What are Patient Rights? The Importance of Information and Consent in the Treatment Process

What are Patient Rights?

Patient rights are the manifestation in the healthcare field of the fundamental rights that a person receiving healthcare possesses not merely because they are "patients," but because they are human beings. When a person visits a hospital, undergoes surgery, has tests done, goes to the emergency room, gives birth, receives dental treatment, or has cosmetic surgery, their body, privacy, health information, and freedom of decision-making directly come into contact with healthcare services. Therefore, patient rights ensure that healthcare services are provided not only within a medical framework, but also within a legal and humanitarian framework.

The Patient Rights Regulation covers all public and private institutions and organizations providing healthcare services, all individuals involved in healthcare services at every level within or outside these institutions, and all persons benefiting from healthcare services. The purpose of the regulation is to concretely define patient rights, to ensure that everyone benefits from healthcare services in a manner befitting human dignity, and to enable them to use legal means of protection against rights violations.

When we talk about patient rights, we shouldn't only understand the right to good treatment in the hospital. The fundamental rights of patients include access to healthcare fairly and equitably, the right to choose a healthcare facility, the right to know and change physicians, the right to request diagnosis and treatment in accordance with modern medical requirements, the right to be informed, the right to review medical records, the right to privacy, the right not to be subjected to intervention without consent, the right to refuse treatment, the right to receive healthcare in a safe environment, the right to have a companion, and the right to complain and sue.

At the heart of these rights lie two concepts: information and informed consent. Because a patient cannot be considered to have truly consented to treatment without knowing what they are agreeing to. For legally valid consent to exist, the patient must be adequately informed about the procedure, the risks, the alternatives, and the consequences of refusing treatment.

The Constitutional Basis of Patient Rights

At the heart of patient rights lies the right to life, the right to protect one's physical and mental well-being, and the right to bodily integrity. According to Article 17 of the Constitution of the Republic of Turkey, everyone has the right to life, to protect and develop their physical and mental existence; bodily integrity cannot be violated except in cases of medical necessity and those stipulated by law. The same article explicitly states that no one can be subjected to scientific and medical experiments without their consent.

This constitutional framework demonstrates that in healthcare, the patient is not merely an “object” to be treated, but a person with the right to make decisions about their own body. The doctor's medical knowledge and professional competence are crucial; however, as a rule, the patient's consent is required for any intervention on their body to be lawful.

Therefore, patient rights do not completely eliminate the doctor's freedom to treat; however, they align the doctor's professional decisions with the patient's informed will. The patient is not obliged to passively endure the treatment process. They have the right to know about their illness, treatment options, risks, alternatives, and what will happen if they do not accept the treatment.

The Right to Fair and Equitable Access to Healthcare Services

Patients have the right to access healthcare services within the framework of justice and equity principles. This right means that individuals receive healthcare services without discrimination based on their economic situation, language, religion, gender, social status, political views, or similar reasons. The Patient Rights Regulation states that healthcare services should be planned and organized in a way that is easily accessible to everyone, and that no discrimination can be made between patients in the provision of healthcare services.

This right is particularly important in emergency services, intensive care units, maternity services, surgical planning, and appointment scheduling. Even if a healthcare facility has limited resources, priority should be determined based on objective and medical criteria. A patient's social status, connections, ability to pay, or personal characteristics cannot override medical priority.

Priority rules are also considered for emergency patients, critically injured individuals, the elderly, people with disabilities, and those requiring special protection. The important thing here is that healthcare is provided in accordance with medical necessity and the law, not arbitrarily.

The Right to Diagnosis, Treatment, and Care in Accordance with Medical Requirements

Patients have the right to be diagnosed, treated, and cared for in accordance with the requirements of modern medical knowledge and technology. The Patient Rights Regulation explicitly states that patients have the right to be diagnosed, treated, and cared for in accordance with the requirements of modern medical knowledge and technology; and that diagnoses and treatments that are contrary to medical principles and legislation, or that are deceptive, cannot be performed.

This right also forms the basis of malpractice lawsuits. Violations of patient rights may arise if a doctor makes a wrong diagnosis, fails to order necessary tests, misinterprets test results, fails to refer the patient to the appropriate specialist, neglects post-operative follow-up, administers the wrong medication, or if the hospital fails to provide the necessary organization.

However, not every negative outcome automatically means medical malpractice. Medical intervention is a risky activity. Some outcomes may occur as complications. Nevertheless, it is necessary to inform the patient about the complication beforehand, to manage it correctly when it arises, and to maintain complete medical records. Otherwise, the excuse of complications may not absolve the doctor or hospital of responsibility.

What is the Right to Information?

One of the most important aspects of patient rights is the right to information. A patient has the right to request verbal or written information about their health condition, the medical procedures to be performed, the benefits and potential risks of these procedures, alternative treatment methods, the consequences of refusing treatment, and the course of their illness. Furthermore, a patient may obtain information about their health condition from a doctor other than the one treating them.

Providing information is not simply about saying "you will have surgery," "you will take medication," or "this procedure is necessary." The patient should be informed about the procedure, who will perform it, how long it will take, the risks involved, the probability of success, whether there are alternatives, and the consequences of not performing the procedure.

For example, a patient about to undergo heart surgery cannot simply be told the name of the operation. The purpose of the surgery, the method, the risks of anesthesia, bleeding, infection, the intensive care process, the possibility of permanent damage, and alternative treatment options must be explained. Similarly, for cosmetic surgery, dental implants, childbirth, orthopedic surgery, cancer treatment, or risky drug therapy, all important factors that could influence the patient's decision must be clarified.

The right to information enables the patient to participate in treatment in an informed manner. Only when adequately informed can the patient decide whether to accept treatment, seek a second opinion, go to another hospital, or refuse treatment altogether.

How should the information be conveyed?

The information should be provided in a way that the patient can understand. According to the regulations, the information should be given in a way that the patient can understand, using an interpreter if necessary, avoiding medical terminology as much as possible, leaving no room for hesitation or doubt, and using gentle language appropriate to the patient's mental state.

This arrangement is particularly important for foreign patients, elderly patients, illiterate individuals, disabled patients, children, and critically ill patients. Providing long and complex explanations using medical terminology may not constitute true information dissemination. The aim of proper information is not for the patient to know as much about medicine as the doctor, but to have enough information to understand the decisions being made regarding their own body.

Therefore, healthcare facilities should use appropriate communication methods for the patient. Interpreter support should be provided for patients who speak a foreign language, appropriate information tools should be used for patients with hearing or visual impairments, and explanations should be given more calmly and clearly to elderly or anxious patients.

Patients should not be pressured during the information process. Statements such as "The surgery won't happen if you don't sign," "Everyone signs this," or "This is just a formality" can weaken the legal value of informed consent. The patient must truly understand what they are consenting to when signing the form.

What is Informed Consent?

Informed consent is when a patient freely consents to a medical procedure after being adequately informed about it. This concept is one of the most critical issues within patient rights, because medical intervention, as a rule, is a procedure directed at a person's bodily integrity. For it to be legally permissible, medical necessity, performance by an authorized person, compliance with medical standards, and the patient's consent must all be considered together.

According to Article 24 of the Patient Rights Regulation, patient consent is required for medical interventions. If the patient is a minor or has limited capacity, permission is obtained from their guardian or legal representative; however, this requirement may not be sought in emergency situations where the patient's guardian or legal representative is not present, unavailable, or the patient lacks the capacity to express themselves.

Article 70 of Law No. 1219 on the Manner of Practice of Medicine and Related Professions stipulates that physicians, dentists, and dental technicians must obtain the prior consent of the patient, or the guardian or trustee if the patient is a minor or incapacitated, for any surgical procedures they perform; and that this consent must be in writing for major surgical procedures.

Therefore, in health law, a consent form is not merely a bureaucratic document. A correctly completed and properly obtained consent form is important evidence regarding the legality of a medical intervention. However, the mere existence of a signed form is not always sufficient. What matters is whether the patient has been truly informed.

Is a Consent Form Always Sufficient?

One of the most common problems in practice is having patients sign numerous documents before surgery and interpreting these signatures as "consent obtained." However, the consent form can become controversial if its content is not relevant to the specific procedure, if the risks have not been explained verbally to the patient, if the form consists of printed and general statements, or if the patient signed under du pressure.

For example, simply having a patient sign a general form stating "I accept the risks of surgery" may not be sufficient for a rhinoplasty surgery. The patient should be informed about breathing difficulties, the possibility of revision surgery, asymmetry, infection, bleeding, the healing process, and individual anatomical risks. Similarly, patient-specific risks should be explained for dental implants, hip replacements, childbirth, eye surgery, or brain surgery.

The Patient Rights Regulation stipulates that it is essential for the patient or their legal representative to be informed and enlightened about the subject and consequences of the medical intervention when consent is obtained. Furthermore, it states that consent obtained in a manner contrary to law and morality is null and void, and that no intervention can be carried out based on such consent.

Therefore, the following questions are important in a legal assessment: When was the form signed by the patient? Is the content of the form appropriate for the specific intervention? Are the risks clearly stated? Was the patient informed in a way they could understand? Was the information provided by a doctor? Was the patient given the opportunity to ask questions? Did the patient give their consent freely?

Patient's Right to Refuse and Discontinue Treatment

As a rule, patients have the right to refuse treatment or to request the discontinuation of treatment that has already begun. According to Article 25 of the Patient Rights Regulation, except in legally mandatory cases, and with the patient bearing responsibility for any negative consequences, patients may refuse or request the discontinuation of planned or ongoing treatment. In this case, the consequences of not administering the treatment must be explained to the patient or their legal representatives, and a written document confirming this must be obtained.

This right is a natural consequence of the patient's freedom to make decisions about their own body. The doctor recommends treatment, explains the risks, and clarifies the consequences of not receiving treatment; however, as a rule, the patient is not obliged to accept this treatment.

Of course, there are some exceptions. Different rules may apply in cases of public health, infectious diseases, emergency intervention, unconsciousness, life-threatening situations, or mandatory circumstances explicitly defined by law. However, outside of these exceptions, forcing a patient to undergo treatment without their consent may constitute a violation of patient rights.

The right to refuse treatment cannot be used against a patient if they subsequently seek treatment at the same healthcare facility. A patient cannot be denied access to subsequent healthcare services or subjected to discriminatory treatment simply because they previously refused treatment.

Is it possible to withdraw consent?

As a rule, the patient can withdraw their consent. The Patient Rights Regulation stipulates that consent can always be withdrawn except in emergency situations threatening a vital organ, and that withdrawal of consent constitutes refusal of treatment. However, withdrawal of consent after the intervention has begun is subject to the condition that there is no medical contraindication.

For example, a patient can withdraw their consent before a planned operation. However, if the operation has already begun and interrupting it would endanger the patient's life, the doctor must act according to medical necessity. Therefore, withdrawing consent is not an absolute right that applies equally in all cases; the specific medical conditions of the case must be taken into account.

The most appropriate approach is to clearly record the patient's intention to withdraw their consent, explain the potential consequences to the patient, and prepare a written record. This protects the patient's will and prevents potential legal disputes for healthcare personnel in the future.

Consent in Young and Crippled Patients

Consent to medical intervention is a more sensitive issue for minors and those with limited legal capacity. As a rule, the consent of a parent or guardian is required for minors or those with limited legal capacity. However, the Patient Rights Regulation stipulates that even in cases where the consent of the legal representative is sufficient, the minor or patient with limited legal capacity should be heard to the extent that they can understand what is being explained, and their participation in decisions regarding their treatment should be ensured as much as possible.

This arrangement shows that the child or person with limited capacity should not be completely ignored. Especially for children who are old enough and mature enough to understand what is happening, the procedure should be explained to them in appropriate language, their fears should be allayed, and they should be involved in the process as much as possible.

A court order may be required in cases where the legal representative does not consent but the intervention is medically necessary. If there is a life-threatening situation and obtaining permission would cause a delay, exceptional provisions may apply for emergency interventions. This is particularly important in cases of blood transfusions, emergency surgery, intensive care interventions, and severe trauma.

Right to Review and Obtain Copies of Medical Records

The patient may review and obtain a copy of the file and records containing information about their health status, either directly or through their representative or legal guardian. These records are only accessible to those directly involved in the patient's treatment. Furthermore, the patient may request corrections to any incomplete, unclear, or inaccurate medical and personal information in their records held by healthcare institutions.

This right is particularly vital in malpractice, misdiagnosis, faulty surgery, birth defects, cosmetic surgery victimization, and private hospital compensation cases. This is because the most important evidence in the litigation process is usually found in hospital records. The discharge summary report, surgical notes, nurse observation form, anesthesia form, laboratory results, imaging records, consultation notes, consent form, and intensive care unit records must be obtained.

The hospital's refusal to provide or incomplete provision of medical records can also be subject to legal disputes. Patient files cannot be viewed as documents solely owned by the hospital; patients have the right to access their own health information.

Patient Privacy and Confidentiality of Health Information

Patient privacy is a fundamental element of healthcare. According to the Patient Rights Regulation, respecting patient privacy is essential, and all medical interventions must be performed with respect for privacy. Examinations, diagnoses, treatments, and procedures requiring direct contact with the patient must be carried out in a reasonably confidential environment. Furthermore, individuals not directly involved in the treatment should not be present during medical procedures.

Health information is confidential and extremely sensitive. A patient's illness, test results, pregnancy status, psychiatric diagnosis, sexual health information, genetic data, or surgical history cannot be disclosed without permission. A patient's privacy and family life must be protected, except in cases of medical necessity.

In teaching hospitals, the presence of students or interns during examination and treatment may be necessary in some cases. However, the Regulation stipulates that if the presence of individuals not directly involved in the patient's treatment is necessary during a medical procedure, separate consent must be obtained from the patient.

Privacy violation is not only an ethical issue. Depending on the specifics of the case, liability for damages, discipline, administrative sanctions, and criminal penalties may arise.

Right to Complaint, Apply, and Sue

Individuals whose patient rights have been violated are not limited to filing complaints solely with the hospital administration. Article 42 of the Patient Rights Regulation stipulates that patients and those related to them have the right to make any appeals, complaints, and lawsuits within the framework of the legislation in case of violations of patient rights. Article 43 of the regulation states that in cases of violations of patient rights, a lawsuit for material and moral damages can be filed against the institution or organization employing the personnel.

In this context, the patient can apply to the hospital's patient rights unit, the chief physician's office, the Provincial Health Directorate, the Ministry of Health, CİMER (the Presidential Communication Center), or relevant professional organizations. However, administrative complaints and compensation lawsuits are different. A complaint allows for an administrative investigation of the violation; a compensation lawsuit aims to compensate the patient for the material and moral damages suffered.

In cases of patient rights violations occurring in state hospitals, depending on the nature of the incident, an appeal to the administration and a full judicial review case in the administrative court may be initiated. The Patient Rights Regulation states that in cases where a lawsuit is to be filed against a public institution or organization, action should be taken in accordance with Articles 12 and 13 of the Administrative Procedure Law No. 2577.

In private hospitals, depending on the nature of the dispute, a consumer court, a civil court of first instance, or another competent court may be involved. The jurisdiction of the competent court and the requirement for mediation should be particularly considered in cases involving private hospitals, cosmetic surgery, dental treatment, private clinics, and paid healthcare services.

Can Lack of Information and Consent Be Grounds for Compensation?

Yes. Lack of information and informed consent can be grounds for compensation, depending on the specifics of the case. Because if a patient consents to a medical procedure without being adequately informed, the legal validity of that consent becomes questionable. Even if the procedure is technically correct, if the risks were not explained to the patient, and the patient would not have accepted the procedure if they had known about these risks, the doctor or healthcare facility may be held liable.

For example, nerve damage, infection, permanent scarring, loss of function, or the need for revision surgery can indeed be medical complications. However, if these risks are not clearly explained to the patient before surgery, the defense against complications may be incomplete. Similarly, if treatment alternatives are not explained, the patient may be deprived of the right to choose a less risky method.

In such cases, the court does not only consider whether "the doctor performed the surgery correctly." It also evaluates questions such as: "Was the patient adequately informed?", "Was the consent form appropriate for the specific procedure?", "Was the patient aware of the risk when it materialized?", "Were alternatives explained to the patient?", and "Was consent obtained freely?".

What types of compensation can be claimed in cases of patient rights violations?

A person who has suffered harm due to a violation of patient rights may claim material and moral compensation if the conditions are met. Material compensation covers economic losses such as treatment costs, medication costs, re-operation costs, travel and accommodation costs, caregiver costs, loss of earning capacity, temporary disability, permanent disability, and loss of income.

Non-pecuniary damages are claimed due to the pain, distress, suffering, fear, psychological trauma, decreased quality of life, violation of bodily integrity, breach of privacy, or denial of the right to make decisions about one's own body experienced by the patient.

Liability for compensation may arise, particularly in cases such as surgeries performed without informed consent, violations of privacy, misdiagnosis, erroneous treatment, birth defects, victims of cosmetic surgery, unnecessary surgeries, unauthorized medical interventions, and failure to provide medical records.

If the patient has passed away, their relatives can claim compensation for loss of support and moral damages. In these cases, the causal link between the harm and the violation of patient rights or the medical intervention must be established through expert reports and medical records.

What should be done in case of suspected patient rights violation?

Anyone who believes their patient rights have been violated should first request all their medical records. This includes the discharge summary report, surgical notes, consent forms, laboratory results, imaging records, prescriptions, consultation notes, nurse observation forms, invoices and payment documents, correspondence with the doctor, and any photographs.

Secondly, it must be determined whether the incident occurred in a private hospital, a state hospital, a university hospital, a private clinic, or a doctor's office. The appropriate legal procedure, the competent court, the statute of limitations, and the defendant may all vary depending on this distinction.

Thirdly, the type of violation must be clarified. Is the issue a misdiagnosis, faulty treatment, lack of consent, violation of privacy, withholding of medical records, ill-treatment, unnecessary surgery, or denial of the right to refuse treatment? The legal avenues and methods of proof may differ for each type of violation.

Fourthly, deadlines must be carefully considered. The application period to the administration in public hospitals, the statute of limitations in private hospitals, mediation in consumer disputes, and the complaint and statute of limitations periods in criminal investigations should be examined separately.

Conclusion: Information and Consent are at the Heart of Patient Rights

Patient rights ensure that healthcare services are provided in a dignified, safe, transparent, and lawful manner. Patients have the right to receive information, to examine their medical records, to demand protection of their privacy, to refuse treatment, to not be subjected to intervention without their consent, and to file complaints and lawsuits.

Informed consent and lack of information are central to these rights during the treatment process. A patient cannot truly make a decision without knowing what will be done to them, the risks involved, the alternatives, and what will happen if they do not accept the treatment. Therefore, simply having a signed form may not suffice; the patient must be genuinely, concretely, and clearly informed.

Medical interventions performed without prior notification or valid consent may, depending on the specific circumstances, constitute a violation of patient rights, malpractice, violation of personal rights, and liability for damages. Individuals experiencing a violation of their patient rights should immediately gather their medical records, evaluate the process on the correct legal grounds, and, if necessary, pursue legal avenues such as seeking compensation for material and moral damages, administrative appeals, or criminal investigations.