Poľsko: Má lekár povinnosť vykonávať interrupcie? | Medicínske právo
              

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Poľsko: Má lekár povinnosť vykonávať interrupcie?


 | 12.6.2014 | komentárov: 280

V Poľsku sa znova otvorila debata o vykonávaní interrupcií a výhrade svedomia. V prevažne katolíckej krajine, ktorá už niekoľkokrát čelila sťažnostiam pred Európskym súdom pre ľudské práva, sa tentokrát k otázke povinnosti lekárov vykonávať interrupciu vyjadril aj premiér Donald Tusk.

Obrazok

V súvislosti s Poľskom sme doteraz informovali už o dvoch prípadoch sťažovateliek pred Európskym súdom pre ľudské práva (ďalej „ESĽP“), ktoré súviseli s neochotou lekárov participovať na výkone umelého prerušenia tehotenstva. V prípade R.R. proti Poľsku sa sťažovateľka nemohla domôcť opakovaného vyšetrenia – amniocentézy a ďalších genetických testov, ktoré by potvrdili alebo vyvrátili podozrenie na ochorenie plodu  (Turnerov syndróm). Vyšetrenia boli vykonané neskoro a výsledok bol známy až v 24. týždni,  keď lekári zhodnotili, že plod je životaschopný, a preto  už nie je možné podstúpiť umelé prerušenie tehotenstva v súlade so zákonom. Európsky súd pre ľudské práva konštatoval v tomto prípade porušenie článku 3 Dohovoru o ochrane ľudských práv a základných slobôd – zákazu mučenia, neľudského a ponižujúceho zaobchádzania alebo trestania.


Druhý prípad P. a S. proti Poľsku sa týkal maloletej, ktorá žiadala vykonanie potratu po tom, čo bola znásilnená a o tejto skutočnosti vydal potvrdenie štátny zástupca. Neúspešne žiadala o tento zákrok v niekoľkých nemocniciach, kde jej ho odmietli vykonať z dôvodu výhrady svedomia. Nemocničný personál zverejnil pre médiá údaje o jej osobe a zdravotnom stave, na základe tvrdení o nátlaku matky na maloletú bola umiestnená v detskom domove. Umelé prerušenie tehotenstva podstúpila napokon na severe krajiny (pochádzala z Lublinu) bez poskytnutia ďalšej starostlivosti.  Európsky súd pre ľudské práva konštatoval porušenie článku 8 Dohovoru v súvislosti so zverejnením informácií o zdravotnom stave sťažovateľky, porušenie článku 5 ods. 1 Dohovoru z dôvodu umiestnenia v detskom domove, ako aj článku 3 Dohovoru vo vzťahu ku konaniu kompetentných orgánov voči sťažovateľke. Sťažovateľkám priznal náhradu nemajetkovej ujmy.


Aktuálne diskutovaný prípad sa týka známeho varšavského gynekológa Bogdana Chazana, jedného zo signatárov „Deklarácie viery“ . Deklaráciu podpísalo podľa informácií Washington Post 3000 poľských lekárov, ktorí odmietajú interrupciu, antikoncepciu, in vitro oplodnenie a eutanáziu a uznávajú "prednosť božského zákona pred právom ľudským“. Bogdan Chazan odmietol z dôvodu výhrady vo svedomí vykonať interrupciu pacientke, o ktorú žiadala pre vážne poškodenie mozgu dieťaťa. Do debaty o prípade sa zapojil premiér Donald Tusk, ktorý vyhlásil, že „Bez  ohľadu nato, čo lekárovi káže svedomie, musí konať podľa zákona. Každý pacient si musí byť istý, že lekár vykoná všetky zákony v súlade s právom a v súlade s jeho povinnosťami.“

Nejasne určené pravidlá pre uplatnenie výhrady vo svedomí  sú pretrvávajúcim problémom, a to nielen v Poľsku. ESĽP už v  rozhodnutí R.R. proti Poľsku upozornil nato, že „štáty sú povinné organizovať systémy zdravotnej starostlivosti, aby bolo zaistené efektívne využívanie slobody svedomia zdravotníckymi pracovníkmi, ktoré by ale zároveň neznemožnilo prístup pacientov k starostlivosti, na ktorú majú podľa platného práva nárok.“ (bod 206)

Podotýkame, že Slovenská republika síce garantuje zdravotníckym pracovníkom právo na výhradu vo svedomí realizujúc aj svoje medzinárodné záväzky, avšak nie sú stanovené konkrétne procedurálne pravidlá pre uplatňovanie výhrady v praxi. Zákonná úprava upravuje výhradu vo svedomí ako prípustný dôvod odmietnutia uzavrieť dohodu o poskytovaní zdravotnej starostlivosti pri umelom prerušení tehotenstva, sterilizácii a asistovanej reprodukcii (§12 ods. 3 Zákon o zdravotnej starostlivosti, službách súvisiacich s poskytovaním zdravotnej starostlivosti a o zmene a doplnení niektorých zákonov v znení neskorších predpisov). Zákon o zdravotnej starostlivosti ani Etický kódex zdravotníckeho pracovníka ale ďalej nešpecifikuje podmienky odmietnutia, ako napr. poskytnutie informácie o inom poskytovateľovi, informovanie poskytovateľa - zamestnávateľa o výhrade vo svedomí zdravotníckeho pracovníka – zamestnanca. Takéto nastavenie má potenciál vyústiť v problém s dostupnosťou požadovaného zákroku na strane pacienta alebo naopak v porušenie povinností vyplývajúcich z pracovnoprávneho vzťahu s poskytovateľom na strane zdravotníckeho pracovníka.

 

Spracovala: Zuzana ZOLÁKOVÁ

Zdroje:


P. a S. proti Poľsku, sťažnosť č. . 57375/08, rozhodnutie Komory z 30. októbra 2012
R.R. proti Poľsku, sťažnosť č. 27617/04, rozhodnutie Komory z 26. mája 2011
Poland’s PM: doctor’s duty is above his faith. In Washington Post [online] 10.6. 2014

 

Obrázok: freedigitalphotos.net




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