compensation for the damages are set out in the Law on the Rights of Patients and Compensation for the Damages to Their Health, the Civil Code, the Law on Insurance and other legal acts.

Compensation for the Damages Caused to the Patient

According to the general compensation outlines established in the Civil Code of the Republic of Lithuania, the rule in the civil law stands that the damages have to be indemnified by the person who caused it. The Law on the Rights of Patients and Compensation for the Damages to Their Health provides the mechanism of the health damage compensation: pre-litigation procedure – insurance against civil liability of institutions (doctors) and the Commission for the establishment of the damage caused to the patient’s under the Ministry of Health and litigation. Compulsory insurance against civil liability of institutions is regulated by the Civil Code of the Republic of Lithuania, The Law on the Rights of Patients and Compensation for the Damages to Their Health of the Republic of Lithuania, Law on Insurance of the Republic of Lithuania, description of the compulsory insurance against civil liability for the Commission on Evaluation of the Damage Caused to the Health of Patients. The damage caused to the patients due to the fault of the institution or its staff during the provision of health care services must be compensated by the health care institution. The aggrieved person has the right to express his requirements directly to the insurer or, if the damage exceeds the sum insured – to the person who caused the damage. Civil litigation process remains main mechanism of the hearing of the compensation for the damages caused to patients’ health related issues. The patient’s right to choose is limited: to resolve a dispute through litigation or claim damages done by the person from the health care institution. He must appeal following the claim lodging procedure – apply to a health care institution and (or) the insurer, and in the absence of insured event of civil liability – to the Commission on Evaluation of the Damage Caused to the Health of Patients under the Ministry of Health. If the patient does not agree with the decisions made by these institutions, litigation solution method is possible – to seek compensation through legal proceedings.

The patient or other persons who are entitled to compensation for the damages caused in violation of the established rights of patients and wishing to receive such compensation must make an application to the Commission on Evaluation of the Damage Caused to the Health of Patients operating under the Ministry of Health. The Commission on Evaluation of the Damage Caused to the Health of Patients shall be a mandatory pre-trial institution for handling disputes concerning the establishment of the fact of the violation of the rights of patients and the amount of damages caused thereby. The procedure for setting up this Commission, carrying out its activities, settling issues falling within its competence shall be regulated by the regulations of the Commission on Evaluation of the Damage Caused to the Health of Patients approved by the Government or an institution authorised by it. The rules of procedure of the Commission on Evaluation of the Damage Caused to the Health of Patients shall be approved by the Minister of Health. Decisions of the Commission on Evaluation of the Damage Caused to the Health of Patients shall be binding on health care institutions and the patient or other persons who are entitled to compensation for the damages. The patient or other persons who are entitled to compensation for the damage, and/or the health care institution, disagreeing with the decision of the Commission on Evaluation of the Damage Caused to the Health of Patients, shall, within 30 days from the adoption of the decision, or the persons who were not present during the decision making – within 30 days of becoming aware of the decision, have the right to apply to the court in accordance with the procedure established by the Code of Civil Procedure for hearing the dispute between the health care institution and the applicant in substance.

Insurance of Health Care Institutions against Civil Liability and its Control

Prior to commencing health care services, each health care institution shall take out compulsory and/ or voluntary insurance against civil liability to compensate for economic and non-economic damages. An insured event shall mean economic and non-economic damages caused to the patient in the course of the provision of health care services through the fault of the health care institution or its employees. 4 Where the insurance benefit is not sufficient to compensate for damages in full, the difference between the insurance benefit paid and the actual damages shall be covered by the health care institution which is liable for the damages caused.