The
(Norwegian) Patients' Rights Act
Act of 2. July 1999 no. 63
relating to Patients' Rights
CONTENTS
1 General
provisions
§ 1-1 Objective
The objective of this Act is to
contribute to ensuring the population equal
access to health care of good quality by granting
patients rights in their relations with the
health service.
The provisions of this Act shall
contribute to the promotion of a relationship
based on trust between the patient and the health
service while having respect for the individual
patient’s life, integrity and human worth.
§ 1-2 Scope
This Act shall apply to all
persons staying within the Realm. The King may in
regulations make an exemption for persons who are
not Norwegian citizens, or who are not staying
permanently within the Realm.
The King stipulates regulations
relating to the application of this act to
Svalbard and Jan Mayen and may lay down special
provisions out of regard for the local
conditions. To the extent determined by the King
in regulations, this Act shall apply to persons
onboard Norwegian ships engaged in foreign trade,
to Norwegian civil aircraft in international
traffic and to installations and vessels at work
on the Norwegian continental shelf.
§ 1-3 Definitions
For the purpose of this Act, the
following terms shall mean:
- patient: person who contacts the health
service, requesting health care, or whom
the health service provides or offers
health care in each individual case the
patient’s next of kin: the person
whom the patient’s names as his kin
or next of kin.
- b) If the patient is incapable to name
his next of kin, his next of kin shall be
the person who to the greatest possible
extent has had lasting and continuous
contact with the patient. As a rule
however, the following order should be
observed: spouse, registered gay partner,
a persons who lives with the patient and
whose relationship with the patient
resembles that of a marriage or a gay
partnership, children who are of age,
parents or others holding parental
responsibility, siblings who are of age,
grandparents, other family members who
are close to the patient, guardian or
supporting guardian
- health care: acts which have a
preventive, diagnostic, therapeutic and
health preserving effects carried out by
health personnel for the purposes of
rehabilitation care and nursing
- the health service: the primary health
service, the specialist health service
and the dental health service
- health personnel, persons mentioned in §
3 in the Act relating to health personnel
2 Right to
health care
§ 2-1 Right to required health
care
The patient is entitled to
emergency medical services. The patient is
entitled to receive required health care from the
municipal health service.
The patient is entitled to
receive required health care from the specialist
health service. The health service shall give
anyone who applies for or who needs health care
the medical and treatment-related information he
will need in order to safeguard his rights.
The right to health care only
applies if the patient can be expected to benefit
from the health care, and that the costs are
reasonable compared to the expected effect that
can be gained from the relevant medical measure.
The right to health care only
applies to the publicly funded specialist health
service within the Realm and other providers that
the county municipality has entered into an
agreement with relating to the provision of
services and within the limits that capacity
allows.
The King may lay down regulations
relating to what shall be deemed to be health
care which the patient may be entitled to, and
the time limit for the implementation of such
health care.
§ 2-2 Right to an evaluation
A patient who is referred to a
public hospital or a specialist outpatient clinic
is entitled to an evaluation of his medical
condition within 30 workdays upon receipt of the
referral. An evaluation of the need for health
care shall be given, as well as information as to
when the treatment is expected to be carried out.
The evaluation shall be based upon the referral.
If necessary, additional information may be
obtained, or the patient may be called in for an
examination.
Upon suspicion of a serious or
life-threatening condition, the patient is
entitled to a more rapid evaluation.
§ 2-3 Right to a re-evaluation
Upon referral from a general
practitioner the patient is entitled to a
re-evaluation of his medical condition carried by
the specialist health service. This right only
applies once for the same condition.
§ 2-4 Right to choose hospitals
The patient is entitled to choose
which hospital or district centre for psychiatry
shall be responsible for his treatment. This does
not apply to treatment within the field of child
and adolescent psychiatry.
The patient may not choose
treatment level
§ 2-5 Right to an individual
plan
A patient who has a need for
long-term, co-ordinated health services, is
entitled to have an individual plan set up in
accordance with the provisions of the Act
relating to the municipal health service, the Act
relating to the specialist health service and the
Act relating to the establishment and
implementation of mental health care.
Not in force. (See Decree of 1 Dec. 2000, No.
1198).
3 Right to
participation and information
§ 3-1 Patient’s right to
participation
The patient is entitled to
participate in the implementation of his medical
treatment. This includes the patient’s right
to choose between available and medically sound
methods of examination and treatment. The form of
participation shall be adjusted according to the
individual patient’s ability to give and
receive information.
If the patient is not capable of
giving an informed consent, the patient’s
next of kin is entitled to participate together
with the patient.
If the patient wants other
persons to be present while health care is given,
his wishes shall in as far as possible, be
granted.
§ 3-2 Patient’s right to
be informed
The patient shall have the
information that is required in order for him to
gain insight into his medical condition and the
contents of the medical treatment given to him.
The patient shall also be informed of possible
risks and side effects involved.
Information shall not be given
against the expressed will of the patient, unless
it is necessary in order to prevent harmful
affects due to the health care given, or it is
determined in or pursuant to law.
Information may be omitted if it
is absolutely necessary to prevent endangering
the patient’s life, or to prevent serious
damage to the patient’s health. Information
may also be omitted if, due to persons who are
close to the patient, it would be clearly
inadvisable, to disclose such information.
If injury or serious
complications are inflicted upon the patient, the
patient shall be informed thereof. The patient
shall at the same time be made aware of his right
to apply for compensation through The Norwegian
System of Compensation for Injuries to Patients.
If, after the treatment has been
completed, it is discovered that the patient may
have suffered considerable injury as a result of
the health care rendered, the patient shall, if
possible be informed thereof.
§ 3-3 Information to the
patient’s next of kin
If the patient gives his consent
thereto, or circumstances justifies it, the
patient’s next of kin shall receive
information relating to the patient’s
medical condition and the treatment that is being
provided.
If the patient is above 16 years
of age and clearly incapable of managing his own
affairs for reasons of physical or mental
deficiencies or for reasons of mental
retardation, both the patient and his next of kin
are entitled to receive information pursuant to
the provisions of § 3-2.
§ 3-4 Information when the
patient is a minor
If the patient is below 16 years
of age, both patient and the parents or others
holding the parental responsibility shall be
informed.
If the patient is between 12 and
16 years of age, information shall not be given
to the parents or others holding parental
responsibility, when the patient for reasons that
must be respected, clearly does not want this.
Information, that is necessary in
order in order to fulfil the parental
responsibility, shall however be given to the
parents or others holding the parental
responsibility if the patient is below 18 years
of age.
If the children’s welfare
service has taken over custody for a child below
the age of 16 in accordance with § 4-12 of the
Children’s Welfare Act, the first, second
and third item shall apply correspondingly to the
children’s welfare service.
§ 3-5 Formal requirements
relating to information
The information shall be adjusted
according to the individual capabilities of the
recipient such as age, maturity and experience as
well as well as cultural and lingual background.
The information shall be given in a kind, caring
manner.
Health personnel shall as far as
possible ensure that the patent has understood
the contents and meaning of the information that
has been passed on to him.
An entrance relating to the
information that has been given shall be made in
the patient’s medical records.
§ 3-6 Right to protection
against the spreading of information
Medical and health-related
information as well as other types of personal
information shall be treated in accordance with
the current provisions relating to
confidentiality. The relevant information shall
be treated with caution and respect for the
integrity of the person whom the information
concerns.
The principle of confidentiality
will cease to apply to the extent to which the
person who is entitled to such confidentiality
gives his consent thereto.
If health personnel disclose
information subject to statutory duty of
disclosure, the person that the information
relates to, shall, in as far as circumstances
dictate be informed thereof, and of then nature
of the information disclosed.
4 Consent to
health care
§ 4-1 General rule relating to
consent
Health care may only be given
with the patient’s consent unless legal
authority or other legal grounds exist which
permit for health care to be rendered without
consent. In order for the consent to be valid,
the patient must have received the necessary
information about his medical condition and the
contents of the health care.
The patient may withdraw his
consent. If the patient withdraws his consent,
the health care provider shall give the necessary
information as to the consequences if the health
care is not given.
§ 4-2 Formal requirements
relating to consent
Consent may be granted expressly
or implicitly. Implied consent is considered to
be present if, based on the patient’s
actions or circumstances in general; it can be
assumed that he accepts the health care.
The Ministry may lay down
regulations stipulating that consent shall be
given in the written form, or lay down other form
requirements in relation to certain types of
health care
§4-3 Who has the he right to
consent to health care
The following are entitled to
grant consent to health care:
- a) persons who are of age unless special
provisions dictate otherwise
- b) minors over 16 years of age unless
special provisions or the nature of the
measure dictate otherwise
The ability to grant consent may
cease to apply wholly or in part if the patient
for reasons of physical or mental deficiencies,
senile dementia or for reasons of mental
retardation, is clearly incapable of
understanding what the consent entails
The provider of health care shall
determine if the patient lacks the ability to
grant consent pursuant to item 2. Health
personnel shall, based on the patient’s age,
mental condition, maturity, experience and
background, make an effort to ensure that the
patient himself may consent to health care cf.
§3-5.
A decision concerning the lack of
ability to grant consent pursuant to item 2,
shall state the reasons behind the decision, and
shall be given in the written form. If possible,
the decision shall immediately be presented to
the patient and his next of kin. If the patient
lacks next of kin the decision shall be presented
to health personnel in accordance with § 4-8.
§ 4-4 Consent on behalf of
children
The parents or others holding
parental responsibility have the right to consent
to health care for patients below 16 years of
age.
If the Children Welfare Service
has taken over the care of children below the age
of 16 pursuant to the Children’s Welfare Act
§4-8 or §4-12, the children’s welfare
service has the right to consent to health care.
As the child develops and
matures, the parents, others holding parental
responsibility or the children’s welfare
service, cf. item 2 shall listen to what the
child has to say before consent is granted. When
the child has reached 12 years of age, it shall
be allowed to give its own opinion in all
questions regarding its own health. Based on the
child’s age and maturity, its opinion shall
carry increasing weight.
§ 4-5 Consent on behalf of
young people who are not competent to grant
consent
The parents or others holding
parental responsibility have the right to consent
to health care for patients between 16-18 years
of age who are not competent to grant consent
If the children’s welfare
service has taken over the care of a child
between 16-18 years of age pursuant to the
Children’s Welfare Act §4-8 or §4-12, the
children welfare service has the right to consent
to health care.
Health care may not be given if
the patient objects thereto, unless special
provisions dictate otherwise.
§4-6 Consent on behalf of
persons who are of age who are not competent to
grant consent
If a patient who is of age is not
competent to give consent, the health care
provider may make decisions on health care that
is of a less invasive nature with regard to
extent and duration.
The patient’s next of kin
may consent to health care that is not included
under item 1. Other medical care may be given if
its considered to be in the patient best
interest, and it is considered likely that the
patient would have granted his consent to such
care. Information from the patient’s next of
kin may be gathered in order to determine what
the patient would have wanted
Health care in accordance with
item 1 and 2 may not be given if the patient
objects thereto, unless special provisions
dictate otherwise.
§4-7 On patients who have been
declared legally incapable
A patient, who has been declared
legally incapable pursuant to the Act of 28
November 1898, shall to the greatest possible
extent grant his consent to medical care by
himself. If this is not possible, his guardian
may grant consent on his behalf.
§ 4-8 On Patients who are not
competent to grant consent, and who do not have
next of kin
The health care provider may, in
collaboration with other qualified health
personnel, consent to health care for patients
who lacks competence to grant consent, and who do
not have next of kin.
§4-9 Patient’s right to
refuse health care under special circumstances
The patient is entitled, due to
serious conviction, to refuse to receive blood or
blood products and to refuse to call off an
ongoing hunger strike.
A dying patient is entitled to
object to life-prolonging treatment. If a dying
patient is incapable of communicating his wishes
on treatment, the health personnel may withdraw
health care if the patient’s next of kin
state wishes corresponding thereto, if the health
personnel, based on an independent evaluation,
find that this corresponds with the
patient’s wishes as well, and therefore
should clearly be respected.
Health personnel must ensure that
a patient as mentioned on item 1 and 2, is of
age, and that he has been given adequate
information and has understood the consequences
to his own health upon refusing treatment.
5 Right of
access to medical records
§ 5-1 Right
of access to medical records
The patient is entitled to have
access to his medical records with additional
notes, and upon special request he is entitled to
a copy. Upon request, the patient is entitled to
a brief and simple explanation of medical terms
etc.
The patient may be denied access
to his medical records if this is absolutely
necessary to prevent endangering the
patient’s life, or to prevent serious damage
to the patient’s health, or if access would
be clearly inadvisable due to persons who are
close to the patient.
A representative for the patient
is entitled to access to information to which the
patient is denied access, unless the
representative is considered unfit thereto. A
medical practitioner or lawyer may not be denied
access, unless special grounds so indicate.
The provisions of §3-3 and §3-4
relating to the right of others to receive
information shall apply correspondingly to access
to medical records.
The Ministry may in regulations
stipulate further regulations relating to the
right of access to medical records, including
provisions relating to payment for copies.
The next of kin is entitled to
access to a patient‘s medical records
following the patient’s death unless special
reasons dictate otherwise.
§5-2
Correction and deletion of medical records
The patient or the person whom
the information concerns may demand that
information in medical records be corrected or
deleted in accordance with the provisions of the
Health Personnel Act §42 to §48.
§5-3 Transfer
and release of medical records
The patient is entitled to object
to the disclosure of his medical records or any
information therein. Furthermore the information
may not be disclosed if there is reason to
believe that the patient would have objected if
asked. Disclosure may still take place if
exceptional grounds so dictate. Transfer and
disclosure of medical records shall be carried
out in accordance with the provisions of the Act
relating to health personnel.
6 Special rights
relating to children
§6-1 Children’s right to
health control
Children are entitled to
necessary medical care, also in the form of
health control in the municipality where the
child lives or stays temporarily, c.f. the
Municipal Health Services Act § 2.2.
§ 6-2 Children’s right to
be accompanied by their parents while staying in
a medical institution
Children are entitled to be
accompanied by at least one parent or others
holding parental responsibility during their
entire stay in a medical institution, unless, for
the sake of the child this is inadvisable, or the
right of contact has ceased to apply pursuant to
the provisions of the Children’s Act or the
Children’s Welfare Service Act.
§6-3 Children’s right to
activity while staying in a medical institution
Children are entitled to be
stimulated and to be engaged in activities during
their stay in a medical institution to the extent
that this is advisable from a medical point of
view.
§6-4 Children’s right to
tuition while staying in a medical institution
Children of compulsory school age
are entitled to tuition while staying in a
medical institution to the extent that this is in
accordance with the Tuition Act
Young people are entitled to
tuition while staying in a medical institution to
the extent that this is in accordance with the
Tuition Act
Pre-school children are entitled
to special educational assistance while staying
in a medical institution to the extent that this
is in accordance with the Tuition Act
Amended by Act of 21 dec. 2000
no. 127 (in force 1 January 2001 pursuant to
Decree of 21. Dec. 2000 No. 1359.
7 Complaint
§ 7-1 Request for performance
The patient or a representative
for the patient who is of the opinion that the
provisions of Chapter 2, 3 and 4, as well as
§5-1, §6-2 and §6-3 have been breached, may
make a request for performance of his rights to
the health care provider.
Item I shall apply
correspondingly to others who are of the opinion
that their independent rights have been breached
pursuant to Chapter 3-6.
The patient’s representative
pursuant to item 1 is the one who has the
authority to complain on behalf of the patient,
or who is competent to grant consent, pursuant to
chapter 4. If the person holding power of
attorney is not a lawyer, he shall present a
written authorisation.
§7-2 Complaint
If the health care provider
rejects the request, or if he is of the opinion
that the rights has already been performed, a
complaint may be submitted to the county medical
officer. The complaint shall be sent to the
county medical officer.
The provisions of §7-1 shall
apply correspondingly to complaints pursuant to
this section.
§7-3 Contents and formal
requirements for complaints
Complaints to the county medical
officer shall be in writing. The complaint shall
be signed by the patient or the patient’s
representative. The complaint should mention the
subject matter that is the cause for the
complaint, and provide information that may be
relevant for the consideration of the complaint.
If the complaint contains mistakes or defects,
the county medical officer will set a brief time
limit for rectification and addition of
information.
§7-4 Request for assessment of
possible breach of duty
The patient or others entitled
thereto may, if he is of the opinion that the
provisions on duty laid down in or pursuant laid
the Health Personnel Act have been breached in
his disfavour, y request that the supervising
authorities impose an administrative reaction on
health personnel pursuant to chapter 11 of the
Health Personnel Act. The provisions of this
chapter do not apply to such requests.
Amended by Act of 21 dec. 2000
no. 127 (in force 1 January 2001 pursuant to
Decree of 21. Dec. 2000).
§7-5 Period for submitting
requests and complaints
The period for submitting
requests pursuant to §7-1 is three weeks from
the time when the relevant person received or
should have received adequate information to
lodge such a complaint. The period is interrupted
when the complaint has been lodged.
The period for submitting
requests to the county medical officer pursuant
to §7-2 is three weeks from the time when the
relevant person was informed or should have been
informed of the outcome of the request.
§ 7-6 Application of the Public
Administration Act
The provisions of the Public
Administration Act relating to the handling of
cases as independent decisions and complaints
shall apply insofar that they are applicable to
the cases relating to complaint handled by the
county medical officer with the special
provisions stipulated in this chapter.
8 The patient
ombud
§ 8-1 Objective
The patient ombud shall work to
safeguard patients’ rights, interests and
legal rights in their relations to the health
service and to improve the quality of the health
service.
§8-2 Functions of and
responsibility for the scheme
Every county municipality shall
have a patient ombud. The functions of the
patient ombud involve the specialist health
service.
The ombud shall carry out his
work independently.
§8-3 Right to contact the
patient ombud
The patient ombud may handle
cases concerning matters in the public specialist
health service, either on the basis of an oral
request, or written request or of his own accord.
Anyone may contact the patient
ombud and request that a case be handled. Persons
who contact the patient ombud are entitled to be
anonymous.
§8-4 Handling of requests
The patient ombud shall by
himself determine if a request provides adequate
grounds for further handling. If the patient
ombud decides not to handle the case, the person
who made the request shall be notified thereof,
and be given a brief explanation for this
decision.
§ 8-5 Right of the patient
ombud to obtain information
Public authorities and other
bodies that provide services for the public
administration shall give the ombud the required
information in order for the ombud to carry out
his tasks. The provisions of the Civil Procedure
Act §204-209 shall apply correspondingly to the
right of the patient ombud to demand information.
§ 8-6 The patient ombud’s
access to the premises of the health services.
The patient ombud shall have
access to all premises where public health
services are being provided.
§ 8-7 Tasks of the patient
ombud
To a reasonable extent, the
patient ombud shall give anyone who requests it
information advice and guidance in matters that
are included in the work of the ombud.
The patient ombud is entitled to
give his opinion on matters that are included in
the work of the ombud, and to suggest concrete
measures of improvement. The patient ombud
himself shall decide whom these statements shall
be directed to. The statements are not mandatory.
The patient ombud shall notify
anyone who has made a request to the ombud of the
outcome following the handling of a case, and a
brief explanation of the result.
The patient ombud shall notify
the supervising authorities on conditions where a
follow-up by the authorities is required.
The patient ombud shall ensure
that the scheme is made known.
§ 8-8 Regulations
The Ministry may issue
regulations on the implementation of the
provisions relating to the patient ombud and may
also issue supplements to these provisions.
9 Entry into
force and amendments to other Acts
§9-1 Entry into force
The Act shall enter into force
from the time determined by the King. The King
may determine that the various provisions of the
Act shall enter into force at different times.
§9-2 Amendments to other Acts
From the time of entry into force
of this Act, the following amendments shall be
made to other Acts.
In force 1 January 2001 with
the exception of § 2-5 pursuant to Decree of 1
dec. 2000, No. 1198.
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