Med. pravo., 2015; 2(16): 11-21
doctoral degree candidate at Legislation Institute of the Verkhovna Rada of Ukraine
The problem of correlation between rights of medical law subjects and freedom of conscience
Medical activities are recently supported by legal mechanisms more widely. Thus is due to several factors: -ongoing health care reform in Ukraine; Awareness patients of their rights; the actual increase in cases related to a particular aspect of medical practice. Thus, in our opinion, patients' rights are highlighted much more than the protection of healthcare professionals rights. Professional medical activity is influenced by -law and legislation, ethics, professional ethics, medical ethics and bioethics.The purpose of this article is to determine the effect of freedom of conscience in relationship arising between doctor and patient, with emphasis on their rights and obligations. We deliberately avoid the assessment of a relation of religion to the issues examined in this article. First of all, this is an area related to the issues of abortion, transplantation and donation, using different methods of reproductive technologies (surrogacy), euthanasia issue, which is known to be banned in Ukraine.
Category freedom of conscience. Freedom of conscience is a multidimensional phenomenon, seen in terms of philosophy, sociology, religion and law. Broadly speaking, freedom of conscience -a wide range of personal beliefs of man in the philosophical, political, moral, ethical, aesthetic and other areas of life. In a narrower sense by freedom of conscience's rights and citizen to freely determine their attitude to religion -namely the right to be believers and unbelievers.National legislation Ukraine resolved the issue of freedom of conscience as the constitutional level and in law -in the special Law of Ukraine "On freedom of conscience and religious organizations" In addition, European Court of Human Rights practice is important source. Regarding medical relations, it is worth mentioning Law of Ukraine "Fundamentals of legislation on health care," certain provisions of the Civil Code of Ukraine. Thus, it is impossible not to note the provisions of the Convention for the Protection of human rights and dignity for the application of biology and medicine: Convention on Human Rights and Biomedicine 1997 Declaration of policy on the rights of patients in Europe, the acts of the World Medical Association and other similar documents.Speaking about the rights of medical law and their relationship with freedom of conscience, we actually will use the already classic division of health law on those who receive medical care or service, and those who provide -private patient and doctor (medical officer).
The relationship between doctor and patient must be based on mutual respect for the integrity, freedom of choice and dignity. This statement is axiomatic.The patient -a person who has applied for medical assistance and / or where such aid. Any person having such an integral moral rights, as the right to freedom of religion, the right to health care, to decide the question of how and by what methods and structures may realize their powers regarding these rights. In fact -the person to decide whether to apply for health care or medical services. According to Part 4 of Article 284 Civil Code of Ukraine competent adult individual that understands the significance of his actions and could control them, has the right to refuse treatment. At the same time pay attention to some terminological clarification. The said article is part of the "treatment", and the article concerning the right to medical care. We believe that the term treatment may be understood as providing medical assistance in the form of a method of medical intervention and the provision of a particular type of medical services.We note that an individual may: 1) abandon the appeal for medical help, and 2) to refuse a particular medical intervention (in this case it is not providing informed consent to medical intervention).
Although the concept of "consent" means acceptance of treatment, the concept of informed consent applies equally to refusal of treatment or choice of alternative treatment. For legislators actuallydoes not matter from which reason a person refuses treatment. Among them -it may be reflections of the freedom of conscience of individuals. However, while based on the provisions of Article 43 of the Basic Laws on Health Care -procedural aspect, the doctor is obliged to explain such an individual that the refusal may lead to serious consequences and further -to take from him written confirmation, and if it is impossible to obtain -refusal to certify the relevant act in the presence of witnesses.This fully correlated with the position of the Russian Orthodox Church, according to its Basic Social Concept states that every person should have the right and the real possibility of not to accept such interventions in your body that are contrary to her religious beliefs.More difficult is the issue of rights and duties correlation doctor and the question of freedom of conscience. Like any other person, the doctor has their own personal rights and freedoms -including freedom of conscience.
There is quite a logical question -how to solve the dilemma value of freedom of conscience medical officer and his direct and immediate duty -to provide medical care to all who need it?The main issue is the possibility of failure of the doctor of medical care. Under the provisions of national law, the doctor has the right to refuse to conduct patient if the latter does not comply with medical prescriptions or internal regulations of health, provided that it does not threaten the patient's life and health.Thus legislatively established only two grounds for refusal of medical treatment further proceedings: -failure patient medical prescriptions, and violation of internal regulations recent health institution. Other grounds, including those related to freedom of conscience -none.
We believe that any refusal of treatment, even on the grounds specified in the Code of Ethics doctor Ukraine contradicts the text Oath doctor Ukraine -"give aid to all who need uu." By the way, doctor Oath Ukraine, as specified Ethical Code inspector of Ukraine contains no provisions on freedom of conscience doctor.In our view, by analogy with the patient's refusal of medical treatment, the doctor must be sure to confirm in writing its refusal to include it in the patient's medical record and send the patient to another doctor demanded to conduct a competent patient care.Determining the interaction of human medical workers and freedom of conscience, we explore the complex symbiosis of heterogeneous social relations -related to the implementation of political rights -to freedom of religion, a number of social rights -the right to health and medical care, proper professional rights of health workers .Morality, bioethics and the right to serve a common purpose -to organize social relations in the field of health, reconciling the interests of the individual and society, to a realization of their legitimate human rights in the field of medical care.
However, speaking of the freedom of conscience should not forget about the equality of all before the law. Shares the view that the state should set about this any exceptions for some categories of the faithful, nor, for its part, a national, whatever religion it is not adhered to, has no right to refuse to perform common law duties. The state should legally define the limits of physical behavior of health care relationships (but not the ideas, not faith).
So long as Ukrainian medical community and society will not come to the possibility of the statutory right medical officer for implementation of freedom of conscience, including the refusal of the granting of a medical intervention, said the dilemma is resolved in favor of the patient. In other words -the establishment of binding the claims of medical care.
Key words: medical law, medical legalrelationship, freedom of conscience, the doctor, the patient, consent to medical treatment.
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