Charter of patients' rights

Bill of rights of patients in Iran

Insight and value

Every member of the society is committed to preserve and respect the dignity of human beings. This is of special importance in the condition of illness. According to the constitution, paying attention to human dignity is one of the basic principles of the Islamic Republic, and the government is obliged to provide healthcare services for every person in the country. Based on this, the provision of health services should be fair and based on respect for the rights and human dignity of patients.

This charter is organized according to high human values and based on Islamic and Iranian culture and on the basis of equality of inherent dignity of all recipients of health services and with the aim of maintaining, promoting and strengthening the human relationship between providers and recipients of health services.

Patient rights

1- It is the patient’s right to receive optimal health services.

• The provision of health services should:

1-1) be worthy of human dignity and with respect for values, cultural and religious beliefs;

2-1) be based on honesty, fairness, politeness and kindness;

3-1) regardless of any discrimination, including ethnic, cultural, religious, type of disease and gender;

4-1) be based on current knowledge;

5-1) be based on the superiority of the patient’s interests;

6-1) regarding the distribution of health resources based on justice and treatment priorities of patients;

7-1) It is based on the coordination of the elements of care including prevention, diagnosis, treatment and rehabilitation;

8-1) along with the provision of all the basic and necessary welfare facilities and away from imposing pain and suffering and unnecessary restrictions;

9-1) pay special attention to the rights of vulnerable groups in society, including children, pregnant women, the elderly, mentally ill, prisoners, mentally and physically disabled, and people without guardians;

10-1) as soon as possible and with respect to the patient’s time;

11-1) considering variables such as language, age and gender of service recipients;

12-1) In the case of urgent and necessary care (emergency), it should be done regardless of the provision of its cost. In non-urgent cases (elective) based on defined rules;

13-1) In urgent and necessary care (emergency), if it is not possible to provide appropriate services, it is necessary to provide the basis for transferring the patient to an equipped unit after providing the necessary services and the necessary explanations;

14-1) In the final stages of life, when the condition of the disease is irreversible and the death of the patient is imminent, it should be presented with the aim of maintaining his comfort. Comfort means reducing the patient’s pain and suffering, paying attention to the mental, social, spiritual and emotional needs of him and his family at the time of death. The dying patient has the right to be with the person he wants in the last moments of his life.

2- Information should be provided to the patient in a good way and in sufficient quantity.

1-2) The information content should include the following:

1-2-2) The provisions of the patient’s bill of rights at the time of admission;

2-1-2) Predictable criteria and costs of the hospital, including medical and non-medical services, insurance regulations and the introduction of support systems at the time of admission;

3-1-2) The name, responsibility and professional rank of the members of the medical group responsible for providing care, including doctors, nurses and students, and their professional relationship with each other;

4-1-2) diagnostic and treatment methods and the strengths and weaknesses of each method and its possible complications, disease diagnosis, prognosis and complications, as well as all information influencing the patient’s decision-making process;

5-1-2) How to access the attending physician and the main members of the medical team during the treatment;

6-1-2) All actions that have a research nature;

7-1-2) providing necessary training for the continuation of treatment;

2-2- The way to provide information should be as follows:

1-2-2)Information should be provided at the right time and according to the patient’s conditions, including anxiety and pain, and his/her personal characteristics, including language, education, and comprehension, unless:

– delay in starting the treatment by providing the above information will cause harm to the patient; (In this case, the transfer of information should be done at the first appropriate time after necessary action).

 – In spite of being informed of the right to receive information, the patient refuses to do so, in which case the patient’s request should be respected, unless the patient’s lack of information puts him or others at serious risk;

2-2-2) The patient can have access to all the information recorded in his clinical file and receive a picture of it and request the correction of the mistakes contained in it.

3- The patient’s right to choose and make a free decision in receiving health services should be respected.

1-3) The range of selection and decision is about the following:

1-1-3) Selection of the treating physician and the center providing health services within the framework of the criteria;

2-1-3) Selection and opinion of the second doctor as a consultant;

3-1-3) Participation or non-participation in any kind of research, with the assurance that his decision will not affect the continuation and manner of receiving health services;

4-1-3) Accepting or rejecting proposed treatments after being aware of the possible side effects of accepting or rejecting them, except in cases of suicide or cases where refusing treatment puts another person at serious risk;

5-1-3) The declaration of the patient’s previous opinion about the future treatment measures when the patient has the capacity to make a decision should be recorded and used as a guide for medical procedures when he/she lacks the capacity to make a decision in accordance with the legal standards and considered by health service providers and the patient’s substitute decision maker.

2-3) The selection and decision-making conditions include the following:

1-2-3) The patient’s choice and decision must be free and informed, based on receiving sufficient and comprehensive information (mentioned in the second paragraph);

2-2-3) After providing the information, the patient should be given enough time to make a decision and choose.

4- The provision of health services should be based on respecting the privacy of the patient (right to privacy) and respecting the principle of confidentiality.

1-4) It is mandatory to observe the principle of confidentiality regarding all information related to the patient, except in cases where the law has made an exception;

2-4) The patient’s privacy must be respected in all stages of care, including diagnosis and treatment. For this purpose, it is necessary to provide all necessary facilities to guarantee the privacy of the patient;

3-4) Only the patient and the treatment group and authorized persons on behalf of the patient and persons who are considered authorized by law can have access to the information;

4-4) The patient has the right to have a trusted person with him during the diagnostic process, including examinations. It is the child’s right to be accompanied by one of the child’s parents in all stages of treatment, unless this is against medical necessity.

5- Access to an efficient complaint handling system is a patient’s right.

1-5) Every patient has the right to complain to the competent authorities in case of violation of his rights, which is the subject of this charter, without disturbing the quality of receiving health services;

2-5) Patients have the right to be informed about the procedure and results of their complaint;

3-5) The damage caused by the error of the health service providers must be compensated in the shortest possible time after investigation and proof according to the regulations.

In implementing the provisions of this charter, if the patient lacks decision-making capacity for any reason, the exercise of all the rights of the patient – mentioned in this charter – will be the responsibility of the substitute legal decision maker. Of course, if the substitute decision-maker prevents the treatment of the patient against the doctor’s opinion, the doctor can request a reconsideration of the decision through the relevant authorities.

If a patient who lacks sufficient capacity to make a decision, but can make a reasonable decision in a part of the treatment process, his decision should be respected.