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17.H1October 2005 Original: English
17.H
1
October 2005 Original: English
THE WORLD MEDICAL ASSOCIATION, INC.
WORLD MEDICAL ASSOCIATION DECLARATION OF LISBON
ON
THE RIGHTS OF THE PATIENT
Adopted by the 34th World Medical Assembly
Lisbon, Portugal, September/October 1981,
and amended by the 47th WMA General Assembly
Bali, Indonesia, September 1995,
and editorially revised at the 171st Council Session,
Santiago, Chile, October 2005
PREAMBLE
The relationship between physicians, their patients and broader society has undergone significant
changes in recent times. While a physician should always act according to his/her conscience, and
always in the best interests of the patient, equal effort must be made to guarantee patient autonomy
and justice. The following Declaration represents some of the principal rights of the patient that the
medical profession endorses and promotes. Physicians and other persons or bodies involved in the
provision of health care have a joint responsibility to recognize and uphold these rights. Whenever
legislation, government action or any other administration or institution denies patients these rights,
physicians should pursue appropriate means to assure or to restore them.
PRINCIPLES
1. Right to medical care of good quality
a. Every person is entitled without discrimination to appropriate medical care.
b. Every patient has the right to be cared for by a physician whom he/she knows to be free to
make clinical and ethical judgements without any outside interference.
c. The patient shall always be treated in accordance with his/her best interests. The treatment
applied shall be in accordance with generally approved medical principles.
d. Quality assurance should always be a part of health care. Physicians, in particular, should
accept responsibility for being guardians of the quality of medical services.
e. In circumstances where a choice must be made between potential patients for a particular
treatment that is in limited supply, all such patients are entitled to a fair selection
procedure for that treatment. That choice must be based on medical criteria and made
without discrimination.
f. The patient has the right to continuity of health care. The physician has an obligation to
cooperate in the coordination of medically indicated care with other health care providers
treating the patient. The physician may not discontinue treatment of a patient as long as
further treatment is medically indicated, without giving the patient reasonable assistance
and sufficient opportunity to make alternative arrangements for care.
2. Right to freedom of choice
a. The patient has the right to choose freely and change his/her physician and hospital or
health service institution, regardless of whether they are based in the private or public
sector.
b. The patient has the right to ask for the opinion of another physician at any stage. 17.H
2
3. Right to self-determination
a. The patient has the right to self-determination, to make free decisions regarding
himself/herself. The physician will inform the patient of the consequences of his/her
decisions.
b. A mentally competent adult patient has the right to give or withhold consent to any
diagnostic procedure or therapy. The patient has the right to the information necessary to
make his/her decisions. The patient should understand clearly what is the purpose of any
test or treatment, what the results would imply, and what would be the implications of
withholding consent.
c. The patient has the right to refuse to participate in research or the teaching of medicine.
4. The unconscious patient
a. If the patient is unconscious or otherwise unable to express his/her will, informed consent
must be obtained whenever possible, from a legally entitled representative.
b. If a legally entitled representative is not available, but a medical intervention is urgently
needed, consent of the patient may be presumed, unless it is obvious and beyond any
doubt on the basis of the patient's previous firm expression or conviction that he/she would
refuse consent to the intervention in that situation.
c. However, physicians should always try to save the life of a patient unconscious due to a
suicide attempt.
5. The legally incompetent patient
a. If a patient is a minor or otherwise legally incompetent, the consent of a legally entitled
representative is required in some jurisdictions. Nevertheless the patient must be involved
in the decision-making to the fullest extent allowed by his/her capacity.
b. If the legally incompetent patient can make rational decisions, his/her decisions must be
respected, and he/she has the right to forbid the disclosure of information to his/her legally
entitled representative.
c. If the patient's legally entitled representative, or a person authorized by the patient, forbids
treatment which is, in the opinion of the physician, in the patient's best interest, the
physician should challenge this decision in the relevant legal or other institution. In case
of emergency, the physician will act in the patient's best interest.
6. Procedures against the patient's will
Diagnostic procedures or treatment against the patient's will can be carried out only in
exceptional cases, if specifically permitted by law and conforming to the principles of medical
ethics.
7. Right to information
a. The patient has the right to receive information about himself/herself recorded in any of
his/her medical records, and to be fully informed about his/her health status including the
medical facts about his/her condition. However, confidential information in the patient's
records about a third party should not be given to the patient without the consent of that
third party. 17.H
3
b. Exceptionally, information may be withheld from the patient when there is good reason to
believe that this information would create a serious hazard to his/her life or health.
c. Information should be given in a way appropriate to the patient’s culture and in such a way
that the patient can understand.
d. The patient has the right not to be informed on his/her explicit request, unless required for
the protection of another person's life.
e. The patient has the right to choose who, if anyone, should be informed on his/her behalf.
8. Right to confidentiality
a. All identifiable information about a patient's health status, medical condition, diagnosis,
prognosis and treatment and all other information of a personal kind must be kept
confidential, even after death. Exceptionally, descendants may have a right of access to
information that would inform them of their health risks.
b. Confidential information can only be disclosed if the patient gives explicit consent or if
expressly provided for in the law. Information can be disclosed to other health care
providers only on a strictly "need to know" basis unless the patient has given explicit
consent.
c. All identifiable patient data must be protected. The protection of the data must be
appropriate to the manner of its storage. Human substances from which identifiable data
can be derived must be likewise protected.
9. Right to Health Education
Every person has the right to health education that will assist him/her in making informed
choices about personal health and about the available health services. The education should
include information about healthy lifestyles and about methods of prevention and early
detection of illnesses. The personal responsibility of everybody for his/her own health should
be stressed. Physicians have an obligation to participate actively in educational efforts.
10. Right to dignity
a. The patient's dignity and right to privacy shall be respected at all times in medical care and
teaching, as shall his/her culture and values.
b. The patient is entitled to relief of his/her suffering according to the current state of
knowledge.
c. The patient is entitled to humane terminal care and to be provided with all available
assistance in making dying as dignified and comfortable as possible.
11. Right to religious assistance
The patient has the right to receive or to decline spiritual and moral comfort including the help
of a minister of his/her chosen religion.
♣ ♣ ♣
14.10.2005
1
October 2005 Original: English
THE WORLD MEDICAL ASSOCIATION, INC.
WORLD MEDICAL ASSOCIATION DECLARATION OF LISBON
ON
THE RIGHTS OF THE PATIENT
Adopted by the 34th World Medical Assembly
Lisbon, Portugal, September/October 1981,
and amended by the 47th WMA General Assembly
Bali, Indonesia, September 1995,
and editorially revised at the 171st Council Session,
Santiago, Chile, October 2005
PREAMBLE
The relationship between physicians, their patients and broader society has undergone significant
changes in recent times. While a physician should always act according to his/her conscience, and
always in the best interests of the patient, equal effort must be made to guarantee patient autonomy
and justice. The following Declaration represents some of the principal rights of the patient that the
medical profession endorses and promotes. Physicians and other persons or bodies involved in the
provision of health care have a joint responsibility to recognize and uphold these rights. Whenever
legislation, government action or any other administration or institution denies patients these rights,
physicians should pursue appropriate means to assure or to restore them.
PRINCIPLES
1. Right to medical care of good quality
a. Every person is entitled without discrimination to appropriate medical care.
b. Every patient has the right to be cared for by a physician whom he/she knows to be free to
make clinical and ethical judgements without any outside interference.
c. The patient shall always be treated in accordance with his/her best interests. The treatment
applied shall be in accordance with generally approved medical principles.
d. Quality assurance should always be a part of health care. Physicians, in particular, should
accept responsibility for being guardians of the quality of medical services.
e. In circumstances where a choice must be made between potential patients for a particular
treatment that is in limited supply, all such patients are entitled to a fair selection
procedure for that treatment. That choice must be based on medical criteria and made
without discrimination.
f. The patient has the right to continuity of health care. The physician has an obligation to
cooperate in the coordination of medically indicated care with other health care providers
treating the patient. The physician may not discontinue treatment of a patient as long as
further treatment is medically indicated, without giving the patient reasonable assistance
and sufficient opportunity to make alternative arrangements for care.
2. Right to freedom of choice
a. The patient has the right to choose freely and change his/her physician and hospital or
health service institution, regardless of whether they are based in the private or public
sector.
b. The patient has the right to ask for the opinion of another physician at any stage. 17.H
2
3. Right to self-determination
a. The patient has the right to self-determination, to make free decisions regarding
himself/herself. The physician will inform the patient of the consequences of his/her
decisions.
b. A mentally competent adult patient has the right to give or withhold consent to any
diagnostic procedure or therapy. The patient has the right to the information necessary to
make his/her decisions. The patient should understand clearly what is the purpose of any
test or treatment, what the results would imply, and what would be the implications of
withholding consent.
c. The patient has the right to refuse to participate in research or the teaching of medicine.
4. The unconscious patient
a. If the patient is unconscious or otherwise unable to express his/her will, informed consent
must be obtained whenever possible, from a legally entitled representative.
b. If a legally entitled representative is not available, but a medical intervention is urgently
needed, consent of the patient may be presumed, unless it is obvious and beyond any
doubt on the basis of the patient's previous firm expression or conviction that he/she would
refuse consent to the intervention in that situation.
c. However, physicians should always try to save the life of a patient unconscious due to a
suicide attempt.
5. The legally incompetent patient
a. If a patient is a minor or otherwise legally incompetent, the consent of a legally entitled
representative is required in some jurisdictions. Nevertheless the patient must be involved
in the decision-making to the fullest extent allowed by his/her capacity.
b. If the legally incompetent patient can make rational decisions, his/her decisions must be
respected, and he/she has the right to forbid the disclosure of information to his/her legally
entitled representative.
c. If the patient's legally entitled representative, or a person authorized by the patient, forbids
treatment which is, in the opinion of the physician, in the patient's best interest, the
physician should challenge this decision in the relevant legal or other institution. In case
of emergency, the physician will act in the patient's best interest.
6. Procedures against the patient's will
Diagnostic procedures or treatment against the patient's will can be carried out only in
exceptional cases, if specifically permitted by law and conforming to the principles of medical
ethics.
7. Right to information
a. The patient has the right to receive information about himself/herself recorded in any of
his/her medical records, and to be fully informed about his/her health status including the
medical facts about his/her condition. However, confidential information in the patient's
records about a third party should not be given to the patient without the consent of that
third party. 17.H
3
b. Exceptionally, information may be withheld from the patient when there is good reason to
believe that this information would create a serious hazard to his/her life or health.
c. Information should be given in a way appropriate to the patient’s culture and in such a way
that the patient can understand.
d. The patient has the right not to be informed on his/her explicit request, unless required for
the protection of another person's life.
e. The patient has the right to choose who, if anyone, should be informed on his/her behalf.
8. Right to confidentiality
a. All identifiable information about a patient's health status, medical condition, diagnosis,
prognosis and treatment and all other information of a personal kind must be kept
confidential, even after death. Exceptionally, descendants may have a right of access to
information that would inform them of their health risks.
b. Confidential information can only be disclosed if the patient gives explicit consent or if
expressly provided for in the law. Information can be disclosed to other health care
providers only on a strictly "need to know" basis unless the patient has given explicit
consent.
c. All identifiable patient data must be protected. The protection of the data must be
appropriate to the manner of its storage. Human substances from which identifiable data
can be derived must be likewise protected.
9. Right to Health Education
Every person has the right to health education that will assist him/her in making informed
choices about personal health and about the available health services. The education should
include information about healthy lifestyles and about methods of prevention and early
detection of illnesses. The personal responsibility of everybody for his/her own health should
be stressed. Physicians have an obligation to participate actively in educational efforts.
10. Right to dignity
a. The patient's dignity and right to privacy shall be respected at all times in medical care and
teaching, as shall his/her culture and values.
b. The patient is entitled to relief of his/her suffering according to the current state of
knowledge.
c. The patient is entitled to humane terminal care and to be provided with all available
assistance in making dying as dignified and comfortable as possible.
11. Right to religious assistance
The patient has the right to receive or to decline spiritual and moral comfort including the help
of a minister of his/her chosen religion.
♣ ♣ ♣
14.10.2005
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17.H1Tháng 10 năm 2005 bản gốc: tiếng AnhHIỆP HỘI Y TẾ THẾ GIỚI, INCHIỆP HỘI Y TẾ THẾ GIỚI TUYÊN BỐ CỦA LISBONONQUYỀN LỢI CỦA BỆNH NHÂNĐược thông qua bởi Hội đồng y tế thế giới thứ 34Lisboa, Bồ Đào Nha, tháng chín/tháng mười 1981và sửa đổi bởi Đại hội lần thứ 47 WMABali, Indonesia, tháng 9 năm 1995,và sửa đổi lại tại kỳ họp hội đồng 171,Santiago, Chi-lê, tháng 10 năm 2005LỜI MỞ ĐẦUMối quan hệ giữa các bác sĩ, bệnh nhân và xã hội rộng lớn hơn của họ đã trải qua đáng kểnhững thay đổi trong thời gian gần đây. Trong khi một bác sĩ nên luôn luôn hành động theo lương tâm anh/cô ấy, vàluôn luôn trong lợi ích tốt nhất của bệnh nhân, bằng nỗ lực phải được thực hiện để đảm bảo quyền tự trị bệnh nhânvà tư pháp. Bản tuyên ngôn sau đây đại diện cho một số chính quyền lợi của bệnh nhân mà cácnghiệp vụ y tế xác nhận và khuyến khích. Bác sĩ và những người khác hoặc các cơ quan tham gia vào cáccung cấp chăm sóc y tế có trách nhiệm chung để nhận ra và duy trì những quyền lợi này. Bất cứ khi nàopháp luật, chính phủ hành động hoặc bất kỳ khác quản lý hoặc cơ sở giáo dục từ chối bệnh nhân những quyền lợi này,bác sĩ nên theo đuổi phương tiện thích hợp để đảm bảo hoặc để khôi phục chúng.NGUYÊN TẮC1. quyền để y tế chăm sóc chất lượng tốt a. mỗi người là quyền mà không phân biệt đối xử để chăm sóc y tế thích hợp. sinh mỗi bệnh nhân có quyền được chăm sóc bởi một bác sĩ người mà anh/cô ấy biết được tự dolàm cho bản án lâm sàng và đạo đức mà không có bất kỳ bên ngoài can thiệp.c. bệnh nhân luôn luôn sẽ được điều trị phù hợp với lợi ích tốt nhất của mình. Điều trịáp dụng sẽ phải phù hợp với nguyên tắc y tế nói chung được chấp thuận. mất đảm bảo chất lượng nên luôn luôn là một phần của chăm sóc sức khỏe. Bác sĩ, trong đó, nênchấp nhận trách nhiệm vì người giám hộ của chất lượng của dịch vụ y tế. e. trong trường hợp mà một sự lựa chọn phải được thực hiện giữa các bệnh nhân tiềm năng cho một đặc biệtđiều trị đó là trong nguồn cung hạn chế, tất cả những bệnh nhân có quyền lựa chọn công bằngthủ tục để điều trị đó. Rằng sự lựa chọn phải được dựa trên các tiêu chí y tế và thực hiệnmà không phân biệt đối xử.f. bệnh nhân có quyền liên tục chăm sóc sức khỏe. Bác sĩ có nghĩa vụhợp tác phối hợp về mặt y tế định chăm sóc với nhà cung cấp chăm sóc y tế khácđiều trị bệnh nhân. Bác sĩ có thể không ngừng điều trị của bệnh nhân miễn làtiếp tục điều trị y tế chỉ định, mà không đưa ra sự hỗ trợ hợp lý bệnh nhânvà các cơ hội đủ để sắp xếp thay thế cho việc chăm sóc.2. quyền để tự do lựa chọna. bệnh nhân có quyền chọn một cách tự do và thay đổi anh/cô ấy bác sĩ và bệnh viện hoặctổ chức dịch vụ y tế, bất kể cho dù họ có trụ sở tại tư nhân hay công cộngkhu vực kinh tế. sinh bệnh nhân có quyền yêu cầu cho ý kiến một bác sĩ tại bất kỳ giai đoạn. 17.H23. quyền để tự quyếta. bệnh nhân có quyền tự quyết, để đưa ra quyết định miễn phí liên quan đếnmình/mình. Bác sĩ sẽ thông báo cho bệnh nhân của những hậu quả của anh/cô ấyquyết định.sinh một bệnh nhân có thẩm quyền về tinh thần dành cho người lớn có quyền cung cấp cho hoặc giữ lại sự đồng ý với bất kỳthủ tục chẩn đoán hoặc điều trị. Bệnh nhân có quyền được thông tin cần thiết đểlàm cho quyết định của mình. Bệnh nhân nên hiểu rõ ràng những gì là mục đích của bất kỳthử nghiệm hoặc điều trị, những gì các kết quả sẽ ngụ ý, và những gì sẽ là các tác động củagiữ lại sự đồng ý.c. bệnh nhân có quyền từ chối tham gia vào nghiên cứu hoặc giảng dạy y học.4. bệnh nhân vô thứca. nếu bệnh nhân là vô thức hoặc nếu không không thể nhận anh/cô ấy sẽ, sự đồng ý thông báo.phải có được bất cứ khi nào có thể, từ một đại diện hợp pháp quyền.b. nếu một đại diện hợp pháp quyền không phải là có sẵn, nhưng một sự can thiệp y tế là khẩn trươngcần thiết, sự đồng ý của bệnh nhân có thể được coi là, trừ khi nó là rõ ràng và hơn thế nữa bất kỳnghi ngờ trên cơ sở của bệnh nhân cụm từ trước của công ty hoặc niềm tin rằng anh/cô ấy sẽtừ chối sự cho phép để can thiệp trong tình hình đó.c. Tuy nhiên, các bác sĩ nên luôn luôn cố gắng để tiết kiệm cuộc sống của một vô thức bệnh nhân do mộtcố gắng tự tử.5. bệnh nhân không đủ năng lực pháp lýa. nếu bệnh nhân là trẻ vị thành niên hoặc nếu không hợp pháp không đủ năng lực, sự đồng ý của một quyền hợp phápđại diện là cần thiết trong một số khu vực pháp lý. Tuy nhiên bệnh nhân phải được tham giara quyết định trong phạm vi được phép bởi khả năng của mình.b. nếu bệnh nhân không đủ năng lực pháp lý có thể đưa ra quyết định hợp lý, quyết định của ông/bà phảitôn trọng, và anh/cô ấy có quyền cấm việc tiết lộ thông tin cho anh/cô ấy về mặt pháp lýquyền đại diện.c. Nếu đại diện hợp pháp quyền của bệnh nhân, hoặc một người được ủy quyền của bệnh nhân, Cấmđiều trị đó là, theo ý kiến của bác sĩ, lợi ích tốt nhất của bệnh nhân, cácbác sĩ nên thách thức quyết định này trong cơ sở giáo dục Pháp lý hoặc khác có liên quan. Trong trường hợpkhẩn cấp, bác sĩ sẽ hành động vì lợi ích tốt nhất của bệnh nhân.6. quy trình của bệnh nhân sẽ chống lại Thủ tục chẩn đoán hoặc điều trị chống lại của bệnh nhân sẽ có thể được thực hiện chỉ trongtrường hợp đặc biệt, nếu được sự cho phép của pháp luật cụ thể và phù hợp các nguyên tắc y tếĐạo Đức.7. quyền để thông tina. bệnh nhân có quyền nhận được thông tin về mình/mình được ghi lại trong bất kỳHồ sơ y tế của mình, và để được thông báo đầy đủ về anh/cô ấy tình trạng sức khỏe bao gồm cácsự kiện y tế về tình trạng của mình. Tuy nhiên, các thông tin bí mật trong của bệnh nhânHồ sơ về một bên thứ ba không nên được trao cho bệnh nhân mà không có sự đồng ý về điều đóbên thứ ba. 17.H3sinh đặc biệt, thông tin có thể được giữ lại từ bệnh nhân khi có lý do tốt đểtin rằng thông tin này sẽ tạo ra một mối nguy hiểm nghiêm trọng tới tính mạng hoặc sức khỏe của mình.c. thông tin nên được đưa ra theo một cách thích hợp với văn hóa của bệnh nhân và như vậyrằng bệnh nhân có thể hiểu.mất bệnh nhân có quyền không được thông báo về anh/cô ấy yêu cầu rõ ràng, trừ khi cần thiết chobảo vệ cuộc sống của người khác.e. bệnh nhân có quyền chọn người, nếu bất cứ ai, nên được thông báo trên danh nghĩa của ông/bà.8. quyền để bảo mậta. tất cả những thông tin về tình trạng sức khỏe của bệnh nhân, bệnh, chẩn đoán,dự đoán và điều trị và tất cả các thông tin khác của một loại cá nhân phải được giữ««bí mật, ngay cả sau khi cái chết. Đặc biệt, con cháu có thể có quyền truy cập vàothông tin sẽ thông báo cho họ về nguy cơ sức khỏe của họ.sinh bí mật thông tin này có thể chỉ được tiết lộ nếu bệnh nhân cho sự cho phép, hoặc nếurõ ràng được cung cấp cho trong pháp luật. Thông tin có thể được tiết lộ cho chăm sóc sức khỏe khácnhà cung cấp chỉ trên một nghiêm "nhu cầu biết" cơ sở trừ khi bệnh nhân đã cho rõ ràngđồng ý.c. tất cả dữ liệu nhận dạng bệnh nhân phải được bảo vệ. Bảo vệ dữ liệu phảiphù hợp với cách thức dung lượng lưu trữ của nó. Chất của con người từ dữ liệu nhận dạngcó thể được bắt nguồn phải được bảo vệ tương tự như vậy.9. quyền để giáo dục sức khỏe Mọi người đều có quyền được giáo dục sức khỏe sẽ hỗ trợ anh ta/cô trong việc thông báosự lựa chọn về sức khỏe cá nhân và về các dịch vụ y tế có sẵn. Giáo dục nênbao gồm thông tin về lối sống lành mạnh và về phương pháp phòng ngừa và sớmphát hiện bệnh. Trách nhiệm cá nhân của tất cả mọi người cho sức khỏe của riêng của ông/bà nênđược nhấn mạnh. Bác sĩ có nghĩa vụ phải tham gia tích cực vào những nỗ lực giáo dục.10. quyền để nhân phẩm a. bệnh nhân phẩm và quyền riêng tư sẽ được tôn trọng ở tất cả các lần trong chăm sóc y tế vàgiảng dạy, như sẽ của ông/bà văn hóa và các giá trị. sinh bệnh nhân có quyền để cứu trợ của anh/cô ấy đau khổ theo hiện trạngkiến thức. c. bệnh nhân được quyền để chăm sóc thiết bị đầu cuối nhân đạo và để được cung cấp với tất cả có sẵnhỗ trợ trong việc đưa ra chết trang nghiêm và cảm thấy thoải mái nhất có thể.11. quyền để hỗ trợ tôn giáo Bệnh nhân có quyền nhận hoặc từ chối Tiện nghi tinh thần và đạo Đức, trong đó có sự giúp đỡcủa một bộ trưởng của anh/cô ấy tôn giáo được lựa chọn.♣ ♣ ♣14.10.2005
đang được dịch, vui lòng đợi..
17.H
1
October 2005 Original: English
THE WORLD MEDICAL ASSOCIATION, INC.
WORLD MEDICAL ASSOCIATION DECLARATION OF LISBON
ON
THE RIGHTS OF THE PATIENT
Adopted by the 34th World Medical Assembly
Lisbon, Portugal, September/October 1981,
and amended by the 47th WMA General Assembly
Bali, Indonesia, September 1995,
and editorially revised at the 171st Council Session,
Santiago, Chile, October 2005
PREAMBLE
The relationship between physicians, their patients and broader society has undergone significant
changes in recent times. While a physician should always act according to his/her conscience, and
always in the best interests of the patient, equal effort must be made to guarantee patient autonomy
and justice. The following Declaration represents some of the principal rights of the patient that the
medical profession endorses and promotes. Physicians and other persons or bodies involved in the
provision of health care have a joint responsibility to recognize and uphold these rights. Whenever
legislation, government action or any other administration or institution denies patients these rights,
physicians should pursue appropriate means to assure or to restore them.
PRINCIPLES
1. Right to medical care of good quality
a. Every person is entitled without discrimination to appropriate medical care.
b. Every patient has the right to be cared for by a physician whom he/she knows to be free to
make clinical and ethical judgements without any outside interference.
c. The patient shall always be treated in accordance with his/her best interests. The treatment
applied shall be in accordance with generally approved medical principles.
d. Quality assurance should always be a part of health care. Physicians, in particular, should
accept responsibility for being guardians of the quality of medical services.
e. In circumstances where a choice must be made between potential patients for a particular
treatment that is in limited supply, all such patients are entitled to a fair selection
procedure for that treatment. That choice must be based on medical criteria and made
without discrimination.
f. The patient has the right to continuity of health care. The physician has an obligation to
cooperate in the coordination of medically indicated care with other health care providers
treating the patient. The physician may not discontinue treatment of a patient as long as
further treatment is medically indicated, without giving the patient reasonable assistance
and sufficient opportunity to make alternative arrangements for care.
2. Right to freedom of choice
a. The patient has the right to choose freely and change his/her physician and hospital or
health service institution, regardless of whether they are based in the private or public
sector.
b. The patient has the right to ask for the opinion of another physician at any stage. 17.H
2
3. Right to self-determination
a. The patient has the right to self-determination, to make free decisions regarding
himself/herself. The physician will inform the patient of the consequences of his/her
decisions.
b. A mentally competent adult patient has the right to give or withhold consent to any
diagnostic procedure or therapy. The patient has the right to the information necessary to
make his/her decisions. The patient should understand clearly what is the purpose of any
test or treatment, what the results would imply, and what would be the implications of
withholding consent.
c. The patient has the right to refuse to participate in research or the teaching of medicine.
4. The unconscious patient
a. If the patient is unconscious or otherwise unable to express his/her will, informed consent
must be obtained whenever possible, from a legally entitled representative.
b. If a legally entitled representative is not available, but a medical intervention is urgently
needed, consent of the patient may be presumed, unless it is obvious and beyond any
doubt on the basis of the patient's previous firm expression or conviction that he/she would
refuse consent to the intervention in that situation.
c. However, physicians should always try to save the life of a patient unconscious due to a
suicide attempt.
5. The legally incompetent patient
a. If a patient is a minor or otherwise legally incompetent, the consent of a legally entitled
representative is required in some jurisdictions. Nevertheless the patient must be involved
in the decision-making to the fullest extent allowed by his/her capacity.
b. If the legally incompetent patient can make rational decisions, his/her decisions must be
respected, and he/she has the right to forbid the disclosure of information to his/her legally
entitled representative.
c. If the patient's legally entitled representative, or a person authorized by the patient, forbids
treatment which is, in the opinion of the physician, in the patient's best interest, the
physician should challenge this decision in the relevant legal or other institution. In case
of emergency, the physician will act in the patient's best interest.
6. Procedures against the patient's will
Diagnostic procedures or treatment against the patient's will can be carried out only in
exceptional cases, if specifically permitted by law and conforming to the principles of medical
ethics.
7. Right to information
a. The patient has the right to receive information about himself/herself recorded in any of
his/her medical records, and to be fully informed about his/her health status including the
medical facts about his/her condition. However, confidential information in the patient's
records about a third party should not be given to the patient without the consent of that
third party. 17.H
3
b. Exceptionally, information may be withheld from the patient when there is good reason to
believe that this information would create a serious hazard to his/her life or health.
c. Information should be given in a way appropriate to the patient’s culture and in such a way
that the patient can understand.
d. The patient has the right not to be informed on his/her explicit request, unless required for
the protection of another person's life.
e. The patient has the right to choose who, if anyone, should be informed on his/her behalf.
8. Right to confidentiality
a. All identifiable information about a patient's health status, medical condition, diagnosis,
prognosis and treatment and all other information of a personal kind must be kept
confidential, even after death. Exceptionally, descendants may have a right of access to
information that would inform them of their health risks.
b. Confidential information can only be disclosed if the patient gives explicit consent or if
expressly provided for in the law. Information can be disclosed to other health care
providers only on a strictly "need to know" basis unless the patient has given explicit
consent.
c. All identifiable patient data must be protected. The protection of the data must be
appropriate to the manner of its storage. Human substances from which identifiable data
can be derived must be likewise protected.
9. Right to Health Education
Every person has the right to health education that will assist him/her in making informed
choices about personal health and about the available health services. The education should
include information about healthy lifestyles and about methods of prevention and early
detection of illnesses. The personal responsibility of everybody for his/her own health should
be stressed. Physicians have an obligation to participate actively in educational efforts.
10. Right to dignity
a. The patient's dignity and right to privacy shall be respected at all times in medical care and
teaching, as shall his/her culture and values.
b. The patient is entitled to relief of his/her suffering according to the current state of
knowledge.
c. The patient is entitled to humane terminal care and to be provided with all available
assistance in making dying as dignified and comfortable as possible.
11. Right to religious assistance
The patient has the right to receive or to decline spiritual and moral comfort including the help
of a minister of his/her chosen religion.
♣ ♣ ♣
14.10.2005
1
October 2005 Original: English
THE WORLD MEDICAL ASSOCIATION, INC.
WORLD MEDICAL ASSOCIATION DECLARATION OF LISBON
ON
THE RIGHTS OF THE PATIENT
Adopted by the 34th World Medical Assembly
Lisbon, Portugal, September/October 1981,
and amended by the 47th WMA General Assembly
Bali, Indonesia, September 1995,
and editorially revised at the 171st Council Session,
Santiago, Chile, October 2005
PREAMBLE
The relationship between physicians, their patients and broader society has undergone significant
changes in recent times. While a physician should always act according to his/her conscience, and
always in the best interests of the patient, equal effort must be made to guarantee patient autonomy
and justice. The following Declaration represents some of the principal rights of the patient that the
medical profession endorses and promotes. Physicians and other persons or bodies involved in the
provision of health care have a joint responsibility to recognize and uphold these rights. Whenever
legislation, government action or any other administration or institution denies patients these rights,
physicians should pursue appropriate means to assure or to restore them.
PRINCIPLES
1. Right to medical care of good quality
a. Every person is entitled without discrimination to appropriate medical care.
b. Every patient has the right to be cared for by a physician whom he/she knows to be free to
make clinical and ethical judgements without any outside interference.
c. The patient shall always be treated in accordance with his/her best interests. The treatment
applied shall be in accordance with generally approved medical principles.
d. Quality assurance should always be a part of health care. Physicians, in particular, should
accept responsibility for being guardians of the quality of medical services.
e. In circumstances where a choice must be made between potential patients for a particular
treatment that is in limited supply, all such patients are entitled to a fair selection
procedure for that treatment. That choice must be based on medical criteria and made
without discrimination.
f. The patient has the right to continuity of health care. The physician has an obligation to
cooperate in the coordination of medically indicated care with other health care providers
treating the patient. The physician may not discontinue treatment of a patient as long as
further treatment is medically indicated, without giving the patient reasonable assistance
and sufficient opportunity to make alternative arrangements for care.
2. Right to freedom of choice
a. The patient has the right to choose freely and change his/her physician and hospital or
health service institution, regardless of whether they are based in the private or public
sector.
b. The patient has the right to ask for the opinion of another physician at any stage. 17.H
2
3. Right to self-determination
a. The patient has the right to self-determination, to make free decisions regarding
himself/herself. The physician will inform the patient of the consequences of his/her
decisions.
b. A mentally competent adult patient has the right to give or withhold consent to any
diagnostic procedure or therapy. The patient has the right to the information necessary to
make his/her decisions. The patient should understand clearly what is the purpose of any
test or treatment, what the results would imply, and what would be the implications of
withholding consent.
c. The patient has the right to refuse to participate in research or the teaching of medicine.
4. The unconscious patient
a. If the patient is unconscious or otherwise unable to express his/her will, informed consent
must be obtained whenever possible, from a legally entitled representative.
b. If a legally entitled representative is not available, but a medical intervention is urgently
needed, consent of the patient may be presumed, unless it is obvious and beyond any
doubt on the basis of the patient's previous firm expression or conviction that he/she would
refuse consent to the intervention in that situation.
c. However, physicians should always try to save the life of a patient unconscious due to a
suicide attempt.
5. The legally incompetent patient
a. If a patient is a minor or otherwise legally incompetent, the consent of a legally entitled
representative is required in some jurisdictions. Nevertheless the patient must be involved
in the decision-making to the fullest extent allowed by his/her capacity.
b. If the legally incompetent patient can make rational decisions, his/her decisions must be
respected, and he/she has the right to forbid the disclosure of information to his/her legally
entitled representative.
c. If the patient's legally entitled representative, or a person authorized by the patient, forbids
treatment which is, in the opinion of the physician, in the patient's best interest, the
physician should challenge this decision in the relevant legal or other institution. In case
of emergency, the physician will act in the patient's best interest.
6. Procedures against the patient's will
Diagnostic procedures or treatment against the patient's will can be carried out only in
exceptional cases, if specifically permitted by law and conforming to the principles of medical
ethics.
7. Right to information
a. The patient has the right to receive information about himself/herself recorded in any of
his/her medical records, and to be fully informed about his/her health status including the
medical facts about his/her condition. However, confidential information in the patient's
records about a third party should not be given to the patient without the consent of that
third party. 17.H
3
b. Exceptionally, information may be withheld from the patient when there is good reason to
believe that this information would create a serious hazard to his/her life or health.
c. Information should be given in a way appropriate to the patient’s culture and in such a way
that the patient can understand.
d. The patient has the right not to be informed on his/her explicit request, unless required for
the protection of another person's life.
e. The patient has the right to choose who, if anyone, should be informed on his/her behalf.
8. Right to confidentiality
a. All identifiable information about a patient's health status, medical condition, diagnosis,
prognosis and treatment and all other information of a personal kind must be kept
confidential, even after death. Exceptionally, descendants may have a right of access to
information that would inform them of their health risks.
b. Confidential information can only be disclosed if the patient gives explicit consent or if
expressly provided for in the law. Information can be disclosed to other health care
providers only on a strictly "need to know" basis unless the patient has given explicit
consent.
c. All identifiable patient data must be protected. The protection of the data must be
appropriate to the manner of its storage. Human substances from which identifiable data
can be derived must be likewise protected.
9. Right to Health Education
Every person has the right to health education that will assist him/her in making informed
choices about personal health and about the available health services. The education should
include information about healthy lifestyles and about methods of prevention and early
detection of illnesses. The personal responsibility of everybody for his/her own health should
be stressed. Physicians have an obligation to participate actively in educational efforts.
10. Right to dignity
a. The patient's dignity and right to privacy shall be respected at all times in medical care and
teaching, as shall his/her culture and values.
b. The patient is entitled to relief of his/her suffering according to the current state of
knowledge.
c. The patient is entitled to humane terminal care and to be provided with all available
assistance in making dying as dignified and comfortable as possible.
11. Right to religious assistance
The patient has the right to receive or to decline spiritual and moral comfort including the help
of a minister of his/her chosen religion.
♣ ♣ ♣
14.10.2005
đang được dịch, vui lòng đợi..
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- a studenr
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