“First, do no harm”: a regulatory and expert assessment of the consequences of failure to provide or improper provision of medical care

The subject of research are regulatory acts which in their comprehensive interrelation define the characteristics of harm inflicted on human health, including its description as publicly dangerous consequence of failure to provide medical care, or improper provision thereof. The study was conducted with regard to criminal and healthcare legislation provisions, as well as regulation of particularities of forensic medical expert examination. The paper aims to test the hypothesis on the regulatory amendments’ to medical legal acts influence on the understanding of iatrogenic crimes, and the practice of their qualification by criminal courts.Historical-legal methodology is deployed to show preconditions, grounds and directions of development of legislation defining criteria of infliction of harm on human health. Systemic analysis methodology allowed the author to disclose the particularities of interconnections between criminal and forensic-medical legislation, to prove the blanket nature of the characteristics of crimes against human life and health. The comparative-legal methodology of research allowed identification of the constant part of legal framework related to provision of medical care, and the definitions extensively transformed by the legislator (harm to human health, shortcomings of medical care provision, consequences of improper provision of medical care). Methods of philosophy and logic allowed for disclosure of particularities of the causation connection to publicly dangerous consequences, and the specificity of causation in criminal cases on medical workers’ omission (including with regard to failure to provide medical care to a patient).Main results. It was established that infliction of harm in the course of, or as the result of provision of medical care cannot be considered an intentional crime, but rather is either innocent or negligent. Inaction of a doctor, as seen from the forensics point of view, is not a harmful external factor, and therefore the feature of infliction of harm on the health of a patient must be established legally (juridically) rather than through expert examination. New normative regulations are aimed at clarifying the features of shortcomings of medical care and their harmful consequences, thus seeking to eliminate some matters of argument and ensure the unified law-enforcement practice. When considering criminal cases related to harm inflicted by medical workers the courts must not only base themselves upon the results of forensic medical expert examinations, but also separately apply the normative regulatory provisions to which there is a blanket reference in the criminal legislation, and which themselves define the criteria of properly qualified medical care as well as the assessment of harm inflicted where said care was improper.Conclusions. The scientific analysis carried out by the author has confirmed the hypothesis of the research, and proved direct application of medical legal acts by courts considering criminal cases on failure to provide medical care to patients or improper provision thereof.