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RIGHTS AND DUTIES OF THE PATIENT

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Federal Law of 21.11.2011 N 323-FZ
(as amended on 04/03/2017)
“On the fundamentals of protecting the health of citizens in the Russian Federation”
Chapter 4. RIGHTS AND RESPONSIBILITIES OF CITIZENS IN THE SPHERE OF HEALTH PROTECTION

 

Article 18. Right to health protection

 

Everyone has the right to health protection.
The right to health protection is ensured by the protection of the environment, the creation of safe working conditions, favorable working conditions, everyday life, recreation, education and training of citizens, the production and sale of food of appropriate quality, quality, safe and affordable medicines, as well as the provision of affordable and high-quality medical assistance.
(in the amended version of Federal Law No. 314-FZ of October 22, 2014)

 

Article 19. Right to medical assistance

 

Everyone has the right to medical assistance.
Everyone has the right to medical care in a guaranteed amount provided without charge in accordance with the program of state guarantees of free medical care to citizens, as well as to receive paid medical services and other services, including in accordance with the contract of voluntary medical insurance.
The right to medical care for foreign citizens residing and staying on the territory of the Russian Federation is established by the legislation of the Russian Federation and the relevant international treaties of the Russian Federation. Persons without citizenship permanently residing in the Russian Federation enjoy the right to medical assistance on an equal basis with citizens of the Russian Federation, unless otherwise stipulated by international treaties of the Russian Federation.
The procedure for providing medical assistance to foreign citizens is determined by the Government of the Russian Federation.
The patient has the right to:
1) the choice of a doctor and the choice of a medical organization in accordance with this Federal Law;

2) prevention, diagnosis, treatment, medical rehabilitation in medical organizations in conditions corresponding to sanitary and hygienic requirements;

3) obtaining consultations of medical specialists;

4) relief of pain associated with the disease and (or) medical intervention, accessible methods and medications;

5) to obtain information about their rights and responsibilities, their state of health, the choice of persons who can be informed about the state of health in the patient’s interests;

6) obtaining therapeutic nutrition in case of a patient being on treatment in stationary conditions;

7) protection of information constituting a medical secret;

8) refusal of medical intervention;

9) compensation for harm caused to health in the provision of medical care;

10) admission of a lawyer or legal representative to protect his rights;

11) the admission of a clergyman to him, and in case of a patient being in hospital – to provide conditions for the conduct of religious rites, which are possible in a stationary environment, including the provision of a separate room, if this does not violate the internal order of the medical organization.

 

Article 20. Informed voluntary consent to medical intervention and to refuse medical intervention

A necessary prerequisite for medical intervention is the provision of informed voluntary consent of a citizen or his legal representative for medical intervention on the basis of the information provided by the medical officer in an accessible form on the purposes, methods of providing medical care, the risk associated with them, possible options for medical intervention, its consequences, as well as the expected results of medical care.
Informed voluntary consent to medical intervention is given by one of the parents or other legal representative in relation to:
1) a person who has not reached the age established by part 5 of Article 47 and part 2 of Article 54 of this Federal Law or a person recognized incompetent in accordance with the procedure established by law, if such person is unable to consent to medical intervention in his condition;

2) a minor patient with drug addiction while providing him with narcological assistance or with a medical examination of a minor with a view to ascertaining the state of narcotic or other toxic intoxication (with the exception of cases established by the legislation of the Russian Federation of the acquisition by minors of full legal capacity until they reach the age of eighteen).

A citizen, one of the parents or other legal representative of the person specified in subsection (2) of this section shall have the right to refuse medical intervention or to demand its termination, except for the cases stipulated in part 9 of this article. A legal representative of a person recognized as legally incompetent legally shall exercise this right in the event that such a person is unable to refuse medical intervention in his state.
If a person, a parent or other legal representative of a person specified in subsection (2) of this section refuses medical intervention, in an accessible form, the possible consequences of such refusal should be explained.
If one of the parents or other legal representative of a person specified in subsection (2) of this section refuses or a legal representative of a person recognized as legally incompetent, from medical intervention necessary to save his life, the medical organization has the right to apply to the court to protect interests such person. A legal representative of a person recognized as legally incapacitated, informs the guardianship and trusteeship authority in the residence of the ward about the refusal of medical intervention necessary to save the life of the ward, not later than the day following the day of this refusal.
The persons indicated in parts 1 and 2 of this article, for obtaining primary health care when choosing a doctor and medical organization for the period of their choice, give informed voluntary consent to certain types of medical intervention that are included in the list established by the authorized federal executive body.
Informed voluntary consent to medical intervention or refusal of medical intervention is made in writing, signed by a citizen, one of the parents or other legal representative, a medical worker and contained in the patient’s medical records.
The procedure for giving informed voluntary consent to medical intervention and for refusing medical intervention, including for certain types of medical intervention, the form of informed voluntary consent to medical intervention and the form of refusal of medical intervention are approved by the authorized federal executive body.
(in the edition of the Federal Law of 25.11.2013 N 317-FZ)

Medical intervention without the consent of a citizen, one of the parents or other legal representative is allowed:
1) if medical intervention is necessary on urgent indications to eliminate the threat to human life and if his condition does not allow him to express his will or there are no legal representatives (in relation to the persons specified in part 2 of this article);

2) in relation to persons suffering from diseases that pose a danger to others;

3) in relation to persons suffering from severe mental disorders;

4) against persons who have committed socially dangerous acts (crimes);

5) during forensic medical examination and (or) forensic psychiatric examination.

The decision on medical intervention without the consent of a citizen, one of the parents or other legal representative is accepted:
1) in the cases specified in clauses 9.1 and 9.2 of this article – by a panel of physicians, and in case the council can not be collected, – directly by the attending doctor on duty, with such a decision being made in the patient’s medical records and subsequent notification of medical officials organization (the head of the medical organization or the head of the department of the medical organization), the citizen in respect of whom the medical intervention is carried out, one of the parents or other legal representative of the person who ordered ano in part 2 of this article and for which medical intervention is carried out, either by the court in cases and in the manner established by the Russian Federation;

(in the edition of the Federal Law of 25.11.2013 N 317-FZ)

2) in respect of persons referred to in paragraphs 3 and 4 of part 9 of this article, by a court in the cases and in the manner established by the legislation of the Russian Federation.

For persons who have committed crimes, compulsory measures of a medical nature may be applied on the grounds and in the manner established by federal law.

Article 21. Choice of doctor and medical organization

When providing medical assistance to a citizen in the framework of the program of state guarantees of free medical care to citizens, he has the right to choose a medical organization in the manner approved by the authorized federal executive body and to choose a doctor, subject to the doctor’s consent. Features choice of medical organization the citizens living in the closed administrative-territorial entities, in areas with hazardous to human health physical, chemical and biological factors that are included in the relevant list, as well as employees of organizations included in the list of organizations selected industries with particularly hazardous conditions are established by the Government of the Russian Federation.
In order to receive primary health care, a citizen chooses a medical organization, including on a territorial-sectoral basis, not more often than once a year (with the exception of cases of a change in the place of residence or place of stay of a citizen). The selected medical organization citizen chooses not more often than once a year (except as substitute for the medical organization) physician, general practitioner divisional pediatrician, pediatrician of the district, a general practitioner (GP) or a medical assistant by filing the application personally or through a representative to the name of the head of the medical organization.
Primary specialized health care is provided by:
1) in the direction of a district doctor, a district pediatrician, a general practitioner (family doctor), a medical assistant, a specialist doctor;

2) in case of self-referral of a citizen to a medical organization, including an organization selected by him in accordance with part 2 of this article, taking into account the procedures for the provision of medical care.

To receive specialized medical care in the planning form, the choice of the medical organization is carried out in the direction of the attending physician. In the event that in the implementation of the territorial program of state guarantees for the free provision of medical assistance to citizens, several medical organizations that provide medical assistance on the appropriate profile participate, the attending physician must inform the citizen about the possibility of choosing a medical organization, taking into account the fulfillment of the conditions for rendering medical assistance established by the territorial program of state guarantees of free medical care to citizens.
Medical assistance in urgent or emergency form is provided to citizens, taking into account compliance with the established requirements for the timing of its provision.
In the provision of a national health care within the health care free provision of the program of state guarantees to citizens the choice of medical organizations (except in cases of medical emergencies) outside the territory of the Russian Federation, which is home to a citizen, according to the procedure established by the authorized federal executive body.
When choosing a doctor and a medical organization, a citizen has the right to receive information in a form accessible to him, including the “Internet” (hereinafter referred to as “the Internet”) located in the information and telecommunications network, the medical organization, its medical activities and doctors, the level of their education and qualifications.
Choice of doctor and medical organization servicemen and persons equated with medical support to the military, citizens undergoing alternative civilian service, citizens to be called up for military service or sent to alternative civilian service, and citizens entering military service under the contract, or equal to it service, as well as detainees, detainees serving sentences in the form of restriction of freedom, arrest, imprisonment or administrative arrest by carrying out Taking into account the specifics of the provision of medical care, as set out in Articles 25 and 26 of this Federal Law.
When providing medical assistance to citizens in the practical training of students on professional educational programs of medical education, the patient should be informed about the participation of students in providing him medical assistance and have the right to refuse participation of students in providing him medical assistance. In this case, the medical organization is obliged to provide such patient with medical assistance without the participation of trainees.
(Part 9 introduced by the Federal Law of July 2, 2013 N 185-FZ)

Article 22. Information on the state of health

Everyone has the right to receive information available in the medical organization on the state of their health, including information on the results of the medical examination, the presence of the disease, the established diagnosis and the prognosis of the development of the disease, the methods of providing medical care, the risk associated with them, Possible types of medical intervention, its consequences and the results of medical care.
Information on the state of health is provided to the patient personally by the attending physician or other medical personnel who are directly involved in medical examination and treatment. In relation to persons who do not reach the age specified in subsection 54 (2) of this Federal Law and citizens recognized as legally incompetent, information on the state of health is provided to their legal representatives.
Information about the state of health can not be given to the patient against his will. In case of an unfavorable prognosis of the development of the disease, the information should be reported in a delicate form to the citizen or his spouse, one of the close relatives (children, parents, adopted children, adoptive parents, siblings, grandchildren, grandmothers) if the patient has not banned to inform them about it and (or) did not specify another person to whom such information should be transferred.
The patient or his legal representative has the right directly to get acquainted with the medical documentation reflecting his state of health in the manner established by the authorized federal executive body and receive consultations on the basis of such documentation with other specialists.
(in the edition of the Federal Law of 25.11.2013 N 317-FZ)

The patient or his legal representative has the right, on the basis of a written application, to receive medical records reflecting the state of health, their copies and extracts from medical documents. The grounds, procedure and terms for the provision of medical documents (copies thereof) and extracts from them shall be established by the authorized federal executive body.
Article 23. Information on factors affecting health

Citizens have the right to receive reliable and timely information on factors that contribute to the preservation of health or exert harmful influence on it, including information on the sanitary and epidemiological well-being of the area of ​​residence, the state of the habitat, rational dietary norms, the quality and safety of industrial production products, food products, goods for personal and domestic needs, the potential hazard to human health of the work performed and services provided. Such information is provided by public authorities and local self-government bodies in accordance with their powers, as well as organizations in the manner provided for by the legislation of the Russian Federation.

Article 24. Rights of employees engaged in certain types of work, on health protection

In order to protect health and preserve the ability to work, prevent and timely identify occupational diseases, workers employed in work with harmful and (or) dangerous production factors, as well as in cases provided for by the legislation of the Russian Federation, workers engaged in certain types of work are compulsory medical examinations.
The list of harmful and (or) dangerous production factors and work, in the performance of which mandatory preliminary medical examinations are performed upon admission to employment and periodic medical examinations, is approved by the authorized federal executive body.
If medical contraindications to the implementation of certain types of work are identified in the course of compulsory medical examinations, the list of which is established by the authorized federal executive body, the employee may be recognized by the medical commission of the medical organization on the basis of the results of expertise of professional fitness temporarily or permanently unfit for the performance of certain types of health works.
In order to protect health, employers have the right to introduce the posts of medical personnel and create units (doctor’s office, health center, medical office, medical unit and other units) that provide medical assistance to employees of the organization. The procedure for organizing the activities of such units and medical personnel is established by the authorized federal executive body.
Employers are required to provide conditions for employees to undergo medical examinations and medical examinations, and to freely let workers go through them.

Article 25. Rights of servicemen and persons equated to medical services for military servicemen, as well as citizens undergoing alternative civilian service, citizens subject to conscription for military service (sent to alternative civilian service), and citizens entering the military service or equated to it contractual service

Servicemen and persons equated for medical services to military servicemen (hereinafter referred to as servicemen and persons equated to them), as well as citizens undergoing alternative civilian service, have the right to pass military medical examination to determine the suitability for military service or equivalent service and for early dismissal from military service or equivalent service on the basis of the conclusion of the military medical commission.
Citizens who are recruited for military service or sent to alternative civilian service, and citizens entering the military service or equivalent service under the contract, undergo a medical examination in the manner prescribed by Article 61 of this Federal Law and are entitled to receive full information about medical contra-indications for military service or equivalent service and testimonies for deferment or exemption from military service for health reasons.
Servicemen and persons of equivalent status have the right to receive medical assistance from departmental medical organizations, and, in their absence or in the absence of relevant departments, specialists or special medical equipment in departmental medical organizations, to receive medical assistance in the manner established by the Government of the Russian Federation, at the expense of budgetary appropriations of the federal budget, provided for these purposes to federal executive authorities and federal state bodies in which the federal law provides for military service or equivalent service.
(in the edition of the Federal Law of 04.06.2014 N 145-FZ)

The procedure for organizing medical assistance for servicemen and persons equated to them is established by the Government of the Russian Federation, the specifics of the organization of medical care for servicemen and persons equated to them, including the procedure for their release from the performance of military service duties (duties) in connection with the disease and other causes, are established by federal executive bodies and federal state bodies, in which the federal law provides for military services but a service equivalent to it.
(in the edition of the Federal Law of 04.06.2014 N 145-FZ)

Citizens when they are registered for military registration, conscription or military service under a contract or equivalent service, admission to military professional educational organizations or military educational organizations of higher education, conclusion of a training agreement with the Ministry of Defense of the Russian Federation in the military training center at the federal state educational organization of higher education under the military training program for military service under the contract for military posts or military department at the federal state educational organization of higher education under the military training of reserve officers, the program of military training of sergeants, reserve foremen or the program of military training of soldiers, reserve sailors, or in the military educational organization of higher education under the military program preparation of sergeants, reserve officers, or the military training program for soldiers, reserve sailors, military training, and citizens, send Those entitled to alternative civilian service are entitled to receive medical assistance in medical organizations as part of the program of state guarantees for the free provision of medical care to citizens, with the exception of medical examination for the purpose of determining fitness for military service or equivalent service.
(part 5 in the redaction of the Federal Law of 03.04.2017 No. 61-FZ)

The specific features of protecting the health of servicemen and persons equated to them, as well as certain categories of citizens who are in military service or equated with it in federal executive bodies and federal state bodies in which the federal law provides for military service or equivalent service, are determined by the legislation of the Russian Federation Federation, regulating the activities of these bodies.
(in the edition of the Federal Law of 04.06.2014 N 145-FZ)

 

Article 26. Rights of persons detained, taken into custody, serving sentences in the form of restriction of freedom, arrest, imprisonment or administrative arrest, for medical assistance

Persons detained, taken into custody, serving a sentence of restriction of freedom, arrest, imprisonment or administrative arrest, are entitled to provide medical assistance, including in necessary cases in medical organizations of the public health system and municipal health system, in accordance with legislation of the Russian Federation.
Pregnant women, women during childbirth and in the postpartum period from the number of persons specified in paragraph 1 of this article, are entitled to provide medical assistance, including in medical organizations for the protection of mothers and children.
If it is not possible to provide medical assistance in the institutions of the penal system, persons imprisoned or serving a sentence of imprisonment are entitled to provide medical assistance to medical organizations of the public health system and the municipal health system, as well as to an invitation for consultations of medical doctors, specialists of the said medical organizations in accordance with the procedure established by the Government of the Russian Federation at the expense of the budgetary appropriations of the federal UDGET provided for this purpose the federal executive authority in charge of the law enforcement functions, functions in the field of penal control and supervision in respect of the convicts.
When providing medical assistance in medical organizations of the public health system and the municipal health system, officers of the bodies and institutions of the penal enforcement system shall protect the persons specified in part 3 of this article and, if necessary, round-the-clock supervision in order to ensure the safety of these persons, medical workers, and other persons who are in medical organizations of the state and municipal health systems, in the order established by the federal nym executive authority responsible for drafting and implementation of the state policy and normative legal regulation in the sphere of execution of criminal penalties, together with the authorized federal executive body.
Clinical approbation, testing of medicinal products, specialized products of therapeutic nutrition, medical products and disinfection means with the involvement of persons referred to in paragraph 1 of this article as an object for these purposes are not allowed.
(in the edition of the Federal Law of 08.03.2015 N 55-FZ)

With regard to persons serving a sentence in the institutions of the penal system, the agreement on voluntary health insurance is terminated.
The procedure for organizing the provision of medical assistance, including in medical organizations of the state and municipal health care systems, to persons specified in part 1 of this article is established by the legislation of the Russian Federation, including regulatory legal acts of the authorized federal executive body that exercises functions for the development and implementation state policy and regulatory and legal regulation in the sphere of execution of criminal penalties, in consultation with the authorized representative of the eralnym executive authority.
Article 27. Obligations of citizens in the sphere of health protection

Citizens are required to take care of their health.
Citizens in cases stipulated by the legislation of the Russian Federation are required to undergo medical examinations, and citizens suffering from diseases that are dangerous to others in the cases provided for by the legislation of the Russian Federation are required to undergo medical examination and treatment, and also to prevent these diseases.
Citizens who are on treatment are obliged to comply with the treatment regime, including those defined for the period of their temporary incapacity for work, and the rules of the patient’s behavior in medical organizations.
Article 28. Public associations for the protection of the rights of citizens in the field of health protection

Citizens have the right to establish public associations to protect the rights of citizens in the field of health protection, formed on a voluntary basis.
Public associations for the protection of the rights of citizens in the field of health protection may, in accordance with the procedure established by the legislation of the Russian Federation, participate in the development of norms and rules in the field of health protection and in resolving issues related to the violation of such rules and regulations.
Public associations for protecting the rights of citizens in the field of health protection are not allowed to advertise specific trade names for medicines, biologically active additives, medical products, specialized products of therapeutic nutrition and breast milk substitutes.

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