Turkey's thriving health tourism sector, renowned for its excellence and affordability, beckons diverse international patients. From those seeking aesthetic enhancements to individuals grappling with severe medical conditions, this burgeoning industry has become a global magnet.
Yet, amid this influx of foreign patients, a striking absence of awareness prevails regarding their rights within Turkey's healthcare realm. Cognizant foreign patients who wield the beacon of understanding not only illuminate their own healthcare journey but also catalyze the flourishing growth of the market through the steadfast foundation of trust.
Within this landscape, the imperative to secure informed consent takes center stage, binding patients and stakeholders, including hospitals, physicians, and intermediary entities.
Don't be surprised, You're consumer!
In Turkey, a critical facet emerges: disputes involving malpractice between patients and private healthcare facilities or practitioners fall under the purview of consumer law. This legal framework acknowledges information asymmetry, necessitating consumer awareness of contractual agreements. It highlights that information asymmetry applies not only to surgical procedures but to all services within health tourism. This perspective reinforces the need for comprehensive patient enlightenment and transparency across all healthcare services provided to international patients.
Illuminating Enlightenment: The Essence of Informed Consent
While addressing information asymmetry from a consumer law perspective, numerous medical regulations on informed consent are grounded in both Turkish law and international agreements concerning patient rights. The fundamental premise behind these regulations is the necessity for patients to have a more comprehensive understanding of medical procedures. The law presumes that patients require this understanding due to the complexity of medical procedures and terminology. At this point, an important distinction is between "enlightenment" and "informed consent." Many individuals tend to conflate these two terms due to their interconnected nature. However, "enlightenment" must occur before the doctor performs any medical procedures and grants the patient the right to self-determination. Informed consent can suffice if preceded by a prompt enlightenment process. Legally effective enlightenment entails clarifying diagnostic interventions, the causes of illness, treatment options, methodologies, duration, purpose, significance, and the potential consequences of refusing intervention. Patients who have been adequately enlightened may choose to withhold consent for surgery.
There are no restrictions on the form of enlightenment, whether verbal or written. In a dispute, the burden of proof lies with the doctors. In this context, informed consent represents a distinct phase separate from enlightenment. Informed consent involves the patient declaring their decision after being correctly enlightened. Through informed consent, the patient grants the doctor the authority to proceed with the procedure. Failing to obtain this consent could lead to accusations of violating bodily integrity, potentially resulting in criminal charges. In many cases, consent must be obtained in writing.
From Enlightenment to Valid Consent: A Legal Evolution
Turkish law, notably Article 70 of the Medical and Dental Professions Law, designates the term "major surgical operation," necessitating written consent from the Patient. A "major surgical operation" typically refers to procedures of significant complexity, risk, or potential impact on the patient's health and well-being. In contrast "minor operations" usually involve less invasive and lower-risk procedures that may not demand written consent forms.
For foreign patients, consent must be in English, per the Regulation on Health Services Within the Scope of Health Tourism and Tourist Health (Article 5). This regulation may not be widely known; hospitals might use translators instead. However, it's important to emphasize that the regulation is precise, and providing consent forms in the patient's mother language is preferred, but English is the minimum requirement. The patient's language shall be used whenever possible to ensure better communication and understanding during enlightenment and obtaining consent. These language-specific consent forms serve as evidence of enlightenment and consent, making them the most effective means of communication with foreign patients. A pivotal change dated 08.05.2014 in the Patient Rights Regulation, removing the translator requirement, aligns with the 2013 Directive on Health Services Within the Scope of Health Tourism and Tourist Health. Analyzing the amendment with the aforementioned regulation, using translators is not sufficient anymore for taking patients' informed consent; the key is an English-language consent form.
Conclusion: Empowering Patients Through Enlightenment
In the realm of health tourism, the intersection of foreign patients' roles as consumers and patients underscores a critical dimension of the industry. Foreign patients often find themselves navigating a complex environment where access to information is of paramount importance. This dedication to information accessibility spans the entire healthcare spectrum, from initial diagnosis to post-operative care. The harmonization of consumer protection, patient rights, and informed consent sets the stage for providing top-tier care.
Within this journey of empowerment, two key legislative instruments stand out prominently: the Patient Rights Regulation Amendment and the 2013 Directive on Health Services in Health Tourism. By stipulating the use of informed consent forms in the English language, these regulations establish a baseline level of protection and send a clear and unequivocal message: foreign patients, regardless of their native language, have the fundamental right to make informed healthcare decisions.
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