The rights of next of kin in Norway
The less a patient is able to look after themselves, the more rights their next of kin will have. The rights of next of kin apply within both the specialist health service and the municipal health and care services.
The right of next of kin to receive guidance and information
All next of kin are entitled to be given general guidance and information when they come into contact with health and care services. Although healthcare professionals are subject to a duty of confidentiality concerning the patient’s illness or other personal circumstances, they are always permitted to speak with you as the patient’s next of kin. For example, healthcare professionals may provide general information such as:
- Contact details for the health service
- Procedures, staff and services
- The possibility of applying for assistive aids, welfare technology, etc.
- Legislation, case handling and rights
- Services available to next of kin, children and adults
- Information concerning user and next of kin organisations
Healthcare professionals will not breach their duty of confidentiality by listening to a patient’s next of kin. Healthcare professionals will also not breach their duty of confidentiality by talking to you about information you are already aware of. If you have been informed of the patient’s diagnosis, healthcare professionals can talk generally about the causes of the condition, symptoms, normal treatment and prognosis without breaching their duty of confidentiality.
Right to receive training and guidance
If you as a next of kin provide care which involves particularly demanding tasks, you will be entitled to receive the necessary guidance and training from the municipality. When your municipality considers what constitutes particularly demanding care, the municipality will place greatest emphasis on:
- scope (hours per month)
- physical and psychological burden of the work
- whether the work must be done regularly or periodically
- duration of care
- whether you have a duty of care
- whether you have incurred a loss of income as a result
The guidance and training will enable you as a next of kin to provide the care recipient with appropriate care and help you look after your own health and life situation.
You might for example receive training and guidance regarding the care recipient's illness or disability, such as learning how to control diabetes or what a dementia diagnosis entails. You might also receive training on how to perform certain tasks, such as heavy lifting or stress management training.
The municipality must decide when you as next of kin need training and guidance which lasts more than 14 days.
Right to information concerning the patient's health and healthcare
As next of kin, you will be entitled to be given information to the extent that the patient permits it (consents).
The patient or user will decide who their closest next of kin are and can designate more people as next of kin if appropriate. He or she can also change who they have chosen as their next of kin.
The age of majority under health law is 16 years. Patients over the age of 16 can generally make decisions concerning their own health data, and healthcare professionals will be subject to a duty of confidentiality. The patient’s consent therefore determines what information you as next of kin are entitled to receive. For example, the patient may consent to you receiving information about a single episode of the disease, a diagnosis or an injury.
Right to access the patient's medical record
The rules concerning the right of next of kin to be given information concerning the patient's healthcare also cover the patient’s medical records. The patient’s consent determines what information in their medical records you can gain access to. As next of kin, you will also be entitled to see the patient’s medical records after their death, unless there are specific reasons why you should not be given such access.
The patient's right to access medical record information from you as next of kin
When you as next of kin disclose information to the health service, the information will be added to the patient’s medical records if it is relevant and necessary for the patient’s healthcare. The patient will be entitled to access their own medical records, and this right normally also covers information provided by others, e.g. next of kin.
The patient may be denied access to such information out of consideration for the next of kin, or if giving the patient access to the information could put the life or health of the patient at risk.
The rights of parents in connection to children's healthcare
Right to information concerning a child's health and healthcare
Parents and others with parental responsibility are generally entitled to information about their child's health status and the healthcare they are receiving until the child reaches 16 years of age, but the rights change as the child grows up.
When your child is aged between 12 and 16, you will not be entitled to access your child's health data if he or she does not want you to and has reasons which should be respected. The same applies in the case of children under 12 years of age if there are compelling reasons which indicate that the information should not be disclosed to the parents. The child's consent exempts healthcare professionals from their duty of confidentiality in the same way as for adult patients.
However, as a parent, you have the right to be given the information you need in order to fulfil your parental responsibilities until your child turns 18. This could for example concern information regarding more severe mental disorders, risk of self-harm, the taking of illegal intoxicants, information concerning risk of suicide and admission to psychiatric day-care centres, and information concerning the current location of the child.
Right to consent to healthcare on behalf of a child
Parents are generally entitled to accept or refuse (consent) to healthcare on behalf of their child until the child reaches 16 years of age. When healthcare is considered to be part of the daily and ordinary care of the child, it is sufficient for one of the parents to consent. The same applies to healthcare that is necessary to ensure that the child does not suffer injury.
As the child develops and matures, parents must listen to what the child has to say before giving their consent. When the child reaches 7 years of age and is able to form their own views on what the consent concerns, the child must give his or her opinion concerning all matters which relate to their own health. If the child is aged 12 or over, the greatest emphasis must be placed on the child’s opinion.
Right to information concerning available services
Parents are entitled to the information that is necessary to ensure they are informed of the services that are available for their child, and in order to safeguard their child's rights.
Right to represent a patient who is unable to look after themselves
When a patient over the age of 16 is unable to safeguard their own interests, you as next of kin have the right to receive the information that is necessary to give you an insight into the health of the patient and the scope of the healthcare that is being provided, so that you can safeguard the patient's rights and interests.
The next of kin of patients who are not competent to make decisions regarding consent are also entitled to be involved in decisions concerning the patient. The healthcare professional will make the decision concerning the provision of healthcare, but in these cases, you as next of kin will have the right to:
- receive information about the patient’s health status and healthcare
- explain what healthcare the patient would have wanted to receive
- be involved, together with the patient, in the provision of healthcare
- be involved in the formulation of services and the preparation of an individual care plan
Right to relief measures to ease the burden of care
Next of kin who have particularly demanding care tasks may be entitled to measures to ease their burden of care, that is relief measures. This right can apply to both carers who do not have a duty of care and to parents who have a duty of care regarding children with challenging medical needs.
The relief measures will enable you to set aside time for recreation, holidays, work, family life, and community activities.
Municipal services such as practical assistance and welfare technology, such as warning and localisation equipment, may be provided in order to give carers relief.
Relief measures are free of charge. The municipality cannot charge a user fee for the provision of relief services. This also applies to practical assistance, day centre services or short-term stays at institutions, that is services which provide relief and for which a user fee can otherwise be charged.
Right to involvement in the case of compulsory healthcare
Right to involvement in the case of compulsory mental healthcare
Next of kin have a number of rights in connection with the establishment and provision of compulsory mental healthcare:
- Right to general guidance, including from the health service, the Control Commission for compulsory institutional care, and the county governor
- Right to ask the municipal medical officer to approve a compulsory medical examination to determine whether the conditions for compulsory mental healthcare are met
- Right to comment before a decision is taken regarding the establishment of compulsory observation or compulsory mental healthcare, and concerning the termination of compulsory mental healthcare
- Right to be notified that a decision has been taken concerning compulsory observation or the establishment, maintenance or termination of compulsory mental healthcare, and concerning the transfer of a patient between institutions or between compulsory mental healthcare with and without stays at a day-care centre
- Right to appeal to the Control Commission against decisions referred to in the previous point
- The right to receive information concerning many implementation decisions under Chapter 4 of the Mental Health Protection Act, for example concerning compulsory medication, with the patient’s consent, and the right to appeal against such decisions to the Control Commission/county governor
- Right to refer the Control Commission’s decisions concerning compulsory observation, the establishment or maintenance of compulsory mental healthcare and decisions concerning transfers to stays at day-care centres, to the courts
- If next of kin appeal against a decision to terminate compulsory mental health protection, they can ask the Control Commission to defer the date of termination until the appeal has been decided
Right to report and have investigated serious cases of substance abuse
Relatives can report cases of serious substance abuse to the municipality. In such cases, the municipality must investigate the matter and decide whether a case should be made for compulsory detention at an institution. Once the matter has been investigated, the next of kin will be entitled to receive feedback on the outcome.
Right to involvement in connection with the exercising of coercion and power on persons with developmental disabilities
Guardians and next of kin must be involved in the decision-making process together with the service recipient when the exercising of coercion or power under Chapter 9 of the Health and Care Services Act may be appropriate. The views of the patient or user and his or her representative must be stated in the municipality's decision. As next of kin, you have the right to:
- give your opinion concerning cases which are to be reviewed
- refer the decision to the county governor as the supervisory authority
Right to involvement in the healthcare of persons who refuse healthcare but are not competent to give or refuse consent
If the patient is not competent to give consent and refuses healthcare, there are rules concerning how you are to be involved as next of kin.
- Wherever possible, next of kin must be notified in advance before a decision concerning healthcare is taken.
- If possible, next of kin must be given the opportunity to provide information concerning what the patient would have wanted.
- Next of kin have the right to be involved in the provision of healthcare.
- Healthcare professionals must consider whether involving next of kin could help to reduce a patient’s reluctance to accept healthcare.
- Next of kin must be informed as soon as possible when a decision is taken. You are entitled to be informed about your right to appeal and give your opinion, and about your right to see documents in the case.
The right of next of kin to financial benefits
If you are a next of kin with particularly demanding care tasks, you can apply for care benefit (in Norwegian).