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Povinná mlčanlivosť versus právo na prístup k informáciám


 | 28.10.2016 | komentárov: 287

"Súkromie online" – je cloud naozaj "safe?" Takýto názov niesla ďalšia zo série diskusií Komory pre medicínske právo – Medius. O povinnosti mlčanlivosti lekárov aj o práve na súkromie pacientov porozprávali v priestoroch košického centra umeleckej kreativity Tabačka Kulturfabrik v Košiciach odborníci z oblasti medicíny, psychológie, práva, žurnalistiky aj bioetiky. So svojimi skúsenosťami z praxe sa s účastníkmi diskusie podelil MUDr. Igor Jenčo (lekár), PhDr. Martin Čižmárik, PhD. (psychológ), JUDr. Ivan Humeník, PhD. (právnik), Richard Takáč (kameraman, fotograf a novinár) a ThLic. Daniel Demočko, PhD. (bioetik).

Obrazok

Jednou z najzákladnejších povinností zdravotníckych pracovníkov je zákonná povinnosť mlčanlivosti. Vyjadruje vzťah dôvery medzi pacientom a lekárom a je podkladom pre úspešné poskytovanie zdravotnej starostlivosti.

"Mlčanlivosť je  absolútnym predpokladom pre dôveru voči lekárovi, je to základný kameň, na ktorom stojí celá liečba, či pacient bude lekárovi veriť, či sa môže na neho spoľahnúť. Netýka sa to len zdravotnej dokumentácie, ale napríklad aj toho, čo sa dozviem pri prechádaní chodbou a súvisí to s liečbou," vysvetlil I. Humeník.

Právo na prístup k informáciám

Povinnosť mlčanlivosti sa však často krát dostáva do konfrontácie s inými právami, či povinnosťami, predovšetkým je to právo na prístup k informáciám. Tie sa verejnosti snažia prinášať najmä médiá.

"Snažíme sa dopátrať k čo najužším informáciám, nesmieme však zverejniť niečo, čo by uškodilo pacientovi, alebo spôsobilo mu to nejaké psychické problémy," vysvetlil Richard Takáč.

Neprekazenie trestného činu

Podľa I. Humenníka, jedným z prípadov, kedy nejde o porušenie povinnosti mlčanlivosti je prekazenie trestného činu upravené v §341 Trestného zákona. Zákon tu trestá toho, kto vie o pripravovanom trestnom čine s prísnejšou trestnou sadzbou (horná hranica trestnej sadzby najmenej 10 rokov) a neprekazí ho.

"Napríklad v susedných Čechách bol obvinený psychiater, ktorý liečil muža, ktorý sa vyhrážal, že zabije svoju manželku. Psychiater ho nebral vážne, hovoril to niekoľko rokov, no on ju napokon naozaj zabil. Polícia pri vyšetrovaní zistila, že to povedal svojmu psychiatrovi," opísal príklad zo zahraničia Humeník.

Čo povedať rodinným príslušníkom?

Okrem rozlišovania, či ide o výnimku z povinnosti mlčanlivosti musia lekári zvažovať aj to, čo povedia rodinným príslušníkom.

"V prípade pediatrie to je jasné, musíme informovať zákonných zástupcov maloletých. Ak už pacient dovŕši 18 rokov, resp. 365 dní od dovŕšenia plnoletosti, pýtame sa, či chce, aby sme informovali aj rodičov," vysvetlil Jenčo.

Niekedy môžu rodičia viac uškodiť

Psychológ sa zase stretáva s prípadmi, kedy rodičia môžu svojim deťom viac uškodiť, ako pomôcť.

"Bol by som zlý psychológ, ak by sa postavil do pozície, že rodičovi je treba povedať všetko, lebo je rodič. Kolegyne na poradniach hovoria, že všetko je v poriadku, kým neprídu rodičia," dodal Čižmárik.

Podobný názor má aj bioetik Daniel Demočko: "Ak rodič prestane byť schopný robiť dobro pre dieťa, ak nedokáže spĺňať úlohy rodiča a svojím konaním spôsobuje zlo, tak sa jeho morálne práva ohraničia. Ťažko vtedy povedať, že má právo na informácie, ak by tým ešte viac uškodil dieťaťu."

Hraničné situácie

Detský onkológ sa počas svojej praxe stretol aj s netradičnými prípadmi, kedy bolo naozaj ťažké neporušiť povinnosť mlčanlivosti.

"Pri liečbe jedného pacienta s leukémiou sme museli vykonať vyšetrenie krvi aj u rodičov a súrodencov, či sú vhodnými darcami na transplantáciu. Zistili sme, že otec dieťaťa nie je jeho biologickým otcom. Keďže sme povinne mlčanliví, nikomu sme to  nepovedali," podelil sa so svojou skúsenosťou Jenčo.

Verejne činné osoby strácajú časť súkromia

Zaujímavou oblasťou, ktorej sa diskutéri dotkli, bolo aj právo na súkromie u verejne činných osôb. Podľa novinára a kameramana Richarda Takáča, tieto osoby prichádzajú o časť svojho súkromia.

"Médiá informujú o tých veciach, ktoré ľudí zaujímajú, vrátane verejne činných osôb. Napríklad pri liečbe exprezidenta Rudolfa Schustera sledovalo jeho stav celé Slovensko, mnohí novinári však išli do takej hĺbky chorobopisu, že to hraničilo s morálkou."

Zákon nerobí rozdiely

Ivan Humeník vysvetlil, že zákon pri povinnosti mlčanlivosti nerozlišuje, či ide o verejne činnú osobu alebo nie.

Iný pohľad však ponúkol Daniel Demočko z bioetického hľadiska.

"Myslím si, že by sme mali vedieť informácie, ktoré môžu negatívne ovplyvniť činnosť verejne činnej osoby. Napríklad ak by išlo o nejakého ministra, ktorý by bol psychicky vážne chorý a jeho choroba by mohla ovplyvniť chod a fungovanie štátu, myslím si, že by sme o tom mali byť informovaní," zhrnul svoj názor Demočko.

Online hlasovanie

Do diskusie sa svojimi otázkami mohli zapojiť aj účastníci, vyjadriť svoj názor mohli tiež prostredníctvom internetového hlasovania. Napríklad v súvislosti s verejne činnými osobami zastala väčšina názor, že by malo byť zachované ich právo na súkromie a nemali by byť zverejňované všetky informácie o ich zdravotnom stave. 

Diskusia organizovaná Komorou pre medicínske právo - Medius sa konala pod záštitou Prezidenta SR Andreja Kisku a primátora mesta Košice Richarda Rašiho, s organizáciou pomohli aj študenti Právnickej fakulty UPJŠ a študentské organizácie ELSA Košice, Spolok medikov mesta Košice a Bratislavský spolok medikov. Odborným partnerom bola Kancelária WHO na Slovensku (World Health Organization), Právnická fakulta UPJŠ Košice a UK Bratislava a Lekárska fakulta UPJŠ Košice.




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