Patient rights and responsibilities

The doctor cannot solve all problems and cannot cure all diseases. Therefore, there cannot be a right to be cured.

However, every person has the right to be treated appropriately, to receive treatment and diagnostic interventions that are scientifically recognized and possibly supported by evidence of documented efficacy, and that can lead to cure or at least improve the quality of life in illness.

Also part of the right to care are the rights to pain relief and respectful support especially at the end of life, ensuring the dignity and wishes of the sick person.

In this context, the active cooperation of the patient is necessary and indispensable. The patient must be able to express his or her feelings and symptoms, as well as his or her personal opinions about the possible origins of the discomfort, treatment, and proposed examinations. This input is essential to enable the physician to understand the nature of the problem, search for the origin of the malaise, recognize the disease behind a symptom, and finally set the most appropriate therapy.

Correct information is essential to enable a patient to give or withhold consent to a health care service.
In this sense, the patient has the right to obtain clear information about:

• their own health status.
• the possible treatments and interventions, as well as their benefits and risks.
• any related costs not covered by compulsory health insurance.

To do this, the doctor will use understandable words and explain clearly and objectively what the disease is (diagnosis), what treatment options exist (therapies), and what the chances of recovery are (prognosis).

The patient also has the right to know the generalities and professional qualifications of those treating him or her. For this purpose, all caregivers working in EOC facilities are identified with an identification card bearing their first name, last name and function.

No treatment may be performed without the patient's consent. This measure applies to all persons capable of discernment, that is, capable of understanding their clinical situation, assessing the implications, and making decisions.

Normally consent must be given explicitly for surgical interventions, major invasive actives, and/or high risk. In these situations, the physician informs the patient promptly and fully about the benefits and possible risks or complications, as well as possible alternatives.

Consent can be withdrawn at any time.

In the case of patients under the age of 16 or over 16 but incapable of discernment, consent is given by the parents or legal representative.

However, minors, including those under the age of 16 and capable of discernment, may obtain the counseling and services of Sexual Health Counseling Centers even without parental consent.

Only in cases of temporary incapacity for discernment (unconscious patient) and imminent danger of death or serious damage to health, the caregivers are authorized to carry out the necessary urgent medical measures, considering the patient's consent presumed.

Within EOC, the following forms are used for interventions that require the patient's signed consent:

Numerous clinical trials are conducted at EOC, aimed at improving the efficacy, quality or safety of a treatment. As a patient, the person may be offered to participate in a specific clinical trial. The patient is free to accept or decline participation in the study, without this choice of his or her having any repercussions on the intake.

The patient, if he or she is capable of understanding what he or she is doing and if he or she is at least 16 years old, has the option of discontinuing a treatment, refusing health care services (treatment, therapy, examinations, or interventions), and leaving the health care facility prematurely.

In such cases, the treating staff, after fully informing the patient of the health risks of the decision made, will have a written statement released from liability.

The patient may give the attending physician written instructions on how he or she wishes to be treated in the event of an irreversible illness if he or she becomes incapacitated and is no longer able to make his or her own decisions. These advance directives can be changed or cancelled at any time.

If the patient does not feel up to drawing up all of his or her wishes in writing, he or she may designate in writing a trusted person (the therapeutic representative), informed of his or her wishes, who can enforce them if the patient is no longer able to do so.

Pursuing the goal of contributing to the advancement of medicine, the patient provides consent to the use of his or her clinical data or residual biological specimens, for research activities.

In the case of consent, the specific information is made available to the scientific community upon approval of the specific study or research by the cantonal ethics committee (or its designee) in coded form.

Consent does not imply any additional clinical act, and the patient may revoke the same at any time without giving any reasons.

A "second opinion" is an additional opinion that a patient may request from another physician for the purpose of improving his or her level of information so that he or she can make a more informed decision about whether or not to undergo a health care service.
The patient has the right to ask for a second opinion for various diagnostic and treatment services, but especially for surgical operations that are not urgent and without an immediate danger to life.

The patient may decide whether he or she prefers to inform the physician from whom he or she requests the second parare that another physician had previously given an indication as to the necessity of the treatment or surgery.

All information related to and about the patient is protected by patient confidentiality. Caregivers caring for the patient may not pass this information on to third parties without the latter's explicit permission.

The duty of confidentiality applies to all EOC employees.
Exceptions to this constraint are:

• the transmission of information to other health care workers who collaborate with the hospital and are directly involved in care;
• the transmission to the physician who referred the patient to the hospital (sending physician);
• the mandatory reports in case of certain communicable diseases, death caused by crime;
• the transmission of information to the cantonal cancer registry;
• the transmission of information necessary for the calculation of respective benefits to mandatory health and accident insurance.
  

In order to ensure the quality and completeness of the data, and in accordance with current cantonal regulations, access to your data may be authorized by the management of the institute only to those persons within the EOC assigned to carry out the necessary verifications. These persons will operate with full respect for privacy and will be bound to the highest level of confidentiality.

The patient has the right to see and have a copy of his or her medical records.
How to access the information is defined below:

• Patient still inpatient: considering that the medical record is likely to be incomplete, the best solution is to involve your referring physician in the hospital by requesting the specific information needed. The EOC caregivers will be happy to answer any questions and/or clarify any doubts.
• Patient already discharged and/or treatment terminated: you can request specific documents or your complete medical records by filling out the online request below.
• Deceased patient: access to the records of a deceased patient requires the appropriate release from the Cantonal Physician. This release is also necessary in cases where the requestor was the patient's therapeutic representative/referral person when the patient was still alive.
  
  In such cases, the request for clinical records must be accompanied by a letter explaining the reasons behind the request.

Please be advised that, depending on what is requested, administrative costs may be billed.

The cantonal health law defines the obligation of the health care facility to retain medical records for 10 years after the end of treatment. The patient may request the destruction of his or her record, or in the case of computerized medical records, the deletion of the same, as of this term. In these cases, the patient will be asked to sign a statement releasing the hospital from any liability related to the specific treatment.

In the event that the patient desires the destruction, respectively deletion of the same before this time frame has elapsed, EOC cannot proceed as requested, but can put in place what is necessary so that the information contained in the medical record is no longer visible to the caregivers. In this case, too, the patient will be asked to sign the aforementioned statement.

EOC puts in place all that is necessary so that the information in the patient's medical record is accessible only by the persons entitled to it (caregivers involved in the patient's care) and the confidentiality of the information is guaranteed. A deletion or obscuring of information in the medical record, may affect the safety of future patient care within EOC.

For more information see the Rights and Duties of Patients page of the Canton Ticino Health Promotion and Evaluation Service.