The dissertation presents a comprehensive study of the theoretical and legal foundations of the patient's right to receive medical care as an independent, multilevel, and dynamic phenomenon of contemporary legal reality. The study is devoted to clarifying the nature of the patient's right to medical care, its place within the system of human rights, the specific features of legal regulation in the field of healthcare, as well as the mechanisms for its provision, implementation, and protection under conditions of reform of the national healthcare system, digitalization, martial law, and European integration processes. The relevance of the topic is substantiated by the fact that the right to medical care belongs to the fundamental social human rights enshrined both in international legal instruments and in the Constitution of Ukraine; however, a significant gap still remains in Ukraine between its normative recognition and the actual possibility of its effective implementation.
The dissertation demonstrates that the patient's right to receive medical care has a complex intersectoral nature and cannot be regarded solely as an element of branch-specific medical law. It lies at the intersection of the theory of state and law, constitutional, civil, administrative, information, and international law, and is also directly related to the right to life, the right to health protection, the right to human dignity, the right to privacy, the right to information, and the right to an effective legal remedy. It is substantiated that the modern understanding of this right should proceed from a patient-centered model, within which the patient is not a passive object of medical intervention, but a full-fledged subject of legal relations, vested with the right to choose a physician and a method of treatment, to give informed consent, to refuse medical intervention, and to confidentiality, safety, quality, and accessibility of medical care.
The first chapter, "The Patient's Right to Receive Medical Care: Historiographical and Methodological Aspects", is devoted to the study of the epistemological foundations, philosophical and ethical-legal underpinnings, as well as the concept and nature of the legal regulation of the patient's right to receive medical care. Within this chapter, a thorough historical and legal analysis of the evolution of the right to medical care is carried out, beginning with customary and religious-moral forms of medical practice in the Kyivan Rus state, through the ancient foundations of medical ethics, the medieval synthesis of medical knowledge, the Lithuanian-Polish and Cossack periods, and up to the formation of state healthcare systems. The philosophical substantiation relies on the discourse between egalitarian (J. Rawls) and libertarian (R. Nozick) approaches to the fair distribution of limited medical resources, as well as on the concept of the four principles of bioethics – autonomy, non-maleficence, beneficence, and justice.
The second chapter, "The Mechanism for Ensuring the Patient's Right to Receive Medical Care", examines this mechanism as an integral system of medical-legal norms, legal facts, legal relations, institutions, and human-rights protection instruments. The systemic and structural elements of this mechanism and the normative-institutional model for ensuring the patient's right to medical care in Ukraine are analyzed, including the role of constitutional provisions (Articles 3, 27, 28, and 49 of the Constitution of Ukraine), the Fundamentals of Ukrainian Legislation on Healthcare, the Law of Ukraine "On State Financial Guarantees of Medical Services to the Population" of 2017, as well as the Medical Guarantees Program, the financing mechanism through the National Health Service of Ukraine (NHSU), the institution of free choice of physician, informed consent, and the Electronic Healthcare System (eHealth). The chapter identifies the systemic challenges to the implementation of the right to medical care – unequal territorial access to medical services, insufficient financing, a low level of legal culture, a formalistic approach to quality standards, and the absence of effective jurisdictional mechanisms for protecting patients' rights.
The third chapter "Standards for the Development of of the Patient's Right to Medical Care: A Comparative Legal Aspect", is devoted to a comparative legal analysis of European models for guaranteeing patients' rights, the study of the structure of the mechanism for ensuring patients' rights in EU countries, as well as the formulation of ways to improve the national mechanism in the context of European integration processes. The Bismarck and Beveridge models of medical insurance, reimbursement mechanisms, and corporate self-governance are analyzed on the examples of Germany, France, Poland, and Slovakia, and the need to harmonize Ukrainian legislation with the EU acquis communautaire is substantiated.
