A lot has been said about the rights of the patient today. Their violation is a rather urgent topic, especially for domestic medicine. But not everyone knows that there are responsibilities of the patient. It is the patient - this is a legal status, in contrast to the term "sick". We also note that these obligations are not symbolic, they are directly spelled out in Russian legislation. What they include, what a violation is fraught with, what sanctions can be - we will analyze all this further.
Legislative Framework
Speaking of the rights and obligations of the patient, we will rely on the following legislative acts of the Russian Federation:
- The constitution of the state. Art. 45 and 46.
- FZ No. 323, adopted in November 2011, - "On the basics of he alth care in the Russian Federation." Art. 30.
- FZ No. 1499-1, adopted in June 1991 - "On he alth insurance in the Russian Federation." Final Variationlaw - 1993 version. Art. 6 and 15.
- FZ No. 2, adopted in January 1996, - "On Protection of Consumer Rights". Art. 17, 44-46.
- FZ No. 4866-1, adopted in April 1993, - "On appealing to the judicial system of the Russian Federation decisions and actions that violate the rights of citizens."
It should be noted that the fundamental document in our case on the rights and obligations of the patient is Law No. 323. Let's analyze it in detail.
Rights under Federal Law No. 323
The rights and obligations of the patient is one of the areas that are affected by the law "On the Fundamentals of He alth Protection in Russia".
The full list of patient rights, according to the Federal Law, is as follows:
- The right to be treated with respect and humaneness by doctors and other he alth workers, service personnel.
- Conducting both examination and treatment in appropriate conditions, in accordance with current sanitary and hygienic standards.
- The right to hold a medical consultation, the possibility of consulting another specialist.
- Relieve severe pain caused by therapy, surgery, etc.
- The right to keep medical secrecy about the procedure, treatment, general history.
- Own written consent to medical intervention, as well as informing physicians of such a possibility.
- The right to refuse medical care.
- Obtaining complete information about the state of one's own he alth, the rights and obligations of the patient and the doctor.
- Usea full package of medical services within the framework of the current voluntary medical insurance program.
- The right to compensation for damage to him (the patient) in case of harm to he alth by he alth workers. But only if the guilt of the doctors is proven in court.
Note that the rights and obligations of patients and he alth workers will be directly interconnected. What does it mean? The rights of the patient are the duties of the doctor, and vice versa.
We continue to analyze the legislative act.
Obligations under Federal Law No. 323
Now list the responsibilities of the patient:
- Follow the internal regulations of the medical institution where he (the patient) is being examined or treated.
- Take care of your he alth. What does affirmation mean? Do not take actions that could harm he alth - both your own and other patients of the medical facility.
- Respect the rights of doctors, attendants, other patients.
- Inform the treating specialist about your misunderstanding/incomplete understanding of the meaning of the upcoming medical intervention.
- Follow the rules of conduct prescribed for patients in this medical facility. In particular, be on time for scheduled procedures, examinations. In case of impossibility of a visit or being late, it is necessary to warn your doctor or nursing staff (nurse) about this fact in a timely manner.
- Follow the instructions of the treating specialist. Report about contacting another doctor for help, stopping the prescribed treatment.
And again, the obligations of the patient and the doctor are connected. Medical rightsinstitutions will flow directly from the duties of his patients.
Classification of Duties
Now let's move on to more general cases. All patient responsibilities can be divided into three categories:
- Provided by the Russian Civil Code. These will be the basic duties of any citizen as a customer, consumer of services in our country.
- Obligations under the Consumer Rights Protection Act. Here it is considered what the consumer of any service should. In particular, medical.
- Responsibilities stipulated specifically by Federal Law No. 323 concerning the protection of the he alth of Russian citizens. Here the patient is considered only as a consumer of medical services.
Now it makes sense to take a closer look at the most important responsibilities of the patient.
Obligation to take care of one's own he alth
This is the key duty of any patient on the territory of the Russian Federation. This duty is directly prescribed to him by paragraph 1 of Art. 27 Federal Law No. 323 "On He alth Protection in the Russian Federation".
Take care of your he alth is a declarative norm that illustrates the humanity of the legal system. Therefore, no sanctions are prescribed for violation of this obligation.
Passing medical examinations: legislative framework
Talking about the rights and obligations of patients in medical law, one cannot but touch on such topics as medical examinations, medical examinations. This preventive measure is alsoconsidered a duty of the patient. However, the obligation does not apply to all Russian citizens - only to certain categories of workers.
Now let's introduce the legislative acts regulating this issue:
- Articles 76 and 213 of the Russian Labor Code.
- FZ No. 273 (2012 version) - "On Education in the Russian Federation". Article 48
- FZ No. 3132-1 (1992 version) - "On the status of a judge in Russia". Article 4.1.
- FZ No. 35 (version of 2005) - "On the electric power industry in the Russian Federation." Article 28.
- FZ No. 52 (1999 version) - "On epidemiological and sanitary well-being in the Russian Federation". Paragraph 4 of Article 34.
Now let's briefly present the content of the prescribed legislative acts.
Who is required to undergo medical examinations?
Once again, we note that this duty of the patient in the Russian Federation is selective. It concerns only the following categories of persons:
- Workers employed in hazardous industries, workers whose activities are associated with dangerous working conditions for life and he alth.
- Workers in the food industry, trade, catering.
- Persons whose work activity is connected with any type of transport.
- Water works workers.
- Specialists employed in children's and medical institutions.
- Working in the judiciary.
- Electricity workers.
The above legislation prescribes mandatory preliminary medical examinations for these categories (to confirmthe fact of professional suitability), as well as periodic annual medical examinations.
The following particulars are indicated:
- An additional duty of a teacher is to undergo an extraordinary medical examination in the direction of his employer.
- Employees in the electric power industry are required to undergo pre-shift medical examinations aimed at identifying the fact of using alcohol, psychotropic or narcotic substances.
If a patient belonging to one of the categories indicated in the list refuses to undergo a medical examination, he is not allowed to work. He can return to work only after passing this preventive examination satisfactorily - if it confirms his professional suitability.
The duties of those suffering from dangerous diseases
A very important topic in the general story about the duties of the patient and the professional role of the doctor. Here we will rely on the Decree of the Russian Government No. 715 (2004) - "List of socially significant diseases, pathologies that are socially dangerous."
It follows from this legislative act that citizens suffering from at least one disease from the List must:
- Get a medical examination.
- Engage in full treatment of pathology according to the recommendations of your doctor.
- Prevent relapse, exacerbation by taking preventive measures.
The list includes the following diseases:
- HIV
- Hepatitis B and C.
- Tuberculosis.
- Diphtheria, etc. (total 15 items).
Responsibilities of those undergoing treatment
We have considered the concept and general characteristics of the duties of the patient, but it should be noted that many, when talking about patients, still have in mind only those people who are currently undergoing treatment. Let's be specific about the debt of these individuals:
- Comply with the treatment regimen. Even if it prescribes their temporary disability.
- Do not violate the internal regulations of a particular medical institution (clause 3, art. 27 of the Federal Law No. 323).
- Obligation to follow the doctor's recommendations, take prescribed medicines, undergo prescribed procedures, provide complete and comprehensive information about your he alth status. In practice, this obligation has a declarative character - the patient does not expect any punishment if he forgets, say, to take the pills on time. Or replace an expensive medicine with a cheap analogue.
- The obligation to assist the medical organization in the proper and complete performance of the medical services provided to him (the patient). The basis for such an assertion is the provisions on the work contract, which are spelled out in Art. 718 Civil Code.
- Comply with the treatment regime, the rules of the patient's behavior, approved by internal acts (orders, orders, etc.) of the medical institution - clinic, hospital, etc.
What is "non-adherence"?
ClearThere is no interpretation of this phrase. To determine its essence, we will rely on the Order of the Ministry of Social Development and He alth of the Russian Federation No. 624n (adopted in 2011) - "On the procedure for issuing disability certificates".
This act under the violation of the treatment regime determines the following actions/inaction:
- Unauthorized leaving the hospital.
- Traveling to another administrative region without permission from the attending physician.
- Untimely attendance at appointment.
- Returning to work without closing a temporary disability sheet.
- Refusal to undergo a medical and social examination.
- Failure to appear at the appointed procedure of the medical and social examination.
- Other violations.
All of the above, the attending doctor is authorized to note in the patient's temporary disability sheet.
If you go to medical practice, then non-compliance with the doctor's prescriptions is usually the following:
- Refusing prescription medications.
- Refusal of tests, other medical interventions.
- Failure to attend a preventive medical examination.
Sanctions when applying for a temporary disability certificate
Punishment for violation of the obligations of the patient can be assigned to a citizen when they apply for sick leave at work. It manifests itself in a decrease in the amount of temporary disability benefits.
In Russia, this sanction is regulated by Part 1 of Art. 8 of the Federal Law No. 255 (adopted in 2006) - "On compulsory social insurance of a citizen in case of temporaryincapacity for work". The following is considered sufficient reason for imposing a sanction:
- Violation during temporary disability of the treatment regimen prescribed by a doctor, without good reason.
- Failure to appear at the scheduled medical examination, medical examination of a citizen in the absence of good reasons.
- Injury or disease that occurred as a result of alcohol, drug, toxic intoxication of the patient. Or his actions directly related to such a state.
There is one exception to all of this. It is forbidden to reduce the amount of temporary disability benefits to persons if it (disability) is associated with an injury received at work, an accident at work.
Denied treatment - a sanction?
Many patients are interested in: can a medical organization, for some reason, refuse to treat them? No, this is not possible in any violation of the obligations of the patient. The legal justification for this assertion is as follows:
- Civil Code of Russia, art. 772. Reliance on the fact that the contract for the provision of medical services is public. A medical institution cannot fail to provide its services if it has the ability to provide them.
- Determination of the Constitutional Court No. 115-O (submitted in 2002).
Paying medical services
The patient is obliged to pay for the medical services voluntarily rendered to him, if they are paid, at the cost that is prescribed in the contract concluded with himcontract.
The following is additionally important:
- If the contract implies an advance payment, then failure to make it on time will be regarded as a refusal to provide services.
- If the patient refused to comply with the terms of the contract, he must still pay the medical organization for the actual costs incurred by it.
There are no such spheres where a person would have only rights. Civil society always means having responsibilities. The medical field will be no exception. The patient, the doctor, and the medical institution as a whole have rights and obligations.
