A doctor’s refusal of medical care and hospitalization: what to do and where to go, procedure, rights of the patient and medical worker, rules and sample of writing a claim

Author of the article:

Muzyko Tatyana Andreevna - lawyer.

People in need of medical care can count on this.
There are various institutions in the country that can provide it quickly and efficiently. If the patient's rights are violated, inevitable punishment will follow from the authorities. Medical workers and entire institutions will bear responsibility.

How is hospitalization carried out?

The decision regarding hospitalization of the patient is made by the doctor after an examination. According to the law “On the fundamentals of protecting the health of citizens in the Russian Federation,” hospitalization is mandatory when:

life-threatening condition;
childbirth;
postpartum period;
injuries received as a result of emergencies and natural disasters.

The patient is taken to the emergency room of the hospital, which is located closer to his place of residence. However, the diagnosis given to the patient and the profile of the medical institution are taken into account. As a rule, wishes expressed by the patient or his relatives regarding the hospital cannot be taken into account.

If the patient lives in a populated area, the place where he will be delivered depends on the diagnosis. They can take you to the local hospital. Calling an ambulance and hospitalization are not paid for by the patient, that is, they are carried out free of charge.

If a situation arises when the ambulance refuses hospitalization or it is not possible to call a team, then the patient has the right to go to the emergency department of the hospital of his choice.

Attention! The presence of registration at the place of residence does not matter for the provision of medical care. Even a foreigner can go to the hospital or call an ambulance.

If the situation in which the doctor decides to hospitalize is not an emergency, then the patient can write a refusal. The refusal is made in writing. When the patient is a minor child or a person deprived of legal capacity, the refusal is drawn up by his legal representative. If the doctor considers that the decision to refuse hospitalization jeopardizes the life and health of the patient, the medical organization will appeal to the guardianship authorities or the court. Also, the senior ambulance crew member is authorized to call the police.

When a person is deprived of legal capacity and is unconscious, relatives cannot prevent his hospitalization. Medical intervention without the consent of a person or his legal representative is permissible:

if such intervention is required for emergency reasons in order to eliminate the existing threat to life or health;
when a person’s condition does not allow him to express his will, and he does not have legal representatives;
if the person suffers from a disease that is dangerous to others;
if the person has a mental disorder that occurs in a severe stage;
if the person has committed a crime;
during a forensic psychiatric or forensic medical examination.

Download for viewing and printing:
Federal Law of November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation”

Is it legal to require the refusal to be put in writing?

Doctors do not have the right to refuse hospitalization to a person whose condition is the basis for providing such assistance. If, after refusing hospitalization, the patient’s condition worsens or he dies, the doctors will be punished under criminal law.

If the patient himself refuses to undergo hospitalization, even though there are grounds for this, doctors are obliged to explain to him the possible consequences. If he still refuses, then the emergency doctors should ask him to write a refusal. This document is necessary so that problems do not arise if the patient’s condition worsens, and doctors are then not accused of refusing to provide assistance to him.

The written refusal indicates the fact that the patient was informed about the possible consequences of refusing hospitalization, and that the patient takes responsibility for such consequences.

Can help be refused?

According to Federal Law No. 323-FZ dated November 21, 2011 (as amended on December 29, 2017) “On the fundamentals of protecting the health of citizens in the Russian Federation,” a refusal to provide medical care is considered unlawful if it is committed by an employee of an organization operating in the healthcare sector. Such an organization must take part in a program to guarantee the provision of free medical care, which is implemented by the state. Attention! In the event that a person needs to provide emergency assistance, it must be provided immediately and free of charge. In case of violation of the rules established by the legislator, liability is provided.

Patient's actions in case of refusal

A refusal to provide assistance, including necessary hospitalization, must be appealed.

A doctor’s refusal to admit a patient is grounds for filing a complaint with the head physician. The complaint must be made in writing in two copies. The text must describe the situation that occurred, as well as exactly what rights were violated.

The petition part indicates a request to provide assistance and punish the doctor who refused it.

The complaint is submitted to the secretary of the chief physician. The secretary must mark receipt on the complainant's copy.

In case of a complaint against a hospital, you must contact Roszdravnadzor, health insurance funds and the Ministry of Health.

In some situations, such a complaint can be filed with the police or prosecutor's office. This is possible if the refusal to provide assistance led to a serious deterioration in health, which required amputation of limbs, other surgery, or led to the death of the patient.

In case of extortion of a bribe for hospitalization, you should also contact the prosecutor's office.

Material damage resulting from the hospital's actions must be compensated in court. The claim specifies the details of the hospital, the guilty employees, the victim, as well as all the circumstances of the case and supporting documents.

Can an ambulance refuse hospitalization?

If, upon arrival to the patient, the ambulance team detects an acute pain attack, but there are no other symptoms confirming that the person is in a serious condition, a decision may be made to relieve the pain with an injection.
Then there is no reason to hospitalize the patient by ambulance. If a person soon becomes ill again and calls an ambulance, this is already grounds for hospitalization.

In a situation where the ambulance staff considered that there was no reason for hospitalization and left, and the patient at that time feels that he is in a serious condition, he must:

Make a second call to number “03” and inform the dispatcher that you are in serious condition. It is also necessary to state that the patient does not agree with the diagnosis and insists on hospitalization;
Call the hotline of the Ministry of Health of the region where the patient lives if the ambulance dispatcher does not accept the second call.

You can find the phone number of a health authority by using the official website of this organization.

Important! The ambulance team does not have the right to refuse to provide medical care if the patient does not have documents with him. This also applies to those cases when a person does not have documents such as a health insurance policy and a passport.

According to legislative norms, if a person who does not have documents is taken to a medical institution by an ambulance, then he has the right to stay there until the threat to his life and health is eliminated. In each situation, the period is determined individually. The specified time spent in a medical institution is free for the patient.

If a controversial situation arises when doctors refuse to carry out treatment due to lack of documents, you must contact the health authority hotline.

If the doctor refuses to provide medical care and hospitalization

As mentioned above, a doctor cannot refuse to provide medical care.
This rule applies to employees of institutions participating in the state program of guarantees of free medical care. In the case where a person was refused medical care by the registrar of a medical institution, then responsibility for such a refusal will be assigned to this organization. When a doctor refuses to provide medical assistance, resulting in harm to the patient’s health, then liability is provided for under Article 124 of the Criminal Code of Russia.

According to the norm in question, if a person who has the obligation to provide medical care, in the absence of valid reasons, refuses to provide it, as a result of which a person’s health is caused to moderate harm, then the punishment is provided for in Part 1 of Article 124 of the Criminal Code of the Russian Federation.

The following applies to the perpetrator:

a fine of up to 40 thousand rubles;
compulsory work for a period of 360 hours;
correctional labor for 12 months;
arrest up to 4 months.

If serious harm is caused to a person’s health, the punishment is toughened and is expressed in forced labor for up to 4 years; as an additional punishment, deprivation of the right to engage in certain activities or hold a position for 3 years is considered. The perpetrator can also be imprisoned for up to 4 years.

Also, the culprit may be held accountable under Article 293 of the Criminal Code of the Russian Federation if negligence is seen in his actions. It is understood as a situation where a person did not fulfill or improperly fulfilled the duties assigned to him, which resulted in a significant violation of the rights and legitimate interests of citizens.

The punishment is expressed in:

a fine equal to 120 thousand rubles;
compulsory work assigned for 360 hours;
corrective labor, which can be assigned for a period of up to 1 year;
arrest for 4 months.

If, as a result of negligence, serious harm was caused to a person’s health or he died, then the culprit:

punishable by forced labor for up to 5 years;
at the discretion of the court, deprived of the right to engage in certain activities or hold a certain position for a period of up to 3 years;
is deprived of liberty for a term of up to 5 years.

Download for viewing and printing:
Article 124 of the Criminal Code of the Russian Federation “Failure to provide assistance to a patient”

Article 293 of the Criminal Code of the Russian Federation “Negligence”

Mediation

In each region of the Russian Federation there is a division of the Medical Chamber of the Russian Federation, which, on the one hand, protects the rights of medical workers, on the other, is called upon to be a guarantor of fairness in resolving a patient/doctor dispute. For this purpose, a mediation procedure has been introduced into the activities of the chamber - pre-trial resolution of disputes through negotiations between the parties with the participation of an intermediary - a mediator.

To protect violated rights through the mediation procedure, you can contact the Mediation Center (pre-trial dispute resolution) “Medical Chamber” of the region, or send your application by email (contacts can be found on the website of the “Medical Chamber” of the subject). The National Medical Chamber of the Russian Federation maintains a register of mediators and issues them permission to carry out activities in the field of medicine; Regional centers are gradually being created in each region of the Russian Federation, which operate free of charge. Contacts of the national medical chamber for more information: +7 495 959 2896, email You can also obtain data from regional medical chambers.

The procedure looks like this:

a meeting is scheduled at which the citizen and medical worker state their demands;
a specially trained mediator, who is not an interested party, conducts negotiations;
if the parties have reached a common decision, this is documented;
if consensus is not found, the patient has the right to use other methods of protection.

Contacting the Medical Chamber is free and does not oblige the patient to any subsequent actions if the dispute resolution option proposed by the mediator and the doctor does not suit him.