The rights of citizens and patients
LA SALUTE E’ UN DIRITTO FONDAMENTALE DI OGNI PERSONA
There health is a fundamental right of every person and in Italy, this right is enshrined in the Constitution ("The Republic protects health as a fundamental right of the individual and in the interest of the community, and guarantees free care to the poor", Italian Constitution art. 32). To protect this right, the National Health Service (SSN) - through its structures, services and activities - pursues the promotion, maintenance and recovery of the physical and mental health of the entire population, according to the principles of universality, Equality and Equity (Law 23 December 1978, n. 833).
Citizens, in their relationship with health services, are holders of specific rights. With the European Charter of Patients' Rights, citizens' and patients' associations have identified 14 fundamental rights:
- Right to preventive measures
- Right to access
- Right to information
- Right to consent
- Right to free choice
- Right to privacy and confidentiality
- Right to respect for patients' time
- Right to compliance with quality standards
- Right to security
- Right to innovation
- Right to avoid unnecessary suffering and pain
- Right to personalized treatment
- Right to complaint
- Right to Compensation
Some of the rights indicated by the European Charter are reflected in the principles that underlie our NHS, while others have been indicated in regulations subsequently issued. Below is a first review of the rights which it is important to be aware of due to the practical implications they have in the experience with health services.
It is the right of every citizen to use thehealth and social care assistance. The National Health Service (SSN) is required to provide all citizens - free of charge or upon payment of a participation fee (ticket) - with public resources collected through general taxation, a set of benefits and services, definitive Essential levels of assistance (LEA). These services concern both the prevention activities aimed at communities and individuals (vaccines, screening, food safety, etc.), and the health and social-health activities and services spread throughout the territory (general practitioner, pediatrician, specialist outpatient assistance, home social and health care, etc.), and hospital care. The list of services included in the LEAs was updated in 2017. (Decree of the President of the Council of Ministers (DPCM) of 12 January 2017). In the section "Services guaranteed by the NHS” of the Transparency Portal you can find a search engine to find the benefits and aids to which you are entitled.
It is the right of every citizen to be able access your medical records upon request at the facility in which he was hospitalized. The release of the copy of the medical record (preferably in electronic format) must take place within 7 days from the date of the request, while any additions can be provided within 30 days of the request (Law 8 March 2017, n. 24 – Article 4 Transparency of data). In the section "Collect reports and medical records” of the Transparency Portal you can find the operating methods with which the individual health and hospital companies deliver reports and medical records.
It is the right of every citizen to express his own opinion informed consent to any proposed diagnostic-therapeutic-rehabilitative treatment. No health treatment can be started or continued without the free and informed consent of the person concerned, with the exception of those conditions governed by specific legal provisions (e.g. compulsory vaccinations, psychiatric illnesses). Only after having been informed, in the context of a relationship of care and trust, in a complete, updated and understandable way is it possible to express a truly informed consent. Informed consent, in whatever form it is expressed (written, video-recorded, with communication devices for people with disabilities), is entered in the medical record and in the electronic health record (Article 32 of the Constitution and Law 22 December 2017, n. 219).
It is the right of every citizen who comes into contact with healthcare facilities and professionals protection of your privacy.. This right guarantees complete confidentiality with respect to one's personal data and in particular with respect to one's sensitive data, ie relating to the state of health, acquired during contact with the structure or the professional. Furthermore, the acquired data must be processed for defined purposes. Each individual has the right to access their data, to obtain their rectification and in some cases, as required by the General Regulations for the protection of personal data, to request their cancellation (right to be forgotten) (General regulation for the protection of personal data n. 2016/679 - General Data Protection Regulation or GDPR; Legislative Decree 10 August 2018, n. 101.).
It is the right of every citizen consult in real time the wait relating to visits and examinations provided in a public or private regime within structures affiliated with the NHS. The citizen can also ask the Health Directorate or the Hospital Medical Directorate to know his own position on the waiting list for admission [National Government Plan for Waiting Lists (PNGLA) 2019-2021]. In the section "Waiting time” of the Transparency Portal you can find out the waiting times published on the web by the regions, by health and hospital companies.
It is the right of every citizen theresafety of care,, which is considered an integral part of every individual's right to health and is pursued in the interest of the individual and the community. The right to safe treatment is also ensured thanks to all the prevention and risk management activities associated with healthcare services and the appropriate use of resources. All health and social care personnel, belonging to public, private or freelance structures, will contribute to these prevention activities (Law 8 March 2017, n. 24).
It is the right of every citizen access pain management and palliative care,, in order to protect the dignity and autonomy of the person as well as his health needs, avoiding suffering and pain. Citizens must be guaranteed an individual treatment program aimed at promoting quality of life at every stage of the disease, particularly in the terminal stage, through adequate health and social-welfare support, both for the sick person and the family (Law 15 March 2010 n. 38). In the section "Palliative care” of the Transparency Portal you can find insights on the subject.
It is the right of every citizen to express advance treatment provisions (DAT).. With these provisions the citizen, of age and in full possession of his faculties, expresses his will on the "end of life" in the hypothesis in which the irreversible loss of the ability to understand and want occurs suddenly. In addition to the possibility of expressing these provisions, citizens have the right to identify a trusted person (trustee) who will take their place and represent them in relations with the doctor and health facilities (Law 22 December 2017, n. 219).
It is the right of every citizen to access the religious assistance service in the hospitalization facilities of the national health service. The competent ASL or the health management of the structure provide the Catholic religious assistance service, but upon request to the responsible body it is possible to activate the service also for other religious cults (Law 23 December 1978, n. 833 - Art.38).