The right to freely make an informed decision, by mutual agreement

The law explains that, in concert with the healthcare professional, the patient must make decisions concerning their health, on the basis of:

• the information the patient has provided to the healthcare professional, and
• the information and advice given to the patient by the healthcare professional.

Thus, the law grants the patient the right to actively take part in decision-making, as part of a shared decision.

The relationship of trust feeds into a process of ‘shared decision-making’, whereby the healthcare professional and patient share information, and the patient receives the necessary support to consider the various options, and is able to express their preferences.

Before beginning to administer care, the healthcare professional must obtain the patient’s free and informed consent.

What information must be provided to the patient in advance?

The healthcare professional is required to provide the patient with the following information in good time, if possible, to allow for sufficient reflection:

• adequate information about the purpose and foreseeable consequences of the proposed courses of treatment,
• the benefits of each option,
• whether they need to be implemented as a matter of urgency,
• the generally known frequent and serious risks or outcomes, weighed up in light of the patient’s specific characteristics,
• the alternatives or therapeutic options which might be considered,
• the foreseeable consequences should the patient opt against the treatment.

Upon the patient’s express request, the healthcare professional will also provide information about the following aspects:

• the overall cost entailed by the proposed healthcare and the intended treatment arrangements, e.g. an estimation of the costs payable by the patient, the excess cost for first class, etc.,
• the foreseeable availability of the proposed healthcare,
• the quality and safety of the healthcare, including the number of interventions which the provider has carried out, and the rate of any known complications which have arisen,
• the likely length of stay if the patient needs to be hospitalised,
• the healthcare provider’s authorisation or registration status,
• the coverage offered by professional liability insurance.

The patient may withdraw their consent at any time. If they do so, the physician must warn the patient of the possible consequences of that choice.

In case of emergency, when it is not possible to obtain the patient’s informed consent and their wishes are not known, the healthcare professional may always take any such measures as are necessary in view of the medical situation.

How is information given to the patient, and by whom?

The healthcare professional will provide the information, typically orally, in clear, comprehensible language, in keeping with the patient’s ability to understand. As far as possible, information should be given in good time to allow for sufficient reflection.

Personalised information should, in principle, be given orally. It may also be confirmed in writing, notably in order to provide the patient with a resource to which to refer when considering their options, and for the healthcare provider to have proof of the contents of the consultation.

The law stipulates that the information may be given in French, German or Luxembourgish. Patients may be accompanied by a translator or interpreter, if necessary.

In principle, the patient’s consent or refusal is expressed orally, but sometimes in writing. Consent may be implicit, where it can clearly be deduced from the patient’s actions – for example, when the patient holds out their arm to receive an injection.

In all cases, the healthcare professional must ensure that the patient has received and understood the information given previously about their state of health.