Rights and Duties of
Health Service Users

User Rights

1. The user has the right to be treated with respect for human dignity.

This is a fundamental human right, which is particularly important in situations of illness. It must be respected by all professionals involved in the care process, both in terms of technical aspects and in the acts of welcoming, guiding and referring patients. It is also essential that the patient be informed about the identity and profession of all staff involved in their treatment. This right also covers the conditions of the facilities and equipment, which must provide the comfort and well-being required by the vulnerable situation in which the patient finds himself.

2. The user has the right to respect for his/her cultural, philosophical and religious beliefs.

Each patient is a person with his or her own cultural and religious beliefs. Health care institutions and providers must therefore respect these values and ensure that they are met. Support from family and friends should be facilitated and encouraged. Likewise, spiritual support should be provided if required by the patient or, if necessary, by someone legitimately representing him or her, in accordance with his or her beliefs.

3. The user has the right to receive care appropriate to his/her state of health, within the scope of preventive, curative, rehabilitation and terminal care.

Health services must be accessible to all citizens, so as to provide timely technical and scientific care that ensures the improvement of the user's condition and recovery, as well as dignified and humane support in terminal situations. Under no circumstances may users be subject to discrimination. Existing resources are fully placed at the service of the user and the community, within the limits of availability.

4. The user has the right to continued care.

In the event of illness, all citizens have the right to receive a prompt and efficient response from the various levels of care (hospitals and health centres) that provides them with the necessary support until they are fully recovered. To this end, hospitals and health centres must coordinate with each other so that there are no interruptions in the provision of care that could cause harm to the patient. The patient and their family members have the right to be informed of the reasons for transferring from one level of care to another and to be informed that the continuity of their care is guaranteed. The patient and their family are provided with the knowledge and information that is essential for the care that the patient should continue to receive at home. When necessary, home or community care should be made available to them.

5. The user has the right to be informed about existing health services, their competences and levels of care.

Citizens must be provided with information about existing local, regional and national health services, their competences and levels of care, and rules of organization and operation, in order to optimize and make their use more convenient. Services providing the various levels of care must ensure that the user is always accompanied by the diagnostic and therapeutic elements considered important for the continuation of treatment. This avoids new examinations and treatments, which are painful for the user and costly for the community.

6. The user has the right to be informed about his/her health situation.

This information must be provided clearly, taking into account the personality, level of education and clinical and psychological conditions of the user. Specifically, the information must contain information relating to the diagnosis (type of disease), prognosis (progress of the disease), treatments to be carried out, possible risks and possible alternative treatments. The user may wish not to be informed of his/her health status, and should indicate, if he/she so wishes, who should receive the information in his/her place.

7. The user has the right to obtain a second opinion about his/her health situation.

This right, which involves obtaining an opinion from another doctor, allows the user to obtain additional information about their health status, giving them the possibility of making a more informed decision about the treatment to be pursued.

8. The user has the right to give or refuse consent before any medical act or participation in clinical research or teaching.

The patient's consent is essential for any medical procedure to be performed, after having been correctly informed. The patient may, except in some special cases, decide, in a free and informed manner, whether to accept or refuse a treatment or intervention, as well as change his or her decision. The aim is to ensure and encourage the right to self-determination, that is, the ability and autonomy that patients have to make decisions for themselves. Consent may be presumed in emergencies and, in the event of incapacity, this right must be exercised by the patient's legal representative.

9. The user has the right to confidentiality of all clinical information and identifying elements concerning him/her.

All information relating to the patient's health status – clinical situation, diagnosis, prognosis, treatment and personal data – is confidential. However, if the patient gives his/her consent and there is no harm to third parties, or if the law so requires, this information may be used. This right implies the obligation of professional secrecy, which must be respected by all personnel working in health services.

10. The user has the right to access the data recorded in his/her clinical file.

A patient's clinical information and identifying elements are contained in their clinical file. The patient has the right to be informed of the data recorded in their file, and this information must be provided in a precise and clear manner. The omission of some of this data is only justifiable if its disclosure is considered harmful to the patient or if it contains information about third parties.

11. The user has the right to privacy in the provision of any and all medical acts.

Healthcare is provided in strict compliance with the patient's right to privacy, which means that any diagnostic or therapeutic procedure may only be carried out in the presence of the professionals required to perform the procedure, unless the patient consents or requests the presence of other individuals. The patient's private or family life may not be interfered with unless it is necessary for the diagnosis or treatment and the patient expresses his or her consent.

12. The user has the right, either personally or through his/her representative, to submit suggestions and complaints.

The user, either by himself or by someone legitimately acting as his or her representative organisation, can assess the quality of the care provided and make suggestions or complaints. For this purpose, the health services have a user office and a complaints book. The user must always receive a response or information about the follow-up given to his or her suggestions and complaints, in a timely manner.

User Duties

1. The user has a duty to take care of his/her health.
2. This means that you must seek to ensure the most complete recovery and also participate in promoting your own health and that of the community in which you live.
3. The user has the duty to provide healthcare professionals with all the information necessary to obtain a correct diagnosis and appropriate treatment.
4. The user has a duty to respect the rights of other users.
5. The user has the duty to collaborate with health professionals, respecting the instructions that are recommended to him/her and that he/she freely accepts.
6. The user has a duty to respect the operating rules of health services.
7. The user has the duty to use health services appropriately and to actively collaborate in reducing unnecessary expenses.

For further information, see: Law no. 15/2014 of 21 March, amended by Decree-Law no. 44/2017 of 20 April. Executive Order no. 153/2017 of 4 May and Executive Order no. 87/2015 of 23 March. Order no. 5344-A/2016 of 14 April, published in the Official Gazette no. 76/2016, 1st supplement, Series II of 19 April. Directorate-General for Health: www.dgs.pt; Health Regulatory Authority: www.ers.pt