Patient Rights and Responsibilities

1. Patient rights

Article 134 of the Code 'On Public Health and the Healthcare System' establishes that a patient has the right to:

1. decent treatment during prevention, diagnosis and treatment, and respect for cultural and personal values;
2. medical care in the order determined solely by medical criteria, without discrimination;
3. choice or replacement of a doctor or a medical organization providing care under GOBMP and/or OSMS, except in cases of emergency and urgent care;
4. notification that audio and/or video surveillance and recording are carried out in the medical organization;
5. relief of suffering to the extent allowed by the current level of medical technology;
6. receiving information about possible risks and benefits, proposed and alternative treatments, consequences of refusing treatment, diagnosis, prognosis and treatment plan in an accessible form, as well as an independent opinion on health status and a consultation (consilium);
7. receiving information about one's rights and duties, services provided, prices of paid services and the amount of co-payment, the procedure for their provision, taking into account accessibility for persons with visual and/or hearing impairments, prescribed medicines and the medical professionals providing services;
8. refusal to participate in the educational process, as well as refusal to allow third parties to be present during diagnostic and treatment procedures;
9. other rights provided for by the laws of the Republic of Kazakhstan.

Medical care is provided after the patient gives informed consent. The patient may designate a person to whom information about their health may be disclosed.

2. Rights of citizens of the Republic of Kazakhstan

Article 77 of the Code 'On Public Health and the Healthcare System' sets out the rights of citizens of the Republic of Kazakhstan, including:

1. to receive the guaranteed volume of free medical care (GOBMP);
2. to be provided with medicines and medical devices under GOBMP and/or OSMS;
3. to freely choose a medical professional and a healthcare entity;
4. to receive therapeutic nutrition during inpatient treatment;
5. to receive additional medical care beyond GOBMP and/or OSMS at the expense of personal funds and other sources;
6. to receive medical and other services on a paid basis;
7. to receive medical care outside the Republic of Kazakhstan at the expense of budget funds if there are indications;
8. to receive documents confirming temporary incapacity for work;
9. to receive reliable information about prevention, diagnosis, treatment, medical rehabilitation and factors affecting health;
10. to protection of information constituting medical confidentiality;
11. to compensation for harm caused to health during the provision of medical care, including through insurance payment;
12. to protection of one's rights and legitimate interests, including appeal against actions (inaction) of medical and pharmaceutical workers;
13. to give informed consent to or refuse treatment and medical interventions, including preventive vaccinations;
14. to co-payment and pain relief in the treatment of chronic incurable diseases.

Persons with disabilities have the right to priority service in healthcare organizations.

3. Patient responsibilities

Article 135 of the Code 'On Public Health and the Healthcare System' establishes that a patient must:

1. take measures to preserve and strengthen one's health;
2. show respect and tact when communicating with medical professionals;
3. provide the doctor with all information necessary to establish a diagnosis and treat the disease, and after giving consent to a medical intervention, strictly follow the instructions of medical professionals;
4. comply with internal regulations, treat the property of the medical organization with care and cooperate with medical staff;
5. timely inform medical professionals about changes in health status during diagnosis and treatment, as well as about diseases posing a danger to others or suspicion thereof;
6. not commit actions that violate the rights of other patients;
7. perform other duties provided for by the laws of the Republic of Kazakhstan.

The duties set out in subparagraphs 2, 3 and 5 also apply to parents and other persons directly caring for a sick child in an inpatient setting.

4. Responsibilities of citizens of the Republic of Kazakhstan

Article 80 of the Code 'On Public Health and the Healthcare System' obliges citizens of the Republic of Kazakhstan to:

1. take care of preserving one's health and bear shared responsibility for preserving and strengthening individual and public health;
2. pay contributions to compulsory social health insurance;
3. undergo preventive medical examinations and screening studies;
4. fulfil the instructions of medical professionals relating to individual and public health;
5. participate in managing one's own health, including chronic disease management programs, and be interested in obtaining information about the disease, treatment methods, risks and complications;
6. inform medical professionals about the individual characteristics of one's body;
7. take precautions to protect one's own health and the health of others, undergo examination and treatment at the request of healthcare entities, and inform medical staff about infectious and other diseases posing a danger to others;
8. comply with the legislation of the Republic of Kazakhstan in the field of healthcare.

If citizens suffering from diseases that pose a danger to others (except HIV infection) evade examination and treatment, compulsory examination and treatment may be applied in accordance with the Code.

5. Informed consent and refusal of medical care

Medical care is provided after the patient gives informed consent. For invasive interventions, consent is drawn up in the form approved by the authorized body.

The patient or their legal representative has the right to refuse medical care, except in cases provided for by Article 137 of the Code.

In case of refusal, the medical professional explains the possible consequences in an accessible form. The refusal is recorded in the medical documents and signed by the patient or their legal representative and the medical professional.

If the legal representatives of a minor or incapacitated person refuse medical care necessary to save life, the medical organization has the right to apply to the guardianship and trusteeship authority and/or the court.

Without the patient's consent, medical care is allowed for persons in a state of shock or coma that does not allow them to express their will; persons with diseases posing a danger to others; persons with severe mental disorders; persons with mental disorders who have committed a socially dangerous act. The decision is made by a consultation (consilium), and if it cannot be convened, by a medical professional with subsequent notification of officials.

Legal basis: Articles 134, 136 and 137 of the Code.

6. Medical confidentiality

Personal medical data, information about the fact of seeking medical care, health status, diagnosis and other information obtained during examination and treatment constitute medical confidentiality.

Disclosure of such information is not allowed, except in cases directly provided for by Article 273 of the Code, including with the patient's informed consent for scientific research and use in the educational process.

The patient may designate a person to whom information about their health status should be communicated. Protection of personal medical data is also regulated by Article 62 of the Code.

Legal basis: Article 273 and Article 62 of the Code.

7. Where to apply if your rights are violated

If you have questions, comments or complaints about the quality and organization of medical care, you can:

1. contact the attending doctor or the head of the relevant department of the polyclinic;
2. contact the Patient Support and Internal Control (Audit) Service — PSS;
3. submit a written appeal to the management of the medical organization;
4. if necessary, contact the authorized state bodies in the manner prescribed by the legislation of the Republic of Kazakhstan.

It is advisable to indicate in the appeal the date and circumstances of the incident, the department or office, the essence of the issue and the preferred method of receiving a response. Do not include personal and medical data of other persons in public appeals. Contacting the PSS does not deprive the patient of the right to use other methods of protecting their rights provided for by law.

PSS contacts

• Office No. 118, 1st floor
• Monday–Friday, 08:00–17:00
• Phone/WhatsApp: +7 771 051 1048

8. Regulatory legal acts

The main regulatory legal act is the Code of the Republic of Kazakhstan No. 360-VI dated 7 July 2020 'On Public Health and the Healthcare System'. Key articles for review:

1. Article 77 — rights of citizens of the Republic of Kazakhstan.
2. Article 80 — duties of citizens of the Republic of Kazakhstan.
3. Article 134 — patient rights.
4. Article 135 — patient duties.
5. Article 136 — right to refuse medical care.
6. Article 137 — provision of medical care without the patient's consent.
7. Article 273 — medical confidentiality.

This memo is for informational purposes and does not replace the full text of regulatory legal acts. When applying a specific norm, the current version of the legislation of the Republic of Kazakhstan should be followed.