1. No one can be subjected to compulsory treatment and sanitary measures except in the cases defined by law (art. 52 (4) Constitution). The principal regulations on the right of informed consent can be found in article 87 of the Health Act, which stipulates that the medical activities shall be performed upon the informed consent expressed by the patient. In order to obtain the informed consent, the physician in charge of the treatment shall inform the patient.
   The patient is free in his/her choice of treatment. Tthe medical information shall be provided in a timely manner and in an appropriate amount and format to ensure the freedom of choice of a treatment.
2. The provision of information by the medical doctor to the patient regarding his/her condition and forthcoming treatment is explicitly regulated in article 88 of the Health Act. The medical information  shall be provided in a timely manner and in an appropriate amount and format to ensure the freedom of choice of a treatment.
3. The form of the informed consent can be oral or written, but it should be “expressed”. In general, the law explicitly enumerates the cases where qualified form (written form or written form with notary certification) is required. The oral form shall apply to the cases not explicitly mentioned by the law.
4. The activities (surgical intervention, general anesthesia, invasive and other diagnostic and therapeutic methods leading to higher risk for the patient’s life or health or temporary change of the mind) may be performed to the benefit of the patient’s health without any informed consent given in writing only if there is an immediate threat to the patient’s life and if his/her physical or mental condition prevents him/her from expressing an informed consent. If urgent, the doctor could give emergency help without the consent of the patient, if the surrounding emergency circumstances, including the physical or mental status of the patient does not allow receiving his/her agreement.
5. Refusal of consent has to be certified in writing. If the patient refuses to certify the refusal in writing, this fact shall be certified with the signature of the physician in charge of the treatment and a witness.
6. According to Bulgarian civil law, a minor is a natural person, who has not reached the age of 18. The Health Act regulates the informed consent of minors and underage patients separately. When the patient is underage his or her informed consent shall be given together with the consent of a parent or custodian.
   

   Article 87 of the Health Act makes a distinction regarding incapacitated adults between patients who have been put under partial legal incapacity and patients who have been put under full legal incapacity. When a patient is put under partial legal incapacity, his/her informed consent is required together with the consent of a custodian or a parent. The patient under full legal incapacity cannot give informed consent him or herself. Informed consent is given by a trustee or a parent, unless the law prescribes otherwise. The difference between custodian and trustee is in the scope of their rights. A third category of incapacitated adults are those who have mental disorders and are incapable of giving informed consent. Informed consent shall be expressed for these patients by the persons, determined by the Court in case of compulsory treatment.

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