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Code of the Republic of Kazakhstan dated July 7, 2020 No. 360-VI “On public health and healthcare system”
Chapter 12. RIGHTS AND OBLIGATIONS OF INDIVIDUALS IN HEALTHCARE
Article 76. Guarantee of rights enforcement in healthcare
1. Guarantees of the state to citizens of the Republic of Kazakhstan are as follows:
1) equal access to medical assistance;
2) good quality of medical assistance;
3) good quality of drug provision;
4) availability, efficacy and safety of medicines;
5) carrying out measures for the prevention of diseases, formation of a healthy lifestyle and healthy nutrition;
6) freedom of reproductive choice, protection of reproductive health and observance of reproductive rights;
7) sanitary-epidemiological welfare.
2. The Republic of Kazakhstan guarantees the citizens of the Republic of Kazakhstan protection from any forms of discrimination and stigmatization due to the presence of any diseases and conditions.
Article 77. Rights of citizens of the Republic of Kazakhstan
1. Citizens of the Republic of Kazakhstan have the right to:
1) a guaranteed volume of free medical care;
2) medicines and medical products within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance;
3) free choice of a physician and a medical facility;
4) medical nutrition in the event of a patient’s treatment in a hospital;
5) additional medical assistance in excess of the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance at the expense of their own funds, funds of organizations, the system of voluntary medical insurance and other sources in accordance with the legislation of the Republic of Kazakhstan;
6) medical and other services on a paid basis;
7) medical assistance provided outside the Republic of Kazakhstan at the expense of budgetary funds, given indications, in the manner prescribed by the authorized body;
8) the receipt and submission of relevant documents certifying the fact of temporary disability, in accordance with the legislation of the Republic of Kazakhstan;
9) free and regular receipt from state bodies, organizations and an attending physician, within their competence, of reliable information on methods of prevention, diagnosis, treatment of the disease and medical rehabilitation, clinical trials, factors affecting health, including the state of the environment, working conditions, life and recreation, healthy diet and food safety;
10) receive information from state bodies, independent expert organizations and entities in the field of distribution of medicines and medical products on the safety, efficacy and good quality of medicines and medical products sold;
11) the protection of information falling under medical confidentiality;
12) compensation for harm caused to health during the provision of medical assistance in accordance with the legislation of the Republic of Kazakhstan;
13) protect their rights and legitimate interests in the field of health protection in accordance with the legislation of the Republic of Kazakhstan;
14) appeal against actions (inaction) of healthcare professionals and pharmaceutical workers in the manner prescribed by the laws of the Republic of Kazakhstan;
15) petition higher authorities for involving independent experts in case of disagreement with the findings of state medical examination;
16) voluntary declaration of will about the opportunity to act as a donor;
17) declaration of will of consent or refusal to remove their tissues (parts of tissue) and (or) organs (parts of an organ) after death for the purpose of transplantation in the manner prescribed by this Code;
18) give informed consent or refusal for treatment and other medical interventions, including preventive vaccinations;
19) co-payment;
20) receive pain relief during the treatment of chronic incurable diseases;
21) get information in an intelligible form on the state of health, including information on the results of medical examination, diagnosis and prognosis of the disease, methods of providing medical care, associated risk, possible types of medical intervention, its consequences and the results of providing medical assistance;
22) get reliable and timely information on factors that contribute to the preservation of health or have a negative impact on them, including information on the prevention of diseases, sanitary-epidemiological welfare, the state of the environment, the potential danger to human health from the work performed and services provided, rational nutritional standards, quality and safety of products, goods and services;
23) other rights in accordance with the laws of the Republic of Kazakhstan.
2. Women have the right to decide on their motherhood and free choice of modern methods of preventing unwanted pregnancy for the purposes of family planning and protecting their health.
The right of citizens to maternity protection is enforced by:
1) medical examinations, follow-up and health improvement of women of reproductive age;
2) medical treatment of common diseases that directly affect the reproductive health of women and the health of the child when admitted to a hospital for the care of a sick child.
Article 78. Rights of children
1. In addition to the rights provided for in Article 77 of this Code, every child has the right to:
1) modern and effective medical services and means of treating diseases and health recovery;
2) education in the field of health protection;
3) preventive medical examinations and follow-up, treatment, drug provision, health improvement and vaccination;
4) provision of medical services during the recovery period and organized recreation in the manner prescribed by the authorized body;
5) sanitary and hygienic education, training and work under conditions appropriate for his/her physiological characteristics and state of health, excluding the influence of adverse factors on him/her;
6) obtain medical documentation on the state of health on a free basis at the place of his/her registration when becoming a student and being employed;
7) obtain information on the state of health in an intelligible form;
8) obtain information in an intelligible form on a healthy lifestyle and proper nutrition, on the dangers of smoking, the use of psychoactive substances;
9) obtain information in an intelligible form on the protection of reproductive health;
10) palliative care.
2. Minors aged sixteen and over have the right to informed consent or refusal to preventive, consultative and diagnostic assistance, except for surgical interventions, artificial abortion, which are performed with the consent of their parents or legal representatives.
3. During treatment of children under five years of age in a hospital, as well as sick children of older age who, according to a doctors’ conclusion, need additional care, mother (father) or another person directly caring for the child is given the opportunity to stay with him/her in the medical facility and a sheet or certificate of temporary disability in accordance with the legislation of the Republic of Kazakhstan.
A nursing mother of a child up to one year of age is provided with free meals by a medical facility for the entire period of childcare.
4. During treatment of children under five years of age in outpatient and hospital-replacing conditions, as well as sick children of older age who, according to a doctors’ conclusion, need additional care, mother (father) or another person directly caring for the child is given the opportunity to stay with him/her and a sheet or certificate of temporary disability in accordance with the legislation of the Republic of Kazakhstan.
5. When receiving specialized medical assistance, medical rehabilitation, as well as palliative medical care in stationary conditions, school-age children have the right to continue education in the manner prescribed by the authorized body together with the authorized body for education.
Healthcare organizations providing medical assistance to children create conditions for their games, recreation and education.
6. Children with disabilities, children infected with HIV have the right to receive free medical-pedagogical correctional support in educational institutions, healthcare organizations in accordance with the legislation of the Republic of Kazakhstan.
Children infected with HIV have the right to stay in children’s homes and other healthcare organizations and educational institutions.
Children born to mothers infected with HIV have the right to receive free adapted milk formulas in accordance with established nutritional standards.
7. The list of medical contraindications for placing children in a children’s home and educational institutions, organizations for orphans and children left without parental care is approved by the authorized body.
8. Orphans, children left without parental care and disadvantaged children up to the age of three years inclusive may live in state-run medical facilities in the manner prescribed by the authorized body.
Article 79. Rights of citizens of the Republic of Kazakhstan and a family in the field of reproductive rights protection
1. Citizens of the Republic of Kazakhstan have the right to:
1) free reproductive choice;
2) receive services for reproductive health protection and family planning;
3) get reliable and complete information on the state of their reproductive health;
4) treatment of infertility, including with the use of modern assisted reproductive methods and technologies, which are permitted in the Republic of Kazakhstan;
5) prevent unwanted pregnancy;
6) safe motherhood;
7) donation of germ cells, tissue of reproductive organs;
8) use and free choice of contraception methods;
9) surgical sterilization;
10) artificial abortion;
11) protect their reproductive rights;
12) free decision-making regarding the number of children and the time of their birth within and out of wedlock, the intervals between births necessary to maintain the health of the mother and child;
13) store germ cells, tissue of reproductive organs, embryos in accordance with the procedure established by the legislation of the Republic of Kazakhstan.
2. When exercising their reproductive rights, citizens are obliged to observe the rights, freedoms and legal interests of other persons.
3. According to medical indications, citizens have the right to consultations on family planning, the presence of socially significant diseases and diseases that pose a danger to others, on the medical and psychological aspects of family and marriage relations, as well as to medical genetic and other consultations and examinations in medical facilities in order to prevent possible hereditary and congenital diseases in descendants.
4. A child’s father or another family member is granted the right, given the woman’s consent and taking into account the state of her health, to be present at the birth of the child, except for cases of operative delivery, provided that obstetrics organizations (individual delivery rooms) have appropriate conditions and the father or another family member has no infectious diseases. This right is exercised free of charge.
5. HIV-infected citizens of the Republic of Kazakhstan have the right to adopt children on an equal basis with other citizens of the Republic of Kazakhstan in accordance with the legislation of the Republic of Kazakhstan.
6. HIV-infected citizens of the Republic of Kazakhstan have the right to use assisted reproductive methods and technologies in accordance with the legislation of the Republic of Kazakhstan.
Article 80. Obligations of citizens of the Republic of Kazakhstan
Citizens of the Republic of Kazakhstan are obliged to:
1) take care of their health, bear joint responsibility for the preservation and strengthening of individual and public health;
2) pay contributions for compulsory social health insurance in accordance with the Law of the Republic of Kazakhstan “On Compulsory Social Health Insurance”;
3) take preventive medical examinations, screening tests;
4) follow the prescriptions of healthcare professionals related to individual and public health;
5) take part in the process of managing their own health, including in programs for managing chronic diseases, if any, be interested in getting information on the disease and methods of its treatment, possible risks and complications;
6) inform healthcare professionals on individual characteristics of their body;
7) observe precautions to protect their own health and the health of others, take examination and treatment at the request of public health entities, inform medical personnel on the presence of infectious and other diseases that pose a danger to others;
8) comply with the legislation of the Republic of Kazakhstan in the field of healthcare.
In case of evasion of examination and treatment, citizens of the Republic of Kazakhstan, having diseases that pose a danger to others, except for HIV infection, are subject to forcible examination and treatment in accordance with this Code and the laws of the Republic of Kazakhstan.
Article 81. Rights and obligations of pregnant women and mothers in the field of health protection
1. Motherhood in the Republic of Kazakhstan is protected and encouraged by the state.
2. Citizens have the right to support breastfeeding, including protection and promotion of breastfeeding:
1) the protection of the rights of pregnant and nursing women is aimed at ensuring conditions for the preparation and implementation of breastfeeding (maternity leave, additional breaks from work to feed infants, part-time work, services on a priority basis in medical facilities, use of the services provided by parenting rooms, etc.);
2) informing the population on the benefits of exclusive breastfeeding for children under six months of age and on continuing breastfeeding with healthy complementary foods for up to two years or more.
3. Pregnant women have the right to:
1) health protection and assistance during pregnancy, during and after delivery, including premature one, determined by the international live birth and stillbirth criteria, using methods permitted in the Republic of Kazakhstan;
2) medical assistance during pregnancy, during and after childbirth;
3) examination, treatment and medical intervention during pregnancy only with their consent or that of a legal representative, except for cases when delay in examination, treatment and medical intervention threatens the life of a woman and a child (fetus), when a decision to carry out examination, treatment and medical intervention is made by a doctor or a medical case conference;
4) observe a work schedule, maternity leave, unpaid leave to care for a child until the child reaches the age of three, and working conditions for pregnant women and nursing mothers in accordance with the labor legislation of the Republic of Kazakhstan;
5) qualified support provided to nursing mothers (parents), counseling by healthcare professionals trained in lactation, methods of exclusive breastfeeding and complementary feeding;
6) support for the practice of breastfeeding, which is implemented by child-friendly medical facilities;
7) time for medical examination and registration as pregnant within twelve weeks of gestation, which is granted by an employer together with protecting job, securing position and preserving average salary;
8) other guarantees and incentives in accordance with the laws of the Republic of Kazakhstan.
4. Pregnant women are obliged to:
1) within twelve weeks of gestation, register as pregnant at the place of registration for receiving medical assistance within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance;
2) follow the doctor’s recommendations during pregnancy, during and after childbirth.
5. If a woman with contraindications for pregnancy plans a pregnancy, she assumes full responsibility for all health risks to herself and the fetus during pregnancy and up to forty-two calendar days of childbirth.
Article 82. Obligations of individual entrepreneurs and legal entities for their employees’ health protection
1. In accordance with their activities, individual entrepreneurs and legal entities are obliged to:
1) take sanitary-antiepidemic and sanitary-preventive measures;
2) comply with regulatory legal acts in the field of sanitary-epidemiological welfare of the population, as well as acts of officials exercising state control and supervision in the field of sanitary-epidemiological welfare of the population;
3) ensure the safety and good quality of works performed, services provided and products during their production, transportation, storage and sales to the population, disposal and destruction;
4) perform production control;
5) promptly inform the state body for the sanitary-epidemiological welfare of the population on emergencies, suspension of production, breakdowns in technological processes that pose a threat to the sanitary-epidemiological welfare of the population, in cases of mass and group infectious and parasitic, occupational diseases and poisoning;
6) promptly inform the state body for the distribution of medicines and medical products on the identification of side effects of medicines and medical products;
7) arrange hygienic training for employees belonging to the decreed population group;
8) provide officials of the state body for the sanitary-epidemiological welfare of the population with the opportunity to take samples of products, raw materials, goods, production environment for laboratory research within their competence;
9) bar from working persons without a document certifying their medical examination, hygienic training, and also those with infectious, parasitic diseases and carriers of pathogens of infectious, parasitic diseases, persons with contraindications to work in harmful and (or) hazardous working conditions identified by public health entities, except for those infected with HIV;
10) prohibit the sales of goods, products, raw materials which are found to be inconsistent with regulatory legal acts in the field of sanitary-epidemiological welfare of the population, and also to make a decision on the possibility of their use or disposal;
11) submit accounting and reporting documentation relating to the sanitary-epidemiological welfare of the population for inspection to the state body for the sanitary-epidemiological welfare of the population;
12) suspend entrepreneurial and (or) other activities if they pose a threat to the life or health of the population;
13) ensure unhindered access of officials exercising state control and supervision in the field of sanitary-epidemiological welfare of the population to facilities in order to check their compliance with regulatory legal acts in the field of sanitary-epidemiological welfare of the population;
14) at their own expense, carry out disinfection, disinsection and deratization according to epidemiological indications and prescriptions, decisions of officials of the state body for the sanitary-epidemiological welfare of the population;
15) pay deductions and (or) contributions for compulsory social health insurance in accordance with the Law of the Republic of Kazakhstan “On Compulsory Social Health Insurance”.
2. The employer shall create favorable conditions for health promotion and disease prevention among employees.
Article 83. Rights and obligations of kandasses, foreigners, stateless persons and other persons
Note of the ILLI!
Paragraph 1 shall be effective in the version of item 4, Art. 276 of Code № 360-VI of the Republic of Kazakhstan dated 07.07.2020 until the enactment of subitem 1) of item 22 of Article 1 of the Law of the Republic of Kazakhstan “On amendments and additions to some legislative acts of the Republic of Kazakhstan on the regulation of migration processes” dated 13.05.2020.
1. Kandasses, refugees, as well as foreigners and stateless persons permanently residing in the Republic of Kazakhstan, have the right to receive a guaranteed volume of free medical care on an equal basis with citizens of the Republic of Kazakhstan.
2. Foreigners and stateless persons temporarily staying in the Republic of Kazakhstan, asylum seekers have the right to receive a guaranteed volume of free medical care for diseases that pose a danger to others, according to the list and in the amount determined by the authorized body unless otherwise provided for by laws of the Republic of Kazakhstan or international treaties ratified by the Republic of Kazakhstan.
3. Kandasses, refugees and asylum seekers, foreigners and stateless persons staying in the Republic of Kazakhstan bear the same responsibilities in the field of healthcare as the citizens of the Republic of Kazakhstan.
Article 134. Rights of patients
1. In addition to the rights specified in Chapter 12 of this Code, the patient has the right to:
1) respectful attitude in the process of prevention, diagnosis, treatment, respect for his/her cultural and personal values;
2) receive medical assistance in accordance with the priority determined solely on the basis of medical criteria, without the influence of any discriminatory factors;
3) select, replace a doctor or a medical facility providing medical assistance within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance, except for cases of emergency and urgent assistance;
4) be informed by a medical facility about audio and (or) video surveillance and recording;
5) be relieved of suffering to the extent enabled by the current level of medical technologies;
6) obtain information (data on possible risks and benefits, proposed and alternative methods of treatment, information on possible consequences of refusing treatment, information on the diagnosis, prognosis and treatment plan in an intelligible form, and also explanation of the reasons for discharging him/her home or transferring to another medical facility), and an independent opinion on the state of his/her health, and a concilium;
7) obtain information on his/her rights and obligations, the services provided, the cost of paid services and the amount of co-payment, the procedure for their provision with account of their accessibility for persons with visual and (or) hearing impairments; the prescribed medicinal product; healthcare professionals providing medical services to him/her;
8) refuse to participate in the educational process, and also to refuse third parties to be present at medical and diagnostic procedures;
9) other rights provided for by the laws of the Republic of Kazakhstan.
2. Information on the patient’s rights is placed on visual outreach boards of medical facilities.
3. Medical assistance is provided after obtaining the patient’s informed consent to receive medical assistance. The informed consent of the patient during invasive interventions is drawn up in the form approved by the authorized body.
4. The patient can choose a person who shall be informed about the state of his/her health. With account of the state of the patient’s health, information thereon can be hidden from the patient and communicated to the patient’s spouse, close relatives or legal representatives.
5. Patients’ rights are protected by state bodies, healthcare organizations, public associations within their competence.
