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The patient - as a subject of medical-legal relations
The study of the issues of legal support of medical activity cannot be complete without an analysis of the legal status of such an important subject of medical and legal relations as a patient. The patient, as the subject of medical and legal relations in the field of medical activity, is a key figure with whom all other subjects are connected in one way or another, who, to one degree or another, take part in organizing, providing or directly providing medical care. It would not be an exaggeration to note that without patients, the functioning of the entire healthcare sector loses much of its meaning.
It should be noted that just like crime, a social phenomenon that always accompanies society, even in the most civilized and highly developed democracies, illness is a social phenomenon, from which even with the highest level of development of medicine and the most careful attitude of citizens to their own health, it is not possible to get rid completely. In this regard, it is no coincidence that one of the priority principles of the health care system is prevention, since the effectiveness of preventive measures is not equal in comparison with other methods aimed at solving the main social tasks of the state in preserving and enhancing the health of the population.
Given the central place of the patient in the field of health care, it seems appropriate to dwell on the study of problems associated with the legal status of the patient in modern Russia. The range of opinions on this issue is very wide. Starting from the fact that patients in our country are practically disenfranchised, and ending with the fact that Russia is in the leading position in the world in terms of legislative support for the rights of patients. Consider this problem in more detail.
Initially, it becomes necessary to determine the patient’s place in the system of medical and legal relations from the point of view of legal theory. The importance of this issue is dictated by the advisability of studying the rights, freedoms, duties and other components of the patient’s legal status, since it is a detailed study that will provide comprehensive coverage of this phenomenon and, importantly, will facilitate the integration of medical and legal phenomena into the system of the theory of legal science. It is the theory of law, based on its fundamental nature and purpose, on the theoretical study of sectoral legal phenomena, that can contribute to the development of medical law as an independent branch of law. In addition, it is the use of general provisions and principles of the theory of law that allows you to analyze in detail such a complex legal phenomenon as the legal status of the patient.
Considering through the prism of the theoretical and legal constructions of the patient as a subject of medical and legal relations, it is necessary, first of all, to give a clear definition of this concept. S.G. Stetsenko believes that “a patient is a person who has applied to a medical institution for diagnostic, medical or preventive medical care or who is involved as a test subject in clinical trials of drugs. In other words, a person must have a real relationship (legal relationship) ) with a medical institution, regardless of its legal form (state, municipal, private), based on the person’s appeal to this institution ezhdenie medical care or his participation in clinical trials, "* (111).
The Patient Rights Bill in the United States contains a definition according to which “a patient is any individual who receives long- or short-term inpatient or outpatient care, emergency or emergency care, and also a client of facilities for long-term care or care" * (112 ) That is, in accordance with this definition, a citizen who applied to a medical institution for a certificate of his state of health cannot be considered a patient.
Even when applying to a medical institution for an extract from a medical record, a certificate of health status, the results of preventive or dispensary examinations conducted earlier or over the course of a number of years, a citizen acquires a special status as a person who has entered into a relationship with a medical institution.
Even if this appeal does not involve any medical interventions, a citizen is vested with certain rights and obligations, and, therefore, gets the right to get acquainted with medical documents and dispose of confidential information regarding his state of health.
In turn, V.I. Akopov and E.N. Maslov noted that “any person who seeks medical care is considered to be a patient, regardless of their state of health or the presence of any disease, that is, it is a broader concept than a patient” * (113).
One should agree with the latter definition, since the term “patient” is indeed a broader concept than the term “patient” and is not related to the presence or absence of a disease. In real life, not all sick people, i.e. those who have deviations in their health state turn to medical institutions for medical help. We are talking about cases of self-medication at home or a citizen's refusal from the proposed medical intervention. In these cases, citizens who do not seek medical help, even if they suffer from diseases, cannot be considered patients, since they have not entered into legal relations with medical workers, that is, they have not accepted the rights and obligations inherent in the subject of medical law relationship.
Considering the above facts, the author believes that the patient is a person who has entered into legal relations with a medical worker (medical institution), and is endowed, in this regard, with specific laws, freedoms and obligations of the subject of medical and legal relations fixed by the state in law.
It should be noted that neither the place of medical care, nor the state of health of a person in need of medical care, are of great importance for determining the legal status of the patient. In particular, medical personnel of the ambulance team provide emergency medical care exclusively outside medical facilities. Moreover, in accordance with the requirements of the current legislation of the Russian Federation, medical workers of any specialty are required to provide first aid to citizens, regardless of location, time of day, the availability of necessary tools and medicines.
At the same time, it is not uncommon for citizens to go to a medical institution, in the absence of signs of illness, in order to conduct a dispensary, preventive or other examination necessary to obtain a certificate of health status, vaccination, employment, etc. In all of these In cases, a citizen, without suffering any disease, enters into legal relations with medical workers or medical institutions. As a result, he is endowed with certain rights, obligations, and, therefore, acquires the specific legal status of the patient as a subject of medical-legal relations.
In this regard, it seems necessary to consider the legal status of the patient as a complex theoretical and legal phenomenon that includes such characteristics as legal personality, fundamental rights, duties, responsibilities, guarantees for the realization of his rights and freedoms.
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The patient - as a subject of medical-legal relations
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