Legal contradictions of the application of medical standards in the implementation of medical activities
Authors:   Postgraduate Institute for Public Health Workers of the Ministry of Health of the Khabarovsk Krai, Khabarovsk, Russia, Savkova V.M. , Savkov D.S. ,   Far Eastern State Medical University of the Ministry of Health of Russia, Khabarovsk, Russia
Published: December 2024

The article presents a review of regulatory legal acts and judicial practice on the application of clinical recommendations. Medical-organizational problems and legal contradictions are indicated, which can be used by medical organizations as grounds for challenging in court some provisions of their application in the implementation of their professional activities.
The relevance of the study. Providing procedures and standards of medical care are the basis for the establishment of insurance support in the compulsory medical insurance system and at the same time guarantee the equal amount of medical care provided throughout the Russian Federation. Based on the procedures, standards, and from January 1, 2019, the clinical recommendations, criteria for assessing the quality of medical care are formed. In addition, since January 2025, medical organizations should proceed to the provision of medical care based on clinical recommendations. In this regard, the legal description of the ratio of the procedure for the provision of medical care, standards of medical care and clinical recommendations becomes especially relevant for both the purpose of the control and supervision functions in the field of medical services, and for specific individuals and legal entities carrying out medical activities. Relevance is also due to the fact that health protection for a single person occurs at the level of receipt of goods, works and medical services. And the safety and quality of medical services necessary to restore and maintain the patient’s health depend on corresponanse of pay services and quality of medical services.
Materials and methods. Within the framework of this study, an analysis of regulatory legal acts and literary sources on the implementation of medical activities in terms of applying the procedures for the provision of medical care, standards of medical care and clinical recommendations posted in the scientific electronic library was carried out. The specified analysis was performed using the reference legal system Consultant Plus. At the same time, along with general scientific logical methods of cognition, they used formally - legal and comparative and legal research methods.
The goals and objectives of the study. Conduct an analysis of the content and legal status of medical standards, determine their ratio in issues of regulating medical activities, identify existing problems in the studied sphere and, based on the data obtained, formulate proposals to harmonize the legal regulation of the standardization of the therapeutic and diagnostic process.
Results and discussions. Medical activity in its main manifestations is multifaceted. Its legal regulation is also difficult, including in relation to the process of providing medical care. The normative determination of medical care is enshrined in law as a set of measures aimed at maintaining and (or) restoration of health and including the provision of medical services [Article 2 of the Law of the Russian Federation No. 323-ФЗ]. According to federal law, the organization and provision of medical care should be carried out in accordance with the procedure for the provision of medical care, on the basis of clinical recommendations and taking into account the standards of medical care [part 3 of article 2, part 1 of article 37 of the Law of the Russian Federation No. 323-ФЗ] .