РЕТРОСПЕКТИВНИЙ АНАЛІЗ ПИТАНЬ, ПОВ'ЯЗАНИХ ІЗ ПРАВОВОЮ ВІДПОВІДАЛЬНІСТЮ ЛІКАРІВ У ЗВ'ЯЗКУ З їХ ПРОФЕСІЙНОЮ ДІЯЛЬНІСТЮ
Для повного розуміння проблеми якості надання медичної допомоги на сучасному етапі, зокрема в Україні, слід вивчити стан цього питання в історичному контексті. У статті наведено результати ретроспективного аналізу питань, пов'язаних із правовою відповідальністю лікарів у зв'язку з їх професійною діяльністю, починаючи зі стародавніх часів. З урахуванням історичних літературних джерел, наведені дані щодо судово-медичної та юридичної оцінки правопорушень медичними працівниками, а також проаналізовано, за якими спеціальностями лікарів найчастіше було притягнуто до відповідальності стосовно «лікарських помилок».Для полного понимания проблемы качества оказания медицинской помощи на современном этапе, в частности в Украине, следует изучить состояние этого вопроса в историческом контексте. В статье приведены результаты ретроспективного анализа вопросов, связанных с правовой ответственностью врачей в связи с их профессиональной деятельностью, начиная с древних времен. С учетом исторических литературных источников, приведены данные судебно-медицинской и юридической оценки правонарушений медицинскими работниками, а также проанализированы, по каким специальностям врачей зачастую было привлечено к ответственности по «врачебным ошибкам». ; We know, that the law, which regulates doctors responsible for medical errors, appeared in ancient times. One of the most famous pieces of legislation, that have come down to us, are the Laws of Hammurabi, who ruled Babylon and Mesopotamia in 1792 1750 yy. BC in ancient India, according to the Laws of Manu (X V century BC.), doctor for the wrong treatment was subjected to a fine. Peculiar medical standards existed in ancient Egypt. Doctors, who followed the canons of "Holy Book". Doctors, who followed the canons of "Holy Book", were exempted from liability regardless of the outcomes. At the time of Christianity in Palestine for failure to assist a patient, doctor was subjected shameful death and confiscation of property. In ancient Greek medical skills were highly valued, because doctors for errors exempted from liability if the patient died "against the will of treating". Rome's Law provided penalties for gross medical error. For the first time medical practice applied the concept of «error», and the concept was wide enough. Inexperience, negligence of doctors and lack of medical care belonged to the medical error. Roman law has permitted the legality of the death of a patient due to disease severity. Intentional killing the patient, using poisoning, abortion, castration were not related to occupational crimes and responsibility of physicians for them was the same as for the other citizens. In the Roman Empire began to show not only the elements of state regulation and state support and medical affairs. In England in the XV century surgeon, who harmed 48 Вісник проблем біології і медицини 2015 Вип. 1 (117) ЛЕКЦІЇ a patient appeared in court mayor, and by the sentence was subjected to a fine, imprisonment or for a specified period deprived of medical practice. In the history of Kiev Rus treatment was equated to magic. The Soviet period our society has shown quite strict internal control of the Ministry of Health for public health. Often legislation is changed to departmental instructions. The law only considered medical crimes punishable act that, for example, illegal abortions. The harassment of doctors for their mistakes in most cases had political orientation. However, in the Soviet period nonexistent legal framework regulating to the issue of quality of care. Despite significant scientific and technological progress, which has undergone medical field for the last 50 years, due to the human factor (incompetence, negligence of medical staff and low educated people in the medical field), we can see a steady increase in cases of improper medical care even in highly countries. Nowadays in Ukraine statistics of medical errors almost completely closed. And only few cases of the public primarily are known through the media newspapers, television. The reason for this is that since Ukraine's independence in 1991, we inherited the Soviet system of evaluation violations of health workers, both in law and in forensic medical aspect, which doesn't meet the current needs of society. The system of legal regulation in Ukraine has many shortcomings, discrepancies concepts and criteria for assessing of many offenses, in particular related to the responsibility of doctors because of their professional activities. This eliminates the possibility of forensic doctors answer questions about the defects of medical care and lawyers to qualify medical acts or omissions. In countries with high levels of development, which introduced health insurance, the issue of «medical errors» are decided by lawyers exclusively by comparing medical appointments and manipulation to protocols and standards of care. In Ukraine, the situation is more complicated. On the one hand, the protocols and standards and are approved by the Ministry of Healthcare, that are valid and imperatively. On the other hand, these protocols and standards are executed not by all doctors. Therefore, a priority to address the Soviet inheritance is the introduction of health insurance, which proved itself in developed countries.
