Discussions on the disciplinary responsibility of doctors in cases of ethical violations will resume / Article

It should be recalled that discussions on this issue began more than two years ago, when it was revealed that the institutions did not respond in substance for a long time to the complaints of several patients about the immunologist Yevgenia Nikiforenko, who is now on trial for sexual violence against female patients. It made me think not only about the errors of the specific case, but about the general correction of system gaps. A working group worked in the Health Inspectorate and the Saeima promised quick changes.

But when the hype died down, so did the action.

And although the issues of patients’ rights were discussed, many things remained only in the folder of proposals prepared by the Health Inspectorate.

One of the suggestions was to establish the obligation to accept and examine patients’ complaints already in the medical institutions themselves. In the view of the Health Inspectorate, this should have been determined not only in the Law of Patients’ Rights, but also in the Law of Medical Treatment, but currently whether and how to do it depends on each individual institution. And even if it is formally done in institutions, it is not always known to patients.

“The inspection regularly works on this, visits health care institutions, meets with the management of institutions and emphasizes these issues, that it must be done seriously systematically and systematically. How – is it related to the specific institution, its size, is it an individual person, but

in any case, the patient must have a clear picture, a clear road map, where and how he can go,”

explained Arnis Bluķis, head of the Quality and Risk Management Department of the Health Inspectorate.

However, more serious measures in relation to specific doctors, especially if they are employees of several medical institutions, cannot be adopted by the hospital. And here another mechanism called for two years ago should start working – the disciplinary responsibility of doctors in cases of ethical violations, even with the possible annulment of the certificate, which was instigated at that time by the Latvian Association of Physicians (LAB). Now the question has been brought up again.

LĀB lawyer Elita Vīksne says that more active discussions took place in March.

“And we have come to the conclusion that it is absolutely necessary. But the big question is finances,” she said.

Namely, funding would be needed for the commission that will carry out this work. Disciplinary responsibility would be assessed based on the suggestion of patients, the Health Inspectorate, and medical institutions. There are still discussions about how disciplinary responsibility for ethical violations could manifest itself, as well as whether the evaluation would be entrusted to one or more institutions,

however, the last option – cancellation of the certificate, which was on offer, was not really considered.

This is not supported by the Ministry of Health, because the aim is to prevent professional violations, not to prevent professional activity. Instead, there might be certain duties to be performed, such as additional training. It is also accepted by the medical association.

Health Minister Hossam Abu Meri (“New Unity”) was not aware of the ongoing negotiations so far, but admitted that he will focus more actively on it. He admitted that the process is not as smooth as it should be, but he has put the protection of patients’ rights as one of the priorities, along with the protection of doctors’ rights.

“And I would not like one side more than the other. To be able to balance, to have the right to defend myself, and I will also talk to the Minister of Justice about these two issues, and she will also help us move forward as quickly as possible,” said Abu Meri.

The Ministry of Health plans to submit the related bill to the Cabinet of Ministers by the end of this year.

Evaluating the changes in the protection of patients’ rights, Solvita Olsen, an expert in the field, admitted in a conversation with “De facto” that steps are being taken in the right direction, but they are too slow and too little is being talked about and acted upon. In his opinion, disciplinary responsibility for ethical violations should also be necessary to improve patient safety, quality of treatment and prevent potentially illegal activities. At the same time, it should be carefully considered which institution to entrust it to, so that conflicts of interest do not arise.