Patient rights: what you should know
Health is our most important asset. Unfortunately, we usually only notice this when we need medical attention. At that point, it is important for patients to take an active role in their treatment.
What is the legal basis of patient rights?
Patient rights in Switzerland are not centrally regulated in a single law, but are based on various federal and cantonal legal principles. The most important legal principles include:
- Federal Constitution (FC)
- Swiss Civil Code (SCC)
- Swiss Code of Obligations (SCO)
- Swiss Penal Code (SPC)
- Federal Data Protection Act (DPA)
- Cantonal health laws
These legal requirements govern, among other things, the relationship between the patient and the medical specialist, the obligation to provide documentation, data protection, and the handling of medical procedures.
A distinction is also made between private law (visiting a doctor or a private hospital) and public law (staying in a cantonal hospital, for example). Which rights apply therefore also depends on the respective framework.
More detailed information on the cantonal differences in patient law can be found on the website of the Federal Office of Public Health (FOPH).
Patient rights at a glance: what are your rights and obligations?
As a patient, you have a number of clearly defined rights in Switzerland. These should ensure that you are informed at all times, have a say in the decision-making process, and ultimately can make your own decisions. At the same time, you protect your privacy and your physical self-determination. Among other things, you have the right to:
- Be informed and to give free consent after being comprehensively informed
- A living will, therapeutic representation, and an advance care directive
- The free choice of healthcare professional and care facility (the choice may be limited depending on the basic insurance model)
- Reject restrictive measures and treatments without consent
- Compliance with professional secrecy of the treating specialists
- View the patient file
- Be accompanied by a person of trust
- Self-determination in matters of organ and tissue donation
In principle, these rights apply regardless of whether you are treated on an outpatient or inpatient basis. These rights must also be explained to you in an understandable form.
What is a living will?
In a living will, you specify which medical treatments you want or refuse. Relatives and specialists use it if you are no longer able to make decisions yourself. This way you can ensure that your own wishes are respected. Typically included are instructions for pain management, artificial nutrition or resuscitation. A well-completed living will also relieves family members who would otherwise have to make decisions at difficult times.
Template AXA-ARAG’s living will (in German) for download.
What are the obligations of patients?
In addition to their rights, patients also have certain obligations. These should help guarantee trusting collaboration with the medical staff and ensure the success of the treatment. This includes not withholding any relevant information: communicate symptoms, previous treatments, and their effects as accurately as possible so that an informed diagnosis is made and appropriate treatment can be carried out. You should also follow the instructions of your treating specialists or at least inform them if you stop treatment on your own. This is because deliberate discontinuation of therapy without notification can be regarded as a refusal of treatment. Your obligations also include paying for medical services on time. If you can’t understand a bill or settle it immediately, discuss this at an early stage. Often a solution can be found.
Your obligation to cooperate does not mean that you have to accept every treatment recommended, but that you communicate your decisions transparently.
To what extent are doctors liable for treatment errors?
Doctors are required by law to inform you about the following points:
- What treatment is planned?
- Are there any treatment alternatives?
- What consequential costs can you expect for the treatment?
- Are certain precautions to be taken?
This duty to provide information protects your self-determination to ensure that you can knowingly consent or decline.
Treatment success cannot be guaranteed, and not every complication automatically constitutes a mistake. A treatment error occurs only if the medical duty of care has been breached, for example through inadequate information, grossly negligent or intentional acts, lack of professional qualifications, or negligent execution of treatment. In such cases, a liability claim may arise. However, this usually has to be proven in court, which can be challenging depending on the situation. Legal protection insurance offers valuable support here. It also makes sense for doctors to insure themselves against legal risks with commercial legal protection.
Treatment obligation, rejection and legal steps in the event of a dispute
In Switzerland, doctors generally have the right to reject new patients, for example if they are overloaded, lack specialization, or if a necessary relationship of trust is not in place. Things are different in an emergency, as there is a statutory duty to treat. Anyone in urgent need of medical assistance must be treated regardless of their previous history or insurance status.
If a patient has been officially admitted for treatment, a legally binding treatment relationship arises. This obliges the doctor to provide professional care while observing the doctor’s duty of care. Although termination of the treatment relationship is possible, it must not be arbitrary. Possible reasons are, for example, serious violations of treatment instructions or a permanent breakdown in the relationship of trust.
What should you do if there is a suspected breach of the duty of care?
If you have the feeling that a mistake has been made in your medical treatment, you should proceed in a structured manner – even before legal action is taken. These measures provide clarification:
- Request access to your complete patient record so that you can track all the treatments carried out and the decisions made.
- Obtain an independent medical second opinion. This should be done by a specialist in the same area.
- If necessary, have the case reviewed by a neutral advisory body, such as the Swiss Foundation for Patients’ Organization (SPO) or a cantonal patient center.
- Contact your health or accident insurer to clarify your entitlement to benefits.
In order for you to receive compensation, it must be documented that there has been a breach of a medical duty of care. As a result, you must have incurred actual damage to your health or financial loss that has not already been covered by another insurer. In the event of a proven breach of duty, you can assert your claim for damages against the professional liability insurance of the attending physician.
In addition, claims for damages generally become time-barred three years after the date on which you became aware of the loss or damage. In some cantons, even shorter deadlines apply to lawsuits against public hospitals, sometimes just one year. That is why it is important to act in good time.
Help with your rights or in disputes with insurance companies
If there are disputes in the medical environment, your personal legal protection insurance can help you assert your patient rights. However, you should first contact the healthcare professional or hospital facility concerned. If this step does not lead to a solution, there are various advisory bodies available to you in the cantons.
Important information and intra-regional contact points (in German):
Written by:
Nadine Graf
Nadine Graf is a theme manager and writes texts for AXA on topics related to insurance and beyond.
