2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VII - Hospitals, Institutions and Health Programs (§§ 3001 — 3891) › Chapter 132 - Bill of Rights and Responsibilities of the Patient (§§ 3041 — 3058) › § 3047 - Rights— Participation in decisions on treatment

All patients, guardians, consumers, or users of medical and hospital health care services in Puerto Rico are entitled to:
(a) Participate fully in all decisions concerning their medical and health care, including the right to choose and demand that their foot conditions be treated by a podiatrist. In the case of patients suffering from diabetes or other chronic conditions, he/she shall request a previous evaluation by an endocrinologist or nephrologist or a specialist in the corresponding medicinal field. In the cases of patients, consumers, or users of medical and hospital health care services who are unfit to participate fully in decisions concerning their medical and health care, such patients, consumers, or users shall be entitled to be represented in said decision-making process by either parent, their tutor, custodian, guardian, or spouse; a relative; or by legal counsel, proxy, or any person appointed by court for such purposes.
(b) All physicians and health care professionals shall provide their patients with sufficient and appropriate information, as well as with the real opportunity to have substantial participation in decisions concerning their medical and health care, in order for the patients to be able to give their consent in said decisions, including but not limited to the discussion of treatment options in a manner comprehensible to the patients and the option of refusing or not receiving any treatment at all; the costs, risks, and chances of success of each of the treatment options or of no treatment at all; and any future preference of the patients in the event they could lose their capability to validly state their consent concerning the various treatment options.
(c) Give instructions or guidelines in advance regarding their treatment, or appoint a person to act as their guardian should it become necessary for the decision-making process. All physicians or health care professionals shall discuss with their patients and the patients’ relatives the matter of using such advanced instructions or guidelines to state their preferences, including but not limited to the use of powers of attorney or living wills. The provider shall honor such wishes to the extent these wishes are allowed by law.
(d) All physicians or health care professionals shall respect and abide by the decisions and preferences stated, either in written or spoken form, by their patients or their guardians concerning the treatment options discussed.
(e) All physicians and health care professionals, as well as health care plans, shall provide their patients, the guardians thereof, insured parties, and beneficiaries with sufficient and adequate information pertaining to any factors, including methods of payment and rates, as well as property, shares, or interest held in health care facilities and medical and hospital health services, which could influence the recommendation of treatment options or alternatives.
(f) All health care plans shall ascertain that their contracts with medical and hospital health service providers are free from any gag clauses, penalty clauses, or any other contractual mechanisms which may impair the ability or capability of providers to contact such insured parties or beneficiaries, or the guardians thereof, to discuss all treatment options available, or to make specific recommendations for treatment according to the professional opinion and judgment of said providers.
(g) All health plans shall contain a provision setting forth that the insurer shall pay the routine medical expenses of any patient suffering from a life-threatening condition for which there is no effective treatment, when the patient is eligible for participating in an authorized clinical treatment study pursuant to the study protocol provisions concerning said treatment, provided the participation of the patient offers a potential benefit to the patient and the physician referring the patient believes that participation in said study is pertinent, or the patient presents evidence of the fact that participation in said study is pertinent. “Routine medical expenses of the patient” shall not be construed to be expenses related to the study, or tests administered to be used as part of the study, or expenses the entity conducting the study is likely to pay.
(h) All physicians or health care professionals shall provide their patients, or the guardians thereof, with the medical order for laboratory tests, x-rays, or medication, in such a way that the patient is able to freely select the health care facility in which to receive these services.
History —Aug. 25, 2000, No. 194, § 9; June 19, 2008, No. 96, § 2; Dec. 16, 2009, No. 176, § 5.