Parental Responsibility Authority Related To The Child's Health Care

Parental Responsibility Authority Related To The Child's Health Care Presented by: Prof. Dr. Tímea Date: 15 May 2022 Introductory Thoughts - Patient has detailed rights and obligations under the Hungarian Act CLIV of 1997 on Healthcare (Healthcare Act). - Includes: patient's right to self-determination in health care - Includes several separate patient rights, such as: • The freedom to choose a doctor, • The right to informed consent to healthcare, • The right to refuse treatment, • The right to medical confidentiality • Disposing of medical records • The right to access medical records - Patient with full legal capacity can exercise these rights fully independently - Children → the involvement of a statutory representative is needed Consent to healthcare - Patients are free to decide whether • They wish to receive healthcare and • Which interventions they consent to or refuse - Participate in decisions concerning their examination and treatment - Healthcare Act → the statutory representative has a narrower scope of control over the treatment of a minor child → LIMITED IN TWO CASES • The consent of the parent must be obtained only before an invasive procedure • The statement of the parent (statutory representative) must not adversely affect the health of the sick child - 1997 Healthcare Act regulated incapacitated minors and minors with limited legal capacity in the same way. - Constitutional Court's decision No 36/2000 (Χ. 27.) → 2002 Healthcare Act - granted a broader right of self-determination to minors over the age of 16 • Minor over the age of 16 may waive the right to be informed • Minors over the age of 16 can nominate a person with legal capacity who is entitled to exercise the right to information, consent and refusal on their behalf - Data protection point of view - "mature minor" - In UK - "mature minor" → minor over the age of 16 can give valid consent to any medical intervention Consent To Surgery One parent is sufficient - or both is required? - Joint parental custody - both required (except cases requiring immediate action) - Parents are separated and have not yet settled the parental custody - exercise jointly - Separated parents - shared the rights and responsibilities of parental custody - only one of the parents exercises the parental rights necessary for the health care - Only one parent exercises parental/custody rights - the consent of the parent exercising parental custody rights is required for invasive interventions • Parent exercising parental custody is obliged to inform the parent living separately of the health of the common minor child The Right To Medical Confidentiality - Doctor-patent relationship - patient also reveals personal secrets to doctor - Obligation of confidentiality - the oldest medical ethical norm => Hippocratic Oath • Both adults and children have the right to medical confidentiality • Whether and when a minor patient has the right to medical confidentiality visà- vis their parents or legal representative? • A minor over the age of 16 - by designating another suitable person as the person entitled to receive such information. The Right To Access To Medical Records - The medical documentation is provided by the healthcare provider, but the rights of the data therein by the patient! - Patient has a number of rights • Being informed about the processing of their data in connection with the treatment, • Access to their medical data, • Access to medical documentation and ✓ the right to obtain extracts or copies thereof. - Minors aged between 14 and 18 are considered equivalent to adults with legal capacity! - The parent with legal representation rights also have access to the medical documentation of the child! The Right To Access To Medical Records - The absence of joint parental supervision => the separate parent has the same rights as the other only in relation to important (material) issues concerning the child's fate (e.g. career choice, choice of location) - BUT NOT in relation to the child's health care! - Separated parent or grandparent who is not entitled to exercise parental rights should also have the given right! - Minors over the age of 16 has the right to designate an entitled person, BUT it is unrealistic The right to medical confidentiality and access to medical records CASE - CASE: • Father has medical qualifications • Ex-wife's order: the father can only visit the child for two hours a day and can be provided any information on or access to her medical documentation • 17-year-old daughter broken both arms • The daughter was scared and she stated that she would only agree to the operation if her father thought it was a good idea and she wanted him to decide on the matter • The father asked the doctor to let him review his child's medical documentation • The treating physician refused the request, claiming that his ex-wife did not agree • The father asked the patient advocate for help CONCLUSION - - The legal provision is in no way sustainable • Only applicable to minors over the age of 16 • Makes the right of a parent to be informed and to have a say in health decisions Parent exercising parental custody rights solely to provide information to the other parent on the health of the minor child is not sufficient. - Child's health care and condition should be regulated among to other relevant issues affecting the child's fate - The Healthcare Act or/and FLB (Family Law Book) should be appropriately amended!