constitutional basics of medical legislation presented by tamar chachibaia, 2007 aieti medical...

Constitutional Basics of Medical Constitutional Basics of Medical LegislationLegislation

Presented by Tamar Chachibaia, 2007

AIETI Medical SchoolAIETI Medical School

„Every person is ultimate destination and could not be considered as a means even

for realization of such tasks, which are deemed to serve for thorough welfare.”

This postulate by Emanuel Cant resides as a backbone of every international and national ethical code, declaration, and other treaties, which are moral and legal regulators to measure extent of medical intervention in physical and psychological state of the humans.

“The interests and welfare of the human being shall prevail over the sole interest of society or science.”

“L’interet et le bien de l’etre humain doivent prevaloir sur le seul interet de la societe ou de la

science.”

““Convention on Human Rights and Biomedicine” Convention on Human Rights and Biomedicine” I I chapter, 2chapter, 2ndnd article. article.

THE CONSTITUTION OF GEORGIA

Article 14

Everyone is born free and is equal before the law, regardless of race, skin colour, language, sex, religion, political and other beliefs, national, ethnic and social origin, property and title of nobility or place of residence.

Law of Georgia on Health CareLaw of Georgia on Health Care Chapter II. Citizens’ Rights in Health Chapter II. Citizens’ Rights in Health

CareCare Article 6.Article 6. 1.1. Discrimination of a patient for Discrimination of a patient for

his/her race, skin color, sex, his/her race, skin color, sex, religious convictions. political and religious convictions. political and other views, ethnic and social origin, other views, ethnic and social origin, the property or title status; place of the property or title status; place of residence, disease, sexual residence, disease, sexual orientation or negative personal orientation or negative personal attitude is prohibited.attitude is prohibited.

2.2. Discrimination of a patient in Discrimination of a patient in imprisonment place during medical imprisonment place during medical care is inadmissible.care is inadmissible.

According to Criminal According to Criminal Code of Georgia - Article Code of Georgia - Article 142.1 „Discrimination of 142.1 „Discrimination of

Equity of Humans” is Equity of Humans” is prosecuted juridically. prosecuted juridically.

Law of GeorgiaLaw of Georgiaon Patients’ Rightson Patients’ RightsChapter Chapter X. X. Rights of a person in detention or held Rights of a person in detention or held in custodyin custody

Article 451. Accessibility of health service of a person in

detention or held in custody is provided through state medical programs.

2. A person in detention or held in custody has right to seek appropriate medical examination, or independent medical expertise and in due case - medical service. Article 46

1. A person in detention or held in custody has all rights proposed in this law.

THE CONSTITUTION OF THE CONSTITUTION OF GEORGIAGEORGIA

Article 14Article 142. Torture, inhumane, brutal or 2. Torture, inhumane, brutal or degrading treatment or punishment degrading treatment or punishment is impermissible.is impermissible.

Criminal Code of GeorgiaCriminal Code of Georgia

ArticleArticle 126126.. TortureTorture ArticleArticle 411. 411. Intentional offence against Intentional offence against international humanitarian legislative international humanitarian legislative norms in the zone of armed conflicts: norms in the zone of armed conflicts: b) torture and other inhuman b) torture and other inhuman treatment, including involvement in treatment, including involvement in medical experiments;medical experiments; ArticleArticle 412.412. Intentional offence against Intentional offence against international humanitarian legislative international humanitarian legislative norms during inter- and intra- norms during inter- and intra- governmental armed conflicts causing governmental armed conflicts causing health risk or handicapping. health risk or handicapping.

Law of Georgia on Health CareChapter V. Medical Activity Article 44. It is a duty of a physician to provide medical

care to a person in detention or held in custody only after the receipt of the informed consent from this person, except for the cases of emergency or grave danger to life when the consent is not available because of the patient’s severe condition. The physician is also obliged to refuse such kind of medical intervention which contradicts medical and ethical norms.

World Medical AssociationWorld Medical Association 1. Declaration of Tokyo1. Declaration of Tokyo - 1975 - 1975 Guidelines for medical doctors concerning torture and Guidelines for medical doctors concerning torture and other cruel, inhuman or degrading treatment or other cruel, inhuman or degrading treatment or punishment in relation to detention and imprisonment.punishment in relation to detention and imprisonment.2. Declaration of Malta - 2. Declaration of Malta - 1991 1991 Guidelines for medical doctors in case of prisoners refusal Guidelines for medical doctors in case of prisoners refusal of nourishment.of nourishment.3. Declaration of Hamburg - 3. Declaration of Hamburg - 1997 1997 Concerning support for medical doctors refusing to Concerning support for medical doctors refusing to participate in, or to condone, the use of torture or other participate in, or to condone, the use of torture or other forms of cruel, inhuman or degrading treatment.forms of cruel, inhuman or degrading treatment.3. Declaration of Istanbul - 3. Declaration of Istanbul - 2001 2001 Guidelines for effective Guidelines for effective examination and documentation examination and documentation of torture or other forms of cruel, inhuman or degrading of torture or other forms of cruel, inhuman or degrading treatment.treatment.

Law of Georgia on Health Care - Article 34. Trade of physician is a free profession in its

sense. In any circumstances it’s inadmissible that either an official, or a private person, de spite their public state and post, shall demand from physician the activity which runs counter to the principles defined in the present law, and ethic norms of doctoral activity. Each activity impeding the accomplishment of professional duties by medical personnel leads to responsi bility envisaged by legislation.


Article 18Article 18 1. The freedom of a person is 1. The freedom of a person is

inviolable.inviolable. 4. The physical or moral coercion 4. The physical or moral coercion

of a detained or otherwise of a detained or otherwise restricted individual is restricted individual is impermissible.impermissible.

Confidentiality and PrivacyTHE CONSTITUTION OF GEORGIA–Article 41.2: 2. Information existing in official papers connected with health, finances or other private matters of an individual are not available to other individuals without the prior consent of the affected individual, except in cases determined by law, when it is necessary for the state and public security, defence of health, rights and freedoms of others.

Medical (doctoral) secrecy reflected in medical legislation

Law of Georgia on Health Care - Article 42. A medical employee and all other employees of a medical

institution are obliged to keep medical (doctoral) secrecy except for the cases when the disclosure of confidential information is demanded by a relative, legal representative of the dead person, judicial or investigatory bodies, and/or if this is necessary for providing public safety, protection of rights and freedom of other persons.

Law of Georgia on Medical Activity - Article 48.1. “Confidentiality of Information” Law of Georgia on Patients’ Rights – Article 27. All information about a patient’s health status, medical

condition, diagnosis, prognosis and treatment and all other information of a personal kind must be kept confidential, even after death.

Law of Georgia on Patients’ Rights – Article 28Confidential of Information can only be disclosed if the patient gives explicit consent or if the law expressly provides for this. Consent may be presumed where disclosure is to other health care providers involved in the patient’s treatment.

THE CONSTITUTION OF GEORGIATHE CONSTITUTION OF GEORGIA

Article Article 41 41 1. Every citizen has the right, 1. Every citizen has the right,

according to the law, to know according to the law, to know information about himself which information about himself which exists in state institutions as well exists in state institutions as well as official records existing there, as official records existing there, except for information containing except for information containing state, professional or state, professional or commercial secrets.commercial secrets.

Law of Georgia on Patients’ Rights – Article 17

Patients have the right to access to their medical files and technical records and to any other files and records pertaining to their diagnosis, treatment and care and to receive a copy of their own files and records or part thereof. Such access excludes data concerning third parties.


Article Article 2020 1. Every individual's private life, place 1. Every individual's private life, place

of personal activity, personal papers of personal activity, personal papers and correspondence are inviolable. and correspondence are inviolable. Communication by telephone and Communication by telephone and other technical means are inviolable. other technical means are inviolable. Restrictions on these rights are Restrictions on these rights are permissible only by a courts order or permissible only by a courts order or without such an order by the without such an order by the necessity as determined by law.necessity as determined by law.

Law of Georgia on Patients’ Rights

Article 29 There can be no intrusion into patient’s

private and family life unless and only if: in addition to the patient consenting to it, it

can be justified as necessary to the patient’s diagnosis, treatment and care.

when it’s dangerous for patient’s family member health and/or life.

(the same statement is reflecting in the Law of Georgia on Medical Activity, article 49)


ArticleArticle 157.157.

intrusion into patient’s private and family intrusion into patient’s private and family life, by the person who is obliged to life, by the person who is obliged to preserve secrecy according to official preserve secrecy according to official status, professional duties or other status, professional duties or other conditions - conditions -

is prosecuted juridically.is prosecuted juridically.

Criminal Code of Georgia – Criminal Code of Georgia – Article 247:Article 247:Penalties for non disclose or Penalties for non disclose or fallacy of information fallacy of information concerning life and health concerning life and health threateningthreatening conditions.conditions.


Article Article 1717 1. A person's honour and dignity are 1. A person's honour and dignity are

inviolable.inviolable. Article Article 1515 1. A person's life is inviolable and is 1. A person's life is inviolable and is

protected by law. protected by law.

• Law of Georgia on Health Care• Chapter XXIV• Critical Conditions, Death and

Euthanasia.• Article 148• A capable and responsible

patient in the terminal stage has the right to deny the resuscitation, life-saving or palliative treatment.

“Clause About Assisted Suicide” 44th World Medical General Assembly, 1992.

Assisted suicide like euthanasia is non ethical and should be condemned by medical community. At the same time notion has to be accepted that decline of treatment is patient’s fundamental right. In this case physicians action is not considered as non ethical, even obeying patient’s will may cause death of the patient.

CRIMINAL CODE OF GEORGIA, CHAPTER CRIMINAL CODE OF GEORGIA, CHAPTER XIXXIX: : `Crime against life’, Article `Crime against life’, Article 110:110: `̀Murder committed after victim’s Murder committed after victim’s demand”demand”

Law of Georgia on Health Care -Article 151 Medical personnel, as well as any other

person are prohibited to accomplish euthanasia, or participate in it.

Conclusion: Consent given by patient to terminate his life never gives right to physician to promote patient’s death, performing passive or active euthanasia. Commitment of murder by doctor will be claimed as premeditated murder.


Article Article 3737 1. Everyone has the right to health 1. Everyone has the right to health

insurance as a means of gaining insurance as a means of gaining medical assistance. In circumstances medical assistance. In circumstances determined by law, free medical determined by law, free medical services are guaranteed.services are guaranteed.

2. The state supervises every health 2. The state supervises every health institution and the production and institution and the production and distribution of medicine.distribution of medicine.


Article Article 3737 3. Everyone has the right to live in a healthy 3. Everyone has the right to live in a healthy

environment and use natural and cultural environment and use natural and cultural surroundings. Everyone is obliged to protect surroundings. Everyone is obliged to protect the natural and cultural surroundings.the natural and cultural surroundings.

4. The state guarantees the protection of 4. The state guarantees the protection of nature and the rational use of it to ensure a nature and the rational use of it to ensure a healthy environment, corresponding to the healthy environment, corresponding to the ecological and economic interests of society, ecological and economic interests of society, and taking into account the interests of and taking into account the interests of current and future generations.current and future generations.

Law of Georgia on Health Care – CHAPTER X

The State Sanitary Surveillance and Setting of Environmental Standards

Article 72 To avoid the negative influence of the environment and

other factors on the environment and other factors on the population’s health, the fulfillment of sanitary and sanitary-anti-epidemic rules and arrangements specially elaborated for this purpose, is mandatory for all physical and legal persons operating in the territory of the country notwithstanding the form of ownership, organizational-judicial, and institutional status.


XXXVI XXXVI chapterchapter

Articles Articles 287287 - - 306306

““Crime against environmental Crime against environmental protection rules” is protection rules” is prosecuted prosecuted juridicallyjuridically

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