2- Rights of Patients with Mental Disorders

The chapter on the rights of patients with mental disorders is one of the most important achievements of the law, despite some shortcomings. Instead of substituting for the gaps in the chapter, the IR has further impoverished the list of patients' rights. We therefore provide a list of those rights below, demanding that they be included in the IR in place of the two short articles (35) and (36).

Chapter V: Rights of patients with mental disorders

Human rights standards and internationally accepted standards for medical practice constitute the main reference on which all rights of patients with mental disorders are based. A patient with a mental disorder, receiving treatment in one of the mental-health facilities listed in article 2 of the Law for the Care of Psychiatric Patients, enjoys all rights and liberties to which all citizens are entitled by law, the Constitution and international treaties and conventions to which Egypt is party. Patients cannot be denied those rights and liberties except in accordance with applied legislation, granting them the full right to appeal any decisions to that effect.

A patient is entitled to enjoy the following rights in particular:

1- The right to receive a comprehensive explanation, in a language understood by him/her, of all the rights granted by the law immediately upon his/her admission, including his/her right to appeal undertaken procedures. In case the patient lacks the capacity to understand those rights, they must be explained to his/her relatives or representatives.

2- The right to receive the necessary medical and psychiatric care in a safe and clean environment, which should be as similar as possible to his/her normal environment, including provision of educational and cultural facilities, facilities for vocational training, communication and recreation. The National Council for Mental Health should specify those criteria as conditions for accreditation of Mental Hospitals.

3- The right to enjoy freedom of movement except in cases where the law permits its restriction. The involuntarily admitted patient shall enjoy sufficiently supervised freedom of movement, in accordance with his/her mental condition and with regard to the patient's own safety or the safety of others.

4- The right to receive treatment in accordance with internationally accepted medical and ethical standards and by qualified personnel.

5- The right to be fully informed of his/her diagnosis, its possible prognosis and the treatment plan, which must be tailored to the patient's needs and include rehabilitation and follow-up management. The institution providing treatment should permit the patient's participation in the process, and the plan must be documented in the patient's file, all with consideration to his/her mental abilities.

6- The right to not be given treatment without the patient's informed consent, which is consent obtained freely, without threats or improper inducements, after appropriate disclosure to the patient of adequate and apprehensible information in a form and language understood by the patient. This information must include diagnostic assessment; purpose, method, likely duration and expected benefit of the proposed treatment; alternative modes of treatment; and possible side effects. The patient has the right to refuse the proposed treatment after being told the health consequences of refusing. This should be done in accordance to the patient's mental capacity.

7- The right to leave the mental-health facility unaccompanied once the conditions that necessitated the patient’s involuntary admission no longer exist. The institution must draw up a plan for subsequent mental-health care, including social and medical care.

8- The right to not be subject to any clinical trials or experimental treatment without informed consent and the approval of the Committee for the Ethics of Scientific Research. The treatment, including its expected effects, must be explained to the patient. The patient must receive an independent evaluation of his/her condition and the approval of the Local Council for Mental Health. No such experiments will be carried out on involuntarily admitted patients or patients receiving compulsory treatment.

9- The right to confidentiality of information related to the patient and his/her medical file. All mental-health facilities should have systems that maintain the privacy of such information, which is not to be disclosed except for therapeutic purposes and in cases dictated by the law.

10- The right to privacy and protection of personal belongings, the right to use his/her personal belongings and to keep them in a safe place. The patient shall not be deprived of this right, with due consideration of all safety regulations.

11- The right to receive a complete and comprehensive report regarding his/her mental state, upon a written request by the patient or his/her custodian or representative, submitted to the director of the mental-health facility. The report should include at least a description of the patient’s medical condition, case development, the treatment plan and any interventions undertaken in the facility. The National Council for Mental Health should decide which elements should be covered in such reports.

12- The right to receive a photocopy of his/her complete file, upon a request submitted to the Local Council for Mental Health. The council will respond to the request within two weeks. After examination of the patient by an independent committee, the council has the right to withhold some of the information for a renewable limited period of time (three months), if the council estimates that it might constitute a threat to the safety of the patient, his/her health or the safety of others. The patient has the right to appeal that decision.

13- The right to appeal or file a complaint to the Patients' Rights Committee in the facility, the National Council for Mental Health, the Local Council for Mental Health, the public prosecution or the court of misdemeanor. The Patients' Rights Committee is obliged to raise the patient's complaint with the body specified by him/her, as well as provide the patient with legal aid upon his/her request, while securing all procedural safeguards including his/her right to choose a lawyer and to receive copies of reports or necessary documents related to his/her condition. The patient and his/her lawyer have the right to submit independent reports and certificates concerning his/her mental condition, in addition to the right to attend the sessions addressing his/her appeal or complaint. The patient and his/her lawyer also have the right to ask for witnesses.

14- The right to receive or to refuse to receive visitors. The patient should not be deprived of his/her right to receive visitors except in exceptional circumstances, as long as the visit does not contradict the treatment plan. The situation must be documented in the patient's file.

15- The right to be protected from economic and sexual exploitation as well as physical or psychological harm or demeaning treatment by the staff or other patients. Economic exploitation includes forced labor or labor without financial remuneration or cases where the labor is not part of the rehabilitation program of the patient. If the patient labors in the treating facility, this has to be based on a legal contract, a copy of which is to be kept in the patient's file, with a second copy kept with the Patients' Rights Committee. Any work agreement must take into consideration the safety of the patient, others and standards for occupational safety.

16- The right to uncensored communication with other individuals in the facility and the outside world through various means, as well as the provision of all services for internal or external communication, to as great an extent as possible—such as mail, phone calls, newspapers/magazines and TV—except for circumstances where such communication could harm the patient or others, according to the prescribed treatment plan.