国家医疗机构提供商业性医疗服务的主要法律风险

E. Pesennikova, O. Gridnev, S. Korostelev
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引用次数: 0

摘要

通过对1990年至2017年发布的与RF医疗活动相关的规范性立法文件的分析,形成了医疗设施法律风险的分类。分类的使用有助于建立系统的法律保护方法。根据《联邦公共保健法》,还通过提供有偿医疗服务来保障健康保护权。根据俄罗斯的立法,这一权利不能只在私营医疗机构中行使,这使得公共医疗机构成为这一进程的合法参与者。但是,根据第1006号政府决议,对提供付费医疗服务的公共医疗机构有一系列限制。例如,他们必须通过告知消费者国家保障计划所保障的权利来证明收费的合理性。通过对保障公共医疗服务规范的规范性立法文件的分析,对法律风险进行了分类。违反《消费者保护法》和《民法典》(合同风险)似乎成为最常见的风险。“医疗差错”没有明确的概念。这就是为什么几乎不可能区分病人的不负责任,工作人员的疏忽或医生的低专业水平。这就是病人的权利和医务人员的责任都要由国家来规范的原因。所作的分析表明,国家机构在提供有偿医疗服务时,如果出现不当行为,就会出现风险和制裁。在提供有偿医疗服务时最典型的不当行为发生在以下情况:可以根据国家保障方案提供医疗服务;未能提供医疗服务;在提供有偿医疗服务时违反医疗和合同文件;病人获得完整和可靠的医疗保健信息的权利受到侵犯。
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Main legal risks in provision of commercial medical services by state medical institution
Based on the analyses of normative-legislative documents related to medical activities in RF published between 1990 and 2017 the classification of medical facility legal risks has been formed. The usage of the classification enables building systematic approach for legal protection.The right for health protection is ensured also by providing paid medical services according to the Federal Act on Public Health Care. It doesn’t follow from Russian legislation that this right could be exercised only in private medical institutions, which makes public medical institutions legitimate participants of the process. However, in accordance with the Government Resolution No. 1006, there is range of restrictions for public medical institutions in case they provide paid medical services. For instance, they must justify charging by informing consumers about their rights guaranteed by the State guarantees program.The analysis of normative-legislative documents that ensure regulation of public medical services caused the classification of legal risks. The violation of the Consumer Protection Act and of the Civil Code (contractual risks) appeared to become the most common ones.There is no clear notion of “medical error”. That’s why it is almost impossible to make a distinction between patient irresponsibility, staff negligence or low doctor’s professionalism. This is the reason for patients’ rights as well as medical personnel responsibility to be regulated by the state.The analysis that is been made shows that risks and sanctions in the provision of Paid Medical Services by State institutions occur in cases of misconduct while providing Paid Medical Services. The most typical cases of misconduct while providing Paid Medical Services come when: medical services could be provided under the State guarantees program; failure to provide medical care occurs; violation of medical and contractual documents in the provision of Paid Medical Services takes place; violation of patient’s rights to receive complete and reliable information related to medical care takes place.
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