The forthcoming WHO Regional Conference on Health Policy wiII provide an important opportunity for further promoting patients' rights in Europe. The proposed WHO Regional Conference on Health Care Systems in Transition in Europe, to be held in Vienna in 1996, will also explore issues conceming the rights, roles and responsibilities of both patients and providers. We propose to WHO that the Regional Office should establish an appropriate mechanism to monitor developments in countries and to present the findings at the Vienna Conference. The present document is an attempt to formulate a set of patient's rights which reflects the evolving concepts and is relevant to the context in which health care will be provided in future. These Principles of the rights of patients in Europe have been drafted in full awareness of the work of others who have already been engaged in drawing up instruments specific to patients' rights. For the most part, though, such previous efforts were directed at particular groups or concerned with specific activities in health care or approached patients' rights from the perspective of the duties and responsibilities of health care providers and establishments. The present text is the result of an attempt to refocus these concems from the patients' point of view as the user and of the partner in health care in all its various forms. It has been deliberately couched in general terms, so far as possible avoiding reference to the circumistances of particular groups or illustrative examples. It is felt, however, that this exposition of general considerations, embraces the basic principles and concepts to be adopted when promoting and guaranteeing patient's rights in a particular country or another situation. The text does not directly cover questions of implementation, since these are necessarily specific to a country or situation; it has nevertheless been drafted in the belief that these guidelines can be further elaborated within countries to suit their particular needs and circumstances. GUIDING PRINCIPLES In this text, the concept of health care is derived from the principles of the World Health Assembly resolution on health for all (HFA) (WHA30.43) and the related model of health care set out in the Declaration of Alma-Ata. Health care thus embraces a full range of services covering health promotion and protection, disease prevention, diagnosis, treatment, care and rehabilitation. Accordingly, the patient encounters a wide variety of health care providers and fulfils a variety of roles, from a sick and dependent person to a client receiving advice from the consumer or the customer obtaining health products for self-administration. Furthermore, this variety of patient roles implies a continuum of health states from a high-level of good health to permanent disability and terminal illness. In the treatment of patients' rights, a distinction should be made between social and individual rights. Social rights in health care relate to the societal obligation undertaken or to otherwise enforced by the government and other public or private bodies to make a reasonable provision of health care for the whole population. What is reasonable in terms of the volume and the range of services available and the degree of sophistication of technology and specialization will be dependent on political, social, cultural and economic factors. Social rights also relate to equal access to health care for all those living in a country or other geopolitical areas and the elimination of unjustified discriminatory barriers, whether financial, geographical, cultural, social and psychological. Social rights are enjoyed collectively and are relative to the level of development of the particular society; they are also in some measure subject to political judgement regarding priorities for development in a society. In contrast, individual rights in patient care are more readily expressed in absolute terms and when made operational can be made enforceable on behalf of an individual patient. These rights cover such areas as the integrity of the person, privacy and religious convictions. Although this text does address social rights, the main focus is on individual rights. The conceptual foundations for this treatment of patients' rights are for the most part laid on a number of intergovernmental declarations relating to human rights and freedom. The intention is not to create new rights but to apply them in one coherent, comprehensive statement to the field of patients and health care. For similar reasons the text does not address general rights, obligations and liabilities, which are covered by the statutes and case law of each country. stupsertod stup5site