TFL Vsebine / Revija Javna uprava

Prispevek obravnava ustavnopravne in sistemske posledice slovenske ureditve, ki zdravnikom zaradi opravljanja tako imenovane „zdravilske“ dejavnosti omejuje terapevtsko svobodo ter jim lahko prepreči pridobitev zdravniške licence oziroma povzroči njen odvzem, kakor tudi grozi z globo za prekršek (drugi odstavek 34. člena, četrti odstavek 37. člena in peta točka 81. člena ZZdrS). Analiza pokaže, da taka ureditev ne deluje kot varovalka pred nestrokovnim ravnanjem, temveč kot sankcioniranje že same uporabe določenih nekonvencionalnih metod, ne glede na konkretno strokovno presojo, varnost in informirano privolitev pacienta. Hkrati se izkaže normativna nekonsistentnost med ZZdrS, ZZDej in ZZdrav, ki je dodatno poglobljena zaradi večdesetletne neizdaje izvedbenega predpisa po 59. členu ZZDej (delna pravna praznina). Prispevek utemeljuje, da je varstvo pacientov mogoče učinkovito zagotavljati z obstoječimi mehanizmi odgovornosti, nadzora in sankcioniranja konkretnih strokovnih kršitev, ne glede na uporabljeno metodo. Na tej podlagi so predlagani amandmaji k ZZdrS-K, ki odpravljajo sankcije odvzema oziroma nepodelitve licenc zdravnikom, vezane na opravljanje »zdravilske dejavnosti«, ter uvajajo prehodno in uskladitveno ureditev za zdravnike z dodatnimi znanji s področja dopolnilnih, tradicionalnih in alternativnih metod.

This article examines the constitutional-law and systemic implications of the Slovenian regulatory framework that, by treating certain medical practice as a so-called healing activity (in Slovenian zdravilska dejavnost), restricts physicians’ therapeutic freedom and may prevent physicians from obtaining a medical licence or lead to the withdrawal of an existing license, while also providing for a fine for a minor offence (Articles 34(2) and 37(4), and point 5 of Article 81 of the Medical Services Act – ZZdrS). The analysis shows that this framework does not function as a safeguard against unprofessional conduct; it instead penalises the mere use of certain non-conventional methods, irrespective of a case-specific professional assessment, safety considerations and the patient’s informed consent. It also reveals legislative inconsistency between ZZdrS, the Health Care Services Act (ZZDej) and the Healing Practices Act (ZZdrav), further ex-acerbated by the decades-long failure to adopt the implementing regulations under Article 59 ZZDej, creating a partial regulatory gap. The article argues that patient protection can be effectively ensured through existing mechanisms of professional accountability, oversight and sanctions for specific professional misconduct, regardless of the method used. On this basis, it proposes amendments to ZZdrS-K that remove sanctions involving licence withdrawal or refusal to grant o license where these are linked to “healing activity”, and introduce transitional and harmonising provisions for physicians with additional training in complementary, traditional and alternative methods.

Legal Restrictions on Physicians’ Choice of Treatment Methods in Slovenia: A Statutory Anomaly in Need of Reform