DISASTER MEDICINE No. 3 •2025

https://doi.org/10.33266/2070-1004-2025-3

Original article

Legal Regulation of the Absence of Expressed Refusal as a Condition for Providing Assistance in Life-Threatening Conditions: Ways to Improve

Zakurdaeva A.Yu. 1,2, Posadkova M.V.1, Kolodkin A.A.2,3,4, Kolodkina V.I.4

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1 Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russian Federation (Sechenov University), Moscow, Russian Federation

2 All-Russian Public Organization “Russian Society of First Aid”, Moscow, Russian Federation

3 Federal Center for Disaster Medicine of the National Medical and Surgical Center named after N.I.Pirogov of the Ministry of Health of the Russian Federation, Moscow, Russian Federation

4 Kuban State Medical University of the Ministry of Health of the Russian Federation, Krasnodar, Russian Federation

UDC 614.88

P. 110-114

 

Summary. Relevance consists of assessing innovations in the regulation of the absence of an expressed refusal as a condition for providing assistance in life-threatening conditions, taking into account legal and bioethical aspects, as well as developing proposals for improving the existing model of regulation.

Materials and research methods. The legal and empirical basis of the scientific research was made up of analytical material devoted to the organization of first aid, contained in the works of Russian scientists. An analysis of legal acts of the Russian Federation dedicated to organizing and providing first aid was conducted. A combination of universal methods of cognition, empirical and theoretical scientific methods was used, including observation, description, comparison, generalization, analysis and synthesis.

Results of the study and their analysis. The article examines the additions to the Federal Law of November 21, 2011 No.323-FZ “On the Fundamentals of Health Protection of Citizens in the Russian Federation” that came into force in 2024, establishing as a condition for providing assistance in life-threatening conditions in out-of-hospital settings the absence of an expressed refusal of the patient (victim) without the need to formalize informed voluntary consent, namely, the innovations of paragraph 1.1 of Part 9 of Article 20 in relation to the provision of emergency medical care outside a medical organization and paragraph 5 of the Procedure for the provision of first aid, approved by Order of the Ministry of Health of Russia dated May 3, 2024 No.220n, in relation to the provision of first aid, are analyzed, and proposals are made to improve the existing model. 

Key words: absence of express refusal, causing harm to health, consent to medical intervention, first aid, human rights, informed voluntary consent, legal regulation, life-threatening conditions

For citation: Zakurdaeva A.Yu., Posadkova M.V., Kolodkin A.A., Kolodkina V.I. Legal Regulation of the Absence of Expressed Refusal as a Condition for Providing Assistance in Life-Threatening Conditions: Ways to Improve. Meditsina Katastrof = Disaster Medicine. 2025;3:110-114 (In Russ.). https://doi.org/10.33266/2070-1004-2025-3-110-114

 

References

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The material was received 06.06.25; the article after peer review procedure 26.06.25; the Editorial Board accepted the article for publication 22.09.25