Ethical principles of formation of the state policy of organizing the provision of medical services

The thesis is devoted to the agenda onpromotion of ethical norms in the formation and implementation of state policy of organizingthe medical services. The legislative environment of ethical behavior and deontology of medical workers in Ukraine and ethics of providing paid medical services have been analyzed. The possibilities of building ethical infrastructure in the field of medical services in Ukraine have been considered. The algorithm for developing or revising the state policy under study has been proposed

Articulation of the problem. The rapid recent public events, especially the COVID-19 pandemic, the crises in the healthcare system, the long duration and incompleteness of reforms in this system have shown the imperfection of the current legislation and administrative decisions on state healthcare policy formation in general in our country and, in particular, the process of organizingthe provision of medical services as its part. The possible way out of this situation is a review of the state policy of organizingthe provision of medical services, as a tactical decision in the strategic planning of state healthcare policy.

Analysis of recent studies and publications. The issue of formation and implementation of state policy in the field of healthcare and its components in the public and administrative context is considered by such scientists as Bilynska M., Vasiuk N., Kniazevych V., Radysh Y. et alia (aspects of understanding the state policy in the field of healthcare, formation of the corresponding state policy, organizational and statutory system, etc.); Hladun Z., Huliaiev O., Kalashnyk N., Klos L., Khudoba O. et alia (sectoral healthcare policies, change of priorities in different areas of healthcare, organizing the provision of medical services at different levels of the healthcare system, etc.); Syniuta I., Haydis D., Cheskhovska I. et alia (legal and organizational principles of ethics of medical activity).

Allocation of previously unresolved parts of the overall agenda. The issues of ethical principles of formation of the state policy of organizing the provision of medical services require additional study and search for ways to overcome the current crisis in the medical field, with a focus on studiesof the mental and ethical and deontological nature of this crisis.

Presentation of the main material. The rapid development of technology over the past two decades, including in the medical field, has created a huge and extensive field of medical services providing both saving of life and enhancing its quality. The main dilemma is what is the moral limit in determining the availability of medical service for the vast majority of the population, how to implement these principles in the state policy of organizingthe provisions of medical services. It is the context of realization of spiritual and social needs that includes the issues of ethics, including the ethics of providing medical services, their accessibility and coincidence of worldviews of those people who formthe state policy at different levels and consumers of services. In other words, in addition to the individual and the state, the business, sports/physical education sector (health preservation content), education, religious communities, security sector, etc. are involved in the realization of the right for health. Our study is of an applied nature, because changes in the principles of cooperation between the individual and the state begin with the awareness of each person – that is acceptance or refusal to accept –of new conditions for living together, including ethical ones.

In order to develop and implement an effective state policy for healthcare field reformation, the system must go through the following three stages: taking political and administrative decisions, their implementation and evaluation of the reform results. The main criteria for determining the priority of the development direction are the prevalence of the disease and the economic ability to provide the specified medical service (medical guarantee). But everyone has the same right for health and medical care, regardless of the prevalence of the disease. Another ethical dilemma is whether a year term is enough to establish a system of providing medical services in a particular area at all levels of the medical care system.

Conclusions. We propose the following algorithm for forming / revising the state policy of organizing the provision of medical services: determining the social need / the most popular types of medical services (both components are equally important), taking political and administrative decisions, their implementation and evaluation of the reform results. The indicative approach should be applied and, depending on the indicators, the priority direction of development will be determined. The following components of ethical infrastructure shall be used to form the state policy oforganizing the provision of medical services: political will, legislation, codes of conduct, reporting and supervision mechanisms, public control, professional socialization, coordinating bodies, conditions for supporting activities. The areas of further study include the reviewing and detailed treatment of the components of ethical infrastructure of the formation of the state policy of organizing the provision of medical services.