member of whom was also the relevant patient, and was familiar with their position on the use of blood and blood substitutes, which is why we were surprised by the initial decision of the hospital. There was also the assumption that the patient’s religious affiliation was the reason for the hospital’s refusal to operate on her. The Ombudsman held a meeting with advocates of the rights of persons with mental disorders, who proposed that the possibility be examined of combining their tasks performed on the basis of the Mental Health Act with the tasks of advocates of patients’ rights, which are implemented by the latter according to the Patient Rights Act, since their tasks frequently overlap. The Ombudsman proposed to the Ministry of Health that the possibility of combining these tasks into a single institution in the light of new legislative solutions should be studied. As the reason for changing its decision, the hospital provided additional information which was obtained through a dialogue with the patient about her associated diseases. The hospital also obtained information on the medicinal products that could be prescribed to the patient. During the discussion, the patient provided a list of medical products that she could receive when being treated in the hospital, and additional documentation which was examined by the medical director as a specialist in anaesthesiology with reanimation, who assessed that there were no professional reservations to prevent the surgical procedure. 2.12.5 Euthanasia as a human right A complainant informed us of his mother’s suffering due to an incurable illness and proposed that euthanasia be made legally available, so that the next of kin rather the ill person could decide in such cases. Although we understand that relatives are affected by the medical condition or slow death of their loved ones, we cannot agree to the idea that euthanasia would comprehensively resolve such problems. Everyone has the right to live, and no one may deprive them of this right, which is one of the fundamental achievements of society. Taking an individual’s life is criminally prosecuted in all countries, and only a few of them permit exemptions that the lives of patients in the terminal phases of illness may be ended by medical means when all the legal conditions are met. Slovenia has not permitted such arrangements, and the Constitution holds that human life is inviolable (Article 17). It was assessed that the option to end someone’s life would lead to numerous moral dilemmas and complicated legal questions, and above all, such conduct could lead to many abuses, the consequences of which could not be rectified. The question of euthanasia is partly resolved in the Patient Rights Act, which stipulates in Article 34 the manner of observing patient’s wishes provided in advance regarding the type of health care he or she does not permit when unable to provide valid consent. We emphasise that the Act grants this right only to patients who are aware of the importance of their decisions, but not to their relatives. The Ombudsman intends to dedicate special attention to questions relating to euthanasia in 2016, and therefore plan a special consultation session at which various aspects and positions on this topic could be discussed and comprehensively highlight this very sensitive issue. The Ombudsman believes that the prerequisite for offering an opinion on the issue of euthanasia includes the suitable provision and accessibility of palliative care at the national level. Example: Problems involving a surgical procedure on a member of Jehovah’s Witnesses Based on the patient’s authorisation, the Ombudsman was contacted by the advocate of patients’ rights (advocate) because Novo mesto General Hospital refused to perform a surgical procedure on the patient. The reason for the refusal was the patient’s refusal to receive blood and blood substitute transfusion even in the event of a life-threatening situation. The patient suffered from associated diseases, including severe allergic reactions to many medicinal products that are administered in a peri-operative period. She was thus allocated to a high-risk group for vital peri-operative complications. The hospital advised the patient to have the procedure in a tertiary institution. The Ombudsman assessed the complaint as justified with regard enforcing the right to health care. In spite of the hospital’s initial refusal to perform surgery on the patient on her terms, a solution acceptable to all was found in the search for the most feasible solution which would also be acceptable in medical profession. The efforts of the advocate and the conduct of the hospital are commendable. The Ombudsman is certain that the described manner of resolving disputes concerning health care could set an example to all health institutions and patients’ rights advocates. The case is published here as an example of good practice in the hospital and the efficient work of the patients’ rights advocate in Novo mesto. 3.4-61/2015 2.12.6 Health Care and Health Insurance Act The 2013 and 2014 annual reports included a presentation of a problem in decisions issued by the Health Insurance Institute of Slovenia (ZZZS) regarding the exercise of rights arising from compulsory health insurance. We received a comprehensive reply from the ZZZS, and assess that the Institute improved the quality of its decisions, and also took decisions within the statutory deadlines in most cases. Communication with the ZZZS is good, because they always respond to our queries within the determined deadlines. We also meet once a year to discuss current issues. A new topic was addressed in 2015 with regard to treatment abroad. A patient may exercise this right only after all treatment options in Slovenia are exhausted, which is decided by a competent expert authority. The case below includes specific complications and procedures, which eventually had a beneficial result for the patent. The Ombudsman proposes that decision making on the right to treatment abroad be regulated in greater detail, so that it is completely clear which authority and within what time limit the decision is made that treatment in Slovenia is no longer possible. The arrangement must eliminate reasons for the public to determine the suitability of treatment and collect financial resources for treatment in cases when treatment (particularly of children) has not been completed and when all patient’s rights are available. Treatment abroad A complainant contacted the Ombudsman claiming that the Health Insurance Institute of Slovenia (ZZZS) had unduly delayed decision making on an application to have his daughter’s congenital heart disease treated abroad. The Ombudsman submitted a query to the hospital, because we wanted to know why the hospital had changed its opinion. In the past, the hospital has conducted several operations on Jehovah’s Witnesses, a Almost simultaneously with the complainant’s application, the ZZZS received the opinion of the medical council of Ljubljana University Medical Centre that the options of treating the little girl in Slovenia had been exhausted. Percutaneous or ‘mini’ surgical closure of ASD was proposed, and the nearest health-care provider abroad was suggested and the anticipated date of admission. Despite this opinion, the ZZZS did not decide on the complainant’s application, and he soon received verbal information that the opinion had been changed and that the medical council would hold another session about the little girl’s treatment. The ZZZS agreed with Ljubljana University Medical Centre to wait for a new (supplemented) opinion of the medical council. Communication between the ZZZS and Ljubljana University Medical Centre was by telephone only and was not 130 ANNUAL REPORT OF THE HUMAN RIGHTS OMBUDSMAN OF THE REPUBLIC OF SLOVENIA FOR 2015 The patient was dissatisfied with being rejected for treatment and sought assistance from the patients’ rights advocate. The advocate filed a request for first consideration, as per Article 56 of the Patient Rights Act, subject to the patient’s authorisation. An agreement was concluded upon first consideration that the hospital would perform the operation and the patient would be informed about the date of the surgical procedure by mail. ANNUAL REPORT OF THE HUMAN RIGHTS OMBUDSMAN OF THE REPUBLIC OF SLOVENIA FOR 2015 131 2.12 HEALTH CARE AND HEALTH INSURANCE 2.12 HEALTH CARE AND HEALTH INSURANCE setting of prices for dental services, which lack supervision, and particularly, doctors’ unawareness of the content of individual patients’ rights (namely, the patient’s choice expressed in advance). The Ombudsman did not receive such complaints, but we mention them as open issues that have to be addressed.