The doctor's relationship with legislation and authorities

Professional legal norms are established by legislation, ethical – by medical codes of ethics. The doctor’s knowledge of the entire legal and ethical basis of his professional activity is called the presumption of the completeness of professional knowledge . It is based on the constitutional presumption of knowledge of the law (of one’s own and others’ rights and obligations) by every citizen.

In relation to those in power (management), a doctor can be in four professional social and legal roles, just like any person in relations with any authority, first of all, with state authority.

The first role is a subject or subject doctor: here any word of the owner (boss) is the law and is accepted for execution without reasoning (the slave cannot and does not want to know what the owner is doing and why). This mode of relationship is called the power of force.

The second role is a guided doctor : here, in addition to the power of power, what is called charisma also works: the subordinate goes where the hand of the boss points, or where he is led, taking him by the hand. It is believed that the boss knows exactly the right direction. This mode of relationship is called the power of power .

The third role is a managed doctor . Here, relations are based not on “subordination”, not “driveability”, but “controllability”. The concept of the right of one and the right of the other appears. The subordinate no longer surrenders and does not look attentively only at the hand of the boss, he is already able to analyze correctly or incorrectly he is given instructions. These relations are built on the right of force.

The fourth, very rare role is a free doctor . He has no superiors, but this does not mean that he is self-willed. It does not depend on individuals and organizations, but on the law (you can recall Cicero: … we will become free only when we become slaves of the law ). This mode of relations is called the power of law. So far, only a few doctors have this status. All other named options are present in the relationship of most doctors and their bosses at all levels. The subject trusts the boss without limit, the guided one trusts the decisions he makes, the controlled one checks for legitimacy and fairness, but only the free one has the opportunity to make all decisions himself. True, he begins to bear full responsibility for their consequences, since only a free person, along with freedom, is entrusted with the corresponding duty to bear responsibility for his decisions. It is enough to recall the circumstances of the execution of Aesop, when with the words I am not free , he could stop the punishment. But he didn’t. Better to die free than live as a slave , he said in response to an offer to return alive as a slave to his former master.

Knowledge of the legislation, in addition to having access to the texts of regulatory legal acts and familiarity with them, means for a doctor knowing the answers to the questions of the ” Roman seven “: what, where, when, who, how, what, why? Therefore, the physician is expected to:

1. Know what a legal norm is, understand what the letter of the law and its spirit are;

1. Know where and by whom legal documents (acts) are created, understand what the legal force of a normative act is;

2. To know when the Belarusian legislation on healthcare appeared, to understand why it consists of documents of several levels;

3. Know who is responsible for fulfilling the requirements of the law, controls their compliance, understand the role of public authorities, health authorities;

4. Know how the legislation regulates private and public medical activities, understand what is the target function of a medical organization ;

5. Know how health care legislation differs from other types of legislation, understand how different types of laws are interconnected in relation to the activities of a doctor;

6. Know why people and organizations break laws, understand the relationship between law and order and civility.

It was assumed that the legislation in the field of health care is based on the following generally binding model of relations in the field of interaction between subjects providing and receiving medical care:

1. Humanity instead of indifference
2. Choice instead of accidents
3. Comfort instead of unsettled
4. Objectivity instead of subjectivity
5. Relief instead of pain
6. Privacy instead of nudes
7. Awareness instead of slyness
8. Autonomy instead of paternalism
9. Clarity instead of Entanglements
10. Financing instead of requisitions
11. Compensation instead of Excuses
12. Representation instead of petitions
13. Respect instead of Disregard for values
14. Accessibility instead of secrecy
15. Protection instead of False corporatism

It is obvious that such a model for the formation of relations between a doctor and a patient, enshrined in legislative acts, is based on ethical principles, primarily such as humanity, freedom of choice, personal autonomy, respect for dignity , etc. And it is very important that the initiators of creating the concept of patients’ rights and their introduction as legal norms into the legislation of all countries of the world were not patients, not lawyers, not legislators, not human rights activists, but doctors.

Chapter 5

In modern medicine, we are talking not only about helping the patient, but also about the possibilities of controlling the processes of pathology, conception and dying, with very problematic physical and metaphysical (moral) consequences for the human population as a whole. The doctor in the course of his activity in practice implements the rights, principles and values – his own as a professional and a patient. The doctor interacts not only with specific people – colleagues, patients, their relatives, but also with the healthcare system as a whole, focusing on the laws of the state and morality, in accordance with his personal convictions. In practical healthcare, as in any other area where the interests of different people, cultures, beliefs, traditions and beliefs collide, conflict and incidental situations can arise that can serve as an indicator of the state of healthcare in general, the activities of professional doctors, reflect the attitude of society towards certain problems in biomedicine.

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