Levytska Y. Ensuring the right of convicts to health care.

The research topic is chosen due to its relevance for the science of criminal executive law and law enforcement practice, since inadequate conditions of convicts’ detention, as well as the lack of medical care, lead to a decrease in their medical condition. Providing proper and adequate medical care to convicts is an important aspect of ensuring their rights and dignity. In the first part of the thesis, which is devoted to clarifying the essence of the right to health care for convicts, it is stated that this term should be understood as the activities of authorized subjects of the penal system, which is a set of medical, social, organizational, legal and financial measures aimed at preserving and restoring the mental and physiological functions of a convicts, preserving their ability to work and social activity, as well as maximizing their life expectancy. The author also conducts a historical and legal analysis of the legal basis for ensuring the health care of convicts, which revealed that the criminal executive legislation regulates the general organization of medical and sanitary supervision, treatment and anti-epidemic support in penal facilities. With the gradual humanization, the scope of rights of convicts has been expanded, including in the field of medical services, namely: the right to confidentiality of health status, the right to freely choose a doctor, the right to receive medicines from other persons, the right to receive an extract from their medical records, the right to palliative care, medical rehabilitation, and preventive medicine. The author also examines the international legal regulation of the right to health care for convicts and found that the majority of international standards are reflected in the norms of national law. In addition, this part of the work also reviews the practice of the European Court of Human Rights regarding violations of the right of convicted prisoners to medical care. Based on the analyzed case law of the ECHR in relation to Ukraine and other Council of Europe countries, it can be argued that the Court notes that medical care provided to convicts must be adequate. Adequacy can be understood as ensuring regular and systematic monitoring of prisoners’ illnesses through prompt and accurate diagnosis, as well as a comprehensive therapeutic approach. Given that measures of imprisonment may contain such an element as suffering, the state has to ensure respect for the dignity of convicted persons, particularly in the context of medical care. The second part of the thesis focuses on the analysis of the conditions under which medical care is provided in penitentiary institutions, based on the reports of the Ukrainian Parliament Commissioner for Human Rights and reports prepared by monitors during visits of NGOs to places of detention. It is summarized that prisoners in places of detention face a wide range of problems, including unsatisfactory conditions of detention that negatively affect their health; problems with untimely medical care; lack of necessary medical equipment; violations of requirements for keeping medical records; understaffing of medical staff; inadequate examination and medical care for prisoners with infectious diseases, etc. Particular attention is paid to the problem of understaffing of medical units of penitentiary institutions. This part of the thesis highlights the results of an empirical study which consisted of a questionnaire survey of employees of the State Institution “Health Care Center of the State Criminal Executive Service of Ukraine”, as well as students and interns of medical educational institutes of Ukraine regarding their attitude to work with such a vulnerable group as convicts. It is established that the reason for the unwillingness to cooperate with this specific group of the population is mainly related to the ethical component. It is proved that the main purpose of medical ethics is to provide recommendations on the moral component of the duties of medical professionals. This implies that doctors should focus on improving the condition of patients, showing compassion and respect for each patient. International documents indicate that healthcare professionals can be responsible for actively engaging in unethical practices. Medical ethics is an integral part of the practice of any medical personnel and its violation is unacceptable in all institutions, including penitentiary institutions. Neglect of medical ethics in the activities of medical personnel in such institutions is a serious problem that can lead to critical consequences for the health and safety of persons in detention. This section also highlights the issue of the spread of infectious diseases among prisoners and proves the importance of ensuring access to proper medical care.