Паліативна допомога і права людини: право на доступність в умовах медичної реформи

Abstract

The peculiarities of exercising the right to access to palliative care (PC) in the context of medical reform have been revealed. Numerous legislative acts have been analyzed and regulatory dissonance has been revealed, which has a negative impact on the peculiarities of the enjoyment of the rights by palliative patients. Attention has been drawn to the fact that PC is not always free, which follows from the analysis of Part 2 of Art. 35-4 of the Law of Ukraine «Fundamentals of the legislation of Ukraine on health care», and only when referring. The Fundamentals clearly regulate the conditions under which PC can be free of charge: 1) in the presence of a referral to a health care institution in which the patient was provided with secondary or tertiary care; 2) an agreement shall be entered into with the referring health care institution of the National Health Service of Ukraine. However, the List of Primary Care Services Annex № 1 to the Primary Care Procedure states that a primary care physician has the right to refer patients in accordance with medical indications for PC to an extent that does not fall beyond primary care. It has been suggested to make changes to the following legislative provisions: 1) Art. 35-4 of the Fundamentals: patients should be entitled to free PC if they have a referral from a primary care physician; 2) Art. 35-4 of the Fundamentals and the Procedure for referring patients to health care institutions and individuals-entrepreneurs who in the manner prescribed by law have received a license to conduct business in medical practice and provide medical care of the appropriate type, approved by the Order of the Ministry of Health of Ukraine from 28.02.2020 № 586 to secure the right to receive free PC without referral. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.