Medicinos standartai administracinės teisės sistemoje
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Medical standards are special legal provisions that are supposed to regulate doctor activities in treating a disease or a group of diseases. Lithuania has just started the development of its own system of medical standards. A unique, highly different from the style of medical standards of other countries it is currently under development in Lithuania. Differently from the standards published by the most countries, Lithuanian medical standards come on a short list, several pages long, and bear a strong resemblance to the short lecture notes. The aim of this paper is to specify the concept of a medical standard, its functions and, in this way, to formulate basic requirements to be met in developing a medical standard. The specification of these requirements provides the criteria for assessment. This, in turn, provides the answer to the key question: to what extent the current Lithuanian standards meet these requirements and if they allow assess the medical standards. The legal nature of medical standards is reviewed. It has been made manifest that medical standards belong to the administrative legal provisions and possess all their legal features. Moreover, medical standards are part of the specific group of administrative provisions, known as the regulatory regimes. Medical standards share all specific traits of such provisions establishing regimes. As with other administrative regime-ensuring provisions, medical standards regulate one of the exceptionally important areas of social life – delivery of health care services and, also similarly as other provisions of this importance, they equip strict methods of regulation. Analysis of the legal nature of the medical standards furnishes their assessment criteria. Medical standards regulate the doctor’s activities in dealing with a medical problem, stress the current medical knowledge on ways to solve the problem. Therefore, medical standards are a translation of the current medical knowledge into the doctor’s actions. This means that a full and exact translation of the current medical knowledge into a system of administrative legal provisions is the basic requirement to the medical standard. These requirements are specified as four basic criteria to assess a medical standard: 1. Full consideration of the current state of art in medicine, a standard has to be inclusive of all related knowledge. 2. Algorithmic vs. descriptive way to present a standard’s recommendations, a standard has to use all current medical knowledge on the most qualified succession of medical actions. 3. Active vs. passive ways to avoid medical mistakes, a standard is supposed not only to guide what has to be done according to the current medical knowledge but also to warn against what should not be done. 4. Correct and precise borderline between the regulation of a doctor’s activities and medical discretion. These criteria should provide the basis for the development of a consistent set of criteria for assessment of medical standards, for the reception of the best foreign medical standards, for the enhancement of their feasibility, and for further perfection of a doctor’s liability for the quality of treatment.
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