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LEGAL ACTS OF THE REPUBLIC OF LATVIA
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The translation of this document is outdated.
Translation validity: 01.01.2014.–13.01.2018.
Amendments not included: 14.12.2017., 01.11.2018.

Text consolidated by Valsts valodas centrs (State Language Centre) with amending laws of:

15 December 2011 [shall come into force from 1 January 2011];
15 November 2012 [shall come into force from 5 December 2012];
10 January 2013 [shall come into force from 13 February 2013];
12 September 2013 [shall come into force from 1 January 2014];
17 October 2013 [shall come into force from 30 October 2013].

If a whole or part of a section has been amended, the date of the amending law appears in square brackets at the end of the section. If a whole section, paragraph or clause has been deleted, the date of the deletion appears in square brackets beside the deleted section, paragraph or clause.

The Saeima1 has adopted and
the President has proclaimed the following law:

Law On the Rights of Patients

Section 1. Terms used in this Law

(1) Terms used in this Law correspond to those terms used in the Medical Treatment Law if this Law does not lay down otherwise.

(2) The following terms are also used in this Law:

1) attending physician - a medical practitioner who heads the medical treatment of a patient, takes decisions related to the medical treatment of the patient and has overall responsibility for all the justification, purposefulness, continuity, quality and results of the medical treatment of the patient;

2) informed consent - the consent of a patient for medical treatment, which he or she gives in oral or written form, or by such activities which unequivocally confirm the consent, moreover, it is given freely, on the basis of the information provided by a medical practitioner in a timely manner regarding the objectives, risks, consequences and methods used for medical treatment;

3) clinical training - training of a person who has acquired medical education or qualification in accordance with a State accredited educational programme performed in a medical treatment institution, which has been granted the appropriate rights in accordance with laws and regulations;

4) medical documents - any information recorded in writing, radiodiagnostic films or in electronic form regarding a patient, his or her state of health, the diagnosis and prognosis of the illness, the preventive, diagnostic and medical treatment methods used, as well as the results of diagnosis and medical treatment; and

5) health care service - a service which is provided by a medical practitioner to a patient within the framework of health care for achievement of a specific medical treatment objective.

Section 2. Purpose of the Law

The purpose of this Law is to promote favourable relationships between a patient and the provider of health care services, facilitating active participation of the patient in his or her health care, as well as to provide him or her with an opportunity to implement and protect his or her rights and interests.

Section 3. General Provisions

(1) The rights of patients shall be implemented in accordance with this Law insofar as other laws do not lay down otherwise.

(2) In ensuring the rights of patients, differential treatment based on a person's race, ethnic origin, skin colour, gender, age, disability, state of health, religious, political or other persuasion, national or social origin, property or marital status or other circumstances is prohibited. Differential treatment shall include the direct or indirect discrimination of a person, infringement of a person or an implication to discriminate him or her.

(3) Differential treatment related to any of the circumstances referred to in Paragraph two of this Section shall only be acceptable in such cases if such treatment is objectively justified with a legal purpose, for the achievement of which the selected means are commensurate.

(4) It is prohibited to punish a patient or otherwise directly or indirectly cause him or her unfavourable circumstances, if the patient is protecting his or her rights.

(5) A patient and his or her relatives have the right to receive mental care which, in accordance with the laws and regulations governing the activities of chaplain services and religious organisations, shall be provided by the chaplain of a medical treatment institution.

(6) Health care against the will of a patient shall not be permissible, if not otherwise laid down by the Law.

Section 4. Right to Information

(1) A patient has the right to information regarding the opportunities for the receipt of health care services and the procedures for the payment for health care services. This information shall be available to the public.

(2) A patient has the right to know the given name, surname, position, profession, specialisation and qualification of attending physicians and other medical practitioners involved in the health care process.

(3) A patient has the right to receive information regarding his or her state of health from the attending physician, including regarding the diagnosis, the plan for medical treatment, examination and rehabilitation of the disease, the prognosis and consequences, the functional restrictions caused by the disease and the opportunities for prophylaxis, as well as the right to receive information after examinations and surgical or other type of invasive intervention performed within the framework of medical treatment regarding the results of the medical treatment, regarding the previously unforeseen outcomes and the reasons thereof.

(4) A patient has also the right to receive information regarding medical treatment from other medical practitioners involved in his or her medical treatment in accordance with their competence.

(5) A patient shall be provided with information in a comprehensible manner, explaining medical terms and taking into account the age, maturity and experience of the patient.

(6) A patient has the right, after medical treatment or termination of any phase thereof (for example, discharge from a medical treatment institution), to receive information regarding the medical services provided to him or her and the justification for the termination of medical treatment, as well as the results of diagnostic examinations and functional assessments (extracts, true copies and copies), instructions and recommendations in relation to further treatment and social services and, if necessary due to the state of health of the patient, to receive a referral to another medical treatment institution for continuation of medical treatment.

(7) Information need not be provided to a patient only in such case if such information or facts are at the disposal of the physician that the receipt of the information significantly threatens the life or health of the patient or other persons.

(8) A patient has the right to refuse the receipt of the information referred to in this Section. He or she shall express his or her refusal thereof in oral or written form or by such actions which unequivocally confirm this.

Section 5. Right to Medical Treatment

(1) In accordance with the procedures laid down in the Medical Treatment Law, each person has the right to receive medical treatment corresponding to the state of health.

(2) A patient has the right to a respectful attitude and qualitative and qualified medical treatment regardless of the nature and severity of his or her disease.

(3) A patient has the right to the support of his or her family and other persons during the medical treatment.

(4) A patient has the right to timely medical treatment. A medical treatment institution, to which the patient has turned, shall provide information regarding the opportunities and terms for the receipt of medical treatment, as well as regarding other medical treatment institutions where appropriate medical treatment may be received.

(5) A patient has the right to receive further medical treatment from all the medical treatment institutions involved in his or her medical treatment.

(6) If opportunities for medical treatment are restricted or if several types of medical treatment are permissible, a patient has the right to the professional choice of the physician, which is based on the medical criteria supported by evidence.

(7) A patient has the right to such medical treatment which is performed in the presence of only those persons which are directly involved in medical treatment. The patient may agree to the presence of other persons during medical treatment or to invite other persons, if it does not hinder the medical treatment.

(8) If a patient has suspended medical treatment and left a medical treatment institution without informing the attending physician or medical treatment institution regarding his or her action, it shall be indicated in his or her medical documents. If a patient is a minor or a person who due to the state of health or age thereof is not capable to look after himself or herself, the medical treatment institution shall inform the lawful representative of the patient immediately, but if such does not exist, - the spouse or closest relative, or if such does not exist either - the Orphan's Court. The medical treatment institution shall inform the competent authorities immediately, if a patient is a threat to the safety or health of other persons due to his or her state of health.

(9) A patient has the right to treatment at home if his or her state of health and living conditions allow it.

Section 6. Consent to Medical Treatment or Refusal Thereof

(1) Medical treatment is permissible if a patient has given the informed consent thereto. The patient has the right to ask questions and receive answers prior to giving the informed consent.

(2) The informed consent shall be drawn up in writing if it is requested by the patient or attending physician.

(3) If the informed consent is given in writing, the patient shall approve it by his or her signature, indicating the date and time. A written consent shall be appended to his or her medical documents.

(4) A patient has the right to refuse medical treatment prior to the commencement thereof, from any method used in the medical treatment, without declining from the medical treatment at large, or to refuse medical treatment during it.

(5) The attending physician shall inform the patient regarding the possible consequences of the decision referred to in Paragraph four of this Section. After receipt of the information provided by the attending physician the patient shall confirm his or her decision on the refusal of medical treatment or regarding suspension thereof by his or her signature, or regarding the refusal of any method used in the medical treatment, indicating that he or she has received the relevant information. If the patient does not change his or her decision, it is the duty of the attending physician to encourage him or her to consult another physician.

(6) If the patient refuses to certify his or her refusal in writing, the attending physician shall invite two adult witnesses with capacity to act who shall certify by their signature that the patient has taken the decision referred to in Paragraph four of this Section.

(7) If a patient has authorised another person (hereinafter - authorised person of the patient) to agree on his or her behalf to medical treatment at large or to any method used in the medical treatment or to refuse medical treatment at large or any method used in the medical treatment, as well as to receive information in accordance with that laid down in Section 4 of this Law, the patient shall inform the medical treatment institution of such authorisation.

Section 7. Right of Another Person to Agree to Medical Treatment or to Refuse it

(1) If a patient is unable to take a decision himself or herself regarding medical treatment due to his or her state of health or age, the spouse of the patient has the right to take a decision on medical treatment at large or any method used in the medical treatment or refusal from medical treatment at large or any method used in the medical treatment, but if such does not exist, an adult closest relative with capability to act in the following order: the children of the patient, the parents of the patient, the brother or sister of the patient, the grandparents of the patient or the grandchildren of the patient.

(2) The spouse or closest relative of a patient or a person authorised by the patient, as well as the lawful representative of the patient, if the patient is under guardianship or trusteeship (hereinafter - person representing the patient), when taking a decision on medical treatment or refusal thereof, shall observe the wish previously expressed by the patient in relation to medical treatment.

(3) If the closest relatives of the patient who have equal right to take a decision on behalf of the patient cannot agree regarding the consent to medical treatment, the decision on medical treatment which would have the most favourable effect the state of health of the patient, shall be taken by the doctors' council.

(4) The attending physician shall explain to the person representing the patient what consequences may be caused by the decision on refusal from medical treatment. After receipt of the information the person representing the patient shall confirm the decision to refuse medical treatment or to suspend it in the medical document by his or her signature, or to refuse any method used in the medical treatment, indicating that he or she has received the relevant information.

(5) If the person representing the patient refuses to take a decision on medical treatment of the patient, but the physician considers that medical treatment is in the interests of the patient, the decision on medical treatment shall be taken by the doctors' council.

(6) If the person representing the patient refuses to confirm refusal in writing, the attending physician shall invite two adult witnesses with capability to act who shall certify by their signature that the person representing the patient has taken the decision referred to in Paragraph four of this Section. The refusal shall be appended to the medical documents of the patient.

(7) If a patient has not indicated a person who is entitled to consent to medical treatment or to refusal it on behalf of the patient, and the patient has no spouse, closest relative or lawful representative or the patient has forbidden in writing the spouse or closest relative from taking a decision on his or her behalf, the decision on medical treatment, which would have the most favourable effect on the state of health of the patient, shall be taken by the doctors' council.

(8) In cases where a delay may endanger the life of the patient and it is not possible to receive the consent of the patient himself or herself or the person representing the patient, the medical practitioner shall perform emergency measures within the scope of his or her competence - examination, medical treatment, including surgical or other type of invasive intervention. In such cases an examination and medical treatment plan shall be approved and a decision taken by a doctors' council, except in cases where first aid or emergency medical care has to be provided.

(9) During a surgical or other type of invasive intervention the attending physician has the right, without the consent of the patient, to perform previously unplanned medical treatment if emergency medical care has to be provided to the patient or if incomparably greater harm to his or her health would arise due to the non-performance of medical treatment.

Section 8. Right to Choose a Physician and Medical Treatment Institution

A patient has the right to choose a physician and medical treatment institution.

Section 9. Right to Become Acquainted with Medical Documents

(1) A patient has the right to become acquainted with his or her medical documents. He or she has the right to request and receive extracts, true copies and copies in accordance with the pricelist approved by the medical treatment institution, except that laid down in the Personal Data Protection Law. Extracts, true copies and copies shall be received by the patient within three days from the date of the submission of the relevant request.

(2) A patient has the right to receive information regarding the use of the information included in his or her medical documents in accordance with that laid down in this Law and the Personal Data Protection Law.

(3) A patient may request that the attending physician makes additions or corrections to medical documents if he or she justifiably regards that the information is inaccurate or incorrect. When making corrections to medical documents, a medical practitioner shall ensure the retaining of the incorrect information, updating it or supplementing it accordingly and informing the attending physician thereof.

(4) If medical documents of a patient include information regarding sensitive data of another person or information, which has been provided by a third person but who has requested the non-disclosure thereof to the patient, the right of the patient to acquaint himself or herself with the medical documents shall be ensured insofar as it does not infringe the rights of the third person.

Section 10. Protection of Patient Data

(1) Information, which relates to an identified or identifiable patient, shall be protected in accordance with the laws and regulations governing the protection of the data of natural persons.

(2) Information regarding a patient may only be disclosed with his or her written consent or in the cases prescribed by this Law.

(3) The information referred to in Paragraph one of this Section shall not be disclosed even after the death of the patient.

(4) Information regarding a patient after his or her death may only be disclosed to the persons referred to in Section 7, Paragraph one of this Law, if:

1) the provision of the information may affect the life or health of the referred to persons or facilitate the provision of health care services thereto;

2) the information is related to the cause of death of the patient or medical treatment during the time period before his or her death.

(5) Upon a written request and receipt of a written permission of the head of the medical treatment institution, information regarding the patient shall be provided to the following persons and institutions not later than five working days after receipt of the request:

1) to medical treatment institutions - for the purpose of achieving the objectives of the medical treatment;

2) to the Data State Inspectorate - for the purpose of verifying the conformity of personal data processing with the requirements of laws and regulations;

3) to the State Labour Inspectorate - for the investigation and registration of accidents at work and occupational diseases;

4) [17 October 2013];

5) to the State Medical Commission for the Assessment of Health Condition and Working Ability - for the performance of expert-examination of disability;

6) to the court, the Office of the Prosecutor, inspectors of the State protection of children's rights, the Orphan's Court, the State Probation Service, the Ombudsman, as well as the pretrial investigation institution - for the performance of the functions laid down by the Law;

7) [17 October 2013];

8) [17 October 2013];

9) to the reserve registration structural units of the National Armed Forces - for the evaluation of the state of health of reserve soldiers and reservists;

10) to the association "Motor Insurers' Bureau of Latvia", insurance companies which perform the mandatory civil legal liability insurance for owners of land vehicles;

11) to the Ministry of Justice - for the ensuring that a request to execute a deprivation of liberty punishment adjudicated in Latvia is sent to a foreign state;

12) to the Central Commission for Medical Expert-examination of the Ministry of the Interior - for the evaluation of compliance with service of the state of health of an official of an institution of the system of the Ministry of the Interior or of the Latvian Prison Administration holding a special service rank or a candidate for the office;

13) to medical treatment institutions of the National Armed Forces - for the evaluation of the state of health of soldiers and national guardsmen, as well as candidates for professional service and service in the National Guard.

(51) Information shall be provided in accordance with the procedures laid down in the laws and regulations regulating the field of health care to the following persons and institutions:

1) to the Centre for Disease Prevention and Control - for the acquisition, aggregation, processing and analysis of statistical information of public health and health care, for the epidemiological supervision of infectious diseases, as well as for the processing of personal data for the purpose of transferring information to a statistical body;

2) to the National Health Service - for the administration of health care services paid from the State budget, as well as for the processing of personal data with the purpose of transferring information to a statistical body;

3) to the State Agency of Medicines - for the ensuring of pharmacovigilance functions;

4) to the Health Inspectorate - for the ensuring of carrying out the supervisory functions of the health sector.

(52) The information accumulated in the health information system regarding a patient shall be processed in accordance with the procedures and in the amount laid down in the laws and regulations regarding the data to be processed in the health information system by:

1) medical practitioners and medical support persons - for the achievement of medical treatment objectives;

2) pharmacists and assistants to pharmacists - for the ensuring of pharmaceutical care;

3) the National Health Service - for the administration of health care services paid from the State budget and for the maintenance of the health information system;

4) the Health Inspectorate - for the ensuring of carrying out the supervisory functions of the health sector;

5) the State Social Insurance Agency - for the administration of sick-leave certificates written out in the health information system;

6) the State Labour Inspectorate - for the investigation and accounting of accidents at work and occupational diseases.

(6) The lawful representative of a minor patient has the right to receive information regarding the state of health of this patient, except that laid down in Section 13 of this Law. Information shall not be provided to the lawful representative of the minor patient, if the disclosure of such information may harm the interests of the respective patient. The physician shall record the decision taken in the medical documents of the patient and inform the Orphan's Court thereof.

(7) The patient data recorded in the medical documents may be used in a research, if one of the following conditions exists:

1) the patient cannot be directly or indirectly identified according to the information to be analysed;

2) the patient has consented in writing that the information regarding him or her may be used in a specific research.

(8) The patient data recorded in the medical documents may also be used in a research, without observing the conditions referred to in Paragraph seven of this Section, if the following conditions exist concurrently:

1) the research is being performed in the public interest;

2) a competent State administrative institution has allowed the use of the patient data in a specific research in accordance with the procedures stipulated by the Cabinet;

3) the patient has not previously prohibited the transfer of his or her data to a researcher in writing;

4) it is not possible to acquire the consent of the patient with commensurate means;

5) the benefit of the research for the public health is commensurable with the restriction of the right to the inviolability of private life.

(9) A medical treatment institution shall provide the information referred to in Paragraphs seven and eight of this Section for the needs of a research, making a note thereof in the medical documents.

(10) In order to ensure the rights and interests of a minor, the State Police, the local government police, the State Inspectorate for Protection of Children's Rights, the State Probation Service, the Orphan's Court, the social service office, the medical practitioner of the social correction educational institution and the medical practitioner of a place of imprisonment, for the performance of the functions laid down in the laws and regulations governing its activity, have the right to receive contact information regarding family doctor or pediatrist of the minor with the help of link means of the information system in cases when a justified necessity has occurred, however, it is not possible to ascertain information regarding health of the minor with the intermediation of parents or other legal representatives or from the minor himself or herself.

[10 January 2013; 17 October 2013]

Section 11. Participation of Patient in Clinical Trial

(1) A patient shall be involved in a clinical trial, which has been approved in accordance with the procedures laid down in the laws and regulations regarding clinical trials, if his or her informed written consent has been received and the clinical trial is being performed upon concurrent existence of the following conditions:

1) the foreseeable risk has been evaluated in relation to the anticipated benefit of the patient, as well as other existing or future patients;

2) there is no alternative for the acquisition of a comparable effect in a different manner;

3) the medical benefit, as well as the benefit for the public health justifies the risk which might threaten the patient.

(2) If a patient is unable to express his or her wishes, the spouse or the closest relative of the patient has the right to consent for his or her participation in a clinical trial, confirming their consent in writing in accordance with the procedures laid down in Section 7, Paragraph one of this Law, upon concurrent existence of that laid down in Paragraph one, Clause 2 of this Section and the following conditions:

1) the results of the clinical trial may provide an actual and direct benefit to the health of the patient;

2) it is not possible to perform a trial with patients who are able to express their wishes, which would provide a comparable effect;

3) the patient has not expressed objections against his or her involvement in the clinical trial.

(3) If a patient is under guardianship or trusteeship, a written consent to involvement of a patient in a clinical trial shall be provided by his or her lawful representative, observing the wishes of the patient, upon concurrent existence of the conditions referred to in Paragraph one, Clause 2 and Paragraph two, Clauses 1 and 2 of this Section, or by the guardian together with the patient according to the scope of restriction of the capacity to act determined by the court. Consent for the involvement of a minor patient in a clinical trial shall be acquired in accordance with the procedures laid down in Section 13 of this Law.

(4) Prior to involvement in a clinical trial a patient shall be provided information regarding the relevant clinical trial, the purpose, methods, duration, anticipated benefit and risk thereof and the conditions for implementation of the clinical trial, as well as regarding the right to withdraw from participation in the clinical trial at any time and regarding other rights.

(5) If a patient is unable to express his or her wish, the information referred to in Paragraph four of this Section shall be provided to the person who has given consent to the involvement of the patient in the clinical trial.

(6) A patient or, if he or she is unable to express his or her wish, the person who has given consent to the involvement of the patient in the trial has the right to refuse the participation of the patient in the clinical trial, as well as to terminate the participation therein at any time. Refusal to participate or termination of participation shall not adversely affect the attitude of the medical practitioner towards further medical treatment of the patient.

(7) The information acquired in clinical trials regarding the patient may be used if the relevant consent has been received from the patient or, if he or she is unable to express his or her wish, from the person who has given consent for the involvement of the patient in the trial, and the anonymity of the patient is guaranteed.

[17 October 2013]

Section 12. Participation of Patient in the Clinical Training Process

(1) If a medical treatment institution or medical practitioner ensuring the medical treatment of a patient is involved in a clinical training process, the patient shall be informed thereof.

(2) A patient or, if he or she is unable to express his or her wish, the person who has given consent for the medical treatment of the patient has the right to refuse the participation in the clinical training process, or to terminate the participation therein at any time. Refusal to participate or termination of participation shall not adversely affect the attitude of the medical practitioner towards further medical treatment of the patient.

(3) The information acquired during the clinical training process regarding the patient may be used if the relevant consent has been received from the patient or, if he or she is unable to express his or her wish, from the person who has given consent to the involvement of the patient in training, and data protection of the patient or his or her anonymity is guaranteed.

Section 13. Rights of Minor Patients

(1) Medical treatment of a minor patient (up to the age of 14 years) shall be permissible if his or her lawful representative is informed thereof and has given his or her consent. The minor patient has the right to be heard and according to his or her age and maturity to participate in the taking of the decision related to the medical treatment.

(2) Medical treatment of a minor patient (from the age of 14 years) shall be permissible if his or her consent has been received, except that laid down in Section 7, Paragraph eight of this Law.

(3) If a minor patient (from the age of 14 years) refuses to give his or her consent for medical treatment, but to the physician's mind the medical treatment is in the interests of this patient, the consent for the medical treatment shall be given by the lawful representative of the minor patient.

(4) A minor patient has the right to receive information comprehensible to his or her age and maturity from a medical practitioner.

Section 14. Consent of the Orphan's Court

(1) If the lawful representative of a minor patient refuses to give his or her consent for the commencement of medical treatment or if the lawful representatives are unable to agree regarding the commencement of medical treatment, or if the whereabouts of the lawful representative of the minor patient is unknown to the physician, but he or she regards that the commencement of medical treatment is in the interests of this patient, the permission for medical treatment, on the basis of a motivated submission of the physician, may be given by the Orphan's Court within three working days after receipt of the motivated submission of the physician, except in the case referred to in Paragraph two of this Section.

(2) If the physician considers that immediate commencement of medical treatment is necessary in the interests of the minor patient, but the lawful representative of the patient refuses to give his or her consent or if the lawful representatives are unable to agree regarding the commencement of medical treatment, or if the whereabouts of the lawful representative of the minor patient is unknown to the physician, the decision to commence medical treatment shall be taken by the doctors' council. The doctors' council shall inform the Orphan's Court regarding the decision taken within three working days according to the jurisdiction determined in this Section.

(3) The consent for medical treatment of a minor patient shall be given by the Orphan's Court of the local government, in the territory of operation of which the place of residence of both parents or guardian of the patient has been declared.

(4) If the place of residence of the parents of a minor patient has been declared in the administrative territories of different local governments, the Orphan's Court, in the territory of operation of which the place of residence has been declared for the parent with whom the patient is living, shall give the consent for his or her medical treatment.

(5) If the parents or guardian of a minor patient have no declared place of residence, the Orphan's Court of the local government, in the territory of operation of which the parents or guardian of the patient actually live, shall give consent to his or her medical treatment.

(6) If sole custody of one parent has been established for a minor patient, the consent to his or her medical treatment shall be given by the Orphan's Court, in the territory of operation of which the place of residence has been declared by the parent in whose sole custody this patient is.

(7) If the parents of a minor patient are not known, or if this patient is a foundling, the consent to his or her medical treatment shall be given by the Orphan's Court, in the territory of operation of which the respective patient has been found.

Section 15. Duties of Patient

(1) A patient has a duty to take care of his or her health.

(2) If the state of health of the patient allows it, he or she has a duty to become actively involved in medical treatment and to provide the attending physician with information within the limits of his or her abilities and knowledge:

1) which is necessary for ensuring medical treatment;

2) regarding his or her diseases, which may endanger the life or health of other persons;

3) regarding previously provided consents and refusals in relation to medical treatment; and

4) regarding any changes to the state of health, which have occurred during medical treatment.

(3) The internal rules of procedure of a medical treatment institution and the instructions of the medical practitioner are binding to the patient.

(4) When registering in a medical treatment institution or receiving medical treatment, a person shall, upon the request of a medical practitioner, present a personal identification document, except in the case when emergency medical care is provided to the patient and he or she is unable to present such document due to his or her state of health. The patient shall present the personal identification document as soon as it is possible.

(5) A patient has a duty to pay for the received health care services in accordance with the procedures laid down in the laws and regulations regarding the organisation and financing of health care.

(6) When implementing his or her rights, a patient and a person representing the patient has a duty to respect the rights of other patients.

(7) Paragraph four of this Section shall not apply to an imprisoned or convicted patient. The Cabinet shall determine the procedures by which a place of imprisonment shall inform a medical treatment institution, which is outside the place of imprisonment, regarding personal data of such imprisoned or convicted patient who has been admitted to the medical treatment institution, and regarding the medical treatment performed in the place of imprisonment.

Section 16. Right to Compensation

(1) A patient has the right to compensation for any harm (also moral harm) caused to his or her life or health, which has been caused by the medical practitioner working in the medical treatment institution through his or her acts or failure to act or caused by the conditions during medical treatment, as well as the right to compensation for expenses related to medical treatment (hereinafter - medical expenses), if medical treatment had been necessary in order to eliminate or reduce the unfavourable consequences of the harm caused to the life or health of the patient by the medical practitioner or the conditions during medical treatment.

(2) A patient has the right to receive compensation from the Medical Treatment Risk Fund for the following:

1) harm (also moral harm) caused to his or her life or health - in the amount of the harm caused, but not more than 142 290 euros;

2) [See Paragraph 3 of Transitional Provisions];

21) medical expenses incurred to him or her - in the amount of the expenses incurred, but not more than 28 460 euros.

(3) The Cabinet shall determine the procedures by which compensation shall be requested from the Medical Treatment Risk Fund for the harm caused to the life or health of the patient, as well as for compensation for medical expenses and the procedures by which the amount of harm caused to the patient shall be evaluated, a decision to pay compensation shall be taken and compensation from the Medical Treatment Risk Fund shall be disbursed.

(4) A patient has the right to receive compensation from the Medical Treatment Risk Fund for the harm caused to his or her life or health, and for compensation for medical expenses regardless of whether the medical treatment institution has made the medical treatment risk contributions.

(5) A patient shall request compensation for the harm caused to his or her life or health, as well as for compensation for medical expenses, from the Medical Treatment Risk Fund not later than within two years from the date of discovering the harm, but not later than within three years from the date of the committing thereof. The compensation referred to in Paragraph two of this Section shall not be disbursed, if the patient has received compensation for the harm caused to his or her life or health, as well as compensation for medical expenses incurred to him or her within the scope of a civil procedure or criminal procedure.

(6) A claim of the patient to compensate the harm caused to his or her life or health, as well as to compensate medical expenses shall be examined and a decision shall be taken within six months after the National Health Service has received a claim for compensation. If it is necessary to request, collect and evaluate additional information, the time period for examining the claim for compensation and taking the decision may be extended up to one year.

[12 September 2013; 17 October 2013 / See Paragraph 4 of Transitional Provisions]

Section 17. Medical Treatment Risk Fund

(1) The funds of the Medical Treatment Risk Fund shall be formed by medical treatment risk contributions and funds acquired by way of subrogation. The Cabinet shall determine the procedures for creating, accumulating and administrating the Medical Treatment Risk Fund.

(2) The keeper and manager of the funds of the Medical Treatment Risk Fund shall be the National Health Service. The decisions and actual actions of the National Health Service in relation to the compensation to be paid to a patient from the Medical Treatment Risk Fund provided in Section 16 of this Law may be contested to the Ministry of Health. A decision of the Ministry of Health may be appealed to a court in accordance with the procedures laid down in the Administrative Procedure Law.

(3) Medical treatment institutions shall perform medical treatment risk contributions each year. The amount of the medical treatment risk contributions and procedures for payment shall be determined by the Cabinet. The revenue and expenditure of the Medical Treatment Risk Fund shall be included in the annual State budget in a separate sub-programme of the basic budget.

(4) The funds of the Medical Treatment Risk Fund shall only be used to settle the claims of patients regarding the harm caused to their life or health, and for medical expenses. The remainder of the funds shall be used for disbursement of compensations to patients in subsequent financial years.

(5) If a medical treatment institution has not made medical treatment risk contributions, the National Health Service has the right to collect from this medical treatment institution all the compensation paid to a patient.

[10 January 2013; 17 October 2013]

Section 18. Protection of Rights and Lawful Interests

(1) A person may use all mechanisms for the protection of rights provided for in laws for the protection of the rights or the interests arising therefrom laid down in this Law, including application to a court in accordance with the procedures laid down in law.

(2) If the protection of the rights or interests takes place within the scope of an administrative procedure, the relevant administrative provisions and actual actions may be contested to the Health Inspectorate if it has not been laid down otherwise in this Law. A decision of the Ministry of Health may be appealed to a court.

(3) For the protection of the rights laid down in this Law or the interests arising therefrom, which are related to medical treatment, a person is entitled to submit a complaint to the Health Inspectorate in accordance with the procedures laid down in laws and regulations for the performance of the necessary activities laid down in laws and regulations, not later than within two years from the date of the infringement of the rights or interests. A reply to the complaint shall be provided in accordance with the time period laid down in the Law On Applications or, if an administrative procedure is commenced, concurrently with the taking of the decision in this procedure. A person who has submitted a complaint shall be informed regarding the commencement of an administrative procedure.

Transitional Provisions

[15 November 2012; 10 January 2013]

1. Section 16, Paragraphs two, three, four and five and Section 17 of this Law shall come into force on 25 October 2013. The compensation provided for in Section 16, Paragraph two of this Law shall be disbursed from 1 May 2014 for the harm caused to a patient after 23 October 2013.

[10 January 2013]

2. Amendments to Section 17 of this Law in relation to replacing the words "Health Payment Centre" with the words "National Health Centre" shall come into force on 25 October 2013.

[10 January 2013]

3. Section 16, Paragraph two, Clause 2 of this Law is repealed as of 1 January 2014.

[17 October 2013]

4. Section 16, Paragraph two, Clause 2.1 of this Law shall come into force on 1 January 2014, and the compensation provided for therein shall be disbursed for medical expenses in order to eliminate or prevent the unfavourable consequences of the harm caused to the life or health of the patient by the medical practitioner or the conditions during medical treatment after 1 January 2014.

[17 October 2013]

Informative Reference to European Union Directives

[15 December 2012; 17 October 2013]

This Law includes legal norms arising from:

1) Council Directive 2000/43/EC of 29 June 2000 implementing the principle of equal treatment between persons irrespective of racial or ethnic origin;

2) Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients' rights in cross-border healthcare;

3) Directive 2010/84/EU of the European Parliament and of the Council of 15 December 2010 amending, as regards pharmacovigilance, Directive 2001/83/EC on the Community code relating to medicinal products for human use;

4) Council Directive 2010/32/EU of 10 May 2010 implementing the Framework Agreement on prevention from sharp injuries in the hospital and healthcare sector concluded by HOSPEEM and EPSU.

This Law shall come into force on 1 March 2010.

This Law has been adopted by the Saeima on 17 December 2009.

President V. Zatlers

Riga, 30 December 2009

 


1 The Parliament of the Republic of Latvia

Translation © 2014 Valsts valodas centrs (State Language Centre)

 
Document information
Status:
In force
in force
Issuer: Saeima Type: law Adoption: 17.12.2009.Entry into force: 01.03.2010.Theme:  Consumer rights; Healthcare, pharmacyPublication: Latvijas Vēstnesis, 205 (4191), 30.12.2009.
Language:
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