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In accordance with the Health and Medical Services Act patients must be informed of their state of health and of the treatment methods available (including diagnostic methods) available within the county council area. If this information cannot be supplied to the patient, it must be supplied to a close relative. This obligation is echoed in the Health and Medical Personnel Act (1994:953).
The latter Act requires that medical care personnel shall, to the extent possible, cooperate with the patient when planning the treatment and when treating him/her. As part of this, the person with the responsibility for the care must make sure that the patient receives information about her/his state of illness and the methods of treatment available. If for some reason the information especially the case when the patient is very young, or unconscious. The information, however, may not be given out if there are grounds to believe that providing such information would be in conflict with the restrictions contained in any state.
No regulations exist which require notations to be made in the patient’s journal of what information has been given to the patient. The Patient Journal Act has, however, some general instructions concerning for example the fact that the journal must contain the information which is needed for good and safe care and that information in the journal be written in a way which respects the personal integrity of the patient.
If a patient makes it quite clear that he or she does not want to know the whole truth, supplying information is regarded as inappropriate. In a situation of this kind a doctor may refer to the provisions in the Health and Medical Services Act requiring that respect and consideration be shown to the patient.
Among the rules introduced in 1999, the health care personnel’s obligation of providing information is specifically emphasized. The provisions states that the obligation of disclosure should be adapted to the patient’s ability to understand and assimilate it. When there is a choice of equally good treatment, the patient has the final decision. However, the effect of an alternative has to be related to the costs for the health services system, which is evaluated by the doctor. All information given and the patient’s decision are to be documented in the patient’s medical record. The provisions are aimed and individualizing the information as well as at increasing patients’ influence in the doctor-patient relation.
Another provision, which did not previously exist within Swedish healthcare, is the right to a second opinion. This possibility has existed earlier in practice in that a patient can turn to another doctor than the one who first gave his opinion. However, the new provision is restricted to patients with a life-threatening or particularly serious disease and where the medical decision is of great importance to the patient or may involve special risks.
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