Please use this identifier to cite or link to this item:https://hdl.handle.net/20.500.12259/60451
Type of publication: master thesis
Field of Science: Teisė / Law (S001)
Author(s): Michejus, Gediminas
Supervisor: Cibulskaitė-Veršinskienė, Giedrė
Title: Ar nepažeidžiamos žmogaus teisės dėl gydytojo atsisakymo gydyti pacientą neregistruotais vaistais?
Other Title: Are human rights not violated if the doctor refuses to treat the patient with unregistered drugs?
Extent: 45 p.
Date: 11-Jan-2019
Event: Vytauto Didžiojo universitetas. Teisės fakultetas
Keywords: Neregistruoti vaistai;Gydytojai;Pacientai;Teisė;Unregistered medicines;Doctors;Patients;Law
Abstract: Stebint dabartinę visuomenę, galima pastebėti, kad vaistų vartojimas yra neatsiejama jos sveikatos priežiūros dalis. Net norėdami ir galėdami padėti savo pacientams,kartais gydytojai negali to padaryti. Galimos to priežastys- paciento atsisakymas gydytis, reikalingų vaistų trūkumas ar netinkamas vaistų vartojimas. Kartais vaistai vartojami per vėlai, netinkama doze ar nesant indikacijų tam. Viena iš tai lemiančių priežasčių – nepakankamas visuomenės informuotumas apie vaistų paskirtį bei galimą šalutinį poveikį. Nesant pakankamam kiekiui žinių apie vaistus, pacientui tampa sunku, o kartais ir neįmanoma dalyvauti sprendime, dėl savo autonomiško pasirinkto gydymo, kas iš dalies prieštarauja informuoto asmens sutikimo principui. Autonomiškumo principas tarp gydytojo ir paciento pasireiškia civilinių įgyvendinimo ir gynimo teisių užtikrinimo teisėtumu. Autonomiškumas yra civilinės teisės subjektas, kurio aktyviu veikimu, t.y. savo interesais, determinuoja pasirenkant teisių įgyvendinimo gydymo būdus. Vienas iš paciento teisių užtikrinimo būdų gauti paciento sutikimą yra informuoti jį dėl gydymo, gydymo eigos ir gydymo rezultato vaistais. Net ir supažindinus pacientą su panašiomis savybėmis pasižyminčiu ar visiškai nauju vaistu, jo vartojimu ar galimu šalutiniu poveikiu organizmui, tokio vaisto vartojimas gali būti netinkamai užtikrintas dėl paciento (netinkamas vartojimas) ar pačios valstybės (vaisto trūkumas šalyje, per didelės jo kainos ar konkretaus vaisto registracijos nebuvimas). Kuriant naujus vaistus, kurie pateks į Lietuvos, ES ar kitas šalis, turi būti praeiti tam tikri vaistų testavimo etapai, užtikrinant vaisto saugumą, jautrumą bei efektyvumą. Nepatvirtinti ar dar testuojami vaistai yra neregistruojami dėl galimai žalingo poveikio, todėl jų vartojimas ir tiekimas rinkai tam tikrose valstybėse gali būti uždrausti. Vaistai į Lietuvos rinką gali patekti tik įregistravus juos Valstybinėje vaistų kontrolės tarnyboje prie LR Sveikatos apsaugos ministerijos, tokia tvarka galioja visose ES ir daugelyje kitų pasaulio šalių, todėl tas pats vaistas gali būti neregistruotas Lietuvoje, tačiau registruotas kituose šalyse, kas kelia klausimų dėl jo vartojimo Lietuvos teritorijoje ir su tuo susijusių teisinių aspektų.
The use of medical supplies is an essential part of human health care. Even if physicians are willing and able to help their patients, sometimes they are not capable to do it. Possible causes are lack of medication at the hospital, patient's refusal to heal, or it’s inappropriate use of medications. Sometimes, when the medication was taken too late, the dose was inadequate or there were no indications for it. One of the main reasons for those causes is the lack of public awareness about the purpose of medical supplies and its possible side effects. In the absence of a sufficient amount of knowledge about medicine, it becomes difficult and sometimes impossible for the patient to participate in the decision of his chosen treatment, which is often contrary to the informed consent principle. The principle of autonomy between the physician and the patient manifests itself in the legitimacy of civil enforcement and defense rights. Autonomy is a subject of the civil law. With its active function, i.e. in his or her interest, determines when choosing the methods of treatment of implementation of rights. One of the ways of obtaining a patient is to inform him about the treatment, as well the course and the outcome of it. Even giving a patient a similar or new medication- the use of it may not be satisfactorily ensured by the patient (inappropriate use) or by the state (small amount of drugs in the country, excessive price or lack of registration of a specific drug). Certain stages of drug testing are obliged to be passed by developing new medicines that are going to be delivered to Lithuania or other countries, to ensure the safety, sensitivity and efficacy of the product. Discontinued medicines or still tested ones are not being registered due to potentially harmful effects, their use or market entry may be prohibited. Medicines can enter the Lithuanian market only after being registered at the State Medicines Control Agency under the Ministry of Health, this procedure is valid in all EU countries and in many other countries of the world. Therefore, the same medical supply may not be registered in Lithuania, but can be registered in other countries, which raises questions about its use in the territory of Lithuania and the related aspects of law. Three research areas are analysed in this paper. The first part of the paper analyses human rights protection in Lithuania in the field of health care, also its development, concept, value, purposes and legal link with health protection. Moreover, the analysis of what is human health protection and improvement in health area not only within the constitutional level but also within the international level is presented. Furthermore, there is an explanation on health security guarantees provided by the state, also values, attitude towards human and society obligations and their execution. In addition, the question on whether not only the state but also people themselves contribute to general improvement of human health is discussed. Both national and international agreements, their projects and strategies being implemented are clarified. Also, there is a description on how various organisations and legal acts define human’s right to health and also the concept of health. Theoretical and literary explanation with other health care protection areas which ensure health services is provided. Furthermore, services that help to realise and implement main principles of human rights in order to gain better personal health are reviewed. During theoretical and literature analysis the rights of doctors and patients regarding treatment with non-registered medication in Lithuania and a possibility to be treated with them are analysed. Theoretical and practical rights, responsibilities, potential needs and expectations about desired treatment of doctors and patients are introduced. Consequently, this chapter discusses not only definitions of national, international concepts of human or health, but also practices of health improvement principles justified by projects. In addition, there is consideration on quality, the risk of potential threats, which are linked with increasing mutual relationship between doctors and patients in Lithuania. The second chapter describes legal aspects of patients and doctors’ rights protection. There is a definition in context on what possible treatment due to non-registered medication provided. Health rights regulation regarding non-registered medication prescription to the patient is described, as well as theoretical treatment with such medication in Lithuania and other foreign countries. Moreover, the actions that are taken in order to consume and prescribe the patient non-registered medication are provided. Besides, methods and means officially needed for non-registered medication to register in Lithuania and rational usage and legal regulation of such medication are shown. Furthermore, realisation and implementation of main human rights principles in order to achieve better personal health in the event of illness and upon choice to take treatment with non-registered medication are described. Legal regulations from abroad that ensure import and licence possession, also permissions to engage in non-registered medication trade are presented. There is a literature and legal analysis of accidents that happened due to non-registered medication that was prescribed by doctors. Besides, evaluation of legal analysis regarding patient’s right to refuse treatment that does not satisfy the patient is given. Practical and theoretical analyses from Lithuania and foreign countries regarding doctor’s right to refuse or not to provide treatment to patients are compared. The third part of the research defines non-registered medication regulation assurance of accessibility and application in Lithuania and other foreign countries. Theoretical, scientific literature descriptions and also methods which describe ways of usage of non-registered medication are provided. In addition, examination of individually guaranteed policy of non-registered medication that is applied not only in Lithuania or EU, but also in the USA, Russia is shown. This final paper examines legal, individual use, realisation and prescription for patients of non-registered medication for treatment purposes not only in Lithuania but also in foreign countries. This paper also aims at presenting analysis of Lithuania and other foreign countries. They analyse Lithuanian and foreign scientific literature, scientific articles, court practices and legal acts. Furthermore, one more goal of this paper is to prove hypothesis that doctor’s refusal to treat a patient with non-registered medication when a person cannot chose desired treatment method may violate human rights.
Internet: https://hdl.handle.net/20.500.12259/60451
Appears in Collections:2019 m. (TF mag.)

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