The patient - the pregnant woman. The rights in policlinic and in maternity hospital: how to protect?
Under the law of the right of the patient - especially if are the pregnant woman - are protected strictly. However in practice difficulties with an attachment to policlinic or a maternity welfare unit, the choice of maternity hospital arise time. How to work in difficult situations, medical experts tell.Answers
vice-the president of League of defenders of patients Svetlana Saverskaya.to
Ya it is prescribed in the south of Moscow, but we live at the dacha near Zelenograd now. I addressed for registration there to policlinic as I plan pregnancy, but I was told that they have no places. What to do to me?
- Spring of last year signed the order of the Ministry of Health and Social Development of the Russian Federation (nowadays the Ministry of Health of the Russian Federation) from 26. 04. 2012 № 406 N “About the statement of the Order of the choice by the citizen of the medical organization when rendering medical care to it within the program of the state guarantees of free rendering medical care to citizens“. In this order the algorithm of an attachment to lechebno - to preventive establishment (MPI) is given. However, the patient has such right once a year if the residence does not change.
the Mentioned order does not provide a possibility of refusal to the citizen in medical care. Besides article 11 of the federal law “About bases of protection of public health in the Russian Federation“ says that refusal in delivery of health care according to the program of the state guarantees of free rendering medical care to citizens by the organization participating in implementation of this program is not allowed. And part 3 of the same article says about responsibility for violation of this rule. Responsibility for refusal in providing medical care is provided also: St. 125 criminal codes of Russian Federation “Leaving are in danger“, to Art. 124 “Not assistance to the patient“ and Art. 293 “Negligence“.
Thus, to you it is necessary to write the application at first to the chief physician of policlinic with the instruction on violation of your rights. And in case of refusal repetition (that is almost improbable in case of written addresses as it will mean existence of the written proof about refusal) - to appeal to the prosecutor`s office or to investigative committee in the location of policlinic behind protection of your rights.
is Answered by the president of National security agency of patients, the member of Public council at Roszdravnadzor Alexey Starchenko.I cannot solve
In any way, where to me to give birth. What you will advise?
- Choosing maternity hospital (and you have such opportunity), pay attention to its specialization, equipment, qualification of medical staff. And for fidelity study the order of the Ministry of Health and Social Development of the Russian Federation № 808 N of October 2, 2009 “About the statement of the Order of rendering akushersko - the gynecologic help“ in which it is painted what states and at what level are treated. If your pregnancy proceeds with problems, choose maternity hospital of level of the perinatal center in which there are conditions for acceptance of the complicated childbirth. In it you have the right to demand hospitalization in advance.
to me to give birth soon, but I whenever possible want to avoid stimulation of patrimonial activity and other aggressive methods. May I declare it at receipt in maternity hospital or it needs to be made in advance?
- Yes, you have the right to sign written refusal from unsafe, from your point of view, medical manipulations on which have to take the voluntary informed consent from you. What in reality not always occurs.
Therefore the most optimal variant - to choose to itself the assistant from among relatives or acquaintances on whom it is necessary to issue the notarized power of attorney granting to it the right to represent your interests in advance. Including - to be present together with you at maternity hospital and, without interfering with actions of doctors, to give or not to agree from yours to a name to these or those medical manipulations.
is Answered by the president of League of defenders of patients, the member of Advisory council at the Government of the Russian Federation Alexander Saversky.
the Wife became pregnant. Came to maternity hospital in advance, and there offer us a voluntary insurance. And here I do not know, it is necessary or not and rather big costs money - 150 thousand. Prompt how to be?
- Paid medical services cannot be rendered in the public or municipal authority as it contradicts Art. 41 of the Constitution of the Russian Federation. Rhoda of your wife are already paid with both the birth certificate, and other sources of financing. If you want to pay still is your right.can be Paid
in the public and municipal authority only for services, but I do not think that rent of the TV and refrigerator in chamber within several days cost 150 thousand rubles. And here it is possible to pay for a good attitude, of course, but what doctors who treat people only for additional money kindly are? Besides usually obstetricians consider as a bad sign receiving money in advance.
U me the child after the delivery died. As I consider, because of doctors. What amount of compensation of moral harm?
- the Average sum of compensation of moral harm across Russia makes about 50 000 rub (data of the compulsory health insurance Federal fund) for 2010. In our practice the sums in cases with death fluctuate from 100 thousand to 1 million 600 thousand rub. And figures grow: in Novosibirsk the woman received 2 million rub for loss of a leg, and in Voronezh for HIV infection during blood transfusion - 3 and a half million rubare important
At determination of the amount of compensation of moral harm according to Art. 151 of the Civil Code of the Russian Federation court takes degree of fault of the violator and other circumstances deserving attention into account:
- designedness of infliction of harm; whether
- is the medical institution budgetary or commercial (compensation is collected from budgetary organizations in a smaller size);
- degree of injuries (at mutilations) and in general the importance of adverse effects;
- an opportunity to smooth down adverse effects;
- duration and power of sufferings of the patient;
- victim`s identity and its self-assessment;
- a standard of living in this district.