Patient rights and obligations
Federal Law of the Russian Federation of November 21, 2011 N 323-FZ
"On the basics of protecting the health of citizens in the Russian Federation"
Adopted by the State Duma on November 1, 2011
Approved by the Federation Council on November 9, 2011
Chapter 4. Rights and obligations of citizens in the field of health protection
Article 18. Right to health protection
1. Everyone has the right to health protection.
2. The right to health protection is ensured by environmental protection, the creation of safe working conditions, favorable working conditions, everyday life, recreation, education and training of citizens, the production and sale of food of appropriate quality, high-quality, safe and affordable medicines, as well as the provision of affordable and quality medical care.
Article 19. Right to medical care
1. Everyone has the right to medical assistance.
2. Everyone has the right to medical care in a guaranteed volume, provided free of charge in accordance with the program of state guarantees of free provision of medical care to citizens, as well as to receive paid medical services and other services, including in accordance with a voluntary medical insurance agreement.
3. The right to medical assistance of foreign citizens living and staying in the territory of the Russian Federation is established by the legislation of the Russian Federation and the relevant international treaties of the Russian Federation. Stateless persons permanently residing in the Russian Federation enjoy the right to medical care on an equal basis with citizens of the Russian Federation, unless otherwise provided by international treaties of the Russian Federation.
4. The procedure for rendering medical assistance to foreign citizens is determined by the Government of the Russian Federation.
5. The patient has the right to:
1) the choice of a doctor and the choice of a medical organization in accordance with this Federal Law;
2) prevention, diagnosis, treatment, medical rehabilitation in medical organizations in conditions that meet sanitary and hygienic requirements;
3) obtaining advice from specialist doctors;
4) relief of pain associated with the disease and (or) medical intervention, available methods and drugs;
5) obtaining information about their rights and obligations, the state of their health, the choice of persons to whom information about the state of their health can be transferred in the interests of the patient;
6) receiving medical food in the event of a patient being treated in an inpatient setting;
7) protection of information constituting a medical secret;
8) refusal of medical intervention;
9) compensation for harm caused to health in the provision of medical assistance;
10) admission of a lawyer or legal representative to him to protect his rights;
11) admission of a clergyman to him, and in the case of a patient being treated in a stationary environment - to provide conditions for the administration of religious rituals, which can be carried out in stationary conditions, including the provision of a separate room, if this does not violate the internal order of the medical organization.
Article 20. Informed voluntary consent to medical intervention and to refuse medical intervention
1. A necessary precondition for medical intervention is the giving of informed voluntary consent of a citizen or his legal representative to medical intervention on the basis of complete information provided by a medical worker in an accessible form about the goals, methods of providing medical care, the associated risk, possible options for medical intervention, about his the consequences, as well as the expected results of medical care.
2. Informed voluntary consent to medical intervention is given by one of the parents or other legal representative in relation to:
1) a person under the age established by Part 5 of Article 47 and Part 2 of Article 54 of this Federal Law, or a person recognized as legally incompetent, if such a person, due to his condition, is not capable of giving consent to medical intervention;
2) a minor patient with drug addiction during the provision of drug treatment or medical examination of a minor in order to establish the state of drug or other toxic intoxication (except for cases established by the legislation of the Russian Federation for the acquisition of full legal capacity by minors before they reach the age of eighteen).
3. A citizen, one of the parents or other legal representative of the person specified in part 2 of this article have the right to refuse medical intervention or demand its termination, with the exception of the cases provided for in part 9 of this article. The legal representative of a person recognized as legally incapable exercises this right if such a person, due to his condition, is unable to refuse medical intervention.
4. In case of refusal of medical intervention to a citizen, one of the parents or other legal representative of the person specified in part 2 of this article, the possible consequences of such refusal must be explained in an accessible form for him.
5. If one of the parents or other legal representative of the person specified in part 2 of this article, or the legal representative of a person recognized as legally incompetent, refuses medical intervention necessary to save his life, the medical organization has the right to apply to the court for protecting the interests of such a person. The legal representative of a person recognized as legally incompetent shall notify the guardianship and trusteeship authority at the place of residence of the ward about the refusal from medical intervention necessary to save the life of the ward, no later than the day following the day of this refusal.
6. The persons specified in parts 1 and 2 of this article, in order to receive primary health care when choosing a doctor and a medical organization for the period of their choice, give informed voluntary consent to certain types of medical intervention, which are included in the list established by the authorized federal executive body. authorities.
7. Informed voluntary consent to medical intervention or refusal of medical intervention is made in writing, signed by a citizen, one of the parents or other legal representative, a medical professional and is contained in the patient's medical records.
8. The procedure for giving informed voluntary consent to medical intervention and refusal of medical intervention in relation to certain types of medical intervention, the form of informed voluntary consent to medical intervention and the form of refusal to medical intervention are approved by the authorized federal executive body.
9. Medical intervention without the consent of a citizen, one of the parents or other legal representative is allowed:
1) if medical intervention is necessary for urgent reasons to eliminate the threat to a person's life and if his condition does not allow expressing his will or there are no legal representatives (in relation to the persons specified in paragraph 2 of this article);
2) in relation to persons suffering from diseases that pose a danger to others;
3) in relation to persons suffering from severe mental disorders;
4) in relation to persons who have committed socially dangerous acts (crimes);
5) when conducting a forensic medical examination and (or) a forensic psychiatric examination.
10. A decision on medical intervention without the consent of a citizen, one of the parents or other legal representative is taken:
1) in the cases specified in clauses 1 and 2 of part 9 of this article - by a consultation of doctors, and if it is impossible to collect a consultation - directly by the attending (duty) doctor with the introduction of such a decision in the patient's medical documentation and subsequent notification of medical officials an organization (the head of a medical organization or the head of a department of a medical organization), a citizen in respect of whom medical intervention has been carried out, one of the parents or other legal representative of the person specified in part 2 of this article and in respect of whom the medical intervention has been carried out;
2) in relation to the persons specified in clauses 3 and 4 of part 9 of this article - by the court in the cases and in the manner established by the legislation of the Russian Federation.
11. Compulsory measures of a medical nature may be applied to persons who have committed crimes on the grounds and in accordance with the procedure established by federal law.
Article 21. Choice of a doctor and a medical organization
1. When providing a citizen with medical care within the framework of the program of state guarantees of free provision of medical care to citizens, he has the right to choose a medical organization in the manner approved by the authorized federal executive body, and to choose a doctor with the consent of the doctor. Features of the choice of a medical organization by citizens living in closed administrative-territorial formations, in areas with physical, chemical and biological factors hazardous to human health, included in the corresponding list, as well as by employees of organizations included in the list of organizations of certain industries with especially hazardous working conditions are established by the Government of the Russian Federation.
2. To receive primary health care, a citizen chooses a medical organization, including on a territorial-district principle, no more than once a year (except for cases of change of place of residence or place of stay of a citizen). In the chosen medical organization, a citizen makes a choice no more than once a year (except for cases of replacement of a medical organization) of a general practitioner, district general practitioner, pediatrician, district pediatrician, general practitioner (family doctor) or paramedic by filing an application in person or through a representative addressed to the head of a medical organization.
3. The provision of primary specialized health care is carried out:
1) on the referral of a district general practitioner, district pediatrician, general practitioner (family doctor), paramedic, specialist doctor;
2) in the case of an independent appeal of a citizen to a medical organization, including an organization chosen by him in accordance with part 2 of this article, taking into account the procedures for the provision of medical care.
4. To receive specialized medical care in a planned form, the choice of a medical organization is carried out in the direction of the attending physician. If several medical organizations are involved in the implementation of the territorial program of state guarantees of free provision of medical care to citizens, providing medical care in the relevant profile, the attending physician is obliged to inform the citizen about the possibility of choosing a medical organization, taking into account the fulfillment of the conditions for the provision of medical care established by the territorial program of state guarantees of free provision of medical care to citizens.
5. Medical assistance in urgent or urgent form is provided to citizens, taking into account the established requirements for the timing of its provision.
6. When rendering medical care to a citizen within the framework of the program of state guarantees of free provision of medical care to citizens, the choice of a medical organization (except for cases of rendering emergency medical care) outside the territory of the constituent entity of the Russian Federation in which the citizen lives is carried out in the manner established by the authorized federal executive body authorities.
7. When choosing a doctor and a medical organization, a citizen has the right to receive information in an accessible form, including information posted on the Internet information and telecommunication network (hereinafter referred to as the Internet), about a medical organization, about its medical activities and about doctors, about their level of education and qualifications.
8. The choice of a doctor and a medical organization by military personnel and persons equated in medical support to military personnel, citizens undergoing alternative civilian service, citizens subject to conscription for military service or sent to alternative civilian service, and citizens entering military service under contract or equivalent her service, as well as those detained, taken into custody, serving a sentence of restraint of liberty, arrest, imprisonment or administrative arrest shall be carried out taking into account the specifics of the provision of medical care established by Articles 25 and 26 of this Federal Law.
Article 22. Information on the state of health
1. Everyone has the right to receive, in an accessible form for him, information available in a medical organization about his or her health, including information about the results of a medical examination, the presence of a disease, the established diagnosis and prognosis of the development of the disease, methods of providing medical care associated with them. risk, possible types of medical intervention, its consequences and the results of medical care.
2. Information about the state of health is provided to the patient personally by the attending physician or other medical workers who are directly involved in the medical examination and treatment. In relation to persons under the age established in part 2 of Article 54 of this Federal Law, and citizens recognized as legally incapacitated, information on the state of health is provided to their legal representatives.
3. Information about the state of health cannot be provided to the patient against his will. In the event of an unfavorable prognosis of the development of the disease, information should be communicated in a delicate form to the citizen or his spouse (wife), one of the close relatives (children, parents, adopted children, adoptive parents, siblings, grandchildren, grandfathers, grandmothers), unless the patient forbids inform them about it and (or) did not determine another person to whom such information should be transferred.
4. The patient or his legal representative has the right to directly get acquainted with the medical documentation reflecting the state of his health, and to receive consultations from other specialists on the basis of such documentation.
5. The patient or his legal representative has the right, on the basis of a written application, to receive medical documents reflecting the state of health, their copies and extracts from medical documents. The grounds, procedure and terms for the provision of medical documents (their copies) and extracts from them are established by the authorized federal executive body.
Article 23. Information on factors affecting health
Citizens have the right to receive reliable and timely information about factors that contribute to the preservation of health or have a harmful effect on it, including information on the sanitary and epidemiological well-being of the area of residence, the state of the environment, rational nutritional standards, the quality and safety of industrial products, food products, goods for personal and household needs, the potential danger to human health of the work performed and the services provided. Such information is provided by public authorities and local self-government bodies in accordance with their powers, as well as by organizations in the manner prescribed by the legislation of the Russian Federation.
Article 24. Rights of workers employed in certain types of work to health protection
1. In order to protect health and preserve the ability to work, to prevent and timely detect occupational diseases, workers employed in work with harmful and (or) hazardous production factors, as well as in cases stipulated by the legislation of the Russian Federation, workers employed in certain types of work are undergoing compulsory medical examinations.
2. The list of harmful and (or) dangerous production factors and work, in the performance of which compulsory preliminary medical examinations upon admission to work and periodic medical examinations are carried out, shall be approved by the authorized federal executive body.
3. If, during the mandatory medical examinations, medical contraindications to the implementation of certain types of work are identified, the list of which is established by the authorized federal executive body, the employee may be recognized by the medical commission of the medical organization on the basis of the results of the professional suitability examination temporarily or permanently unsuitable for health reasons. certain types of work.
4. In order to protect health, employers have the right to introduce medical personnel into the staff and create subdivisions (doctor's office, health center, medical office, medical unit and other subdivisions) that provide medical assistance to employees of the organization. The procedure for organizing the activities of such units and medical workers shall be established by the authorized federal executive body.
5. Employers are obliged to provide conditions for employees to undergo medical examinations and medical examinations, as well as to release employees without hindrance for their passage.
Article 25. Rights of military personnel and persons equated in medical support to military personnel, as well as citizens doing alternative civilian service, citizens subject to conscription for military service (sent to alternative civilian service), and citizens entering military service or equivalent to it contract service, health care
1. Military personnel and persons equated in medical support to military personnel (hereinafter - military personnel and persons equated to them), as well as citizens undergoing alternative civilian service, have the right to undergo a military medical examination to determine fitness for military service or equivalent to it service and for early dismissal from military service or service equivalent to it on the basis of the conclusion of the military medical commission.
2. Citizens subject to conscription for military service or sent to alternative civilian service, and citizens entering military service or service equivalent to it under a contract, undergo a medical examination in the manner prescribed by Article 61 of this Federal Law, and have the right to receive a full information on medical contraindications for military service or equivalent service and indications for postponement or exemption from military service for health reasons.
3. Servicemen and persons equated to them have the right to receive medical care in departmental medical organizations, and in their absence or in the absence of departments of the corresponding profile, specialists or special medical equipment in departmental medical organizations, to receive medical care in the manner established by the Government of the Russian Federation. Federation, at the expense of budgetary allocations from the federal budget, provided for these purposes by the federal executive authorities, in which the federal law provides for military service or service equivalent to it.
4. The procedure for organizing medical care for servicemen and persons equated to them is established by the Government of the Russian Federation, the specifics of organizing the provision of medical care for servicemen and persons equated to them, including the procedure for their release from military service duties (official duties) in connection with illness and other reasons, established by the federal executive authorities, in which the federal law provides for military service or service equivalent to it.
5. Citizens, when registering them, conscription or enrollment in military service or equivalent service under a contract, admission to military educational institutions of vocational education, conscription for military training, as well as citizens sent to alternative civilian service, have the right to receiving medical care in medical organizations within the framework of the program of state guarantees of free provision of medical care to citizens, with the exception of medical examination in order to determine fitness for military service or service equivalent to it.
6. The peculiarities of health protection of military personnel and persons equated to them, as well as certain categories of citizens doing military service or service equivalent to it in federal executive bodies, in which military service or service equivalent to it is provided for by federal law, are determined by the legislation of the Russian Federation, regulating the activities of these bodies.
Article 26. The rights of persons detained, taken into custody, serving a sentence of restraint of liberty, arrest, imprisonment or administrative arrest, to receive medical assistance
1. Persons detained, taken into custody, serving a sentence of restraint of liberty, arrest, imprisonment or administrative arrest, have the right to provide medical care, including, if necessary, in medical organizations of the state health care system and the municipal health care system, in in accordance with the legislation of the Russian Federation.
2. Pregnant women, women during childbirth and in the postpartum period from among the persons specified in part 1 of this article have the right to medical assistance, including in medical organizations for the protection of mothers and children.
3. If it is impossible to provide medical care in institutions of the penal system, persons who are in custody or are serving a sentence of imprisonment have the right to provide medical care in medical organizations of the state health care system and the municipal health care system, as well as to an invitation for consultations medical specialists of these medical organizations in the manner established by the Government of the Russian Federation, at the expense of budgetary allocations from the federal budget, provided for these purposes by the federal executive body that carries out law enforcement functions, functions of control and supervision in the field of the execution of criminal sentences in relation to convicts.
4. When providing medical care in medical organizations of the state health system and the municipal health system, employees of the bodies and institutions of the penal system shall guard the persons specified in part 3 of this article, and, if necessary, round-the-clock surveillance in order to ensure the safety of these persons, medical workers, as well as other persons who are in medical organizations of the state and municipal health systems, in the manner prescribed by the federal executive body responsible for the development and implementation of state policy and legal regulation in the field of the execution of criminal punishments, together with the authorized federal executive body ...
5. Testing of new methods of prevention, diagnostics, treatment, medical rehabilitation, as well as medicines, specialized medical food products, medical devices and disinfectants with the involvement of persons specified in part 1 of this article as an object for these purposes is not allowed.
6. In respect of persons serving sentences in institutions of the penal system, the contract on voluntary medical insurance is terminated.
7. The procedure for organizing the provision of medical care, including in medical organizations of the state and municipal health systems, to persons specified in part 1 of this article, is established by the legislation of the Russian Federation, including regulatory legal acts of the authorized federal executive body performing the functions of developing and implementation of state policy and legal regulation in the field of the execution of criminal sentences, in agreement with the authorized federal executive body.
Article 27. Responsibilities of citizens in the field of health protection
1. Citizens are obliged to take care of the preservation of their health.
2. Citizens in cases stipulated by the legislation of the Russian Federation are required to undergo medical examinations, and citizens suffering from diseases that pose a danger to others, in cases stipulated by the legislation of the Russian Federation, are required to undergo medical examination and treatment, as well as to prevent these diseases.
3. Citizens undergoing treatment are obliged to comply with the treatment regimen, including those determined for the period of their temporary disability, and the rules of patient behavior in medical organizations.
Article 28. Public associations for the protection of citizens' rights in the field of health protection
1. Citizens have the right to create public associations for the protection of citizens' rights in the field of health care, formed on a voluntary basis.
2. Public associations for the protection of citizens' rights in the field of health protection may, in accordance with the procedure established by the legislation of the Russian Federation, take part in the development of norms and rules in the field of health protection and in resolving issues related to violation of such norms and rules.
3. Public associations for the protection of citizens' rights in the field of health protection shall not have the right to advertise specific trade names of medicines, biologically active additives, medical products, specialized medical food products and breast milk substitutes.
