On the issue of responsibility for non-compliance with medical recommendations and violation of the treatment regime

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Introduction. Historically, the relationship between a doctor and a patient has been based on trust, mutual respect, and teamwork to achieve the main goal of restoring and preserving the patient's health. Modern medicine, which is based on patient orientation, emphasizes the importance of active patient participation in the treatment process. However, effective treatment, whether it is drug therapy, rehabilitation procedures, or lifestyle changes, is impossible without the patient following the medical recommendations and prescribed treatment regimen. Unfortunately, non-compliance with these recommendations is a widespread phenomenon that leads to serious consequences - deterioration of health, development of complications, decreased effectiveness of therapy, and increased treatment time. In this regard, the issue of the patient's responsibility for non-compliance with medical recommendations and violation of the treatment regime is becoming particularly acute and requires comprehensive consideration. This article analyzes various aspects of this problem, including ethical, legal, and practical aspects, in order to identify key factors influencing treatment adherence and develop approaches to increasing patient responsibility for their health.
The purpose of the work is to analyze existing approaches to determining patient responsibility for non-compliance with medical recommendations and violation of the treatment regimen, identify factors affecting treatment adherence, and suggest ways to increase patient responsibility for their health.
Materials and methods of research. We have analyzed Federal Law No. 323-FZ dated 11/21/2011 "On the Fundamentals of Public Health protection in the Russian Federation", regulatory legal acts of the Russian Federation regulating healthcare issues, rights and duties of patients, scientific articles on compliance, adherence to treatment and patient responsibility, as well as reviews of judicial practice in cases involving related to non-compliance with medical recommendations [1]. The research methods included an analysis of the regulatory framework, a systematic review of the literature, and statistical data analysis.
The results of the study. An analysis of Federal Law No. 323-FZ dated 11/21/2011 "On the basics of Public Health protection in the Russian Federation", regulatory legal acts of the Russian Federation showed that Article 27 establishes the duties of citizens in the field of health protection, including the duty to take care of their health, undergo medical examinations, and follow the treatment regimen defined for the period their temporary disability, and the rules of conduct in medical organizations. However, the law does not provide for specific liability measures for non-fulfillment of these duties. Other regulations also mostly declare the rights of patients, leaving questions about responsibility for non-compliance with recommendations open [1]. A review of scientific articles allowed us to identify the key factors influencing treatment adherence. It turned out to be important: "doctor-patient communication" and the patient's understanding of the purpose, goals and side effects of treatment are directly related to the quality of communication with the doctor [2]. Studies show that patients who feel supported and understood by a doctor are more likely to follow the recommendations. "Complexity of the treatment regimen" - the more complex the regimen (a large number of medications, inconvenient admission times, complex procedures), the lower the likelihood of its compliance. "Faith in the effectiveness of treatment" - if a patient does not believe in the effectiveness of treatment or considers it harmful, he is less likely to comply with it [3]. The studied literature suggests various ways to increase treatment adherence, such as educating patients and providing them with clear and understandable instructions, simplifying the treatment regimen, for example, using combination medications, using reminders in mobile applications, and involving family and friends in the treatment process [2, 3, 4]. An analysis of judicial practice has shown that direct prosecution of patients for non-compliance with medical recommendations is not practiced in Russia. However, the patient's behavior may be taken into account by the court when considering cases of poor-quality medical care, for example, if the patient's actions (violation of the regime, self-medication) he contributed to the deterioration of his condition. A specific example of the case is the case of the sixth Court of Cassation of General Jurisdiction dated 05/21/2024 No. 88-12816/2024 [5].
Conclusion. The study showed that the regulatory framework of the Russian Federation does not provide for specific measures of responsibility for non-compliance with medical recommendations by the patient, although it establishes the duty of citizens to take care of their health and follow the treatment regimen. Treatment adherence depends on many factors, including the quality of communication between the doctor and the patient, the complexity of the treatment regimen, the patient's faith in the effectiveness of therapy, and socio-economic conditions. Failure to follow medical recommendations leads to negative consequences for the patient's health.

About the authors

Alina Vadimovna Vanina

Kursk State Medical University

Email: alinaprimakova2000@yandex.ru
ORCID iD: 0009-0006-0497-359X

student

Russian Federation, 3,Karl Marx Street, 305041,Kursk, Russian Federation

Rimma Zorikovna Simonyan

Kursk State Medical University

Author for correspondence.
Email: rimmasimonyan@mail.ru
ORCID iD: 0000-0001-6360-3229
Russian Federation, 3, Karl Marx Street, 305041,Kursk, Russian Federation

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