Proposed bill · Health, Social Protection and Family

Patients’ Rights, Medical Liability and Healthcare Quality and Safety

A unified legislative framework establishing patients’ rights, defining standards of medical liability and technical expertise, and making care quality and patient safety measurable, accountable obligations, while protecting practitioners from criminalisation of complications or undesirable outcomes not arising from professional fault.

Prepared by: Ali Zuweid

Document number: POL-74
Version: 1.0
Publication date: 5 October 2026
Scope: Republic of Iraq

Executive summary

Iraq has a clear constitutional basis for the right to healthcare. Public Health Law No. (89) of 1981, as amended, governs broad aspects of public health; the Federal Private Health Institutions Establishment Law No. (25) of 2015 governs establishment and oversight of the private health sector; and Doctors Protection Law No. (26) of 2013 protects doctors from assault and tribal claims. However, no single federal law brings together patients’ rights, informed consent, access to medical records, disclosure of adverse events, the standard of medical fault, an independent and organised technical-expertise mechanism, professional insurance, patient-safety incident reporting and learning systems, and quality and accreditation requirements.

The draft addresses this gap without assuming that every poor treatment outcome constitutes fault and without granting immunity from liability. Liability arises where there is a professional duty, a provable breach of the required standard of care, harm and a causal relationship. A recognised complication, unsuccessful treatment or differences between accepted medical approaches do not alone establish fault. Patients, meanwhile, receive explicit rights to dignity, information, consent, privacy, medical records, second opinions, emergency care, complaints, clear billing and compensation where harm is established.

For care safety, the draft establishes a unified national quality and accreditation framework, a confidential incident-reporting and learning system, a mechanism for serious events, mortality and morbidity reviews and publication of aggregate performance indicators. Learning investigations are functionally separated from disciplinary or criminal investigations, so the safety system neither conceals errors nor punishes workers merely for reporting them.

Constitutional and legal context

The draft rests on the constitutional right to healthcare. Article (31) of the Constitution of the Republic of Iraq establishes every Iraqi’s right to healthcare and the state’s responsibility for public health and provision of prevention and treatment, while recognising private health institutions under state supervision. Article (30) guarantees social and health security. Provisions on equality, dignity, privacy and personal freedom protect rights directly related to treatment delivery and medical decision-making. Article (114/Fifth) makes general health policy a shared responsibility exercised cooperatively by federal authorities, regions and governorates not incorporated into a region, requiring drafting that respects the federal structure.

Public Health Law No. (89) of 1981, as amended, remains the general public-health framework. Subsequent amendments and decisions include Amendment No. (20) of 2021 and a decision published in 2026 changing a fine in Article (96/First/A). Federal Private Health Institutions Establishment Law No. (25) of 2015 regulates licensing and oversight of private institutions and expressly invalidates agreements between a hospital and service recipient exempting liability arising from doctors or staff. Doctors Protection Law No. (26) of 2013 protects doctors against assaults and tribal or unlawful claims.

Medical liability itself is currently distributed across general rules. The Iraqi Penal Code defines unintentional fault through negligence, recklessness, inattention, lack of precaution and failure to observe laws, regulations and orders. It permits medical treatment performed according to professional standards with the patient’s or representative’s consent, or without consent in urgent cases. Civil Code rules govern compensation, while medical expertise and forensic medicine play a practical role in court disputes.

Legislative conclusion: The requirement is not to abolish these general rules or replace ordinary courts with medical courts, but to establish specialist legislation defining rights, standards and technical procedures while leaving liability assessment and awards of compensation or punishment to courts within their jurisdiction.

Legislative gap

The main gap is not the absence of all rules concerning doctors or patients, but their fragmentation across general, professional and institutional legislation. This creates three parallel problems: patients lack a single statutory list of clear rights and enforcement mechanisms; health practitioners lack detailed legislative standards distinguishing complications from fault and accepted professional judgment from negligence; and health institutions lack a unified national reporting, learning, accreditation and transparency system.

Principal gaps and legislative responses
Area	Gap	Draft response
Patients’ rights	Rights scattered across general rules, instructions and inconsistent institutional practices.	Binding provisions on information, consent, privacy, records, second opinions, emergency care and complaints.
Medical liability	Reliance on general rules without comprehensive statutory definitions of complications, fault and the standard of care.	A clear liability test, excluding a poor outcome alone as proof of fault.
Technical expertise	Variation in expert selection, committee composition and challenges to reports.	A national expert register, multidisciplinary expert panels and published challenge and conflict-of-interest procedures.
Compensation	Potentially lengthy disputes and enforcement difficulties where a provider or institution is insolvent.	Phased professional liability insurance and voluntary settlement without barring court access.
Patient safety	Scattered programmes and initiatives without a binding, consistent national incident-learning system.	National reporting and learning, mandatory reporting of serious events and root-cause analysis.
Quality	Varying standards and capabilities across institutions and sectors.	National standards, phased accreditation and published quality and safety indicators.
Professional balance	Two opposing risks: genuine fault escaping accountability, or complications and accepted professional decisions being criminalised.	Protect complaints and litigation while protecting practitioners against presumed fault merely because harm occurred.

Judicial and professional developments in Iraq confirm the need for this distinction. Supreme Judicial Council publications have addressed medical fault and its burden of proof, emphasising that unsuccessful treatment does not itself constitute medical fault and that liability requires proof of departure from professional standards and causation. In August 2026, a judicial workshop in Nineveh specifically discussed the distinction between complications and medical errors and their legal consequences, illustrating the continued need for a clearer legislative framework.

Proposed legislative policy

One law for patients and safe practice: Bring rights, liability and quality into an interconnected framework rather than addressing errors after they occur without preventing recurrence.
Liability based on fault and causation: No liability merely because a complication, death or failure to recover occurs; no immunity where negligence, departure from scientific standards or absence of required consent is established.
Expertise independent of the care provider: No treatment institution, professional association or ministry monopolises assessment of fault. Rules select experts without interests linking them to the parties, with a right to challenge.
Learning separate from punishment: Internal safety reports identify and correct system risks and do not automatically constitute admissions of liability. Medical records and underlying facts remain usable under the law.
Institutions are also responsible:Inadequate sterilisation, equipment, medicines, organisation or safe staffing may constitute institutional fault; not every harm may be reduced to the treating doctor’s actions.
Transparency after incidents: Patients have a right to know that a material adverse event occurred and what treatment and corrective actions were taken, without requiring a prior admission of legal liability before investigation is complete.
Phased professional insurance: Ensure capacity to compensate, particularly in the private sector, without making insurance a requirement that drives practitioners out of underserved areas.
Proper federal implementation: Respect shared health-policy responsibilities and coordinate with the Kurdistan Region and governorates, while preserving federal civil and criminal rules within their constitutional remit.

Draft Patients’ Rights, Medical Liability and Healthcare Quality and Safety Law

In the name of the people

Presidency of the Republic

Pursuant to the enactment of the Council of Representatives under Article (61/First) and Article (73/Third) of the Constitution, the following Law is issued:

Chapter One — General provisions

Article (1) — Title

This Law shall be called the ‘Patients’ Rights, Medical Liability and Healthcare Quality and Safety Law’.

Article (2) — Definitions

For the purposes of this Law, the following terms have the meanings set out below:

Patient: Any person receiving or seeking health, medical, preventive, diagnostic, therapeutic, rehabilitation or palliative services.
Service provider: Any person legally licensed to practise a medical, health, nursing, pharmaceutical or technical profession related to care.
Health institution: Any hospital, centre, clinic, laboratory or public, private or charitable institution licensed to provide a health service.
Standard of care: The care, skill and precaution expected of a qualified provider in the same category and specialty under comparable professional circumstances, considering legitimately available resources and accepted scientific knowledge at the time of service.
Medical fault: An unjustified breach of the required standard of care, scientific and professional standards or a legal care-related duty, proven to have caused harm to the patient.
Complication: A harmful or undesirable outcome that may occur despite care meeting the required standard and reasonable precautions, and does not itself constitute medical fault.
Adverse event: A care-related occurrence resulting in patient harm, whether or not subsequently established to arise from fault.
Serious incident: An adverse event causing unexpected death, permanent disability or severe harm, or a high-risk occurrence defined by national standards that requires prompt reporting and analysis.
Informed consent: Free and specific acceptance by a patient with decision-making capacity or their legal representative after receiving the material information needed to decide.
Medical record: All paper or digital data and documents concerning the patient’s assessment, diagnosis, treatment, medicines, procedures, test results, consents, discharge plan and follow-up.
Medical expert opinion: An impartial technical opinion provided by an expert or expert panel under this Law to assist a judicial or administrative authority in understanding medical and technical issues.
Reporting and learning system: A system collecting and analysing reports of patient-safety incidents, risks and near misses to identify preventive and improvement measures.
Accreditation: A structured institutional assessment of a health institution’s compliance with approved national quality and safety standards.

Article (3) — Objectives and principles

Protect patient dignity, autonomy and the right to safe and equitable care.
Establish enforceable patients’ rights and duties for providers and health institutions.
Establish a balanced medical-liability standard protecting patients from negligence and practitioners from presumed fault merely because an adverse outcome occurs.
Promote harm prevention, institutional learning, transparency and a safety culture.
Improve care quality and harmonise minimum national standards while respecting constitutional responsibilities.
Ensure access to justice and prohibit advance waivers of liability for medical harm.

Article (4) — Scope

This Law applies to providers and health institutions under federal jurisdiction and in governorates not incorporated into a region, and to the federal private health sector.
General health-policy development and implementation shall respect Article (114/Fifth) of the Constitution. Coordination with regions and governorates shall ensure interoperability of standards and data, patient transfer and continuity of care.
This Law does not prejudice a region’s constitutional powers or the priority of regional law within Article (115) of the Constitution where its conditions apply.

Chapter Two — Patients’ rights

Article (5) — Dignity and equality

Patients shall be treated with respect and dignity, without discrimination based on sex, origin, ethnicity, religion, sect, disability, age, economic status, residence, health condition or any factor unrelated to medical need.
Health institutions shall provide reasonable accommodation for persons with disabilities, older persons and those requiring assistance with communication, mobility or decision-making.
Clinical priority shall be determined by medical need and severity. Care must not be advanced or delayed because of influence or unlawful benefit.

Article (6) — Information and communication

Patients have the right to know the identity and professional role of the provider responsible for their care.
Information shall be provided in clear language appropriate to the patient’s understanding, using communication aids or interpretation where needed and feasible.
Material information includes the expected diagnosis, treatment purpose, reasonable alternatives, material risks and significant complications, the option of no treatment and approximate recovery time where estimable.
Information about a patient’s condition shall not be withheld unless temporary delay is necessary to prevent serious, immediate health harm documented by the doctor in the record. Withholding shall not exceed what necessity requires.

Article (7) — Informed consent

A diagnostic or therapeutic intervention involving material risk, anaesthesia, surgery or an invasive procedure requires informed consent, unless a statutory exception applies.
Consent shall be written for surgery, anaesthesia, invasive procedures and high-risk treatments, and may be recorded electronically under approved controls.
A general form does not replace the medical discussion needed to understand a decision. Consent is invalid if obtained through coercion or deception or if material information was deliberately withheld.
Patients may withdraw consent before or during a procedure where stopping is medically possible without exposing them to a disproportionate greater risk.

Article (8) — Lack of capacity and minors

Where a patient cannot decide because of incapacity or unconsciousness, consent shall be obtained from their legal representative under applicable laws, involving the patient to the extent they can understand and express a view.
A minor’s views shall receive consideration proportionate to their age and maturity, while consent remains with the legally authorised person.
If a legal representative refuses treatment necessary to prevent serious danger to a minor’s life or safety, the institution shall pursue urgent judicial or protective procedures provided by law. Life-saving intervention shall not be delayed where a decision cannot be obtained in time.

Article (9) — Urgent cases

Necessary treatment may be provided without prior consent where the situation is urgent, timely consent from the patient or representative cannot be obtained, and delay would seriously endanger life or safety.
Non-consensual intervention shall be limited to necessity, restoring the patient’s or representative’s participation in decisions as soon as the impediment ends.
The grounds for the exception and nature of the procedure shall be recorded in the medical record.

Article (10) — Refusing treatment

A patient with capacity may refuse treatment or request its cessation after being informed of expected consequences and reasonable alternatives.
Refusal shall be documented in the medical record. It does not relieve the institution or provider of providing emergency care the patient accepts, pain relief or palliative care where appropriate.
Patients shall not be punished or discriminated against merely for exercising the right to refuse.

Article (11) — Privacy and confidentiality

Patient privacy shall be respected during examination, treatment and admission. Persons not required for care may attend only with the patient’s consent or for a regulated educational purpose that the patient may refuse without affecting treatment.
Health information is confidential and may be disclosed only with patient consent, under law or a judicial order, for professional necessity within the care team, or to fulfil a specific statutory reporting duty.
Institutions shall apply security and access controls to digital records and maintain access logs.

Article (12) — Medical records

Patients or their legal representatives may inspect and obtain copies of medical records within a reasonable period, at actual copying cost if any.
Data revealing the identity of a legally protected third party, or whose disclosure would cause specific serious harm, may be withheld by a reasoned decision open to challenge.
Patients may request correction of inaccurate personal data. Original medical opinions or assessments shall not be erased; a dated clarification or correction may be added while preserving record integrity.
Instructions shall define record-retention periods according to service type and legal and clinical risks. Records subject to an ongoing complaint, dispute or investigation must not be destroyed.

Article (13) — Second opinions and continuity of care

Patients may seek a second medical opinion at their own expense or within their coverage entitlement. Transfer of information needed for that purpose must not be obstructed.
Necessary clinical information shall be sent securely and promptly when patients transfer between institutions.
On discharge, patients shall receive a clear summary of diagnosis, procedures, medicines, warnings and follow-up plans where needed.

Article (14) — Emergencies and no advance-payment requirement

Licensed health institutions must not refuse emergency assessment, first aid and necessary stabilisation because of an unpaid deposit, incomplete administrative procedure or insurance dispute.
This does not prevent institutions from collecting legally due fees after urgent care or arranging safe transfer after stabilisation where another institution is better suited to provide care.

Article (15) — Financial transparency and complaints

Private-sector patients have the right to know charges or their calculation method before non-urgent services, insofar as the treatment permits, and to receive an itemised bill for services, medicines and supplies.
Every patient may complain, receive a tracking number and obtain a reasoned response. Retaliation or reduced care because of a complaint is prohibited.
Institutions shall prominently display and publish through digital channels a summary of patients’ rights, complaint procedures and contact details.

Chapter Three — Duties of providers and health institutions

Article (16) — Provider duties

Practise within licence, competence and specialty limits and seek consultation or referral when a case exceeds professional ability.
Exercise due care under scientific standards accepted at the time of service.
Verify patient identity, procedure, medicine, dosage and other relevant safety elements.
Promptly document assessments, material decisions, procedures, medicines, consent and significant clinical events.
Report risks and incidents through the safety system without concealment or alteration of records.
Maintain confidentiality and avoid conflicts of interest, unlawful referrals and commissions.

Article (17) — Health institution duties

Provide qualified staff, equipment, medicines, sterilisation, infection-control and maintenance systems appropriate to the licence and advertised services.
Apply written policies for informed consent, correct patient identification, medication safety, safe surgery, blood transfusion, infection prevention and response to clinical deterioration.
Provide systems for managing risks, complaints and incidents and reviewing quality, mortality and complications.
Do not assign providers work outside their competence or in avoidable operating conditions exposing patients to unjustified risk.
Ensure medical records are maintained, protected from unlawful alteration and accessible to authorised persons.

Article (18) — Medical documentation

Documentation shall be legible or electronically secured, dated and identify its creator.
Where an earlier entry requires correction, the system shall retain the original and display the correction, its date, reason and author.
Creating a later record to misrepresent it as contemporaneous, deleting a material event or destroying a document relevant to a dispute or serious incident is prohibited.

Article (19) — Adverse-event disclosure

Following a material adverse event, the institution shall inform the patient or representative of confirmed clinical facts then known, measures needed to address harm and prevent deterioration, and whether a safety investigation will take place.
Disclosure shall be supplemented when material new information emerges and shall respect the patient without concealing the event or misleading them.
Disclosure of an event or a humane apology alone does not constitute a final admission of legal liability unless it expressly acknowledges its elements.

Chapter Four — Medical liability, expertise and compensation

Article (20) — Establishing medical liability

Medical liability arises where all the following elements are established:

A duty of care or professional obligation towards the patient.
Breach of the required standard of care or a material statutory care-related duty.
Material, bodily, psychological or non-pecuniary harm compensable under the law.
A causal relationship between breach and harm under the standard of proof prescribed by the applicable law.

Article (21) — Matters not themselves constituting fault

None of the following alone constitutes evidence of medical fault:

Failure to recover or deterioration despite adherence to the standard of care.
A recognised complication or rare outcome that could not reasonably be prevented.
Choosing a scientifically accepted treatment where several recognised professional approaches or options exist, on a reasonable clinical basis.
An urgent decision in life-threatening circumstances with limited information or resources not attributable to the provider’s own negligence, where the decision was reasonable in those circumstances.
The patient’s deliberate concealment of material information or failure to follow explained instructions, insofar as this caused the harm.

Article (22) — Standard of care

The standard of care shall be assessed in light of the provider’s specialty and licensed expertise, institution type, legitimately available resources, patient condition, urgency and accepted scientific knowledge at the time of the event.
Resource scarcity does not lower safety standards where the shortage arose from preventable institutional failings or the institution continued providing a service without minimum safe capacity, warning or referral.
A general practitioner shall not be assessed against a specialist standard outside their scope unless they represented themselves as, or actually performed work as, a specialist without the required competence.

Article (23) — Consent and liability

An intervention without required consent or materially exceeding its limits constitutes a separate infringement of patients’ rights, subject to statutory exceptions.
Signing a consent form does not preclude liability for professional fault in performance or concealment of a material risk reasonably capable of affecting the patient’s decision.
Advance agreements exempting providers or institutions from liability for medical fault, fraud or deliberate concealment are prohibited.

Article (24) — Institutional liability

An institution is liable for harm arising from attributable organisational or operational fault, including deficient sterilisation, maintenance, medicines, safe systems, supervision or use of unqualified staff, where causation is established.
An individual provider must not bear responsibility for an institutional failing they lacked authority to prevent or remedy, unless they failed to report it or made an unjustified decision despite knowing the risk and being able to avoid it.
Civil Code rules on employers’ liability for their employees’ acts apply insofar as consistent with this Law.

Article (25) — Proof and missing records

Liability elements shall be proved through legally prescribed means. Medical expertise is an important technical means of evidence but does not bind the court’s lawful assessment.
Fault shall not be presumed merely because harm occurred.
Where an institution or provider is proven deliberately to have destroyed or concealed a record required to be retained and directly relevant to the dispute, the court may draw inferences permitted by evidentiary rules, without relieving the claimant of proving harm and causation to the extent the circumstances permit.

Article (26) — Expert register and panels

The Ministry of Health, coordinating with professional and academic bodies, shall establish a national medical-liability expert register by specialty, with standards for competence, experience, integrity and training in legal medicine and patient safety.
Expert panels in complex disputes shall have an odd number of members, at least three, with a majority from the relevant specialty or directly related fields.
Experts with a direct personal, financial or professional interest involving a party, or working in the same unit where the event occurred in circumstances raising serious doubts about impartiality, may not participate.
Courts may select experts outside the register where necessary, stating their reasons.

Article (27) — Expert-report methodology

Expert reports shall identify established medical facts, the required standard of care, any departure from it and causation, expressly distinguishing fault, complications and natural disease progression.
Reports shall give reasons and identify principal scientific sources where a specialist issue is disputed.
Experts provide technical opinions and do not determine final legal liability, punishment or compensation amounts.
Under judicial procedures, parties shall have opportunities to challenge reports, request supplementation, question experts or request another assessment where serious grounds exist.

Article (28) — Criminal proceedings concerning professional events

An adverse outcome or patient death alone is insufficient evidence of a professional offence.
Where legal classification depends on a technical medical question, specialist expertise shall be sought before final referral where possible, without prejudice to investigating judges’ powers, cases of flagrante delicto or intentional offences.
This provision does not confer immunity from arrest, detention or accountability where legal conditions and supporting evidence exist.

Article (29) — Civil compensation

Compensation shall be assessed under applicable civil rules to make good proven harm without unjust enrichment.
Assessment shall consider bodily harm, lost earnings, proven future treatment costs, non-pecuniary harm and other legally compensable losses.
Where there are multiple causes or responsible persons, Civil Code rules on causation, contribution, joint and several liability and recourse apply.

Article (30) — Professional liability insurance

Private health institutions shall obtain insurance or an approved financial guarantee for professional and institutional liability, through phases and categories defined in regulations under this Law.
Self-employed providers may be subject to compulsory insurance according to specialty, risk and practice size, considering insurance costs and service availability in understaffed areas.
The state shall cover public-institution staff through appropriate financial and insurance arrangements, without precluding recourse against persons proven to have acted intentionally or with gross fault under applicable laws.
Insurers must not interfere in clinical decisions or prevent lawful settlements merely to protect their financial interests. Insurance policies are subject to competent oversight.

Chapter Five — Healthcare quality and safety

Article (31) — National quality and safety framework

The Ministry of Health, with competent authorities, regions and governorates, shall establish and periodically review a national healthcare quality and safety framework.
The framework shall include measurable objectives for medication safety, infection control, safe surgery, critical care, maternal and newborn health, blood transfusion, diagnosis, emergency care, risk management and patient experience.
A public version of the framework and national monitoring indicators shall be published with personal data protected.

Article (32) — Accreditation

Hospitals and institutions designated by instructions shall undergo phased accreditation under published standards appropriate to institution type and service level.
Accreditation does not replace licensing: licensing establishes the legal threshold for operating, while accreditation measures quality and safety.
Public contracts and health insurance shall progressively be linked to accreditation requirements or approved corrective plans under a published timetable.

Article (33) — Mandatory minimum care-safety requirements

According to its service level, each institution shall apply national requirements including, at a minimum:

Correct patient identification before medication, procedures or specimen collection.
Infection control, hand hygiene, sterilisation and instrument safety.
Management of high-risk medicines and prevention of medication confusion.
Checklists for surgery, invasive procedures and anaesthesia.
Safety of blood and blood products and pre-transfusion verification.
Response to sudden deterioration, resuscitation and review of delays.
Medical-device management, maintenance and calibration where needed.
Safe communication during shift handovers, referrals and transfers.

Article (34) — Medication and diagnostic safety

Institutions shall establish mechanisms to review prescribing, dispensing and administration and report errors and near misses, with controls for look-alike and sound-alike medicines and high-risk drugs.
Systems shall ensure critical test results are reviewed and communicated promptly to the responsible clinician.
Repeated diagnostic delays or errors shall be reviewed within the quality programme to identify systemic causes, without the review itself proving individual liability.

Article (35) — Reporting and learning system

The Ministry of Health shall establish a national patient-safety incident reporting and learning system receiving reports from institutions and staff and aggregated data from complaints and reviews.
The system shall distinguish voluntary learning reports from mandatory reports of serious events under Article (36).
Data shall be limited to what analysis requires, using unified classifications to identify patterns and recurring risks.
The Ministry shall issue periodic de-identified bulletins on lessons and resulting preventive measures.

Article (36) — Serious events

Institutions shall notify the competent regulator of serious incidents within a period specified by instructions and no longer than necessary for a prompt response and collection of clinical evidence.
Institutions shall begin a structured review of causes and contributing factors and prepare a corrective plan. Analysis must not merely seek an individual to blame.
Where there is suspected crime, manipulation or continuing danger to patients, the regulator shall immediately take appropriate legal measures.
Reporting does not remove the obligation to preserve records or inform the patient under Article (19).

Article (37) — Mortality and morbidity reviews and clinical audit

Hospitals shall establish regular programmes reviewing unexpected deaths, complications, unplanned returns to surgery or critical care and other risk indicators.
Clinical audit shall compare practice with standards, identify opportunities for improvement and remeasure after intervention.
Corrective actions, implementation responsibilities and follow-up dates shall be documented.

Article (38) — Patient and family participation

The Ministry of Health and institutions shall provide structured mechanisms to use patient and family experiences to improve policies and services.
Patient representatives may participate in quality and public-policy committees without disclosure of other patients’ data.
Educational materials shall help patients ask about medicines, procedures, identity and follow-up plans and report risks.

Article (39) — Employment protection for good-faith reporters

Retaliation against workers who report a risk or safety incident in good faith through designated channels is prohibited.
Protection does not extend to malicious reports, falsified data, deliberate concealment of fault or refusal to provide emergency assistance.
A de-identified internal learning report shall not alone prove a particular person’s fault. This does not prevent lawful orders obtaining medical records, documents and underlying facts.

Chapter Six — Complaints, settlement and oversight

Article (40) — Patients’ rights offices

Hospitals and care institutions of a size specified by instructions shall establish an organisationally independent office or role to receive complaints, explain rights and follow up responses.
Reasonable response periods shall reflect complaint severity, prioritising ongoing patient risks.
Administrative complaints do not bar access to courts, regulators or professional associations.

Article (41) — Settlement and mediation

Parties may voluntarily mediate or settle civil medical-care claims before or during litigation under applicable law or regulations issued under this Law.
Mediation is not compulsory and does not prevent suspension of limitation periods or urgent measures to preserve evidence or rights as provided by procedural laws.
Public prosecution rights in offences for which the law does not permit reconciliation cannot be settled.

Article (42) — Inspection and corrective plans

The Ministry of Health and legally authorised bodies shall oversee compliance with this Law using a risk-based approach.
Where remediable deficiencies are found, an institution may be required to implement a corrective plan with defined deadlines and indicators and undergo reinspection.
Where deficiencies pose imminent, serious danger, immediate measures shall restrict or suspend services to the extent of that danger while ensuring patient transfer and care continuity.

Article (43) — Administrative measures

Without prejudice to penalties under other laws, the competent authority may, after hearing the institution, apply graduated measures: notification, corrective plan, warning, restriction of a particular activity, partial or complete licence suspension, and an application for licence revocation under the law.
Measures shall reflect the violation’s seriousness and recurrence, the institution’s cooperation in correction and any resulting risk or harm.
Decisions shall give reasons and be open to grievance and appeal under applicable laws.

Article (44) — Professional and criminal accountability

Administrative measures do not preclude disciplinary proceedings before the competent professional body or criminal and civil liability where their conditions are met.
The same authority shall not impose disciplinary punishment more than once for the same act, while administrative, professional, civil and criminal liabilities remain distinct according to their nature.
Violations involving suspected crimes shall be referred to the competent authority. Administrative bodies shall not determine criminal guilt.

Chapter Seven — Governance, transitional and final provisions

Article (45) — National Council for Healthcare Quality and Safety

A Council of Ministers decision shall establish the ‘National Council for Healthcare Quality and Safety’, without separate financial legal personality, with its technical secretariat in the Ministry of Health.
Membership shall include federal health authorities, a regional representative where participating, governorates, medical and health professional bodies, universities, health insurance, a health-law expert, and patient and civil society representatives under integrity and conflict-of-interest rules.
Its composition shall reflect expertise, diversity and balance between providers and recipients. No provider shall dominate decisions assessing its own safety.

Article (46) — Council responsibilities

Propose and review national quality and patient-safety policy.
Approve national standards and measurement indicators submitted by the competent technical authority.
Monitor the national reporting and learning system and publish a de-identified annual report on trends, risks and corrective measures.
Propose expert accreditation, training and conflict-of-interest prevention rules.
Propose research and training priorities in patient safety and medical liability.
Report annually to the Council of Ministers and Council of Representatives on implementation and legislative and funding gaps.

Article (47) — Public data and indicators

The Ministry of Health shall publish aggregated healthcare quality and safety indicators, avoiding data identifying patients or individual reporters unless disclosure is legally required.
Institution-level indicators may be published after verifying comparability and adjusting for significant case-mix differences, to avoid misleading comparisons or encouraging institutions to reject higher-risk patients.
Instructions shall define a minimum national dataset, update frequency and audit mechanisms.

Article (48) — Implementation plan and transition

Within one hundred and eighty days of publication, the Ministry of Health shall prepare a national implementation plan covering costs, human resources, digital systems, training and phases.
Patients’ rights, documentation and prohibition of advance liability-waiver provisions shall apply within ninety days of publication.
The national reporting system and expert register shall begin within twelve months.
Mandatory accreditation and professional insurance shall be phased in over no more than three years by institution category and specialty, prioritising high-risk services.

Article (49) — Relationship to existing legislation

Public Health Law No. (89) of 1981, as amended; Federal Private Health Institutions Establishment Law No. (25) of 2015; Doctors Protection Law No. (26) of 2013; Forensic Medicine Law No. (37) of 2013; and health-profession laws remain effective insofar as consistent with this Law.
Protection of doctors against tribal or unlawful claims shall not be interpreted to prevent patients from submitting complaints or pursuing civil, criminal or disciplinary proceedings through lawful channels.
Any provision permitting advance exemption from medical liability or obstructing patients’ rights to records or complaints in express conflict with this Law is repealed.

Article (50) — Regulations, instructions and commencement

The Council of Ministers may issue regulations necessary to implement this Law.
The Minister of Health may issue necessary instructions and technical standards after consultation with competent authorities and publish them publicly.
This Law shall enter into force ninety days after publication in the Official Gazette, subject to its specific transitional periods.

Statement of reasons

This Law is enacted to ensure patients’ right to safe, respectful healthcare based on information and consent; harmonise principles governing medical liability, technical expertise and compensation; balance protection against negligence with protection of doctors and providers against presumed liability merely because a complication or undesirable outcome occurs; establish a national framework for quality, patient safety, reporting, learning and accreditation; and regulate institutional liability alongside individual professional liability.

Explanatory memorandum

1. Why a separate law?

Existing health laws perform important but different functions. The Public Health Law concerns public-health functions and oversight; the private institutions law concerns establishment and licensing; the Doctors Protection Law protects against assault and unlawful claims; while civil and criminal liability remain distributed across general rules. The draft therefore adds a specialist layer without repealing these laws: how should patients be treated, when does medical liability arise, how should expertise be organised, and how can harm be used to prevent recurrence?

2. A patient is not an ordinary consumer

Healthcare is an unequal relationship in knowledge, need and freedom of choice, particularly in emergencies. General contract rules alone are therefore insufficient. The draft establishes rights an institution cannot contract away: information, consent, confidentiality, records, first aid, complaints and freedom from retaliation.

3. Why does harm not equal fault?

Medicine involves probabilities and inherent risks even with the highest standard of care. Making every complication a basis for liability encourages ‘defensive medicine’, unnecessary tests or referrals, higher costs and fear, and concealment rather than learning. Conversely, denying liability for every complication leaves patients unprotected. The solution is a legal test requiring breach of the standard of care, harm and causation.

4. A realistic, not permissive, standard of care

The standard considers specialty, circumstances and legitimately available resources at the time. A doctor in a crowded emergency department is not assessed in the same way as a specialist performing a planned elective procedure. However, equipment or sterilisation deficiencies caused by institutional negligence are no excuse. The Law therefore distinguishes individual and institutional fault.

5. Informed consent

Consent is not a signature on a general form. It is communication allowing patients to understand a procedure’s nature, benefits, material risks and alternatives. The draft requires written consent for high-risk procedures, preserves the emergency exception and prevents consent from operating as an exemption for negligent performance.

6. Medical records are part of safety and justice

Complete records protect patients and providers alike. Patients need them for second opinions and continuing treatment; doctors need them to establish examinations and decisions; institutions need them for learning and audit. The draft therefore rejects retrospective rewriting that conceals the original and makes every correction traceable.

7. Technical expertise does not replace courts

Experts answer medical questions: what standard of care applied, whether there was a departure and whether it can explain the harm. Final legal judgment belongs to the courts. The draft regulates expert registration, prevents conflicts of interest and requires reasoned, challengeable reports without creating a parallel professional court.

8. Professional insurance

Compensation fails its purpose where judgment is entered against a person or institution unable to pay. The draft therefore phases in insurance or financial guarantees, beginning with higher-risk institutions and specialties. It sets no price or premium in the Law because these require actuarial data and an adaptable insurance market, and must not drive doctors from underserved areas.

9. Why non-punitive reporting?

Highly reliable health systems also learn from ‘near misses’: errors that almost caused harm but did not. If every report immediately triggers punitive investigation, reporting stops. The draft therefore separates internal learning reports from underlying evidence. Protection excludes falsification, concealment and crime but allows good-faith workers to report risks without fear of retaliation.

10. Serious events require a different pathway

Serious incidents are not left to voluntary reporting alone. Institutions must notify regulators, preserve clinical evidence, inform patients, analyse causes and address continuing risks. At the same time, an event is not presumed to prove a crime or individual fault.

11. Accreditation and quality

Licensing asks whether an institution may operate; accreditation asks whether it has verifiable quality and safety systems. The draft separates them and phases in accreditation, allowing health-insurance and public-purchasing contracts to be linked to it so quality becomes a financial incentive rather than paper instructions.

12. Doctors’ protection and patients’ rights are complementary

The Doctors Protection Law addresses the real problem of assault and tribal claims. The draft retains that protection while clarifying that it does not prevent judicial, civil or disciplinary complaints. Doctors should be held accountable under law where they are at fault and protected by the same law against unlawful pressure where fault is not established.

13. The federal dimension

The Constitution makes general health policy a shared responsibility, with a special priority rule in Article (115). The draft therefore does not give the federal Ministry of Health unlimited authority over the region, but distinguishes federal civil and criminal rules from health standards and policies requiring cooperation and coordination.

Alignment with existing legislation

Related legislation
Legislation	Relationship to the draft	Approach
Constitution of the Republic of Iraq 2005	Articles 30 and 31, fundamental rights, Article 114/Fifth and Article 115.	Basis for the right to health and limits of federal/regional jurisdiction.
Public Health Law No. 89 of 1981, as amended	General public-health and oversight framework.	Remains effective; the draft adds patients’ rights, liability and quality.
Federal Private Health Institutions Establishment Law No. 25 of 2015	Private-sector licensing and oversight, and invalidity of liability exemptions.	Harmonise patients’ rights and link licensing to safety standards without repealing the Law.
Doctors Protection Law No. 26 of 2013	Protects doctors against assault and tribal claims.	Retain protection while affirming patients’ lawful remedies.
Penal Code No. 111 of 1969, as amended	Unintentional fault and legality of medical acts subject to professional standards and consent or necessity.	The draft clarifies technical practice standards without replacing general criminal law.
Civil Code No. 40 of 1951	Liability and compensation rules.	Remains the reference for compensation, causation and joint and several liability in matters not expressly regulated.
Forensic Medicine Law No. 37 of 2013, as amended	Forensic medical expertise before courts.	Integration with expert registration and specialist assessment mechanisms.
Health Insurance Law No. 22 of 2020	Purchasing and financing services for insured persons.	Contracting and purchasing may be linked to the draft’s quality and accreditation standards.
Health-profession practice and professional association laws	Licensing and professional discipline.	Their responsibilities remain, with coordination of overlapping complaints and decisions.

Financial and implementation impact

The draft creates no independent body with a separate budget; the proposed National Council operates through a Ministry of Health technical secretariat, reducing establishment costs. Effective implementation nevertheless requires resources in four areas: a digital reporting and learning system linked to health information systems; training medical-liability experts and quality teams; patients’ rights and risk-management functions in major institutions; and expanded accreditation and inspection programmes.

Available public data cannot support a reliable national cost without knowing each health directorate’s digital infrastructure, the number of institutions entering accreditation and existing staffing. The Law therefore requires an implementation and costing plan within 180 days rather than a falsely precise estimate in the legislation.

Costing approach before wider implementation
Item	Establishment costs	Operating costs	Cost-reduction opportunities
Reporting and learning system	Platform development, integration and cybersecurity.	Analysis, technical support and updates.	Build on existing digital health systems rather than a parallel platform.
Expert register and training	Curriculum, accreditation and initial training.	Accreditation renewal and fees for commissioned expertise.	Use medical colleges, forensic medicine and professional associations.
Accreditation and quality	Develop standards and assessment tools.	Assessment and follow-up visits.	Integrate existing inspection and quality teams and avoid duplicate bodies.
Professional insurance	Not borne entirely by the budget.	Risk-based premiums.	Group purchasing for public institutions, actuarial pricing and phasing by specialty.

Over the medium term, reduced acquired infections, medication errors, repeated incidents and unstructured disputes may generate savings. Any numerical estimate must first rely on an Iraqi baseline and actual claims and incident data.

Transitional provisions and implementation requirements

Phasing is necessary: applying the Law immediately across thousands of institutions could reduce requirements to formal compliance. The text proposes three periods: patients’ rights and documentation within 90 days; expert registration and reporting within 12 months; and accreditation and professional insurance within three years. This permits staff training, system development and time for under-resourced institutions to improve without deferring fundamental rights.

First-year priorities are hospitals, surgical centres, anaesthesia, critical care, maternity, emergency and blood services, which combine high risk with many transitions. Once standards and data are established, requirements expand to other care levels in proportion to each institution’s nature.

Relevant international and comparative principles

The draft aligns with international movement from responding after harm to managing risks beforehand. The World Health Organization’s Global Patient Safety Action Plan 2021–2030 calls for national policies, learning systems, patient and family engagement and environments reducing avoidable harm. WHO reporting and learning guidance likewise emphasises that reporting’s value lies not merely in counting incidents but in converting them into knowledge and preventive actions that can be monitored.

For patients’ rights, the World Medical Association’s Declaration of Lisbon emphasises autonomy, choice, information, consent and confidentiality. The draft does not reproduce the declaration verbatim but adapts these principles to the Iraqi Constitution and local rules on capacity, emergencies and jurisdiction.

Modern comparative approaches to medical liability distinguish fault from complications, organise specialist expertise, introduce insurance or funds in some systems, and link liability to patient safety. The draft adopts elements suitable for Iraq: phased insurance, structured expertise and learning systems, retaining ordinary courts and Iraqi civil and criminal rules as the final basis for liability.

Sources and references

Iraqi Council of Representatives — Constitution of the Republic of IraqRights to healthcare and health security, and shared responsibility for general health policy.
Ministry of Justice — Public Health Law No. (89) of 1981 with amendmentsOfficial source of the translated text and the public-health law in force.
Ministry of Justice — enactment of Public Health Law Amendment No. (20) of 2021Evidence of the amendment published in the Iraqi Gazette.
Ministry of Justice — Iraqi Gazette, issue 4867 of 2026Includes a decision amending the fine under Article (96/First/A) of the Public Health Law.
Ministry of Justice — Federal Private Health Institutions Establishment Law No. (25) of 2015Regulates licensing and oversight and invalidates agreements waiving liability.
Ministry of Justice — Iraqi Gazette, Doctors Protection Law No. (26) of 2013Legal framework protecting doctors against assault and unlawful claims.
Supreme Judicial Council — Protection of DoctorsJudicial explanation of the Doctors Protection Law and the roles of medical committees and courts in claims arising from medical practice.
Supreme Judicial Council — Medical Liability and FaultDiscusses fault standards, civil and criminal liability and general Iraqi legal rules.
Supreme Judicial Council — Proving Medical FaultAddresses the burden of proof, expertise and causation in medical disputes.
Supreme Judicial Council — Legality of Medical PracticeDiscusses Penal Code Article (41/2), consent, emergencies and professional standards.
Supreme Judicial Council — workshop on complications and medical errors, August 2026Recent judicial discussion distinguishing complications from medical errors and examining liability frameworks.
World Health Organization — Global Patient Safety Action Plan 2021–2030Global framework for national policies, patient safety and reducing avoidable harm.
World Health Organization — Patient Safety Incident Reporting and Learning SystemsGuidance on designing incident reporting and learning systems.
World Health Organization — Global Patient Safety Report 2024Recent international reference on policies, legal frameworks, reporting and patient engagement.
World Health Organization — Iraq country results 2024–2025Covers Iraqi activities in service quality, governance and data systems and highlights non-punitive learning from maternal and perinatal deaths.
World Health Organization — UHC Partnership, IraqIncludes ongoing development of unified care-quality and patient-safety tools in primary healthcare.
World Medical Association — Declaration of Lisbon on the Rights of the PatientPrinciples of autonomy, information, consent, confidentiality and respect for patients.

This document is a proposed bill within Ali Zuweid’s Political Programme. It is not an enacted law unless it completes the constitutional and legislative procedures prescribed in the Republic of Iraq.