The Charter of Rights and Responsibilities of citizens in relation to health and healthcare is a social contract between citizens and the healthcare system. It defines what we as people expect from the healthcare system (rights) and also how we commit to it as active individuals (responsibilities).

The principles on which the Charter is based are the recognition of the dignity of the person, freedom and autonomy, equality, access to health information and knowledge, and civic engagement.

We protect your personal health data

When a person goes to a health centre, it's to resolve a specific health issue. They place themselves in our hands and we have a technical, medical and ethical commitment for as long as he is in charge of us.

However, healthcare service providers are expected to demonstrate not only this ad hoc commitment, but a more general commitment, as people's passage through the healthcare system generates a whole series of particularly sensitive data, of which to ensure its protection.

More information: consult the Type Code

What are the customer's rights?

1. Rights relating to equality and non-discrimination of persons

1.1.- Right to healthcare and health services: People have the right to enjoy healthcare services, health services and corresponding benefits, individually or collectively, in accordance with the provisions of the regulations.

1.2. Right to enjoy, without discrimination, the rights recognised in this charter: The enjoyment of the rights and freedoms recognised in this Charter shall be secured without discrimination on any ground such as sex, race, colour, language, religion, political or other opinion, national or social origin, association with a national minority, property, birth, genetic make-up, illness or any other status.

1.3.- Rights of more vulnerable groups concerning specific healthcare actions: Children, the elderly, people with mental health conditions, individuals suffering from chronic and disabling illnesses, and those belonging to specific groups recognised by health authorities as being at risk, are entitled, taking into account available means and resources, to specific actions and programmes. Public authorities shall ensure that the rights and duties set out in this charter are respected and fulfilled, so that the rights to equality and non-discrimination are enjoyed effectively.

2.1.- The right to receive prior information in order to subsequently give consent (informed consent) for any diagnostic or therapeutic procedure to be carried out.
Informed consent is understood as the acceptance of a procedure by a patient, after having adequate information and sufficient time, to freely involve themselves in a decision (risks, benefits, side effects of the procedure, alternative procedures, etc.). However, the patient may withdraw their consent, with complete freedom, at any time.
Exceptional circumstances regarding the requirement for informed consent: When non-intervention presents a risk to public health. When urgency does not permit delays because it may cause irreversible damage or because there is a risk of death.
Situations where consent is granted by substitution: When the patient, in the opinion of the doctor responsible for their care or of the team attending them, is not competent to understand the information, owing to being in a physical or mental state that prevents them from grasping their situation, consent must be obtained from relatives, representatives or other persons associated with them. In cases of legal incapacity, the person holding the guardianship requires a court order to administer medical treatments to the incapacitated person that could, in essence, place their life or physical or mental integrity in serious jeopardy. If the urgency of administering this treatment makes it impossible to obtain this authorisation, notification must be given to the court or guardianship council within a maximum of twenty-four hours. In the case of persons detained on account of a mental disorder, relatives or the person concerned require judicial authorisation to administer to the affected person medical treatments that could fundamentally endanger their life or their physical or mental integrity. If the urgency of administering this treatment makes it impossible to obtain this authorisation, notification shall be made to the court or guardianship board within a maximum of twenty-four hours. This consent must be given in writing in cases of surgical interventions, invasive diagnostic procedures and, in general, when carrying out procedures that involve obvious and foreseeable risks and disadvantages, which could affect the health of the patient or the foetus, if the case concerns a pregnant woman. In all cases where the patient has given their informed consent in writing, they shall be entitled to be given a copy of the signed document.

2.2.- The patient's right to choose between different therapeutic options and to refuse medical treatments or proposed healthcare interventions.
The patient has the right to freely choose between the options presented by the medical officer and to refuse diagnostic tests and/or treatments if they disagree. The patient has the right to choose between different therapeutic options and/or to refuse medical treatments, even those that are life-saving. Informed consent will be given in accordance with the provisions of section 2.1, and the same exceptions will apply. In no case may the patient be denied the care, treatments, and support they require, and, when appropriate, alternative treatments, if available at the centre, must be offered, or guidance will be provided to find an appropriate resource before discharge.

2.3. The child's right to be consulted, so that their opinion is considered a determining factor, in line with their age and level of maturity, in decisions relating to any interventions that may be adopted concerning their health.
When the minor is not competent – either intellectually or emotionally – to understand the scope of the intervention on their health, consent must be given by their representative after having heard, in any case, their opinion if they are over 12 years old. In other cases, and especially in cases of emancipated minors and adolescents over 16 years old, the minor must give their consent personally.

2.4. Everyone has the right to experience the process of their own death in accordance with their concept of dignity.
Everyone has the right to live the process leading up to their death with dignity. The person has the right to refuse any treatment aimed at prolonging their life when they believe that a therapy or intervention may reduce their quality of life to a degree incompatible with their conception of personal dignity, thereby avoiding the so-called therapeutic obstinacy. All people have the right to access palliative comfort treatments and, in particular, pain relief, which should be provided in the most suitable setting possible (home, hospital, etc.). When the patient is in hospital, every effort should be made to facilitate the presence of family members, in a suitable social setting that allows for privacy and, ultimately, for mourning. If death occurs in hospital, special care must be taken to ensure that family members and loved ones receive appropriate treatment and guidance at this time. The relevant procedures and actions must not incorporate provisions contrary to the law.

2.5. The right to have advance wishes, established through the corresponding document, taken into account.
In an advance decision document, an adult, with sufficient capacity and acting freely, expresses instructions to be taken into account when they are in a situation where circumstances do not permit them to express their wishes personally, in accordance with the requirements and effects established by law. Advance decisions or actions that incorporate provisions contrary to the legal system or good clinical practice, or that do not exactly correspond to the factual assumption that the individual had foreseen when making them, cannot be taken into account. In such cases, a reasoned annotation will be made in the patient’s medical record.

3.1.- Right to decide who can be present during medical procedures: Except for those professionals who, by virtue of their responsibility, must be unavoidably present, this right implies the possibility of limiting the presence of researchers, students or other professionals who do not have direct responsibility for the care to be provided. Efforts will be made to facilitate the presence of family members or associated individuals when patients prefer it, except in cases where this presence is incompatible or inadvisable with the provision of treatment. In this regard, during the childbirth process, access for a family member to be present must be facilitated. These considerations are particularly important in the case of minors and all those with diminished autonomy: the elderly, the mentally ill, etc.

3.2. Right to preserve a patient's bodily privacy from others: This implies that the necessary care will be provided with consideration for the basic aspects of privacy: hygiene, visits, care, examinations, etc., the provision of single-occupancy changing rooms, and limitations on access by professionals and other users, whether related or not, if they do not directly assist in the care. In the case of hospitalised patients, it implies the right to a private physical space within the room that guarantees a degree of privacy.

3.3. Right to care in an environment that guarantees the individual's privacy, dignity, autonomy and safety: In the event of a hospital admission, the patient has the right to continue to maintain contact with the outside world and with their loved ones, in accordance with the framework and organisational rules of the centres and services. Likewise, their lifestyle habits must be respected, provided they are compatible with their healthcare needs, the rights of other patients, and the internal regulations of the centre. The patient has the right to freedom and confidentiality of correspondence and communications. The patient has the right to receive healthcare in centres and establishments that uphold safety standards for the physical spaces and facilities where care is provided.

3.4.- Right to freedom of ideology, religion, and worship: A person has the right to have their moral and cultural values, as well as their religious and philosophical convictions, respected. Any practice deriving from these must be compatible with medical practice and respectful of the centre's regulations. In situations of hospitalisation, the right to refuse or receive spiritual assistance, without distinction of belief, must be respected.

3.5. Right to confidentiality of information: This right means that information relating to data from medical records must be kept strictly confidential and protected by the patient's right to privacy. This is especially important for those types of data that may be more sensitive: those relating to health itself, beliefs, genetic inheritance, adoption, infectious diseases, being subject to abuse, etc. In this regard, it should be borne in mind that only healthcare personnel directly involved in the patient's care may access the data, and that they may not be disclosed to other professionals or to family members or other associated persons without the patient's authorisation. It should be noted that the right to confidentiality is not absolute and that various exceptions are recognised, the most notable of which are as follows: When maintaining confidentiality could pose a significant risk or harm to other people; when the patient authorises the disclosure of information to third parties, which does not oblige the professional to provide it; or when maintaining confidentiality becomes detrimental to the patient themselves, which is particularly important in cases of abuse.

3.6. Right of access to personal data obtained during healthcare: This is the right to know the personal information and data that appear in files and records, whether automated or not, which have been obtained during healthcare. Notwithstanding what is established for the clinical history in section 7.3 of this document, the patient has the right to access, rectify, and cancel data, in accordance with the provisions of the regulations. Likewise, they have the right to know the security measures and the persons and/or bodies/institutions that may access this data and guarantee its confidentiality.

3.7. The right to be asked for consent before the taking and dissemination of iconographic records: The patient has the right to give prior consent for the creation and dissemination of iconographic records that allow their identification (photos, videos, etc.) and to be informed of the reason for their creation and the scope of their dissemination.

4.1.- Right to the confidentiality of your genome information and that it is not used for any kind of discrimination: Every person must have the right to the confidentiality of their genomic information guaranteed, and this information must not be used for any form of individual or collective discrimination. Genomic data records shall be configured and equipped with the necessary mechanisms to guarantee the confidentiality of genomic information.

4.2.- The right to enjoy the benefits derived from new genetic technologies within the current legal framework: In the performance of genomic tests, when indicated, to identify individuals carrying genes responsible for a disease or to detect a predisposition to developing it. These tests may only be carried out for medical or medical research purposes and within the framework of appropriate genetic counselling, always with the individual's informed consent. To intervene on the human genome for preventive, diagnostic and therapeutic purposes. Only interventions aimed at modifying the human genome for preventive, diagnostic or therapeutic reasons may be carried out, and only when they do not seek to introduce a modification into the genome of the offspring. To use assisted reproduction techniques to prevent sex-linked hereditary diseases. Interventions aimed at creating a human being genetically identical to another, whether living or dead, are prohibited. A genetically identical human being is understood to be one who shares the same nuclear genetic load.

5.1. The right to know if prognostic, diagnostic, and therapeutic procedures applied to a patient can be used for a teaching or research project, which in no case may pose any additional danger to their health.

In any case, prior written authorisation from the patient will be essential, along with acceptance from the doctor and the management of the relevant healthcare centre. People can participate in research and experimental studies if the following conditions are met:

  1. That there is no alternative method in human experimentation of comparable efficacy.
  2. That the risks that the person may incur are not disproportionate to the potential benefits of the experiment.
  3. That the experimental project has been approved by a competent authority (clinical research ethics committees or other interdisciplinary committees external to the experimentation) after an independent study has been carried out regarding its scientific relevance, including an evaluation of the importance of the experiment's subject, as well as a multidisciplinary study at the ethical level. In the case of clinical trials, it must have the relevant authorisation from the Ministry of Health.
  4. That the individual has been informed of the rights and guarantees established by law for the protection of individuals undergoing experimentation, of the identity of the person responsible, and the source of funding.
  5. I freely, expressly, specifically and in writing grant consent to participate in the experiment, as established in sections 2.1 and 2.2 of this document. Consent may be revoked at any time.
  6. Be aware that the person has the right to anonymity when the results are published. Should their anonymity not be maintained through publication, the signed consent of the patient will be required.
  7. So that I can be aware of the results of the research I have participated in, in the form of publications arising from it and understandable summaries.

When a person lacks the capacity to give their consent freely, an experiment may only be carried out on them when:

  1. The conditions announced in points 1, 2, 3 and 4 of the previous section have been met.
  2. The anticipated results of the experiment represent a real and direct benefit to your health.
  3. The experiment cannot be carried out with comparable efficacy in individuals who can give consent.
  4. Specifically and in writing, authorisation has been offered by the representative of the person, or by an authority or institution designated by law.
  5. The person did not express their rejection of the experiment.
  6. Exceptionally, experiments that do not provide a direct benefit to the health of the person may be authorised if criteria 1, 3, 4, and 5 are met, and furthermore, if the experimentation aims to significantly improve scientific knowledge, which allows for benefits to be obtained, within a defined timeframe, for the person undergoing experimentation or for others with diseases and disorders of a similar nature.
  7. If the experiment only involves minimal risk or inconvenience to the person.

5.2.- The patient has the right to receive tissue preparations or biological samples obtained from a biopsy or extraction for the purpose of obtaining a second opinion from a professional or for the continuation of care at a different centre: This implies the existence of a system for the custody of biological samples, so that their accessibility is sufficiently regulated and documented. Whenever tissues or biological samples from a biopsy, extraction or donation are kept, the patient has the right to be informed about it and to authorise their use. When the patient does not authorise the use of tissues or biological samples from a biopsy or extraction, they must be disposed of as sanitary waste.

6.1. Individuals have the right to adequate knowledge of community health problems that pose a risk to health, have a relevant incidence, and are of interest to the community. This information shall be disseminated in terms that are understandable, truthful, and suitable for the protection of health. People have the right to adequate knowledge regarding hazards related to the environment, food, drinking water, and individual behaviours that pose a risk to health and have an impact and relevance to the community. This information should be disseminated in terms that are understandable, truthful, and suitable for protecting health. This information must be sufficient, understandable, and appropriate, and must include risk factors, situations, and causes, as well as general epidemiological information regarding the most common health problems, in order to promote the improvement of healthy behaviours and habits, both individually and collectively.

6.2.- Right to enjoy a quality environment: This right must allow for a dignified, healthy and well-being-filled life for both current and future generations.

6.3. - Right to consume safe food and drinking water.

6.4. The right to be informed about plans, actions and services relating to health prevention, promotion and protection, and to know how they are implemented.

6.5. Right to receive preventive benefits within the framework of the usual consultation: Healthcare professionals are the ones who must provide them, along with information about the activities to be carried out and their purpose, always bearing in mind that preventive practices do not pose an additional risk to the person.

6.6. Right to refuse preventive measures proposed in situations that do not pose risks to third parties, notwithstanding what is established by public health regulations: When a person rejects preventive measures in situations that do not pose a risk to third parties, this rejection will be recorded in writing in their medical history or, where appropriate, in the corresponding document.

7. 1. Right to receive information about the care process and health status: The patient has the right to know all information obtained regarding their health and to have, in terms they can understand, truthful and appropriate information about their health and the care process, including the diagnosis, risks and benefits, the consequences of treatment and of not being treated, the possible alternatives to this treatment and, whenever possible, the prognosis. Nevertheless, a person's wish not to be informed must be respected if they so choose. Information will be provided in language that is accessible to them, taking into account their personal, cultural, linguistic, educational and other characteristics. At the same time, information should be provided in a way that enables them to understand it, so that they have sufficient elements for judgement to make the necessary decisions regarding their care. Healthcare professionals must ask their patients to specify who they wish to be given the information. Related persons should be informed, to the extent permitted by the patient, either expressly or tacitly. In the case of minors or patients who lack the capacity to understand the information, they will be informed according to their level of understanding, as will their representatives, family members or other related persons.

7.2.- Right to a complete medical record that collects all information on the state of health and clinical and healthcare actions from different care episodes: The integrated and single medical record must incorporate all information on the patient's health status and the clinical and health actions corresponding to the different care episodes. This information must be truthful and up-to-date and must include the patient's identification data and attendance, clinical and care data, and social data, where applicable. To the extent that technical resources make it possible, the Department of Health and Social Security will promote mechanisms to enable the shared use of medical records, so that patients treated in different centres do not have to undergo repeated examinations and procedures, and care services have access to all available clinical information.

7.3. The user's right to access their medical records: The patient has the right to access the documentation of their clinical history, as well as to obtain a copy of the data contained therein. Healthcare centres are responsible for regulating the procedure to ensure access. The patient also has the right to be informed of this procedure. Patients' right of access to their clinical history documentation may never be exercised to the detriment of third parties' right to the confidentiality of their data, if any such data appear therein, nor of the rights of the professionals who have been involved in its preparation. These professionals may invoke the confidentiality of their observations, assessments or subjective annotations. This right may be exercised by proxy, provided that the proxy is duly accredited. In the case of deceased patients, access to their medical record will be granted to their heirs, unless the patient had expressly prohibited it. As for other relatives and associated persons, they may access relevant healthcare data if there is a serious risk to their health or when required by a court order.

7.4. Right to written information on the care process and health status: People have the right to information written in understandable terms, whether it concerns a hospital discharge report, an outpatient consultation, or an emergency visit. This also includes medical certificates confirming a person's state of health, in cases established by a legal or regulatory provision.

8.1. Right of access to public healthcare services: Within the framework of public insurance, people have the right to access quality healthcare in their place of residence and to have an integrated offer of referral services.

8.2. Right to choose healthcare professionals and healthcare centres: Patients using public healthcare services have the right to have their preferences regarding healthcare professionals and facilities respected, both in primary, specialist, and socio-healthcare settings. This right is subject to the terms and conditions established, and based on the availability within the public healthcare network. The insuring entity will guide patients wishing to exercise this right by providing the necessary information for accessing services. The chosen professionals will be their main point of contact and responsible for their care pathway, along with the healthcare team, and will be responsible for integrating information relating to their case.

8.3. Right to obtain necessary medicines and sanitary products for health: Patients have the right to obtain necessary medicines and health products to promote, maintain, or restore their health under the terms established by regulations. Healthcare professionals must inform patients, in understandable language, about the correct use of medicines, expected effects, possible adverse effects, potential interactions with other medicines or foods, and, if necessary, existing alternatives, in order to encourage the rational use of medicines.

8.4. The right to care within a timeframe appropriate to the pathological condition and in accordance with equity criteria: Health services and assistive devices must be organised as efficiently as possible so that the patient can be treated as soon as possible, in accordance with criteria of equity, appropriateness and resource availability, type of pathology, urgency priority, and a previously established reasonable waiting time, and so that continuity of care is guaranteed. The patient has the right for the duration of their treatment process or hospital stay to be appropriate to medical criteria, depending on the pathology that gives rise to it.

8.5. Right to request a second opinion: When a patient wishes to obtain complementary or alternative information about a diagnosis and therapeutic recommendations of significant individual importance, they have the right to access a second opinion from a professional, in accordance with statutory provisions.

9.1. Right to have the charter of rights and responsibilities in all healthcare centres: All health and social health centres, services and establishments must make the charter of rights and duties of citizens in relation to health and health services available to everyone, as a framework for the relationship between the centre and users.

9.2. Right to receive general information and information on benefits and services: The patient has the right to be informed about services and the requirements for their use, the centre's operating procedures, access procedures, and useful information, as well as comparative healthcare information about available technology, care outcomes, and waiting lists, among others. Furthermore, they have the right to receive economic information relating to the certain and predictable expenses arising from healthcare and to know how to obtain further information.

9.3. Right to be informed of the benefits covered by the insurance: The patient has the right to know the benefits covered by the insurance, whether public or private, and the conditions under which they will be provided, as well as the limiting clauses and complaint mechanisms in case of conflict.

9.4. The right to know and identify the healthcare professionals providing care: The patient has the right to know the name and qualifications of the healthcare professionals providing care and that staff identify themselves clearly and visibly.

9.5. Right to submit complaints and suggestions: The patient has the right to know and use the procedures for submitting suggestions and complaints. These must be evaluated and responded to in writing, within an appropriate timeframe, in accordance with the terms established by regulation.

9.6. The right to participate in healthcare activities, through community participation institutions and bodies, and social organisations, as established by regulations.

9.7. Right to use information and communication technologies, in accordance with the level of implementation and development of these technologies within the healthcare network: Users have the right to expect healthcare services to use available information technologies in order to minimise the time required by the user for access, administrative procedures and receiving information. This access shall be understood in accordance with the development of these systems within the healthcare network and with the confidentiality and security guarantees provided for by current legislation.

10.1. Right to healthcare of human and scientific quality: Healthcare professionals must provide healthcare in accordance with ethical guidelines and standards of practice, conduct, respect for human dignity, and taking into account the habits and beliefs of each person. This healthcare, based on current scientific knowledge, shall be adapted to the needs and characteristics of each person and, in case of illness, shall be adapted to the severity and complexity it entails.

Right to be informed of the quality level of care centres: For this purpose, patients have the right to know the quality assurance mechanisms implemented by a healthcare centre or service, as well as the institutions and organisations that endorse them. Likewise, patients have the right to know the results of healthcare provided, as measured by indicators.

10.3. Right to receive continuing and comprehensive healthcare: Every patient has specific rights in this area: To have a doctor in primary care responsible for integrating their care process and the attention received over time, as well as a designated nursing professional. To receive healthcare that includes prevention, diagnosis, treatment, and rehabilitation measures. For there to be cooperation and coordination mechanisms between the different levels, entities, centres, and professionals involved in their care, with the aim of guaranteeing quality.