Please use this identifier to cite or link to this item:https://hdl.handle.net/20.500.12259/34703
Type of publication: Magistro darbas / Master thesis
Field of Science: Teisė / Law
Author(s): Kavaliauskaitė, Goda
Title: Ar asmuo, apdraustas privalomuoju sveikatos draudimu Lietuvoje, yra atsakingas už profilaktinių priemonių savo sveikatos išsaugojimui taikymą?
Other Title: Whether a person who is insured by compulsory health insurance in Lithuania, is responsible for preventive measures for his health preservation?
Extent: 47 p.
Date: 2-Jun-2017
Event: Vytauto Didžiojo universitetas. Teisės fakultetas
Keywords: Profilaktinės priemonės;Sveikata;Atsakomybė;Žala;Prevention;Health care;Liability;Damage
Abstract: Profilaktinės priemonės, tokios kaip skiepai, profilaktiniai sveikatos patikrinimai ar prevencinės patikros programos, yra visuma priemonių, skirtų išvengti ligų bei pailginti sveiko gyvenimo trukmę. Nepakankamas asmenų naudojimasis minėtomis priemonėmis sąlygoja siekį išsiaiškinti teisines, sistemines bei organizacines sveikatos sistemos kliūtis, įgyvendinant sveikatos priežiūros tikslus. Neaiškus teisės aktų reglamentavimas nustatant atsakingą subjektą už žalą sveikatai, kilusią netaikius profilaktinių priemonių, sąlygojo šio magistrinio darbo temos pasirinkimą. Taigi, šiuo magistriniu darbu siekiama tiksliai apibrėžti subjektus, atsakingus už žalą asmens sveikatai, kilusią dėl profilaktinių priemonių netaikymo, tam, kad žalą patyrusio asmens interesai būti tinkamai apginti. Pirmajame šio darbo skyriuje nustatyta, jog tarptautiniais bei nacionaliniais teisės aktais įtvirtintas valstybės įsipareigojimas rūpintis asmenų sveikata, be kita ko, numato teisę asmeniui būti informuotam apie šalyje įgyvendinamas profilaktines priemones, kurios apmokamos privalomojo sveikatos draudimo lėšomis, bei galimybę jomis pasinaudoti. Antrajame skyriuje išnagrinėtos asmens sveikatos priežiūros specialistų ir visuomenės sveikatos priežiūros specialistų pareigos taikant profilaktines priemones bei nustatyta, jog valstybėje nėra aiškiai reglamentuotas šių sveikatos priežiūros specialistų bendradarbiavimas, todėl informacija apie vykdomas profilaktines priemones ne visada pasiekia konkretų asmenį. Trečiajame skyriuje, panaudojus hipotetinių situacijų analizę, nustatyta, jog atsakomybė dėl profilaktinių priemonių netaikymo konkretaus asmens atveju, gali kilti dviems subjektams – pačiam asmeniui bei pirminės asmens sveikatos priežiūros specialistams (šeimos gydytojui, dirbančiam su bendrosios praktikos slaugytoju), kurių vykdoma veikla nukreipta į asmenį bei sprendžia jo sveikatos problemas, tuo tarpu visuomenės sveikatos priežiūros specialistai pagal dabartinį teisinį reguliavimą nebūtų laikomi atsakingais, kadangi jų vykdomos pareigos taikant profilaktines priemones yra nukreiptos į visuomenę, o ne į konkretų asmenį, taigi, nėra priežastinio ryšio tarp konkretaus asmens sveikatos pablogėjimo ir šių specialistų vykdomos veiklos. Asmuo tampa atsakingu elgdamasis aplaidžiai po to, kai jis buvo informuotas apie riziką sveikatai bei rekomenduotinas profilaktines priemones, tačiau atsisakė jomis pasinaudoti. Asmens sveikatos priežiūros specialistams atsakomybė kyla tada, kai pažeidus pareigą informuoti asmenį apie taikomą profilaktiką bei riziką jo sveikatai, asmuo nepasinaudojo teikiamomis paslaugomis, dėl ko kilo žala sveikatai. Nustačius teisinės atsakomybės pasiskirstymą, pasiektas magistrinio darbo tikslas bei pateiktos rekomendacijos dėl profilaktinių priemonių taikymo reglamentavimo.
A question analysed in this master thesis is whether a person who is insured by compulsory health insurance in Lithuania, is responsible for preventive measures for his health preservation. Considering health to be one of the most important fundamental rights of every human, both national and international laws create an obligation to the country to provide appropriate health care to people. Preventive measures such as vaccinations, preventive health examinations or preventive screening programmes are remedies that aim to prevent diseases and improve health. Moreover, medical expenses are being saved due to preventive health care services if treatment is avoided. The biggest challenge of health care systems is to control chronic diseases such as cancer and cardiovascular diseases which are the leading cause of mortality not only in Lithuania but in all European Union as well. Early diagnosis of these diseases are directly related with participating in preventative check-ups or screening programmes, such as cervical cancer, breast cancer, prostate cancer and others, which are covered under the compulsary health insurance in Lithuania. However, the lack of engagement in preventive measures indicates the need to ascertain legal, organizational and systemic obstacles of the health care system while organizing and implementing health care. The question of responsibility while executing preventive measures has not been raised before. Therefore, the purpose of this thesis is legal uncertainty of subjects who would be held responsible for causing damage to individual’s health by not applying preventive measures. The first chapter of this thesis analyses the country‘s obligation to create a health care system which allows to obtain health care services. Article 53 of the Constitution of the Republic of Lithuania as well as international documents concerning human rights which are adopted by Lithuanian law, indicates the obligation of the country to take care of health of the individuals. The Charter of fundamental rights of European Union consolidates the right of access to prevention as well as medical treatment. This responsibility implicates the duty to a country not only to guarantee the treatment of illnesses but also measures and diagnostic techniques to prevent illnesses as well. Compulsory health insurance in Lithuania is based on the principle of solidarity and guarantees that health care services, including the sufficient information about prevention and access to the health system‘s facilities would be provided to every person by health care professionals. Furthermore, information to a person has to be presented in a such way that he could understand and evaluate the opportunity to engage in a particular preventive service. Considering the fact, that preventive health care can be provided through public health and health care practicioners (the key role plays primary health care practicioners who coordinate health care process of a person – family doctors working together with general practise nurses), the second part analyses the duties of both public health practicioners and primary health care practicioners in prevention of diseases by analysing whether their functions are oriented towards an individual and whether their functions reaches him. It has also been identified that the cooperation between these two groups of healthcare specialists is not clearly regulated by government, therefore, there is no guarantee that sufficient information about preventive health care reaches a particular person. Collaboration and sharing responsibilities between two foregoing groups of healthcare specialists would promote health care and would allow to avoid medical malpractise. The third chapter aims to define when a person can be liable for his health preservation and when health care practicioners can be liable for the damage caused to person’s health due to unapplied preventive measures. Lithuanian Health System Act determines the duty for resident to take care of his own health and Lithuanian Rights of Patients and Compensation for the Damage to Their Health Act consolidates the duty for patients to take care of their own health. The main finding of this chapter is that person is liable for the consequences to his health if he refuses preventive services after being informed about the risk factors to his health and the need of preventive measures to preserve his health. However, if a person is not aware about preventive measures, therefore does not participate in preventive health care programmes, there is a breach of duty of primary care physicians to provide information to a person. This indicates negligence liability if there is a causality between the damaged caused and primary healthcare physicians‘ actions. The study leads to the conclusion that according to current legislation public health specialists can not be held liable for the damage to individual’s health because their practice is focused on the society as a whole, therefore their activity does not reach an individual. The purpose of this master thesis is achieved by determining the distribution of responsibilities regarding an individual and health care specialists and by suggesting recommendations as regulatory framework in order to establish specific responsibilities of public health practicioners cooperating with primary health care practicioners.
Internet: https://eltalpykla.vdu.lt/1/34703
https://hdl.handle.net/20.500.12259/34703
Appears in Collections:2017 m. (TF mag.)

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