Alexander, in our difficult times, the most heroic profession was the work of physicians. For their daily and hourly work, the government decided to help them. However, in many regions without the intervention of your subordinates to do failed.
Alexander Bastrykin: the Work of lawyers and doctors in many aspects very similar. In the center of our attention always are the highest values: life, health, rights and freedoms of the individual, his honor and dignity. Only with cooperation, we can resolve many issues.
Really, in terms of coronavirus reality the work of physicians has acquired a special significance. Today, they, being at the forefront of the fight against a new disease for us, every day save human lives. However, we have to admit that the doctors were the most vulnerable category of citizens.
what do you mean professional?
Alexander Bastrykin: This of course primarily due to the fact that the doctors every day risk their own health. However, it is strange to imagine how, being in constant stress and in helping the sick, they need to think more about the protection of their rights in terms of calculating the payments.
Health workers were virtually hostages of the situation: they were forced to use almost all channels of communication – was addressed through the media and social networks, the helpline, through the Internet reception, personal methods.
somewhere there were complete facts of non-payment of compensation, where a partial.
the Investigating authorities organised a procedural check on the 249 reports, one criminal case about negligence.
So what happened when the regions doctors about the help has learned from the media, but either got nothing or they were given the insulting penny.
Alexander Bastrykin: Our investigators have found that some heads of medical institutions are often distorted interpreted the language specified in the regulations of the government establishing such payments.
We have made every effort to help physicians: continuously monitoring the media and social networks for references about the violation of the rights of doctors, was the organized and systematic work on the verification of these facts. The result of this work we see after taken, including us measures required premiums to physicians were paid and their violated rights restored.
compared to the doctors in your Department has developed a mixed picture. You each personally hear complaints of improper actions of doctors with a tragic ending. And the Investigative Committee must respond to.
Alexander Bastrykin: Indeed, complaints from patients and their relatives that approval.ridout that they received poor quality of medical care, the investigators do often. Statistics in recent years we have repeatedly voiced. It is important to understand that by itself, the complaint is a signal, asking for help, and it is very important to understand the essence, the causes of the problem. People lose their loved ones, trapped because of certain health problems to a medical facility. Somewhat predictable that in such a situation, the first to come under attack, the doctors that were there. In most cases the fault of doctors in tragic situations with the patients there. Nevertheless, if we receive the appropriate treatment, we have to check all the facts, all the possible versions.
And show that verification of such statements?
Alexander Bastrykin: the vast majority of cases, indeed, it turns out that the doctors had acted correctly to the situation to influence it. But in order to ascertain this, the investigators should clearly conform to the law mechanism. Often different experts, and representatives of the medical community criticized us for what we excited criminal proceedings on the facts of death or injury to patients. Note: in fact, not in relation to a particular doctor. Here it is necessary to understand that to perform certain expertise, to give a legal assessment of the specific facts, to establish or refute a causal link between the actions of doctors and the ensuing negative consequences for patients is only possible in the framework of the criminal case.
And then what can be called the most important “health checks”?
Alexander Bastrykin: the hardest part of the job of investigation in this category of criminal cases to establish or refute this causal relationship. Sometimes even the expert examination does not provide answers to all questions. It is important for us to interact with physicians. Their help in establishing the truth in each case is simply necessary.
Our work together is extremely important to establish all the circumstances of the accidents in the medical field, their objective and impartial evaluation to avoid subsequent adverse consequences both for patients and for doctors.
How often do you refer to private receptions with complaints in which asked to check the correctness of medical care?
Alexander Bastrykin: every month I spend personal reception of citizens, and a significant number of cases is indeed due to accidents in the medical field. To see me come devastated people who can’t get their loved ones, they are asking for a one – spravedlivoti. Is years is the clarification of the circumstances of the particular incident, and it is very difficult to make a final decision. This is due to the duration of the examination, as well as the peculiarities of enforcement. I stress that we are not talking in these cases about the crimes. Given the great complexity of this subject, the presumption of innocence, to speak about the fact as such, are not defining it as a crime. Often people just want to know the truth, and the investigators cannot find it due to objective or subjective reasons. Sometimes the results of examinations contradict each other. In some cases, people, overwhelmed with grief, refuse to accept what their relatives it was impossible to help, and continue to contact us.
In the end, we have developed efficient mechanism – the most complicated cases are transferred to a special Department in the Central office, which specializiruetsya on medical topics.
due to the fact that the Investigative Committee is a specialized unit investigating “medical” things, criticize you. How to respond to such accusations?
Alexander Bastrykin: I demand from his subordinates a thorough study of each case. Our investigators are focused first and foremost on establishing objective truth and the restoration of the violated rights of citizens, rather than attracting doctors to criminal prosecution, what we are often accused of. Statistics confirm it: in 2019 6.5 thousand cases opened 2168 criminal cases, but the courts sent much less – 273 cases. In the first quarter of this year were sent to the courts for consideration on the merits of criminal cases 52.
We are trying to develop our cooperation with the medical community to improve quality and reduce the time of carrying out is judicial-medical examination, an essential tool of evidence in criminal proceedings. Because the investigator is often a need for additional, repeated, and Commission examinations, the findings of which should be the basis for the charges and subsequent court decisions. In this regard, in may last year, I issued an instruction on additional measures to strengthen control over the appointment of forensic examinations in such cases. The investigators focused on to immediately consider and grant the petition of the experts on the provision of missing materials and objects of study within a period not later than 14 days.
Another important aspect of interaction with the medical community is an analysis of the causes and conditions of accidents and to inform the health authorities in order to further exclude tragic cases.
In recent years, actively discussed the Investigation Committee developed a lawaproject on the criminal responsibility of medical workers. Why such different opinions into account?
Alexander Bastrykin: Here is a small parallel. Remember how in our country people are arguing for the decriminalization of domestic violence? In 2017 instead of criminal prosecution for assault in the family began to advance only administrative responsibility. All saw a significant increase in such offences, about which much has been said publicly. And first affected children. The legal qualification of actions of doctors is, of course, much more complex sphere. But the lack of special rules that could govern such cases, in our opinion, will also lead to the fact that many cases remain without proper evaluation. That is why we have prepared a draft law on amendments to the criminal code concerning the criminal liability of medical workers.
I am Convinced that the vast majority of doctors are highly trained specialists, professionals, utterly devoted to his cause. However, there are some violations committed by physicians, leading to tragic consequences. The reasons for their different, and we must in each particular case, to thoroughly scrutinize and take action.
recent media attention focused on the situation around the criminal cases of the Kaliningrad doctors Elina Sushkevich and Helen White. Write different. Can you tell me what is the problem?
Alexander Bastrykin: the Situation is indeed very controversial and caused heated discussion in society. Many began to speak out in support of the doctors were of the opposite opinion. I believe that here we must very carefully analyze everything. And conclusions to do very carefully, based on factual circumstances and objective evidence, completely ignoring the emotional component. The investigators have done extensive work on this criminal case.
they Collected materials, including the conclusion of the examinations, indicate the presence in the actions of the accused signs of a particularly serious crime – murder. According to investigators, in 2018, the resident of the Kaliningrad region had a baby – premature, but viable. To maintain the life support the child needed certain resources, and according to the materials of the criminal case Elena White these resources to waste not wanted, assuming that he will still die later that would worsen the statistics of the regional perinatal center, where they had to guide the child for further treatment. Therefore, the consequence put forward the version that the doctor made the decision to commit the murder of a newborn, having it look like he died at birth.
How it all happened and what confirmed this information?
Alexander Bastrykin: the investigation is really caused confusion among the medical community, regional residents and individual citizens. But, as I said, the investigators are always interested in objectivity. Their insights on qualification was made on the basis of the weight of evidence: conclusions of Commission a comprehensive forensic examination of cause of death of the child, spectrographic and other examinations of witnesses, as well as on the basis of aggregate and other collected evidence. We have no doubt as to the objectivity of the examinations, because they also did medical experts. Their findings allowed to give a legal assessment of the incident. Based on their findings and other evidence, it follows that Sushkevich at the direction of White was administered a fatal dose of magnesium sulfate, resulting in the death of a child.
the Experts found that the drug was introduced in the notoriously toxic dose that greatly exceeds the maximum allowable, this naturally led to newborn’s death from acute poisoning. In addition, the use of magnesia was absolutely contraindicated for the child, and the doctors knew about it. Then, according to the investigation, in the history of childbirth defendants have made knowingly false information about what took place the fact of the death of the fetus during delivery.
What, in your opinion, is caused by statements and comments on innocence to the crime of the accused?
Alexander Bastrykin: Looking at this case only from the outside, without delving into the essence of the question, not knowing the materials of the criminal case, many are trying to assess what has happened and to introduce a kind of negative precedent. But we, as lawyers, the findings are only based on the actual circumstances of the case, based on expert judgement and weight of evidence. It should be noted that in the medical community there is no unambiguous position on this criminal case. Experts who are directly involved in the examination and familiar with the materials of the criminal case, expressed an opinion similar to the position of the investigation. The other part of the medical community is not aware of the resulting consequence of objective data, this position is unwilling to admit. But we all should be interested in establishing the truth. Not accidentally, the founder of the Russian military-field surgery Nikolai Ivanovich Pirogov was one of the first who considered the disclosure of medical errors professional duty. And such cases, when we’re talking about murder, and certainly needs to be in the public domain.
Now there is a judicial process involving the jury, the media and social networks are used as a tool for speculating public opinion. I felt particularly��Yeon that it is necessary to enable the court to objectively assess the available evidence and make a fair decision, without interfering in the competence of the court and not a jury trying to impose their point of view.
