The Supreme Court reminded the Russians that an ultrasound requires a doctor’s permission

The Supreme Court (SC) of the Russian Federation recognized as legal the ban on ultrasound without a referral from the attending physician, rejecting the administrative claim of Oksana Ivanova. Earlier, in a private clinic, Ms. Ivanova was denied the procedure, because the referral issued by the attending physician did not indicate the institution, as required by the standards established by the Ministry of Health. The plaintiff considered the actions of doctors a violation of rights. The medical department noted that the Armed Forces only confirmed the norms in force in Russia since 2020, and assured that no new restrictions would be introduced.

Oksana Ivanova appealed to the Supreme Court with a demand to invalidate the ban on conducting a paid service – ultrasound – without consulting a doctor, within the framework of which a referral for an ultrasound is issued. In a private medical organization, the plaintiff said, they indicated that she did not have a referral. At the same time, the conclusion of the attending physician, in which the procedure was recommended, was not accepted, since, according to representatives of the clinic, there were no data provided for by the rules, in particular, the name of the organization where the patient is sent for the study.

The ultrasound examination procedure is regulated by the rules approved in 2020 by the Ministry of Health of Russia. Paragraph 9 of the document states that ultrasounds are carried out on the appointment of the attending physician or a paramedic or midwife if they are assigned certain functions of the attending physician, taking into account the patient’s right to choose a medical organization. At the same time, the name of the medical institution to which the patient is sent for an ultrasound scan must be indicated in the direction.

Ms. Ivanova considered that these norms do not comply, in particular, with the laws “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation”, “On Protection of Consumer Rights”, and “On Protection of Competition”.

The Ministry of Health and the Ministry of Justice of Russia, in response to the administrative claim, indicated that “the contested regulations comply with current legislation and do not violate the rights and legitimate interests of the administrative plaintiff.”

The Supreme Court refused Mrs. Ivanova. She later filed an appeal, but the court did not change its decision.

In a number of media there were reports that the Supreme Court thus forbade Russians to do ultrasound without a doctor’s prescription. The Ministry of Health had to explain that there would be no additional restrictions on the passage of ultrasound examinations: “No additional restrictions and requirements have been introduced for more than 2.5 years of the operation of the rules for conducting ultrasound examinations, nor will they be with the decision of the Supreme Court.”

Lawyer of the Yakovlev and Partners legal group, lecturer at the Department of Medical Law and Bioethics of the Samara State Medical University Evgenia Ryzhkova points out in this regard that the consumer protection law obliges each client to provide a service, and also prohibits imposing additional ones, however, when providing medical services, the law has priority ” On the basics of protecting the health of citizens. “The medical service may have contraindications, and the ultrasound doctor, for example, cannot assess the feasibility of the procedure, taking into account the patient’s history,” explains Ms. Ryzhkova. As for the direction itself, its “controversial form”, according to the lawyer, was developed within the framework of the MHI: it is important that the patient knows exactly the organization where he will be provided with free assistance. However, the expert continues, the queue for CHI can be long, and the patient may wish to go to another clinic at his own expense.

“The court decided that the patient can choose a medical institution himself, but in this case he must contact the attending physician again and correct the referral, even if he seeks paid medical services,” says Yevgenia Ryzhkova.

At the same time, she added that “in practice, I have not seen a medical institution punished for carrying out a procedure in a direction in which there were formal errors.”

Sergey Lezhnin, CEO of the Doctis group of companies, points out that the development of technology is an absolute boon for medicine and healthcare, but “any health question should begin not with reading chats, but with a visit to the local or attending physician, and only the doctor prescribes all subsequent manipulations “. He emphasizes that the decision of the Supreme Court is about maintaining the current practice, which is aimed at obtaining comprehensive medical care, as well as creating a culture of interaction between patients and the healthcare system and reducing the burden on doctors. According to him, there are no clinical studies that would demonstrate the dangers of ultrasound: “However, there are much more harmful studies, such as radiography, MRI, and therefore it is important to unify the rules regarding any instrumental studies.”

Natalya Kostarnova