Text consolidated by Valsts valodas centrs (State
Language Centre) with amending laws of:
26 February 1998 [shall
come into force from 12 March 1998];
1 June 2000 [shall come into force from 28 June
2000];
20 June 2001 [shall come into force from 20 July
2001];
25 March 2004 [shall come into force from 22 April
2004];
27 May 2004 [shall come into force from 30 June
2004];
16 June 2005 [shall come into force from 20 July
2005];
8 June 2006 [shall come into force from 11 July
2006];
1 March 2007 [shall come into force from 29 March
2007];
27 September 2007 [shall come into force from 5 October
2007];
8 November 2007 [shall come into force from 1 January
2007];
8 May 2008 [shall come into force from 11 June
2008];
8 April 2009 [shall come into force from 13 May
2009];
18 June 2009 [shall come into force from 1 July
2009];
1 December 2009 [shall come into force from 1 January
2010];
10 December 2009 [shall come into force from 1 March
2010];
16 June 2010 [shall come into force from 1 January
2011];
7 October 2010 [shall come into force from 1 January
2011];
31 March 2011 [shall come into force from 4 May
2011];
21 June 2012 [shall come into force from 25 July
2012];
18 April 2013 [shall come into force from 1 July
2013];
11 September 2014 [shall come into force from 15 October
2014].
If a whole or part of a section has been amended, the
date of the amending law appears in square brackets at
the end of the section. If a whole section, paragraph or
clause has been deleted, the date of the deletion appears
in square brackets beside the deleted section, paragraph
or clause.
|
The Saeima1 has adopted
and
the President has proclaimed the following Law:
Medical Treatment Law
Chapter I
General Provisions
Section 1.
The following terms are used in this Law:
1) medical treatment - professional and individual
prophylaxis, diagnosis and medical treatment of diseases, medical
rehabilitation and care of patients;
2) medical practitioners - persons who have a medical
education and who are engaged in medical treatment;
3) medical treatment institutions - doctors' practices,
State and local government institutions, performers of economic
activity and commercial companies which are registered in the
Register of Medical Treatment Institutions, conform with the
mandatory requirements for medical treatment institutions and
structural units thereof laid down in laws and regulations and
provide medical treatment services;
4) certificate of a medical practitioner - a document
issued by the Union of Professional Organisations of Medical
Practitioners of Latvia, the Latvian Medical Association, or the
Latvian Nurses Association that certifies the professional
proficiency of the relevant person and indicates that the medical
practitioner as a specialist is competent to independently engage
in the practice of medical treatment (specialist practice) in the
relevant field;
5) certification of a medical treatment institution -
activity of an independent third person certifying that the
medical treatment institution, its unit or services provided
conform to the requirements specified by the relevant
standards;
51) certificate of medical and diagnostic
methods - a document issued by the Union of Professional
Organisations of Medical Practitioners of Latvia, the Latvian
Medical Association, or the Latvian Nurses Association that
certifies the professional proficiency of the relevant person and
indicates that the medical practitioner in addition to the
competence specified thereto in laws and regulations is entitled
to independently apply the medical or diagnostic method indicated
in the certificate;
6) doctors' council - a meeting of not less than three
doctors in order to determine a diagnosis and the further tactics
of medical treatment;
7) human infectious disease - a disease induced by an
infectious disease-causing agent, the spread of which may cause
an epidemic (hereinafter - infectious disease);
8) medical education - the aggregate of knowledge and
skills in the field of medicine conforming to an educational
programme accredited in accordance with the procedures laid down
in law, which is certified by a educational document issued by an
educational institution;
9) medical technologies - methods to be applied in
medical treatment, medical devices and medicinal products;
10) emergency medical assistance - assistance to
victims (persons who have been taken ill) in a critical state of
danger to life or health, provided by persons specially prepared
(trained, equipped) for such cases with relevant qualifications
in medicine who in accordance with such qualifications have legal
liability for their actions or omissions and the consequences of
such actions or omissions;
11) patient - a person who receives health care
services or seeks them;
12) care of patients - part of health care which is
directly or indirectly related to the maintenance, promotion,
protection and recovery of health of the public, a family or a
person;
13) first aid - assistance provided to victims (persons
who have been taken ill) in a critical state of danger to life or
health by persons with or without medical qualifications, within
the scope of their knowledge and possibilities irrespective of
their proficiency and equipment;
14) medical rehabilitation - a field of medicine
dealing with the development or recovery of physical,
psychological, social, vocational and educational potential of a
person in conformity with his or her physiological or anatomical
limitations or, in the case of stable health impairment, with the
adaptation of the life of a patient to the environment and
society;
15) [27 May 2004];
16) [21 June 2012];
17) improvement of professional qualifications - part
of post-graduate education in a specific profession or
speciality, which occurs in accordance with a freely selected
education programme, the content and time of acquisition of which
is not regulated;
18) mandatory requirements for medical treatment
institutions and their structural units - requirements, the
observing of which shall be ensured by medical treatment
institutions or their structural units so that the provision of
medical assistance therein is permitted;
19) residency - employment legal relations with a
medical treatment institution implementing an educational
programme, for the education of an existing doctor in the
acquisition in the official language of a speciality in
accordance with an accredited professional residency educational
programme in medicine;
20) clinical guidelines - taking into account medical
principles based upon evidence, an established systematic
description of the medical treatment process for a particular
patient group in which are specified the necessary activities,
the order of performance thereof and the essential criteria for
the choice of tactics for the medical treatment of a patient to
achieve the best medical treatment result;
21) medicinal devices - all tools, appliances, devices,
software, materials or other items which are used separately or
together with other devices, including together with a software
which the manufacturer thereof has intended for use in medical
treatment in order to diagnose, prevent, monitor and heal
illnesses or ease the course thereof, to diagnose, monitor, heal,
ease or compensate injuries or physical deficiencies, to
research, replace or change human anatomy or physiological
processes, to control insemination and which the intended basic
activity on a human body surface or in a human body do not
achieve by pharmacological, immunological or metabolic means, but
it is possible to help to ensure functioning of a medical device
with such means;
22) psychiatric assistance - individual prophylaxis,
out-patient or in-patient diagnosis, medical treatment,
rehabilitation and care for persons with mental health
disorders;
23) psychiatric assistance without the consent of the
patient - in-patient diagnosis, medical treatment,
rehabilitation and care for persons with mental health disorders
without the consent of such person;
24) emergency and disaster medical system - an
aggregate of State co-ordinated measures, which are performed by
medical treat institutions and other health care sector
institutions irrespective of the form of ownership in order that
in emergency medical and emergency public health situations to
save human lives and to reduce the destructive impact on public
health;
25) medical treatment support person - a person who
does not have the right to engage in medical treatment, but who
is directly involved in ensuring the health care process;
26) medical treatment support person certificate - a
document issued by the Union of Professional Organisations of
Medical Practitioners of Latvia, which certifies the professional
preparedness of the relevant person and indicates that the
medical treatment support person is competent to become involved
in ensuring the health care process in a specific sector;
27) unified electronic information system of the health
sector (hereinafter - health information system) - a
structured information system of the health sector, which
includes individual information data sets of the health sectors
and ensures their unified operation;
28) team of emergency medical assistance - a mobile
unit for provision of emergency medical assistance, which
consists of the persons specified in laws and regulations and
which has an emergency medical vehicle at its disposal, which
conforms to the requirements laid down in laws and
regulations;
29) telemedicine - provision of remote health care
service, by using information and communication technologies. It
includes safe resending of medical data and information necessary
for medical treatment in the form of text, sound, pictures or
other.
[26 February 1998; 1 June 2000; 25
March 2004; 27 May 2004; 8 June 2006; 8 November 2007; 8 May
2008; 8 April 2009; 10 December 2009; 7 October 2010; 21 June
2012; 11 September 2014]
Section 2.
The purpose of this Law is to govern public relationships in
medical treatment in order to ensure qualified prophylaxis and
diagnosis of diseases or injury, and also qualified medical
treatment and rehabilitation of patients, and to determine
special legal regulation provisions for economic activity of
medical treatment institutions.
[11 September 2014]
Section 3.
(1) Health is physical, mental and social well-being, the
natural basis of the existence and survival of the State and the
nation. Health care is the complex of measures implemented by
health care service providers, including telemedicine and
activities with medicinal products and medical devices for
ensuring, maintaining and renewal of a patient's health.
(2) The priority is health care of a pregnant woman, child and
person with foreseeable disability. Health care is a set of
measures implemented by health care service providers for the
provision, maintenance and restoring of the health of
patients.
[8 May 2008; 10 December 2009; 16
June 2010; 11 September 2014]
Section 4.
(1) The procedures for organising and financing health care,
procedures for establishing queues of applicants for receipt of
systematic health care services, the types and amounts of medical
treatment services thereof, which are paid for from the State
basic budget and from the resources of recipients of services, as
well as the procedures for such payments shall be determined by
the Cabinet.
(2) A medical practitioner employed in local government
institutions, State and local government capital companies and
public private capital companies, who provides health care
services paid from the State budget in a medical treatment
institution, which has entered into a contract regarding the
payment for the health care services provided, shall receive
remuneration in accordance with the Law On Remuneration of
Officials and Employees of State and Local Government
Authorities.
[27 May 2004; 16 June 2005; 8 June
2006; 1 December 2009]
Section 5.
Everyone has a duty to take care of and everyone is
responsible for his or her own health, the health of the nation,
and the health of his or her relatives and dependants.
Section 6.
[10 December 2009]
Chapter II
Supervision of Medical Treatment
Section 7.
The Ministry of Welfare shall carry out supervision of medical
treatment and other institutions specified in laws and
regulations.
[25 March 2004]
Section 8.
In the field of health care, the Ministry of Welfare shall
perform the following functions:
1) formulate State policy in the field of health care and
co-ordinate the implementation of such policy;
2) at the State level co-ordinate and manage the provision of
emergency medical care to victims in emergencies on a regional or
national scale;
3) [8 June 2006];
4) [27 May 2004];
5) [27 May 2004];
6) prepare and submit to the Cabinet for approval a list of
occupational diseases;
7) in co-operation with the Latvian Medical Association and
professional organisations of medical practitioners formulate
proposals of mandatory requirements for medical treatment
institutions and their structural units;
8) [8 June 2006];
9) [27 May 2004].
[1 June 2000; 25 March 2004; 27 May
2004; 8 June 2006]
Section 9.
(1) The Cabinet shall determine the procedures for developing,
supplementing and maintaining registers of medical practitioners,
medical treatment support persons, medical treatment
institutions, and medical devices, and of patients who are ill
with certain diseases, new-born diseases, as well as for
approving medical technologies to be used in medical treatment
and the procedures for introducing new medical technologies.
(2) The procedures for organising the emergency and disaster
medical system shall be determined by the Cabinet.
(3) The Cabinet shall determine the provision of a first aid
training system, the content of the provision of first aid
training programme and the procedures for ensuring such
training.
[27 May 2004; 16 June 2005; 8 June
2006; 8 May 2008; 21 June 2012]
Section 9.1
(1) Medical treatment shall be performed in conformity with
clinical guidelines or by methods used in medical treatment and
an evaluation of the safety of use of medicinal products and the
effectiveness of the medical treatment, which is performed taking
into account medical principles based upon evidence.
(2) The Cabinet shall determine the procedures by which
clinical guidelines shall be developed, evaluated, registered and
implemented.
[8 June 2006; 8 May 2008; 16 June
2010; 11 September 2014]
Section 10.
In medical treatment institutions the quality of professional
health care and work disability expert examination shall be
controlled by the Health Inspectorate.
[27 May 2004; 27 September
2007]
Section 11.
Advertisements and advertising related to medical treatment,
medical treatment institutions and medical practitioners shall be
placed in the mass media in accordance with the procedures laid
down in laws and regulations.
Section 12.
Persons who do not have a medical education and who are
independently engaged in medical treatment of patients, provision
of assistance in deliveries (except in cases where emergency
assistance must be provided), hypnosis, conditioning and other
methods affecting the human psyche, correction of the human
energy field (bio-correction), acupuncture and other methods of
affecting the energy system of the human organism, as well as
persons who provide support for medical treatment activities by
persons who do not have a medical education or do not have the
right to practice a speciality shall be subject to liability laid
down in law.
Section 12.1
A medical practitioner is entitled to get involved in the
provision of health care process, if he or she is registered in
the register of medical treatment support persons.
[21 June 2012]
Chapter III
Medical Ethics Committee
Section 13.
Medical ethics committees are advisory bodies established for
resolving problems of medical ethics, which committees operate in
accordance with model regulations approved by the Cabinet.
Section 14.
Medical treatment institutions and professional organisations
of medical practitioners shall establish medical ethics
committees. Such committees shall examine ethical matters related
to the activities of medical practitioners and new medical
technologies.
Section 15.
The Central Medical Ethics Committee shall operate in
accordance with Cabinet regulations and it shall examine ethical
issues of biomedical progress relating to social problems. The
Cabinet upon recommendation from the Minister for Welfare shall
approve members of the Central Medical Ethics Committee.
[25 March 2004]
Chapter IV
Rights and Responsibilities of Persons with Respect to Health
Care
Section 16.
Everybody has the right to receive emergency medical care in
accordance with procedures stipulated by the Cabinet.
[26 February 1998]
Section 17.
(1) The amount of medical treatment services paid from the
State basic budget and from the funds of the recipient of
services in accordance with the procedures stipulated by the
Cabinet shall be provided to:
1) Latvian citizens;
2) Latvian non-citizens;
3) citizens of Member States of the European Union, of
European Economic Area states and Swiss Confederation who reside
in Latvia in relation to employment or as self-employed persons,
as well as the family members thereof;
4) third-country nationals who have a permanent residence
permit in Latvia;
5) refugees and persons who have been granted alternative
status;
6) persons detained, arrested and sentenced with deprivation
of liberty.
(2) Medical treatment services in the amount referred to in
Paragraph one of this Section shall be provided at the time and
place where it is necessary, in conformity with the medical
practitioner's qualifications and the diagnostic, medical
treatment and equipment for patient care level of the relevant
medical treatment institution.
(3) The spouses of Latvian citizens and Latvian non-citizens
who have a temporary residence permit in Latvia have the right to
receive free of charge the care for pregnant women and birth
assistance paid from the State basic budget and from the funds of
the recipient of services in accordance with the procedures
stipulated by the Cabinet.
(4) The children of the persons referred to in Paragraph one
of this Section have the right to receive free of charge the
amount of medical treatment services paid from the State basic
budget and from the funds of the recipient of services.
(5) Persons who are not referred to in Paragraphs one, three
and four of this Section shall receive medical treatment services
for a fee.
[8 June 2006; 8 May 2008]
Section 18.
Other medical assistance to the persons referred to in Section
17 of this Law shall be provided for payment from insurance
companies, employers, patients themselves or from other resources
in accordance with laws and regulations.
Section 19.
[8 June 2006]
Section 20.
[10 December 2009]
Section 21.
[10 December 2009]
Section 22.
[10 December 2009]
Section 23.
[10 December 2009]
Section 24.
[10 December 2009]
Section 25.
[10 December 2009]
Chapter V
Medical Practitioners and their Medical Treatment Activities
Section 26.
(1) Medical practitioners who have been registered in the
medical practitioners register are permitted to independently
engage in medical treatment in the relevant profession in
conformity with the competence specified by the Cabinet.
(2) Medical practitioners who have been certified and
registered in the medical practitioners register are permitted to
independently engage in medical treatment in a specific basic
speciality, sub-speciality or additional speciality in conformity
with the competence stipulated by the Cabinet.
(3) Registered medical practitioners who have acquired an
educational programme conforming to the requirements laid down in
laws and regulations in relation to education necessary for
acquisition of the particular speciality have the right to apply
for a medical practitioners certificate in a specific speciality.
Registered medical practitioners who have acquired a further
education programme of the relevant medical treatment or
diagnostic method have the right to apply for a certificate of
medical treatment and diagnostic methods in a specific medical
treatment or diagnostic methods.
(4) A specific medical treatment or diagnostic method included
in the classification of medical treatment and diagnostic methods
may be independently applied by medical practitioners registered
in the register of medical practitioners, who use the relevant
medical treatment or diagnostic method in accordance with the
competence specified in laws and regulations in medical treatment
or who are certified in the relevant medical treatment or
diagnostic method.
[8 May 2008; 21 June 2012]
Section 27.
The competence of medical practitioners in medical treatment,
as well as the amount of theoretical and practical knowledge
shall be determined by the Cabinet, taking into account the point
of view expressed in conformity with their competence by the
Latvian Medical Association, Union of Professional Organisations
of Medical Practitioners of Latvia or Latvian Nurses
Association.
[8 June 2006; 21 June 2012]
Section 28.
The acquisition of a diploma of medical education shall permit
the medical practitioner, until registration in the medical
practitioner's register, to engage in medical treatment only
under the supervision or guidance of such medical practitioner as
has a certificate and who is registered in accordance with the
procedures laid down in laws and regulations regarding the
medical practitioner's register.
[8 June 2006]
Section 29.
(1) The right to practice a speciality shall be certified by a
medical practitioner's certificate and its registration in
accordance with the procedures laid down in laws and regulations.
The Cabinet shall determine the procedures for certification of
medical practitioners.
(11) In the process of certification of a medical
practitioner the certification authority shall take a decision to
grant a certificate or to refuse to grant a certificate within
three months from the day of receiving an application. Due to
objective reasons the certification authority may extend the time
period for taking a decision for a time period not exceeding four
months from the day of receiving the application, notifying the
submitter thereof.
(2) The certification of a medical practitioner in conformity
with their competence shall be performed by:
1) Latvian Medical Association - doctor and dentist
certification;
2) Union of Professional Organisations of Medical
Practitioners of Latvia - functional specialist, functional
specialist assistant, doctor's assistant, radiologist's
assistant, radiographer, masseur, cosmetician, laboratory
assistant, podologists, beauty care specialists (cosmetologists)
and dental technician certification;
3) Latvian Nurses Association - nurse, dental nurse, midwife
and dental hygienist certification.
(3) The list of medical treatment support person professions
to be certified and the procedures for certification shall be
determined by the Cabinet.
(4) The pricelist for the paid services of testing of the
professional knowledge, the preparation, registration and
duplication of certificates of medical practitioners and medical
treatment support persons shall be approved by the Cabinet.
(5) The competence of medical treatment support persons in the
provision of health care process, as well as the amount of
theoretical and practical knowledge of such persons shall be
determined by the Cabinet.
[1 June 2000; 8 May 2008; 8 April
2009; 21 June 2012; 11 September 2014]
Section 30.
[1 June 2000]
Section 31.
Persons with a diploma of foreign medical education shall
acquire the right to engage in medical treatment in Latvia after
expert examination and recognition of the diploma in accordance
with the procedures laid down in law. The abovementioned persons
shall acquire the right to practice a speciality in accordance
with the procedures laid down in this Law.
[20 June 2001]
Section 32.
[1 June 2000]
Section 33.
(1) Persons studying at medical education institutions within
the framework of the educational programme may engage in medical
treatment only under direct supervision of a certified medical
practitioner.
(2) The lists of the medical practitioners who have the right
to perform the teaching of students and medical practitioners, in
conformity with their competence shall be approved by the Latvian
Medical Association, the Union of Professional Organisations of
Medical Practitioners of Latvia or the Latvian Nurses
Association.
(21) Any medical practitioner certified in basic
speciality, sub-speciality or additional speciality whose work
experience in the relevant basic speciality, sub-speciality or
additional speciality after acquisition of a medical
practitioners certificate is not less than five years has the
right to carry out training of residents at medical treatment
institutions according to accredited residency educational
programmes in medicine.
(3) Students who have acquired the first or second level of a
professional higher medical education programme and the amount of
knowledge and skills of whom conforms to specified qualification
and competence requirements may take part in medical treatment.
The qualification requirements and amount of competence shall be
determined by the Cabinet.
[8 May 2008; 21 June 2012]
Section 34.
(1) The Cabinet shall specify the procedures for the sale,
distribution, registration, operation and technical supervision
of medical devices. The head of a medical treatment institution
shall be directly responsible for compliance with the procedures
specified for the medical treatment institution.
(2) The Cabinet shall determine the procedures for the
clinical investigation of medical devices for provision to
persons.
(3) The quality and safety standards for the collection,
testing, processing, storage and distribution of human blood and
blood components, as well as compensation for expenditures for
the renewal of the lost volume of blood shall be determined by
the Cabinet.
[1 June 2000; 16 June 2005; 8 June
2006]
Section 35.
A head of a medical treatment institution shall be held liable
in accordance with the procedures laid down in law if the
institution managed by him or her uses medical technologies that
have not been approved in accordance with the procedures laid
down in the Cabinet.
[1 June 2000; 25 March 2004; 27 may
2004]
Section 36.
Medical practitioners shall be held liable for the use of
selected medical technology and consequences caused by it.
[1 June 2000]
Chapter VI
Profession of Doctor
Section 37.
(1) A doctor is a medical practitioner who has acquired an
education, which conforms to the requirements laid down in the
Law On Regulated Professions and Recognition of Professional
Qualifications, and who with scientifically grounded medical
activities, directly or indirectly affects humans and within the
scope of his or her professional activities:
1) performs illness prophylaxis, diagnosis, medical treatment
and medical rehabilitation of the patient;
2) evaluates illnesses and the functional restrictions to the
body caused thereof, at the activity and participation level;
3) investigates the origin of illnesses and the prophylactic
possibilities.
(2) [8 May 2008]
[8 June 2006; 8 May 2008]
Section 38.
A doctor shall be independent in his or her professional
activities. All doctors have the right to provide an opinion on
the state of health and treatment of a patient.
Section 39.
A doctor shall engage in a speciality (there may be several
specialities) specified in his or her doctor's certificate. A
doctor may engage in a sub-speciality, additional speciality or
use a particular examination or treatment method only if he or
she has a doctor's certificate in the primary speciality.
[1 June 2000]
Section 40.
A doctor has a duty to protect unborn life and he or she has a
duty to try to dissuade a pregnant woman from terminating
pregnancy if the pregnancy is not in contradiction with the
woman's state of health and if there is no danger that the
new-born baby will have an inherited or acquired disease. A
doctor has the right to refuse to terminate a pregnancy if there
are no medical grounds for such termination.
Section 41.
[10 December 2009]
Section 42.
In cases where the life of a patient is not endangered but the
patient does not observe the specified regimen, does not comply
with instructions of the medical practitioners or knowingly harms
his or her health and thus directly affects the medical treatment
of the specific disease, the doctor has the right to refuse
further treatment of the patient.
Section 43.
A doctor may examine or treat a patient jointly with other
medical practitioners or not permit their participation.
Chapter VI A
Profession of Dentist
[25 March
2004]
Section 43.1
A dentist is a medical practitioner who has acquired an
education, which conforms to the requirements laid down in the
Law On Regulated Professions and Recognition of Professional
Qualifications, and who within the scope of his or her
professional activities:
1) performs prophylaction, diagnosis and medical treatment of
alveolar outgrowths and oral cavity mucous membrane, jaws and the
tissue illnesses associated thereof;
2) investigates the origins and prophylactic possibilities of
the illnesses referred to in Clause 1 of this Section.
Chapter VII
Nurses and Profession of Doctor's Assistant
[11 September
2014]
Section 44.
(1) A nurse is a medical practitioner who has acquired an
education in conformity with the requirements laid down in the
Law On Regulated Professions and Recognition of Professional
Qualifications.
(2) A nurse within the framework of professional activity
thereof in conformity with the competence thereof shall:
1) provide patient care;
2) participate in medical treatment;
3) manage the work of providing care to patients;
4) work with education of patients in matters of health;
5) perform professional education work.
Section 45.
(1) A doctor's assistant is a medical practitioner who has
acquired a secondary professional education or first level higher
professional education, or higher education in conformity with an
accredited doctor's assistant study programme.
(2) A doctor's assistant within the framework of professional
activity thereof in conformity with the competence thereof shall
carry out professional and individual diagnosing and medical
treatment, and also in co-operation with a doctor ensure
preventive measures.
Chapter VII A
Functional Specialist and Assistant to a Functional
Specialist
[20 June
2001]
Section 45.1
(1) A functional specialist (physiotherapist, occupational
therapist, riding therapist, technical orthopaedist, audio speech
therapist, or nutritional specialist) is a medical practitioner
who has acquired a professional higher medical education at the
second level and acts according to his or her competence in
medical treatment.
(2) An assistant to a functional specialist (an assistant to a
physiotherapist, an assistant to an occupational therapist) is a
medical practitioner who has acquired a higher medical education
at the first level or at least at the third professional
qualification level and acts according to his or her competence
in medical treatment.
[8 June 2006; 8 May 2008; 21 June
2012]
Section 45.2
(1) In his or her speciality a functional specialist, within
the scope of his or her professional competence:
1) shall understand the evaluation of human functional
limitations and rehabilitation principles;
2) performs medical treatment by using appropriate
diagnostics, evaluation and medical technologies, and provides
opinions;
3) perform professional education work.
(2) In his or her speciality an assistant to a functional
specialist, within the scope of his or her professional
competence:
1) shall understand the evaluation of human functional
limitations and rehabilitation principles;
2) performs medical treatment by making use of appropriate
medical technologies under the supervision of a functional
specialist or a doctor.
Chapter VII B
Profession of Midwife
[25 March
2004]
Section 45.3
A midwife is a medical practitioner who has acquired an
education, which conforms to the requirements laid down in the
Law On Regulated Professions and Recognition of Professional
Qualifications, and who within the scope of his or her
professional activities shall:
1) ensure the physiological care of pregnancy, organise and
manage physiological birth and care after physiological birth,
and perform care of a healthy new-born;
2) having determined health risk factors or possible pathology
in the pregnant, natal and postnatal women or new-born in his or
her care, send the patient to the relevant specialist doctor;
3) participate in medical treatment;
4) provide information and perform educational activities in
relation to family planning and contraception, pregnancy, natal
and postnatal, breast-feeding, sexual and reproductive health and
child care issues.
Chapter VII C
Profession of Military Paramedic
[31 March
2011]
Section 45.4
A military paramedic is a medical practitioner who has
acquired education conforming to the requirements laid down in
the Law On Regulated Professions and Recognition of Professional
Qualifications, and who, upon fulfilling the duties of military
service in and outside the territory of Latvia, within the scope
of his or her professional activities shall:
1) evaluate the state of health of a patient;
2) provide emergency medical assistance.
Section 45.5
A military paramedic may maintain his or her professional
skills in providing emergency medical assistance in the amount
corresponding to his or her qualification during military service
in a team of an emergency medical assistance institution under
direct control and supervision of a medical practitioner
certified in emergency medicine.
Chapter VII D
Profession of Masseur
[21 June
2012]
Section 45.6
A masseur is a medical practitioner who has acquired first
level vocational higher education or vocational secondary
education and acts according to his or her competence in medical
treatment.
Chapter VIII
Duties and Rights of Medical Practitioners in Medical
Treatment
Section 46.
Medical practitioners have a duty to provide first aid and
emergency medical care.
Section 47.
A medical practitioner has the right to refuse first aid and
emergency medical care in circumstances that endanger the life of
the medical practitioner himself or herself, and also where a
medical practitioner is incapable of doing so due to his or her
state of health.
Section 48.
A medical practitioner has a duty to regularly improve his or
her professional qualifications and become educated in the
provision of emergency medical care.
[1 June 2000; 27 May 2004]
Section 49.
[10 December 2009]
Section 50.
[10 December 2009]
Section 51.
[10 December 2009]
Section 52.
[18 June 2009]
Section 53.
A doctor or a doctor's assistant shall determine temporary
work disability of a person. The Cabinet shall determine the
procedures for the issue of documents certifying temporary work
disability.
[26 February 1998]
Section 53.1
(1) The norms of the laws and regulations governing employment
legal relations shall be applicable to a medical practitioner
insofar as it is not specified otherwise in this Law.
(2) Such extension to the normal working hours of a medical
practitioner may be applied, which exceeds the normal working
hours specified in the Labour Law, if the general principles of
work safety and health protection are observed.
(3) In order to ensure the access to medical treatment, upon
the initiative of a medical practitioner or a medical treatment
institution, such extension to the normal working hours of a
medical practitioner may be applied, which does not exceed 60
hours per week and 240 hours per month.
(4) It is prohibited to punish a medical practitioner or
otherwise directly or indirectly cause unfavourable consequences
thereto, if this person does not agree to the application of an
extension to the normal working hours.
(5) If an extension to the normal working hours is applied to
a medical practitioner, then it shall be necessary for a medical
treatment institution to receive a written consent of the person
to the application of the extension to the normal working hours
not less than once every four months.
(6) A medical treatment institution shall perform the
recording of those medical practitioners to whom an extension to
the normal working hours has been applied, and shall provide the
State Labour Inspectorate with the access to this
information.
(7) If an extension to the normal working hours of a medical
practitioner has been applied, work remuneration for the working
hours, which exceed the normal working hours specified in the
Labour Law, shall be determined in proportion to the increase in
working hours not less than in the amount of the specified hourly
or daily wage rate but, if a lump-sum payment has been agreed
upon, in accordance with the piece-work rate for the amount of
work performed.
(8) The provisions of this Section shall also apply to a
person of an emergency medical assistance team who is not a
medical practitioner.
[8 April 2009; 18 June 2009; 21
June 2012 / See Paragraph 17 of Transitional Provisions]
Section 53.2
(1) In case of establishing a trusteeship and future
authorisation the commission of medical practitioners shall
provide an opinion on whether a person has lost the ability to
understand the meaning of his or her actions and to control them
due to mental or health disorders.
(2) A statement on the basis of the opinion referred to in
Paragraph one of this Section may be requested by:
1) the future authorised person, presenting the future
authorisation;
2) the court or Orphan's court in order to establish a
trusteeship in accordance with the procedures laid down in the
Civil Procedure Law.
(3) A statement on the basis of the opinion referred to in
Paragraph one of this Section shall be issued by the head of the
medical treatment institution within 10 working days from the day
of receiving the request. If the statement is issued in relation
to a future authorisation, it shall be indicated in the statement
that it is intended for submission to the register of future
authorisations in order to record information in the register in
accordance with the procedures laid down in the Notariate
Law.
(4) The procedures by which a medical treatment institution,
in case of establishing a trusteeship and future authorisation,
shall establish a commission of medical practitioners, by which
the commission of medical practitioners shall provide an opinion
on the ability of the person to understand the meaning of his or
her actions and to control them, by which the head of the medical
treatment institution shall issue a relevant statement on the
basis of the opinion, as well as the procedures for covering the
costs of the statement issued on the basis thereof, shall be
determined by the Cabinet.
[18 April 2013]
Chapter IX
Medical Treatment Institutions
Section 54.
(1) A medical treatment institution may be established by
State institutions, local governments, natural or legal
persons.
(2) Medical treatment institutions may be outpatient
institutions where patients, if placement in a hospital is not
necessary, are provided with medical treatment services, and
hospitals where patients who are under constant 24-hour care of
medical practitioners are provided with emergency medical
assistance, diagnosis and medical treatment services until a
specific level of medical treatment is reached.
(3) For the provision of the medical treatment services
referred to in Paragraph two of this Section, a medical treatment
institution is entitled to provide the following services related
to the medicine until a specific level of medical treatment is
reached:
1) overnight accommodation, which is provided to a patient and
a person who stays with the patient;
2) food, which is provided to a patient;
3) transportation of a patient with a vehicle which is
specially equipped with medical devices.
[1 June 2000; 18 June 2009]
Section 55.
(1) Only such medical treatment institutions as conform to the
mandatory requirements specified for medical treatment
institutions and their structural units may engage in medical
treatment.
(2) The Cabinet shall determine mandatory requirements for
medical treatment institutions and their structural units.
[1 June 2000; 8 April 2009]
Section 56.
(1) Certification of medical treatment institutions and their
structural units shall be voluntary.
(2) The Cabinet shall determine the procedures for certifying
medical treatment institutions and their structural units.
(3) A certificate for a medical treatment institution or its
structural units, in accordance with the health care financing
procedures stipulated by the Cabinet, shall give the relevant
medical treatment institution advantages when entering into a
contract with the National Health Service.
[1 June 2000; 10 December 2009; 21
June 2012]
Section 56.1
(1) If a medical treatment institution provides assistance to
a patient and there are grounds for considering that the patient
has suffered from violence, the medical treatment institution
shall notify the State Police thereof without delay but not later
than within 12 hours.
(2) If a medical treatment institution provides assistance to
an underaged patient and there are grounds for considering that
the patient has suffered from the lack of sufficient care and
supervision or other violation of the rights of the child, the
medical treatment institution shall notify the State Police
thereof without delay but not later than within 12 hours.
[7 October 2010]
Section 57.
The Cabinet shall determine the procedures for distribution of
residents and for the financing of residency.
[1 June 2000]
Section 58.
[25 March 2004]
Section 59.
The procedures for keeping medical documents in medical
treatment institutions shall be stipulated by the Cabinet.
[25 March 2004; 27 May 2004; 10
December 2009]
Section 60.
Regulations for the production of prescription forms and
procedures for writing out prescriptions shall be governed by
Cabinet regulations and other laws and regulations.
Chapter X
Medical treatment of Alcohol, Narcotic, Psychotropic, Toxic
Substances, Gambling and Computer Game Addictive Illnesses
[27 May
2004]
Section 60.1
The Cabinet shall determine the procedures for the examination
of the effect of alcohol, narcotic, psychotropic or toxic
substances.
[27 May 2004]
Section 61.
Medical treatment of alcohol, narcotic, psychotropic, toxic
substances, gambling or computer game addiction shall be
voluntarily if the addict wishes, in addiction treatment
institutions in accordance with the procedures stipulated by the
Cabinet.
[27 May 2004]
Section 62.
In cases where as the result of the use of alcohol, narcotic,
psychotropic, toxic substances, participation in gambling or
computer games, a patient performs activities dangerous to the
public, systematically commits administrative violations or by
his or her actions endangers himself or herself, his or her
closest relatives or the public, the compulsory measures of
social and psychosocial rehabilitation prescribed by law shall be
applied, but for minors - compulsory measures of an educational
nature.
[1 June 2000; 27 May 2004]
Section 63.
The compulsory measures for social and psychosocial
rehabilitation of alcohol, narcotic, psychotropic, toxic
substances, gambling or computer game addiction shall be as
follows:
1) registration in the police prophylactic register and a
warning in writing by the police that the patient must terminate
the use of alcohol, narcotic, psychotropic, toxic substances,
participation in gambling or computer games and the committing of
the related administrative violations thereof, as well as to
start mandatory medical treatment;
2) registration in the register of addicts and development of
motivation to make the patient interested in undergoing voluntary
medical treatment for alcohol, narcotic, psychotropic, toxic
substances, gambling or computer game addiction;
3) a court adjudication regarding the requirement for the
convicted person to undergo medical treatment.
[1 June 2000; 27 May 2004]
Section 64.
In imposing a suspended sentence, a court may impose, for a
convicted person who has committed a crime under the influence of
alcoholism, narcotic, psychotropic addiction or toxic substance
addiction, or is addicted to gambling or computer games with his
or her consent, the duty to undergo treatment for alcohol,
narcotic, psychotropic, toxic substances, gambling or computer
game addiction at a social or psychiatric rehabilitation
institution.
[27 May 2004]
Chapter XI
Mental Illness
Section 65.
Persons with mental disorders and mental illness shall be
ensured all the civil, political, economic and social rights
provided for by law. Mental disorders or mental illness shall not
be a basis for discrimination of an individual.
Section 66.
Mentally ill persons have the right to receive medical
assistance and care of a quality that conforms with accepted
standards of general medicine.
Section 67.
(1) Psychiatric assistance shall be based upon the voluntary
principle. In-patient assistance shall be provided in a
psychiatric medical treatment institution or a medical treatment
institution psychiatric department (hereinafter - psychiatric
medical treatment institution) if due to the state of health of
the patient such assistance can not be provided on an out-patient
basis or at the place of residence.
(2) A patient may be admitted to a psychiatric medical
treatment institution with his or her written permission on the
basis of a determined mental disorder and a justified decision by
a psychiatrist regarding the necessity for the investigation of
mental health, medical treatment and rehabilitation in a
psychiatric medical treatment institution. The consent of the
patient for admission shall be appended to the medical
documents.
[1 March 2007; 10 December
2009]
Section 68.
(1) Psychiatric assistance without the consent of a patient
shall be provided if the patient:
1) has threatened or threatens, tried or is trying to do
personal injuries to him or herself or to another person or has
behaved or behaves violently to other persons and a medical
practitioner has determined that the patient has a mental health
disorder for which the possible consequences may be personal
injury to the patient him or herself or another person;
2) the patient has indicated or indicates an inability to care
for him or herself or for a person under his or her guardianship
and a medical practitioner has determined that the patient has a
mental health disorder for which the possible consequences may be
unavoidable and serious deterioration of the persons health.
(2) In providing psychiatric assistance without the consent of
a patient in the cases specified in Paragraph one, Clauses 1 and
2 of this Section, if it is possible, the necessity for providing
compulsory psychiatric assistance shall be explained to the
patient. The patient has the right to receive information
regarding his or her rights and duties.
(3) If in providing psychiatric assistance it is necessary to
admit a patient to a psychiatric medical treatment institution
without his or her consent, a doctors' council of psychiatrists
shall within a 72-hour period examine the patient and take a
decision to provide psychiatric assistance in the psychiatric
medical treatment institution without his or her consent
(hereinafter - decision to provide psychiatric assistance) or to
suspend such assistance.
(4) The doctors' council of psychiatrists shall without delay
notify the patient of its decision. If the doctors' council of
psychiatrists takes a decision to provide psychiatric assistance,
the lawful representative of the patient shall be informed of
this. If the patient does not have a lawful representative, in
respect of the decision taken, the doctors' council of
psychiatrists shall inform the spouse of the patient or one of
the nearest relatives of the patient (parents, adult children,
brothers or sisters), or at the request of the patient another
person. In deciding to which person the decision to provide
psychiatric assistance shall be notified, as far as possible the
point of view of the patient shall be taken into account.
(5) If the doctors' council of psychiatrists has taken a
decision to provide psychiatric assistance, the psychiatric
medical treatment institution shall not later than within 24
hours inform in writing a district (city) court (in conformity
with the location of the psychiatric medical treatment
institution), sending it a true copy of the decision and copies
of the documents at the disposal of the psychiatric medical
treatment institution, which justify the placement of the patient
in a psychiatric medical treatment institution, as well as
provide information regarding the representative of the patient
if there is such.
(6) A judge upon receipt of the decision and the documents
appended thereto referred to in Paragraph five of this Section
shall without delay, utilising accessible communication resources
(telephone, fax, electronic mail), as well as at the same time
sending the relevant notification by post, inform the district
(republican city) public prosecutor (in conformity with the
location of the psychiatric medical treatment institution), the
representative of the patient and the psychiatric medical
treatment institution of the day, time and place for the
examination of the submitted material.
(7) Upon determining that the patient does not have an
advocate, the judge after receipt of the documents referred to in
Paragraph six of this Section shall without delay request that
the Latvian Sworn Advocate Council for the representation of the
interests of the patient assign a sworn advocate and at the same
time inform the Latvian Sworn Advocate Council regarding the day,
time and place for the examination of the submitted material.
(8) On the basis of a request from the public prosecutor,
representative of the patient or advocate, the court shall ensure
the possibility to become acquainted with the decision and the
documents appended thereto referred to in Paragraph five of this
Section. The psychiatric medical treatment institution on the
basis of a request from the representative of the patient or
advocate shall ensure the possibility to meet with the patient in
order to provide consultations.
(9) A judge shall examine the materials submitted regarding
the provision of psychiatric assistance in the psychiatric
medical treatment institution without the consent of the patient
in a closed sitting in the psychiatric medical treatment
institution in which the patient has been placed. The sitting
shall be attended by the patient (if his or her health condition
allows it), the public prosecutor, representative of the patient
or advocate.
(10) The materials regarding the provision of psychiatric
assistance in the psychiatric medical treatment institution
without the consent of the patient shall be examined within a
period of 72 hours after the receipt of the doctors' council of
psychiatrists decision. The judge on his or her own initiative or
also on the basis of a justified request from the public
prosecutor, representative of the patient or advocate shall
decide regarding the deferral of examination of the materials for
a period, which is not loner than 48 hours if it is not possible
to examine the materials because one of the persons referred to
in Paragraph eight of this Section has not appeared or it is
necessary to acquire additional evidence. The decision of the
judge cannot be appealed, except the decision in which a time is
not specified for the examination of the material.
(11) In examining the materials, the judge shall hear the
representative of the doctors' council of psychiatrists,
representative of the patient or advocate, the patient (if it is
possible), as well as the public prosecutor and shall take a
decision to approve the decision of the doctors' council of
psychiatrists regarding the provision of psychiatric assistance
for a period up to two months or regarding a refusal to approve
the decision of the doctors' council of psychiatrists.
(12) In the examination of materials regarding the provision
of psychiatric assistance in the psychiatric medical treatment
institution without the consent of the patient, persons who are
involved in the medical treatment process of the patient are
permitted to attend. A judge on his or her own initiative or also
on the basis of a justified request from the public prosecutor,
representative of the patient or advocate may hear also other
persons who may provide information regarding important
circumstances in the matter. The decision of the judge cannot be
appealed.
(13) In the decision of the judge to approve the decision of
the doctors' council of psychiatrists regarding the provision of
psychiatric assistance for a period up to two months or regarding
a refusal to approve the decision of the doctors' council of
psychiatrists shall be indicated the name of the relevant court,
the given name and surname of the judge, the date of the
examination of the materials, information regarding the
psychiatric medical treatment institution, regarding the persons
who have participated in the examination of the materials, and
the patient, reasons for the decision, the provisions of the law
upon which the judge based the decision, and the adjudication, as
well as shall indicate the procedures for the appeal of the
decision.
(14) The judge shall without delay notify the persons who
participated in the examination of the material of the decision.
A true copy of the decision shall be issued to the patient,
representative of the patient or advocate, as well as the
psychiatric medical treatment institution and the public
prosecutor. If it is not possible to draw up the decision in
writing without delay (after the examination of materials
regarding the provision of psychiatric assistance without the
consent of the patient), a true copy thereof shall be sent to the
persons referred to in the first sentence of this Paragraph by
post not later than the next working day after notification of
the decision. The decision shall be implemented without
delay.
(15) The persons referred to in Paragraph nine of this
Section, as well as the patient may, within 10 days from the day
of the notification of the decision of the judge, submit an
appeal to the chairperson of the court, but the public prosecutor
- a protest. The written submitted appeal or protest shall be
examined by the chairperson of the court within 10 days from the
end of the time period for the submission of an appeal or
protest. In examining an appeal or protest, the chairperson of
the court shall evaluate only the arguments included in the
appeal or protest.
(16) If the chairperson of the court in examining the
submitted appeal or protest and the documents appended thereto
finds that the decision of the judge is without justification, he
or she shall take a decision on the setting aside thereof. The
decision of the chairperson of the court shall without delay be
notified to the psychiatric medical treatment institution and the
public prosecutor, as well as to the submitter of the appeal. A
true copy of the decision shall be sent to the public prosecutor,
patient, representative of the patient or advocate, as well as
the psychiatric medical treatment institution not later than the
next working day after the day the decision was taken.
(17) Not later than seven day prior to the end of the time
period specified by the decision of the judge, the doctors'
council of psychiatrists shall again examine the patient and take
a decision on the necessity to continue to provide to the patient
without his or her consent psychiatric assistance in the
psychiatric medical treatment institution or regarding the
discontinuance of such assistance. If the doctor providing
medical treatment to the patient finds that the provision of
psychiatric assistance in the psychiatric medical treatment
institution is no longer necessary, the provision of psychiatric
assistance shall be suspended prior to the end of the time period
specified in the decision of the judge. If the doctors' council
of psychiatrists has taken a decision on the necessity to
continue to provide to the patient without his or her consent
psychiatric assistance in the psychiatric medical treatment
institution for a period of up to six months, the psychiatric
medical treatment institution shall perform the activities
indicated in Paragraph five of this Section. The doctors' council
of psychiatrists is entitled to take repeatedly a decision
regarding necessity to continue to provide to the patient without
his or her consent psychiatric assistance in the psychiatric
medical treatment institution for another six months or regarding
the discontinuance of such assistance in conformity with the
procedures laid down in this Section.
(18) A judge shall examine the materials of the matter
regarding the further provision of psychiatric assistance to the
patient without his or her consent in the psychiatric medical
treatment institution or regarding the discontinuance of such
assistance according to the procedures specified in Paragraphs
six - sixteen of this Section and shall take a decision on the
approval of the doctors' council decision referred to in
Paragraph seventeen of this Section or regarding a refusal to
approve the decision of the doctors' council.
(19) The time periods for the provision of psychiatric
assistance without the consent of the patient shall be counted
from the moment when the patient in the cases specified in
Paragraph one of this Section has been conveyed to the
psychiatric medical treatment institution in order to receive
psychiatric assistance without his or her consent.
(20) A patient, who is placed in a psychiatric medical
treatment institution for medical treatment in accordance with
the procedures laid down in this Section, has the right not more
than once in two months to submit a submission to the district
(city) court (according to the location of a psychiatric medical
treatment institution) with a request to review decision to
provide psychiatric assistance to the patient without his or her
consent.
[8 November 2007; 11 September
2014]
Section 68.1
(1) In the cases specified in Section 68 of this Law, payment
for the legal assistance provided by the advocate assigned by the
Latvian Sworn Advocates Council shall be performed, as well as
compensatory expenditures associated with the provision of legal
assistance shall be reimbursed in conformity with laws and
regulations, which determine the amount of payment for State
ensured legal aid in civil matters, not taking into account the
restrictions specified therein in relation to the amount of State
ensured legal aid types. The Legal Aid Administration shall,
within a period of one month after the receipt of the
notification submitted within the specified time period perform
the payment in accordance with the submitted notification of the
advocate regarding the legal assistance provided, from State
budget funds intended for such purposes.
(2) The Legal Aid Administration shall perform payments to an
advocate who has been assigned by the Latvian Sworn Advocates
Council in the cases specified in Section 68 of this Law for the
following types of legal assistance: for becoming acquainted with
the materials of the matter, legal consultations, advocacy at the
court sitting in the psychiatric medical treatment institution,
as well as for the preparation of appeals to the chairperson of
the court.
(3) For the receipt of the payment, the advocate shall, within
two months, submit to the Legal Aid Administration an approved
notification regarding the provided legal assistance.
(4) The notification regarding the provided legal assistance -
becoming acquainted with the materials of the matter, advocacy at
the court sitting in the psychiatric medical treatment
institution and preparation of appeals to the chairperson of the
court - shall be approved the judge or in the case specified in
Section 68, Paragraph fifteen of this Law, the chairperson of the
court. The notification shall indicate the given name and surname
of the advocate, personal identity number, address of the
practice, given name and surname of the patient, personal
identity number, the name of the court, the type of legal
assistance, the date and time (number of hours) of the provision
thereof, amount of payment (without value added tax), name of the
bank and the account into which the payment shall be made, and
appending to it documents, which certify other compensatory
expenditures.
(5) The notification regarding the provided legal assistance -
legal consultations provided to the patient - shall be approved
by an official of the psychiatric medical treatment institution.
The notification shall indicate the given name and surname of the
advocate, personal identity number, address of the practice,
given name and surname of the patient, personal identity number,
the number of the material, the type of legal assistance, the
date and time (number of hours) of the provision thereof, amount
of payment (without value added tax), name of the bank and the
account into which the payment shall be made, and appending to it
documents, which certify other compensatory expenditures.
[8 November 2007]
Section 69.
(1) If a person due to a mental disorder or mental disease
disturbs public order, his or her detention, conveyance to and
supervision at the psychiatrist shall be performed by police
officers in accordance with the Law On the Police.
(2) The police officers shall submit to the psychiatrist a
notice in writing of the anti-social nature of the behaviour of
the patient.
Section 69.1
(1) A patient who is admitted in a psychiatric medical
treatment institution without his or her consent, and a patient
for whom medical treatment in the psychiatric medical treatment
institution has been determined as a compulsory measure of
medical nature in criminal proceedings, has:
1) the patient's rights laid down in the Law on the Rights of
Patients;
2) the right to receive and send letters, to receive postal
items (parcels), to use communication means in order to get in
touch with persons outside a psychiatric medical treatment
institution, to meet with relatives and other persons, and also
the right to daily walk.
A medical practitioner shall immediately inform a patient
regarding such rights in the form understandable for him or her
and taking into account the age, maturity and experience of the
patient. If necessary, the medical practitioner shall repeatedly
provide the abovementioned information.
(2) If there are direct threats that a patient due to psychic
disorders may commit injuries to himself or herself or other
persons, or a patient demonstrates violence towards other
persons, a doctor has the right to prohibit the patient's meeting
with relatives and other persons and a daily walk. The
prohibition shall be immediately cancelled, if the threat caused
by the patient does not exist anymore. The doctor shall indicate
the reason and duration of application of the prohibition in the
medical documentation of the patient.
(3) The Cabinet shall determine the list of those items which
are prohibited to be kept in a psychiatric medical treatment
institution and to receive in consignments (parcels).
(4) A doctor, having assessed each case, may take a decision
regarding a patient's meeting with relatives and other persons at
the presence of the medical practitioner, if it is necessary due
to safety considerations or it is requested by a visitor or
patient. A doctor shall indicate the decision taken and
substantiation thereof in the medical documentation of the
patient.
(5) If a medical practitioner has justified doubts that items
prohibited in a medical treatment institution are kept by a
patient or present in his or her belongings, a doctor has the
right to take a decision regarding searching of the patient or
his or her belongings. A doctor shall indicate the decision taken
and substantiation thereof in the medical documentation of the
patient. A medical treatment institution shall ensure that
searching of the patient is carried out by a medical practitioner
of the same gender.
(6) In cases, when there are direct threats that a patient due
to psychic disorders may commit injuries to himself or herself or
other persons or a patient demonstrates violence towards other
persons and attempts to discontinue threat by verbal convincing
have failed, the following confining means may be used in
psychiatric medical treatment institutions:
1) physical confinement by using physical force for
confinement of movements of the patient;
2) mechanical confinement by using confining cords or
belts;
3) injection of medicines to a patient against his or her
will;
4) placement in a monitoring ward.
(7) Confining means may be used for a patient by force only in
such case, if the patient is hospitalised in a psychiatric
medical treatment institution without his or her consent, and for
a patient for whom medical treatment in a psychiatric medical
treatment institution has been determined as a compulsory measure
of medical nature. Confining means, by taking into account the
conditions abovementioned in this Section, may be applied also in
the case when psychiatric assistance is provided to a patient
without his or her consent, prior the decision of the judge
abovementioned in Section 68, Paragraph eleven of this Law is
taken.
(8) A decision to apply confining means shall be taken by a
doctor and implemented by a medical practitioner. Application of
confining means shall be proportional to direct threat caused by
a patient and application thereof shall be immediately
discontinued, if the threat caused by the patient does not exist
anymore. A doctor shall indicate application of confining means
in the medical documentation of a patient, by indicating the
reasons for application of confining means, the starting and end
time and injuries caused, if any have been caused for the patient
or medical practitioner.
(9) The Cabinet shall determine the procedures for carrying
out confining of patients, by using confining means.
(10) A patient has the right to appeal the decisions
abovementioned in Paragraph two and six of this Section within
one month to the manager of the medical treatment institution who
shall examine a submission and take a decision within seven days.
A patient has the right to appeal the decision of the manager of
the medical treatment institution to the Health Inspectorate
within one month which shall examine a submission and take a
decision within 20 days. A patient has the right to appeal the
decision of the Health Inspectorate to the district (city) court
within one month. A judgment of the district (city) court may not
be appealed.
[11 September 2014]
Section 70.
[1 March 2007]
Chapter XII
Health and Ability to Work, Forensic and Legal Psychiatric
Expert-examination
Section 71.
In cases of persistent or permanent restrictions of physical
or mental capacity and in cases of functional restrictions of the
body, at the activity and participation level, health and work
disability expert-examination shall be performed and disability
shall be determined by the Medical Commission for
Expert-Examination of Health and Working Ability(MCEEHWA)
authorised by the State, the operation of which Commission shall
be governed by laws and regulations.
[8 June 2006]
Section 72.
Court forensic and court psychiatric expert-examination shall
be performed in accordance with a decision taken by the
institution (official), investigator, participant of an
investigation group, public prosecutor or the court (judge) in
accordance with the procedures laid down in law. The Cabinet
shall determine procedures for the performance of court forensic
and court psychiatric expert-examination.
[16 June 2010]
Section 73.
[1 June 2000]
Chapter XIII
Suspension of the Operations of a Medical Treatment Institution
of the Structural Unit Thereof or Suspension of Health Care
Service Provided Thereby
[8 May 2008; 11
September 2014]
Section 74.
A decision to suspend the operations of a medical treatment
institution or the structural unit thereof or to suspend the
health care service provided thereby if the laws and regulations
governing the field of medical treatment have been infringed
shall be taken by the manager of the Health Inspectorate and his
or her deputies, or by the manager of the territorial office of
the Health Inspectorate and his or her deputies.
[11 September 2014]
Section 75.
(1) If the Health Inspectorate inspector has determined such a
violation of the laws and regulations governing the field of
medical treatment, which create a risk for the course of a
successful medical treatment process, he or she shall express a
written warning to the medical treatment institution. In the
warning shall be indicated all the determined violations of the
laws and regulations governing the field of medical treatment and
shall provide recommendations, as well as shall determine the
time period for the rectification of the violations.
(2) Taking into account the impact of the violation on the
medical treatment process and the actual possibilities of the
rectification thereof, the time period for the rectification of
the violation included in the warning shall not shorter than:
1) two years if for the rectification of the violation capital
construction is necessary;
2) six months if for the rectification of the violation
partial reconstruction of a building or capital repairs of
equipment is necessary.
(3) In the rest of the cases, which are not referred to in
Paragraph two of this Section, the Health Inspectorate inspector,
taking into account the impact of the violation on the medical
treatment process and the actual possibilities of the
rectification thereof, shall determine a time period for the
rectification of the violation from one month to six months.
(4) If the infringements indicated in the warning are not
rectified in the laid down time period, the official
abovementioned in Section 74 of this Law shall take a decision to
suspend the operations of the relevant medical treatment
institution or the structural unit thereof or to suspend the
health care service provided thereby.
(5) The suspension of the operation of medical treatment
institutions or the structural unit thereof shall be ensured by
the manager of the medical treatment institution with the
participation of the official who took the decision to suspend
the operations of the medical treatment institution or the
structural unit thereof, or his or her authorised official.
Suspension of the health care service provided by the medical
treatment institution shall ensure the manager of the medical
treatment institution.
(6) The suspension of the operation of a medical treatment
institution or the structural unit thereof or the suspension of
the provided health care service shall be performed so that:
1) the determined violations may be rectified without
hindrance;
2) the damage to premises and equipment due to meteorological
conditions or corrosion is reduced as far as possible;
3) the operations of other structural units and equipment is
disturbed as little as possible.
(7) Control of the suspension of the operation of a medical
treatment institution or the structural unit thereof or control
of the suspension of the provided health care service shall be
ensured by an official who has taken a decision to suspend the
operation or to suspend the health care service, or his or her
authorised person.
(8) The operation of a medical treatment institution or the
structural unit thereof or the provided health care service may
be suspended without previous warning if due to infringements of
the laws and regulations governing the field of medical treatment
there is created a threat to human health and life.
(9) The official who has the right to take the decision
abovementioned in Paragraph eight of this Section shall take it
within three working days after it became known to him or her
regarding the infringements of the laws and regulations governing
the field of medical treatment abovementioned in Paragraph eight
of this Section, and it is to be implemented without delay.
[11 September 2014]
Section 76.
(1) The relevant medical treatment institution shall notify in
writing the official who has taken a decision to suspend the
operation of a medical treatment institution or to suspend the
operation of the structural unit thereof or to suspend the health
care service provided thereby regarding rectification of the
infringements of the laws and regulations governing the field of
medical treatment. Such official shall within five working days
after receipt of the notification verify whether the relevant
violations have been rectified.
(2) If all infringements referred to in a written warning or
decision to suspend operation of the medical treatment
institution or structural unit thereof, or to suspend the
provided health care service, have been rectified, the relevant
official shall, within three working days after performance of
the inspection issue a written permission to renew operation of
the medical treatment institution or structural unit thereof, or
provision of health care service.
(3) If all infringements referred to in a written warning or
decision to suspend operation of the medical treatment
institution or structural unit thereof, or to suspend the
provided health care service have not been rectified, the
relevant official shall, within three working days after
performance of the inspection, notify regarding refusal to issue
a permission to renew operation of the medical treatment
institution or structural unit thereof, or provision of health
care service.
[11 September 2014]
Section 77.
(1) A submission, where the decision of the Health
Inspectorate to suspend operation of the medical treatment
institution or structural unit thereof, or to suspend the
provided health care service without prior warning is contested,
shall be examined and decision shall be taken within 10 working
days after receipt of the submission.
(2) The contesting and appeal of the decisions referred to in
this Section shall not suspend the fulfilment thereof.
[11 September 2014]
Chapter XIV
Health Information System
[7 October
2010]
Section 78.
(1) In order to ensure organisation of health care and to
facilitate the provision of health care services, data of the
health sector shall be accumulated in the health information
system.
(2) The Cabinet shall determine the manager of the health
information system, the data to be stored in the health
information system and the procedures for processing them, as
well as the procedures for issuing data.
(3) The manager of the health information system is entitled
to transfer the functions of the holder of such system to another
authorised institution or several institutions. The Cabinet shall
determine the institutions to which the manager of the health
information system is entitled to transfer the functions of the
holder of the abovementioned system, and the data sets to be
assigned to the relevant institutions.
Section 79.
(1) In order to ensure accumulation of true and current
information and completeness of information in the health
information system, the manager or holder of such system, if the
functions of the holder of the health information system have
been transferred to an authorised institution, is entitled to
request and receive free of charge information from State and
local governments, medical treatment institutions, medical
practitioners and patients.
(11) Inclusion of data in the health information
system shall be making of an entry or completing of a structured
electronic document in the online regimen. The entry shall be
certified with a safe electronic signature or other system
authentication tools and procedures, which ensure authenticity of
the entry and approve the identity of the signatory. The
procedures for use of system authentication tools, and also the
procedures for ensuring the authenticity of procedural entries
shall be determined by the Cabinet.
(2) The information accumulated in the health information
system regarding patients shall be provided in accordance with
the Law On the Rights of Patients. Other information shall be
provided free of charge in accordance with the procedures laid
down in laws and regulations:
1) to medical treatment institutions, medical practitioners,
medical support persons according to their competence;
2) to employees of a medical treatment institution (for
example, an employee of the reception at a medical treatment
institution) according to carrying out the official duties;
3) to undertakings manufacturing medicinal products, drug
wholesalers, pharmacies, pharmacists and pharmacist's assistances
according to their competence.
[11 September 2014]
Section 80.
The manager or holder of the health information system, if the
functions of the holder of such system have been transferred to
an authorised institution, is entitled not to inform the data
subject regarding processing of personal data in the health
information system, unless the data subject is specifically
requesting it and processing of personal data is necessary
for:
1) the needs of medical treatment;
2) the provision of health care services or their
administration;
3) the distribution of medicinal products and medical devices
or their administration;
4) the collection of statistical information specified by the
State.
Chapter XV
Special Provisions of Economic Activity of a Medical Treatment
Institution
[11 September
2014]
Section 81.
(1) If delay is related to agreements on delivery of goods,
purchase or provision of a service and a debtor is a medical
treatment institution, which conforms to the criteria of a
commissioning party in accordance with the laws and regulations
in the field of public procurements or criteria of a public
institution in accordance with the laws and regulations in the
field of providers of public services (a public commissioning
party), the provisions of the Civil Law which are referable to
agreements on delivery of goods, purchase or provision of a
service shall be applied to the delay, by taking into account the
time period of delay of the debtor laid down in Paragraph two of
this Section.
(2) If a medical treatment institution has not made the
payment in the cases abovementioned in Paragraph one of this
Section within 60 days after the setting in of the conditions
referred to in Section1668.2, Paragraph one of the
Civil Law, the delay shall set in with all consequences arising
therefrom.
(See Paragraph 21 of Transitional Provisions)
Transitional Provisions
1. Medical practitioners who have acquired a qualification
category or a certificate in any of the sub-specialities or
additional specialities and have practised it for more than five
years may continue his or her practice without obtaining a
primary speciality certificate. Certification of such specialists
shall take place in the acquired sub-speciality or additional
speciality.
2. Medical practitioners who have acquired a qualification
category or a certificate in any of the primary specialities,
sub-specialities or additional specialities and have practised it
for more than ten years, upon a change in the classification of
specialities, may continue his or her practice without obtaining
a primary speciality certificate if such speciality is recognised
as a medical treatment or diagnostic method.
3. [1 June 2000]
4. With the coming into force of this Law, Cabinet Regulation
No. 177, On Medical Treatment, issued in accordance with Article
81 of the Constitution (Latvijas Republikas Saeimas un
Ministru Kabineta Ziņotājs, 1994, No. 19; 1995, No. 4; and
1997, No. 5), is repealed.
5. Medical treatment institutions and their structural units,
which were established before 30 June 2000, shall be evaluated by
31 December 2001 in conformity with the mandatory
requirements.
[1 June 2000]
6. The Cabinet shall issue by 1 November 2004 the regulations
referred to in Section 4; Section 9, Paragraph one; Section 17,
Paragraph one (text as at 27 May 2004); Sections 59 and
60.1 of this Law.
[27 May 2004; 16 June 2005; 8 June
2006]
7. The Cabinet shall issue by 1 October 2005 the regulations
referred to in Section 9, Paragraph two and Section 34, Paragraph
three in the text of 16 June 2005 of this Law.
[16 June 2005; 8 May 2008]
8. The Cabinet shall by 1 January 2007 issue the regulations
referred to in Section 9.1, Paragraph two and Section
33 in the text of 8 June 2006 of this Law.
[8 June 2006; 8 May 2008]
9. Amendments to Section 4, Paragraph two; new text of Section
27 and new text of Section 37, Paragraph two of this Law shall
come into force on 1 January 2007.
[8 June 2006]
10. The new text of Section 37, Paragraph one, Clause 2 of
this Law shall come into force on 1 July 2009. Up to 30 June 2009
a doctor within the scope of his or her professional activities
shall evaluate illnesses and the consequences caused thereof.
[8 June 2006]
11. The new text of Section 71 of this Law shall come into
force on 1 July 2009.
[8 June 2006]
12. In order to receive payment for the representation of a
patient, which was performed up to 31 December 2007, advocates
assigned by the Latvian Sworn Advocates Council by 1 March 2008
shall submit to the Legal Aid Administration completed
notifications according to the procedures specified in Section
68.1, Paragraphs four and five of this Law, and
appending to them documents, which certify other compensatory
expenditures.
[8 November 2007]
13. The new text of Section 17, Paragraph three of this Law
shall come into force on 1 July 2008.
[8 May 2008]
14. The new text of Section 26, Paragraphs one and two;
Section 29, Paragraphs two and three and Section 33, Paragraph
three of this Law shall come into force on 1 January 2009.
[8 May 2008]
15. Section 29, Paragraph five of this Law shall come into
force on 1 January 2010.
[8 April 2009]
16. The amendment to Section 50 of this Law in relation to the
Health Payment Centre and the amendment regarding the deletion of
Section 52 shall come into force on 1 October 2009.
[18 June 2009]
17. Section 53.1, Paragraph eight of this Law shall
be in force until 31 December 2016.
[21 June 2012; 11 September
2014]
18. The Cabinet shall issue the regulations referred to in
Section 53.2, Paragraph four of this Law by 1 December
2013. Until the day of coming into force of the abovementioned
Cabinet regulations an opinion on whether a person has lost the
ability to understand the meaning of his or her actions and to
control them due to mental or health disorders shall be provided
by a commission established by the head of the medical treatment
institution in the composition of at least three doctors one of
whom is a psychiatrist. The costs of the opinion and the
statements issued on the basis thereof shall be covered according
to the price list of paid services of the medical treatment
institution:
1) by the future authorised person who requested the
statement, on the basis of Section 53.2, Paragraph
two, Clause 1 of this Law;
2) by the Court Administration within one month after request
of the medical treatment institution, on the basis of Section
53.2, Paragraph two, Clause 2 of this Law.
[18 April 2013]
19. The Cabinet shall issue the regulations abovementioned in
Section 69.1, Paragraph three of this Law by 1
December 2014.
[11 September 2014]
20. The Cabinet shall issue the regulations abovementioned in
Section 69.1, Paragraph nine of this Law by 1 January
2015. Until the day of coming into force of the abovementioned
Cabinet regulations confinement of patients by using confining
means shall be carried out in conformity with the medical
technologies approved in accordance with the laid down
procedures.
[11 September 2014]
21. Provisions of Section 81 of this Law shall not be
applicable to the agreements entered into until the day of coming
into force of Section 81 of this Law, and to the agreements that
entered into in accordance with the laws and regulations in the
field of granting of public procurements or concessions after the
day of coming into force of Section 81, if procurements or
concession procedures in accordance with the procedures laid down
in the laws and regulations have been commenced until the day of
coming into force of Section 81 of this Law.
[11 September 2014]
Informative Reference to the
European Union Directives
[8 June 2006; 8
April 2009; 11 September 2014]
This Law contains legal norms arising from:
1) Council Directive 93/42/EEC of 14 June 1993 concerning
medical devices;
2) Council Directive 2004/83/EC of 29 April 2004 on minimum
standards for the qualification and status of third country
nationals or stateless persons as refugees or as persons who
otherwise need international protection and the content of the
protection granted;
3) Directive 2004/38/EC of the European Parliament and of the
Council of 29 April 2004 on the right of citizens of the Union
and their family members to move and reside freely within the
territory of the Member States amending Regulation (EEC) No
1612/68 and repealing Directives 64/221/EEC, 68/360/EEC,
72/194/EEC, 73/148/EEC, 75/34/EEC, 75/35/EEC, 90/364/EEC,
90/365/EEC and 93/96/EEC (Text with EEA relevance);
4) Directive 2003/88/EC of the European Parliament and of the
Council of 4 November 2003 concerning certain aspects of the
organisation of working time;
5) Directive 2007/47/EC of the European Parliament and of the
Council of 5 September 2007 amending Council Directive 90/385/EEC
on the approximation of the laws of the Member States relating to
active implantable medical devices, Council Directive 93/42/EEC
concerning medical devices and Directive 98/8/EC concerning the
placing of biocidal products on the market;
6) Directive 2011/7/EU of the European Parliament and of the
Council of 16 February 2011 on combating late payment in
commercial transactions;
7) Directive 2011/24/EU of the European Parliament and of the
Council of 9 March 2011 on the application of patients' rights in
cross-border healthcare.
This Law shall come into force on 1 October 1997.
This Law has been adopted by the Saeima on 12 June 1997.
President G. Ulmanis
Rīga, 1 July 1997
1 The Parliament of the Republic of
Latvia
Translation © 2015 Valsts valodas centrs (State
Language Centre)