1. The law on the rights of patients contains rules to protect the rights of patients who are legally or factually not capable of exercising their rights as a patient.
2. The rights of adult patients who have the legal status of ‘extended minority’ or have been declared incompetent are exercised by their parents or guardians. Such patients have to be involved as much as possible and depending on their comprehension, in the exercise of their rights.
3. The rights of adult patients who are not capable of exercising their rights as a patient; are exercised by the person previously designated by said patients to act on their behalf when and for as long as they are unable to exercise these rights themselves. This so-called ‘patient-designated representative’ has to be designated using a specific written mandate, dated and signed by the patient and by this person, clearly showing the latter’s consent. Patients or patient-designated representatives may revoke this mandate.
   If there is no patient-designated representative or if he fails to act, the rights of the incapable adult patient can be exercised by the cohabiting spouse, the legally cohabiting partner or the actual cohabiting partner. If this person refuses or if there is no such person, the rights can be asserted, in descending order, by an adult child, a parent or an adult brother or sister of the patient. If these persons refuse or if there are no such persons, the health professional concerned has to take care of the patient’s interests, possibly after multidisciplinary consultation. This is also the case when there is a conflict between two or more representatives of equal rank, for instance a conflict between two children of the patient.
   An adult, incapacitated patient has to be involved as much as possible and depending on his comprehension, in the exercise of his rights.
4. Whereas a patient may take ‘irrational’ decision, the legal representative of an incapacitated patient has always to act in the interests of the patient. In order to guarantee this, the law provides for a possibility and sometimes even an obligation for the health professional concerned to deviate from the decision taken by the representative.
   For the purpose of protecting the patient’s privacy the health professional concerned may reject the request, in whole or in part, of a legal representative for having access to the medical records of the patient or for having a copy of it. In such a case, the right to access the medical records or to get a copy has to be exercised by a health professional chosen by the representative.
   A health professional, possibly after multidisciplinary consultation, has an obligation to deviate from the decision taken by the legal representative of the patient, in the interest of the patient, to avert a threat to the patient’s life or serious damage to his health. However, when the decision was taken by a so-called ‘patient-designated representative’, the health professional may deviate from this decision only in so far as this representative is unable to refer to the patient’s express will, such as an express refusal of a life-saving treatment.
5. The law on the rights of patient prescribes for certain well-defined cases that the health professional must add a written motivation to the patient’s records (article 15).

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