Медичне забезпечення в установах виконання покарань: аналіз проблеми (з урахуванням практики ЄСПЛ)

Abstract

У статті проаналізовано проблеми належного медичного забезпечення осіб, позбавлених волі, крізь призму міжнародних стандартів і застосування практики Європейського суду з прав людини. Визначено ключові критерії належної медичної допомоги, виявлено системні недоліки пенітенціарної медицини в Україні та обґрунтовано напрями щодо її вдосконалення з урахуванням принципу еквівалентності надання медичних послуг й гарантій прав людини в місцях позбавлення волі. The article is devoted to a comprehensive analysis of the problems of ensuring proper medical care for persons deprived of liberty through the prism of international human rights protection standards and the case law of the European Court of Human Rights. It is substantiated that the quality and accessibility of medical care in penitentiary institutions constitute one of the key indicators of adherence to the rule of law, respect for human dignity, and the effectiveness of the state human rights protection system. Particular emphasis is placed on the heightened vulnerability of persons held in places of detention, given their complete dependence on state institutions in matters of health care.Based on an analysis of the judgments of the ECtHR, in particular in cases against Ukraine, the main criteria of “adequate medical care” in conditions of deprivation of liberty are identified. These include timely access to a physician, proper diagnosis, continuity and effectiveness of treatment, as well as the compatibility of detention conditions with prisoners’ medical needs. It is demonstrated that the formal provision of medical procedures without achieving a real clinical outcome does not meet the standards of Article 3 of the Convention for the Protection of Human Rights and Fundamental Freedoms.The article analyzes Ukrainian national legislation in the field of medical care for convicted persons and establishes that, despite its formal compliance with international standards, the practice of its implementation remains problematic. Systemic shortcomings of penitentiary medicine are identified, including the institutional dependence of medical staff on prison administrations, insufficient funding and shortages of specialized personnel, outdated material and technical resources, and the ineffectiveness of national legal remedies.On the basis of generalizing the case law of the European Court of Human Rights and international recommendations, the article proposes key directions for improving the system of medical care for persons deprived of liberty. These include completing the integration of penitentiary medicine into the civilian health care system, ensuring the genuine implementation of the principle of equivalence of medical care, strengthening guarantees of the professional independence of physicians, and enhancing the role of judicial and non-judicial oversight. It is concluded that the implementation of these measures is a necessary condition for fulfilling Ukraine’s international obligations and reducing the number of human rights violations in places of detention.