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Physician and the law: health care providers exempted from liability for unsafe services
On Tuesday, December 17, the State Duma passed in the second and third readings a bill that excludes the effect of the Criminal Code of the Russian Federation on substandard performance of services on medical workers. The document was published in the system of ensuring legislative activity. Read more about the importance of the bill for the health care system in Russia and when the innovations will come into force - in the material "Izvestia".
The abolition of Art. 238 of the Criminal Code of the Russian Federation: what happened, the latest news
Medical workers want to exempt from liability under Art. 238 of the Criminal Code of the Russian Federation ("Provision of services that do not meet safety requirements"), according to paragraph 3 of the document published on December 17, adopted by the State Duma.
The article concerns the production, storage, transportation or sale of goods and products, performance of work or services that do not meet safety requirements. Note in paragraph 3 of the article states that the action does not apply to cases of medical care provided by medical workers.
In addition, the State Duma proposed to stop calling a set of actions by doctors to treat a patient a medical service, leaving this term only for financial documents and certain specified cases.
In March, the co-author of the bill, Senator Daria Lantratova, told Izvestia about these amendments. According to her, replacing the term "service" with "assistance" in medicine restores the main meaning of the medical profession.
According to the Parliamentary Gazette, doctors were leaving hospitals en masse and changing their profession because of unfounded complaints and fear of criminal prosecution. Under the current legislation, minor violations of the law could result in two years in prison, and causing serious harm or death to a patient - up to six years. In exceptional scenarios, a doctor could get away with a fine of 100,000-500,000 rubles or in the amount of wages or other income for up to two years.
Now the bill must be discussed and accepted or rejected in the Federation Council, and then it will be sent for signature to Russian President Vladimir Putin.
The new law: why the amendments are important for the Russian Federation
Badma Bashankaev, first deputy chairman of the State Duma's health protection committee, explained to Izvestia that the new bill will allow medics to breathe a little easier.
"Today, medics can be held criminally liable under various articles of the Criminal Code of the Russian Federation. And the 238th is one of the most frequently used. Among the main reasons here is the attribution by law enforcers of medical care to services rendered within the framework of civil-law relations," Bashankaev said.
According to him, every year the Investigative Committee receives more than 6 thousand applications related to medical errors, but only about 10% reach the court stage. That is, about 6 thousand doctors every year face prejudice and unfounded accusations, the deputy emphasizes.
At the same time, the number of criminal cases initiated under Article 238 increases annually. Bashankaev cites statistics, according to which in 2022, 138 cases were initiated under the first part of the article, and in 2023 their number increased to 216. As for the second part of the article (serious crimes), there is an even more active growth: in 2022, 136 cases were registered, and in 2023 this figure reached 247.
As a result, this leads to mass exodus from the profession and a significant shortage of staff. The new legislation recognizes doctors not just as performers of services, but as professionals who save lives and provide care in the most difficult situations.
"Being a doctor is always a risk. Especially for professionals who are on the front lines of medicine: surgeons, anesthesiologists, obstetricians. They save lives every day, face the most difficult situations, provide emergency, planned, high-tech assistance. It is assistance, not services! And the new bill will allow doctors, as they call it, to breathe a little easier," summarized Bashankaev.
In addition, from January 1, 2025, new medical standards based on clinical recommendations (CR) will be introduced. The innovations establish uniform conditions for diagnosis and treatment, which reduces the likelihood of medical errors, improves the quality of treatment and increases the predictability of medical care.
What other laws regulate the activities of a doctor today
Working in the medical sphere implies great responsibility. In Russia, the actions of doctors are regulated by several legal acts, including the Constitution, the Law on the Fundamentals of Public Health Protection, the Law on Medical Insurance, the Doctor's Code of Professional Ethics and the Labor Code. At the same time, unlawful actions will have to be proved.
Doctors may incur disciplinary liability for failure to comply with their duties. It comes if the employee constantly delays appointments or behaves rudely with patients. In this case, three types of punishment are possible: reprimand, reprimand or dismissal.
The CAO stipulates the cases when a doctor may incur administrative responsibility, usually a fine. The measure is applied in case of violation of patient's rights, it may be disclosure of medical secrets, non-compliance with sanitary standards or concealment of information from the patient about the possibility to receive medical services on a free basis.
A medical worker can also be held civilly liable. This is possible if the patient was refused treatment under the MHI, although they should have been. A doctor is brought to such liability by a court of general jurisdiction.
Criminal liability is incurred when committing serious crimes related to the actions or inaction of a doctor. Surgeons, anesthesiologists-resuscitators, therapists, obstetricians-gynecologists and ambulance paramedics are most often subject to criminal prosecution. The most frequent reasons for criminal proceedings are causing death by negligence, committed as a result of improper performance of professional duties by a medical worker (part 2 of article 109 of the Criminal Code of the Russian Federation), performance of work or provision of services that do not meet safety requirements (article 238 of the Criminal Code of the Russian Federation) and negligence (part 2 of article 293 of the Criminal Code of the Russian Federation).
It is important to remember that medical workers perform difficult and important work. It is not worth writing complaints without a justified reason. Appeal to Roszdravnadzor and law enforcement authorities is possible only when a doctor violates the rights of a patient.
