Exploring patient participation in reducing health-care-related safety risks

e desirable to have a special statute concerning patients’ rights (de Oliveira, personal
communication, 2012).
Patient participation in elective surgery safety in Portugal
The increasing awareness of this subject among Portuguese legislators is noticeable,
as illustrated by the Parliamentary discussions on the 2008 Bill No. 788/X (which
focused on the right to be informed and informed consent) (33) and the special concern
expressed by the 10th Health Parliamentary Commission. Several bills have been
introduced in the Portuguese Parliament to replace the Basic Law on Health (No. 48/90
of 1990) (31) with more detailed legislation regarding patients’ rights (Table 6.1).
Three charters providing for protection of patients’ rights within the NHS have been
developed. Although they are not legally binding, these tools represent an important
commitment on the part of the Portuguese Government in this field.
The Ministry of Health published a charter of patients’ rights and duties in 1997 (34). 33
Its main goals are to assert the citizen’s role as the main actor in the health system and
to (re-)assure fundamental human rights in health care provision, especially in terms of
protecting human integrity and dignity, as well as the right to “autodetermination” (34).
Among other rights, the patient has the right to be informed about available health
services, the competences and levels of care available within them (Article 5), and to
be informed in a clear way about diagnosis, prognosis, treatment possibilities and risks
(Article 6). Patients also have the right to access information in their own clinical file
(Article 10) and to a second opinion about their health condition (Article 7), and to give
or refuse their consent before any medical or research procedure (Article 8). The right to
safety is vaguely stated in Article 1 (right to human dignity) and Article 3 (right to be
treated in a proper way) (Table 6.1).
A charter on inpatients’ rights and duties, based on this charter, was published in
2005(36), 34 with HCWs as its main target.
A charter for hospitalized children (38) approved in 1988 in Leiden was published in
Portugal in 1998 by the Portuguese Child Support Institute. The charter declares that
children and families have the right to receive appropriate information about a disease
and its treatments, with the purpose of being able to take part in the decision-making
process. It also states that hospitals should respond to children’s needs, assuring safety,
proper equipment and professional care.
The Entidade Reguladora da Saúde (ERS) [Health Regulation Authority], an
independent public entity responsible for overseeing access to health care and for the
maintenance of quality and safety of health services, published a technical report and
presented the concept of a charter of consumers’ rights for public consultation and
discussion on 2 June 2011 (39).
33 Founded on the Portuguese Constitution (29); the Basic Law on Health (31); and the Hospitals Statute (35) .
34 Founded on the Portuguese Constitution (29), the Convention on Human Rights and Biomedicine (26), the Basic Law on
Health (31), the Charter of Fundamental Rights of the European Union (37) and the Charter of Patients’ Rights and Duties (34).
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