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AnnexesActive Citizenship Network: EuropeanCharter of Patients’ Rights1

Presented in Brussels on 15 November 2002

Preamble

Despite their differences, national health systems in European Union countriesplace the same rights of patients, consumers, users, family members, weakpopulations and ordinary people at risk. Despite solemn declarations on the‘‘European Social Model’’ (the right to universal access to health care), severalconstraints call the reality of this right into question.

As European citizens, we do not accept that rights can be affirmed in theory, butthen denied in practice, because of financial limits. Financial constraints, howeverjustified, cannot legitimise denying or compromising patients’ rights. We do notaccept that these rights can be established by law, but then left not respected, assertedin electoral programmes, but then forgotten after the arrival of a new government.

1 This document is the result of the work of a Cittadinanzattiva-Active Citizenship Network groupcomposed of Giuseppe Cotturri, Stefano A. Inglese, Giovanni Moro, Charlotte Roffiaenand Consuelo Scattolon, who produced a first draft in July, 2002. The draft was discussedin Rome on 7 September. The participants in the Rome seminar were: Ekkehard Bahlo, DeutscheGesellschaft für Versicherte und Patienten e. V. (DGVPV); Pascale Blaes, Fédération Belge contrele Cancer; Fátima Carvalho Lopes, APOVITA, Portugal; Ana Etchenique, Confederacion deConsumidores y usurarios (CECU), Spain; Ioannis Iglezakis, KE.P.KA, Greece; Stefano A.Inglese, Cittadinanzattiva/Tribunal for Patients’ Rights, Italy; Stephen A. McMahon, Irish PatientsAssociation Ltd; Giovanni Moro, Active Citizenship Network; Margrethe Nielsen, DanishConsumer Council; Teresa Petrangolini, Cittadinanzattiva, Italy; Ysbrand Poortman, VerenigingSamenwerkende Ouder- en Patiëntenorganisaties (VSOP), The Netherlands; Charlotte Roffiaen,Active Citizenship Network; Martin Rusnak, International Neurotrauma Research Organization,Austria; Bas Treffers, Nederlandse Patiënten Consumenten Federatie (NPCF); Simon Williams,The Patients Association, UK. This text was also presented and discussed during the Conference‘‘The Future Patient’’ held the 14–15 November 2002 in Brussels organized by Active CitizenshipNetwork (ACN), International Association of Patients’ Organization (IAPO), Ippr, Picker InstituteEurope, Merck Sharpe & Dhome. The present text has been prepared based on these discussions.The ACN also would like to thank George France for his careful review of the text. Of course,the content of the text is the exclusive responsibility of Active Citizenship Network

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The Nice Charter of Fundamental Rights will soon be part of the new Europeanconstitution. It is the basis of the declaration of the fourteen concrete patients’rights currently at risk: the right to preventive measures, access, information,consent, free choice, privacy and confidentiality, respect of patients’ time,observance of quality standards, safety, innovation, avoidance of unnecessarysuffering and pain and personalised treatment, and the right to complain and toreceive compensation. These rights are also linked to several internationaldeclarations and recommendations, issued by both the WHO and the Council ofEurope. They regard organisational standards and technical parameters, as well asprofessional patterns and behaviour.

Each of the national health systems of the EU countries manifests quitedifferent realities with respect to patients’ rights. Some systems may have patients’rights charters, specific laws, administrative regulations, charters of services,bodies such as ombudspersons, procedures like alternative dispute resolution, etc.Others may have none of these. In any case, the present Charter can reinforce thedegree of protection of patients/citizens’ rights in the different national contexts,and can be a tool for the harmonisation of national health systems that favourscitizens’ and patients’ rights. This is of the utmost importance, especially becauseof the freedom of movement within the EU and the enlargement process.

The Charter is submitted for consideration by civil society, national and EUinstitutions, and everyone who is able to contribute, by actions and omissions, tothe protection or the undermining of these rights. Because of its connection to thepresent European reality, and to trends in health care, the Charter may besubmitted to future reviews and will evolve over time.

The implementation of the Charter shall be primarily entrusted to those activecitizenship organisations working on patients’ rights at national level. It will alsorequire the commitment of health care professionals, as well as managers,governments, legislatures and administrative bodies.

Part 1: Fundamental Rights

1. The EU Charter of Fundamental Rights

• The Charter of Fundamental Rights, which will represent the first ‘‘brick’’ in theEuropean constitution, is the main reference point of the present Charter. Itaffirms a series of inalienable, universal rights, which EU organs and MemberStates cannot limit, and individuals cannot waive. These rights transcendcitizenship, attaching to a person as such. They exist even when national laws donot provide for their protection; the general articulation of these rights is enoughto empower persons to claim that they be translated into concrete proceduresand guarantees. According to Article 51, national laws will have to conform tothe Nice Charter, but this shall not override national constitutions, which will beapplied when they guarantee a higher level of protection (Article 53). Inconclusion, the particular rights set forth in the Nice Charter are to be

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interpreted extensively, so that an appeal to the related general principles maycover any gaps in the individual provisions.

• Article 35 of the Charter provides for a right to health protection as the ‘‘right ofaccess to preventive health care and the right to benefit from medical treatmentunder the conditions established by national laws and practices’’. Article 35specifies that the Union must guarantee ‘‘a high level of protection of humanhealth,’’ meaning health as both an individual and social good, as well as healthcare. This formula sets a guiding standard for the national governments: do notstop at the floor of the ‘‘minimum guaranteed standards’’ but aim for the highestlevel, notwithstanding differences in the capacity of the various systems toprovide services.

• In addition to Article 35, the Charter of Fundamental Rights contains manyprovisions that refer either directly or indirectly to patients’ rights, and are worthrecalling: the inviolability of human dignity (Article 1) and the right to life(Article 2); the right to the integrity of the person (Article 3); the right tosecurity (Article 6); the right to the protection of personal data (Article 8); theright to non-discrimination (Article 21); the right to cultural, religious andlinguistic diversity (Article 22); the rights of the child (Article 24); the rights ofthe elderly (Article 25); the right to fair and just working conditions (Article 31);the right to social security and social assistance (Article 34); the right toenvironmental protection (Article 37); the right to consumer protection (Article38); the freedom of movement and of residence (Article 45).

2. Other International ReferencesThe 14 rights illustrated below are also linked to other international documents

and declarations, emanating in particular from the WHO and the Council of Europe.As regards the WHO, the most relevant documents are the following:

• The Declaration on the Promotion of Patients’ Rights in Europe, endorsed inAmsterdam in 1994;

• The Ljubljana Charter on Reforming Health Care, endorsed in 1996;• The Jakarta Declaration on Health Promotion into the twenty first Century,

endorsed in 1997.

As regards the Council of Europe, one must recall in particular the 1997Convention on Human Rights and Biomedicine, as well as RecommendationRec(2000)5 for the development of institutions for citizen and patient participationin the decision-making process affecting health care. All these documents considercitizens’ health care rights to derive from fundamental rights and they form,therefore, part of the same process as the present Charter.

Part 2: Fourteen Rights of the Patient

This part proposes the proclamation of 14 patients’ rights, which together seek torender the fundamental rights recalled above concrete, applicable and appropriate

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to the current transitory situation in the health services. These rights all aim toguarantee a ‘‘high level of human health protection’’ (Article 35 of the Charter ofFundamental Rights), to assure the high quality of services provided by the variousnational health services. They must be protected throughout the entire territory ofthe European Union.

With regard to the 14 patients’ rights, some preliminary statements are calledfor:

• The definition of rights implies that both citizens and health care stakeholdersassume their own responsibilities. Rights are indeed correlated with both dutiesand responsibilities.

• The Charter applies to all individuals, recognising the fact that differences, suchas age, gender, religion, socio-economic status and literacy etc., may influenceindividual health care needs.

• The Charter does not intend to take sides on ethical issues.• The Charter defines rights as they are valid in contemporary European health

systems. It shall therefore be reviewed and modified to allow for their evolution,and the development of scientific knowledge and technology.

• The 14 rights are an embodiment of fundamental rights and, as such, they mustbe recognised and respected independently of financial, economic or politicalconstraints, taking the criteria of the appropriateness of care into consideration.

• Respect for these rights implies the fulfilment of both technical/organisationalrequirements, and behavioural/professional patterns. They therefore require aglobal reform of the ways national health systems operate.

• Each article of the Charter refers to a right and defines and illustrates it, withoutclaiming to foresee all possible situations.

1. Right to Preventive MeasuresEvery individual has the right to a proper service in order to prevent illness.The health services have the duty to pursue this end by raising people’s

awareness, guaranteeing health procedures at regular intervals free of charge forvarious groups of the population at risk, and making the results of scientificresearch and technological innovation available to all.

2. Right of AccessEvery individual has the right of access to the health services that his or her

health needs require. The health services must guarantee equal access toeveryone, without discriminating on the basis of financial resources, place ofresidence, kind of illness or time of access to services.

An individual requiring treatment, but unable to sustain the costs, has the rightto be served free of charge.

Each individual has the right to adequate services, independently of whether heor she has been admitted to a small or large hospital or clinic.

Each individual, even without a required residence permit, has the right tourgent or essential outpatient and inpatient care.

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An individual suffering from a rare disease has the same right to the necessarytreatments and medication as someone with a more common disease.

3. Right to InformationEvery individual has the right to access to all kind of information regarding

their state of health, the health services and how to use them, and all that scientificresearch and technological innovation makes available.

Health care services, providers and professionals have to provide patient-tailored information, particularly taking into account the religious, ethnic orlinguistic specificities of the patient.

The health services have the duty to make all information easily accessible,removing bureaucratic obstacles, educating health care providers, preparing anddistributing informational materials.

A patient has the right of direct access to his or her clinical file and medicalrecords, to photocopy them, to ask questions about their contents and to obtain thecorrection of any errors they might contain.

A hospital patient has the right to information which is continuous andthorough; this might be guaranteed by a ‘‘tutor’’.

Every individual has the right of direct access to information on scientificresearch, pharmaceutical care and technological innovations. This information cancome from either public or private sources, provided that it meets the criteria ofaccuracy, reliability and transparency.

4. Right to ConsentEvery individual has the right of access to all information that might enable him

or her to actively participate in the decisions regarding his or her health; thisinformation is a prerequisite for any procedure and treatment, including theparticipation in scientific research.

Health care providers and professionals must give the patient all informationrelative to a treatment or an operation to be undergone, including the associatedrisks and discomforts, side-effects and alternatives. This information must be givenwith enough advance time (at least 24 h notice) to enable the patient to activelyparticipate in the therapeutic choices regarding his or her state of health.

Health care providers and professionals must use a language known to thepatient and communicate in a way that is comprehensible to persons without atechnical background.

In all circumstances which provide for a legal representative to give theinformed consent, the patient, whether a minor or an adult unable to understand orto will, must still be as involved as possible in the decisions regarding him or her.

The informed consent of a patient must be procured on this basis.A patient has the right to refuse a treatment or a medical intervention and to

change his or her mind during the treatment, refusing its continuation.A patient has the right to refuse information about his or her health status.

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5. Right to Free ChoiceEach individual has the right to freely choose from among different treatment

procedures and providers on the basis of adequate information.The patient has the right to decide which diagnostic exams and therapies to

undergo, and which primary care doctor, specialist or hospital to use. The healthservices have the duty to guarantee this right, providing patients with informationon the various centres and doctors able to provide a certain treatment, and on theresults of their activity. They must remove any kind of obstacle limiting exerciseof this right.

A patient who does not have trust in his or her doctor has the right to designateanother one.

6. Right to Privacy and ConfidentialityEvery individual has the right to the confidentiality of personal information,

including information regarding his or her state of health and potential diagnosticor therapeutic procedures, as well as the protection of his or her privacy duringthe performance of diagnostic exams, specialist visits, and medical/surgicaltreatments in general.

All the data and information relative to an individual’s state of health, and to themedical/surgical treatments to which he or she is subjected, must be consideredprivate, and as such, adequately protected.

Personal privacy must be respected, even in the course of medical/surgicaltreatments (diagnostic exams, specialist visits, medications, etc.), which must takeplace in an appropriate environment and in the presence of only those whoabsolutely need to be there (unless the patient has explicitly given consent or madea request).

7. Right to Respect of Patients’ TimeEach individual has the right to receive necessary treatment within a swift and

predetermined period of time. This right applies at each phase of the treatment.The health services have the duty to fix waiting times within which certain

services must be provided, on the basis of specific standards and depending on thedegree of urgency of the case.

The health services must guarantee each individual access to services, ensuringimmediate sign-up in the case of waiting lists.

Every individual that so requests has the right to consult the waiting lists, withinthe bounds of respect for privacy norms.

Whenever the health services are unable to provide services within thepredetermined maximum times, the possibility to seek alternative services ofcomparable quality must be guaranteed, and any costs borne by the patient must bereimbursed within a reasonable time.

Doctors must devote adequate time to their patients, including the timededicated to providing information.

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8. Right to the Observance of Quality StandardsEach individual has the right of access to high quality health services on the

basis of the specification and observance of precise standards.The right to quality health services requires that health care institutions and

professionals provide satisfactory levels of technical performance, comfort andhuman relations. This implies the specification, and the observance, of precisequality standards, fixed by means of a public and consultative procedure andperiodically reviewed and assessed.

9. Right to SafetyEach individual has the right to be free from harm caused by the poor

functioning of health services, medical malpractice and errors, and the right ofaccess to health services and treatments that meet high safety standards.

To guarantee this right, hospitals and health services must continuously monitorrisk factors and ensure that electronic medical devices are properly maintained andoperators are properly trained. All health professionals must be fully responsiblefor the safety of all phases and elements of a medical treatment.

Medical doctors must be able to prevent the risk of errors by monitoringprecedents and receiving continuous training.

Health care staff that report existing risks to their superiors and/or peers must beprotected from possible adverse consequences.

10. Right to InnovationEach individual has the right of access to innovative procedures, including

diagnostic procedures, according to international standards and independently ofeconomic or financial considerations.

The health services have the duty to promote and sustain research in thebiomedical field, paying particular attention to rare diseases.

Research results must be adequately disseminated.

11. Right to Avoid Unnecessary Suffering and PainEach individual has the right to avoid as much suffering and pain as possible, in

each phase of his or her illness.The health services must commit themselves to taking all measures useful to this

end, like providing palliative treatments and simplifying patients’ access to them.

12. Right to Personalized TreatmentEach individual has the right to diagnostic or therapeutic programmes tailored

as much as possible to his or her personal needs.The health services must guarantee, to this end, flexible programmes, oriented

as much as possible to the individual, making sure that the criteria of economicsustainability does not prevail over the right to health care.

13. Right to ComplainEach individual has the right to complain whenever he or she has suffered a

harm and the right to receive a response or other feedback.

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The health services ought to guarantee the exercise of this right, providing (withthe help of third parties) patients with information about their rights, enabling themto recognise violations and to formalise their complaint.

A complaint must be followed up by an exhaustive written response by thehealth service authorities within a fixed period of time.

The complaints must be made through standard procedures and facilitated byindependent bodies and/or citizens’ organizations and cannot prejudice thepatients’ right to take legal action or pursue alternative dispute resolution.

14. Right to CompensationEach individual has the right to receive sufficient compensation within a

reasonably short time whenever he or she has suffered physical or moral andpsychological harm caused by a health service treatment.

The health services must guarantee compensation, whatever the gravity of theharm and its cause (from an excessive wait to a case of malpractice), even whenthe ultimate responsibility cannot be absolutely determined.

Part 3: Rights of Active Citizenship

The rights set forth in the Charter refer to the ‘‘individual’’ rather than the‘‘citizen’’ insofar as fundamental rights override the criteria of citizenship, as notedin the first part. Nevertheless, each individual who acts to protect his or her ownrights and/or the rights of others performs an act of ‘‘active citizenship.’’ Thissection thus employs the term ‘‘citizens’’ to refer to active persons working in theterritory of the European Union.

In order to promote and verify the implementation of the above stated patients’rights, some citizens’ rights must be proclaimed. They mainly regard differentgroups of organized citizens (patients, consumers, advocacy groups, advice-givers,self-help groups, voluntary and grassroots organisations, etc.) that have the uniquerole of supporting and empowering individuals in the protection of their ownrights. These rights are pegged to the rights of civic association, contained inArticle 12, Section 1, of the Charter of Fundamental Rights.

1. Right to Perform General Interest ActivitiesCitizens, whether individuals or members of an association, have the right,

rooted in the principle of subsidiarity, to perform general interest activities for theprotection of health care rights; there is a concomitant duty on the part of theauthorities and all relevant actors to favour and encourage such activity.

2. Right to perform advocacy activitiesCitizens have the right to perform activities for the protection of rights in the

area of health care, and in particular:

• The right to the free circulation of persons and information in public and privatehealth services, within the bounds of respect for privacy rights;

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• The right to carry out auditing and verification activities in order to measure theeffective respect for the rights of citizens in the health care system;

• The right to perform activities to prevent violation of rights in the field of healthcare;

• The right to directly intervene in situations of violation or inadequate protectionof rights;

• The right to submit information and proposals, and the consequent obligation,on the part of the authorities responsible for the administration of public andprivate health services, to consider them and reply;

• The right to public dialogue with public and private health authorities.

3. Right to Participate in Policy-Making in the Area of HealthCitizens have the right to participate in the definition, implementation and

evaluation of public policies relating to the protection of health care rights, on thebasis of the following principles:

• The principle of bilateral communication with regard to agenda setting, or, inother words, the ongoing exchange of information among citizens andinstitutions in the definition of the agenda;

• The principle of consultation in the two phases of policy planning and decision,with the obligation on the part of institutions to listen to the proposals ofcitizens’ organisations, to give feedback on these proposals, to consult thembefore taking each decision, and to justify their decisions if they differ from theopinions expressed;

• The principle of partnership in implementation activities, which means that allpartners (citizens, institutions and other private or corporate partners) are fullyresponsible and operate with equal dignity;

• The principle of shared evaluation, which implies that the outcomes of theactivities of the civic organisations ought to be considered as tools forevaluating public policies.

Part 4: Guidelines for Implementing the Charter

The dissemination and application of the contents of this Charter will have to becarried out at many different levels, particularly at the European, national and locallevels.

Information and EducationAs a means of informing and educating citizens and health care workers,

the Charter may be promoted in hospitals, the specialised media and other healthcare institutions and organisations. The Charter may also be promoted in theschools, universities and all other places where questions regarding theconstruction of the ‘‘Europe of Rights’’ are addressed. Special attention shouldbe devoted to training and educational activities for doctors, nurses and otherhealth care stakeholders.

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SupportSupport for and subscription to the Charter could be gathered from health care

stakeholders and citizens’ organisations. The special commitments of those healthservices and professionals that subscribe to the Charter should be defined.

MonitoringThe Charter may also be used as a means of monitoring the state of patients’

rights in Europe by civic organisations, the information media and independentauthorities, with the use of appropriate tools. A periodic report could be publishedto further awareness of the situation and outline new objectives.

ProtectionThe Charter may be used to launch activities for the protection of patients’

rights, conceived as prevention as well as actions to restore rights that have beenviolated. Such activities may be pursued by active citizenship organisations, byinstitutions and bodies like ombudspersons, ethical committees or AlternativeDispute Resolution commissions, justices of the peace, as well as by the courts.Institutions, procedures and tools coming from the ‘‘European legal space’’ shouldbe employed to this end.

DialogueA dialogue among the stakeholders can be pursued on the basis of the Charter’s

contents, in order to work out policies and programmes for the protection ofpatients’ rights. Such a dialogue would take place among governmentalauthorities, public and private companies involved in health care, as well asprofessional associations and labour unions.

BudgetingIn relation to the patients’ rights contained in this Charter, quotas, representing a

percentage of the health budget to set aside for the resolution of specific situations(for example, waiting lists), or for the protection of those in particularly criticalsituations (like the mentally ill), could be set and applied. The respect for suchquotas, or the degree of deviation from them, could be verified by annual reporting.

LegislationThe Charter rights may be incorporated into national and European laws and

regulations in full or in part, to make the goal of protecting patients’ rights anordinary part of public policies, notwithstanding the immediate implementation ofsuch rights in light of the European Union Charter of Fundamental Rights.

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Active Citizenship Network: Citizens’ Agenda2

Warsaw, 8 November 2003

1. The political attitude towards civic activismNo results can be achieved if the attitude of political representatives towards

civic activism does not change. Active citizens are not only a resource, but also acommon good for the development of democratic practices and structures. Citizensand citizens’ organizations have to be empowered and not assisted; they are notcompetitors but facilitators of institutions; they are a factor of problem solving andnot of trouble making.2. The legislation

Frequently it is the legislation itself, which instead of facilitating the existenceand activity of citizens’ organizations makes it extremely difficult. In other cases,legislation either reflects an underestimating vision of citizens’ role and ability or adistrust in their intentions and motivations. Identifying and removing thelegislative obstacles seems to be a real priority for the development of aneffective policy on civic activism in Europe.3. The consultation process

Where there are no clearly stated and practical procedures and no pertinentcriteria of selection of the relevant organizations, what prevails is often anarbitrary, ‘‘fake’’ or merely symbolic process of consultation, where most of thetime decisions have already been taken before the consultation. Someorganizations are privileged for reasons unrelated with the object of theconsultation, while timing and other organizational constraints deny in practicewhat has been established in principle. In other cases, consultation does not takeplace at all.

2 The Citizens’ Agenda is based on the findings and conclusions of ‘‘Citizens for the NewEurope’’, a survey on public policies vis-à-vis citizens’ organizations promoted by ActiveCitizenship Network and carried out in 28 European countries and at the EU level (see Chap. 5of this book). It has been drafted and discussed with about a hundred people from European civicorganizations and public institutions, during the final conference of this project in Warsaw on 7–8November 2003.

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4. The implementation processToo often the management of partnerships in the implementation process

causes a waste of resources, time and energy on the citizens’ organizations side. Insome cases governments are in competition with citizens’ organizations, in othercases they ignore the results of citizens’ activities and do not take into account theresults of their programs as a tool for the assessment of the outcomes of publicpolicies.5. The culture of public officials

To deal with citizens is as complex as dealing with trade unions or businesses.It cannot be based on the common wisdom or the good will of single publicservants, but requires specific know-how and sensitivity which must be built withmotivational and training activities towards human resources of publicadministration. On the contrary, when a bureaucratic approach prevails,frustration, anger and conflicts are the usual results of the interlocution or thecooperation.6. Financial matters

The present situation risks to make the rich, richer and the poor, poorer.Citizens’ organizations are not a way to manage ‘‘marginal’’ public affairs and theymust be involved not because they are cheaper, but because they can do better. Theamount of funds invested in civic activism, as well as rules and practices related tofinancial matters put at risk the existence of citizens’ organizations everywhere inEurope, and also at the EU level, in spite of solemn principle declarations.7. Checks and assessment of citizens’ organizations

The excess of administrative and fiscal controls and the lack of assessment ofthe real ability and effectiveness of citizens’ organizations risk to privilege thosethat excel in the paper flow to the detriment of those that are really active.Citizens’ organizations that cooperate with institutions must be seriously evaluatedand assessed as regards their relevance, effectiveness, efficiency, knowledge ofsituations, ability to solve problems, and so on.

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Active Citizenship Network and FONDACA:European Charter of Active Citizenship3

July 2006

Preamble

We, active citizens organized in movements and associations operating in differentEuropean Union countries have drawn up this European Charter of ActiveCitizenship.

We submit it to the public debate at the Community and national level andrequest that it be included in the European constitutional process, as well as in theMember States’ legal frameworks.

The Charter concerns citizens’ organizations and not individuals. Moreover, itrefers to public institutions, understood both as governmental and administrativebodies/agencies, irrespective of their legal status.

The Charter draws on the actual experiences of Autonomous Citizens’Organizations (ACOs),4 which are directly or indirectly involved in Europeanand national public policies.

3 This text is the result of the joint work of the team FONDACA (Active CitizenshipFoundation)-Active Citizenship Network (the European program of the Italian civic movementCittadinanzattiva), composed of Cinzia Carnevale, Giuseppe Cotturri, Cecília Fonseca, GiovanniMoro, Charlotte Roffiaen and Ilaria Vannini. The text is the outcome of a project managedby Active Citizenship Network with the participation of World of NGOs (Austria); ConsumersDefense Association (Czech Republic); Sozialburo Main-Taunus (Germany); Ghaqda-tal-Konsumatori (Malta); Association of Polish Consumers (Poland); Animar (Portugal); RomanianAssociation for Consumer Protection (Romania); Legal Information Center for NGOs (Slovenia);Helsinki Citizens Assembly (Turkey). The project was supported by a grant from the DGEducation and Culture of the European Commission and Unicredito.The project team tookalso into consideration the contributions from 22 organizations, institutions and individual expertsduring the consultation period (March–April 2006) and the comments done during the projectfinal conference held in Vienna the 22nd and the 23rd May 2006.4 We prefer the expression Autonomous Citizens’ Organizations rather than the other existingones (Civil Society Organizations, Third Sector Organizations, Non-profit Organizations, etc.)that refer to economic, philosophical and ethical aspects, which are currently under discussion.

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The Charter is also based on the analysis of a number of good practices inPublic institutions-citizens’ organizations relationships, as well as on documentsproduced by the European institutions, the scientific community, active citizenshiporganizations and previous Charters and Conventions addressing the issue ofcitizens’ participation in policy-making.

There are two fundamental reasons why this Charter has been drawn up: theexistence of a paradox concerning citizens’ participation in the democratic life ofthe European Union and the presence of a normative gap in European legalframework.

The paradox is that while citizens and their autonomous organizations areusually asked to contribute with material and immaterial resources to filling the‘‘democratic deficit’’ of the European Union, they are, at the same time, hardlyconsidered and often mistrusted by Public institutions.

This paradox is linked to a normative gap: while EU documents contain severalreferences to the activity of citizens’ organizations in the public arena, theycompletely lack legally binding texts defining the roles, rights and responsibilitiesof ACOs, as well as the related obligations of Public institutions. The EuropeanUnion has yet to define, in fact, citizens’ organizations activity in the public arenain terms of rights, thus confining this matter to the field of policy making.

The European Charter of Active Citizenship aims at addressing this paradoxand at filling the normative gap, by finally acknowledging the role of ACOs aslegitimate and fundamental actors in the construction of Europe.

The Charter contributes to the building and development of the Europeandemocratic space through the collective exercise of citizens’ rights, alreadyguaranteed as recognised fundamental rights, by ACOs.

Its strength lays on its process of implementation, specifically when serving as abasis for the enhancement and improvement of the relationship between ACOs andpublic institutions. The Charter must be understood as an ongoing process ofdeliberation and discussion between both actors.

It must be pointed out that this role does neither conflict with the responsibilityof Public institutions, nor challenge the mechanisms of democratic representationin the European Union. The activity of ACOs is rather meant to integrate Europeaninstitutions’ actions and to enrich democratic life with new energy.

The European Charter of Active Citizenship draws its inspiration, amongothers, from the Charter of Fundamental Rights of the European Union andparticularly from Article 11 on the freedom of expression and information, Article12 on the freedom of assembly and association, Article 21 on non-discriminationand Article 41 on the right to good administration.5

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5 These rights, already guaranteed by that Charter, will therefore not be directly quoted in thebody of the text. Moreover, the Charter does not make reference to the European Treaties thathave yet to be ratified.

The 20 articles of the Charter are thus an embodiment of fundamental rightsand, as such, they exist and must be respected even when European and nationallaws do not explicitly provide for their protection.

The Charter contains 20 articles and is divided into the following sections:

• General Principles• Rights of Civic Participation• Public Institutions’ Obligations• Enforcement• Implementation

The articles of the Charter shall be considered together. Specifically, Articles10, 11, 12, 13 and 19 shall be interpreted based on the provisions of Articles 2, 3,5, 6, 7, 8, 9 and 18.

Annexed to the Charter is a summary of national examples of good practicesgathered in ten European countries during the project, which were used toidentify the rights of the Charter; they testify to the fact that these rights areattainable. These examples shall, therefore, be considered as an integral part ofthe Charter.

General Principles

1. Definition of Autonomous Citizens Organisations

The Autonomous Citizens Organisations (ACOs) are created and managed bycitizens. They achieve civic participation contributing to the protection of thefundamental rights and to the enhancement of the democratic life.

They work for the protection of citizens’ rights and/or the preservation ofcommon goods through advocacy activities, delivery of services and theempowerment of citizens. They operate in the general interest throughdemocratic structures, without seeking for profit.

2. Right to Participation

Each individual has the right to actively participate, through ACOs, inpublic life.

Public life refers to situations and places where issues of general interest aredealt with, including the fields of action addressed by Public institutions.

ACOs shall have the opportunity to directly participate in the entire policy-making process; meaning that they shall be considered as one of the key playerswhen setting the public agenda, when implementing the policy and whenevaluating it. Furthermore, they shall contribute to the decisions right from thebeginning of the decision-making process, and not when the decisions havealready been taken.

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3. Role of Public institutions

Public institutions value and encourage ACOs’ activities aimed at protectingrights, preserving and/or enhancing the common good and/or general interest.

Public institutions in the European Union—that is local, national and EUinstitutions—shall remove the obstacles to the development of ACOs’ activitiesand support them, particularly by putting in place adequate instruments, systemsand processes to promote greater participation; formulating policies in atransparent and clear manner; supporting and collaborating in ACOs’autonomous initiatives and working in partnership with them on common projects.

Public institutions shall call for the views of ACOs, encouraging theirparticipation in decision-making processes.

Finally, Public institutions shall integrate the lessons learned from the bestpractices in their work standards.

4. Responsibilities of Autonomous Citizens Organizations

ACOs have the responsibility to contribute to the promotion of a greaterEuropean awareness among citizens and to increasing people’s participation inthe Union’s democratic life.

In doing so, they shall comply with the following requirements:

a. Accountability towards their members and their constituency at large.b. Transparency, especially on financial matters and when beneficiary of public

funds and/or citizens’ contributions.c. Independence from other actors (such as trade unions, political parties and the

institutions themselves) whose role they shall not take on.d. Democracy in their structure and procedures.

ACOs shall promote the interests and aspirations of citizens, conveying them tolocal, national and EU policy-makers, with special attention to marginalizedgroups of people.

ACOs shall provide citizens with concrete opportunities to work together andparticipate in the construction of the EU through European, national and localprojects and initiatives.

When ACOs bring to the political agenda new issues or problems they shallpropose the appropriate measures to address them and shall also motivate theiropinions and demands.

ACOs shall comply with minimum standards of transparency such as adopting aCode of Conduct and publishing the organisation’s objectives, mission, legalstatus, membership, governing bodies, accountability and consultation modalities,financial sources, budgets and accounts, work programme and monitoringprocedures.

Public institutions shall support ACOs in taking on their civic responsibilitiesand shall encourage their compliance with the four basic requirements.

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Rights of Civic Participation

5. Right to Intervention

Whenever citizens’ rights and general interests are at stake, ACOs have theright to intervene with opinions and actions, as well as publicly disclosing theactions and/or omissions which may have an effect on such rights and generalinterests. They have the right to ask for injunctions and file compensation actionsfor damages before the competent courts of the European Union and its MemberStates in order to protect citizens’ rights, the common good or general interests, asalready established for consumer organizations.

When ACOs report a violation of citizens’ rights or a damage to the commongood, Public institutions shall respond with concrete and participatory actions.

Moreover, private sector actors shall facilitate the exercise of this right.When a European Union law or decision infringes the European fundamental

rights, ACOs may present an appeal to the European Court of Justice and ask forthe suspension of the legal acts’ application.

When a national law or decision infringes the European fundamental rights, andespecially the high levels of protection established in Articles 35, 37 and 38 of theCharter of Fundamental Rights, ACOs may present an appeal to the competentnational courts and ask for the suspension of the legal acts’ application.

6. Right to Carry Out Prevention Activities

ACOs have the right to carry out activities aimed at preventing injuries anddamages to persons and common goods, as well as the lowering of the high levelsof protection of human health, the environment and consumer rights established bythe Charter of Fundamental Rights of the European Union.

When ACOs report a risk of any kind to Public institutions, these in turn shallintervene to prevent the risk from taking place. Public institutions shall alsointegrate ACOs’ experience in prevention in their public planning. Finally, Publicinstitutions shall encourage those prevention activities directly carried out by ACOs.

7. Right to Consultation

ACOs have the right to participate in all public consultations.The appropriateness and design of consultations shall be decided in a

participatory manner. Their objective shall be clearly defined before theconsultation process is launched.

When consultations are to be held, Public institutions shall guarantee that thefinal decisions will not have been taken yet and that ACOs views will be taken intoaccount.

Consultation procedures shall be open and be conducted according totransparent rules, which will not however be overly bureaucratized.

In defining and managing the consultation processes, Public institutions shallalso have to take into account ACOs’ limited human, time and financial resources.

8. Right to Access

ACOs have the right to access to all the sources of information and documentation.ACOs are entitled to access to the spaces where citizens’ rights, common goods and/

or general interests are at stake, in order to verify their respect and actual fulfilment.They have the same right to access to public and private media as all other

actors involved in policy-making do.Public institutions shall facilitate ACOs’ access to information and

documentation.They shall provide effective, complete, clear and quality information on laws,

programs and other policy measures in a language understandable to all theinterested stakeholders.

Information shall be made accessible through different communication channelsand made available as soon as possible.

Public institutions shall facilitate ACOs’ access to and free circulation in publicplaces.

9. Right to Evaluate

ACOs have the right to publicly communicate their evaluation of public andprivate actors’ activities concerning the fulfilment of the common good and/orgeneral interest, as well as to the respect of citizens’ rights.

To this end, ACOs have the right to take part in evaluation procedures and bodies.Public institutions shall involve ACOs in the evaluation process, creating and

using participatory monitoring and evaluation instruments.To this end, evaluation procedures shall be transparent and formalized and the

evaluation method clearly defined.

10. Right to a Qualified Interlocution

In their relations with Public institutions, ACOs have the right to dialogue andcollaborate with properly qualified public officials or institutions’ representatives.

Public institutions shall make sure that their representatives and civil servantsdealing with citizens’ matters be clearly identifiable and accessible to ACOs andthat their number be sufficient to deal with ACOs’ requests. In order to meet thisrequirement, Public institutions shall promote training and periodic updatingactivities. They shall also guarantee continuity of relations, even when theirrepresentatives and civil servants change posts.

Public Institutions’ Obligations

11. Respect of Time and Obligation to Give Feed back

Public institutions shall:

a. respect ACOs’ time, by adopting swift and simple procedures;b. provide timely replies to ACOs’ inputs and properly motivate their answers.

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Public institutions shall define an appropriate timetable for ACOs’ participationin the different phases of policy-making and disclose them in advance. They shallinvolve ACOs in this process.

These participative procedures are intended to avoid an excessivebureaucratization, which may prevent ACOs’ participation.

ACOs are entitled to receive a clear and prompt feedback from Publicinstitutions on whether and how their recommendations will be taken into accountin the drafting of policies. Public institutions shall motivate their response in aclear and exhaustive manner, especially when they reject an ACOs’ proposal.

12. Trust and Equal Dignity

Public institutions shall carry out their relations with ACOs on the basis oftrust, equal dignity and the principle of non-discrimination.

Public institutions shall formally recognize the autonomy and equal dignity ofACOs, as well as the importance of their role. This means that Public institutions shalltreat ACOs on an equal footing and not consider them as quasi-administrative bodies.

When establishing a relationship of dialogue, collaboration or partnership withACOs, Public institutions shall follow the principle of non-discrimination. Thismeans that Public institutions shall identify their interlocutors/partners through apublic and participated process, using transparent criteria adapted to each policy-making phase and specific situation as defined in Article 19.

Moreover, Public institutions cannot expect to have just one ACOrepresentative as their only interlocutor.

13. Facilitation and Support Measures

In order to promote and support the development of civic activities, Publicinstitutions shall provide tax relief to ACOs, contribute to their expenses andfacilitate their access to logistical resources.

Public institutions shall develop funding policies that take into account theobjectives and needs of ACOs. They shall define, together with ACOs, a list ofclear criteria and procedural rules regarding funding.

They shall guarantee timely payment, promptly inform ACOs on future fundingand ensure that funding decisions be taken according to principles of fairness andtransparency.

In order to facilitate ACOs’ activities and their participation in public decisionsand debates, Public institutions shall provide them with specific training and withlogistical resources.

Enforcement

14. Applicability of the European Charter of Active Citizenship

The articles contained in this Charter are to be applied immediately anddirectly to all the Public institutions and ACOs in the European Union at the local,national or EU level.

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15. Administrative Claims

ACOs have the right to submit claims requesting the respect of the Charter’srights and the fulfilment of the concerned Public institutions’ obligations, directlyto the competent public administration or independent authorities.

16. Appeal to the National Courts

When national a law or decision infringes the provisions of the present Charter,the ACOs affected by this law or decision may present an appeal to the competentcourts and ask for the suspension of the legal act’s application.

17. Appeal to the European Court of Justice

When a European law or decision infringes the provisions of the presentCharter, the ACOs affected by this law or decision may present an appeal to theEuropean Court of Justice and ask for the suspension of the legal act’sapplication.

Implementation

18. Institution of Horizontal Bodies

In order to effectively implement the principles of this Charter, Publicinstitutions shall set up horizontal departments or agencies and ad hoc structures,and/or liaison officers, devoted to coordinating and supporting the interactionbetween ACOs and Public institutions.

Public institutions shall not deal with ACOs in a fragmented manner, so thatdifferent approaches and policy styles towards ACOs are avoided within the sameinstitution.

19. Criteria for Involving ACOs

Public institutions shall define and apply a set of criteria to identify the ACOswith which to establish relationships of collaboration and partnership.

These criteria shall vary according to the type of relationship being consideredand shall be adapted to the concrete situations. Dialogue shall remain acompletely open process.

For the use of this Charter, dialogue is understood as those situations in whichpublic institutions listen to ACOs’ inputs, give them a feedback and take it intoaccount.

Collaboration refers to the situations in which public institutions and ACOshave convergent objectives. Partnership refers to the situations in which ACOs andpublic institutions share objectives, resources, responsibilities and risks.

The criteria for involving ACOs in collaboration and partnership shall both beobjective (field of activity, size, territory scope, degree or operational level,stability, resources, etc.) and evaluative (experience, expertise, reputation, trust,

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networking, internal organization, ability to express general or focused interests,past results, quality of project, etc).

The selection of the appropriate criteria will be conducted through an open andpublic consultation process. ACOs shall be invited to participate in the definitionof the criteria.

The selected criteria shall be communicated and applied in a transparentmanner. The application of such criteria shall involve ACOs as much as possible,for example through the use of joint bodies. The results of the identificationprocess shall be motivated and publicly disclosed.

20. Insertion of the Charter’s Provisions in the Nationaland EU Legal Orders

In order to reinforce the protection of the ACO’s rights, the general principlesof the Charter shall be recognized by the national and EU constitutions. Itsspecific provisions shall be included in the national and EU laws.

The European Union shall encourage Member States to adopt national lawsguaranteeing the exercise of active citizenship’ rights vis-à-vis public and privatebodies involved in public interest activities. The future European Constitution andevery future European Treaty shall include the principles of this Charter. On theoccasion of National Constitutions’ revisions, these principles shall be taken dueconsideration.

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Background Projects

Part II of this book was grounded on the results and the products of differentprojects implemented by Active Citizenship Network and/or FONDACA since2002 in the framework of the joint action and research program on Europeanactive citizenship. Hereafter, the basic information on those projects are reported.All projects’ products can be downloaded on http://www.activecitizenship.net andhttp://www.fondaca.org.

Rethinking the Principle of SubsidiarityImplementation timeframe: 2002–2003Promoter: Active Citizenship NetworkSupport: European Commission, Secretariat-GeneralInvolved countries: Austria, Czech Republic, Estonia, Finland, France, Greece,Hungary, Italy, Latvia, The Netherlands, Poland, Portugal, Romania, Slovakia,SpainPartner organizations: The World of NGOs (Austria); Consumers DefenceAssociation (Czech Republic); Peipsi Center for Transboundary Cooperation(Estonia), The Consumers (Finland), Réseaux Services Publics (France); EuropeanExpression (Greece); National Association for Consumer Protection (Hungary);FONDACA (Italy); Meridian Plus (Latvia); Centrum voor Europese Studies enOpleidingen (The Netherlands); Association of Polish Consumers (Poland);Associação Portuguesa Para o Desenvolvimento Local—Animar (Portugal); ProDemocracy Association (Romania); Association of Consumer Organizations inSlovakia e Association of Slovak Consumers (Slovakia); Confederación deConsumidores y Usuarios (Spain)Products: Rethinking the Principle Of Subsidiarity. Towards a New Frameworkfor Citizen Participation in European Policy-Making, Report, 2003.Team: Charlotte Roffiaen

G. Moro, Citizens in Europe, DOI: 10.1007/978-1-4614-1942-6,� Springer Science+Business Media, LLC 2012

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European Charter of Patients’ RightsImplementation timeframe: 2002Promoter: Active Citizenship NetworkSupport: Merck Sharp & DhomeInvolved countries: Austria, Belgium, Denmark, Germany, Greece, Ireland, Italy,The Netherlands, Portugal, Spain, United KingdomPartner organizations: International Neurotrauma Research Organization(Austria); Fédération Belge contre le Cancer (Belgium); Danish ConsumerCouncil (Denmark); Deutsche Gesellschaft f€ur Versicherte und Patienten e. V.(DGVPV) (Germany); KE.P.KA (Greece); Irish Patients Association Ltd (Ireland);Cittadinanzattiva/Tribunale per i diritti del malato (Italy); Nederlandse Pati€entenConsumenten Federatie (NPCF) (The Netherlands); Vereniging SamenwerkendeOuder-en Patiëntenorganisaties (VSOP) (The Netherlands); APOVITA (Portugal);Confederación de Consumidores y Usuarios (Spain); The Patients Association(United Kingdom)Products: European Charter of Patients’ Rights, 2002Team: Giuseppe Cotturri, Stefano A. Inglese, Giovanni Moro, Charlotte Roffiaen,Consuelo Scattolon

Citizens for the New EuropeImplementation timeframe: 2002–2003Promoter: Active Citizenship NetworkSupport: European Commission—Directorate General Education and Culture,Bristol-Myers Squibb, GEMedical Systems, Bank Pekao, Unicredito Italiano,Alitalia.Involved countries: Austria, Belgium, Bulgaria, Cyprus, Czech Republic,Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy,Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania,Slovakia, Slovenia, Spain, Sweden, Turkey, United Kingdom.Partner organizations: The World of NGOs (Austria); Fondations pour lesgénérations futures (FGF) (Belgium); Federation of Consumers, NGODevelopment Center, Index Foundation (Bulgaria); KIDDA–Patient RightsAction Group (Cyprus); Consumers Defence Association (Czech Republic);Danmarks Aktive Fobrugere—Active Consumers Denmark (Denmark); PeipsiCenter for Transboundary Cooperation (Estonia); Kuluttajat-Konsumenternary—The Consumers (Finland); Consommation Logement et Cadre de Vie (CLCV)(France); Deutsche Gesellschaft für Versicherte und Patienten e. V. (DGVP)(Germany); Europaiki Ekfrasi—European Expression (Greece); NationalAssociation of Consumer Protection in Hungary (NACPH) (Hungary); Ireland;Cittadinanzattiva (Italy); Meridian Plus (Latvia); NGO Information and SupportCentre (NISC) (Lithuania); Luxembourg; Ghaqda tal-Konsumaturi—Consumers’Union (Malta); Centrum for Europese Studies en Opleidingen (CESO) (TheNetherlands); European Environmental Center, Association of Polish Consumers(Poland); Associação Portuguesa Para o Desenvolvimento Local—Animar(Portugal); APC (Romania); Association of Consumers Organizations,

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Association of Slovak Consumers, Slovak Academic Information Agency—Service Center for the Third Sector (SAIA-SCTS) (Slovakia); Legal InformationCenter for NGOs (Slovenia); Asociación Valenciana de Consumidores y Usuarios(AVACU); Confederación de Consumidores y Usuarios (CECU); Asociación parala Defensa de los usarios de Bancos y Cajas de Ahorros de Espana (ADICAE)(Spain); Sveriges Konsumenter i Samverkan—Swedish Consumer Coalition(Sweden); Helsinki Citizens’ Assembly (Turkey); Rutland Citizens AdviceBureau (United Kingdom)Products: Public Institutions Interacting with Citizens’ Organizations: A surveyon public policies regarding civic activism in Europe, Report, 2004Team: Giovanni Moro, Charlotte Roffiaen, Melody Ross, with the collaboration ofGiulia Savarese

Assessing and Reviewing the Criteria of Representativeness of Civic NGOsImplementation timeframe: 2003–2004Promoter: Active Citizenship NetworkSupport: European Commission—DG Education and Culture, Inter-AmericanDevelopment Bank (IADB), United Nations Development Programme (UNDP),European Economic and Social Committee, World Bank and the Secretaría deCooperación Iberoamericana (SECIB)Involved countries: Austria, Belgium, Bulgaria, Cyprus, Czech Republic,Denmark, Estonia, Finland, France, Germany, Greece, Ireland, Italy, Latvia,Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Slovak Republic,Romania, Slovenia, Spain, Sweden, Turkey, United Kingdom, as well as Australia,Canada, Tunisia, USAPartner organizations: The World of NGOs (Austria); Foundation for FutureGenerations European Confederation of Workers’ Co-operatives, SocialCooperatives and Participative Enterprises (CECOP), European LiaisonCommittee on Services of General Interest (CELSIG), European Citizen ActionService (ECAS), International Federation for Human Rights (FIDH) (Brussels);NGO Development Centre Bourgas (Bulgaria); Cyprus Consumers Association(Cyprus); Consumer Defence Association (Czech Republic); Danmarks AktiveForbrugere (Denmark); Peipsi Centre for Transboundary Cooperation (Estonia);The Consumers (Finland); Réseaux Services Publics (France); Maecenata Institut(Germany); European Expression, Consumer Protection Center (KEPKA)(Greece); Nosza Projekt (Hungary); Age Action (Ireland); AssociazioneNazionale delle Cooperative di Servizi e Turismo (ANCST) (Italy); ConsumersAssociation (Malta); Center for European Studies and Training (CESO)(Netherlands); European Centre of Sustainable Development (CEZR) (Poland);Oikos (Portugal); Association of Slovak Consumers (Slovakia); RomanianAssociation for Consumers Protection (APC) (Romania); Legal InformationCenter for NGOs (PIC) (Slovenia); Confederación de Consumidores y Usuarios(CECU) (Spain); Kvinnoforum (Sweden); The Human Resources DevelopmentFoundation (HRDF) (Turkey); Rutland Citizens’ Advice Bureau (UnitedKingdom)

Annexes 207

Products: Participation in policy-making: criteria for the involvement of CivicNGOs, Report, 2004Team: Cecília Fonseca, Pamela Harris, Giovanni Moro, Melody Ross, CharlotteRoffiaen, with the collaboration of Inés Brill

Citizens’ Report on the Implementation of the European Charter of Patients’RightsImplementation timeframe: 2003–2005Promoter: Active Citizenship NetworkSupport: Merck & Co., Inc.Involved countries: Austria, Denmark, Finland, France, Germany, Greece,Ireland, Italy, The Netherlands, Portugal, Spain, Sweden, United Kingdom.Partner organizations: Women’s Health Center Graz (Austria); National DanishAssociation against Breast Cancer (Europa Donna) (Denmark); Finnish Patients’Association (Finland); Missions Publiques en Europe (OMIPE) (France); DeutscheGesellschaft für Versicherte und Patienten e. V. (DGVP) (Germany); Forum forHealth and Health Services (Greece); Age Action (Ireland); Cittadinanzattiva/Tribunale per i diritti del malato (Italy); National Foundation for Patients,Handicapped and Elderly (The Netherlands); ‘‘Sempre Bem’’—Association for thePromotion: of the Welfare (Portugal); Confederación de Consumidores y Usuarios(CECU) (Spain); Bröstcancerföreningarnas Riksorganisation-BRO (EuropaDonna) (Sweden); The Patients Association (United Kingdom)Products: Citizens’ Report on the Implementation of the European Charter ofPatients’ Rights, Working paper, 2005Team: Alessandro Lamanna, Giovanni Moro, Melody Ross, with the collaborationof Fiorenza Deriu

Citizens as CSR PartnersImplementation timeframe: 2005–2006Promoter: Active Citizenship Network, FONDACASupport: European Commission—Directorate General Employment, SocialAffairs and Equal Opportunities, ENEL, UniCredit GroupInvolved countries: Austria, Cyprus, Germany, Hungary, Italy, Malta, Poland,Slovenia, United KingdomPartner organizations: The World of NGOs (Austria); Cyprus ConsumerAssociation (Cyprus); BBE-Bundesnetzwerk, B€urgerschaftliches Engagement(Germany); Association for Consumer Protection (Hungary); Cittadinanzattiva(Italy); Ghaqd-tal-Konsumaturi (Malta); Association of Polish Consumers(Poland); Legal Information Center for NGOs (Slovenia); Rutland CitizensAdvise Bureau (United Kingdom)Products: Not Alone. A Research on Partnerships between Private Companiesand Citizen’s Organizations in Europe, Report, 2006Team: Barbara D’Alessio, Cecília Fonseca, Antonio Gaudioso, Giovanni Moro,Charlotte Roffiaen, Melody Ross, Monica Ruffa, Ilaria Vannini

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European Charter of Active CitizenshipImplementation timeframe: 2005–2006Promoter: Active Citizenship Network, FONDACASupport: European Commission—Directorate General Education and Culture,UniCredit GroupInvolved countries: Austria, Czech Republic, Germany, Italy, Malta, Poland,Portugal, Romania, Slovenia, TurkeyPartner organizations: The World of NGOs (Austria); Consumers DefenseAssociation (Czech Republic); Sozialbüro Main-Taunus (Germany);Cittadinanzattiva (Italy); Ghaqda-tal-Konsumatori (Malta); Association of PolishConsumers (Poland); Animar (Portugal); Romanian Association for ConsumerProtection (Romania); Legal Information Center for NGOs (Slovenia); HelsinkiCitizens’ Assembly (Turkey)Products: European Charter of Active Citizenship, 2006Team: Cinzia Carnevale, Giuseppe Cotturri, Cecília Fonseca, Giovanni Moro,Charlotte Roffiaen, Ilaria Vannini

Lisbon Minus 3: Evaluating CSR PartnershipsImplementation timeframe: 2006–2007Promoter: Active Citizenship Network, FONDACASupport: European Commission—Directorate General Employment, SocialAffairs and Equal Opportunities, UniCredit GroupInvolved countries: Austria, Bulgaria, Denmark, France, Germany, Hungary,Italy, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, United KingdomPartner organizations: The World of NGOs (Austria); Index Foundation(Bulgaria); Denmark Consumer Council (Denmark); Union Nationale desAssociations Familiales (France); Centrum für Corporate Citizenship(Germany); National Association for Consumer Protection (Hungary);Cittadinanzattiva (Italy); CentrumCSR.pl (Poland); Animar (Associaçãoportuguesa para o desenvolvimento local) (Portugal); Employer’s Confederationof Industry, Services and Commerce (Romania); Association of Slovak Consumers(Slovakia); Legal Information Centre for NGOs (Slovenia); Economistas SinFronteras (Spain); Rutland Citizens Advice Bureau (United Kingdom)Products: Toolbox for Evaluating Partnerships between Companies and Citizens’Organisations, 2007Team: Adele Bottiglieri, Barbara D’Alessio, Giovanni Moro, Chiara Prost,Charlotte Roffiaen, Melody Ross, Monica Ruffa, Ilaria Vannini

The role of civic organizations in the communication processes of the European UnionImplementation timeframe: 2006Promoter: FONDACASupport: European Commission—Representation in ItalyInvolved countries: ItalyProducts: The role of civic organizations in the communication processes of theEuropean Union, Report, 2006

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Team: Giovanni Moro, Ilaria Vannini, with the collaboration of AlbertoCastagnini, Alessia Sabbatino e Giulia Savarese

Patients’ Rights in Europe. Civic information on the Implementation of theEuropean Charter of Patients’ RightsImplementation timeframe: 2006–2007Promoter: Active Citizenship Network with the collaboration of FONDACASupport: Merck & Co. Inc.Involved countries: Austria, Belgium, Denmark, Finland, France, Germany,Greece, Ireland, Italy, The Netherlands, Portugal, Spain, Sweden, United Kingdom.Partner organizations: Women’s Health Center Graz (Austria); Gruppo nazionaledi Europa Donna (Belgium); National Danish Association against Breast Cancer(Europa Donna) (Denmark); Finnish Patients Association (Finland); MissionsPubliques en Europe (OMIPE) (France); Deutsche Gesellschaft für Versicherte undPatienten e. V. (DGVP) (Germany); Forum For Health and Health Services(Greece); Age Action and Adelaide Hospital Society (Ireland); Cittadinanzattiva/Tribunale per i diritti del malato (Italy); Stichting Fonds PGO: NationalFoundation for Patients, Handicapped and Elderly (The Netherlands); SempreBem, Association for the promotion of the welfare (Portugal); Confederación deConsumidores y Usuarios (CECU) (Spain); Bröstcancerf€oreningarnasRiksorganisation-BRO (Europa Donna) (Sweden); The Patients Association(United Kingdom)Products: Patients’ Rights in Europe. Civic information on the Implementation ofthe European Charter of Patients’ Rights, Report, 2007Team: Alessandro Lamanna, Giovanni Moro, Melody Ross, Ilaria Vannini, withthe collaboration of Fiorenza Deriu

Monitoring and Evaluating the State of the Rights to European Active CitizenshipImplementation timeframe: 2007–2008Promoter: Active Citizenship Network, FONDACASupport: European Commission—Directorate General Education and Culture,Marche RegionInvolved countries: Bulgaria, Cyprus, Czech Republic, Germany, Greece, Italy,Poland, Romania, Slovenia, TurkeyPartner organizations: Civicus (International ONG, Johannesburg); IndexFoundation (Bulgaria); The Management Centre of the Mediterranean (Cyprus);Consumers Defense Association-SOS (Czech Republic); Maecenata Institut(Germany); Evropaiki Ekfrasi (Greece); Cittadinanzattiva (Italy); Women’sRights Center (Poland); The National Association for Consumers’ Protection(Romania); Legal Information Center for NGOs (Slovenia); The Human ResourcesDevelopment Foundation—IKGV (Turkey)Products: Monitoring checklist and Evaluation matrix, 2008Team: Giovanni Moro, Charlotte Roffiaen, Melody Ross, Monica Ruffa, IlariaVannini

210 Annexes