Patient rights and duties in healthcare services (Ley 8239)

The Ley de Derechos y Deberes de las Personas Usuarias de los Servicios de Salud Públicos y Privados (Ley N.º 8239, of April 19, 2002) protects anyone receiving healthcare in Costa Rica, whether at the Caja Costarricense de Seguro Social (CCSS) or at a private facility.

Main rights (Artículo 2) — among those most frequently consulted:

To receive clear information about your own rights and duties, as well as the full name, professional qualifications, and position of the healthcare provider.
To receive the necessary information to give or withhold informed consent before a medical procedure or treatment.
Dignified treatment, with respect, consideration, and kindness, without discrimination of any kind.
Efficient and diligent medical care, without delay in emergencies, and punctual according to the appointment (except in cases of unforeseeable events or force majeure).
To refuse examination or treatment, except in exceptional or emergency situations where public health or the rights of third parties prevail.
If the patient is unconscious or unable to express their will, consent is provided by a legal representative; if none is available and the intervention is urgent, patient consent is presumed unless it was previously made clear that they would refuse it.
To accept or refuse participation in clinical research studies.
Access to your own medical record and to receive a copy of it.
Confidentiality of your medical history and information about your illness (except where another law requires notification to health authorities).
To decide at any time regarding organ donation.
To file complaints before the corresponding authorities when you feel a right has been violated.
In public services, if uninsured, to receive an itemized bill of treatment expenses.

Additional rights exclusively in private facilities (Artículo 3): to receive an itemized bill of all expenses (not just if uninsured), and to specify which individuals have priority to visit.

Patient duties (Artículo 4): to provide the most complete information possible about your health status, previous illnesses, hospitalizations, and medications; to follow the instructions of healthcare personnel (and take responsibility if you do not follow them); to respect the rights of personnel and other patients; and to contribute to the financing of public health services when you have the financial means to do so.

How to file a complaint if a right was violated (Artículo 14): the complaint is submitted to the Contraloría de Servicios de Salud of the facility where the incident occurred (every health center must have one), or to the Auditoría General de Servicios de Salud of the Ministerio de Salud if there is none. It can be submitted in writing or verbally, by yourself or through an authorized third party. Deadline: immediately or within a maximum of 5 business days following the incident — if the patient was hospitalized, the deadline begins upon discharge. The resolution must be issued within a maximum of 8 days after the complaint is submitted.

Note: this fact sheet summarizes the most frequently consulted rights and complaint mechanisms of a law with its own regulation (Decreto N.º 32612-S). For a specific case or the full text, it is advisable to check with the Ministerio de Salud or the Contraloría de Servicios de Salud of the corresponding medical facility.