The rights and obligations of citizens in the field of health protection

Patient's rights

According to Federal Law No. 323-FZ of 11/21/2011 (as amended on 06/11/2022, with amendments. dated 07/13/2022) "On the basics of protecting the health of citizens in the Russian Federation" (with amendments and additions, introduction. effective from 06/29/2022)the patient has the right to:

Article 18. The right to health protection

1. Everyone has the right to health protection.

2. The right to health protection is ensured by environmental protection, the creation of safe working conditions, favorable working conditions, everyday life, recreation, education and training of citizens, the production and sale of food of appropriate quality, high-quality, safe and affordable medicines, as well as the provision of affordable and high-quality medical care.

Article 19. The right to medical care

1. Everyone has the right to medical care.

2. Everyone has the right to guaranteed medical care provided without charge in accordance with the program of state guarantees of free medical care to citizens, as well as to receive paid medical services and other services, including in accordance with the contract of voluntary medical insurance.

3. The right to medical care for foreign citizens residing and staying in the territory of the Russian Federation is established by the legislation of the Russian Federation and relevant international treaties of the Russian Federation. Stateless persons permanently residing in the Russian Federation enjoy the right to medical care on an equal basis with citizens of the Russian Federation, unless otherwise provided for by international treaties of the Russian Federation.

4. The procedure for providing medical care to foreign citizens is determined by the Government of the Russian Federation.

5. The patient has the right to:

1) the choice of a doctor and the choice of a medical organization in accordance with this Federal Law;

2) prevention, diagnosis, treatment, medical rehabilitation in medical organizations in conditions that meet sanitary and hygienic requirements;

3) getting consultations from specialist doctors;

4) relief of pain associated with a disease, condition and (or) medical intervention, methods and medications, including narcotic drugs and psychotropic drugs;

(paragraph 4 of the ed. Federal Law No. 18-FZ of 06.03.2019)

5) receiving information about their rights and obligations, their state of health, choosing persons to whom information about their state of health can be transferred in the interests of the patient, including after his death; (as amended. Federal Law No. 315-FZ dated 07/02/2021)

6) receiving medical nutrition in the case of a patient being treated in an inpatient setting;

7) protection of information constituting a medical secret;

8) refusal of medical intervention;

9) compensation for damage caused to health during medical care;

10) admission of a lawyer or legal representative to him to protect his rights;

11) the admission of a clergyman to him, and in the case of a patient being treated in an inpatient setting, to provide conditions for the performance of religious rites, which can be performed in an inpatient setting, including the provision of a separate room, if this does not violate the internal regulations of the medical organization.ed. Federal Law No. 314-FZ dated 10/22/2014)

Article 20. Informed voluntary consent to medical intervention and refusal of medical intervention

1. A necessary prerequisite for medical intervention is the provision of informed voluntary consent of a citizen or his legal representative for medical intervention on the basis of complete information provided by a medical professional in an accessible form about the goals, methods of medical care, the associated risk, possible options for medical intervention, its consequences, as well as the expected results of medical care.

2. Informed voluntary consent to medical intervention is given by one of the parents or another legal representative in relation to:

1) a person who has not reached the age established by part 5 of Article 47 and part 2 of Article 54 of this Federal Law, or a person recognized as legally incompetent, if such a person is unable to consent to medical intervention due to his condition;

2) a minor with drug addiction when providing him with narcological assistance or during a medical examination of a minor in order to establish a state of narcotic or other toxic intoxication (with the exception of cases established by the legislation of the Russian Federation when minors acquire full legal capacity before they reach the age of eighteen).

3. A citizen, one of the parents or another legal representative of the person referred to in paragraph 2 of this Article shall have the right to refuse medical intervention or demand its termination, except for the cases provided for in paragraph 9 of this Article. The legal representative of a person recognized as legally incompetent shall exercise this right if such a person is unable to refuse medical intervention due to his condition.

4. In case of refusal of medical intervention, the possible consequences of such refusal must be explained to a citizen, one of the parents or another legal representative of the person specified in paragraph 2 of this article in a form accessible to him.

5. If one of the parents or other legal representative of the person specified in paragraph 2 of this Article, or the legal representative of the person recognized as legally incompetent, refuses medical intervention necessary to save his life, the medical organization has the right to apply to the court to protect the interests of such person. The legal representative of a person recognized as legally incompetent shall notify the guardianship and guardianship authority at the place of residence of the ward of the refusal of medical intervention necessary to save the life of the ward, no later than the day following the day of this refusal.

6. The persons specified in parts 1 and 2 of this Article, in order to receive primary health care, when choosing a doctor and a medical organization for the period of their choice, give informed voluntary consent to certain types of medical intervention, which are included in the list established by the authorized federal executive authority.

7. Informed voluntary consent to medical intervention or refusal of medical intervention is contained in the medical documentation of a citizen and is issued in the form of a paper document signed by a citizen, one of the parents or another legal representative, a medical professional, or is formed in the form of an electronic document signed by a citizen, by one of the parents or other legal representative using an enhanced qualified electronic signature or a simple electronic signature through the use of a unified identification and authentication system, as well as by a medical professional using an enhanced qualified electronic signature. Informed voluntary consent to medical intervention or refusal of medical intervention by one of the parents or other legal representative of the person specified in paragraph 2 of this article may be formed in the form of an electronic document if the patient's medical documentation contains information about his legal representative. When obtaining informed voluntary consent for medical intervention, a citizen or his legal representative has the right to identify persons to whom information about the patient's state of health can be transmitted in the interests of the patient, including after his death. The effect of these requirements regarding the method of signing informed voluntary consent to medical intervention or refusal of medical intervention in the form of an electronic document may be changed with respect to participants in the experimental legal regime in the field of digital innovation in accordance with the program of the experimental legal regime in the field of digital innovation, approved in accordance with Federal Law No. 258 of July 31, 2020-Federal Law "On experimental legal regimes in the field of digital innovations in the Russian Federation".

(ed. Federal Laws dated 07/29/2017 N 242-FZ, dated 07/22/2021 N 315-FZ, dated 07/22/2021 N 331-FZ)

8. The procedure for giving informed voluntary consent to medical intervention and refusal of medical intervention, including in relation to certain types of medical intervention, the form of informed voluntary consent to medical intervention and the form of refusal of medical intervention shall be approved by the authorized federal executive authority.

(ed. Federal Law No. 317-FZ of 11/25/2013)

9. Medical intervention without the consent of a citizen, one of the parents or another legal representative is allowed:

1) if medical intervention is necessary for emergency reasons to eliminate a threat to human life and if his condition does not allow him to express his will or there are no legal representatives (in relation to the persons specified in paragraph 2 of this Article);

2) in relation to persons suffering from diseases that pose a danger to others;

3) in relation to persons suffering from severe mental disorders;

4) in relation to persons who have committed socially dangerous acts (crimes);

5) when conducting a forensic medical examination and (or) a forensic psychiatric examination;

6) when providing palliative care, if the condition of the citizen does not allow him to express his will and there is no legal representative.

(Item 6 was introduced by Federal Law No. 18-FZ dated 06.03.2019)

10. A decision on medical intervention is made without the consent of a citizen, one of the parents or another legal representative:

1) in the cases specified in paragraphs 1 and 2 of Part 9 of this Article, by a consultation of doctors, and if it is impossible to assemble a consultation, - directly by the attending (duty) doctor with the introduction of such a decision in the medical documentation of the patient and subsequent notification to officials of the medical organization (the head of the medical organization or the head of the department of the medical organization), the citizen in respect of whom the medical intervention was performed, one of the parents or other legal representative of the person specified in part 2 of this article and in relation to whose medical intervention was performed, or by a court in cases and in accordance with the procedure established by the legislation of the Russian Federation;

(ed. Federal Law No. 317-FZ of 11/25/2013)

2) in respect of the persons specified in paragraphs 3 and 4 of Part 9 of this Article, by the court in cases and in accordance with the procedure established by the legislation of the Russian Federation;

3) in the case specified in paragraph 6 of Part 9 of this Article, by a medical commission or, if it is impossible to assemble a medical commission, - by a consultation of doctors or directly by the attending (duty) doctor with the introduction of such a decision into the patient's medical documentation and subsequent notification to officials of the medical organization (head of the medical organization or head of the department of the medical organization), the citizen in respect of whom the medical intervention was performed, one of the parents or other legal representative of the person specified in part 2 of this article and in respect of which a medical intervention was performed.

(Clause 3 was introduced by Federal Law No. 18-FZ dated 06.03.2019)

11. Compulsory medical measures may be applied to persons who have committed crimes on the grounds and in accordance with the procedure established by federal law.

12. In the case of providing medical care to a minor, the attending physician is obliged to inform a minor who has reached the age established by part 2 of Article 54 of this Federal Law, one of the parents or other legal representative of a minor who has not reached this age about the drug used, including those used in accordance with the indicators (characteristics) of the drug not specified in the instructions for its use, its safety, expected effectiveness, and the degree of risk to the patient, and also about the actions of the patient in case of unforeseen effects of the drug on the patient's health.

(Part 12 was introduced by Federal Law No. 482-FZ of 12/30/2021)

Article 21. Choosing a doctor and a medical organization

1. When providing medical care to a citizen within the framework of the program of state guarantees of free medical care to citizens, he has the right to choose a medical organization in accordance with the procedure approved by the authorized federal executive authority, and to choose a doctor, taking into account the consent of the doctor. The specifics of choosing a medical organization by citizens living in closed administrative-territorial entities, in territories with physical, chemical and biological factors dangerous to human health included in the relevant list, as well as employees of organizations included in the list of organizations of certain industries with particularly dangerous working conditions, are established by the Government of the Russian Federation.

2. In order to receive primary health care, a citizen chooses a medical organization, including on a territorial-precinct basis, no more than once a year (except in cases of change of residence or place of residence of a citizen). In the chosen medical organization, a citizen makes a choice no more than once a year (except in cases of replacement of a medical organization) of a general practitioner, a district internist, a pediatrician, a district pediatrician, a general practitioner (family doctor) or a paramedic by submitting an application personally or through his representative addressed to the head a medical organization.

3. The provision of primary specialized health care is carried out:

1) in the direction of a district general practitioner, a district pediatrician, a general practitioner (family doctor), a paramedic, a specialist doctor;

2) in the case of a citizen's independent application to a medical organization, including an organization chosen by him in accordance with part 2 of this article, taking into account the procedures for providing medical care.

4. In order to receive specialized medical care in a planned form, the choice of a medical organization is carried out in the direction of the attending physician. If several medical organizations providing medical care in the appropriate profile participate in the implementation of the territorial program of state guarantees of free medical care to citizens, the attending physician is obliged to inform the citizen about the possibility of choosing a medical organization, taking into account the fulfillment of the conditions for medical care established by the territorial program of state guarantees of free medical care to citizens.

5. Medical assistance in an urgent or emergency form is provided to citizens, taking into account compliance with the established requirements for the timing of its provision.

6. When providing medical care to a citizen within the framework of the program of state guarantees of free medical care to citizens, the choice of a medical organization (except in cases of emergency medical care) outside the territory of the subject of the Russian Federation in which the citizen resides is carried out in accordance with the procedure established by the authorized federal executive authority.

7. When choosing a doctor and a medical organization, a citizen has the right to receive information in a form accessible to him, including information posted on the Internet information and telecommunications network (hereinafter referred to as the Internet), about a medical organization, about its medical activities and about doctors, about their level of education and qualifications.

8. The choice of a doctor and a medical organization by military personnel and persons equated in medical care to military personnel, citizens undergoing alternative civil service, citizens subject to conscription or sent to alternative civil service, and citizens entering military service under a contract or equivalent service, is carried out taking into account the specifics of medical care, established by Article 25 of this Federal Law, as well as taking into account the specifics, established by Federal Law No. 53-FZ of March 28, 1998 "On Military Duty and Military Service".

(Part 8, ed. Federal Law No. 131-FZ dated 30.04.2021)

8.1. The choice of a doctor and a medical organization by detainees, detainees serving a sentence of restriction of liberty, arrest, deprivation of liberty or administrative arrest is carried out taking into account the specifics of providing medical care established by Article 26 of this Federal Law.

(Part 8.1 was introduced by Federal Law No. 131-FZ dated 30.04.2021)

9. When providing medical care to citizens within the framework of practical training of students in professional educational programs of medical education, the patient must be informed about the participation of students in providing him with medical care and has the right to refuse the participation of students in providing him with medical care. In this case, the medical organization is obliged to provide such a patient with medical care without the participation of students.

(Part 9 was introduced by Federal Law No. 185-FZ of 07/02/2013)

Article 22. Health information

1. Everyone has the right to receive, in an accessible form, information available to him in a medical organization about the state of his health, including information about the results of a medical examination, the presence of a disease, the established diagnosis and prognosis of the disease, methods of medical care, the associated risk, possible types of medical intervention, its consequences and the results of medical care.

2. Information about the patient's health status is provided to the patient personally by the attending physician or other medical professionals who are directly involved in medical examination and treatment. In respect of persons who have not reached the age established in part 2 of Article 54 of this Federal Law, and citizens recognized as legally incompetent in accordance with the procedure established by law, information on the state of health is provided to their legal representatives. In respect of persons who have reached the age established by part 2 of Article 54 of this Federal Law, but have not acquired full legal capacity, information on the state of health is provided to these persons, as well as to their legal representatives before these persons reach the age of majority.

(ed. Federal Law No. 271-FZ of 07/31/2020)

3. Information about the state of health cannot be provided to the patient against his will. In case of an unfavorable prognosis of the disease, information should be communicated in a delicate form to a citizen or his spouse, one of the close relatives (children, parents, adopted children, adoptive parents, siblings, grandchildren, grandfathers, grandmothers), unless the patient has forbidden to inform them about it and (or) has not determined another person to whom such information should be transmitted.

4. The patient or his legal representative has the right to get acquainted directly with the medical documentation reflecting his state of health and to receive consultations from other specialists on the basis of such documentation. The spouse, close relatives (children, parents, adopted children, adoptive parents, siblings, grandchildren, grandfathers, grandmothers) or other persons indicated by the patient or his legal representative in written consent to the disclosure of information constituting a medical secret, or informed voluntary consent to medical intervention, have the right directly to get acquainted with the patient's medical documentation, including after his death, if the patient or his legal representative has not prohibited the disclosure of information constituting a medical secret. The procedure for familiarization with the patient's medical documentation is established by the authorized federal executive authority.

(part 4 of the ed. Federal Law No. 315-FZ dated 07/02/2021)

5. The patient or his legal representative has the right, upon request, including in electronic form, to receive medical documents reflecting the patient's state of health (copies thereof) and extracts from them, including in the form of electronic documents. A spouse, close relatives (children, parents, adopted children, adoptive parents, siblings, grandchildren, grandfathers, grandmothers) or other persons indicated by the patient or his legal representative in written consent to the disclosure of information constituting a medical secret, or informed voluntary consent to medical intervention, have the right to receive medical documents (copies thereof) and extracts from them, including after his death, unless the patient or his legal representative has prohibited the disclosure of information constituting a medical secret. The procedure and deadlines for the provision of medical documents (copies thereof) and extracts from them are established by the authorized federal executive authority.

(ed. Federal Laws dated 07/29/2017 No. 242-FZ, dated 07/22/2021 No. 315-FZ)

Article 23. Information about factors affecting health

Citizens have the right to receive reliable and timely information about factors contributing to the preservation of health or having a harmful effect on it, including information on the sanitary and epidemiological well-being of the area of residence, the state of the habitat, rational nutrition standards, the quality and safety of industrial and technical products, food, goods for personal and household needs, potential the risks to human health of the work performed and the services provided. Such information is provided by state authorities and local self-government bodies in accordance with their powers, as well as organizations in accordance with the procedure provided for by the legislation of the Russian Federation.

Article 24. The rights of employees engaged in certain types of work to health protection

1. In order to protect health and preserve the ability to work, prevent and timely detect occupational diseases, employees engaged in work with harmful and (or) dangerous production factors, as well as in cases provided for by the legislation of the Russian Federation, employees engaged in certain types of work undergo mandatory medical examinations.

2. The list of harmful and (or) dangerous production factors and works, during which mandatory preliminary medical examinations are carried out upon admission to work and periodic medical examinations, is approved by the authorized federal executive authority.

3. In case of identification during mandatory medical examinations of medical contraindications to the implementation of certain types of work, the list of which is established by the authorized federal executive authority, the employee may be recognized by the medical commission of a medical organization on the basis of the results of the examination of professional suitability temporarily or permanently unfit for health reasons to perform certain types of work.

4. In order to protect health, employers have the right to recruit positions of medical workers and create units (doctor's office, health center, medical office, medical unit and other units) providing medical care to employees of the organization. The procedure for organizing the activities of such units and medical workers is established by the authorized federal executive authority.

5. Employers are obliged to provide conditions for employees to undergo medical examinations and medical examinations, as well as freely release employees for their passage.

Article 25. The rights of military personnel and persons equated to military personnel in terms of medical care, as well as citizens undergoing alternative civil service, citizens subject to conscription for military service (sent to alternative civil service), and citizens entering military service or equivalent service under a contract, to health protection

1. Military personnel and persons equated to military personnel in terms of medical support (hereinafter referred to as military personnel and persons equated to them), as well as citizens undergoing alternative civil service, have the right to undergo a military medical examination to determine their suitability for military service or equivalent service and for early dismissal from military service or equivalent services to her on the basis of the conclusion of the military medical commission.

2. Citizens who are subject to conscription for military service or sent to alternative civil service, and citizens who enter military service or equivalent service under a contract, undergo a medical examination in accordance with the procedure provided for in Article 61 of this Federal Law, and have the right to receive full information about medical contraindications for military service or equivalent to her service and indications for postponement or exemption from conscription for health reasons.

3. Military personnel and persons equated to them have the right to receive medical care in departmental medical organizations, and in their absence or in the absence of departments of the appropriate profile, specialists or special medical equipment in departmental medical organizations - to receive medical care in accordance with the procedure established by the Government of the Russian Federation, at the expense of budget allocations from the federal budget provided for these purposes to federal executive authorities and federal state bodies in which federal law provides for military service or equivalent service.

(ed. Federal Law No. 145-FZ dated 06/04/2014)

4. The procedure for organizing medical care for military personnel and persons equated to them shall be established by the Government of the Russian Federation, the specifics of organizing medical care for military personnel and persons equated to them, including the procedure for their release from military service (official duties) in connection with illness and other causes, shall be established by federal executive authorities and federal state bodies in which federal law provides for military service or equivalent service.

(ed. Federal Law No. 145-FZ dated 06/04/2014)

5. Citizens upon their military registration, conscription or admission to military service under a contract or equivalent service, admission to military professional educational organizations or military educational organizations of higher education, conclusion of an agreement with the Ministry of Defense of the Russian Federation on training at a military training center at the federal state educational organization of higher education under the military training program or in a military educational organization of higher education under the program of military training of sergeants, reserve officers or the program of military training of soldiers, reserve sailors, conscription for military training, as well as citizens sent to alternative civilian service, have the right to receive medical care in medical organizations under the program of state guarantees of free medical care to citizens, with the exception of medical examination in order to determine fitness for military service or equivalent to her service.

(part 5 of the ed. Federal Law No. 309-FZ of 08/03/2018)

6. The specifics of protecting the health of military personnel and persons equated to them, as well as certain categories of citizens undergoing military service or equivalent service in federal executive bodies and federal state bodies in which federal law provides for military service or equivalent service, are determined by the legislation of the Russian Federation regulating the activities of these bodies.

(ed. Federal Law No. 145-FZ dated 06/04/2014)

Article 27. Obligations of citizens in the field of health protection

1. Citizens are obliged to take care of their health.

2. Citizens, in cases provided for by the legislation of the Russian Federation, are obliged to undergo medical examinations, and citizens suffering from diseases that pose a danger to others, in cases provided for by the legislation of the Russian Federation, are obliged to undergo medical examination and treatment, as well as to prevent these diseases.

3. Citizens undergoing treatment are obliged to comply with the treatment regime, including those defined for the period of their temporary disability, and the rules of patient behavior in medical organizations.

Article 26. The rights of persons detained, detained, serving sentences in the form of restriction of liberty, arrest, deprivation of liberty or administrative arrest to receive medical care

1. Persons detained, imprisoned, serving sentences in the form of restriction of liberty, arrest, deprivation of liberty or administrative arrest, have the right to medical care, including, where necessary, in medical organizations of the state health care system and the municipal health care system, in accordance with the legislation of the Russian Federation.

2. Pregnant women, women during childbirth and in the postpartum period from among the persons specified in paragraph 1 of this Article have the right to medical care, including in medical organizations for the protection of motherhood and childhood.

3. If it is impossible to provide medical care in institutions of the penal enforcement system, persons detained or serving a sentence of imprisonment have the right to provide medical care in medical organizations of the state health system and the municipal health system, as well as to invite specialist doctors of these medical organizations to consult in accordance with the procedure established by the Government of the Russian Federation Of the Russian Federation, at the expense of budgetary allocations of the federal budget, provided for these purposes to the federal executive authority exercising law enforcement functions, functions of control and supervision in the field of execution of criminal penalties in relation to convicted persons.

4. When providing medical care in medical organizations of the state health system and the municipal health system, employees of bodies and institutions of the penal enforcement system protect the persons specified in part 3 of this article, and, if necessary, round-the-clock monitoring in order to ensure the safety of these persons, medical workers, as well as other persons located in medical organizations of the state and municipal healthcare systems, in accordance with the procedure established by the federal executive authority, responsible for the development and implementation of state policy and regulatory legal regulation in the field of execution of criminal penalties, together with the authorized federal executive authority.

5. Clinical approbation, testing of medicines, specialized medical nutrition products, medical devices and disinfectants with the involvement of persons specified in paragraph 1 of this Article as an object for these purposes is not allowed.

(ed. Federal Law No. 55-FZ of 08.03.2015)

6. In respect of persons serving sentences in institutions of the penal enforcement system, the contract on voluntary medical insurance is terminated.

7. The procedure for organizing the provision of medical care, including in medical organizations of the state and municipal health care systems, to persons specified in part 1 of this Article, is established by the legislation of the Russian Federation, including regulatory legal acts of the authorized federal executive authority responsible for the development and implementation of state policy and regulatory regulation in the field of in the field of execution of criminal penalties, in coordination with the authorized federal executive authority.

Article 27. Obligations of citizens in the field of health protection

1. Citizens are obliged to take care of their health.

Article 28. Public associations for the protection of citizens' rights in the field of health protection

1. Citizens have the right to establish public associations for the protection of citizens' rights in the field of health protection, formed on a voluntary basis.

2. Public associations for the protection of citizens' rights in the field of health protection may, in accordance with the procedure established by the legislation of the Russian Federation, participate in the development of norms and rules in the field of health protection and resolving issues related to violations of such norms and rules.

3. Public associations for the protection of citizens' rights in the field of health protection are not entitled to advertise specific trade names of medicines, biologically active additives, medical devices, specialized medical nutrition products and breast milk substitutes.