Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”
Code of the Republic of Kazakhstan
On Public Health and the Healthcare System
Chapter 12. RIGHTS AND OBLIGATIONS OF PERSONS IN THE FIELD OF HEALTHCARE
Article 76. Guarantees of rights in the field of healthcare
1. The State guarantees citizens of the Republic of Kazakhstan:
1) equal access to medical care;
2) quality of medical care;
3) quality of pharmaceutical provision;
4) accessibility, effectiveness and safety of medicines;
5) disease prevention measures and promotion of healthy lifestyles and healthy nutrition;
6) freedom of reproductive choice, protection of reproductive health and observance of reproductive rights;
7) sanitary and epidemiological well-being.
Article 77. Rights of citizens of the Republic of Kazakhstan
1. Citizens of the Republic of Kazakhstan have the right to:
1) receive the guaranteed volume of free medical care;
2) be provided with medicines and medical devices within the guaranteed volume of free medical care and/or the mandatory social health insurance system;
3) freely choose a physician and a medical organization;
4) receive therapeutic nutrition during inpatient treatment;
5) receive additional medical care beyond the guaranteed volume of free medical care and/or the mandatory social health insurance system at their own expense, at the expense of organizations, voluntary medical insurance or other lawful sources;
6) receive medical and other services on a paid basis;
7) receive medical care outside the Republic of Kazakhstan at the expense of the state budget where medically indicated, in the procedure determined by the authorized body;
8) receive and provide documents confirming temporary incapacity for work in accordance with the legislation of the Republic of Kazakhstan;
9) regularly and free of charge receive reliable information, within the competence of state bodies, organizations and the attending physician, on methods of disease prevention, diagnosis, treatment and medical rehabilitation, clinical trials, and factors affecting health, including environment, working and living conditions, leisure, healthy nutrition and food safety;
10) receive information from state bodies, independent expert organizations and entities in the circulation of medicines and medical devices on the safety, effectiveness and quality of medicines and medical devices;
11) protection of information constituting medical confidentiality;
12) compensation for harm caused to health during medical care in accordance with the legislation of the Republic of Kazakhstan;
13) protection of their rights and lawful interests in healthcare;
14) appeal against actions or inaction of medical and pharmaceutical workers in accordance with the laws of the Republic of Kazakhstan;
15) petition higher authorities to engage independent experts when disagreeing with the conclusions of a state medical examination;
16) voluntarily express willingness to act as a donor;
17) express consent or refusal regarding posthumous removal of tissues and/or organs for transplantation in accordance with this Code;
18) give informed consent to or refuse treatment and other medical interventions, including preventive vaccinations;
19) co-payment;
20) receive pain relief in the treatment of chronic incurable diseases;
21) receive information on health status in an accessible form, including examination results, diagnosis, prognosis, methods of medical care, associated risks, possible interventions, consequences and results;
22) receive reliable and timely information on factors contributing to health or adversely affecting it, including disease prevention, sanitary and epidemiological well-being, environmental conditions, potential health hazards of work and services, rational nutrition standards, and the quality and safety of products, goods and services;
23) other rights provided by the laws of the Republic of Kazakhstan.
Article 78. Rights of children
1. In addition to the rights provided by Article 77 of this Code, every child has the right to:
1) use modern and effective healthcare services and means of disease treatment and health restoration;
2) health education;
3) preventive medical examinations and dynamic follow-up, treatment, pharmaceutical provision, health improvement and vaccination;
4) receive medical care during health improvement and organized recreation;
5) sanitary and hygienic education, training and work under conditions appropriate to physiological characteristics and health status and excluding adverse factors;
6) receive medical documentation on health status free of charge at the place of attachment when enrolling in education or employment;
7) receive information on health status in an accessible form;
8) receive accessible information on healthy lifestyle and proper nutrition and on the harm of smoking and psychoactive substances;
9) receive accessible information on reproductive health protection.
2. Minors aged sixteen years and older have the right to give informed consent to or refuse preventive and consultative-diagnostic care, except for surgical interventions and termination of pregnancy, which require consent of parents or legal representatives.
3. When children under five years of age, as well as older sick children who, according to physicians, need additional care, are treated in inpatient settings, the mother, father or another person directly caring for the child may stay with the child in the medical organization and receive a temporary incapacity certificate in accordance with the legislation of the Republic of Kazakhstan. A breastfeeding mother of a child under one year of age is provided free meals during the entire period of stay while caring for the child.
4. When children under five years of age, as well as older sick children who need additional care, are treated in outpatient or inpatient-substitution settings, the mother, father or another person directly caring for the child may stay with the child and receive a temporary incapacity certificate in accordance with the legislation of the Republic of Kazakhstan.
5. School-age children receiving specialized medical care, medical rehabilitation or palliative care in inpatient settings have the right to continuous education. Healthcare organizations providing care to children create conditions for play, rest and educational activities.
Article 80. Obligations of citizens of the Republic of Kazakhstan
Citizens of the Republic of Kazakhstan are obliged to:
1) care for preservation of their health and bear shared responsibility for individual and public health;
2) pay mandatory social health insurance contributions in accordance with the Law of the Republic of Kazakhstan “On Mandatory Social Health Insurance”;
3) undergo preventive examinations and screening;
4) comply with healthcare professionals’ instructions related to individual and public health;
5) participate in management of their own health, including chronic disease management programs where applicable, and seek information on disease, treatment methods, possible risks and complications;
6) inform healthcare professionals of individual characteristics of their body;
7) observe precautions to protect their own health and the health of others, undergo examinations and treatment when required by healthcare entities, and inform medical staff of infectious and other diseases dangerous to others;
8) comply with healthcare legislation of the Republic of Kazakhstan.
SECTION 3. ORGANIZATION OF MEDICAL CARE
Chapter 16. GENERAL PROVISIONS FOR THE PROVISION OF MEDICAL CARE
Article 134. Patient rights
1. In addition to the rights specified in Chapter 12 of this Code, the patient has the right to:
1) dignified treatment during prevention, diagnosis and treatment, and respect for cultural and personal values;
2) medical care in an order determined solely by medical criteria, without discriminatory factors;
3) choose or replace a physician or medical organization providing care within the guaranteed volume of free medical care and/or the mandatory social health insurance system, except in emergency and urgent care;
4) be informed that audio and/or video surveillance and recording are conducted in the medical organization;
5) relief of suffering to the extent permitted by the existing level of medical technology;
6) receive information in an accessible form on possible risks and benefits of proposed and alternative treatment methods, possible consequences of refusal, diagnosis, prognosis and treatment plan, reasons for discharge or transfer, as well as an independent opinion and a medical consultation by a panel of specialists;
7) receive information on rights and obligations, available services, cost of paid services and co-payment, the procedure for their provision taking into account accessibility for persons with visual and/or hearing impairments, prescribed medicines and healthcare professionals providing care;
8) refuse participation in the educational process and the presence of third parties during diagnostic and treatment procedures;
9) other rights provided by the laws of the Republic of Kazakhstan.
2. Information on patient rights is displayed in healthcare organizations.
3. Medical care is provided after obtaining the patient’s informed consent. Informed consent for invasive interventions is drawn up in the form approved by the authorized body.
4. The patient may designate a person to whom information on the patient’s health should be disclosed. Depending on the patient’s condition, health information may be withheld from the patient and communicated to the spouse, close relatives or legal representatives.
5. Patient rights are protected by state bodies, healthcare organizations and public associations within their competence.
Article 135. Patient obligations
1. In addition to the obligations specified in Chapter 12 of this Code, the patient shall:
1) take measures to preserve and improve health;
2) show respect and tact in communication with healthcare professionals;
3) provide the physician with all information necessary for diagnosis and treatment and, after consenting to medical intervention, strictly follow healthcare professionals’ instructions;
4) observe internal rules and take care of the property of the medical organization and cooperate with medical staff;
5) promptly inform healthcare professionals of changes in health status during diagnosis and treatment, as well as diseases dangerous to others or suspected such diseases;
6) refrain from actions violating the rights of other patients;
7) fulfill other obligations provided by the laws of the Republic of Kazakhstan.
2. The obligations specified in subparagraphs 2), 3) and 5) of paragraph 1 also apply to parents or other persons directly caring for a sick child in inpatient settings.
Article 136. Right to refuse medical care
1. A patient or legal representative has the right to refuse medical care except in cases provided by Article 137 of this Code.
2. In case of refusal, a healthcare professional explains the possible consequences in a form accessible to the patient or legal representative.
3. Refusal of medical care, indicating possible consequences, is recorded in medical documentation, including electronic form, and signed by the patient or legal representative and the healthcare professional. If the patient or legal representative refuses to sign the refusal, an appropriate entry is made in the medical documentation and signed by the healthcare professional.
4. If legal representatives of a minor or incapacitated person refuse medical care necessary to save that person’s life, the medical organization may apply to guardianship authorities and/or the court to protect the person’s interests.
