Act No. 373 / 2011 Coll.

Law on Specific Health Services

Valid Law Effective from 01.04.2012
373
THE LAW
of 6 November 2011
on specific health services
Parliament has decided on this law of the Czech Republic:

HLAVA I

GENERAL PROVISIONS
Basic provisions
§ 1
This law
(a) regulate the provision of specific health services and the associated exercise of public administration, the rights and obligations of patients and providers of health services (the provider) and the rights and obligations of other legal and natural persons in connection with the provision of specific health services;
(b) it shall incorporate the relevant provisions of the European Union1), lay down general principles for the radiation protection of persons in the context of medical radiation, a regime for the implementation of radiological procedures and activities involving medical exposure and the degree of responsibility of providers and health professionals in relation to such procedures and activities, and lay down measures to ensure safety and health at work.
§ 2
(1) Specific health services are health services provided under this Act.
(2) The provisions of the Health Services Act shall apply in relation to the provision of specific health services, unless otherwise provided for in that Act.

HLAVA II

HEALTH SERVICES PROVIDED UNDER SPECIFIC CONDITIONS

Díl 1

Acquired reproduction
§ 3
(1) Aimed reproduction means the methods and procedures by which germ cells are collected, handled, produced by human embryo by fertilisation of an egg of sperm outside the body of a woman, handled, including storage, of human embryos, for the purpose of artificial fertilisation of a woman
(a) for health reasons in the treatment of its infertility or infertility, if:
1. it is unlikely or completely excluded for a woman to become pregnant in a natural way or to have a viable foetus; and
2. other treatments for her infertility or infertility have not led to or with a high degree of probability lead to her pregnancy; or
(b) as regards the need for an early genetic examination of the human embryo where the health of the future child is at risk because of the demonstrable risk of transmission of genetically conditioned diseases or defects borne by that woman or man.
(2) Germ cells are ova and sperm for assisted reproduction purposes.
(3) Artificial insemination of a woman means:
(a) the introduction of sperm into the female sex organs; or
(b) the transfer of a human embryo resulting from fertilisation of a sperm egg outside the body of a woman to the female's sex organs.
(4) For artificial insemination of a woman can be used
(a) ova obtained from this woman (2);
(b) sperm obtained from a man (2) which undergoes fertility treatment with a woman together,
(c) germ cells donated by a person (2) other than those referred to in (a) and (b) ("anonymous donor"); an anonymous donor may only be a woman who has completed the age of 18 and has not exceeded the age of 35, or a man who has completed the age of 18 and has not exceeded the age of 40.
(5) Germ cells and human embryos can only be used for artificial insemination. This does not apply if human embryos are not used for artificial insemination that can be used for human stem embryonic cell research under the conditions and for the purposes laid down by the Act governing human stem embryonic cell research (3).
§ 4
The treatment of assisted reproduction methods may only be carried out by a provider authorised to provide health services in the field of reproductive medicine or in the case of artificial insemination in accordance with § 3 (3) (a) in the field of gyno and obstetrics.
§ 5
(1) The methods and procedures of assisted reproduction may be implemented if the requirements laid down in the Human Tissue and Cell Act (2) have been met.
(2) The use of assisted reproduction methods and procedures shall not be permitted for the purposes of the choice of the sex of the future child, except in cases where the use of assisted reproduction methods and procedures can be avoided by serious genetically modified diseases linked to sex.
§ 6
(1) Artificial insemination may be carried out on a woman of her childbearing age if her age does not exceed 49 years, at the written request of the woman and the man who intends to undergo this service together (hereinafter referred to as "infertile couple"). The application of a infertile couple applying for artificial insemination shall not be more than 6 months old; is part of the medical documentation of a woman.
(2) Artificial insemination may not be carried out on a woman who has had a relationship with a man with whom he has submitted an application pursuant to paragraph 1, excluding a relationship of kin under another legal provision concerning the conclusion of marriage.
§ 7
(1) Germ cells may be collected and used for assisted reproduction methods and procedures if medical fitness has been assessed
(a) persons to whom germ cells are to be collected; and
(b) women to be artificially inseminated (hereinafter referred to as "the recipient").
(2) The beneficiary shall not be a person whose incapacity is restricted in such a way that he is not able to assess the provision of health services or, where appropriate, the consequences of such provision, or to parental responsibility, even in part. The beneficiary may also not be a person placed in a police cell, in the exercise of custody, in prison or in detention.
(3) The anonymous donor must not be a person,
(a) whose competence is limited in such a way that it is not capable of assessing the provision of health services or, where appropriate, the consequences of providing them;
(b) which is located in a police cell, in the exercise of custody, in a prison sentence or in a detention facility or in a asylum facility;
(c) which have been ordered to be isolated, to be quarantined or in the performance of bed protection treatment; or
(d) which is hospitalized without consent.
§ 8
(1) Before commencing the methods and procedures of assisted reproduction, the provider shall submit to the infertile couple information on the nature of the proposed methods and procedures, their permanent consequences and potential risks and the manner in which superfluous human embryos may be handled, including the estimated financial costs of their storage and the duration of their storage. Part of the lesson of the infertile couple is also information on the determination of parenthood to a child under the Civil Code, if the child was conceived by artificial insemination. An infertile couple may require that a witness of his choice be present when submitting the information. The record of the submission of the information shall be signed by the infertile couple, the attending physician or, where appropriate, the witness; the record is part of the health file of the recipient.
(2) On the basis of the information referred to in paragraph 1, the infertile couple shall give written consent to performing assisted reproduction; written consent shall be given repeatedly before any artificial insemination is carried out. Consent is part of the medical documentation of the recipient.
(3) Individual performances of assisted reproduction may be performed by the beneficiary if they have given their consent prior to their commencement. The consent shall be entered in the health file of the beneficiary by the doctor who signs the alert; the record shall also be signed by the beneficiary.
§ 9
(1) If not all human embryos produced for the benefit of the infertile pair have been used in the artificial insemination of the recipient, they may be stored and used for further artificial insemination of the recipient. This is not the case if the infertile couple declares in writing that they do not intend to use the embryos for their further artificial insemination and at the same time give their consent to be used for another anonymous infertile couple, or consent to the use of excess embryos for research under the Human Embryonic Stem Cell Research Act or their disposal. The declaration may be withdrawn at any time by the infertile couple; This does not apply if human embryos have been used in another infertile pair or disposed of in accordance with the declaration. A human embryo resulting from the recipient's ova or sperm of a man from an infertile pair may be used for the artificial insemination of another recipient, provided that the fitness of the infertile pair has been assessed to the extent specified for anonymous donors.
(2) If the human embryos have not been used or the infertile couple has not made a written declaration of destruction as referred to in paragraph 1, the provider may, after 10 years of storage, repeatedly demonstrate in writing that the infertile couple has made observations on the continued storage of those embryos, including the granting of consent to their destruction. If the infertile couple does not respond to a repeated proven written request from the provider, the human embryos may be disposed of without expressing the infertile couple.
(3) A repeated written invitation referred to in paragraph 2 shall mean its demonstrable transmission through the postal service operator to the address of the infertile couple known to the provider at least twice with a time interval of at least 60 days. The time limit for expressing the infertile couple on the basis of the second call shall be 30 days from the date of its delivery.
(4) The invitation shall be received on the date on which the addressee takes it over, otherwise it shall be deemed to have been received by the expiry of a period of 10 days from the date of notification of its deposit with the postal operator. Where an invitation with regard to a change in the address of the infertile couple is untouchable or refused to take over, the invitation shall be deemed to have been received on the date of its return to the provider. Similarly, if the call is not delivered to only one person from a barren pair, the procedure shall be followed.
(5) On the basis of the written declaration referred to in paragraph 1 or the written consent made following the invitation referred to in paragraph 2, the provider shall ensure the disposal of frozen human embryos in the presence of at least two health professionals. The health file kept on the recipient shall include a written declaration or written consent, or, where appropriate, a delivery or other document certifying that a written invitation to the infertile couple has been sent and a record of the destruction of human embryos; the entry shall be signed by the health professionals present at the disposal of the human embryos.
§ 10
(1) The provider who is authorised to carry out the methods and procedures of assisted reproduction shall ensure that the anonymity of the anonymous donor and the infertile couple and the anonymity of the anonymous donor and of the child born from assisted reproduction is maintained.
(2) The provider who has carried out an assessment of the medical fitness of the anonymous donor and of the woman or man from the infertile couple shall be obliged to transmit the information on their health necessary for artificial insemination to the provider carrying out artificial insemination; the provider is obliged to retain the data on the state of health of the anonymous donor for 30 years after the artificial insemination has been carried out and, upon written request, to pass on to the infertile couple or adult born from assisted reproduction information on the state of health of the anonymous donor.
§ 11
The collection of germ cells shall not entitle the person who has been withdrawn to a financial or other remuneration. The supplier who has carried out the procurement shall, upon request, pay the anonymous donor effectively, economically and demonstrably the costs incurred in the donation of germ cells. Their replacement may require the recipient to be artificially inseminated or the provider to whom the germ cells or human embryos have been transmitted to perform assisted reproduction. The provider who has taken over the germ cells or human embryos to perform assisted reproduction and who has paid the expenditure referred to in the second sentence may claim compensation for such expenditure for the recipient to be artificially inseminated.

Díl 2

Sterilisation
§ 12
Sterilisation means a health performance preventing fertility without removing or damaging the sex glands. Sterilisation may be carried out for health or other than health reasons. Health reasons are those diseases or defects where there is a high level of likelihood of a serious threat to health or life due to pregnancy or childbirth or healthy development of the fetus or to the health or life of a future child.
§ 13
(1) Sterilisation for health reasons shall be performed on a patient who has completed 18 years of age, provided that written consent is given to carry out sterilisation.
(2) A patient whose incapacity is restricted in such a way that he is unable to assess the provision of health services or, where appropriate, the consequences of such provision (hereinafter referred to as "a patient with limited incapacity"), or a minor may only be sterilised for medical reasons, on the basis of:
(a) the written consent of the guardian of a patient with limited professional capacity (hereinafter referred to as "the guardian of the patient") or the legal representative of a minor patient (hereinafter referred to as "the legal representative of the patient"); This is without prejudice to the provisions of Section 35 of the Health Services Act,
(b) the favourable opinion of the Panel of Experts; and
(c) the consent of the judical22a).
(3) The expert committee is set up by the provider. The members of the expert committee shall be:
(a) 3 doctors with specialised competence in urology, if it is about sterilisation in men,
(b) 3 doctors with specialised competence in the field of gyno and obstetrics, when it comes to sterilisation in a woman,
(c) a clinical psychologist; and
(d) a person designated by a provider who received a higher education in a Master's Law Study Programme (hereinafter referred to as "lawyer").
(4) At least 4 members of the Panel shall not be in employment or similar relations with the provider, a member of the monitoring body of the provider or a statutory body, a member of the statutory body or a member of the provider.
(5) The treating physician of the patient who recommended the conduct of the medical performance is always invited to attend the panel meetings, but the attending physician must not be present during the interview with the patient.
(6) The patient and the legal representative of the patient or guardian of the patient are always invited to the meetings of the expert committee; the deliberations of the expert committee must be initiated in such a way as to avoid endangering the patient's life or health. The expert committee shall provide the patient and his legal representative or the patient's guardian with information on the nature of the medical performance, its lasting consequences and potential risks and shall verify that the patient and the patient's legal representative or the patient's guardian have fully understood this information. The patient will take into account his rational maturity. The record of the submission of information shall be signed by members of the expert committee, patient and legal representative of the patient or guardian of the patient. The patient's opinion is part of the record. If the patient is unable to understand the information or to sign the alert due to his reasonable maturity, this shall be recorded. The record is part of the patient's medical file.
(7) The expert panel shall draw up a written expert opinion assessing whether all the conditions for sterilisation are fulfilled; indicate, at the same time, the period of validity of the opinion, taking into account the urgency of the performance of health. The approval of all members of the Panel of Experts is required for a positive opinion on the implementation of sterilisation. In the event that the consent of all members is not achieved, the Panel shall describe in its opinion the reasons for this. The provider shall forward a copy of the Panel's opinion to the legal representative of the patient or the guardian of the patient.
(8) The application for authorisation to carry out sterilisation is submitted to the court by the provider. The provider shall attach to the application the written consent of the legal representative of the patient or the guardian of the patient, a copy of the record of the submission of the information referred to in paragraph 6 and the opinion of the Panel. If the patient is unable to express his or her opinion pursuant to paragraph 6 in view of his or her reasonable maturity, the provider shall state the reasons for this in the proposal.
§ 14
Sterilisation for reasons other than health can be performed on a patient who has completed 21 years of age, unless there are serious health reasons preventing it from being carried out, following his written request. The application is part of a patient-led medical file.
§ 15
(1) Before performing sterilisation for medical or non-medical reasons, the treating physician is required to provide the patient with information on the nature of the medical performance, its lasting consequences and potential risks. The information shall be submitted before a witness to whom he is a medical professional. If the patient requests the presence of another witness of his choice, the provider will allow it. The record of the submission of the information shall be signed by the treating physician, patient, witness or, where appropriate, by witnesses; the record is part of the patient's medical file. There shall be a reasonable period between the submission of information and the granting of consent; if there is sterilisation for health reasons, the period shall be at least 7 days; If there is sterilisation for reasons other than health, the period shall be at least 14 days.
(2) The conduct of sterilisation may be initiated if the patient or the legal representative of the patient or the patient's guardian has given written consent immediately before the patient is started.
§ 16
Sterilisation cannot be carried out in medical facilities Prison services of the Czech Republic ("Prison Service").

Díl 3

Therapeutic castration, testicular pulpectomy
§ 17
(1) Therapeutic castration or testicular pulpectomy (hereinafter "castration") means the medical performance of removing the hormone-active part of the sex gland in a man in order to suppress its sexuality.
(2) Castration may be given to a patient who has completed 21 years of age in whom:
(a) a specialist medical examination has demonstrated a specific paraphile disorder;
(b) a proven specific paraphile disorder has manifested itself by committing a sexually motivated crime; a sexually motivated criminal offence means, for the purposes of this law, a violent sexually motivated crime and a sexual abuse offence;
(c) a professional medical examination has demonstrated a high degree of probability of committing a sexually motivated crime in the future; and
(d) other treatment methods have not been successful or other treatment methods cannot be used for health reasons; the fact that other treatment methods cannot be effectively applied to the patient for medical reasons, the results of expert examinations must be demonstrated.
(3) Castration may also be carried out in specially justified cases where the conditions laid down in paragraph 2 (a), (c) and (d) are met, the age of 21 years of the patient and the proven paraphile disorder has a serious negative impact on the quality of life of the patient.
(4) The patient's castration is based on:
(a) his written request; and
(b) positive opinions of the Panel of Experts.
(5) The castration referred to in paragraph 2 shall only be carried out to a patient who is in protective treatment or in the performance of a protective response, where the proven paraphile disorder has a serious negative impact on the quality of his life, on the basis of:
(a) his written request;
(b) the favourable opinion of the Panel of Experts; and
(c) the consent of the court.
§ 18
(1) The Technical Commission is set up by the Ministry of Health (hereinafter referred to as the Ministry). The members of the expert committee shall be:
(a) a medical professional who is an employee of the State assigned to the Ministry;
(b) a doctor with specialised competence in the field of sexuality or with special competence in the field of sexuality;
(c) a physician with specialised competence in the field of psychiatry,
(d) a clinical psychologist,
(e) a doctor with specialised competence in urology,
(f) a lawyer with knowledge of medical law.
(2) A member of the Panel of Experts may not be in employment or similar relations with the provider, may not be a member of the monitoring body of the provider or the statutory body, a member of the statutory body or member of the provider.
(3) The patient's request shall be transmitted without delay by the provider to the Ministry; the application shall be accompanied by:
(a) a favourable opinion with castration processed by the treating physician with specialised competence in the field of sexuality or with special competence in the field of sexuality; Part of the agreed opinion is the diagnosis and description of the treatment to date, including a medical report, which clearly shows that other treatment methods cannot be effectively used to treat the patient for medical reasons, and that, if castration is carried out in accordance with § 17 (3) or (5), an assessment of the severity of the impact of paraphile disorder on the quality of life of the patient,
(b) a medical report demonstrating a high degree of probability that the patient will commit a sexually motivated crime in the future, processed by a doctor with specialised competence in the field of sexuality or with specific competence in the field of sexuality, which is not the treating physician referred to in (a) and by an employee of the provider who transmits the patient's application.
The Ministry may, in order to verify compliance with the conditions for the commission of a criminal offence referred to in Article 17 (2) (b), request a copy of the Register of Penalties; a request for the issuance of a copy of the Register of Penalties and a copy of the Register of Penalties shall be transmitted in electronic form in a way enabling remote access.
(4) The patient is always invited to a meeting of the expert committee, which takes place no later than 3 months after the date of the patient's request. The expert committee shall provide the patient with information on the nature of the health performance, its lasting consequences and potential risks and shall verify whether the patient has fully understood this information and whether the patient has come forward on a voluntary basis. The patient who is in protective treatment or in the performance of security detention will be advised that castration does not give entitlement to his release.
(5) The record of the submission of information will be signed by members of the expert committee and the patient.
(6) The expert panel shall, after consulting the request, draw up a written expert opinion assessing whether all the conditions for castration are fulfilled; indicate, at the same time, the period of validity of the opinion, taking into account the urgency of the performance of health. The approval of all members of the Panel of Experts is required for a positive opinion on castration. In the event that the consent of all members is not achieved, the Panel shall describe in its opinion the reasons for this. The expert committee shall forward to the Ministry a technical opinion in 3 copies and a copy of the record of the hearing.
(7) The treating physician of the patient who recommended the conduct of the medical performance is always invited to attend the panel meetings, but the attending physician must not be present during the interview with the patient.
(8) Part of the patient's medical documentation
(a) the patient's written request;
(b) a copy of the consensual opinion of the treating physician with specialised competence in the field of sexuality or with special competence in the field of sexuality;
(c) the medical report referred to in paragraph 3;
(d) an entry from the meetings of the expert committee; and
(e) the opinion of the expert committee.
(9) The Ministry shall transmit:
(a) a copy of the opinion of the Panel of Experts and a copy of the record from the panel's deliberations to the patient;
(b) (2) a copy of the opinion of the Panel of Experts to the health care provider referred to in paragraph 8 and a copy of the report of the Panel's deliberations.
(10) The application for approval of the castration shall be submitted to the court by the provider. The provider shall attach a written request from the patient and the opinion of the expert committee to the proposal.
§ 19
Castration may be initiated if the patient has given written consent immediately prior to its initiation.
§ 20
Castration may not be carried out in the health facilities of the Prison Service and persons in custody and in prison. Castration may also not be performed on a patient with limited capacity.

Díl 4

Gender change in transsexual patients
§ 21
(1) A transsexual patient is a person in whom there is a permanent mismatch between the psychological and physical sex (hereinafter referred to as "sexual identification disorder").
(2) Surgical procedures towards gender change may be performed on the patient,
(a) which has been clearly identified as having a sexual identification disorder and demonstrated the ability to live permanently as a person of the opposite sex; and
(b) who has not entered into a marriage or who has not entered into a registered partnership or similar union of persons of the same sex abroad, proving, where appropriate, that his marriage or registered partnership or similar union has ceased to exist.
(3) Surgical procedures towards gender change should be performed on the basis of a patient who has completed the age of 18 years.
(a) his written request; and
(b) positive opinions of the Panel of Experts.
(4) Surgical procedures towards gender change should be performed on the basis of a patient with limited fitness,
(a) the written request of the patient's guardian; This is without prejudice to the provisions of Section 35 of the Health Services Act,
(b) the favourable opinion of the Panel of Experts; and
(c) the consent of the court.
§ 22
(1) The Ministry shall establish the expert committee. The members of the expert committee shall be:
(a) a medical professional who is an employee of the State assigned to the Ministry;
(b) a doctor with specialised competence in the field of sexuality or with special competence in the field of sexuality;
(c) a physician with specialised competence in the field of psychiatry,
(d) a clinical psychologist,
(e) a physician with specialised competence in endocrine and diabetes,
(f) a doctor with specialised competence in urology or gynaecology and obstetrics;
(g) a lawyer with knowledge of medical law.
(2) A member of the Panel of Experts may not be in employment or similar relations with the provider, may not be a member of the monitoring body of the provider or the statutory body, a member of the statutory body or member of the provider.
(3) The patient's or the patient's guardian's request shall be transmitted by the provider to the Ministry without delay; The application shall be accompanied by the consent of the treating physician with specialised competence in the field of sexuality or with specific competence in the field of sexuality with the implementation of gender change.
(4) The patient and the guardian of the patient are always invited to a meeting of the expert committee, which shall take place no later than 3 months after the date of the application of the patient or the guardian of the patient. The expert panel shall provide the patient and the patient's guardian with information on the nature of the health performance, its lasting consequences and potential risks and shall verify whether the patient and the patient's guardian fully understand this information and whether the patient and the patient's guardian have received the application on a voluntary basis. If the patient referred to in Paragraph 21 (4) is involved, he shall take into account his reasonable maturity.
(5) The record of the submission of information shall be signed by members of the expert committee, the patient and the patient's guardian. The record also includes the opinion of a patient with limited incapacity. If the patient is unable to express his or her opinion or to sign the alert due to his or her reasonable maturity, this shall be recorded.
(6) The expert committee shall, after consulting the request, draw up a written expert opinion assessing whether all the conditions for a sex change are fulfilled; indicate, at the same time, the period of validity of the opinion, taking into account the urgency of the performance of health. The consent of all members of the Panel of Experts is required for a positive opinion on the implementation of the sex change. In the event that the consent of all members is not achieved, the Panel shall describe in its opinion the reasons for this. The expert committee shall forward to the Ministry a technical opinion in 3 copies and a copy of the record of the hearing.
(7) The treating physician of the patient who recommended the performance of health care is always invited to the meeting of the Panel of Experts, but the attending physician must not be present during the interview with the patient.
(8) Part of the patient's medical documentation
(a) the patient's written request or the patient's guardian;
(b) a copy of the consensual opinion of the treating physician with specialised competence in the field of sexuality or with special competence in the field of sexuality;
(c) an entry from the meetings of the expert committee; and
(d) the opinion of the expert committee.
(9) The Ministry shall transmit:
(a) a copy of the opinion of the Panel and a copy of the minutes of the Panel's deliberations to the patient or the patient's guardian;
(b) (2) a copy of the opinion of the Panel of Experts to the health care provider referred to in paragraph 8 and a copy of the report of the Panel's deliberations.
(10) The application for consent to a sex change shall be submitted to the court by the provider. The provider shall add to the application a written request from the patient or a written request from the guardian of the patient, a statement from the patient with limited competence and the opinion of the expert committee. If the patient is unable to make a statement in the light of his reasonable maturity, the provider shall state the reasons for this in the proposal.
§ 23
(1) A change in sex may be initiated if the patient or the patient's guardian has given written consent to this immediately prior to its initiation.
(2) The provider shall issue a confirmation to the patient and the patient's guardian about the sex change.

Díl 5

Psychosurgery
§ 24
(1) Psychosurgery is a neurosurgery performed to remove or relieve symptoms of mental illness when other therapeutic methods are already exhausted and when there is a high degree of probability that performance will be effective.
(2) Psychosurgery should be performed on a patient who has completed 18 years of age, based on:
(a) the patient's written consent; and
(b) positive opinions of the Panel of Experts.
(3) A patient who has completed the age of 18 years and who is in custody, a custodial sentence, a security detention or a protective treatment shall only have psychosurgery performed on a case-by-case basis, on the basis of:
(a) his written consent;
(b) the favourable opinion of the Panel of Experts; and
(c) the consent of the court.
(4) To an underage patient or patient with limited capacity, psychosurgery shall only be performed on a case-by-case basis.
(a) the written consent of the patient's legal representative or guardian; This is without prejudice to the provisions of Section 35 of the Health Services Act,
(b) the favourable opinion of the Panel of Experts; and

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Regulation Information

CitationAct No. 373 / 2011 Coll., on Specific Health Services
Regulation TypeLaw
Author-
CollectionCode of Laws
Date of Promulgation08.12.2011
Effective from01.04.2012
Effective until-
Status Valid
The regulation text is for informational purposes only.
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