Patients’ rights awareness in Greece has increased over the last 25 years as a result of social and scientific changes due to the development of medical research and medical technology, the ever-increasing internet access for medical information, the rising awareness for human rights protection, etc. Patients’ rights are freedoms that are provided for and protected by the Greek Constitution.
In 2002, the Active Citizenship Network (ACN), together with 12 other European organizations, drafted the European Charter of Patients’ Rights.
The European Charter of Patients’ Rights enacts 14 patients’ rights the overall objective of which is to guarantee a “high level of protection of human health” (Article 35 of the Charter of Fundamental Rights of the European Union) and to ensure the high quality of services provided by the various national health institutions in Europe.
This Charter was adopted by the European Economic and Social Committee (EESC) in 2007 and now forms part of European Law. The 14 rights of the patient are as follows: the right to preventive measures, the right of access, the right to information, the right to consent, the right to free choice, the right to privacy and confidentiality, the right to respect of patients’ time, the right to enjoy quality services, the right to safety, the right to innovation, the right to avoid unnecessary suffering and pain, the right to personalized treatment, the right to complain and the right to compensation.
In Greece, the statutory framework, which regulates patients’ rights and recipients of health services, comprises of:
The rights of the hospital patients
According to Article 47 of Law 2071/1992 (Government Gazette, Series I, No 123):
- the right to access hospital services,
- the right to receive care with due respect for human dignity,
- the right of the patients to consent or refuse any diagnostic or therapeutic operation to be carried out on them,
- the patients’ right to request information about their state of health and the risks involved in a diagnostic or therapeutic procedure,
- the right to privacy,
- the patients’ right to respect and acknowledge of their religious or ideological beliefs,
- the right to voice or duly lodge protests and objections and to be notified of the action taken and the outcome of the action taken in response.
The Council of Europe’s Convention for the Protection of Human Rights and Human Dignity with regard to Biology and Medicine.
Law 2619/1998 (Government Gazette, Series I, No 132) which ratified the “Convention on Human Rights and Biomedicine”, contains articles related to patients’ rights such as:
• the right to equitable access to healthcare (Chapter 1, Article 3),
• the right to give consent freely
‘An intervention in the health field may only be carried out after the person concerned has given free and informed consent to it’. […] ‘The person concerned may freely withdraw consent at any time’ (Chapter II, Article 5)).
The law also includes articles on the protection of persons who are unable to consent or who have psychological problems (Chapter II, Articles 6 and 7).
• right to information
“Everyone has the right to respect for their private life in relation to information about their state of health” (Chapter III, Article 10).
The rights of recipients in psychiatric healthcare
According to Article 2(3) of Law 2716/1999 (Government Gazette, Series I, No 96), the following are acknowledged and protected:
• the right to dignified living conditions in psychiatric health units,
• the right to specialized personalized treatment,
• the right to contest involuntary care in court, to speak in private with a lawyer and to access the data in his file
• the right to protect his property and the right to social reintegration.
The Code of Medical Ethics.
Articles 8-15 of Law 3418/2005 (Government Gazette, Series I, No 287, ‘Code of Medical Ethics’), describe patients’ rights as follows (Chapter III on doctor/patient relations):
- ‘Doctors shall ensure that a relationship of mutual trust and respect is established between them and users/patients. They shall listen to their patients, behave towards them with respect and understanding and respect their opinions, privacy and dignity’ (Article 8(2)).
- ‘A doctor’s first priority shall be to protect the patient’s health’ (Article 9(1)).
- ‘Doctors have a duty to be truthful with patients. They must provide patients with comprehensive and intelligible information on the actual state of their health, the content and results of the proposed medical procedure, the consequences of it and any risks or complications it may involve, the proposed alternatives and the anticipated recovery time, so that the patient is fully aware of the medical, social and financial factors and consequences of his condition and can make a decision accordingly’ (Article 11(1)).
- ‘Doctors must not proceed with any medical procedure without the patient’s prior consent’ (Article 12(1)).
- ‘Doctors must keep all information concerning a patient or his relatives that comes to their attention or is disclosed to them by a patient or a third party during the performance of their duties in strict and absolute confidence’ (Article 13(1)).
- ‘Patients have a right of access to their medical records and to take copies of their records’ (Article 14(8)).
Directive 2011/24/EU of the European Parliament and the Council of 9 March, 2011 on patients’ rights in cross-border healthcare.
Law 4213/2013 (Government Gazette, Series I, No 261) as the transposition law of Directive 2011/24/ΕU on patients’ rights in cross-border healthcare, sets out patients’ rights in cross-border healthcare.
The International Relations Division of the National Organization for the Provision of Health Services (EOPYY) is designated as the National Contact Point (NCP) for Cross-Border Healthcare with the responsibility of informing patients of EU member states about their rights in Greece and the EU.
In particular, the Directive specifies rights related to:
- reimbursement of cross-border healthcare costs;
- ensuring that individual patients make informed choices, including treatment options, availability, quality and safety of healthcare;
- information provision on the licenses or registration status of healthcare providers, their insurance coverage or other means of individual or collective protection in relation to their professional liability;
- information provision on the procedure and mechanisms for filing complaints or charges in the event of any harm arising from the healthcare;
- privacy with respect to the processing of personal data;
- ensuring continuity of care and access to their medical records and,
- ensuring non-discrimination with regard to nationality of patients from other EU member states.
Article 59(1) of Law 4368/2016 (Government Gazette, Series I, No 21) lists and protects patients’ rights such as:
- the right to non-discriminatory access to healthcare services,
- the right to dignified conditions of healthcare and treatment,
- the right to continuity of healthcare,
- the right to quality health services,
- the right to information on the provision of appropriate and documented healthcare,
- the right of self-determination,
- the right of consent and information,
- the right of access to medical records and files,
- the right to confidentiality, privacy and personal data protection,
- the right to protection of genetic identity and,
- the right to receive reports and written answers.
Designated authorities and bodies for the protection of patients’ rights
The designated agencies and bodies for protecting patients’ rights are:
- The Unit for the Protection of Patients’ Rights at the Ministry of Health (Article 7(2)(d) of Presidential Decree 106/2014, Government Gazette, Series I, No 173), which is responsible for: a) monitoring and overseeing the protection of the rights of patients and persons with psychological problems; b) investigating complaints and charges and referring them to the Committee for the Protection of the Rights of Patients and the Committee for the Protection of the Rights of Persons with Psychological Problems; c) issuing instructions to Citizen Advice Centres and the Hospital Committees for the Defence of Civil Rights; and d) informing and raising awareness about issues surrounding the protection of patients, workers in healthcare units and citizens in general.
- The Committee for the Protection of the Rights of Healthcare Recipients (Article 59 of Law 4368/2016, Government Gazette, Series I, No 21), which is responsible for: monitoring and overseeing the protection of healthcare recipients’ rights in public- and private-sector primary, secondary and tertiary healthcare and treatment agencies and units, including: a) processing complaints, reports or charges without discrimination from any healthcare recipient, organisation, agency, committee or authority; b) visiting healthcare services at regular intervals; c) visiting healthcare services unannounced or following complaints; d) cooperating with and receiving twice-yearly reports from the Offices for the Rights of Healthcare Recipients in hospitals; e) cooperating with the Independent Service for the Protection of Patients’ Rights of the Ministry of Health (now the Department for the Protection of Patients’ Rights of the Ministry); f) informing the public about the rights of healthcare recipients through events, leaflets, television spots and other messages and by posting the conclusions of its reports on the Ministry of Health website; g) advising the Ministry of Health if the rights of healthcare recipients have been violated and of the action which it has taken and, whether it identifies serious violations of rights, making recommendations and sending a report to the competent body for disciplinary or criminal prosecution.
- The Special Committee for the Protection of the Rights of Persons with Psychiatric Disorders (Article 2 of Law 2716/1999, Government Gazette, Series I, No 96, as replaced by Article 11 of Law 4272/2014, Government Gazette, Series I, No 145), which is responsible for monitoring and overseeing the protection of the rights of persons with psyciatric disorders. The Special Committee is primarily responsible for: a) processing complaints, reports and charges from any citizen, organisation, agency, committee or authority; b) visiting psychiatric healthcare services at regular intervals; c) visiting psychiatric healthcare services unannounced or following complaints; d) informing citizens of the rights of psychiatric patients by all appropriate means, such as leaflets, announcements in the press or television spots; e) processing and examining the mandatory annual reports prepared by service managers and the three-member patient rights defence committees referred to in Article 1(4)(2) of Law 2519/1997; f) submitting annual reports on its work to the chair of the Committee for the Protection of the Rights of Patients; g) submitting a report to the chair of the Committee for the Protection of the Rights of Persons with Psychiatric Disorders, so that it can take any further legal action deemed necessary; h) intervening whenever it identifies infringement of the rights of persons with psychiatric disorders, making recommendations and sending a report to the competent body for disciplinary or criminal prosecution; i) organising, overseeing and coordinating voluntarily legal assistance on issues relating to the protection of the rights of persons with psychiatric disorders with bar associations in their place of residence or domicile in accordance with the principles laid down by the Legal Assistance Department of the Athens Bar Association.
- The Offices for the Protection of the Rights of Healthcare Recipients in hospitals (Article 60 of Law 4368/2016, Government Gazette, Series I, No 21), which are responsible for providing patients with information on hospital procedures and their rights, providing administrative support, collecting and processing complaints and facilitating the submission of reports to the Ombudsman, the National Human Rights and Bioethics Committees, the Committees for the Protection of Rights at the Ministry of Health and other competent authorities. These offices provide information, cooperate on and report infringements of patients’ rights to the Department for the Protection of Patients’ Rights of the Ministry of Health and to the Committee for the Protection of the Rights of Healthcare Recipients.
- The Body of Inspectors of Health and Welfare Services (Law 2920/2001 Government Gazette, Series I, No 13), which as of 2019 operates under the jurisdiction of the National Transparency Authority, is responsible for the development and operation of a central and regional mechanism for conducting systematic inspections and investigations into all services and bodies under the supervision of the Ministry of Health, with a view to improving productivity and efficiency, the quality upgrade of the provision of health services, the elimination of maladministration and the protection of the health and property of citizens.
- The Health and Social Solidarity Ombudsman (Article 18, Chapter Β, of Law 3293/2004, government Gazette, Series I, No 231). The Greek Ombudsman also acts as the Health and Social Solidarity Ombudsman. During the exercise of his powers in connection with health, welfare and social solidarity rights, the Health and Social Solidarity Ombudsman recommends measures to the competent ministry to restore and protect citizens’ rights, eliminate maladministration and improve the functioning of health and welfare services and their relations with the public. The Minister for Health may refer reports by citizens against public health and welfare services to the Health and Social Solidarity Ombudsman for him to investigate within the framework of his powers.