Žalos pacientams kompensavimo ypatumai sveikatos teisėje ; Peculiarities of the Compensation of Damage for Patients in Health Law
Researched problem and relevance of the paper. In the second half of the 198th century the concept of medicine as art was finally refused: achievements of the science of medicine allowed to explain physiological processes, revealed the reasons of many pathological processes, quickly developed technologies granted a possibility not only observe all functions of an organism, nut frequently – to control them as well. On one hand, rapid development of the science of medicine and practice determined an obvious improvement of health indicators (decrease of babies' mortality, extension of average lifetime), on the other hand, it has to be admitted that possibilities to control the treatment process and to achieve the desired result are limited . Application of nanotechnologies and genes engineering in medicine aroused the problems of the preservation of the identity of an individual, therefore it had to be discussed anew the nature and essence and the effectiveness of the means ensuring the protection of patients' rights including the effectiveness of legal instruments. The topic of the regulation of patients' rights and duties and the effectiveness of the provided legal protection are determined by the following factors: multiplicity and complexity of the relationship of the physician and patient, frequent ethnical problems arising during treatment and examination, fragmentary regulation of the relationship of physician and patient at the national level and abundant non-codified so-called soft law norms, the participation of the state which provided social guarantees to patients in the relationship of physician and patient, phenomena of the culture of consumption and "shame and blame" in the health relationship, increasing effectiveness of health care and potential dangerous for the patient's health and rapid increase of patients' civil plaints and the amount of the adjusted loss, provoking health care services providers' civil liability insurance "crisis" (situation, when there no insurance companies in the market which provide the services of civil liability insurance). In 1997 the Council of Europe approved the Protection of Human Rights and Dignity of the Human Being with re-gard to the Application of Biology and Medicine (hereafter in referred to as Convention on Human Rights and Biomedi-cine) which is a fundamental over-national document in the law doctrine, consolidating patients' rights. Political, eco-nomic, social processes of integration requires a deep analysis of the content of the patients' rights entrenched in the sys-tems of national rights, their implementation and protection mechanisms, the need of the provided legal protection unifi-cation and possibilities. Recognition of the sanctity of a person's body in health care, implementation of new treatment and examination methods, more frequent implementation of the automatic management of the data on a patient's health and other factor require to evaluate the topicality of the patient's rights' list and to correct them if needed. However, the aim of this paper – to examine, considering the acknowledgement in the law doctrine, the peculiarities of one of the most important patient's right – patient's right to the compensation of loss aroused due to treatment or examination, and the institutes influencing the conditions of compensation – informed consent of the patient and the patient's duties. The topicality of the theme is determined by different factors. In recent years the date of the performed researches confirms the topicality of the topic of the compensation of damage aroused due to treatment or examination: health care has been acknowledged as the most dangerous activity of humanity; frequency of undesirable events in developed countries comprises more than 10 percent of all treatment events , at least 44 000 residents of the United States of America (hereinafter – USA) die in hospitals due to the mistakes of treatment . Therefore it is necessary to evaluate the effectiveness of the legal protection provided to patients. The conclusions of the audit performed by State control institutions of the Republic of Lithuania of the implementation of the compulsory insurance of the civil liability for the damaged performed to patients and the social researches performed in Lithuania show the distrust of the society in the system of the compensation to patient for damage and the dissatisfaction of the participants of the health system for the present legal regime of the patient's right to compensation for damage and the way of the implementation of this right. The validity of such opinion is supposed by the fact that the number of complaints regarding the compensation for damage suffered by patients is one of the smallest in the world (37 claims for a million of residents per year). The number of complaints regarding the compensation for damage suffered by patients in other countries varies a lot (for example, in North European countries there are five times more complaints regarding the compensation for damage suffered by patients for a million of residents per year than in the USA). On the other hand, the expenses for compensation of the damaged made for the patient in various countries correlates not with the number of the satisfied claims, but with the regime of the protection of patients' rights: the largest expenses of the compensation for damage suffered by patients where the patients' right to the compensation of damage is implemented according to the plaint order of the rule of civil liability in case of fault (USA – 112 EUR/ resident, Italy – 41 EUR/ resident) .At the meantime, in the countries which have implemented special systems of compensation for damage suffered by patients which are based on the concept of health care services providers' civil liability without fault, the expenses of these systems for one resident fluctuates from 4 to 9 Euros (9 EUR / resident in Denmark, 4 EUR / resident in Sweden, 6 EUR / resident in Finland, 8 EUR / resident in New Zealand). The systems of the compensation of special damage for patients are deemed as favourable for patients and it is often indicated that these systems are based on the concept of liability without fault. Therefore it is purposeful to examine of the countries with the longest experience of the regulation of the systems of the compensat