The Medical Treatment Agreement Act (WGBO) will be amended. On June 4, 2019, the Senate agreed to the bill to amend the WGBO. In April of this year, the Lower House already agreed to the proposal.
The bill includes the following changes:
In addition to the provider's duty to inform, it clarifies that consultation between the patient and the provider must take place;
The custody arrangement is being updated;
Provision is made for the right of access by next of kin and former representatives to the medical records of deceased patients;
Relevant parts of the Youth Act, the Social Support Act 2015, the Mandatory Mental Health Act and the Care and Compulsion of Psychogeriatric and Mentally Disabled Clients Act are aligned with this bill.
The WGBO stipulates that the patient must give his or her own consent for treatments to be performed. Carrying out operations without consent is not allowed and constitutes a violation of the patient's physical integrity. In order to give consent, it is important that the patient is properly informed. To this end, the WGBO includes a duty of information for the care provider.
In addition to the provider's duty to inform, consultation between the provider and the patient has become increasingly important. Informing and consulting together is often referred to as "deciding together." In this relationship model, the patient is seen as the social worker's interlocutor. Deciding together based on relevant information, the chances, risks and possible outcomes of treatment, side effects and any other treatment options, allows the patient to make better decisions. This relationship model is better reflected in the amended WGBO:
consultation should take place in a timely manner;
in addition to the consequences and risks, the counselor also discusses the option of not treating;
Other possible examinations and treatments include examinations and treatments by other care providers;
the caregiver discusses the time frame in which examinations or treatments can be performed and the expected length of time;
the caregiver is aware of the patient's situation and personal needs;
the provider invites the patient to ask questions.
The second amendment relates to the extension of the retention period for medical records from 15 years to 20 years and when the retention period begins. The government's position is that by keeping records for a minimum of 20 years, more knowledge is gained of previous illnesses, correlations between previously experienced illnesses or treatment undergone and later illness or treatment. Data on treatment in early childhood, at least until the patient is physically mature, often prove useful for proper assistance later in life. The importance of this is increasing given higher life expectancy.
Currently, the retention period for each individual piece of information in the medical record begins at the time it is created. It is proposed that the retention period run for the entire file from the last change in the file. This eliminates the need to consider how long each part of the file should be kept. In practice, this interpretation of the moment of commencement for the retention period is often already used.
If a person has died, the next of kin may feel the need to see data from the deceased's medical file, for example, in order to consider a complaints procedure if a medical error has been made. In principle, however, the care provider has a duty of confidentiality, which means that such access cannot always be granted. On the basis of case law, next of kin can still be given access if certain conditions are met. The WGBO will now legislate the right of inspection for next of kin. There will then be a right of inspection in the following cases:
The deceased patient has consented to post-death viewing at the time of life and this consent is recorded in writing or electronically.
The next of kin received a notification from a healthcare provider pursuant to the Care Quality, Complaints and Disputes Act ("Wkkgz") that an incident had occurred.
The survivor has a compelling interest in inspection and can plausibly demonstrate that this interest will be harmed.
for the parents and guardian of a deceased child , a special and broader arrangement for inspection is included.
The WGBO is of interest to everyone involved in medical care. When a care provider, for example a doctor or a nurse, examines or treats a patient, there is a medical treatment agreement. The WGBO regulates the relationship between care provider and patient. It establishes important rights and obligations of patients and caregivers, including the requirement of consent, the right to information, the right to inspect and copy medical records, and the right to privacy and confidentiality of patient medical information.
This article can also be found in the Privacy in Healthcare file
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