RPCU

Your rights within the LSSSS

1. The right to information (Art. 4); is comprised of 2 sections. 

It is the right to be informed about the existence of services and the resources available in your environment, as much in the Health field as in the Social Services field.

It is the right to know the modalities in order to access these services and resources.

It is the right to be informed about your physical and mental status, diagnoses, prognoses and treatment options along with the risks and consequences associated with these treatments, and about incidents and their possible consequences during the provision of the services.

COMMUNICATE with your establishment's Users and In-patients' Committee which will be able to inform you and direct you according to your information request.

2. Rights to services (Art. 5,13 and 100);

It is the right to receive the appropriate services from Health and Social services at the scientific and human levels as well as the social level in a continuous, personalized and safe manner. 

However, this right to receive care and services is limited according to the availability of resources. (See LSSSS articles 13,100, 101 and 105). For example, if the required equipment for a specific treatment is not available in the establishment and if this equipment is only available in “Doctor Stethoscope’s” private clinic, the User will have to cover the equipment cost him/herself.

3. The right to choose a professional or an establishment (Art. 6 and 13);

It is the right to choose the professional of your choice who will provide you with the services and to choose the establishment where you will receive these services within specified limits.

How to exercise this right

At the professional level, it is the User who follows the procedures in order to get the professional of his/her choice to provide him/her with services.

• As for the establishment, the User can choose where he/she wishes to receive care, treatments or interventions.
  
• However, this right to choose your own professional or establishment is not absolute. In certain cases, this right can be limited (See LSSSS Articles 6 al.2, 13 and 105).
  One must, amongst other things, keep in mind:

• The limited number of resources, within various regions as well as in the establishments themselves.
  
• The sectors of services
  
• The financial, human and material resources which are available within the establishment.

In certain circumstances, a professional has the right to accept or to refuse to provide treatment.

In its provision of services, the establishment must keep in mind the resources at its disposal, the User's needs and the needs of other Users as well.

Inasmuch as it is possible, the establishment will accommodate the User as adequately as possible.

However, the User can not demand treatments or interventions on a specified date, at a specific hour or in a specific location, for example. There is an entire array of administrative policies to be respected and one must consider that the Health system, though certainly available to all, works according to specific procedures.

4. The right to receive the care which is needed according to one's health status (Art. 7);

It is the User's right to receive the appropriate care which his/her health status requires when his/her life or integrity is in danger (that is, in the case of an emergency) and be informed thereof of the possible treatment options and of the risks associated with these treatments.

Therefore, in all cases where the establishment's staff is capable to act in order to save the life of a User, he or she is authorized to do so. Moreover, this is one of the exceptional measures which does not require the User's immediate consent. A person coming into a hospital in an emergency situation, who is not in a state to give a free and enlightened consent, will nevertheless receive the care needed in order to save his/her life. However, the doctor will have to obtain the person's consent as soon as this person is able to give it.

 How to exercise this right

• First of all, the User must cooperate with the professionals (inasmuch as it is possible in an emergency situation, the person's free and enlightened consent can be bypassed) by giving all the necessary information so that the care he/she receives is appropriate and well evaluated and/or, if it happens to be the case, so that his/her long term care or treatment plan be well expanded and/or revised.
• The User, in as much as he/she is conscious, exercises this right also by asking questions or by requesting explanations from the professionals working in the establishment where he/she is receiving care. This right in itself confirms the right to services.

5. The right to consent to care or to refuse care (Art. 8 and 9);

It is the right to consent to or to refuse appropriate care once one has received the information on his/her health status.

In this manner, no one can be subjected to get care such as: exams, blood samples or any treatment or intervention of any sort, without his/her consent. 

How to exercise this right

• This right to consent to or to refuse care, specific treatments or any other type of intervention is coupled with the user's right to be made aware of his/her health status and well-being (Art.8). So, exercising this right depends on the information imparted to the User, whether it be voluntary information given by the professional or answers to the user's questions so that this last one may give a free and enlightened consent.
• This right to consent to or to refuse appropriate care is based on the professional's duty to impart clear and pertinent information to the User, taking into account  the User's degree of knowledge, or lack thereof, and of his/her capacity to understand, not taking for granted that the user already understands.

At the root of all care, treatment or intervention lies a free and enlightened consent, except in emergencies and/or other exceptional situations.

This consent can be given in various forms.

Firstly, there is the consent given by the person in need of the care, treatments or intervention.

Secondly, when the User is incapacitated or inapt, there is the substituted consent of another person who is authorized by the Law or the consent given by proxy, in the case where a mandate is signed and approved in the advent of inaptitude.

6. The right to actively participate in decision-making (Art. 10);

It is the right to take part in all decision-making which has to do with one's health status or physical and mental well-being. This right also allows one to participate in the setting-up of their interventions plan (care), personalised services, or even their modifications.

How to exercise this right:

• Firstly, by cooperating with the establishment's professionals and by respecting the setting-up of the personalised care plan interventions' and services.
• Obviously, the right to participate in decision-making includes the right to question professionals, so as to better be able to cooperate with the interventions plan (care).
  Therefore, in order to participate in decision-making, the User must be informed (LSSSS Art. 8) and, in particular, have the right to:
  •  To receive information on his/her health status.
    
  • To receive information on the diagnoses of his/her health status.
    
  • To receive information on the prognoses.
    
  • To receive information on the foreseen treatments along with the risks and consequences associated with these treatments.
    
  • To receive information on incidents and their consequences which may occur during the provision of services.
  • To receive information on the resultsof blood samples and/or exam results.

7. The right to be accompanied, assisted and represented (Art. 11 & 12);

It is the User's right to be accompanied, assisted by someone of his/her choice or to be represented when he/she wishes to obtain information or to set up the process of receiving services provided by the establishment or a professional.

How to exercise this right

• By asking someone to accompany us, assist us or represent us.

However, the person accompanying us, assisting us or representing us cannot be the person dictating the needed services or treatments. He or she is there to gather information or to question a service provided by the establishment or professional.

8. The right to shelter (Art. 14);

It is the User's right to get shelter from the establishment until his/her  health status permits him/her return home or a transfer to another establishment or intermediary resources or family-type resource so that he/she is able to receive the care which his/her health status requires.

The User has the right to shelter even if he/she has received leave from his/her professional until accommodation in another establishment, intermediary resource or a family-type resource has been found for this User and where he/she can receive the care his/her health status requires.

Therefore, the right to shelter does not confer the right to remain in the particular establishment of the moment. Remaining in the establishment after having received leave from the professional, is conditional. One must always remember that other Users also have the right to access the services of the Health and Social Services and therefore have also the right to shelter. This is why certain conditions apply to this right.

How to exercise this right

• For as long as the User needs to receive care in order to stabilize his/her condition, or has not secured a place in another establishment so that he/she may receive the services required by his/her health status, the User has a right to shelter.
• In this way, the User's collaboration is needed. He/she must divulge any perceivable change in his/her health status and, if this is the case, he/she must declare to be incapacitated to return home. If a User is not able to do this, a member of his/her family or a legal representative can do so in his/her stead.

9. The right to receive services in English (Art. 15);

It is the User's right to receive services in English. Therefore, the law dictates that the establishments in collaboration with the Health and Social Services agencies must put in place a program in which Anglophones and their regions can access services in English.

This right provides the User with the choice to receive the services  and information in the language of his/her choosing. However, as mentioned above, an Access Program must be in place in order for the User to receive services in English.

For this reason, certain establishments have been selected in order to offer services in both official languages and the other establishments must provide some services in English.

How to exercise this right

• First of all, you should be made aware of this right at the establishment to which you go, by asking if the Access Program is in place.
• However, you can always get in touch with the Users and In-patients' Committee to ask if the Access Program exists and to ask about its limitations.

10. The right to access your User's file (Art. 17 to 28); 

It is the User's right to have access to his/her own file within certain limits. This right also includes the right to be accompanied by a qualified professional in order to understand the information.

Certain particularities exist in regards to accessing one's file.

In general, all persons have the following rights:

• The User who is 14 years old and above can access his/her file. However, the law foresees certain particularities which permit staff on site to momentarily refuse access to the file when it could cause a serious damage to the User's health. In this case, the establishment, upon the doctor's recommendation, determines when access to the information on the file (or part of it) can be divulged (Art. 17).
  
• The right, by consent, to give access to one's file to another person (Art. 19, alineas [paragraph] 1).
  
• The right to transfer a copy, excerpt or synopsis of one's file to another establishment, or even, to another professional (Art. 24).
  
• The right, upon request, to be assisted by a qualified professional in order to understand the information (whether medical or social in nature) with which the establishment has provided him/her (Art. 25).
  
• The right to have access to one's file within the shortest time frame possible (Art. 26).
  
• When access to a file is refused, the User has the possibility to ask to have access to his/her file. Again, the consensus is that the User should have access to his/her file and that refusal of access is only in the case of certain exceptions (Art. 27).

Please note that the LSSSSS takes precedence over other Access laws and Information Protection laws so that the User can have access to his/her file (Art. 28).

How to exercise this right

• By asking the staff in the establishment the name of the person who is responsible for communicating information related to Users' files.
• Moreover, the Users and In-patients' Committee can certainly give answers to the User who asks about how to proceed with accessing his/her file, and can direct the User to the establishment's Archives Department.

11. The User's right to have his file kept confidential (Art. 19);

It is the User's right to demand that, without his/her consent, the information in his/her file not be divulged. This information, unless it is an exception, must be kept confidential. Therefore, a User's file is confidential and no one can have access to it without the User's consent or the consent of the person who is legally authorized to do so.

How to exercise this right

• It goes without saying that this right is exercised without any real action on the part of the User, except when it comes to the authorization of divulging information which must come from the User him/herself or from his/her legal representative.

• Health and Social Services' confidentiality is airtight as it is protected simultaneously by professional secrecy (for the professionals); the establishment's obligation to respect confidentiality and the establishment's employees' obligation to respect confidentiality.

12. The right to voice a complaint (Art. 34, 44, 53, 60 and 73);

It is the User's right to voice a complaint when he/she is unsatisfied of the services which he/she received or should have received or services which he/she is receiving or requiring from the establishment. The right to voice a complaint may seem like a forceful approach, but one must also keep in mind that the reason the legislator has included this provision is precisely in order to improve the quality of the services.

To exercise this right, he/she is allowed to be assisted.

This right is of utmost importance if it is to create trust, on the User's part, toward the Health system. This right permits the User to experience that a certain control exists, and ensures that the establishment is running a well-organized system and that  the professionals are qualified.

Who can voice a complaint?

All Health and Social Services' network Users, a User's representative, an heir or a deceased User's legal representatives.

How to exercise this right

• The User can voice a verbal or written complaint. However, we encourage a written complaint.
• In order to voice a complaint, a User may be assisted or accompanied by (depending on the situation) the local or regional Complaint Commissaire; the establishment's User's Committee or by the Help and Assistance Centre (CAAP) which is linked to the establishment.

Where to go in order to voice a complaint? It depends on the service provided:

I. If the content of the complaint deals with:

A Health and Social Services establishment
An intermediary or family-type resource
An organism (other than at the regional level), society or person with who the organism deals.

The complaint is given to the establishment's Local Complaint and Quality of Services' Commissaire. However, if the complaint is directed towards a doctor, dentist or pharmacists, the Complaint Commissaire forwards it to the establishment's medical investigator.

On the other hand, if the content of the complaint deals with:

• An old-persons' residence
• A private shelter residence
• A Health and Social Services Agency
• A community organism
• An emergency vehicle' services**

You may voice your complaint to the Regional Complaints and Quality of Services' Commissaire.

** For the Montreal and Laval Regions, you may  lodge a complaint against an emergency service vehicle company (ambulance) to the Corporation d'Urgences-santé's Regional Complaints and Quality Services Commissaire.

II. When you are unsatisfied with the result of your complaint which you have voiced and given to the Local or Regional Complaints and Quality of Services' Commissaire, you then may go to the Protecteur du Citoyen.
For a complaint which was dealt with by the medical examiner, you may ask to have it reviewed by the establishment's Revision Committee.

Please note that doctors', dentists' or other health professionals' private clinics are not covered by the enacted regulation on the treatment of Complaints contained within the Law on Health and Social Services, unless they are bound by a service contract with a Health and Social Services' Network establishment.

Filing a Complaint Against a Health Care Institution

P.S. The rights held by all persons in the LSSSS (Art. 12) can be exercised by a representative.

The following persons are assumed to be representatives, according to the circumstances and with all proper reservesas per the Civil Code's priorities:

1. The person holding parental authority over the under-aged User or this User's guardian;
2.  The trustee, guardian, partner or a close relative of an inapt adult User;
3.  The person authorized by a mandate given to him /her by an adult User before this one became inapt;
4.  The person who demonstrates an interest towards an inapt adult User.

The representative acts in lieu of the User: He or she becomes the User's substitute. It is therefore important that the representative respect the User's wishes.