Firstov Stepan



Physician, Politician, Social Activist, Associate Member of the World Medical Association

«The most important condition to implement the human right to health is professionally skilled and responsible for their work physicians. To protect a physician means to protect a patient.»

Stepan Firstov

Home News Сurrent issues on medical law were discussed at the State Duma.

Сurrent issues on medical law were discussed at the State Duma.

18 February 2019

Fabruary 18, there was a round table discussion on topic of «Medicine and Law. A doctor and a patient» at the State Duma of the Russian Federation. 1 A chairperson of the organizing committee, Dmitry Morozov was a moderator of the event. A Council member of the CCI of the RF on entrepreneurial and professional activity, associate member of the World Medical Association, Stepan Firstov took part at the event along with representatives of professional associations in the sphere of health protection, patients' communities, heads of health authorities of constituent entities of the Russian Federation.

The participants of the round table discussed legal basis and culture of relationships between a patient and a doctor as well as issues related to differentiation of rights and responsibilities of medical workers; rights, duties and responsibilities of patients. They also touched some current problems on judicial practice in relation to medical workers as well as patients' and doctors' right protection in modern realities. There were many other legal aspects of life and health protection of the medical workers in a focus of attention of experts.There were among speakers of the event: Health Minister of the RF deputy, Oleg Salagay, director of the research institute of emergency pediatric surgery of children and traumatology, Leonid Roshal, head of the LDPR faction in the State Duma Vladimir Zhirinovsky, and many others.

Special attention was devoted on the issues related to professional insurance at the round table. The participants noticed such a gap in the legislation as a lack of fixed definition of medical error. The main massage of the discussion was the topic of doctors' protection. Several options on formation of doctors' legal protection were proposed. There was a point of view of an important role of professional associations in this issue. An alternative opinion suggested creating a special state body, which should be between the Investigative Committeee and doctors. Deputies of the «United Russia» faction in the State Duma proposed introducing compulsory risk insurance for doctors and creating an institute of an independent medical experts in the Russian Federation.

As a member of the State Duma committee of health protection, Boris Mendelevich, says: «A doctor can not work under a constant supervision being scared of taking risks and appointing though a complex, but in each individual case the most effective treatment.»

He reminded us that a federal law about clinical recommendations had been adopted recently. This document introduced treatment protocols and algorithm of medical worker's actions concerning the patient. The algorithm would be accurately established and detailed. The parliamentarian says: «It is guaranteed at the legislative level… improvement of medical services quality by regulated requirements and protocols of treatment. Thus, we protect both doctors and patients.»
The next step, according to Mendelevich opinion, should be implementation of compulsory professional responsibility insurance for all medical workers. The parliamentarian appealed to the Ministry of Health with proposal to consider this issue from all its sides together with the professional community and to submit a respective bill to the State Duma.

President of the National Medical Chamber, Leonid Roshal, stated that patients indeed were better protected with law than doctors. At the same time, the punishment severity to doctors is preserved. Roshal informs: «We conducted a survey on the topic «Should a doctor be in prison, if health damage was made unintentionally? And even the overwhelming majority of patients replied «no».

«Member of health protection committee, Tatyana Solomatina, offered to create an independent medical experts institute in Russia, whereat medical errors will be professionally examined. As an example, she says: «doctors implemented a unique surgery, which had been never implemented in the country before, but an expertise was made by another doctor who did not even know that such procedure could be implemented.» The deputy noticed: «the result of this surgery and technique itself depend on those who conducted this examination and the consequences of the expert opinion after examination.» Solomatina thought that it was necessary to raise question on creation of independent experts’ institute in our country. She is convinced: «This problem is really current today.» Solomatina said: «We appeal to relevant ministry to think about it and make appropriate decision.» It is also necessary to create specialized departments involved in the investigation of medical errors in the structure of the investigative bodies. The politician is sure: «To investigate such cases, it is necessary to understand the main principles of health system organisation and provision of medical care.» She believes, that it would be useful to consider an issue related to eduction process of people, who will consider medical errors using the basic knowledge in health system. Solomatina added: «Many doctors today avoid making decisions when they start thinking about what would happen, if they made this or that decision, but it would not give expected effect.»

Summarizing his own impressions, Stepan Firstov noticed: «The the round table in the State Duma was demonstrated one more time, that, unfortunately, no one has ready-made solutions in direction put forward for discussion.» The medical community is divided and in the patients' one there is growing discontent. Thus, the Ministry of health keeps silence. As for results of the round table, no specific decisions had been made. At the same time, I want to emphasize, that many of the participants spoke in favour of professional insurance. But it is impossible, if a doctor is not a subject of law. It was spoken about lack of legal training of doctors and about professional weakness of lawyers in medical organizations. I think, it is important that within the walls of the State Duma was said that the professionalism of colleagues can be assessed only by doctors themselves and more qualified colleagues.» In General, Stepan Firstov characterized the round table on «Medicine and law. A doctor and a patient» as a certain step in the promotion of the basic provisions of professional self-regulation in health care.