Medical ethics legislation comes to the foreground again in Latvia / Article


Discussions on the issue began more than two years ago when it emerged that the institutions had persistently failed to respond to complaints from several patients about immunologist Jevgēņijs Ņikiforenko, who is now being tried for sexual abuse of female patients. A working group was formed at the Health Inspectorate and the Saeima promised swift changes.

But as the sensation subsided, so did action. Although patient rights issues were discussed, much remained only in the proposal folder prepared by the Health Inspectorate.

One of the suggestions was to oblige the treatment institution to accept and deal with patient complaints themselves. According to the Health Inspectorate, this should have been laid down in the Law on patients’ Rights and the Law on Medical Treatment. Now complaint filing depends on each individual institution.

“The inspectorate regularly works on this, visits health facilities, meets with institutional leadership, and highlights these issues that this needs to be done seriously systematically. How – it depends on the institution in question, its size, whether it is a separate department, but either way, the patient needs to have a clear picture, a clear road map, where and how they can go,” said Arnis Bluķis, Head of Quality and Risk Management Division of the Health Inspectorate.

However, more serious measures against specific medical workers, especially if they are employees of several medical facilities, cannot be carried out by the hospital. And this is where another mechanism, already invoked two years ago – disciplinary responsibility of doctors in cases of ethical violations, should start, with possible revocation of the certificate, which was then prompted by the Latvian Medical Association (LĀB). The issue has now been raised again.

LĀB lawyer Elita Vīksne says more active discussions took place in March. “And we have come to the conclusion that it is imperative. But the big issue is finance, “she said. There are also discussions on how disciplinary responsibility for ethical violations could take place, as well as whether assessment would be entrusted to one or more institutions, however, the final option of revoking the certificate is no longer really examined.

Revocation of certificates is not supported by the Ministry of Health, since “the aim is to prevent professional misconduct and not to prevent professional activity”. Instead, there could be certain responsibilities to be performed, such as additional training. It is also accepted by the Medical Association.

In assessing the changes in the protection of patients’ rights, lawyer Solvita Olsena, an expert in the field, acknowledged in a conversation with De Facto that steps were being taken in the right direction, but they were too slow and too small. Disciplinary action for ethical violations, she said, would be needed to improve patient safety, quality of treatment and prevent potentially illegal activities. At the same time, careful consideration should be given to which institution to entrust it so that conflicts of interest do not arise.

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