A/HRC/41/33/Add.4 Ad Part VI “Health”, paragraph 51 This paragraph concerns the regulatory framework on the exercise of contentious objection, which was considered ineffective. It was also noted that “doctors are no longer obliged to provide referrals since the lifting of the requirement by Constitutional Court ruling in October 2015”. In this respect, it should be clearly emphasised that in Poland the use by doctors of the socalled “conscience clause” has been regulated in a manner ensuring, on the one hand, the exercise of the doctor’s right to refrain from performing a service contrary to their conscience, and on the other hand, enabling the patient to obtain the service to which they are entitled (as well as the exercise of the patient’s right to information). Patients’ rights in the above-mentioned scope have not been weakened in connection with the ruling of the Constitutional Tribunal of 7 October 2015, file No K 12/14. Currently, pursuant to Article 39 of the Act of 5 December 1996 on the professions of a doctor and dental practitioner, a doctor may refrain from performing health services contrary to their conscience, subject to Article 30 of the same Act (in so far as it provides for the obligation of a doctor to provide medical assistance whenever a delay in its provision could result in the risk of loss of life, serious bodily injury or serious disorder of health). The doctor is required to justify and record this fact in the medical records. In addition, a doctor practising their profession on the basis of an employment relationship or in the service is also required to notify their superior in writing in advance. As a result of the above-mentioned ruling of the Constitutional Tribunal, the following provisions of law were repealed: 1) Article 39, first sentence, in conjunction with Article 30 of the Act of 5 December 1996 on the professions of a doctor and dental practitioner, in so far as they impose an obligation on a doctor to perform health services in “other urgent cases” which are incompatible with their conscience; 2) Article 39, first sentence of the Act of 5 December 1996 on the professions of doctor and dental practitioner, in so far as it imposed an obligation on a doctor who refrained from providing health services contrary to their conscience to indicate the real possibility of obtaining such services from another doctor or other medical entity. Therefore, an analysis was undertaken of the functioning of the provisions, as amended by the Tribunal’s judgement, as to whether they safeguard the right of the doctor to refrain from performing such a service, on the one hand, and whether they ensure that the patient receives the service to which they are entitled (and, in this case, also ensure that the patient’s right to information is exercised). In this respect, reference should be made to the applicable provisions of the Act of 15 April 2011 on medical activity. In accordance with Article 14 of the above Act, the entity conducting medical activity publishes information on the scope and types of health care services provided. At the request of the patient, the entity conducting medical activity provides also detailed information on the health care services provided, in particular information concerning the diagnostic or therapeutic methods used and the quality and safety of those methods. At the same time, it should be noted that health care providers, while providing guaranteed health care services, perform contractual obligations resulting from the agreement concluded in this respect with the National Health Fund. Obligatory provisions of agreements concluded with health care providers have been defined in the General Terms and Conditions of Agreements on the provision of health care services (hereinafter referred to as “GTCA”) attached to the decree of the Minister of Health of 8 September 2015 on the general terms and conditions of agreements on the provision of health care services. Pursuant to Article 3 of the GTCA, the provider is required to perform the agreement in accordance with the conditions for providing services specified in the Act and provisions issued on its basis (in particular decrees concerning guaranteed services), general terms and conditions and in accordance with specific terms and conditions of agreements specified by the President of the National Health Fund, and is also required to provide services to the beneficiaries with due diligence and to observe the rights of the patient. Moreover, it should 10