СТАНДАРТИЗАЦІЯ МЕДИЧНОЇ ДОПОМОГИ В ПАЦІЄНТ ЦЕНТРИЧНІЙ МОДЕЛІ ПРИЙНЯТТЯ КЛІНІЧНОГО РІШЕННЯ: ПИТАННЯ ПРАВОВОЇ ДОКТРИНИ ТА СУДОВОЇ ПРАКТИКИ

Abstract

The article is devoted to the study of the problem of the legal balance of imperative and dispositive means of legal regulation of relations with the application of medical and technological standards. An analysis of the modern methodology of evidence-based medicine and medical-technological standards was carried out in terms of their role in the modern legal model of the choice of treatment methods. Peculiarities of legal regulation of relations with the use of medical-technological documents are determined. The role of medical discretion in the process of making a clinical decision and choosing treatment methods for an individual patient is substantiated. The legal assessments of Ukrainian courts on the issue of the legal significance of standards in the system of clinical decision-making based on evidence-based medicine are disclosed. The main conclusions of the study are the following provisions. The modern legal model of the choice of treatment methods is a complex multifactorial process that takes place in the coordinate system "medical standard – medical discretion – patient's choice". The basic information ground for making a clinical decision is the available modern technologies of evidence-based medicine, however, the influence of other factors can adjust the decision around the main one, which is legitimate clinical guidelines and recommendations. The legal position of the Supreme Court of Ukraine in resolving disputes about the application of medical-technological standards in the professional activity of a doctor moves towards recognizing the significant role of medical discretion in making a clinical decision. Thus, in the modern conditions of standardization of service provision processes in the field of health care, quality clinical recommendations, patient-oriented approach and critical thinking of the doctor play an objectively important role. Key words: methodology of evidence-based medicine, standards of medical care, clinical decision, doctor’s discretion.