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adamianis uflebebi
adamianis uflebebi janmrTelobis dacvis sferoSi praqtikuli saxelmZRvanelo iuristebisTvis saqarTvelo adamianis uflebebi janmrTelobis dacvis sferoSi praqtikuli saxelmZRvanelo iuristebisTvis saqarTvelo 2011 weli avtorebi: kaxaber aslaniSvili _ iuristi mamuka jibuti _ Tbilisis saxelmwifo samedicino universiteti, sazogadoebrivi jandacvis skolis dekani aleqsandre imedaSvili _ dasavleT-saqarTvelos saolqo prokurori givi javaSvili _ saqarTvelos bioeTikis erovnuli sabWos Tavmjdomare, Tbilisis saxelmwifo samedicino universitetis saojaxo medicinis kaTedris profesori nino kiknaZe _ fondi Ria sazogadoeba saqarTvelo _ kanonis, mediisa da janmrTelobis proeqtis direqtori zaza meiSvili _ saqarTvelos uzenaesi sasamarTlos Tavmjdomaris moadgile, sisxlis samarTlis saqmeTa palatis Tavmjdomare nino mirzikaSvili _ saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministros aparatis ufrosi dizaineri _ Tornike lorTqifaniZe redaqtori _ marina dekanoiZe ISBN: 978-9941-0-3010-9 avtoris/avtorebis mier winamdebare saxelmZRvaneloSi gamoTqmuli mosazreba ar gamoxatavs fondis `Ria sazogadoeba-saqarTvelos~ pozicias. Sesabamisad, fondi ar aris pasuxismgebeli masalis Sinaarsze. Sinaarsi winasityvaoba 4 1 Sesavali 6 2 saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi 16 3 pacientze zrunvis adamianis uflebebis dacvis regionuli sistema 70 4 saerTaSoriso da regionuli procedurebi 118 5 qveynis Sesabamisi SeniSvnebi 136 6 pacientis uflebebi da movaleobebi saqarTveloSi 150 7 provaiderTa erovnuli uflebebi da movaleobebi 206 8 erovnuli procedurebi da damatebebi 238 leqsikoni/terminTa saZiebeli 246 3 winasityvaoba ufleba janmrTelobaze didi xnis manZilze miCneuli iyo, rogorc `meore Taobis ufleba~, rac gulisxmobs, rom igi ar sruldeba erovnul doneze da Sedegad, mis ganxorcielebas arasaTanado yuradreba eTmoba. Tumca es midgoma mniSvnelovnad Seicvala, radgan sxvadasxva qveynebma ufleba janmrTelobaze da misi ZiriTadi elementebi, rogorc fundamenturi ufleba, Seitanes sakuTar konstituciebSi da Sida kanonmdeblobaSi. erovnuli sasamarTloebis mniSvnelovanma gadawyvetilebebma, gansakuTrebiT aziaSi, afrikaSi da laTinur amerikaSi, kidev ufro Seuwyo xeli janmrTelobaze uflebis realizebas da am mimarTlebiT sasamarTlo praqtikis Camoyalibebas. miuxedavad am da sxva pozitiuri cvlilebebis Sedegad miRweuli progresisa fizikuri da mentaluri janmrTelobis umaRlesi standartebis dakmayofilebis mizniT, ufleba janmrTelobaze ar aris srulad realizebuli da xelmisawvdomi yvelasTvis diskriminaciis gareSe, radgan mravali marginaluri da daucveli jgufisaTvis janmrTelobis dacvis maRali standarti kvlav miuwvdomelia. xSirad, jandacvis provaiderebTan urTierTobas Tan axlavs diskriminacia, Seuracxyofa da uflebebis darRveva. gaeros generaluri asambleisadmi wardgenil angariSSi, romelic informirebul Tanxmobasa da uflebas janmrTelobaze exeba, xSir SemTxvevaSi adgili aqvs piradi cxovrebisa da fizikuri xelSeuxeblobis uflebis darRvevas. pacientebsac da eqimebsac sWirdebaT daxmareba, rom janmrTelobis dacvis sferoSi Tavidan airidon, gamoavlinon da aRadginon darRveuli uflebebi, gansakuTrebiT iseT SemTxvevebSi, rodesac pacientsa da eqims Soris urTierTobisas gansxvavebuli ndobis xarisxisa da araTanabari codnis da gamocdilebis Sedegad arsebul uTanasworo SesaZleblobebs, kidev ufro amZafrebs sxvadasxva socialur-ekonomikuri faqtori, rogoricaa klasi, sqesi, eTnikuri warmomavloba da sxva. miuxedav imisa, rom adamianis uflebaTa principebis Sesaxeb mravali publikacia arsebobs, Zalian cota gamocema ukavSirdeba adamianis uflbebis dacvas jandacvis sferoSi, aqedan gamomdinare, mniSvnelovnad miviCnieT aRniSnuli saxelmZRvanelos Seqmna. saxelmZRvaneloSi aRwerili konkretuli sakiTxebi dakavSirebulia mxolod aRmosavleT evropis qveynebTan, Tumca misi gamoyeneba SeiZleba saerTaSoriso donezec. vimedovnebT, momzadebuli masala xels Seuwyobs jandacvis sferoSi arsebuli darRvevebis winaaRmdeg damcavi meqanizmebisa da samarTlebrivi saSualebebis danergvas. saxelmZRvanelo daexmareba, rogorc jandacvis provaiderebs, iuristebs da janmrTelobis dargSi moRvawe pirebs adamianis uflebaTa normebis praqtikis danergvaSi, aseve xels Seuwyobs sazogadoebis cnobierebis amaRlebas da sakuTari uflebebis dacvis moTxovnas janmrTelobis dacvis sferoSi. avtorebma didi da rTuli samuSao Seasrules janmrTelobis uflebis gasamtkiceblad da gansakuTrebul madlobas imsaxureben. aseve madloba minda gadavuxado Ria sazogadoebis instituts am mniSvnelovani naSromis dafinansebisa da gamocemisTvis. darwmunebuli var, praqtikuli saxelmZRvanelo mniSvnelovan rols Seasrulebs jandacvis sferoSi adamianis uflebebis dasacavad da amasTanave iqneba fasdaudebeli wyaro jandacvis uflebis sakiTxze momuSave adamianebisTvis. anand groveri gaeros specialuri momxsenebeli 4 adamianis uflebebi janmrTelobis dacvis sferoSi madlobebi janmrTelobis dacvis sferoSi adaminis uflebebis efeqtuad dacvis gadaudebeli saWiroebidan gamomdinare, saxelmZRvanelo aris im adamianebisa da organizaciebis erToblivi produqti, romelTa mizanicaa dadebiTi cvlilebebis moxdena adamianis uflebebis da jandacvis sferoSi. saxelmZRvanelos mizans warmoadgens daexmaros janmrTelobis dacvis provaiderebs, pacientebs da gansakuTrebiT iuristebs, moaxdinon uflebebis Tanabari realizeba da daicvan adamianis Rirseba. am proeqtis ganxorcielebas mxari dauWira fondma `Ria sazogadoeba saqarTvelom~ (`kanonis, mediisa da janmrTelobis iniciativa~), Ria sazogadoebis institutma (`kanonis da janmrTelobis iniciativa da `adamianis uflebebisa da mmrTvelobis sagranto programa~). Zalian dasafasebelia am organizaciebSi momuSave adamianebis wvlili: nino kiknaZe (fondi `Ria sazogadoeba saqarTvelo); Tamar ezeri da jonaTan koeni, romlebic zogadad zedamxedvelobisa da redeqtirebis garda, arian saerTaSoriso da regionuli procdurebis, pacientis uflebebis da valdebulebebis Tavis da judi overalTan erTad Sesavali nawilis Tanaavtorebi; madlobas vuxdiT mariana berbek rostass regionuli procedurebis Tavis ganaxlebisTvis; pol silvas (Ria sazogadoebis institutis komunikacebis oficeri) saxelmZRvanelos dizainTan dakavSirebiT rCevebisa da koordianciisTvis da jin kriskolas da Tornike lorTqifaniZes saxelmZRvanelos dizainisaTvis. gansakuTrebul madlobas imsaxureben: ian birne, `inerraiTs~-is mTavari iuristi, romelmac dawera janmrTelobis dacvis sferoSi adamianis uflebebis saerTaSoriso da regionuli sistemebi da judi overalTan erTad moamzada saxelmZRvanelos terminTa saZiebeli; ester cernusi erovnuli nawilis redaqtirebisTvis; aseve sara abiola saerTaSoriso da regionuli nawilis stilisturi redaqtirebisTvis, ana krukova ratificirebuli dokumntebis cxrilis momzadebisTvis. madlobas imsaxureben: Tamar dekanosiZe da mariam RavTaZe saboloo redaqtirebisaTvis, abreviaturebis nawilis da cxrilebis momzadebisaTvis da marina kvaWaZe saerTaSoriso samarTlebrivi instrumentbis mimoxilvisTvis. da bolos, es saxelmZRvanelo ver iarsebebda rom ara Ria sazogadoebis institutis konsultantis, judi overalis enTuziazmi da monawileoba am proeqtSi. 5 Tavi 1: Sesavali 1.1 Sesavali 1.2 saxelmZRvanelos mimoxilva 1.3 abreviaturebi 1.4 ratifikaciebis cxrili 6 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 1.1 1 Sesavali 1.1 Sesavali saxelmZRvanelo iuristebisaTvis `janmrTelobis dacvis samarTalSi~ warmoadgns erT-erT mniSvnelovan gamocemas, romelzec muSaobdnen Ria sazogadoebis institutis `kanonis da janmrTelobis~ da `adamianis uflebebisa da mmarTvelobis sagranto programebi~ da fondi `Ria sazogadoeba-saqarTvelos~ _ `kanonis, mediis da janmrTelobis~ iniciativa. saxelmZRvanelo praqtikuli daniSnulebisaa da wamoadgens gzamkvlevs iuristebisaTvis, raTa maT gauadvildeT samarTlebrivi meqanizmebis/instrumentebis gamoyeneba jandacvis sferoSi adamianis uflebebis dasacavad. saxelmZRvanelo mimoixilavs konstituciur debulebebs, konvenciebs, kanonebs, kanonqvemdebare normatiul aqtebs, romlebic dakavSirebulia pacientebTan da jandacvis momsaxurebis mimwodeblebTan. masSi, kategoriebis mixedviT, ganxilulia samedicino momsaxurebis gamwevis da pacientis ufleba-movaleobani. garda amisa, ganxilulia realuri magaliTebi da saqmeebi. 7 Tavi 1: Sesavali 1.2 saxelmZRvanelos mimoxilva ganmartebiTi saxelmZRvanelo iuristebisaTvis `adamianis uflebebi janmrTelobis dacvis sferoSi~ Sedgeba rva Tavisgan. II da III Tavebi mimoixilavs janmrTelobis dacvasTan dakavSirebul adamianis uflebaTa saerTaSoriso da regionul samarTlebriv aqtebs, asev konkretul SemTxvevebsa da magaliTebs. Tavebi miesadageba rogorc pacientis, aseve jandacvis profesionalebis uflebebs. es uflebebia: sicocxlis ufleba, Tavisuflebis da usafrTxoebis ufleba, piradi cxovrebis xelSeuxeblobis ufleba, informaciis miRebis ufleba, simarTlis codnis ufleba, xarisxiani jandacvis momsaxurebis ufleba, jandacvis xelmisawvdomobis ufleba, adekvaturi samuSao pirobebis ufleba, pacientis ufleba, ar gaxdes wamebis, sastiki, aradamianuri da damamcirebeli mopyrobis msxverpli, sajaro politikaSi monawileobis ufleba da diskriminaciis dauSvebloba; IV TavSi ganxilulia am uflebebis dacvis saerTaSoriso da regionuli procedurebi. V, VI, VII da VIII Tavebi mimoixilavs saqarTvelos specifikas sxvadasxva kuTxiT. V TavSi ganxilulia Sesabamisi saerTaSoriso da regionuli SeTanxmebebi, romlebic ratificirebulia saqarTvelos mier, aseve, ama Tu im qveynebis magaliTebi, jandacvis samarTlebrivi sistema. VI Tavi exeba pacientis uflebebsa da movaleobebs evropis qartiidan gamomdinare. qartia Seiqmna 2002 wels aqtiuri moqalaqeebis qselis mier, romelic aris momxmarebelTa da pacientTa organizaciebis evropuli samoqalaqo qseli. evropis pacientis uflebaTa qartia iuridiulad savaldebulo dokumenti araa, magram igi miCneulia pacientis uflebaTa yvelaze naTel da yovlismomcvel dokumentad. qartia cdilobs gadaitanos jandacvisa da adamianis uflebaTa dokumentebi 14 konkretul muxlSi: prevenciuli zomebis miRebis ufleba, xelmisawvdomoba, informaciis miRebis ufleba, informaciuli Tanxmoba, Tavisufali arCevani, piradi cxovrebis pativiscema da konfidencialoba, pacientis drois pativiscema, xarisxobrivi standartebis dacva, usafrTxoeba, novacia, aragardauvali tkivilisa da tanjvis arideba, individualuri mkurnaloba, saCivris Setana da zianis anazRaureba. es uflebebi gamoiyeneba, rogorc saxelmZRvanelo evropaSi janmrTelobis dacvis sistemebis SefasebisTvis da rogorc modeli erovnuli kanonmdeblobisTvis.1 ase rom, me-6 Tavi iyenebs pacientis uflebaTa evropul qartiaSi mocemul uflebebs, rogorc saxelmZRvanelo principebs. amasTanave, TiToeul uflebasTan mimarTebiT gaanalizebulia Sesabamisi erovnuli kanonmdeblobis muxlebi. aRniSnuli uflebebi ganmeorebiT miTiTebulia ufro zogadi uflebebis ganxilvisas saerTaSoriso da regionuli meqanizmebis Sesaxeb TavebSi. VII exeba samedicino momsaxurebis mimwodeblis uflebebsa da movaleobebs, maT Soris gaerTianebis Tavisuflebas, samarTlian sasamarTlo process, saTanado samuSao pirobebsa da sxva Sesabamis uflebebs, romlebic qveynebis Taviseburebidan gamomdinareobs. 1 ix. me-3 Tavi damatebiTi informaciisTvis pacientis uflebaTa evropuli qartiis Sesaxeb 8 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 1.2 VIII Tavi ganixilavs procedurul meqanizmebs pacientisa da samedicino momsaxurebis mimwodeblis uflebebisa da movaleobebis aRsrulebisTvis. pirveli nawili moicavs saerTaSoriso da regionul meqnizmebs, xolo meore _ calkeuli qveynisTvis damaxasiaTebel procedurebs. qveynisTvis damaxasiaTebeli nawili mokled ganixilavs sisxlis, samoqalaqo, administraciul procedurebs da alternatiul meqanizmebs, aseve im dawesebulebebsa da institutebs, romlebic kavSirSi arian Tavisi saqmianobiT adamianis uflebebTan da jandacvasTan (saxalxo damcvelis ofisi, eTikis komitetebi da sxva). saxelmZRvanelos bolo nawili moicavs jandacvis sistemaSi adamianis uflebebTan dakavSirebuli terminebis saZiebels. saxelmZRvanelos gamoyeneba saxelmZRvanelo Seqmnilia rogorc sasamarTloSi davis warmoebis damxmare masalad, aseve treiningebisaTvis. miuxedavad imisa, rom saxelmZRvanelo ZiriTadad iuristebisTvisaa Seqmnili, igi SeiZleba saintereso iyos agreTve eqimebisTvis, sazogadoebrivi janmrTelobis specialistebisaTvis, jandacvis menejerebisaTvis da pacientebisaTvis, romelTac surT ufro axlos gaecnon pacientis da jandacvis mimwodeblis uflebebisa da movaleobebis iuridiul safuZvels da aRsrulebis meqanizmebs. vebgverdi janmrTelobis dacvis sferoSi moqmedi kanonmdebloba da regulaciebi mudmivad icvleba, viTardeba da amitom, saWiroa saxelmZRvaneloSi cvlilebebis Setana regularulad. saxelmZRvanelos eleqtronul versia ganTavsebulia da masSi periodulad Seva cvlilebebi Semdeg vebgverdze: http://www.healthrights.ge avtorebisgan saxelmZRvaneloSi Sesuli masala warmoadgens samarTlisa da medicinis eqspertTa interdisciplinuri samuSao jgufis Sexedulebas. saxelmZRvanelos mizani ar aris Caanacvlos kvalificiuri iuristis samarTlebrivi konsultacia. piriqiT, saxelmZRvanelo aris avtorebis mcdeloba, asaxon samarTlisa da iuridiuli praqtikis Tanamedrove pozicia, janmrTelobis dacvis sistemaSi. avtorebi mzad arian miiRon nebismieri SeniSvna Secdomebis, gamotovebuli informaciis an saWiro damatebebis Sesaxeb, agreTve SekiTxvebi, Tu rogor aregulirebs kanoni calkeul faqtobriv garemoebas. rogorc saxelmZRvanelo gviCvenebs, adamianis uflebebi jandacvis sferoSi jer kidev axali dargia da viTardeba. saxelmZRvaneloSi mocemuli bevri debulebis interpretacia jer ar momxdara sasamarTloebis mier da kvlav mzadaa gamoyenebisa da interpretaciisTvis. janmrTelobis dacvis sistemaSi adamianis uflebebis praqtikuli gamoyenebis mxriv vxvdebiT mniSnelovan xarvezebs. ase rom, es saxelmZRvanelo aris iuridiuli kvlevis dasawyisi da ar Seicavs saboloo pasuxebs adaminis uflebebTan da jandacvasTan dakavSirebiT. 9 Tavi 1: Sesavali 1.3 abreviaturebi AC (Advisory Committee) - mrCevelTa komiteti CAT (Convention Against Torture and Other Forms of Cruel, Inhuman, or Degrading Treatment or Punishment) - konvencia wamebis da sxva sastiki, araadamianuri an Rirsebis Semlaxavi mopyrobis an sasjelis winaaRmdeg CE (ILO Committee of Experts) - Sromis saerTaSoriso organizaciis eqspertTa komiteti CEDAW (Convention on the Elimination of All Forms of Discrimination Against Women) - konvencia qalTa mimarT diskriminaciis yvela formis aRmofxvris Sesaxeb CERD (Committee on the Elimination of Racial Discrimination) - rasobrivi diskriminaciis aRmofxvris komiteti CES CR (Committee on Economic, Social and Cultural Rights) - ekonomikur, socialur da kulturul uflebaTa komiteti CHR (Commission on Human Rights) - adamianis uflebaTa komisia CMW (International Convention on the Protection of the Rights of All Migrant Workers and Members of their Families) - migranti muSebisa da maTi ojaxis wevrebis uflebebis dacvis saerTaSoriso konvencia COE (Council of Europe) - evropis sabWo CRC (Committee on the Rights of the Child) - bavSvis uflebaTa komiteti CRPD (Convention on the Rights of Persons with Disabilities) - konvencia SezRuduli SesaZleblobebis mqone pirTa uflebebis Sesaxeb ECHR (European Convention on Human Rights) - adamianis uflebaTa da ZiriTad TavisuflebaTa dacvis evropuli konvencia ECtHR (European Court of Human Rights) - adamianis uflebaTa evropuli sasamarTlo ECOSOC (UN Economic and Social Council) - gaeros ekonomikuri da socialuri sabWo ECSR (European Committee on Social Rights) - socialur uflebaTa evropuli komiteti EPHA (European Public Health Alliance) - sazogadoebrivi jandacvis evropuli aliansi ESC (European Social Charter) - evropis socialuri qartia EU (European Union) - evrokavSiri FCNM (Framework Convention for the Protection of National Minorities) - CarCo konvencia erovnul 10 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 1.3 umciresobaTa dacvis Sesaxeb HRC (Human Rights Committee) - adamianis uflebaTa komiteti IAPO (International Alliance of Patients’ Organizations) - pacientTa organizaciebis saerTaSoriso aliansi ICCPR (International Covenant on Civil and Political Rights) - saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb ICERD (International Convention on the Elimination of All Forms of Racial Discrimination) - saerTaSoriso konvencia rasobrivi diskriminaciis yvela formis likvidaciis Sesaxeb ICES CR (International Covenant on Economic, Social and Cultural Rights) - saerTaSoriso paqti ekonomikuri, socialuri da kulturuli uflebebis Sesaxeb ICN (International Council of Nurses) - eqTnebis saerTaSoriso sabWo ILO (International Labour Organization) - Sromis saerTaSoriso organizacia OHCHR (Office of the High Commissioner for Human Rights) - adamianis uflebaTa umaRlesi komisris ofisi SR (Special Rapporteur on the Rights to Health) - specialuri momxsenebeli jandacvis uflebebis Sesaxeb UDHR (Universal Declaration of Human Rights) - adamianis uflebaTa sayovelTao deklaracia UN (United Nations) - gaero UPR (Universal Periodic Review) - universaluri perioduli gadaxedva WHO (World Health Organization) - msoflio jandacvis organizacia WMA (World Medical Association) - msoflios eqimTa asociacia 11 Tavi 1: Sesavali 1.4 ratifikaciis cxrili dokumenti mierTebis TariRi/ Setyobineba xelmoweris TariRi ratificirebis TariRi ZalaSi Sesvla moqmedeba qveynis kanonmdeblobaSi daTqma saerTaSoriso saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb 03.05.94 03.08.94 moqmedebs arcerTi samoqalaqo da politikuri uflebebis Sesaxeb saerTaSoriso paqtis fakultaturi oqmi 03.05.94 03.08.94 moqmedebs arcerTi saerTaSoriso paqti ekonomikuri, socialuri da kulturuli uflebebis Sesaxeb 03.05.94 03.08.94 moqmedebs arcerTi qalTa diskriminaciis yvela formis aRmofxvris konvencia 26.10.94 25.11.94 moqmedebs arcerTi konvencia rasobrivi diskriminaciis yvela formis likvidaciis Sesaxeb 26 .10.94 02.07.99 moqmedebs 1 konvencia wamebisa da sxva sastiki, araadamianuri an Rirsebis Semlaxavi mopyrobis an dasjis winaaRmdeg 26.10.94 25.11.94 moqmedebs 2 wamebisa da sxva sastiki, araadamianuri an damamcirebeli mopyrobis an dasjis winaaRmdeg konvenciis fakultaturi oqmi 26.10.94 22.06.06 moqmedebs arcerTi bavSvis uflebaTa konvencia 02.06.94 02.07.94 moqmedebs arcerTi yvela migranti muSisa da maTi ojaxis wevrebis uflebaTa dacvis saerTaSoriso konvencia 02.06.94 moqmedebs arcerTi SezRuduli SesaZleblobis mqone pirTa uflebaTa konvencia 10.07.09 evropuli (regionaluri) biologiasa da medicinaSi adamianis uflebebis da Rirsebis dacvis Sesaxeb konvencia: 22.11.00 11.05.00 27.09.00 01.03.01 moqmedebs arcerTi konvencia adamianis uflebebisa da biomedicinis Sesaxeb, 1997 22.11.00 11.05.00 27.09.00 01.03.01 moqmedebs arcerTi 12 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 1.4 dokumenti mierTebis TariRi/ Setyobineba xelmoweris TariRi ratificirebis TariRi ZalaSi Sesvla moqmedeba qveynis kanonmdeblobaSi daTqma biologiasa da medicianSi adamianis uflebebis da Rirsebis 18.12.02 25.03. 02 27.09.02 01.05.06 moqmedebs arcerTi 11.05. 00 27.09.00 01.03.01 moqmedebs arcerTi 25.03. 02 27.09.02 01.05.06 moqmedebs arcerTi 21.02. 05 08.04.10 01.08.10 moqmedebs arcerTi 27.04.99 20.05.99 20.5.1999 moqmedebs arcerTi dacvis Sesaxeb konvenciis damatebiTi oqmi adamianis klonirebis akrZalvis Sesaxeb adamianis uflebebisa da biomedicinis Sesaxeb konvenciis damatebiTi oqmi adamianis organoebisa da qsovilebis gadanergvis Sesaxeb adamianis uflebebisa da biomedicinis Sesaxeb konvenciis damatebiTi oqmi biosamedicino kvlevis Sesaxeb 22.11.00 18.12.02 adamianis uflebebisa da biomedicinis Sesaxeb konvenciis damatebiTi oqmi janmrTelobis dacvis mizniT genetikuri testirebis Sesaxeb adamianis uflebaTa da ZiriTad TavisuflebaTa dacvis konvencia (adamianis uflebaTa evropuli konvencia) evropis socialuri qartia 1961 evropis socialuri qartia 1996 erovnul umciresobaTa dacvis Sesaxeb evropuli CarCo konvencia 22.08.05 30.06.00 moqmedebs 01.10.00 22.12.05 01.04.06 1 moqmedebs arcerTi 21.01.00 evro gaerTianebis fundamenturi uflebebis qartia adamianis uflebaTa dacvis deklaracia 15.09.91 1949 wlis 12 agvistos Jenevis konvencia moqmed jarSi daWrilTa da avadmyofTa mdgomareobis gaumjobesebis Sesaxeb 20.07.93 1949 wlis 12 agvistos Jenevis konvencia sazRvao SeiaraRebul ZalebSi daWrilTa, avadmyofTa da gemis katastrofis msxverplTa mdgomareobis gaumjobesebis Sesaxeb 20.07.93 moqmedebs 14.03.94 moqmedebs arcerTi 14.03.94 moqmedebs arcerTi 13 Tavi 1: Sesavali dokumenti ratificirebis TariRi ZalaSi Sesvla moqmedeba qveynis kanonmdeblobaSi daTqma 1949 wlis 12 agvistos Jenevis konvencia omis tyveebis mopyrobis Sesaxeb 20.07.93 14.03.94 moqmedebs arcerTi konvencia socialuri politikis ZiriTadi miznebisa da standartebis Sesaxeb, 1062 16.10.96 21.10.98 moqmedebs gaeros konvencia narkotikuli saSualebebisa da fsiqotropul nivTierebaTa ukanono trafikis Sesaxeb 28.05.97 08.04.98 moqmedebs arcerTi gaeros konvencia fsiqotropul nivTierebaTa Sesaxeb 28.05.97 08.04.98 moqmedebs arcerTi konvencia bavSvTa dacvisa da saerTaSoriso gaSvilebis sferoSi TanamSromlobis Sesaxeb 01.08.99 01.08.99 moqmedebs arcerTi gaeros konvencia narkotikul saSualebaTa Sesaxeb 23.02.00 26.04.00 moqmedebs arcerTi adamianis uflebaTa da ZiriTad TavisuflebaTa dacvis evropuli konvenciis oqmi N4 23.02.00 13. 04. 00 moqmedebs arcerTi adamianis uflebaTa da ZiriTad TavisuflebaTa dacvis evropuli konvenciis oqmi N6 23.02.00 01. 05. 00 moqmedebs arcerTi adamianis uflebaTa da ZiriTad TavisuflebaTa dacvis evropuli konvenciis oqmi N7 13.04.00 01. 07. 00 moqmedebs arcerTi wamebisa da araadamianuri an damamcirebeli mopyrobis an dasjis aRkveTis evropuli konvencia 20.06.00 01.10.00 moqmedebs 1 wamebisa da araadamianuri an damamcirebeli mopyrobis an dasjis evropuli konvenciis damatebiTi oqmi N 1 20.06.00 01.03.02 moqmedebs arcerTi wamebisa da araadamianuri an damamcirebeli mopyrobis an dasjis evropuli konvenciis damatebiTi oqmi N 2 20.06.00 01.03.02 moqmedebs arcerTi adamianis uflebaTa da ZiriTad TavisuflebaTa dacvis evropuli konvenciis oqmi N 12 15.06.01 01.04.05 moqmedebs 1 14 mierTebis TariRi/ Setyobineba xelmoweris TariRi adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 1.4 dokumenti mierTebis TariRi/ Setyobineba xelmoweris TariRi ratificirebis TariRi ZalaSi Sesvla moqmedeba qveynis kanonmdeblobaSi daTqma adamianis uflebaTa da ZiriTad TavisuflebaTa dacvis evropuli konvenciis oqmi N 1 27.12.01 07.06.02 moqmedebs 2 konvencia bavSvTa Sromis ukiduresi formebis akrZalvisa da dauyovnebliv aRmofxvris RonisZiebebis Sesaxeb 18.05.02 24.07.03 moqmedebs arcerTi bavSvTa uflebebis Sesaxeb konvenciis damatebiTi oqmi SeiaraRebul konfliqtebSi bavSvTa monawileobis Sesaxeb 21.06.02 qalTa diskriminaciis yvela formis aRmofxvris konvenciis me-20 muxlis I punqtis Sesworeba 27.09.02 30.09.05 moqmedebs arcerTi bavSvis uflebebis konvenciis damatebiTi oqmi bavSvebiT vaWrobis, bavSvTa prostituciisa da bavSvTa pornografiis Sesaxeb 27.09.02 28.07.05 moqmedebs arcerTi moqmedebs 15 2.1 Sesavali 2.2 ZiriTadi wyaroebi 23 pacientis uflebebi Tavisuflebis da usafrTxoebis ufleba piradi cxovrebis xelSeuxeblobis ufleba informaciis miRebis ufleba fizikuri xelSeuxeblobis ufleba sicocxlis ufleba ufleba janmrTelobis umaRles xelmisawvdom standartebze wamebis da sastiki, araadamianuri da damamcirebeli mopyrobis akrZalva sajaro politikaSi monawileobis ufleba diskriminaciis akrZalva da Tanasworobis ufleba 2.4 janmrTelobis uflebebi dacvis momsaxurebis mimwodebelTa/provaiderTa saTanado pirobebSi muSaobis ufleba Sekrebisa da gaerTianebis Tavisufleba samarTalwarmoebis ufleba da Sesabamisi uflebebi 16 adamianis uflebebi janmrTelobis dacvis sferoSi 2 saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi 2.1 Sesavali winamdebare TavSi warmodgenilia pacientTa mzrunvelobis sferoSi arsebuli adamianis uflebebis dacvis saerTaSoriso standartebi da ganmartebebi, Tu rogor aris interpretirebuli es standartebi gaerTianebuli erebis organizaciis xelSekrulebebSi. Tavi dayofilia sam nawilad: pirvel nawilSi aRwerilia janmrTelobis dacvis sferoSi arsebuli adamianis uflebebis ZiriTadi saerTaSoriso wyaroebi; meore Tavi exeba pacientTa uflebebs, xolo mesame provaiderebis uflebebs. yvela nawili moicavs qveTavebs, romlebSic ganxilulia standartebi da mocemulia Sesabamisi uflebis interpretacia (magaliTad, adamianis Tavisuflebis da usafrTxoebis ufleba), aseve SesaZlo uflebadarRvevis magaliTebi. mocemuli standartebi moicavs, rogorc savaldebulo Zalis mqone xelSekrulebebs (rogoricaa magaliTad samoqalaqo da politikuri uflebebis saerTaSoriso paqti), aseve gaeros da arasamTavrobo organizaciebis mier SemuSavebul arasavaldebulo Zalis mqone dokumentebs (magaliTad msoflio eqimTa asociaciis deklaracia pacientTa uflebebze). 17 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi 2.2 ZiriTadi wyaroebi gaeros dokumentebi adamianis uflebaTa sayovelTao deklaracia 1948 adamianis uflebaTa sayovelTao deklaracia ar aris saerTaSoriso xelSekruleba, magram adamianis uflebaTa saerTaSoriso samarTlis ganviTarebaSi mis mier Setanili mniSvnelovani wvlilidan da im faqtidan gamomdinare, rom misi debulebebi efeqturadaa gadmocemuli saerTaSoriso SeTanxmebebSi, misma mravalma debulebam saerTaSoriso CveulebiTi samarTlis xasiaTi SeiZina da amdenad, mas sayovelTaod da udavod miiCneven. deklaraciis ZiriTadi debulebebi moicavs: • muxli me-3 (sicocxlis ufleba); • muxli me-5 (wamebis, sastiki, araadamianuri an Rirsebis Semlaxavi mopyrobis akrZalva); • muxli me-7 (diskriminaciis akrZalva); • muxli me-12 (piradi cxovrebis xelSeuxeblobis ufleba); • muxli me-19 (informaciis moZiebis, miRebisa da gavrcelebis ufleba); • muxli 25-e (janmrTelobis dacvis ufleba). saerTaSoriso xelSekrulebebi1 Svidive ZiriTadi saerTaSoriso xelSekruleba adamianis uflebaTa Sesaxeb, moicavs adamianis uflebebis dacvis saTanado garantiebs pacientebze mzrunvelobis sferoSi. miuxedavad imisa, rom es xelSekrulebebi mxolod im saxelmwifoebisTvisaa savaldebulo, romelTac maTi ratifikacia ganaxorcieles, maT standartebs aramonawile saxelmwifoebisTvisac mZlavri moraluri da politikuri Zala aqvs. umetesoba am xelSekrulebaTagan (iseTebi, rogorebicaa zemoxsenebuli ori saerTaSoriso konvencia da bavSvTa uflebebis Sesaxeb saerTasoriso konvencia, gansakuTrebiT am ukanasknelis SemTxvevaSi) ratificerebulia saxelmwifoTa didi umravlesobis mier. am xelSekrulebebiT Seqmnili saerTaSoriso organoebis mier gamocemulia mravali `zogadi komentari~, rac qmnis saerTaSoriso xelSekrulebaTa standartebis ganmartebis kvalificiur saxelmZRvanelos. magaliTad, ekonomikur, socialur da kulturul uflebaTa komitetma gamosca me-14 zogadi komentari konvenciis me-12 muxlze, romelmac ufleba janmrTelobaze ganmarta, rogorc adamianis ufleba, akontrolebdes sakuTar janmrTelobasa da sxeuls. 1 18 ix. ratificirebuli xelSekrulebebis cxrili: http://www2.ohchr.org/english/bodies/docs/status.pdf adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.2 xelSekrulebebiT Seqmnili yvela organo, zedamxedvelobs saxelmwifoTa moqmedebebis Sesabamisobas amave saxelmwifoebis perioduli angariSebis meSveobiT da gamoscems Semajamebel Sefasebebs. iseTebi ki, rogoricaa adamianis uflebaTa saerTaSoriso komiteti, qalTa diskriminaciis aRmofxvris komiteti (CEDAW), wamebis sawinaaRmdego komiteti (CAT), rasobrivi diskriminaciis aRmofxvris komiteti (CERD) da SezRuduli SesaZleblobebis mqone pirTa uflebebis komiteti (CRPD) individualur saCivrebsac ganixilaven. zemoT aRniSnuli erTobliobaSi gamoiyeneba saerTaSoriso standartebis interpretaciisTvis. ` saerTaSoriso paqti samoqalaqo da politikur uflebaTa Sesaxeb (ICCPR)2 adamianis uflebaTa sayovelTao deklaraciasa da ekonomikur, socialur da kulturul uflebaTa saerTaSoriso paqtTan erTad, qmnis adamianis uflebaTa saerTaSoriso bils (aqts). samoqalaqo da politikur uflebaTa Sesaxeb paqtis Sesrulebas zedamxedvelobas uwevs adamianis uflebaTa komiteti. Sesatyvisi debulebebi moicavs: • muxli 2(1) (diskriminaciis akrZalva); • muxli 6 (sicocxlis ufleba); • muxli 7 (wamebis akrZalva); • muxli 9 (usafrTxoebisa da Tavisuflebis ufleba); • muxli 10 (dakavebulTa ufleba Rirseul mopyrobaze); • muxli 17 (piradi cxovrebis xelSeuxebloba); • muxli 19(2) (ufleba informaciaze); • muxli (26) (kanonis winaSe Tanasworoba). ` ekonomikur, socialur da kulturul uflebaTa Sesaxeb saerTaSoriso paqti (ICESCR)3 Sesrulebas zedamxedvelobas uwevs ekonomikur, socialur da kulturul uflebaTa komiteti. ZiriTadi debuleba: • me-12 muxli (ufleba janmrTelobis dacvis umaRles miRwevad standartze), romelic ganmartebulia zemoxsenebuli me-14 zogadi komentariT.4 2 ix. teqsti ing. enaze: http://www2.ohchr.org/english/law/ccpr.htm 3 ix. teqsti ing. enaze: http://www2.ohchr.org/english/law/cescr.htm 4 ix. teqsti ing. enaze: http://daccessdds.un.org/doc/UNDOC/GEN/G00/439/34/PDF/G0043934.pdf?OpenElement 19 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi sxva Sesabamisi debulebebia: • muxli 2(1) (diskriminaciis akrZalva); • muxli 10(3) (bavSvTa dacva); • muxli 11 (cxovrebis adekvaturi standarti). ` konvencia qalTa diskriminaciis yvela formis aRmofxvris Sesaxeb (CEDAW)5 Sesrulebas zedamxedvelobs qalTa diskriminaciis aRmofxvris komiteti (CEDAW). konvenciis ZiriTadi debulebebia: • muxli 12 (janmrTelobis dacvis sferoSi qalTa diskriminaciis aRmofxvra); • muxli 14(2)(b) (soflad mcxovreb qalTa ufleba janmrTelobis dacvis adekvatur saSualebebze) (ix. aseve, 24-e `zogadi rekomendacia“ konvenciis me-12 muxlze (qali da janmrTeloba) _ qalTa janmrTelobis moTxovnebis safuZvliani analizi da rekomendaciebi samTavrobo moqmedebebisaTvis) ` rasobrivi diskriminaciis yvela formis aRmofxvris Sesaxeb konvenciis (CERD)6 Sesrulebas zedamxedvelobs rasobrivi diskriminaciis aRmofxvris komiteti. konvenciis ZiriTadi debulebaa: • muxli 5(1)(e) (rasobrivi diskriminaciis akrZalva sazogadoebriv jandacvasa da samedicino momsaxurebis gawevis procesSi) ` konvenciis wamebisa da sxva sastiki, araadamianuri an Rirsebis Semlaxavi mopyrobis an dasjis winaaRmdeg (CAT)7 Sesrulebas zedamxedvelobs wamebis sawinaaRmdego komiteti. komitetma 2006 wels SeimuSava axali damatebiTi oqmi, romelic mimarTulia wamebis prevenciaze. ` bavSvis uflebaTa konvenciis (CRC)8 Sesrulebas zedamxedvelobs bavSvis uflebaTa dacvis komiteti. konvencia Seicavs samoqalaqo, politikur, ekonomikur, socialur da kulturul uflebebisa da garantiebis farTo speqtrs. konvenciis ZiriTadi debulebaa: • muxli 24 (ufleba janmrTelobis dacvis umaRles miRwevad standartze) 5 ix. teqsti ing. enaze: http://www2.ohchr.org/english/law/cedaw.htm 6 ix. teqsti ing. enaze: http://www2.ohchr.org/english/law/cerd.htm 7 ix. teqsti ing. enaze: http://www2.ohchr.org/english/law/cat.htm 8 ix. teqsti ing. enaze: http://www2.ohchr.org/english/law/crc.htm 20 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.2 ` saerTaSoriso konvencia yvela migranti muSa-mosamsaxurisa da maTi ojaxis wevrebis dacvis Sesaxeb (CMW)9 Sesrulebas zedamxedvelobs migrant muSa-mosamsaxureTa uflebebis dacvis komiteti. konvencia moicavs samoqalaqo, politikur, ekonomikur, socialur da kulturul uflebebisa da garantiebis farTo speqtrs. konvenciis ZiriTadi debulebebia: • muxli 28 (ufleba samedicino momsaxurebaze); • muxlebi 43 da 45(1)(g) (Tanaswori mopyroba janmrTelobis dacvaSi). ` konvencia SezRuduli SesaZleblobebis mqone pirTa uflebebis dacvis Sesaxeb (DRC)10 (ZalaSia 2008 wlis 12 maisidan) konvenciis mizania fizikuri da fsiqikuri problemebis mqone pirebis uflebebis dacva. konvencia moicavs samoqalaqo, politikur, ekonomikur, socialur da kulturul uflebebisa da garantiebis farTo speqtrs. konvenciis ZiriTadi debulebebia: muxli 25 (janmrTeloba) sxva Sesabamisi debulebebi moicavs: • mux. 5 (Tanasworoba da diskriminaciis akrZalva); • mux. 6 da 7 (qalebi da bavSvebi); • mux. 9 (samedicino obieqtebis da momsaxurebis xelmisawvdomoba); • mux. 10 (sicocxlis ufleba); • mux. 14 (Tavisufleba da usafrTxoeba); • mux. 15 (wamebis akrZalva); • mux. 16 (eqpluataciis da Zaladobis akrZalva); • mux. 17 (fizikuri da fsiqikuri xelSeuxebloba); • mux. 19 (damoukidebeli cxovreba); • mux. 21 (informaciis xelmisawvdomoba); 9 ix. teqsti ing. enaze: http://www2.ohchr.org/english/law/cmw.htm 10 ix. teqsti ing. enaze: http://www2.ohchr.org/english/law/disabilities-convention.htm 21 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi • mux. 22 (piradi cxovrebis pativiscema); • mux. 26 (habilitacia da reabilitacia); • mux. 29 (sazogadoebrov cxovrebaSi monawilebis ufleba). specialuri momxsenebeli janmrTelobis uflebis Sesaxeb:11 specialuri momxsenebeli gaeros mandatiT aRWurvili damoukidebeli eqspertia (amJamad anand groveri, romelmac 2008 wlis agvistoSi prof. pol hanti Secvala), romelic ikvlevs imas, Tu rogor unda moxdes janmrTelobis dacvis uflebis, rogorc umaRlesi miRwevadi standartis, efeqturi ganxorcieleba. igi amzadebs yovelwliur angariSs da siRrmiseulad swavlobs calkeul sakiTxebs. magaliTisaTvis, 2007 wlis seqtemberSi, man Seqmna gzamkvleli farmacevtuli kompaniebisaTvis medikamentebis xelmisawvdomobis Sesaxeb.12 specialuri momxseneblis erT-erTi amJamindeli prioriteti jandacvis profesionalebTan muSaobaa: „zomierni rom viyoT, vityodi, rom janmrTelobis dacvis sferos profesionalebs xSirad arc smeniaT janmrTelobis dacvis uflebis Sesaxeb. Tu ram smeniaT, maT xSirad warmodgena ara aqvT, ras niSnavs es konceptualurad an yoveldRiur cxovrebaSi. amasTan, isini xSirad Relaven da goniaT, rom es ufleba maT problemebs SeuqmniT.~13 sxva saerTaSoriso dokumentebi ` patimarTa mopyrobis gaeros standartuli wesebi14; ` nebismieri formiT dakavebuli yvela piris dacvis gaeros principebis erToblioba15; ` gaeros principebi fsiqikuri problemebis mqone pirTa da fsiqikuri janmrTelobis dacvis gaumjobesebis Sesaxeb16 sxva dokumentebi zemoT CamoTvilis garda, arsebobs sxvadasxva saerTaSoriso dokumentebi, romelTac ar aqvT iuridiuli Zala, magram warmoSoben Zlier politikur da moralur valdebulebas. ` jandacvis msoflio organizaciis deklaracia 197817 11 http://www2.ohchr.org/english/issues/health/right/ 12 ix. teqsti: http://www2.ohchr.org/english/issues/health/right/docs/draftguid.doc 13 specialuri momxseneblis angariSi fizikuri da fsiqikuri janmrTelobis umaRles miRwevad standartze xelmisawvdomobis uflebis Sesaxeb 2007 (A/HRC/4/28) par.43. 14 ix. teqsti ing. enaze: http://www2.ohchr.org/english/law/treatmentprisoners.htm 15 ix. teqsti ing. enaze: http://www2.ohchr.org/english/law/bodyprinciples.htm 16 ix. teqsti ing. enaze: http://www2.ohchr.org/english/law/principles.htm 17 ix. teqsti ing. enaze: http://www.who.int/hpr/NPH/docs/declaration_almaata.pdf 22 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.2 deklaracia gansazRvravs, janmrTelobis definicias da ambobs, rom janmrTelobaze xelmisawvdomoba adamianis fundamenturi uflebaa (muxli 1). deklaracia mTavar yuradRebas uTmobs pirveladi janmrTelobis dacvis mniSvnelobas. ` advokatTa qartia janmrTelobis uflebis Sesaxeb, 2005 weli (advokatTa saerTaSoriso kavSiri).18 qartia Seexeba Tanxmobisa da piradi cxovrebis sakiTxebs. ` deklaracia pacientTa uflebebis Sesaxeb, 2005 (msoflio samedicino asociacia) (WMA)19 deklaracia exeba iseT sakiTxebs, rogoricaa: konfidencialoba, informaciis miRebis ufleba da informirebuli Tanxmoba. deklaracias preambulaSi vkiTxulobT: bolo drois ganmavlobaSi, eqimebs, pacientebsa da farTo sazogadoebas Soris urTierTobebma mniSvnelovani cvlilebebi ganicada. im dros, rodesac eqimma unda imoqmedos sindisis karnaxiT da yovelTvis pacientis interesebidan gamomdinare, Tanabari ZalisxmeviT unda iqnes uzrunvelyofili pacientis avtonomiuroba da samarTlianoba. winamdebare deklaracia warmoadgens pacientTa zogierT im uflebebs, romlebic samedicino profesionalTa mier gaTavisebul da mxardaWeril unda iyos. eqimebs, sxva pirebsa da organizaciebs, romlebic monawileoben samedicino momsaxurebis miwodebis procesSi, gaaCniaT erToblivi pasuxismgebloba am uflebaTa aRiarebasa da uzrunvelyofaze. im SemTxvevaSi Tu kanonmdebloba, mTavrobis saqmianoba an sxva romelime administraciuli dawesebuleba ar asrulebs pacientTa am uflebebs, eqimebma Zalisxmeva unda mimarTon raTa es uflebebi uzrunvelyofil an aRdgenil iqnes. ` deklaracia pacientze orientirebuli janmrTelobis dacvis Sesaxeb, 2007 (pacientTa organizaciebis saerTaSoriso aliansi) (IAPO)20 deklaraciis Seqmnis mizani iyo pacientTa interesebis da saWiroebebis warmoCena jandacvis saerTaSoriso, regionul da nacionalur politikaze zegavlenis mosaxdenad. dokumenti ganamtkicebs xuT princips: pativiscema: pacientebsa da pacientis kanonier warmomadgenlebs, meurveebsa da mzrunvelebs ufleba aqvT moiTxovon pacientze orientirebuli jandacva da pacientisaTvis nebis Tavisufali gamoxatvis ufleba; arCevani da gaZliereba: pacientebs aseve ufleba aqvT, maTi SesaZleblobis fargelebSi monawileoba miiRon iseTi gadawyvetilebebis miRebis procesSi, rac gavlenas axdens maT cxovrebaze. jandacvis momsaxurebam unda uzrunvelyos pacientTa saWiroebebis Sesabamisi mkurnalobisa da menejmentis arCevanis saSualeba, unda moxdes pacientTa organizaciebis gaZliereba, raTa maT efeqturad SeZlon pacientebis da maTi ojaxebis daxmareba. pacientTa monawileoba jandacvis politikaSi: pacientebma da pacientTa organizaciebma monawileoba unda miiRon jandacvis politikis SemuSavebis yvela safexurze, raTa uzrunvelyofili iyos, rom politika pacientTa interesebzea orientirebuli. monawileoba ar 18 ix. teqsti ing. enaze: www.uianet.org/documents/qquia/resolutions/Sante4GB.pdf 19 ix. teqsti ing. enaze: www.wma.net/e/policy/l4.htm 20 ix. teqsti ing. enaze: www.patientsorganizations.org/ 23 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi unda Semoifarglebodes mxolod jandacvis sferoTi, aramed pacientTa CarTuloba uzrunvelyofili unda iyos sxva iseT sferoebSic (magaliTad socialuri politika), rac gavlenas axdens maT cxovrebaze. xelmisawvdomoba da mxardaWera: jandacvis momsaxureba xelmisawvdomi unda iyos pacientebisTvis, rac gulisxmobs usafrTxo, xarisxian da saTanado momsaxurebas, mkurnalobas da prevenciul RonisZiebebs. jandacvis xelmisawvdomoba uzrunvelyofili unda iyos yvela pacientisTvis miuxedavad maTi socialur-ekonomikuri statusisa. informacia: imisaTvis rom pacientebma da maTma warmomadgenlebma miiRon informirebuli gadawyvetileba mkurnalobis Sesaxeb, aucilebelia swori, saTanado da detaluri informaciis miwodeba. informaciis miwodeba unda moxdes Sesabamisi formiT pacientis mdgormareobis, enis, asakis, SesaZleblobebis da kulturis gaTvaliswinebiT. ` jakartis deklaracia 21-e saukuneSi janmrTelobis popularizaciis RonisZiebaTa warmarTvis Sesaxeb (1997)21 deklaracia jandacvis me-4 saerTaSoriso konferenciis saboloo Sedegobrivi dokumentia. man Camoayaliba 21-e saukuneSi jandacvis popularizaciis prioritetebi, socialuri pasuxismgeblobis, investiciebis zrdis, usafrTxo infrastruqturisa da individis gaZlierebis CaTvliT. ` eqTnebi da adamianis uflebebi 1998, eqTanTa saerTaSoriso sabWo (ICN)22 eqTanTa saerTaSoriso sabWo jandacvis uflebas ganixilavs, rogorc TiToeuli individis uflebas, ganurCevlad finansuri, politikuri, georgrafiuli, rasobrivi Tu religiuri niSnisa. es ufleba moicavs uflebas, airCio da uari Tqva samedicino momsaxurebaze, mzrunvelobaze Tanxmobis gacxadebisa da uaris Tqmis CaTvliT; informirebul Tanxmobas, konfidencialobas, Rirsebas, Rirseulad gardacvalebis uflebis CaTvliT. amasTan, igi moicavs rogorc pacientis, ise samedicino momsaxurebis gamwevis uflebebs. 2.3 pacientTa uflebebi winamdebere Tavi pacientis cxra ZiriTad uflebas exeba. esenia: pirovnebis Tavisuflebisa da usafrTxoebis ufleba; piradi cxovrebis xelSeuxebloba; informaciis miRebis ufleba; fizikuri xelSeuxeblobis ufleba; sicocxlis ufleba; ufleba janmrTelobis umaRles xelmisawvdom standartze; wamebis da sastiki, araadamianuri da damamcirebeli mopyrobis akrZalva; sajaro politikaSi monawileobis ufleba; diskriminaciis akrZalva da Tanasworobis ufleba. ekonomikuri, socialuri da kulturuli uflebebis komitetma moaxdina pacientTa uflebebis mniSvnelovani saerTaSoriso samarTlebrivi ganmarteba. gaeros me-14 zogadi komentaris SemuSavebis procesSi, romelic exeba janmrTelobis dacvis umaRles xel- 21 ix. teqsti ing. enaze: www.who.int/hpr/NPH/docs/jakarta_declaration_en.pdf 22 ix. teqsti ing. enaze: www.icn.ch/pshumrights.htm 24 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.3 misawvdom standarts, komitetma gansakuTrebuli roli iTamaSa. man aseve araerTxel gaakritika saxelmwifoebi pacientebisTvis Seqmnili arasaTanado janmrTelobis dacvis pirobebis gamo, magram individualuri saCivrebis meqanizmis ar arseboba aferxebs komitets sistemuri xasiaTis darRvevebis garda, rac qveynebis angariSebSi aisaxeba, Seiswavlos konkretuli darRvevebi. aseTi meqnizmis arseboba saSualebas miscemda ekonomikuri, socialuri da kulturuli uflebebis komitets, adamianis uflebaTa komitetis msgavsad, daemkvidrebia mniSvnelovani sasamarTlo praqtika pacientTa mzrunvelobis sferoSi adamianis uflebaTa dacvis kuTxiT. miuxedavad imisa, rom ekonomikuri, socialuri da kulturuli uflebebis komitetma SeimuSava yvelaze detaluri ganmartebebi janmrTelobis uflebasTan dakavSirebiT, gaeros sxva uwyebebsac aqvT gakeTebuli mniSvnelovani komentarebi pacientTa uflbebze. adamianis uflebaTa komitetma araerTxel miuTiTa samoqalaqo da politikuri uflebebis Sesaxeb paqtis me-9 da me-10 muxlebze, rodesac dagmo fsiqikuri janmrTelobis problemebis mqone pacientebis ukanoni Tavisuflebis aRkveTa da dakavebulTaTvis mkurnalobaze uaris Tqma. komitetma aseve gamoiyena samoqalaqo da politikuri uflebebis Sesaxeb paqtis me-17 muxli samedicino informaciis konfidencialobis da me-6 muxli (sicocxlis ufleba) winaswari patimrobis dros samedicino momsaxurebis uflebis dasacavad. garda amisa, gaeros uwyebebi, romlebic rasobrivi da sqesobrivi niSniT diskriminacias uweven zedamxedvelobas, uzrunvelyofen janmrTelobis dacvis Tanabar xelmisawvdomobas. garda savaldebulo Zalis mqone normebisa, sxva saerTaSoriso standartebic, rogoricaa, magaliTad patimarTa mopyrobis minimaluri standartuli wesebi, axdenen pacientTa uflebebze miTiTebas. miuxedavad imisa, rom am standartebis dacva savaldebulo ar aris saxelmwifoebisTvis, pacientebs da maT damcvelebs SeuZliaT daeyrdnon da moaxdinon maTi interpretireba. Tavisuflebisa da usafrTxoebis ufleba uflebis potenciur darRvevaTa magaliTebi piri dakavebulia fsiqikuri avadmyofobis safuZvelze eqimis daskvnis gareSe; instituciebSi moTavsebul pirebs ar atyobineben imis Sesaxeb, rom aranebayoflobiT mkurnalobis SemTxvevaSi, maT aqvT sasamarTloSi gasaCivrebis ufleba; narkotikebis momxmarebel qals, mSobiarobis Semdeg akaveben saavadmyofoSi da arTmeven dedobis uflebas. adamianis uflebaTa standartebi da interpretacia samoqalaqo da politikur uflebaTa saerTaSoriso paqti (ICCPR), mux. 9 (1): TiToeul adamians aqvs Tavisuflebisa da piradi xelSeuxeblobis ufleba. aravin ar SeiZleba TviTneburad daapatimron an patimrobaSi aiyvanon. aravis ar SeiZleba Tavisufleba aRukveTon sxvagvarad, Tu ara iseT safuZvelze da iseTi proceduris Sesabamisad, romlebic kanoniT aris dawesebuli. 25 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi adamianis uflebaTa komitetma ganacxada, rom pacientis iZulebiTi mkurnaloba fsiqiatriul dawasebulebaSi warmoadgens adamianis Tavisuflebis uflebis SezRudvas samoqalaqo da politikur uflebaTa saerTaSoriso paqtis me-9 muxlis mixedviT.23 am konteqstSi, komiteti miiCnevs, rom sasamarTlos gadawyvetilebis gareSe ToTxmeti dRiT piris dakaveba fsiqikuri janmrTelobis problemebis gamo ewinaaRmdegeba me-9 muxls.24 piris fsiqiatriul dawesebulebaSi ukanonod moTavsebis Sesaxeb, rodesac dazaralebuli qmedunariani iyo da SeeZlo sakuTari saxeliT moqmedeba25,, komitetma ganacxada Semdegi: `wevr saxelmwifos gansakuTrebuli valdebuleba akisria misi iurisdiqciis farglebSi daicvas specialuri saWiroebebis mqone pirebi, maT Soris fsiqikuri problemebis mqone adamianebi. saxelmwifom mxedvelobaSi unda miiRos Semdegi: Tu piris SezRuduli SesaZleblobebi ar aZlevs mas saSualebas efeqturi monawileba miiRos sasamarTlo ganxilvaSi, sasamarTlom unda uzrunvelyos piris daxmareba da warmomadgenloba ise, rom misi uflebebi sakmarisad iyos daculi saqmis ganxilvis periodSi. komiteti aRiarebs iseTi garemoebebis Seqmnis SesaZleblobas, rodesac piris fsiqikuri janmrTeloba imdenad dazianebulia, rom TviT am piris, an sxva adamianebisTvis zianis miyenebis Tavidan asacileblad dakavebis brZanebis gacema gardauvali iyos. aRniSnul SemTxvevaSi, araviTari gansakuTrebuli garemoeba ar arsebobda. aqedan gamomdinare, komiteti askvnis, rom piris dakaveba iyo ukanono da ewinaaRmedegeboda paqtis me-9 muxlis 1 punts.26 ` bavSvis uflebaTa konvencia (CRC), mux. 25: monawile saxelmwifoebi aRiareben kompetenturi organoebis mier movlis mizniT meurveobis qveS myofi bavSvis uflebas, iyos daculi da isargeblos fizikuri Tu fsiqikuri mkurnalobiT; aRiareben bavSvis uflebas, periodulad xdebodes misTvis gaweuli mkurnalobis da mis mimarT aseT meurveobasTan dakavSirebuli sxva pirobebis Sefaseba. ` konvencia SezRuduli SesaZleblobebis pirTa uflebebis Sesaxeb (DRC) mux. 14: `1. wevrma saxelmwifoebma unda uzrunvelyon, rom SezRuduli SesaZleblobebis mqone pirebma, sxvebTan Tanaswor pirobebSi: a) isargeblon Tavisuflebisa da usafrTxoebis uflebiT; b) ar aRekveTo Tavisufleba ukanonod da TviTneburad. Tavisuflebis nebismieri formiT aRkveTa unda iyos kanonis Sesabamisi da SezRuduli SesaZleblobebis statusi arc erT SemTxvevaSi ar SeiZleba iyos Tavisuflebis aRkveTis gamamarTlebeli safuZveli. 2. wevrma saxelmwifoebma unda uzrunvelyon, rom Tu SezRuduli SesaZleblobebis mqone pirebs aRekveTebaT Tavisufleba nebismieri procesiT, sxvebTan Tanasworad unda isargeblon garantiebiT adamianis uflebaTa saerTaSoriso samarTlis mixedviT da unda isargeblon mopyrobiT, am konvenciiT gaTvaliswinebuli miznebisa da principebis Sesabamisad. . .~ 23 axali zelandiis winaaRmdeg(A. v. New Zealand), N. 754/1997, da filakovska poloneTis winaaRmdeg (Fijalkovska v. Poland) (1061/2002), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/60/40 vol. II (26 ivlisi 2005) 103 $ 8.2 24 samoqalaqo da politikuri uflebebis komiteti, daskvniTi Sefasebebi estoneTis Sesaxeb [CCPR/CO/77/EST (HRC, 2003), $ 10 25 samoqalaqo da politikuri uflebebis komiteti, daskvniTi Sefasebebi estoneTis Sesaxeb [CCPR/CO/77/EST (HRC, 2003), $ 10 26 Ibid, $ 8.3 26 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.3 ` gaeros principebi nebismieri saxiT dakavebul yvela pirTa dacvis Sesaxeb ` gaeros principebi fsiqikuri daavadebis mqone pirTa dacvisa da fsiqikuri janmrTelobis dacvis gaumjobesebis Sesaxeb ` janmrTelobis uflebis qartia, mux. 6: dauSvebelia piris Tavisuflebis aRkveTa TviT am piris an sxva adamianTa mimarT samedicino safrTxis safuZvelze, Tu es safrTxe ar aris dadasturebuli kompetenturi da damoukidebeli eqimebis mier da ar arsebobs Sesabamisi samarTlebrivi procedurebis dacviT miRebuli sasamarTlos gadawyvetileba. piradi cxovrebis xelSeuxeblobis ufleba uflebis potenciur darRvevaTa magaliTebi eqimi amJRavnebs informacias pacientis mier narkotikebis moxmarebis Sesaxeb pacientis Tanxmobis gareSe; saxelmwifo garkveuli formiT iTxovs aiv/Sidsis infeqciis statusis gamJRavnebas; jandacvis muSakebi iTxoven axalgazrdebisgan mSoblebis Tanxmobas seqsualuri janmrTelobis servisebis miwodebisTvis; instituciebSi moTavsebul pirebs ar aqvT calke adgili piradi nivTebis Sesanaxad. adamianis uflebaTa standartebi da interpretacia ` saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb (ICCPR), mux. 17: aravin ar unda ganicados TviTneburi an ukanono Careva Tavis pirad an ojxur cxovrebaSi, misi sacxovreblis Seuvalobis an misi korespondenciis saidumloebis TviTneburi an ukanono xelyofa, an misi Rirsebis da reputaciis ukanono xelyofa. ` bavSvis uflebaTa konvencia (CRC), mux. 16 (1): arc erTi bavSvi ar SeiZleba iyos piradi da ojaxuri cxovrebis, sacxovrebeli binis xelSeuxeblobis an korespondenciis saidumloebis uflebaTa mis mier ganxorcielebaSi TviTneburi an ukanono Carevis, an misi Rirsebisa da reputaciis ukanono xelyofis obieqti; ` ekonomikuri, socialuri da kulturuli uflebebis komiteti (CESCR) zogadi komentari (GC) 14 par. 12: informaciis xelmisawvdomobam ar unda SezRudos piradi samedicino monacemebis konfidencialobis ufleba. ` ekonomikuri, socialuri da kulturuli uflebebis komiteti (CESCR) zogadi komentari (GC) 14 par. 23: mozardTa janmrTelobis dacvis uflebis realizacia damokidebulia maTze orientirebuli jandacvis arsebobaze, romelic pativs scems konfidencialobas, pirad cxovrebas da moicavs seqsualuri da reproduqciul janmrTelobis saTanado servisebs. ` SezRuduli SesaZleblobebis mqone pirTa uflebebis konvencia, mux. 22: 1. SezRuduli SesaZleblobebis mqone arc erTi piri, miuxedavad misi sacxovrebeli adgilisa da pirobebisa, ar 27 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi unda ganicdides TviTnebur an ukanono Carevas mis pirad cxovrebaSi, ojaxSi, sacxovrebeli adgilis arCevaSi, korespondenciasa da sxva saxis komunikaciaSi; dauSvebelia misi Rirsebisa da reputaciis ukanono xelyofa. aseTi saxis Carevis SemTxvevaSi, SezRuduli SesaZleblobebis mqone pirebs ufleba aqvT iyvnen daculi kanoniT. 2. monawile saxelmwifoebma Tanabrad unda daicvan SezRuduli SesaZleblobebis mqone pirTa piradi, samedicino da sareabilitacio momsaxurebasTan dakavSirebuli informaciis konfidencialuroba. ` janmrTelobis uflebis qartia, mux. 8: eqimebis valdebulebaa daicvan konfidencialurobis principi pacientebTan mimarTebaSi. konfidencialoba xels uwyobs janmrTelobis dacvis efeqturobas. kanoniT mkacrad gansazRvruli samedicino konfidencialobis gamonaklisebi unda emsaxurebodes mxolod janmrTelobis, usafrTxoebis da sajaro higienis normebis dacvas. pacientebi ar arian valdebulni daicvan samedicino konfidencialoba. ` msoflio eqimTa asociaciis (WMA) deklaracia pacientis uflebebis Sesaxeb, principi 8 konfidencialobis ufleba a. yvela saxis informacia pacientis janmrTelobis statusis, samedicino mdgomareobis, diagnozis, prognozis da mkurnalobis Sesaxeb, aseve yvela sxva piradi informacia unda iyos konfidencialuri piris gardacvalebis Semdegac ki. gamonaklisis saxiT, STamomavlebs SeiZleba hqondeT ufleba xeli miuwvdebodeT informaciaze, romelic amcnobs maT janmrTelobis SesaZlo riskis Sesaxeb. b. konfidencialuri informaciis gamJRavneba SeiZleba mxolod kanoniT dadgenil SemTxvevbSi an pacientis Tanxmobis Semdeg. g. pacientis yvela saidentifikacio monacemebi unda iyos daculi. cxadia, rom samedicino informaciis dacvis aucileblobam SeiZleba zegavlena moaxdinos jandacvis sxvadasxva sakiTxebze, Tumca, konfidencialoba gansakuTrebiT mniSvnelovania seqsualuri da reproduqciuli janmrTelobis sakiTxebTan dakavSirebiT. gaeros saxelSekrulebo organoebis analizis mixedviT, piradi cxovrebis ufleba moicavs (I) samarTlebrivi valdebulebis uaryofas, romlis mixedviTac jandacvis personali valdebulia ganacxados abortis SemTxvevebi, rogorc proceduris zogadi kriminalizaciis nawili gamonaklisis gareSe, ris gamoc qalebi ferxdebian samedicino dawesebulebis mimarTvisas, rac safrTxes uqmnis maT janmrTelobas.27 (II) gamoZiebis Catarebis saWiroebas imis Sesaxeb, rom ucxour sawarmoebSi dasaqmebis msurvel qalebs utareben orsulobis testebs da Txoven upasuxon detalur SekiTxvebs pirad sakiTxebze, rasac moyveba fexmZimobis sawinaaRmdego wamlebis gamowera28 da (III) problemebis gadawyvetas da mozardTa konfidencialobis dacvis saWiroebas seqsualuri da reproduqciuli janmrTelobis sakiTxebSi, maT Soris im pirebTan dakavSirebiT, romlebic daqorwindnen adreul asakSi da, amasTanave, daucveli mosaxleobis mimarT. 29 27 adamianis uflebaTa komiteti, daskvniTi Sefasebebi Ciles Sesaxeb, saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/54/40 vol. I (1999) 44 $ 211 da 216; venesuela, saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/56/40 vol. I (2001) 49 $ 77(19) 28 adamianis uflebaTa komiteti, daskvniTi Sefasebebi meqsikis Sesaxeb, saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/54/40 vol. I (1999) 61 $ 329 29 bavSvis uflebaTa komitetis daskvniTi Sefasebebi, jibuti, CRC/C/97 (2000) 96 $ 555 28 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.3 informaciis miRebis ufleba uflebis potenciur darRvevaTa magaliTebi mTavroba krZalavs publikaciebs narkotikebis gamoyenebasa da zianis Semcirebaze, radgan acxadebs, rom amgvari informacia arakanonier saqmianobas uwyobs xels; axalgazrdebs ganzrax ar awvdian informacias sqesobrivi gziT gadamdebi daavadebebis da prezervativis gamoyenebis Sesaxeb; boSa qalebisTvis ar aris xelmisawvdomi informacia seqsualuri da reproduqciuli janmrTelobis Sesaxeb. adamianis uflebaTa standartebi da interpretacia ` saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb (ICCPR), mux. 19 (2): TiToeul adamians aqvs ufleba Tavisuflad gamoTqvas sakuTari azri; es ufleba moicavs Tavisuflebas, sakuTari arCevaniT, saxelmwifo sazRvrebis miuxedavad moiZios, miiRos da gaavrcelos yovelgvari informacia zepirad, werilobiT an presisa da gamoxatvis sxva saSualebebiT; adamianis uflebaTa komitetis wevrma, saqmeSi Jeludkovi ukrainis winaaRmdeg30 aRniSna, rom: `adamianis ufleba xeli miuwvdebodes Tavis samedicino Canawerze, aris nawili TiToeuli adamianis uflebis, xeli miuwvdebodes pirad informaciaze sakuTari Tavis Sesaxeb. saxelmwifos ar dausaxelebia mizezi, rac gaamarTlebda mis uars informaciis xelmisawvdomobaze. ubralod msxverplis moTxovnis uaryofa, gaecnos Tavis samedicino Canawerebs aris saxelmwifos valdebulebis darRveva pativi sces yoveli adamianis uflebas `moepyron adamianurad adamianuri Rirsebis dacvas~, miuxedavad imisa, amgvari uari msxverplis samedicino mkurnalobaze moaxdens Tu ara zegavlenas.~31 ` ekonomikuri, socialuri da kulturuli uflebebis komiteti (CESCR) zogadi komentari 14, pr. 12 (b)(IV): jandacvis xelmisawvdomoba `moicavs janmrTelobis Sesaxeb cnobebis moZiebis, miRebisa da gadacemis uflebas~. ` ekonomikuri, socialuri da kulturuli uflebebis komiteti (CESCR) zogadi komentari 14, pr. 23: wevrma saxelmwifoebma unda Seqmnan usafrTxo da wamaxalisebeli garemo mozardebisTvis, rac uzrunvelyofs maT monawileobas maT janmrTelobasTan dakavSirebul gadawyvetilebis miRebis procesSi, xels Seuwyobs saWiro unarebis gamomuSavebas, rac aucilebelia Sesa30 (726/1996), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/58/40 vol. II (29 Ooqtomberi 2002) 12 (CCPR/C/76/D/726/1996 31 individualuri Sefaseba (sesilia medina qiroga) 29 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi bamisi informaciisa da konsultaciis miRebisTvis. ` bavSvis uflebaTa konvencia (CRC), mux. 17: monawile saxelmwifoebi aRiareben masobrivi informaciis saSualebaTa mniSvnelovan rols da uzrunvelyofen bavSvisaTvis sxvadasxva erovnuli da saerTaSoriso wyaroebiT gavrcelebuli informaciisa da masalebis xelmoisawvdomobas, gansakuTrebiT iseTi informaciisa da masalebisa, romlebic mimarTulia bavSvis socialuri, sulieri da moraluri keTildReobisaken, agreTve jansaRi fizikuri da fsiqikuri ganviTarebis xelSewyobisaken. konvencia SezRuduli SesaZleblobebis mqone pirTa dacvis Sesaxeb (DRC), mux. 21: monawile saxelmwifoebma unda miiRon yvela Sesabamisi zoma, SezRuduli SesaZleblobebis mqone pirTa mier azrisa da gamoxatvis Tavisuflebis uzrunvelsayofad, maT Soris informaciisa da ideebis moZiebis, miRebisa da gamoyenebis Tanabari ufleba maT mier arCeuli nebismieri saxis sakomunikacio saSualebebis gamoyenebiT, rogorc es gansazRvrulia winamdebare konvenciis me-2 muxliT, rac moicavs: a) SezRuduli SesaZleblobebis mqone pirTaTvis, farTo sazogadoebiTvis gankuTvnili informaciis misawvdomobis uzrunvelyofas sxvadasxva saxis SezRudvis Sesabamisi formatiTa da teqnologiebis gamoyenebiT, dayovnebisa da damatebiTi xarjebis gareSe. msoflio eqimTa asociacia, deklaracia pacientis uflebaTa Sesaxeb, principi 7: a) pacients ufleba aqvs miiRos mis Sesaxeb samedicino CanawerebSi arsebuli informacia da sruli informacia misi janmrTelobis statusis Sesaxeb, maT Soris mis mdgomareobaze arsebuli samedicino faqtebis Sesaxeb. Tumca, pacientis CanawerebSi arsebuli konfidencialuri informacia mesame pirs ar unda miewodos pacientis Tanxmobis gareSe; b) gamonaklisis saxiT, infrmacia SeiZleba ar miewodos pacients, rodesac arsebobs dasabuTebuli varaudi imisa, rom informaciis miwodeba mniSvnelovan safrTxes Seuqmnis pacientis sicocxles an janmrTelobas; g) informaciis miwodeba unda moxdes pacientis aRqmis gaTvaliswinebiT da misTvis gasagebi formiTa da eniT; d) pacients ufleba aqvs ar miiRos informacia, garda im SemTxvevisa, rodesac es saWiroa sxva adamianis sicocxlis dasacavad. e) pacients ufleba aqvs airCios, vis (Tu arsebobs aseTi piri) unda miewodos informacis mis Sesaxeb. ` pacientTa organizaciebis saerTaSoriso aliansis (IAPO) deklaracia pacientze orientirebuli jandacvis Sesaxeb, principi 532: 32 ixileT aseve pacientTa organizaciebis saerTaSoriso aliansi (IAPO) http://www.patientsorganizations.org/showarticle. pl?id=126&n=962 30 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.3 swori, Sesabamisi da yovlismomcoveli informaciis floba aucilebelia, raTa pacientebs da mzrunvelebs mieceT saSualeba miiRon informirebuli gadawyvetilebebi mkurnalobis da cxovrebis dagegmvis Sesaxeb. informacia warmodgenili unda iyos saTanado formatiT jandacvis cnoberebis Seqmnis principebis Tanaxmad, piris mdgomareobis, asakis, cnobierebis, erovnebis, SesaZleblobebis da kulturis gaTvaliswinebiT. SeniSvna: informacia seqsualuri da reproduqciuli janmrTelobis Sesaxeb gansakuTrebiT mniSvnelovania saTanado da drouli informaciis miwodeba seqsualuri da reproduqciuli janmrTelobis Sesaxeb. gaeros saxelSekrulebo organoebma mouwodes saxelmwifoebs gaaumjobeson xelmisawvdomoba, mozardebs Soris abortis SemTxvevebis gazrdis sapasuxod da seqsualuri gziT gadamdebi daavadebebis, maT Soris aiv/Sidsis Sesaxeb. aseTi informacia unda vrceldebodes bavSvebze da adamianebze im teritoriebSi, sadac xSiria Tambaqos da alkoholis gamoyeneba. fizikuri xelSeuxeblobis ufleba uflebis potenciur darRvevaTa magaliTebi xSiria SemTxvevbi, roca boSa qalis sterilizacia xdeba misi nebis sawinaaRmdegod; eqimi aiZulebs narkotikebis momxmarebel fexmZime qals gaikeTos aborti; instituciebSi pacientebs mkurnaloben maTin nebarTvis gareSe, radgan miaCniaT, rom pacientebs ar aqvT unari Tavad miiRon gadawyvetileba mkurnalobis Sesaxeb; daxurul instituciebSi, pacientebs rTaven samedicino kvlevebSi maTi Tanxmobis gareSe; pacientebs utardebaT eleqtro-konvulsiuri Terapia (ECT), maT ki eubnebian, rom es aris `Zilis Terapia~. adamianis uflebaTa standartebi da interpretacia fizikuri xelSeuxeblobis ufleba calke ar aris aRniSnuli samoqalaqo da politikur uflebaTa, aseve, ekonomikur, socialur da kultirul uflebaTa paqtSi. Tumca, aRniSnuli ufleba aRiqmeba rogorc Semdegi uflebebis nawili: adamianis usafrTxoebis ufleba (ICCPR 9), wamebis, araadamianuri da Rirsebis Semlaxavi mopyrobis akrZalva (ICCPR 7), piradi cxovrebis xelSeuxebloba (ICCPR 17), ufleba janmrTelobis umaRles miRwevad standartze (ICESCR 12). ` bavSvis uflebaTa konvencia (CRC), mux. 12(1) _ monawile saxelmwifoebi uzrunvelyofen sakuTari Sexedulebis Camoyalibebis unaris mqone bavSvis uflebas, Tavisuflad gamoxatos es Sexedulebebi bavSvTan dakavSirebul yvela sakiTxze, amasTan, bavSvis Sexedulebebs saTanado yuradreba eTmoba bavSvis asakisa da mowifulobis Sesabamisad. ` bavSvis uflebaTa konvencia (CRC), mux. 39: monawile saxelmwifoebi yvela zomas iReben, raTa xeli Seuwyon im bavSvis fizikur da fsiqologiur gajansaRebas da socialur reintegracias, romelic nebismieri saxis ugulebelyofis, eqspluataciis an borotad gamoyenebis, wamebis, sastiki, araadamianuri da Rirsebis Semlaxveli mopyrobis, sasjelis 31 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi an SeiaraRebuli konfliqtis msxverplia. aseTi gajansaReba da reintegracia unda xorcieldebodes bavSvis janmrTelobis, sakuTari Tavis pativiscemisa da Rirsebis grZnobis SenarCunebis uzrunvelmyof pirobebSi. ` SezRuduli SesaZleblobebis mqone pirTa dacvis konvencia (DRC), mux. 17: SezRuduli SesaZleblobebis mqone yvela pirs aqvs sakuTari fizikuri da mentaluri xelSeuxenlobis Tanabari ufleba. ` ekonomikuri, socialuri da kultiruli uflebebis komiteti, zogadi komentari 14, pr. 8: janmrTelobis ufleba moicavs `aranebayoflobiTi mkurnalobis da eqsperimentebisgan dacvis uflebas.~ ` saerTaSoriso eTikuri gaidlainebi biosamedicino kvlevaSi adamianTa Cabmis Sesaxeb33 ` janmrTelobis uflebis qartia, mux. 5: nebismieri samedicino Carevis SemTxvevaSi saWiroa pacientis Tanxmoba, garda gadaudebeli SemTxvevebisa, romelsac aregulirebs kanoni. ` eqimTa msoflio asociaciis (WMA) deklaracia pacientis uflebaTa Sesaxeb, principi 2-6: 1. Tavisufali arCevanis ufleba a) miuxedavad samedicino dawesebulebis iuridiuli formisa (kerZo da sajaro), pacients ufleba aqvs Tavisuflad airCios da Seicvalos eqimi, saavadmyofo an jandacvis dawesebuleba. b) pacients nebismier etapze ufleba aqvs hkiTxos azri sxva eqims. 3. TviTgamorkvevis ufleba a) pacients aqvs TviTgamorkvevis da sakuTari Tavis Sesaxeb damoukidebeli gadawyvetilebebis miRebis ufleba. eqimi acnobebs pacients misi gadawyvetilebis Sedegebis Sesaxeb. b) gonebrivad adekvatur, zrdasrul pacients ufleba aqvs ganacxados (an nebismier dros uari Tqvas) Tanxmoba nebismier diagnostikuri proceduris Tu Terapiis Catarebaze. aseve ufleba aqvs miiRos informacia rac aucilebelia misTvis gadawyvetilebis misaRebad. pacientma naTlad unda gaacnobieros nebismieri testisa Tu samedicino Carevis mizani, mosalodneli Sedegebi da ra SeiZleba mohyves armkurnalobas da mkurnalobis Sewyvetas. g) pacients ufleba aqvs ar miiRos monawileoba samedicino kvlevaSi Tu swavlebaSi. 2. ugono mdgomareobaSi myofi pacienti a) Tu pacienti aris ugono mdgomareobaSi, an sxva mizezebis gamo ar SeuZlia gamoxatos sakuTari azri, informirebuli Tanxmobis miReba unda moxdes kanonieri warmomadgenlisgan. b) Tu kanonieri warmomadgeneli ar arsebobs, magram saswrafod aris saWiro samedicino 33 2002 wlis ganxiluli gaidlainebi http://www.cioms.ch/frame_guidelines_nov_2002.htm 32 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.3 Careva, pacientis Tanxmoba SeiZleba nagulisxmevad iyos miCneuli, garda im SemTxvevisa, rodesac arsebobs pacientis mier manamde gacxadebuli mkafio survili, rom ar moxdes amgvari samedicino Careva, Tuki amis aucilebloba dadgeba. g) Tumca eqimi yovelTvis unda Seecados gadaarCinos pacientis sicocxle, romlis ugono mdgomareoba gamowveulia TviTmkvlelobis mcdelobiT. 3. qmeduunaro pacienti a) qveynebis samarTlebrivi sistemebidan gamomdinare, samedicino momsaxurebs gawevisas xSir SemTxvevaSi saWiroa mcirewlovani, an qmeduunaro pacientis kanonieri warmomadgenlis Tanxmoba. miuxedavad amisa, pacienti misi SesaZleblobis farglebSi maqsimalurad unda iyos CarTuli gadawyvetilebis miRebis procesSi. b) Tu qmeduunaro pacients SeuZlia racionaluri gadawyvetilebebis miReba, mis gadawyvetilebas pativi unda scen. mas aseve ufleba aqvs akrZalos masTan dakavSirebuli informaciis gamJRavneba misi kanonieri warmomadgenlisTvis. g) Tu pacientis kanonieri warmomadgeneli, an pacientis ndobiT aRWurvili piri uars ambobs SeTavazebul samedicino momsaxurebaze, romelic eqimis azriT pacientisTvis mniSvnelovania, eqmimma unda gaasaCivros es gadawyvetileba Sesabamis samarTlebriv an sxva dawesebulebaSi. gadaudebeli SemTxvevebis dros eqimma unda imoqmedos pacientis interesebis gaTvaliswinebiT. 4. pacientis nebis sawinaaRmdego procedurebi pacientis nebis sawinaaRmdego diagnostikuri procedurebi an mkurnaloba SeiZleba Catardes mxolod gamonaklis SemTxvevebSi, Tu is nebadarTulia kanoniT da Seesabameba samedicono eTikis principebs. ` saxelSekrulebo organoebma cnes, rom iseTi praqtika, rogoricaa qalis sasqeso organos mutilacia, arRvevs qalis usafrTxoebis uflebas, mis fizikur da moralur xelSeuxeblobas da safrTxes uqmnis mis sicocxlesa da janmrTelobas.34 34 qalTa mimarT diskriminaciis sawinaaRmdego komitetis daskvniTi Sefasebebi burkina-fasos Sesaxeb, A/55/38 nawili I (2000) 25 $261 da kameruni, A/55/38 nawili II (2000) 53 $ 43 33 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi sicocxlis ufleba uflebis potenciur darRvevaTa magaliTebi eqimebi uars amboben umkurnalon pirs narkotikebis gadaWarbebuli dozis SemTxvevaSi, radgan es kanonsawinaaRmdego qmedebaa. ar mkurnalobas ki pacientis sikvdili moyveba; narkotikis momxmarebelTa gardacvaleba xdeba daxuruli tipis saavadmyofoSi; saxelmwifo awesebs gaumarTlebel samarTlebriv SezRudvebs aiv/Sidsis prevenciisa da mkurnalobis saSualebebze; sikvdilianobis maCvenebeli instituciaSi gansakuTrebiT maRalia zamTris TveebSi Senobis arasaTanado mdgomareobis, araadekvaturi sanitaruli pirobebisa da gaTbobis da pacientebze aradamakmayofilebeli mzrunvelobis gamo; fsiqiatriul saavadmyofoSi ar xdeba TviTmkvlelobis riskis qveS myofi pacientebis saTanado meTvalyureoba, ris gamoc xSiria suicidis SemTxvevebi adamianis uflebaTa standartebi da interpretacia ` saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb (ICCPR), mux. 6(1): sicocxlis ufleba TiToeuli adamianis ganuyofeli uflebaa. am uflebas icavs kanoni. aravis ar SeiZleba TviTneburad waarTvan sicocxle. ` samoqalaqo da politikuri uflebebis saerTaSoriso komisia (ICCPR) zogadi komentari 6 pr. 1 da 5: sicocxlis ufleba `ar SeiZleba viwro gagebiT iyos interpretirebuli~ an `SezRudvebi vrceldebodes~, da misi dacvisTvis `aucilebelia, rom saxelmwifoebma miiRon pozitiuri zomebi . . . sicocxlis saSualo xangrZlivobis gasaumjobeseblad~. adamianis uflebaTa komitetma daadgina samoqalaqo da politikuri uflebebis Sesaxeb saerTaSoriso paqtis me-6 muxlis darRveva (me-10(1) muxlTan erTobliobiT), rodesac axalgazrda janmrTeli mamakaci daavadda winaswari patimrobis dawesebulebaSi da miuxedavad araerTi moTxovnisa, ar miuRia samedicino daxmareba da Sesabamisad gardaicvala. komitetma aRniSna: `patimrobaSi myofi pirebi ki ar unda iTxovdnen dacvas, aramed saxelmwifo valdebulia uzrunvelyos maTi sicocxlis ufleba... saxelmwifo aseve valdebulia uzrunvelyos Tavisuflebis aRkveTis dawesebulebebi Sesabamisi pirobebiT da icodes Tavisufleba aRkveTili pirebis janmrTelobis mdgomareoba. Sesabamisi finansebis nakleboba ver Seamsubuqebs am pasuxismgeblobas~.35 vinaidan Tavisuflebis aRkveTis dawesebulebas hqonda srulad funqcionirebadi samedicino servisi da unda scodnodaT dazaralebulis janmrTelobis gauaresebis Sesaxeb, saxelmwifo valdebuli iyo dauyovnebliv mieRo zomebi me-6 da me-10 muxlebis Sesabamisad. aseTi valdebuleba arsebobs iseT SemTxvevaSic, rodesac msgavs insituciebs marTavs kerZo kompania.36 35 lancova ruseTis federaciis winaaRmdeg(No 763/1997), gadasinjulia 2002 wlis 26 marts,par 9.2 36 adamianis uflebaTa komiteti zogadi komentari #20 wamebis akrZalvis Sesaxeb saerTaSoriso konvenciis samoqalaqo da politikuri uflebebis Sesaxeb me-7 muxlis Tanaxmad, par: 1, 13 34 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.3 miuxedavad imisa, rom komitets pirdapir ar uRiarebia abortis gakeTebis ufleba, komitetma daadgina, rom saxelmwifoebs ekisrebaT valdebuleba miiRon zomebi, raTa daicvan im orsuli qalis sicoxlis ufleba, romlis orsulobac sruldeba, rac SeiZleba ganixilebodes, rogorc am proceduris upirobo akrZalvis dasruleba.37 SezRuduli SesaZleblobebis mqone pirTa dacvis konvencia (DRC), mux. 10: saxelmwifo mxareebi kvlavac adastureben, rom yvela adamians gaaCnia sicocxlis ufleba da unda gadadgan yvela aucilebeli nabiji, raTa uzrunvelyon rom SezRuduli SesaZleblobis mqone pirebma sxvebTan, Tanabrad efeqturad isargeblon sicocxlis uflebiT. ufleba janmrTelobis umaRles xelmisawvdom standartebze uflebis potenciur darRvevaTa magaliTebi saxelmwifo ver dgams progresul nabijebs, raTa gaxados xelmisawvdomi antiretrovirusuli wamlebi dedidan bavSvze aiv-infeqciis gadacemis Tavidan asacileblad; ar aris daculi xelmisawvdomobis (geografiuli xelmisawvdomoba) principi. zogierT Rarib sofelSi samedicino dawesebulebebi ar mdebareobs sasoflo samezoblos siaxloves; saxelmwofo ver amzadebs samedicino personals paliatiuri mzrunvelobis sferoSi; cudi kvebis gamo socialuri mzrunvelobis dawesebulebebSi, bavSvebi sawols mijaWvulebi arian; zogierT fsiqiatriul saavadmyofoSi bavSvebi moTavsebuli arian palataSi mozrdilebTan erTad; fsiqikuri aSlilobis mqone qalebis sqess ar iReben mxedvelobaSi da ar sTavazoben maT reproduqciuli janmrTelobis servisebs. adamianis uflebaTa standartebi da interpretacia ` ekonomikuri, socialuri da kulturuli uflebebis saerTaSoriso paqti mux. 12: 1. monawile saxelwifoebi cnoben yvelas uflebas fizikuri da fsiqikuri janmrTelobis umaRles xelmisawvdom standartebze. 2. konvenciis wevr-saxelmwifoebis gadasadgmeli nabijebi am uflebis sruli ganxorcielebisaTvis moicavs Semdegs:... g) epidemiuri, endemuri, okupaciuri da sxva daavadebebis prevencia, mkurnaloba da kontroli; d) pirobebis Seqmna, romelic uzrunvelyofs yovelgvar samedicino momsaxurebasa da mzrunvelobas avadmyofobis SemTxvevaSi. ekonomikuri, socialuri da kuturuli uflebebis komiteti, zogadi komentari N14, paragrafi 4, 11 da 12: janmrTelobis ufleba moicavs uamrav social-ekonomikur faqtors, romlebic xels uwyobs iseTi pirobebis Seqmnas, sadac adamianebs SeuZliaT icxovron jansaRi cxovrebiT. igi 37 adamianis uflebaTa komiteti, daskvniTi Sefasebebi Ciles Sesaxeb A/54/40 vol. 1 (1999)44, par:. 216. ixileT aseve qalTa mimarT diskriminaciis winaaRmdeg komiteti, zogadi rekomendaciebi abortis kriminalizaciis winaaRmdeg, par. 19 da 24(m) 35 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi vrceldeba janmrTelobis ZiriTad determinantebze, rogorebicaa: sakvebi da kveba, sacxovrebeli, usafrTxo sasmeli wylis da saTanado sanitariis xelmisawvdomoba, usafrTxo da jansaRi samuSao pirobebi da jansaRi garemo. janmrTelobis dacvis servisebi unda iyos xelmisawvdomi, Sesabamisi xarisxis da miRwevadi (fizikurad da ekonomikurad) yvelasTvis diskriminaciis gareSe. paragrafi 30-37: aseTi servisebis miwodebis dros saxelmwifoebi valdebuli arian, progresulad moaxdinon janmrTelobis uflebis realizacia38 adamianTa arsebuli resursebis pativiscemiT, maTi dacviT mesame pirTa uaryofiTi moqmedebebisgan, danaklisis SevsebiT da sakmarisi resursebiT uzrunvelyofiT, amgvari resursebis ararsebobis SemTxvevaSi. paragrafi 46-52: janmrTelobis uflebis darRveva SeiZleba gamoiwvios ganzraxma qmedebam, an saxelmwifos mxridan umoqmedobam. ekonomikuri, socialuri da kulturuli uflebebis saerTaSoriso paqtis me-12 muxlTan dakavSirebiT komitetma mravaljer dagmo saxelmwifoebi, radgan maT ver uzrunvelyves saTanado resursebis gamoyofa samedicino momsaxurebisTvis, ramac aSkara mavne efeqti moaxdina pacientebze.39 komitetma mosTxova saxelmwifoebs SeimuSaon Sesabamisi kanonmdebloba pacientis uflebebis dasacavad, maT Soris samedicino Secdomebis gamosasworeblad.40 ` bavSvis uflebaTa konvencia, muxli 3.3: ,,monawile saxelmwifoebi uzrunvelyofen, rom bavSvze zrunvaze, an mis dacvaze pasuxismgebeli dawesebulebebi, samsaxurebi an organoebi Seesabamebodnen kompetenturi organoebis mier dawesebul normebs, kerZod, usafrTxoebisa da janmrTelobis dacvis sferoSi maTi personalis ricxobriobisa da vargisianobis, agreTve kompetenturi zedamxedvelobis TvalsazrisiT.~ ` bavSvis uflebaTa konvencia, muxli 24: ,,1. monawile saxelmwifoebi aRiareben bavSvis uflebas, isargeblos janmrTelobis dacvis sistemis yvelaze ufro srulyofili momsaxurebiT, daavadebaTa mkurnalobisa da janmrTelobis aRdgenis saukeTeso saSualebebiT. monawile saxelmwifoebi cdiloben uzrunvelyon, rom arc erT bavSvs ar CamoerTvas ufleba, isargeblos janmrTelobis dacvis sistemis aseTi momsaxurebiT. 2. monawile saxelmwifoebi cdiloben, srulad ganaxorcielon mocemuli ufleba da aucilebel zomebs iReben: a) Cvil-bavSvTa sikvdilobis donisa da bavSvTa sikvdilianobis SemcirebisaTvis; b) yvela bavSvisaTvis aucilebeli samedicino daxmarebisa da janmrTelobis dacvis uzrun- 38 zogierTi valdebulebis, rogoricaa diskriminacis akrZalva, realizacia unda moxdes dauyovnebliv, kvalifikaciis gareSe. 39 daskvniTi Sefasebebi urugvais Sesaxeb, E/1998/22 (1997) 67 par. 368 _ ukmayofileba gamoTqmuli saeqTno personalisTvis dabali anazRaurebis gamo. ixileT aseve Sefasebebi kongos Sesaxeb E/2001/22 (2000) 43 par. 206 _ ukmayofileba gamoTqmuli jandacvis standartebis ugulvebelyofis Sesaxeb jandacvis sferoSi arsebuli mwiri dafinansebis gamo; monRoleTi, E/2001/22 (2000) 53 par. 271 40 daskvniTi Sefasebebi ruseTis Sesaxeb (E/C.12/1/ADD.94 (CESCR, 2003) par. 32 36 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.3 velyofisaTvis, imisaTvis, rom upiratesi yuradReba daeTmos pirveladi samedicino sanitaruli daxmarebis gawevas; g) daavadebebTan da SimSilobasTan brZolisaTvis, maT Soris pirveladi samedicino-sanitaruli daxmarebis farglebSi, sursaTiTa da sasmeli wyliT momaragebis gziT, garemos dabinZurebis saSiSroebisa da riskis gaTvaliswinebiT; d) dedebisaTvis mSobiarobamde da mSobiarobis Semdgom periodSi janmrTelobis dacvis saTanado momsaxurebis gawevisaTvis.~ ` SezRuduli SesaZleblobis mqone pirTa uflebebis konvencia mux. 25: 1. monawile saxelmwifoebi aRiareben SezRuduli SesaZleblobis mqone pirTa uflebas, isargeblon janmrTelobis dacvis maqsimalurad misaRwevi standartebiT, SezRuduli SesaZleblobis safuZvelze aRmocenebuli yovelgvari diskriminaciis gareSe. monawile saxelmwifoebi iReben yvela Sesabamis zomas, SezRuduli SesaZleblobis mqone pirTaTvis, jandacvis sferos samsaxurebis misawvdomobis uzrunvelsayofad; iTvaliswineben genderul specifikas, maT Soris janmrTelobis mdgomareobis gamo sareabilitacio momsaxurebaSi. kerZod, monawile saxelmwifoebi: (a) SezRuduli SesaZleblobis mqone pirebs uzrunvelyofen jandacvis Tanabari standartebis, xarisxisa da donis ufaso momsxurebiTa da programebiT, maT Soris seqsualuri da reproduqciuli janmrTelobis sferosa da zogadad mosaxleobaze gaTvlili sazogadoebrivi programebis CaTvliT; (b) SezRuduli SesaZleblobis mqone pirebs uzrunvelyofen uSualod SezRuduli SesaZleblobis gamo aucilebeli jandacvis sferos momsaxurebiT, maT Soris adreuli diagnostikiT, Sesabamis SemTxvevebSi _ koreqciiTa da momsaxurebiT, romlis mizania Semdgomi SezRudulobis miniumamde dayvana da prevencia, maT Soris bavSvebsa da moxucebSi; (g) samedicino momsaxurebis organizebas axdenen aRniSnuli kategoriis pirTa sacxovrebel adgilebTan axlos, maT Soris soflad; (d) jandacvis profesionalebs moeTxovebaT Tanabari xarisxis momsaxureba gauwion SezRuduli SesaZleblobis mqone pirebs, maT Soris Tavisufali da informirebuli Tanxmobis safuZvelze, adamianis uflebebis, SezRuduli SesaZleblobis mqone pirTa avtonomiisa da saWiroebaTa Sesaxeb cnobierebis amaRlebiT, treningebis, saxelmwifo da kerZo jandacvis sistemaSi eTikuri standartebis miRebiT; (e) krZalaven SezRuduli SesaZleblobis mqone pirTa diskriminacias samedicino dazRvevis gacemisa da sicocxlis dazRvevis dros maSin, rodesac es ukanaskneli nebadarTulia erovnuli kanondmdeblobiT da iTvaliswineben maT gacemas samarTlian da normalur pirobebSi; (v) ar dauSveben SezRuduli SesaZleblobiT gamowveul diskriminaciul uars, jandacvisa da samedicino momsaxurebaSi, aseve sakvebisa da siTxis miRebaSi. 37 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi wamebis, sastiki, araadamianuri da damamcirebeli mopyrobis akrZalva uflebis potenciur darRvevaTa magaliTebi eqimi uars ambobs tkivilis Sesamsubuqeblad pacientisTvis morfis gamoweraze, radgan saxelmwfos mxridan eSinia devnis; simsivniT daavadebul patimars uars eubnebian mkurnalobaze; dakavebul narkotikebis momxmarebels uars eubnebian fsiqiatriul daxmarebaze; instituciebSi moTavsebul pirebs ar aqvT adgili piradi nivTebis Sesanaxad; instituciebSi myofi pacientebis samedicino Canawerebi xelmisawvdomia mTeli personalisTvis, maT Soris im pirebisTvis, romlebic pacientis mkurnalobaSi ar iReben monawileobas; instituciebSi myof pacientebs ar aqvT ufleba, ataron sakuTari tansacmeli vinaidan tansacmeli saerTo moxmarebisaa; instituciebSi myof qal pacientebs moeTxovebaT, miiRon Sxapi mamrobiTi sqesis personalis meTvalyureobis qveS. adamianis uflebaTa standartebi da interpretacia ` saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb mux. 7: aravin unda ganicdides wamebas an sastik, araadamianur an misi Rirsebis damamcirebel mopyrobasa Tu sasjels. kerZod, aravin SeiZleba iyos samedicino eqsperimentisa Tu kvlevis subieqti informirebuli Tanxmobis gareSe. ` saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb mux. 10(1): yvela TavisuflebaaRkveTil pirs aqvs ufleba, rom humanurad moeqcnen da pativi scen mas adamianis uflebaTa komitetma ganmarta, rom samoqalaqo da politikur uflebaTa saerTaSoriso paqtis mux. 10 (1) moqmedebs nebismier pirTan mimarTebaSi, romelic Tavisufleba aRkveTilia saxelmwifos mier, imyofeba cixeSi, saavadmyofoSi _ gansakuTrebiT fsiqiatriul saavadmyofoSi _ dakavebis banakSi an gamosasworebel instituciaSi, agreTve nebismier adgilas, sadac wevrma saxelmwifoebma unda uzrunvelyon, rom paqtSi gancxadebuli principebi daicvas yvela instituciam da dawesebulebam Tavisi iurisdiqciis farglebSi.41 adamianis uflebaTa komitetma sxvadasxva SemTxvevebSi araerTxel daadastura, rom samoqalaqo da politikur uflebaTa saerTaSoriso paqtis 10 (1) muxlSi nagulisxmevi valdebulebebi pirovnebis Rirsebisa da pativiscemis Sesaxeb, Seicavs dakavebis dros adekvatur samedi- 41 samoqalaqo da politikuri uflebebis komiteti, zogadi komentari 21 (24-e sesia, 1992); muxli 10 anacvlebs zogad komentars 9. a/47/40 (1992) 195par. 2 38 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.3 cino daxmarebas42 da xSirad me-7 muxlTa erTobliobaSi vlindeba darRvevebi.43 gansakuTrebuli darRvevebi aRiniSneba fsiqiatriuli saavadmyofos pacientebSi. adamianis uflebaTa komitetma moiTxova higienuri mdgomareobis gaumjobeseba, regularuli fizikuri varjiSis SemoReba da adekvaturi mkurnaloba amgvar dawesebulebebSi.44 warumatebloba fsiqikuri avadmyofobis mkurnalobaSi ufro mwvavdeba `sikvdilis rigis~ fenomeniT, rac agreTve arRvevs mux. 7-s da mux. 10 (1)-s.45 mux. 10(1)-Tan mimarTebiT, adamianis uflebaTa komitetma aRmoaCina darRveva, roca sikvdilis rigSi myof patimars uari uTxres samedicino daxmarebaze46, roca metismetma gadatvirTvam miusjeli patimrebis moTavsebis adgilas arajansaRma pirobebma da arahumanurma mopyrobam gamoiwvia dakavebulis gardacvalebas.47 42 ixileT: qeli iamaikis winaaRmdeg (Kelly v. Jamaica) (253/1987), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/46/40 (8 aprili 1991) 241 (samoqalaqo da politikuri uflebebis komiteti/C/41/D/253/1987) § 5.7 me-10(1) muxlis darRveva: patimars qonda janmrTelobis problemebi ZiriTadi samedicino momsaxurebis ar Catarebis gamo da aseve mas dRis ganmavlobaSi mxolod 30 wuTiT qonda saknis datovebis ufleba; ix. aseve lintoni iamaikis winaaRmdeg (Linton v. Jamaica) (255/1987), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/48/40 vol. II (22 oqtomberi 1992) 12 (samoqalaqo da politikuri uflebebis komiteti /C/46/D/255/1987) § 2.7 da 8.5, me-7 da me-10(1) muxlebis darRveva; beili iamaikis winaaRmdeg (Bailey v. Jamaica) (334/1988), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/48/40 vol. II (31 marti1993) 72 (samoqalaqo da politikuri uflebebis komiteti /C/47/D/334/1988) § 9.3; Tomasi iamaikis winaaRmdeg (Thomas v. Jamaica) (321/1988), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/49/40 vol. II (19 oqtomberi 1993) 1 (samoqalaqo da politikuri uflebebis komiteti /C/49/D/321/1988) § 9.2 da 11; mika miha ekvatoruli gvineis winaaRmdeg (Mika Miha v. Equatorial Guinea) (414/1990), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/49/40 vol. II (8 ivlisi 1994) 96 (samoqalaqo da politikuri uflebebis komiteti/C/51/D/414/1990) § 6.4; kolin jonsoni iamaikis winaaRmdeg (Colin Johnson v. Jamaica) (653/1995), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/54/40 vol. II (20 oqtomberi 1998) 135 (samoqalaqo da politikuri uflebebis komiteti /C/64/D/653/1995) § 8.1 da kalenga zambiis winaaRmdeg (Kalenga v. Zambia) (326/1988), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/48/40 vol. II (27 ivlisi 1993) 68 (samoqalaqo da politikuri uflebebis komiteti /C/48/D/326/1988) § 6.5. 43 ixileT: uaiTi iamaikis winaaRmdeg (Whyte v. Jamaica) (732/1997), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/53/40 vol. II (27 ivlisi 1998) 195 (samoqalaqo da politikuri uflebebis komiteti /C/63/D/732/1997) § 9.4; lesli iamaikis winaaRmdeg (Leslie v. Jamaica) (564/1993), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/53/40 vol. II (31 ivlisi 1998) 21 (samoqalaqo da politikuri uflebebis komiteti /C/63/D/564/1993) § 3.2-3.5, 3.8 da 9.2; henri iamaikis winaaRmdeg (Henry v. Jamaica (610/1995), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/54/40 vol. II (20 oqtomberi 1998) 45 (samoqalaqo da politikuri uflebebis komiteti /C/64/D/610/1995) § 7.3; fenanti iamaikis winaaRmdeg (Pennant v. Jamaica) (647/1995), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/54/40 vol. II (20 oqtomberi 1998) 118 (samoqalaqo da politikuri uflebebis komiteti /C/64/D/647/1995) § 8.3; levi iamaikis winaaRmdeg (Levy v. Jamaica) (719/1996), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/54/40 vol. II (3 noemberi 1998) 208 (samoqalaqo da politikuri uflebebis komiteti /C/64/D/719/1996) § 7.4; marSali iamaikis winaaRmdeg (Marshall v. Jamaica) (730/1996), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/54/40 vol. II (3 noemberi 1998) 228 (samoqalaqo da politikuri uflebebis komiteti/C/64/D/730/1996) § 6.7; morgani da uiliamsi iamaikis winaaRmdeg (Morgan and Williams v. Jamaica) (720/1996), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/54/40 vol. II (3 noemberi 1998) 216 (samoqalaqo da politikuri uflebebis komiteti /C/64/D/720/1996) § 7.2; morisoni iamaikis winaaRmdeg (Morrison v. Jamaica) (663/1995), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/54/40 vol. II (3 noemberi 1998) 148 (samoqalaqo da politikuri uflebebis komiteti /C/64/D/663/1995) § 8.8; brauni iamaikis winaaRmdeg (Brown v. Jamaica) (775/1997), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/54/40 vol. II (23 marti 1999) 260 (samoqalaqo da politikuri uflebebis komiteti /C/65/D/775/1997) § 3.2 and 6.5; beneti iamaikis winaaRmdeg (Bennett v. Jamaica) (590/1994), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/54/40 vol. II (25 marti 1999) 12 (samoqalaqo da politikuri uflebebis komiteti /C/65/D/590/1994) at paras. 10.7 and 10.8; Smith and Stewart v. Jamaica (668/1995), ICCPR, A/54/40 vol. II (8 aprili 1999) 163 (samoqalaqo da politikuri uflebebis komiteti /C/65/D/668/1995) § 7.5.; mulezi kongos demokratiuli respublikis winaaRmdeg (Mulezi v. Democratic Republic of the Congo) (962/2001), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/59/40 vol. II (6 ivlisi 2004) 159; saidovi tajikeTis winaaRmdeg (Saidov v. Tajikistan) (964/2001), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/59/40 vol. II (8 ivlisi 2004) 164 44 daskvniTi Sefasebebi bosnia da hercegovinas Sesaxeb (samoqalaqo da politikuri uflebebis komiteti /C/BIH/CO/1 (adamianis uflebaTa komiteti, 2006), § 19. 45 uiliamsi iamaikis winaaRmdeg (Williams v. Jamaica (609/1995), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, A/53/40 vol. II (4 noemberi 1997) 63 (samoqalaqo da politikuri uflebebis komiteti /C/61/D/609/1995) § 6.5 46 levisi iamaikis winaaRmdeg (komunikacia #527/1993, gadasinjuli 1996 wlis 18 ivliss). ixileT aseve pinto trinidadis da tobagos winaaRmdeg (232/1987), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb a/45/40 . II (20.07.1990) 69 paragrafi 12.7. ix.aseve henri da duglasi iamaikis winaaRmdeg (571/1994), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb a 1/40 . II (25.07 1996) 155 (samoqalaqo da politikuri uflebebis komiteti /C/57/D/571/1994) § 9.5; lihongi iamaikis winaaRmdeg (Leehong v. Jamaica) (613/1995), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb A/54/40 vol. II (13 ivlisi 1999) 52 (samoqalaqo da politikuri uflebebis komiteti /C/66/D/613/1995) § 3.11 da 9.2 47 lancova ruseTis federaciis winaaRmdeg (Lantsova v Russian Federation) (komunikacia # 763/1997, 2002 wlis 26 martis Sefasebebi) 39 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi sxva magaliTebi, sadac me-7 da me-10(1) muxlebis darRvevas hqonda adgili, moicavs SemTxvevebs, rodesac dakavebuli piri moTavsebuli iyo individualur, miwisqveSa sakanSi. mas sami Tvis ganmavlobaSi awamebdnen da uars eubnebodnen mkurnalobaze da aucilebel samedicino momsaxurebaze.48 sxva magaliTebi aCvenebs, rom saknebis zomam, higienurma mdgomareobam, cudma kvebam da stomatologiurma problemebma gamoiwvia me-7 da me-10(1) muxlebis darRveva.49 dakavebulisTvis samedicino Canawerebis xelmisawvdomobaze uaris Tqmam, gansakuTrebiT im SemTxvevaSi, roca aman SeiZleba mkurnalobis procesze moaxdinos zegavlena, SeiZleba gamoiwvios me-10(1) muxlis darRveva.50 samoqalaqo da politikuri uflebebis Sesaxeb saerTaSoriso paqtis mux. 2(3)(a)-s mixedviT, SeiZeleba moicavdes debulebebs saTanado samedicino da fizikuri mzrunvelobis Sesaxeb.51 ` konvencia wamebisa da sxva sastiki, araadamianuri an damamcirebeli mopyrobis an sasjelis winaaRmdeg ` muxli 1: (1) am konvenciis miznebisaTvis gansazRvreba `wameba~ niSnavs nebismier moqmedebas, romliTac romelime pirs ganzrax ayeneben Zlier tkivils an tanjvas, fizikurs da zneobrivs, raTa misgan an mesame pirisagan miiRon cnobebi an aRiareba, dasajon qmedebisaTvis, romelic man an mesame pirma Caidina an romlis CadenaSic igi eWvmitanilia, agreTve daaSinon an aiZulon igi an mesame piri usafuZvlo mizeziT, romelsac safuZvlad udevs nebismieri xasiaTis diskriminacia, roca aseT tkivilsa da tanjvas ayenebs saxelmwifos Tanamdebobis piri an sxva oficialuri piri, an maTi waqezebiT, nebarTviT da mdumare TanxmobiT. am gansazRvrebaSi ar igulisxmeba tkivili da tanjva, romlebic warmoiSveba mxolod kanonier sanqciaTa Sedegad, am sanqciaTa ganuyofeli nawilia an SemTxveviT aris maTgan gamowveuli. (2)es muxli zians ayenebs romelime saerTaSoriso xelSekrulebas an erovnul kanonmdeblobas, romelic Seicavs an SeiZleba Seicavdes ufro farTod gamoyenebis debulebebs. ` muxli 2: (1) yoveli monawile saxelmwifo iRebs efeqtian sakanonmdeblo, adminitraciul, sasamarTlo da sxva RonisZiebebs mis iurisdiqciaSi Semaval nebismier teritoriaze wamebis aqtebis Tavidan asacileblad. (2) araviTari gansakuTrebuli garemoebebiT, rogoric unda iyos igi, iqneba es saomari mdgomareoba Tu omis safrTxe, Sida politikuri arastabiluroba an nebismieri sxva sagangebo mdgomareoba, ar SeiZleba wamebis gamarTleba. (3) zemdgomi ufrosis an saxelmwifo xelisuflebis brZaneba ar SeiZleba iyo wamebis gamamarTlebeli sabuTi.muxli 4: (1) yoveli monawile saxelmwifo uzrnvelyofs, rom wamebis yvela aqti, misi sisxlis samarTlis kanonmdeblobis Sesabamisad, ganixilebodes rogorc danaSauli. igive exeba wamebis mcdelobis da nebismieri piris moqmedebas, romelic Tavisi arsiT aris wamebaSi Tanamonawileoba an monawileoba. (2) yoveli monawile 48 setelihi/sendiki urugvais winaaRmdeg (Setelich / Sendic v. Uruguay) (R.14/63), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb A/37/40 (28 oqtomberi 1981) 114 § 20 49 houeli iamaikis winaaRmdeg (Howell v. Jamaica) (798/1998), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb A/59/40 vol. II (21 oqtomberi 2003) 21 (samoqalaqo da politikuri uflebebis komiteti /C/79/D/798/1998) 50 Jeludkovi ukrainis winaaRmdeg (Zheludkov v. Ukraine) (726/1996), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb A/58/40 vol. II (29 oqtomberi 2002) 12 (samoqalaqo da politikuri uflebebis komiteti /C/76/D/726/1996. 51 sahadaTi trinidadi da tobagos winaaRmdeg (Sahadath v. Trinidad and Tobago) (684/1996), saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb A/57/40 vol. II (2 aprili 2002) 61 (samoqalaqo da politikuri uflebebis komiteti /C/684/1996) § 9 40 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.3 saxelmwifo gansazRvravs Sesabamis sasjels aseTi danaSaulisaTvis, maTi mZime xasiaTis gaTvaliswinebiT. muxli 16: (1) yoveli monawile saxelmwifo kisrulobs valdebulebas Tavis iurisdiqciaSi Semaval nebismier teritoriaze Tavidan aicilos sastiki, araadamianuri da Rirsebis Semlaxavi mopyrobisa da dasjis sxva aqtebi, romlebsac ar moicavs I muxlSi aRniSnuli wamebis gansazRvreba, roca aseT aqtebs sCadis saxelmwifo Tanamdebobis piri an sxva oficialuri piri, an maTi waqezebiT, an maTi nebarTviT an umoqmedobiT. (2) am konvenciis debulebebi zians ar ayenebs sxva saerTaSoriso xelSekrulebebis an erovnuli kanonmdeblobis debulebebs, romlebic krZalaven sastik, araadamianur an Rirsebis Semlaxav mopyrobas da dasjas an exeba damnaSavis gadacemas. wamebis sawinaaRmdego komitetma gansazRvra, rom gadatvirTuli/gadaWedili sivrce, arasaTanado sacxovrebeli pirobebi da piris xangrZlivi gamoketva fsiqiatriul saavadmyofoSi aris `araadamianuri da damamcirebeli mopyrobis tolfasi.~52 man aseve dagmo msgavsi gadatvirTuloba cixeebSi, sadac sacxovrebelma da higienurma pirobebma SeiZleba safrTxe Seuqmnas patimrebis janmrTelobas da sicocxles53, samedicino meTvalyureobis naklebobasTan erTad.54 komitetma aseve xazgasmiT aRniSna, rom samedicino personali, romelic monawileobs wamebis procesSi, eqvemdebareba pasuxisgebaSi micemas da dasjas.55 ` bavSvis uflebaTa konvencia muxli 37: monawile saxelmwifoebi uzrunvelyofen, rom: a) arc erTi bavSvi ar SeiZleba gaxdes wamebis an sxva sastiki, araadamianuri an Rirsebis Semlaxveli mopyrobis an dasjis msxverpli. muxli 39: monawile saxelmwifoebi yvela zomas mimarTaven, raTa xeli Seuwyon im bavSvis fizikuri da fsiqologiuri mdgomareobis aRdgenas da socialur reintegracias, romelic aris ugulvebelyofis, eqspluataciis an Zaladobis, wamebis an nebismieri sxva sastiki, araadamianuri an Rirsebis Semlaxavi mopyrobis, dasjis, an SeiaraRebuli konfliqtebis msxverpli; mdgomareobis msgavsi aRdgena da reintegracia unda xorcieldebodes bavSvis janmrTelobis, misi pirovnebis da Rirsebis pativiscemis uzrunvelyofiT. ` konvencia SezRuduli SesaZleblobebis mqone pirTa uflebebis dacvis Sesaxeb mux. 15: 1. aravin SeiZleba gaxdes wamebis, sastiki, araadamianuri an damamcirebeli mopyrobisa da dasjis msxverpli. gansakuTrebiT, aravis gamoyeneba ar SeiZleba samedicino Tu 52 daskvniTi Sefasebebi ruseTis Sesaxeb (wamebis sawinaaRmdego komiteti/C/RUS/CO/4 (CAT, 2007), § 18. 53 adamianis uflebaTa umaRlesi komisris ofisi (OHCHR). daskvniTi Sefasebebi, kameruni (konvencia wamebis da sxva sastiki, araadamianuri an Rirsebis Semlaxavi mopyrobis an sasjelis winaaRmdeg CAT /C/CR/31/6) 54 adamianis uflebaTa umaRlesi komisris ofisi (OHCHR). daskvniTi Sefasebebi, nepali (konvencia wamebis da sxva sastiki, araadamianuri an Rirsebis Semlaxavi mopyrobis an sasjelis winaaRmdeg (CAT) /C/NPL/CO/2). ixileT agreTve Sefasebebi paragvais (CAT /C/SR.418) da braziliis Sesaxeb (CAT /C/SR.471) 55 adamianis uflebaTa umaRlesi komisris ofisi (OHCHR). daskvniTi Sefasebebi, argentina (A/48/44) 41 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi samecniero kvlevaSi misi Tavisufali Tanxmobis gareSe. 2. monawile saxelmwifoebma unda miiRon yvela efeqturi sakanonmdeblo, administraciuli, iuridiuli da sxva zomebi, raTa uzrunvelyon SezRuduli SesaZleblobebis pirTa dacva wamebis an sastiki, arahumanuri, damamcirebeli mopyrobisa an sasjelisagan, sxvebTan Tanasworobis safuZvelze. ` samarTaldamcavi organoebis TanamSromelTa qcevis kodeqsi muxli 2: sakuTari movaleobebis Sesrulebisas samarTaldamcavi organoebis warmoamdgenlebma pativi unda scen da daicvan adamianis uflebebs da Rirsebas. muxli 5: samarTaldamcavi organos arcerT TanamSromels ar aqvs ufleba ganaxorcielos, provocireba moaxdinos an dauSvas wamebis an sxva sastiki, araadamianuri an Rirsebis Semlaxavi nebismieri faqti, aseve gamosces aqti an dauSvas gamonaklisi wamebis, an sxva sastiki, araadamianuri an Rirsebis Semlaxavi mopyrobis an dasjis Sesaxeb. ` samedicino eTikis principebi jandacvis personalis, gansakuTrebiT ki eqimebis rolis Sesaxeb patimarTa da dakavebulTa wamebis da sxva sastiki, araadamianuri da damamcirebeli mopyrobisa da sasjelisgan dasacavad (1982)56 ` gaeros principTa erToblioba nebismieri formiT dakavebuli an patimrobaSi myofi yvela piris dacvis Sesaxeb: ` principi 1: nebismieri formiT dakavebul an dapatimrebul yvela pirs unda moepyron adamianurad, misi Rirsebisa da pirovnebis pativiscemiT. principi 6: dakavebuli an patimrobaSi myofi arcerTi piri ar SeiZleba gaxdes wamebis an sxva sastiki, araadamianuri an Rirsebis Semlaxavi mopyrobis an dasjis msxverpli. arcerT garemoebaSi ar daiSveba wamebis an Rirsebis Semlaxavi mopyrobis an dasjis gamarTleba. ` patimrebTan mopyrobis gaeros minimaluri standartuli wesebi wesi 22-26 samedicino momsaxurebis Sesaxeb wesi 22 (1) _ yvela dawesebulebas unda hyavdes erTi iseTi kvalificiuri medicinis muSaki, romelsac fsiqiatriaSic eqneba umaRlesi ganaTleba. saWiroa samedicino momsaxurebis organizeba jandacvis adgilobriv an saxelmwifo organoebTan mWidro kontaqtSi. igi unda moicavdes fsiqiatriul diagnostikur samsaxurebs da, sadac es aucilebelia, daavadebulTa mkurnalobasac. wesi 22 (2) _ avadmyofi patimrebi, romlebsac specialistTa yuradReba esaWiroebaT, unda gadaiyvanon specialur dawesebulebebSi an samoqalaqo saavadmyofoSi. cixis saavadmyofoebs unda hqondeT Sesabamisi samedicino momsaxurebisTvis da maTi mkurnalobisaTvis saWiro danadgarebi, preparatebi da medikamentebi, agreTve sakmarisad kvalificiuri personali. wesi 22 (3)-is Tanaxmad, TiToeul patimars unda hqondes imis SesaZlebloba, rom isargeblos kvalificiuri stomatologis momsaxurebiT. 56 www.unhchr.ch/html/menu3/b/h_comp40.htm 42 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.3 wesi 23 _ qalTa sapatimro dawesebulebebSi unda iyos calke saTavsoebi fexmZime da mSobiare qalebis mosavlelad. iq, sadac es SesaZlebelia, unda vizrunoT imaze, rom mSobiaroba moxdes ara cixis, aramed samoqalaqo hospitalSi. wesi 24 _ TiToeulma patimarma saWiroebis SemTxvevaSi, unda gaiaros samedicino Semowmeba misi sapatimroSi miyvanisTanave da SemdgomSic, raTa dadgindes, aris Tu ara igi daavadebuli fizikurad an gonebrivad; miRebul unda iqnas Sesabamisi zomebi; unda moxdes im patimrebis izolireba, romelTa Sesaxeb SeiZleba gaCndes eWvi, rom isini daavadebulni arian raime infeqciuri an gadamdebi daavadebiT. wesi 25 _ patimarTa fizikur da fsiqikur janmrTelobaze unda zrunavdes eqimi, romelic yoveldRiurad moinaxulebs avadmyofebs da yvelas, vinc Tavs SeuZlod grZnobs. rodesac eqims miaCnia, rom patimris fizikuri an gonebrivi janmrTeloba darRveulia, amis Sesaxeb unda moaxsenos direqtors. wesi 26 _ eqimi valdebulia, regularulad ganaxorcielos inspeqtireba da Caabaros angariSi direqtors Semdegi sakiTxebis Sesaxeb: sakvebi, higiena, sanitaruli mdgomareoba, gaTboba, ganaTeba da ventilacia dawesebulebaSi; patimrebis tansacmelisa da saZile nivTebis vargisianoba da sisufTave. Sesabamisad, direqtori unda iTvaliswinebdes eqimis mier warmodgenil angariSebs da rCevebs, ris Semdegac dauyovnebliv unda miiRos zomebi aRniSnuli problemebis aRmosafxvrelad. ¾ eqimTa adamianis uflebaTa principebi wamebis faqtebis efeqturi aRricxvis da dokumentaciis Sesaxeb. stambulis oqmi57 sajaro politikaSi monawileobis ufleba uflebis potenciur darRvevaTa magaliTebi mkvidri mosaxleobis jgufebs uars eubnebian monawileoba miiRon gadawyvetilebebis miRebis procesSi, romlebic maT janmrTelobas da keTildReobas exeba, radgan maT ar miiCneven saTanado kompetenciis mqoned; lgbt (lesboseli, gei, biseqsuali da transgenderuli) adamianebs ganzrax eubnebian uars, monawileoba miiRon aiv/Sidsis sawinaaRmdego strategiis SemuSavebaSi. adamianis uflebaTa standartebi da interpretacia saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb mux. 25: TiToeul moqalaqes raime diskriminaciis da dausabuTebel SezRudvaTa gareSe unda hqondes ufleba da SesaZlebloba: 57 www.physiciansforhumanrights.org/library/istanbul-protocol.html 43 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi a) monawileobdes saxelmwifo saqmeTa warmoebaSi, rogorc uSualod, ise Tavisuflad arCeuli warmomadgenlebis saSualebiT. ` konvencia qalTa mimarT diskriminaciis yvela formis likvidaciis Sesaxeb mux. 7: monawile saxelmwifoebi iReben yvela saWiro zomebs qveynis politikur da sazogadoebriv cxovrebaSi qalTa mimarT diskriminaciis aRmosafxvrelad, kerZod: ganurCevlad sqesisa uzrunvelyofen uflebas, rom: a) adamianebma xma miscen arCevnebSi, monawileoba miiRon sajaro referendumebSi da qalebს, iseve rogorc mamakacebს, შეეძლოთ ნებისმიერი თანამდებობის დაკავება; b) miiRon monawileoba arasamTavrobo organizaciebisa da asociaciebis saqmianobaSi, romlebic qveynis sazogadoebrivi da politikuri cxovrebis problemebze muSaoben; mux. 14 (2) (a): qalebi, msgavsad mamakacebisa, monawileobdnen yvela donis ganviTarebis gegmis SemuSavebasa da ganxorcielebaSi. ` msoflio jandacvis organizaciis alma-atas deklaracia: ` mux. IV: xalxs ufleba aqvs, monawileoba miiRos individualurad da koleqtiurad TavianTi janmrTelobis dacvis dagegmvasa da implementaciaSi. ` pacientTa organizaciebis saerTaSoriso aliansiს (IAPO) deklaracia pacientze orientirebuli jandacvis Sesaxeb: arCevani da Zalauflebis miniWeba principi N2 pacientsa da misi ojaxis wevrebs (kanonier warmomadgenlebs, meurveebsa da mzrunvelebs), maTi SesaZleblobebis farglebSi, ufleba aqvT monawileoba miiRon im gadawyvetilebebis miRebaSi, romlebic maT cxovrebaze axdens zegavlenas. aRniSnuli moiTxovs interaqtiuli jandacvis servisebis arsebobas, romelic pacients sTavazobs arCevans mkurnalobasa da menejmentSi. amasTanave, biZgs aZleven pacientebs da janmrTelobis damcvelebs, romlebic marTaven da mimarTulebas aZleven mkurnalobas, miaRwion sicocxlis umaRles xelmisawvdom xarisxs. pacientTa organizaciebs unda mieniWoT Zalaufleba, raTa iTamaSon ufro mniSvnelovani lideruli roli pacientebis da maTi ojaxebis mxardasaWerad imisTvis, rom maT daicvan TavianTi ufleba jandacvis arCevanTan mimarTebaSi. ` pacientTa organizaciebis saerTaSoriso aliansiს (IAPO) deklaracia pacientze orientirebuli jandacvis Sesaxeb: pacientis CarTva jandacvis politikaSi principi N358: pacientebma da pacientTa organizaciebma unda gainawilon jandacvis politikis gansazRvris pasuxismgebloba yvela doneze/etapze gadawyvetilebaTa miRebaSi gonivruli CabmiT imis uzrunvelsayofad, rom am yvelafris SemuSaveba pacientis monawileobiT xdeba. es ar unda moicavdes mxolod jandacvis politikas, aramed unda moicavdes socialur politikas, rac sabolood pacientis sicocxleze moaxdens zegavlenas. ekonomikuri, socialuri da kulturuli uflebebis Sesaxeb saerTaSoriso paqti, muxli 12: (1) 58 ix. aseve pacientTa moZraobis politikis gancxadeba http://www.patientsorganizations.org/showarticle.pl?id=590&n=962 44 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.3 winamdebare paqtis monawile saxelmwifoebi aRiareben TiToeuli adamianis uflebas fizikuri da fsiqikuri janmrTelobis umaRles SesaZlo standartebze. (2) zomebi, romlebic winamdebare paqtis monawile saxelmwifoebma unda miiRon am uflebis sruli realizaciisTvis, unda Seicavdes RonisZiebebs, romlebic aucilebelia: ... (g) epidemiuri, endemuri, profesiuli da sxva daavadebebis Tavidan asacileblad, samkurnalod da Sesamowmeblad; (d)iseTi pirobebis Sesaqmdenlad, romlebic avadmyofobis SemTxvevaSi yvelasTvis uzrunvelyofs samedicino daxmarebas da movlas. ` ekonomikuri, socialuri da kulturuli uflebebis komitetma mouwoda saxelmwifoebs, SeimuSaon ,,erovnuli sazogadoebrivi jandacvis strategia da samoqmedo gegma~, romelic ,,periodulad unda gadamowmdes interaqtiuli da gamWvirvale procesis meSveobiT.~59 amasTanave, ,,janmrTelobis xelSewyoba unda moicavdes efeqtur sazogadoebriv moZraobas prioritetebis gansazRvris, gadawyvetilebaTa miRebis, dagegmvis da strategiebis danergvisa da Sefasebis kuTxiT, janmrTelobis ukeTesi donis misaRwevad.~60 diskriminaciis akrZalva da Tanasworobis ufleba uflebis potenciur darRvevaTa magaliTebi TavSesafris maZieblebs uars eubnebian mkurnalobaze, garda gadaudebeli samedicino daxmarebisa; saavadmyofoebi boSa qalebs mudmivad aTavseben calke samSobiaro ganyofilebebSi/palatebSi; narkotikebis momxmareblebi naklebad arian CarTulebi Sidsis samkurnalo programebSi, miuxedavad imisa, rom isini warmoadgenen SidsiT daavadebuli mosaxleobis umetesobas; qals, romelsac aqvs Sizofreniis diagnozi, eubnebian, rom tkivili, romelsac igi ganicdis muclis areSi, ubralod eCveneba misi fsiqikuri mdgomareobidan gamomdinare. Semdeg ki, avadmyofs saSvilosnos kibos diagnozs usvamen. adamianis uflebaTa standartebi da interpretacia ` saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb mux. 26: yvela adamiani Tanasworia kanonis winaSe da yovelgvari diskriminaciis gareSe aqvs kanonis Tanaswori dacvis ufleba. am mxriv yovelgvari diskriminacia unda aikrZalos da kanoni unda uzrunvelyofdes yvela piris Tanaswor da efeqtian dacvas raime niSnis (rogoricaa rasis, kanis feris, sqesis, enis, religiis, politikuri da sxva mrwamsis, erovnuli Tu socialuri warmoSobis, qonebrivi mdgomareobis, dabadebisa Tu sxva garemoebis) gamo diskriminaciis winaaRmdeg. 59 ekonomikur, socialur da kulturul uflebaTa komiteti 14, paragrafi 43. 60 ekonomikur, socialur da kulturul uflebaTa komiteti 14, par: 54 45 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi ` mux. 2(1): am paqtis monawile TiToeuli saxelmwifo kisrulobs valdebulebas pativi sces da misi teritoriis farglebsa da mis iurisdiqciaSi myofi yvela pirisaTvis uzrunvelyos am paqtiT aRiarebuli uflebebi: rasis, kanis feris, sqesis, enis, religiis, politikuri an sxva mrwamsis, erovnuli Tu socialuri warmoSobis, qonebrivi mdgomareobis, dabadebisa Tu sxva garemoebis gamo. ` ekonomikuri, socialuri da kulturuli uflebebis komiteti, zogadi komentari 14, par. 12: jandacvis dawesebulebebi, saSualebebi da momsaxureba unda iyos yvelasaTvis xelmisawvdomi diskriminaciis gareSe, ,,gansakuTrebiT ki mosaxleobis mowyvladi jgufebisaTvis.~ kerZod, amgvari jandacvis dawesebulebebis da momsaxurebis ,,Rirebuleba unda iyos yvelasTvis xelmiswvdomi~ da ,,Rarib ojaxebs ar unda daawve meti tvirTi mkurnalobis Rirebulebis gamo SeZlebul ojaxebTan SedarebiT.~ ekonomikuri, socialuri da kulturuli uflebebis komitetma gansakuTrebuli yuradReba dauTmo ,,eTnikuri umciresobebis, mkvidri mosaxleobis, qalebis, bavSvebis, mozardebis, xanSiSesulebis, SezRuduli SesaZleblobebis pirebis da aiv/SidsiT daavadebulTa saWiroebebs.~61 ` ekonomikuri, socialuri da kulturuli uflebebis komiteti, zogadi komentari 5, par. 15: gansazRvra SezRuduli SesaZleblobebis mqone pirTa diskriminacia, rogorc ,,araTanaswori mopyroba, gariyva, SezRudva, anda saTanado sacxovrebel pirobebze uaris Tqma SezRuduli SesaZleblobebis gamo, rac, Tavis mxriv, iwvevs ekonomikur, socialur da kulturul uflebaTa gamoyenebis SezRudvas an SeuZleblobas.~62 sabWom agreTve aRniSna, rom saWiroa `ara mxolod saxelmwifo jandacvis seqtori, aramed kerZoc _ daemorCilos diskriminaciis akrZalvis princips SezRuduli SesaZleblobebis pirebTan dakavSirebiT.~63 qalis da mamakacis TanasworobasTan mimarTebiT janmrTelobis dacvis dros, ekonomikuri, socialuri da kulturuli uflebebis komitetma mosTxova saxelmwifoebs, sul mcire, gaeuqmebinaT iuridiuli da sxva saxis barierebi, romlebic xels uSlis qalebsa da mamakacebs, Tanasworad isargeblon jandacvis servisebiT. aRniSnuli gulisxmobs im genderuli stereotipebis moSlas, romlebic iwvevs genderul gansxvavebebs sakvebisa da wylis miRebis mxriv, aseve samarTlebrivi SezRudvebis moxsnas reproduqciuli janmrTelobis xelmisawvdomobaSi; qalis sasqeso organos dasaxiCrebis akrZalvas, jandacvis profesionalTa saTanado momzadebas qalTa janmrTelobis sakiTxebSi.64 ¾ konvencia rasobrivi diskriminaciis yvela formis likvidaciis Sesaxeb mux.5 (e) (IV): am konvenciis me-2 muxlSi aRniSnuli ZiriTadi movaleobebis Sesabamisad, monawile saxelmwifoebi valdebulebas iReben, akrZalon da aRmofxvran nebismieri formis rasobrivi diskriminacia da uzrunvelyon yvela adamianis Tanasworoba kanonis winaSe, miuxedavad rasisa, kanis ferisa, erovnuli da eTnikuri kuTvnilebisa, gansakuTrebiT Semdegi uflebebis ganxorcielebisaTvis: uflebebi ekonomikur, socialur da kulturul sferoebSi, kerZod, janmrTelobis dacvis, samedicino daxmarebis, socialuri uzrunvelyofis da socialuri momsaxurebis ufleba. 61 ekonomikur, socialur da kulturul uflebaTa komiteti 14, par: 12. 62 ekonomikur, socialur da kulturul uflebaTa komiteti 14, par 15 63 ekonomikur, socialur da kulturul uflebaTa komiteti 14, par 26 64 ekonomikur, socialur da kulturul uflebaTa komiteti, zogadi komentari 16 (34-e sesia, 2005): muxli 3: Tanabari uflebebi qalebisa da kacebisaTvis isargeblon ekonomikuri, socialuri da kulturuli uflebebiT, e/2006/22 (2005) 116 par:29. 46 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.4 rasobrivi diskriminaciis aRmofxvris komitetma urCia wevr-saxelmwifoebs, TavianTi gansakuTrebuli garemoebebis gaTvaliswinebiT, uzrunvelyon moqalaqeobis armqone pirTa fizikuri da fsiqikuri janmrTelobis uflebis pativiscema prevenciul, samkurnalo da paliatiur mzrunvelobaze uaris Tqmisgan Tavis SekavebiT.65 ¾ konvencia qalis diskriminaciis yvela formis likvidaciis Sesaxeb mux. 12 1. monawile saxelmwifoebi iReben yvela saWiro zomas janmrTelobis dacvis sferoSi qalTa mimarT diskriminaciis aRmosafxvrelad, raTa mamakacTa da qalTa Tanasworobis safuZvelze uzrunvelyon samedicino momsaxurebis xelmisawvdomoba (ojaxis dagegmva da sxva); 2. am muxlis I-li punqtis debulebebTan erTad monawile saxelmwifoebi qalebisTvis uzrunvelyofen Sesabamis momsaxurebas orsulobis, mSobiarobis da mSorbiarobis Semdgom periodSi. zog SemTxvevaSi, saWiroebidan gamomdinare, uweven ufaso momsaxurebas, agreTve uzrunvelyofen Sesabamis kvebas orsulobis da meZuZurobis periodSi. 2.4. janmrTelobis dacvis momsaxurebis mimwodebelTa uflebebi mravali saerTaSoriso xelSekruleba da konvencia moicavs iseT uflebebs, romlebic icavs dasaqmebulTa interesebs da uzrunvelyofs maTTvis usafrTxo da jansaR samuSao garemos. gaeros da mis uwyebebs, maT Soris Sromis saerTaSoriso organizacias, SemuSavebuli aqvs Sromis saerTaSoriso standartebi da zedamxedveloben maT implementacias. saxelmZRvanelos am nawilSi warmodgenilia ramdenime standarti, Tu rogor xdeba maTi interpretireba jandacvis servisis mimwodebelTa sam ZiriTad uflebasTan mimarTebiT. es uflebebia: saTanado pirobebSi muSaobis ufleba (gonivruli anazRaurebis CaTvliT); Sekrebisa da gaerTianebis Tavisufleba (maT Soris profkavSirebSi gaerTianeba da gaficvis ufleba); samarTalwarmoebis ufleba da Sesabamisi uflebebi, maT Soris samarTliani sasamarTlo ganxilvis ufleba, ufleba dacvis efeqtur saSualebaze, piradi cxovrebis da reputaciis dacva, gamoxatvis da informaciis Tavisufleba. am seqciis pirveli nawili exeba saTanado pirobebSi muSaobis uflebas. meore TavSi warmodgenilia Sekrebisa da gaerTianebis ufleba, xolo mesame TavSi ganxilulia samarTalwarmoebis ufleba. yoveli seqcia moicavs: ganmartebas, Tu ra mniSvneloba aqvs konkretul uflebas jandacvis momsaxurebis mimwodebelTaTvis, uflebis SesaZlo darRvevaTa magaliTebs, gaeros xelSekrulebebSi asaxul Sesabamis SromiT standartebs da sxvadasxva oficialur dokumentebSi arsebul interpretaciebs. 65 rasobrivi diskriminaciis akrZalvis Sesaxeb komiteti, zogadi rekomendacia XXX (65-e sesia, 2004): a/59/18 (2004) 93 47 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi saTanado pirobebSi muSaobis ufleba gaeros organoebis ganmartebiT ar arsebobs ufleba, rom piri uzrunvelyofili iyos misi arCevanis Sesabamisi samsaxuriTa da TanamdebobiT. Tumca saxelmwifom ar unda SeuSalos xeli pirovnebis karierul winsvlas. saxelmwifo aseve valdebulia uzrunvleyos migrant muSaTa mimarT samarTliani mopyroba. es ZiriTadad exeba jandacvis im muSakebs, romlebic dasaqmebulni arian sxva qveynebis saavadmyofoebsa da klinikebSi. gaeros saxelSekrulebo uwyebebma araerTi kvelva Caatares dasaqmebulTa anazRaurebis da samuSao pirobebis Seswavlis mizniT. Sedegad, gamoCnda, rom jandacvis muSakebi ZiriTadad ukmayofiloni arian zog qveyanaSi arsebuli dabali anazRaurebiT. muSaobis ufleba uflebebis potenciur darRvevaTa magaliTebi yvela migranti mosamsaxure, maT Soris eqimis da meddis poziciaze dasaqmebulni, romlebic X qveynidan iyvnen, gaaZeves maT qveyanasTan diplomatiuri urTierTobebis daZabvis gamo; dasaqmebul qalTa mimarT mudmivad xorcieldeba seqsualuri Seuracxyofa sxva TanamSromlebis mxridan da aRniSnulis aRmosafxvrelad ar aris miRebuli saTanado zomebi; ar xdeba jandacvis muSakTa samuSao drois regulireba da xSirad maT uxdebaT gadaWarbebiT kviraSi 80 saaTi muSaoba. adamianis uflebebaTa standartebi da interpretacia ` adamianis uflebaTa sayovelTao deklaracia, muxli 23(1): yvelas aqvs Sromis, samuSaos Tavisufali arCevis, samarTliani da xelsayreli samuSao pirobebisa da umuSevrobisgan dacvis ufleba. ekonomikur, socialur da kulturul uflebaTa komiteti, zogadi komentari #18 (muSaobis ufleba): 1: muSaobis ufleba mniSvnelovania sxva adamians uflebebis realizebisTvis da warmoadgens adamianis Rirsebis ganuyofel nawils. yvela adamians aqvs ufleba, hqondes muSaobis SesaZlebloba, rac Rirseul cxovrebas uwyobs xels. muSaobis ufleba amavdroulad xels uwyobs pirovnebis da misi ojaxis gadarCenas, ganviTarebas da sazogadoebaSi aRiarebis mopovebas. 4: ekonomikur, socialur da kulturul uflebaTa saerTaSoriso paqtiT garantirebuli Sromis ufleba saxelmwifos akisrebs valdebulebas, uzrunvelyofili iyos pirovnebis mier samuSaos sakuTari survilisamebr arCevis ufleba, maT Soris ar moxdes pirisTvis muSaobis uflebis ukanonod warTmeva. es gansazRvreba xazs usvams, rom pirovnebis da misi Rirsebis pativiscema gamoixateba samuSaos Tavisuflad arCevis uflebaSic, rac xels uwyobs pirovnebis ganviTarebasa da mis socialur da ekonomikur damkvidrebas. 48 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.4 ekonomikur, socialur da kulturul uflebaTa komiteti, zogadi komentari #18, 6, 23 da 25: muSaobis ufleba ar gulisxmobs samsaxuris mopovebis absolutur da upirobo uflebas, aramed niSnavs, rom arc saxelmwfom da arc sxvebma (magaliTad, kerZo kompaniebma) ar unda ganaxorcielon ukanono da diskriminaciuli qmedeba, rac xels SeuSlis pirovnebis mier anazRaurebis miRebas da profesiul saqmianobas. ekonomikur, socialur da kulturul uflebaTa komiteti, zogadi komentari #16, 23: paqtis me-3 muxlis ganxorcieleba, me-6 muxlTan mimarTebiT, inter alia gulisxmobs, rom rogorc kanonmdeblobiT, ise praqtikaSi, mamakacebs da qalebs hqondeT muSaobis Tanaswori ufleba yvela doneze da nebismier Tanamdebobaze; aseve, sajaro da kerZo seqtoris satreningo da saxelmZRvanelo programebma uzrunvelyon mamakacebis da qalebis aRWurva saWiro unarebiT, informaciiT da codniT, rac aucieleblia muSobis uflebis Tanasoruflebiani realizebisaTvis. ekonomikur, socialur da kulturul uflebaTa komiteti, umuSevrobis maRali maCveneblis gamo saxelmwifoebis mimarT gamoTqmuli araerTi kritikis garda, gmobs aseve a) aiv-SidsiT inficirebuli ucxo qveynis muSebis samsaxuridan gaTavisuflebas, romlebsac aqvT muSaobis moqnedi ufleba;66 b) dabalanazRaurebad, naxevar ganakveTian samuSaoze qalTa araproporciul raodenobas67 da g) sajaro seqtorSi Statebis Semcirebas mniSvnelovani socialuri SedegebiT68. ` saerTaSoriso konvencia rasobrivi diskriminaciis yvela formis likvidaciis Sesaxeb rasobrivi diskriminaciis sawinaaRmdego komitetma araerTxel gamoTqva ukmayofileba imis Taobaze, rom saxelmwifoebi ar uzrunvelyofen eTnikur umciresobaTa da migrant muSaTa dasaqmebas.69 rasobrivi diskriminaciis sawinaaRmdego komitetma daadgina, rom eqimebis gamocdebis da kvotirebis sistema, romlebsac sxva qveynebSi aqvT miRebuli ganaTleba, ar arRvevs migrant muSa-mosamsaxureTa rasobrivi diskriminaciis yvela formis likvidaciis Sesaxeb konvenciis me-5 muxliT miniWebul uflebas. me-5 muxliT garantirebulia muSaobis da samuSaos arCevis ufleba ganurCevlad rasis, kanis feris an erovnuli Tu eTnikuri warmomavlobis.70 gaeros deklaracia pirTa, jgufebis da sazogadoebrivi uwyebebis uflebebisa da movaleobebiis Sesaxeb uzrunvelyon da daicvan sayovelTaod aRiarebuli adamianis uflebebi da ZiriTadi Tavisuflebebi, 1998, muxli 1171: yvelas aqvs ufleba hqondes sakuTari samuSao da profesia individualurad an sxvebTan erTad. yvelam unda daicvas dasaqmebulTa uflebebi da pativi sces maT Rirsebas. 66 ekonomikur, socialur da kulturul uflebaTa saerTaSoriso komiteti. daskvniTi Sefasebebi: did britaneTis da Crd. irlandiis gaerTianebuli samefo, 1997 (E/1998/22), ix. aseve daskvniTi Sefasebebi: ukraina, 1995 (E/1996/22) 67 ekonomikur, socialur da kulturul uflebaTa saerTaSoriso komiteti. solomonis kunZuli, 1999 (E/2000/22) 68 rasobrivi diskriminaciis sawinaaRmdego komiteti. daskvniTi Sefasebebi: poloneTi, 1997 (A/52/18) 69 rasobrivi diskriminaciis sawinaaRmdego komiteti. daskvniTi Sefasebebi: poloneTi, 1997 (A/52/18). ix. aseve: norvegia, 1994 (A/49/18); did britaneTis da Crd. irlandiis gaerTianebuli samefo, 1991 (A/46/18); israeli, 1998 (A/53/18); niderlandebi, 1998 (A/53/18); libani, 1998 (A/53/18); azerbaijani, 1999 (A/54/18) (A/60/18) dania, 2000 (A/55/18); latvia, 2003 (A/58/18); islandia, 2005 (A/60/18) da TurqmeneTi, 2005 (A/60/18) 70 rasobrivi diskriminaciis sawinaaRmdego komiteti. mosazreba, gamoTqmuli saqmeSi b.m.s. avstraliis winaaRmdeg, 1996 (C/54/ D/8/1996); gadawyvetileba, 1999 (A/54/18) 71 gaeros generaluri asambleis rezolucia 53/144. 09.12.1998 49 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi qalebTan dakavSirebuli standartebi konvencia qalTa mimarT diskriminaciis yvela formis aRmofxvris Sesaxeb, muxli 11 (1): monawile saxelmwifoebi iReben yvela saWiro zomas dasaqmebis sferoSi qalTa mimarT diskriminaciis aRmosafxvrelad, raTa mamakacTa da qalTa Tanasworobis safuZvelze uzrunvelyon Tanabari uflebebi, kerZod: a) Sromis ufleba, rogorc yvela adamianis ganuyofeli ufleba; g) profesiis an samuSaos saxeobis Tavisufali arCevis, Tanamdebobrivi dawinaurebis da dasaqmebis garantiis, agreTve samuSaos yvela SeRavaTis da pirobebis gamoyenebis, profesiuli momzadebis da gadamzadebis, maT Soris mowafeobis, gazrdili donis profesiuli momzadebis da regularuli gadamzadebis ufleba; migrant muSebTan dakavSirebuli standartebi ` saerTaSoriso konvencia yvela migranti muSakisa da maTi ojaxis wevrebis dacvis Sesaxeb, muxli 51: migranti muSebi, romlebsac dasaqmebis saxelmwifoSi ar eZlevaT ufleba Tavisuflad airCion anazRaurebadi saqmianoba, ar unda CaiTvalon rogorc uCveulo mdgomareobaSi myofni da ar unda dakargon cxovrebis ufleba im faqtis gamo, rom SeuwydaT anazRaurebadi samuSao, rodesac maT aqvT moqmedi muSaobis nebarTva, garda im SemTxvevisa, rodesac maTi saxelmwifoSi cxovrebis ufleba pirdapir ukavSirdeba maT mier iseTi anazRaurebadi saqmianobis ganxorcielebas, romlis gamoc isini miiRes. aRniSnul migrant muSebs unda hqondes ufleba moiZion alternatiuli samuSao, monawileoba miiRon sajaro samuSao sqemebSi da SeinarCunon darCenili periodis ganmavlobaSi muSaobis ufleba, muSaobis nebarTvaSi miTiTebuli pirobebisa da SezRudvebis farglebSi. samarTliani anazRaurebisa da usafrTxo samuSao pirobebis ufleba uflebebis potenciur darRvevaTa magaliTebi meddebs da damxmare personals uxdian dawesebul minimalur SromiT anazRaurebaze naklebs; personalisTvis gankuTvlili sasadilo agrZelebs funqcionirebas, miuxedavad ZiriTadi higienuri normebis ararsebobisa; rentgenoloogis ganyofilebaSi momuSave personali mudmivad aris radiaciis maRali donis safrTxis qveS gaumarTavi aRWurvilobis gamo, romlis Semowmeba an gamocvla ar xdeba; medda dainficirda aiv-SidsiT arasaTanadod gasterilebuli samedicino aRWurvilobis gamo. 50 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.4 adamianis uflebebaTa standartebi da interpretacia ` saerTaSoriso paqti ekonomikuri, socialuri da kulturuli uflebebis Sesaxeb muxli 7: winamdebare paqtis monawile saxelmwifoebi aRiareben TiToeuli adamianis uflebas, hqondes Sromis samarTliani da xelsayreli pirobebi, rac, gulisxmobs: a) anazRaurebas, romelic yvela mSromels uzrunvelyofs sul mcire: (i) samarTliani xelfasiTa da tolfasovani SromisaTvis Tanabari anazRaurebiT raime niSniT gansxvavebis gareSe, kerZod, qalebisaTvis qmnis Sromis iseTi pirobebis garantias, romelic mamakacis Sromis pirobebze uaresi ar iqneba, da Tanabari SromisaTvis Tanabari anazRaurebis SesaZleblobas; (ii) masa da mis ojaxs Rirseuli arsebobis SesaZleblobiT, winamdebare paqtis debulebaTa Sesabamisad. b) usafrTxo da jansaR Sromis pirobebs; c) TiToeulisaTvis ufro maRal samsaxurebriv safexurze dawinaurebis Tanabar SesaZleblobas mxolod da mxolod SromiT staJisa da kompetenciis Sesabamisad; d) dasvenebis, Tavisufali drois qonis da samuSao saaTebis gonivruli SezRudvis, agreTve perioduli anazRaurebadi Svebulebis SesaZleblobas iseve, rogorc anazRaurebas sazogadoebrivi uqme dReebisaTvis. muxli 12: 1. winamdebare paqtis monawile saxelmwifoebi, aRiareben TiToeuli adamianis uflebas fizikuri da fsiqikuri janmrTelobis umaRles SesaZlo stndartebze. 2. zomebi, romlebic winamdebare paqtis monawile saxelmwifoebma unda miiRon am uflebis sruli realizaciisaTvis, unda Sicavdes RonisZiebebs, romlebic aucilebelia: b) garemos higienisa da mrewvelobaSi Sromis higienis yvela aspeqtis gasaumjobeseblad... ekonomikur, socialur da kulturul uflebaTa komitetma gamoxata ukmayofileba samuSao pirobebTan dakavSirebul rig sakiTxebze, maT Soris: erovnuli Sromis kodeqsis harmonizacia saerTaSoriso standartebTan, gansakuTrebiT dekretul SvebulebasTan,72 uTanasworo anazRaurebasTan da kerZo da sajaro seqtors Soris gansxvavebebTan dakavSirebiT;73 samsaxurSi diskriminacia politikuri Sexedulebebis gamo;74 saxelmwifos mier dadgenili minimaluri xelfasis odenobis ararseboba sajaro seqtoris TanamSromlebisTvis da zogierTi maTganis (gansakuTrebiT pedagogebis) anazRaurebis mniSvnelovani kleba; pedagogebsa da saxelmwifos Soris konfliqturi urTierTobebis arseboba da aRniSnuli situaciis gasaumjobeseblad gadadgmuli nabijebis ara efeqturoba;75 araefeqturi kampania higienuri da usafrTxoebis zomebis Sesaxeb cnobierebis amaRlebis mizniT, im dawesebulebebSi, sadac es aRiarebul standartebze dabalia;76 muSaTa samuSao saaTebis xangrZlivobis da dasvenebis drois standartebis dacva yovelTvis ar xdeba kerZo seqtorSi momuSave adamianebisTvis; Sesabamisi sakanonmdeblo normebis ararseboba im dasaqmebulTa dasacavad, romelebic daqiravebulni arian koleqtiuri xelSekrulebis safuZvelze minimalur xelfasTan, janmrTelobisa da dekretul benefitebTan da usafrTxo samuSao garemosTan mimarTebiT;77 saxifaTo samuSao pirobebi da kompensaaciT ar dakmayofileba samuSaos Sesrulebisas miRebuli dazia72 ekonomikur, socialur da kulturul uflebaTa komiteti. Semajamebeli daskvnebi: ekvadori, 1990 (E/1991/23) 73 ekonomikur, socialur da kulturul uflebaTa komiteti. Semajamebeli daskvnebi: espaneTi, 1991 (E/1992/23); kolumbia, 1991 (E/1992/23) 74 ekonomikur, socialur da kulturul uflebaTa komiteti. Semajamebeli daskvnebi: germania, 1993 (E/1994/23) 75 ekonomikur, socialur da kulturul uflebaTa komiteti. Semajamebeli daskvnebi: urugvai, 1994 (E/1995/22); fineTi, 1996 (E/1997/22) 76 ekonomikur, socialur da kulturul uflebaTa komiteti. Semajamebeli daskvnebi: argentina, 1994 (E/1995/22) 77 ekonomikur, socialur da kulturul uflebaTa komiteti. Semajamebeli daskvnebi: avstria, 1994 (E/1995/22) 51 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi nebebisTvis;78 dasaqmebis inspeqciebisa da kontrolis sistemebis privatizacia;79 samuSo usafrTxoebasTan dakavSirebiT sakanonmdeblo normebis miRebis saWiroeba80 da rogorc sajaro ise kerZo seqtorSi zeganakveTuri samuSao saaTebis anazRaureba.81 ` saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb gaeros adamianis uflebaTa sabWom dagmo samsaxurSi seqsualuri Seviwroveba82 da kanonmdeblobis arasaTanado implementacia samuSao standartebTan dakavSirebiT. samuSao standartebTan dakavSirebuli kanonmdebloba moicavs standartebs, romelic uzrunvelyofs samuSao pirobebze saTanado zedamxedvelobas da samuSao adgilebis sainspeqcio uwyebebis sakmaris dafinansebas.83 Sromis saerTaSoriso organizacia, samuSaos usafrTxoebisa da janmrTelobis konvencia (#155, 1981)84, muxli 4: saxelmwifo valdebulia moaxdinos sawarmoo usafrTxoebis, sawarmoo janmrTelobis da samuSao garemos erovnuli politikis formulireba, implementacia da perioduli gadaxedva im mizniT, rom moxdes samuSaosTan dakavSirebuli ubeduri SemTxvevebis da janmrTelobis dazianebis Tavidan acileba, samuSao garemoSi safTxis gamomwvwevi mizezebis minimalizaciis gziT. Sromis saerTaSoriso organizacia, samsaxureobrivi jandacvis servisebis Sesaxeb konvencia (#161, 1985)85, muxli 3(1): saxelmwifoebi iReben valdebulebas ganaviTaron progresulad sawarmoo jandacvis servisebi yvela dasaqmebulisTvis, maT Soris sajaro seqtorSi dasaqmebulTaTvis. Sromis saerTaSoriso organizacia, Sromis usafrTxoebis da janmrTelobis Sesaxeb konvenciis ganxorcielebis gegma, (#187, 2006)86, muxli 2(1): saxelmwifoebma, yvelaze warmomadgenlobiT damsaqmebelTa da dasaqmebulTa organizaciebTan konsultaciiT, unda SeimuSavon erovnuli politika, sistema da programa raTa mudmivad xdebodes Sromis usafrTxoebisa da janmrTelobis dacvis mdgomareobis gaumjobeseba samuSao dazianebebis, daavadebebis da gardacvalebis faqtebis Tavidan acilebis mizniT. pacientis movlaze pasuxismgebel personalTan (saeqTno personalTan) dakavSirebuli standartebi ` Sromis saerTaSoriso organizacia, saeqTno personalis Sesaxeb konvencia # 149, 197787 muxli 1(2): winamdebare konvencia vrceldeba mTel saeqTno personalze miuxedavad maTi samuSaos adgilmdebareobisa. 78 ekonomikur, socialur da kulturul uflebaTa komiteti. Semajamebeli daskvnebi: surinami, 1995 (E/1996/22) 79 ekonomikur, socialur da kulturul uflebaTa komiteti. Semajamebeli daskvnebi: argentina, 1999 (E/2000/22) 80 ekonomikur, socialur da kulturul uflebaTa komiteti. Semajamebeli daskvnebi: fineTi, 2000 (E/2001/22) 81 ekonomikur, socialur da kulturul uflebaTa komiteti. Semajamebeli daskvnebi: iaponia, 2001 (E/2002/22) 82 samoqalaqo da politikuri uflebebis komiteti. Cile, 1999 (A/54/40) 83 samoqalaqo da politikuri uflebebis komiteti. dominikis respublika, 1993 84 Sromis saerTaSoriso organizacia (ILO). htt p://www.ilocarib.org.tt / projects/ cariblex/conventi ons_19.shtml 85 Sromis saerTaSoriso organizacia (ILO). htt p://www.ilo.org/ilolex/cgi-lex/convde.pl?C161 86 Sromis saerTaSoriso organizacia (ILO). htt p://www.ilo.org/ilolex/cgi-lex/convde.pl?C187 87 Sromis saerTaSoriso organizacia (ILO). htt p://www.ilo.org/ilolex/cgi-lex/rati fce.pl?C149 52 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.4 muxli 2(1): yvela wevrma saxelmwifom, romelic moaxdens am konvenciis ratifikacias, zogadi jandacvis programis farglebSi unda miiRos da ganaxorcielos saeqTno momsaxurebisa da saeqTno personalis Sesaxeb qveynis Sesabamisi politika, raTa uzrunvelyon xarisxiani saeqTno mzrunveloba mosaxleobisTvis SesaZlo umaRlesi janmrTelobis dacvis xarisxis misaRwevad. (2) kerZod, maT unda miiRon aucilebeli zomebi, rom uzrunvelyon saeqTno personalisTvis Semdegi pirobebi.. (a) maTi funqciebis gansaxorcieleblad saWiro ganaTlebisa da treningis miwodeba, da (b) dasaqmebisa da samuSao probebi karieruli winsvlisa da anazRaurebis CaTvliT, rac aucilebelia personalis mosazidad da SesanarCuneblad. (3) am muxlis pirvel paragrafSi aRniSnuli politikis formulireba unda moxdes Sesabamis damsaqmebelTa da muSakTa organizaciebTan (sadac arsebobs aseTi organizaciebi) konsultaciiT. (4) aRniSnuli politika unda Seesabamebodes jandacvis sxva aspeqtebTan dakavSirebul politikas Sesabamis damsaqmebelTa da muSakTa organizaciebTan konsultaciis safuZvelze. muxli 6: saeqTno personali unda sargeblobdes minimum igive pirobebiT, riTic sargebloben sxva muSakebi, maT Soris: (a) samuSao saaTebis xangrZlivoba zeganakveTuri samuSaos, araxelsayreli samuSao drois da cvlaSi muSabis regulirebisa da kompensaciis CaTvliT; (b) yovelkvireuli dasvenebis dReebi; (g) anazRaurebadi wliuri Svebuleba; (d) ganaTlebis done; (e) dekretuli Svebuleba; (v) avadmyofobis Svebuleba; (z) socialuri dacva. muxli 7: TiToeulma wevrma saxelmwifom, saWiroebis SemTxvevaSi, unda gaaumjobesos sawarmoo janmrTelobasTan da usafrTxoebasTan dakavSirebuli kanonmdebloba da regulaciebi maTi saeqTno saqmianobasTan da pirobebTan SesabamisobaSi moyvaniT. qalebTan dakavSirebuli standartebi saerTaSoriso paqti ekonomikuri, socialuri da kulturuli uflebebis Sesaxeb: muxli 10(2): gansakuTrebuli dacva unda hqondeT qalebs orsulobis dros da mSobiarobis Semdeg gonivruli periodis manZilze. am periodis manZilze, momuSave dedebs unda eZleodeT anazRaurebadi Svebuleba an Svebuleba, romlis drosac miscemen sakmaris socialur daxmarebas. muxli 7: 1. am paqtis monawile saxelmwifoebi aRiareben TiToeulis uflebas hqondes Sromis samarTliani da xelSemwyobi pirobebi, maT Soris, kerZod: a) anazRaureba, romelic yvela mSromelisaTvis, rogorc minimums, uzrunvelyofs; I) samarTlian xelfass da Tanabar anazRaurebas tolfasovani SromisaTvis raime gansxvavebis gareSe, amasTan, kerZod, qalebisaTvis garantirebuli unda iyos Sromis iseTi pirobebi, romlebic mamakacTa Sromis pirobebze uaresi ar iqneba da Tanabari anazRaureba Tanabari SromisaTvis; II) maTi da maTi ojaxebis damakmayofilebel arsebobas am paqtis debulebaTa Sesabamisad; b) usafrTxoebisa da higienis moTxovnebis Sesabamisi Sromis pirobebi; g) yvelasaTvis erTnairi SesaZlebloba samuSaoze dawinaurdes Sesabamis ufro maRal safexurze mxolod da mxolod SromiTi staJisa da kvalifikaciis safuZvelze; d) dasveneba, Tavisufali dro da samuSao drois gonivruli SezRudva da perioduli anazRaurebuli Svebuleba, iseve rogorc anazRaureba uqme dReebisaTvis. ekonomikur, socialur da kulturul uflebaTa komiteti, zogadi komentari 16, 24: paqtis me7(a) muxlis Tanaxmad, monawile saxelmwifoebi aRiareben TiToeuli adamianis uflebas, hqon- 53 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi des Sromis samarTliani da xelsayreli pirobebi, maT Soris samarTliani xelfasi da tolfasovani SromisTvis Tanabari anazRaureba. me-3 muxli me-7 muxlTan mimarTebiT gulisxmobs, rom monawile saxelmwifoebi kisrulloben valdebulebas moaxdinon reagireba Sromis araTanabar anazRaurebaze, raTa qalebma da mamakacebma isargeblon Tanaswori uflebebiT. saxelmwifom sakanonmdeblo doneze unda uzrunvelyos samuSao adgilebSi Tanabari pirobebis Seqmna dawinaurebasTan, kompensaciasTan da sxva sakiTxebTan dakavSirebiT. konvencia qalTa diskriminaciis yvela formis aRmofxvris Sesaxeb, muxli 11(1): monawile saxelmwifoebi iReben yvela saWiro zomas dasaqmebis sferoSi qalTa mimarT diskriminaciis aRmosafxvrelad, raTa mamakacTa da qalTa Tanasworobis safuZvelze uzrunvelyon Tanabari uflebebi, kerZod: a) Sromis ufleba, rogorc yvela adamianis ganuyofeli ufleba; g) profesiis an samuSaos saxeobis Tavisufali arCevis, Tanamdebobrivi dawinaurebis da dasaqmebis garantiis, agreTve samuSaos yvela SeRavaTis da pirobebis gamoyenebis, profesiuli momzadebis da gadamzadebis, maT Soris mowafeobis, gazrdili donis profesiuli momzadebis da regularuli gadamzadebis ufleba. qalTa mimarT diskriminaciis aRmofxvris komiteti xSirad gamoTqvams kritikas im qalebis uTanasworo ricxvTan dakavSirebiT, romlebic dasaqmebuli arian dabal Tanamdebobze, dabalanazRaurebad, naxevarganakveTian samuSaoebze, maT Soris jandacvis seqtorSic.88 komitetma aseve xazi gausva, rom qalebi naklebad arian warmodgenilni maRal gadawyvetilebis mimReb da administraciul Tanamdebobebze, rogorc sajaro ise kerZo seqtorSi.89 qalTa mimarT diskriminaciis aRmofxvris komitetma dagmo: pasuxismgeblobis da dacvis saSualebebis ar arseboba kerZo seqtorSi seqsualuri Seviwrovebis faqtebze;90 cudi samuSao pirobebi qalebistvis rogorc sajaro ise kerZo seqtorSi, gansakuTrebiT minimaluri xelfasis dawesebasTan da socialur da janmrTelobis SeRavaTebTan dakavSirebiT;91 qalTa mimarT diskriminacia orsulobis da dekretuli periodis gamo;92 bavSvis movlis xelmisawvdomobis nakleboba;93 sabavSvo baRebis raodenobis gazrdis aucilebloba, romlebic xelmisawvdomi iqneba momuSave dedebisTvis.94 rasobriv sakiTxebTan, ucxo qveynis moqalaqeebTan da migrant muSebTan dakavSirebuli standartebi konvencia rasobrivi diskriminaciis yvela formis likvidaciis Sesaxeb, muxli 5(e)(I): am konvenciis me-2 muxlSi aRniSnuli ZiriTadi movaleobebis Sesabamisad, monawile saxelmwifoebi valdebulebas iReben akrZalon da aRmofxvran nebismieri formis rasobrivi diskriminacia da uzrunvelyon yvela adamianis Tanasworoba kanonis winaSe, miuxedavad rasisa, kanis ferisa, erovnuli da eTnikuri kuTvnilebisa, gansakuTrebiT Semdegi uflebebis ganxorcielebisaTvis: Sromis, Tanabari anazRaurebis, samuSaos Tavisufali arCevis, Sromis samarTliani da 88 qalTa mimarT diskriminaciis aRmofxvris komitetis angariSi, belarusia, 2004. (A/59/38 [nawili I]) 89 qalTa mimarT diskriminaciis aRmofxvris komitetis angariSi, fineTi, 1995. (A/50/38); eTiopia, 1996 (A/51/38); albaneTi, 2003 (A/58/38 [nawili I]) 90 qalTa mimarT diskriminaciis aRmofxvris komitetis angariSi, argentina, 1997. (A/52/38); kuba, 2000 (A/55/38); 91 qalTa mimarT diskriminaciis aRmofxvris komitetis angariSi, CineTi, 1999. (A/54/38) 92 qalTa mimarT diskriminaciis aRmofxvris komitetis angariSi, bangladeSi, 1997. (A/52/38) 93 qalTa mimarT diskriminaciis aRmofxvris komitetis angariSi, gvinea, 2001 (A/56/38) 94 qalTa mimarT diskriminaciis aRmofxvris komitetis angariSi, irlandia, 2005 (A/60/38) 54 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.4 xelSemwyobi pirobebis, umuSevrobidan dacvis, Tanabari SromisaTvis Tanabari anazRaurebis, samarTliani da damakmayofilebeli anazRaurebis ufleba. rasobrivi diskriminaciis sawinaaRmdego komiteti, zogadi komentari 30, 33-35: komiteti rekomendacias uwevs wevr saxelmwifoebs miiRon Semdegi saxis zomebi: (33) gaataron RonisZiebebi samuSao pirobebsa da moTxovnebTan dakavSirebuli diskriminaciis aRmosafxvrelad (maT Soris dasaqmebis im wesebisa da praqtikis aRmosafxvrelad, romlebsac diskriminaciuli miznebi an Sedegebi aqvT) im pirebTan mimarTebiT, romlebic ar arian maTi moqalaqeebi; (34) gadadgan efeqturi nabijebi ucxo qveynis moqalaqeTa dasaqmebasTan dakavSirebuli problemebis aRmosafxvrelad da maTi uflebebis aRsadgenad, gansakuTrebiT iseT sakiTxebTan dakavSirebiT, rogoricaa: pasportis CamorTmeva an ukanono dakaveba, gaupatiureba da fizikuri Seuracxyofa; (35) miuxedavad imisa, rom saxelmwifos SeuZlia uari uTxras moqalaqeobis armqone pirs, romelsac ar aqvs muSaobis ufleba, samuSaos SeTavazebaze, yvela pirs aqvs muSaobasTan dakavSirebuli uflebebiT sargeblobis ufleba, maT Soris Sekrebis da gaerTianebis ufleba, SromiTi urTierTobebis dawyebis Semdeg da maT dasrulebamde. saerTaSoriso konvencia yvela migranti muSakisa da maTi ojaxis wevrebis dacvis Sesaxeb, muxli 25: 1. migranti muSakebi unda sargeblobdnen aranakleb sargebliani reJimiT damsaqmebeli saxelmwifos moqalaqeebTan SedarebiT anazRaurebis nawilSi da Sromis sxva pirobebis nawilSi, rogorebicaa, zeganakveTuri Sroma, samuSao saaTebis raodenoba, yovekvireuli dasveneba, fasiani Svebuleba, usafrTxoebis normebi, janmrTeloba, samuSao kontraqtis Sewyveta da Sromis sxva nebismieri piroba, romelic erovnuli kanoniTa da praqtikiT, igulisxmeba pirobebSi; dasaqmebis sxva pirobebis nawilSi, maT Soris dasaqmebis minimaluri asaki, saxlSi muSaobis SezRudva da sxva sakiTxebi, romlebic erovnuli kanonmdeblobiTa da praqtiT iTvleba dasaqmebis pirobebad. 2. ukanonod unda iqnas cnobili kerZo SromiT xelSekrulebebSi Tanaswori mopyrobis principidan gadaxveva, rogorc aris mocemuli muxlis 1 paragrafSi. 3. saxelmwifo organoebma unda miiRon yvela saWiro zoma, rom migrant muSakebs, qveyanaSi maTi binadrobisa da dasaqmebis sakiTxebSi dadgenili wesebidan gadaxvevis gamo, ar waerTvaT am principidan gamomdinare uflebebi. kerZod, damsaqmeblebma ar unda aaridon Tavi samarTlebrivi an xelSekrulebiT nakisri valdebulebebis Sesrulebas, arc Tavad valdebulebebi unda SeizRudos raime formiT amgvari gadaxvevebis arsebobis sababiT. muxli 70: monawile saxelmwifoebi mimarTaven zomebs, aranakleb xelsayrels vidre is zomebi, romlebic vrceldeba am saxelmwifos moqalaqeebze, raTa regularul situaciaSi myofi migrant muSakTa da maTi ojaxis wevrTa samuSao da sacxovrebeli pirobebi Seesabamebodes usafrTxoebis, janmrTelobisa da adamianuri Rirsebis principebs. Sekrebis da gaerTianebis ufleba uflebebis efeqturad dacvisa da jandacvis muSakTa mier Tanabari uflebebebiT sargeblobis mizniT, Zalian mniSvnelovania, muSakebs uknaono Carevis gareSe, hqondeT kavSirebis Camoyalibebis, gawevrianebis da marTvis saSualeba. gamomdinare iqidan, rom jandacvis seqtori uzrunvelyofs mniSvnelovan momsaxurebas, mis warmomadgenlebs garkveul gamonaklis situaciaSi SeiZleba SeezRudoT koleqtiur RonisZiebebSi monawileoba. Sekrebisa da gaerTianebis TavisuflebasTan dakavSirebuli gaeros iurisprudencia fokusirebulia arasamTavrobo organizaciebsa da politikur partiebze, Tumca misi ZiriTadi aspeqtebis interpretaciiT aRniSnuli ufleba SeiZleba gavrceldes profesiul kavSirebzec, romelsac aseve exeba Sromis saerTaSoriso organizaciis standartebic. 55 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi adamianis uflebaTa damcvelebis Sesaxeb gaeros deklaraciis garkveul muxlebSi xazgasmulia jandacvis momsaxurebis mimwodebelTa, rogorc adamianis uflebaTa damcvelebis roli, romlebic uzrunvelyofen da icaven socialur da ZiriTad samoqalaqo uflebebs, rogorebicaa sicocxlis ufleba da wamebis da araadamianuri an Rirsebis Semlaxavi mopyrobisgan dacva. Sekrebis da gaerTianebis Tavisufleba uflebebis potenciur darRvevaTa magaliTebi jandacvis saministrom ar daamtkica profesiuli samedicino asociacia, radgan misi prezidenti erT-erTi opoziciuri politikuri partiis wamyvani wevria; Tanamdebobis pirebi, samarTlebrivi safuZvlis gareSe, xels uSlian jandacvis muSakebis mier anazRaurebis momatebisa da pirobebis gaumjobesebis mizniT aqciis Catarebas. adamianis uflebebaTa standartebi da interpretacia zogadi standartebi adamianis uflebaTa sayovelTao deklaracia, muxli 20: (1) yvelas aqvs ufleba mSvidobiani Sekrebisa da gaerTianebis Tavisuflebisa; (2) aravin SeiZleba aiZulon Sevides raime gaerTianebaSi. saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, muxli 21: aRiarebulia mSvidobiani krebebis ufleba. am uflebiT sargeblobas SeiZleba dauwesdes mxolod iseTi SezRudvebi, romlebic Seesabameba kanons da saWiroa demokratiul sazogadoebaSi saxelmwifo Tu sazogadoebrivi uSiSroebis, sazogadoebrivi wesrigis, mosaxleobis janmrTelobisa da zneobis dacvisa Tu sxva pirTa uflebebisa da Tavisuflebebis dacvis interesebisaTvis. miuxedavad imisa, rom Sekrebis Tavisufleba ar aris absoluturi ufleba, adamianebis mSvidobiani protestis nebismieri SezRudva SeiZleba moxdes mxolod paqtis 22-e muxlSi CamoTvlili pirobebiT. saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, muxli 22: 1. TiToeul adamians aqvs sxvebTan asociaciis Tavisuflebis ufleba, maT Soris ufleba Seqmnas profkavSirebi da Sevides profkavSirebSi Tavisi interesebis dasacavad. 2. am uflebiT sargeblobas SeiZleba dauwesdes mxolod iseTi SezRudvebi, romlebsac kanoni iTvaliswinebs da romlebic saWiroa demokratiul sazogadoebaSi saxelmwifo an sazogadoebrivi uSiSroebis, sazogadoebrivi wesrigis, mosaxleobis janmrTelobisa da zneobis dacvis Tu sxva pirTa uflebebisa da Tavisuflebebis dacvis interesebisaTvis. es muxli xels ar uSlis, rom am uflebiT sargeblobis kanonieri SezRudvebi SemoiRon im pirTaTvis, romlebic Sedian SeiaraRebli Zalebisa da policiis SemadgenlobaSi. 3. am muxlSi araferi ar aZlevs uflebas saxelmwifoebs, romlebic monawileoben Sromis saerTaSoriso organizaciis 1948 wlis konvenciaSi asociaciaTa Tavisuflebisa da organizaciis uflebis dacvis Sesaxeb, miiRon sakanonmdeblo aqtebi aRniSnuli konvenciiT gaTvaliswinebuli garantiebis sazianod, an kanoni gamoiyenon iseTnairad, rom es saziano iyos am garantiebisaTvis. 56 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.4 gaurkvevelia samoqalaqo da politikuri uflebebis paqtis 22-e muxli moicavs Tu ara Tavisuflebas, piri ar SeuerTdes romelime gaerTianebas. aseT SemTxvevaSi profesiuli kavSiris iseTi praqtika, romelic iTvaliswinebs mxolod im pirTa dasaqmebas, romlebic konkretuli kavSiris wevrebvi arian, CaiTvleboda konvenciis darRvevad. Tumca, savaraudod, aRniSnuli muxli moicavs am Tavisuflebasac. asociaciis dasafuZneblad saWiro formaluri procedurebi ar unda iyos imdenad garTulebuli, rom winaaRmdegobaSi modiodes samoqalaqo da politikuri uflebebis Sesaxeb paqtis 22-e muxlTan. SesaZloa kanonmdebloba, romelic gansazRvravs gaerTianebis statuss, SesabamisobaSi iyos paqtis 22-e muxlTan, Tumca praqtikaSi saxelmwifo zRudavdes Sekrebisa da gaerTianebis Tavisuflebas.95 Sromis saerTaSoriso organizaciis konvencia #87 Sekrebisa da organizebis Tavisuflebis Sesaxeb, muxli 2: yvela muSaks da damsaqmebels ufleba aqvs winaswari nebarTvis gareSe sakuTari arCevaniT Seqmnan organizacia, agreTve Sevidnen aseT organizaciaSi mxolod ukanasknelTa wesdebis gaTvaliswinebiT. aRniSnuli ufleba _ yvela muSaks qondes ufleba winaswari nebarTvis gareSe Seqmnas an gawevriandes organizaciaSi, warmoadgens Sromis saerTaSoriso organizaciis konvenciis me-2 muxliT gaTvaliswinebul fundamentur uflebas, romliTac yvela dasaqmebuli unda sargeblobdes yovelgvari gamonaklisis gareSe; saavadmyofos personals sruli ufleba aqvs isargeblos aRniSnuli uflebiT. kanoni, romelis Tanaxmad gaerTianebis Tavisufleba moiTxovs saxelmwifos nebarTvas, ewinaaRmdegeba Sromis saerTaSoriso organizaciis #87 konvenciiT gaTvaliswinebul gaerTianebis Tavisuflebis princips. gaeros deklaracia sazogadoebrivi organizaciebis, jgufebis an individebis uflebebze da pasuxismgeblobaze, raTa daculiyo iyos adamianis sayovelTaod aRiarebuli uflebebi da ZiriTadi Tavisuflebebi (adamianis uflebaTa damcvelTa deklaracia) 1998 muxli 1: yvelas, individualurad an sxvebTan erTad, aqvs ufleba moaxdinos sakuTari uflebebis da ZiriTadi Tavisuflebebis realizacia da moiTxovos maTi dacva rogorc erovnul aseve saerTaSoriso doneze. muxli 5: adamianis uflebebisa da ZiriTadi Tavisuflebebis dacvis mizniT, individualurad an sxvebTan erTad, rogorc erovnul aseve saerTaSoriso doneze yvelas aqvs ufleba: (a) mSvidobiani Sekrebis; (b) Seqmnas an gaerTiandes arasamTavrobo organizaciebSi, asociaciebSi da jgufebSi; (g) hqondes komunikacia arasamTavrobo da saxelmwifoTaSoris organizaciebTan. 95 adamianis uflebaTa komiteti. daskvniTi. Semajamebeli daskvnebi: libani, 1997 (A/52/40) 57 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi qalebTan dakavSirebuli standartebi konvencia rasobrivi diskriminaciis yvela formis likvidaciis Sesaxeb, muxli 5(d)(9): am konvenciis me-2 muxlSi aRniSnuli ZiriTadi movaleobebis Sesabamisad, monawile saxelmwifoebi valdebulebas iReben akrZalon da aRmofxvran nebismieri formis rasobrivi diskriminacia da uzrunvelyon yvela adamianis Tanasworoba kanonis winaSe, miuxedavad rasisa, kanis ferisa, erovnuli da eTnikuri kuTvnilebisa, gansakuTrebiT Semdegi uflebebis ganxorcielebisaTvis: ...mSvidobiani Sekrebebisa da asociaciebis ufleba. profkavSirebi da gaficvis ufleba uflebebis potenciur darRvevaTa magaliTebi jandacvis muSakTa profkavSirebi da profesiuli gaerTianebebi ar iqnen damtkicebulni jandacvis saministors mier, raTa maT warmoedginaT TavianTi wevrebi; meddas ar SeuZlia imuSaos gansazRvrul saavadmyofoSi, vidre igi ar gawevriandeba erTaderT profkavSirSi, romelic aRiarebulia menejmentis mier; zogierTi eqimi da eqTani daiTxoves samsaxuridan mas Semdeg, rac maT erToblivi zomebi miiRes dabali anazRaurebisa da cudi samuSao pirobebis gamo. adamianis uflebebaTa standartebi da interpretacia muxli 22 saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb: 1. TiToeul adamians aqvs sxvebTan asociaciis Tavisuflebis ufleba, maT Soris ufleba Seqmnas profkavSirebi da Sevides profkavSirebSi Tavisi interesebis dasacavad. 2. am uflebiT sargeblobas SeiZleba dauwesdes mxolod iseTi SezRudvebi, romlebsac kanoni iTvaliswinebs da romlebic saWiroa demokratiul sazogadoebaSi saxelmwifo an sazogadoebrivi uSiSroebis, sazogadoebrivi wesrigis, mosaxleobis janmrTelobisa da zneobis dacvis Tu sxva pirTa uflebebisa da Tavisuflebebis dacvis interesebisaTvis. es muxli xels ar uSlis, rom am uflebiT sargeblobis kanonieri SezRudvebi SemoiRon im pirTaTvis, romlebic Sedian SeiaraRebli Zalebisa da policiis SemadgenlobaSi. 3. am muxlSi araferi ar aZlevs uflebas saxelmwifoebs, romlebic monawileoben Sromis saerTaSoriso organizaciis 1948 wlis konvenciaSi asociaciaTa Tavisuflebisa da organizaciis uflebis dacvis Sesaxeb, miiRon sakanonmdeblo aqtebi aRniSnuli konvenciiT gaTvaliswinebuli garantiebis sazianod, an kanoni gamoiyenon iseTnairad, rom es saziano iyos am garantiebisaTvis. • saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb muxli 22(1) uzrunvelyofs profkavSirebis specialur dacvas;96 amave paqtis muxli 22(3) xazs usvams ukve arsebul valdebulebas Sromis saerTaSoriso organizaciis 87-e konvenciis Sesabamisad. 96 saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb 22(1) muxli: TiToeul adamians aqvs sxvebTan asociaciis Tavisuflebis ufleba, maT Soris ufleba Seqmnas profkavSirebi da Sevides profkavSirebSi Tavisi interesebis dasacavad. 58 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.4 • kanoniT garantirebuli mravali profkavSirebis arsebobis saWiroebas xazs usvams rogorc adamianis uflebaTa komiteti, ise ekomomikur, socialur da kulturul uflebaTa komiteti97, da dagmobilia Sesabamisi kanonmdeblobis ar arseboba.98; • muSakTa uflebebis dacvis aucileblobas (maT Soris koleqtiuri molaparakebebi, Tavisufali gaerTianebis uflebis SezRudvisgan da Tavisufleba profkavSirebis saqmianobaSi aramarTlzomieri Carevisagan dacva) mravaljer gausva xazi adamianis uflebaTa99 da ekonomikuri, socialuri da kulturuli uflebebis sakiTxTa komitetma.100 • adamianis uflebebis komitetma daadgina 22 da 19 (gamoxatvis Tavisufleba) muxlebis darRvevebi, romelic gamoixateboda pirovnebebis ukanono dakavebaSi maTi prokavSirebSi saqmianobis gamo.101 • profkavSirebis dacva moicavs Semdegis uzrunveloyofas: ucxoeli muSakebisaTvis ar aris akrZaluli oficialuri Tanamdebobis dakaveba da kavSirebi ar uqmdeba aRmasruleblebis mier102 • muxli 22(3) erTmniSvnelovnad ar iZleva gaficvis uflebis garantias;103 • saxelmwifo moxelisaTvis uaris Tqma uflebis miniWebaze _ Seqmnas asociacia da awarmoos molaparakebebi, koleqtiurad ganixileba rogorc saerTaSoriso paqtis samoqalaqo da politikuri uflebebis Sesaxeb 22-e muxlis darRveva.;104 • im saxelmwifo moxeleTa gaficvis absoluturma akrZalvam, romlebic ar moqmedeben saxelmwifos saxeliT da ar arian CarTulni `mniSvnelovan samsaxurebSi~, rac gansazRvrulia Sromis saerTaSoriso organizaciis mier, SeiZleba gamoiwvios saerTaSoriso paqtis samoqalaqo da politikuri uflebebis Sesaxeb 22-e muxlis darRveva105 97 saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb. brazilia, 1996. (A/51/40 [vol. I]); ICES CR. ruanda, 1989. (E/1989/22). 98 saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb. saqarTvelo, 1997. (A/52/40 [vol. I]). 99 saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb. kosta rika, 1999. (A/54/40 [vol. I]). `kavSirebis Seqmnis ufleba, maT Soris koleqtiuri molaparakebebis warmoebis ufleba unda hqones yvela adamians. Sormis kanonmdebloba unda gadaixedos da saWiroebis SemTxvevaSi clilebebi Sevides raTa warmodgenil iqnas adcvis saSualebebi represaliebis winaaRmdeg asociaciebisa da profkavSirebis SeqmnisaTvis da aseve uzrunvelyofil iqnas, rom muSakebs eqnebaT efeqtiani samarTlebrivi dacvis saSualebebis swrafi wvdoma. aseve ix. domenikis respublika , 2001. (A/56/40 [vol. I]; argentina, 1995. (A/50/40 [vol. I]); gvatemala, 1996. (A/51/40 [vol. I]); nigeria, 1996. (A/51/40 [vol. I]); bolivia, 1997. (A/52/40 [vol. I]); venesuela, 2001. (A/56/40 [vol. I]). 100 saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb. iamaika, 1990. (E/1990/23). 101 Burgos v. Uruguay. (R.12/52); saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb. A/36/40. 29 ivlisi, 1981; Pietraroia v. Uruguay. (R.10/44); saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb. A/36/40. marti 27, 1981; Weinberger v. Uruguay. (R.7/28); saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb. A/36/40. 29 oqtomberi, 1980; Sohn v. Republic of Korea. (518/1992); saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb. (A/50/40 [vol. II ]). 19 ivlisi, 1995. (CCPR/C/54/D/518/1992). 102 adamianis uflebaTa dacvis komiteti. adamianis uflebaTa dacvis komitetis daskvniTi dakvirvebebi: senegali, 1997. (CCPR/C/79/Add.) 103 umravlesobis Sexeduleba J. B. and Ors v. Canada. (118/82). komitetis sagrZnobi umciresoba ar eTanxmeboda. 104 adamianis uflebaTa dacvis komiteti. daskvniTi dakvirvebebi: libani 1997. (A/52/40 [vol. I]); saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb. Cile, 1999. (A/54/40 [vol. I]). 105 saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb. germania, 1997. (A/52/40 [vol. I]). 59 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi adamianis uflebaTa sayovelTao deklaracia. muxli 23(4) yovel adamians aqvs ufleba Seqmnas profesiuli kavSirebi da Sevides profesiul kavSirebSi Tavisi interesebis dasacavad. ¾ ekonomikuri, socialuri da kulturuli uflebebis Sesaxeb saerTaSoriso paqti, muxli 8 1. winamdebare paqtis monawile saxelmwifoebi kisruloben valdebulebas uzrunvelyon: a) TiToeuli adamianis ufleba Tavisi ekonomikuri da socialuri interesebis gansaviTareblad da dasacavad, Seqmnas profesiuli kavSirebi da Sevides aseT kavSirebSi Tavisi arCevaniT da organizaciis Sesabamisi wesebis Tanaxmad. aRniSnuli uflebis gamoyeneba ar eqvemdebareba araviTar SezRudvas im SezRudvebis garda, romlebic gaTvaliswinebulia kanoniT da aucilebelia demokratiul sazogadoebaSi saxelmwifo uSiSroebisa da sazogadoebrivi wesrigis interesebisaTvis an sxvaTa uflebebisa da Tavisuflebebis dasacavad; b) profesiuli kavSirebis ufleba Seqmnan erovnuli federaciebi da konfederaciebi da am ukanasknelTa ufleba Seqmnan saerTaSoriso profesiuli organizaciebi an SeuerTdnen maT; g) profesiuli kavSirebis ufleba imoqmedon Tavisuflad, raime SezRudvis gareSe, im SezRudvebis garda, romlebic gaTvaliswinebulia kanoniT da aucilebelia demokratiul sazogadoebaSi saxelmwifo uSiSroebisa da sazogadoebrivi wesrigis interesebisaTvis an sxvaTa uflebebisa da Tvisuflebebis dasacavad; d) gaficvebis ufleba im pirobiT, rom es ukanaskneli ganxorcieldeba konkretuli qveynis kanonmdeblobis Sesabamisad. 2. es muxli ar ewinaaRmdegeba kanonis Sesabamisad am uflebis gamoyenebis SezRudvas im pirTaTvis, romlebic imyofebian SeiaraRebuli Zalebis, policiis an saxelmwifo administraciis SemadgenlobaSi. 3. am muxlSi araferi aZlevs uflebas asociaciaTa Tavisuflebisa da organizaciis uflebis dacvis Sesaxeb Sromis saerTaSoriso organizaciis 1948 wlis konvenciis monawile saxelmwifoebs, miiRon sakanonmdeblo zomebi aRniSnuli konvenciiT gaTvaliswinebuli garantiebis sazianod an kanoni gamoiyenon ise, rom ziani miadges am garantiebs. ¾ Sromis saerTaSoriso organizaciis konvencia 87 `gaerTianebis Tavisuflebisa da gaerTianebis uflebis dacvis Sesaxeb~106: muxli 2: mSromelebsa da mewarmeebs, ganurCevlad, ufleba aqvT winaswari nebarTvis gareSe sakuTari arCevaniT Seqmnan organizacia, agreTve ufleba aqvT Sevidnen aseT organizaciaSi mxolod erTi pirobiT _ daemorCilon am ukanasknelTa wesdebebs 106 ratifikaciebis cxrili htt p://www.ilo.org/ilolex/cgi-lex/rati fce.pl?C087 60 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.4 muxli 3 1. mSromelTa da mewarmeTa organizaciebs ufleba aqvT SeimuSavon sakuTari wesdebebi da reglamentebi, Tavisuflad airCion Tavisi warmomadgenlebi, Camoayalibon aparati, warmarTon TavianTi saqmianoba, dasaxon samoqmedo programa. 2. saxelmwifo xelisufleba Tavs ikavebs yovelgvari Carevisagan, romelic SezRudavs am uflebas an win aRudgeba mis kanonier ganxorcielebas. muxli 4: mSromelTa da mewarmeTa organizaciebi ar SeiZleba daTxovnil iqnen an droebiT administraciuli wesiT akrZalul iqnen. muxli 5: mSromelTa da mewarmeTa organizaciebs ufleba aqvT Seqmnan federaciebi da konfederaciebi da gaerTiandnen maTTan. yovel aseTi organizacias, federacias Tu konfederacias ufleba aqvs Sevides mSromelTa da mewarmeTa saerTaSoriso organizaciebSi. ¾ Sromis saerTaSoriso organizaciis konvencia 98 `gaerTianebisa da koleqtiuri molaparakebis uflebis Sesaxeb~ 107: muxli 1: mSromelebi sargebloben saTanado dacviT nebismieri im diskriminaciuli moqmedebis sawinaaRmdegod, romlebic mimarTulia Sromis sferoSi gaerTianebis Tavisuflebis Selaxvisaken. 2. aseTi dacva gamoiyeneba gansakuTrebiT im moqmedebaTa mimarT, romlebic miznad isaxaven: a) samuSaoze mSromelis miRebas an misTvis samuSaos SenarCunebas im pirobiT, Tu is ar Seva profkavSirSi an gamova profkavSirebidan; b) mSromelis gaTavisuflebas an sxva nebismieri meTodiT zianis miyenebas im safuZvelze, rom igi profkavSiris wevria an monawileobas iRebs profkavSirul saqmianobaSi arasamuSao an samuSao dros mewarmesTan SeTanxmebiT. muxli 2 (1). mSromelTa da mewarmeTa organizaciebi sargebloben saTanado dacviT erTmaneTis an maTi agentebis, an wevrTa mxridan Carevis nebismieri aqtis sawinaaRmdego organizaciebis Seqmnis, saqmianobisa da marTvisas. muxli 6: am konvenciis moqmedeba ar vrceldeba saxelmwifo moxeleebze. igi aranairad ar iqneba ganmartebuli, rogorc maTi uflebisa da debulebis Semlaxavi. miuxedavad imisa, rom arc erT Sromis saerTaSoriso organizaciis konvenciasa Tu rekomendaciaSi ar aris calke aRiarebuli gaficvis ufleba, Sromis saerTaSoriso organizaciis Sekrebisa da gaerTianebis Tavisuflebis komiteti xSirad aRniSnavs, rom gaficvis ufleba aris mSromelebis da maTi organizaciebis fundamenturi ufleba da adgens sazRvrebs, romlis farglebSic is SeiZleba gamoyenebul iqnas. amasTan erTad, Sromis saerTaSoriso organizaciis konferenciis ori rezolucia, romlebic warmoadgenen Sso-s 107 ratifikaciebis cxrili: htt p://www.ilo.org/ilolex/cgi-lex/rati fce.pl?C098 61 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi politikis gaidlains, minimum or rezoluciaSi usvams xazs gaficvis uflebis aRiarebis aucileblobas wevri saxelmwifoebis mier.108 saxelmwifo saavadmyofoebSi momuSave pirebi unda sargeblobdnen koleqtiuri molaparakebis uflebiT, rac garantirebulia Sromis saerTaSoriso organizaciis 98-e konvenciiT.109 sajaro moxelis SemTxvevaSi, gaerTianebis Tavisuflebis principis aRiareba imavdroulad ar gulisxmobs gaficvis uflebas.110 Sso-s Sekrebisa da gaerTianebis Tavisuflebis komitets gaTviTcnobierebuli aqvs, rom gaficvis ufleba SeiZleba SezRuduli iqnas an Tundac akrZaluli saxelmwifo samsaxurSi an garkveul mniSvnelovan samsaxurebSi maSin, rodesac gaficvam SeiZleba seriouzuli ziani miayenos sazogadoebas, Tu uzrunvelyofilia rom SezRudvebs Tan erTvis konkretuli kompensaciis garantiebi.111 Sromis saerTaSoriso organizaciis komitetma naTlad aRniSna, rom saavadmyofos seqtori aRiarebulia mniSvnelovani momsaxurebis mimwodeblad da Sesabamisad ar SeiZleba misi muSaobis SeCereba.112 ufro konkretulad ki, imisaTvis rom ganisazRvros situaciebi, rodesac gaficva SeiZleba aikrZalos mniSvnelovan samsaxurebSi, unda arsebobdes aSkara da gardauvali safrTxe sicocxlis, pirovnebis usafrTxoebis, an zogadad sazogadoebis an misi nawilis janmrTelobisTvis. TumcaRa iseT samsaxurebSic ki, romelic miCneulia mniSvnelovnad, muSakTa garkveul kategorias, rogorebicaa magaliTad laborantebi da mebaReebi, ar unda waerTvaT gaficvis ufleba. samarTalwarmoebis ufleba da masTan dakavSirebuli uflebebi es nawili mimoixilavs samarTalwarmoebis standartebs, romlebiTac sargebloben jandacvis momsaxurebis momwodebeli pirebi, rodesac isini mimarTaven sasamarTlos an Tavad warmoadgenen samoqalqo sasamarTlo procesis mxares, maT Soris disciplinaruli sakiTxebis ganxilvisas. es nawili moicavs samarTlebrivi dacvis efeqtian saSualebebs, magram ar exeba sisxlis samarTlis saqmeSi braldebulTa uflebebs.113 ganmarteba Tu ra aris nagulisxmevi samoqalaqo da politikuri uflebebis Sesaxeb saerTaSoriso paqtis 14(1) muxlSi mocemul terminSi `samoqalaqo procesi~ kvlavac viTardeba, Tumca profesiuli organizaciis saqmianobebis regulireba da am regulirebis sasamarTlos mier Seswavla SesaZloa masSi moiazrebodes. 1998 wlis gaerTianebuli erebis adamianis uflebaTa damcvelTa deklaraciaSi mocemul Sesabamis standartebSi xazgasmulia, rom jandacvis momsaxurebis momwodebeli pirebi arian uflebebis damcvelebi maT yoveldRiur saqmianobaSi da aseve sargebloben igive ZiriTadi uflebebiT, rogorc pacientebi. es nawili aseve detalurad warmoadgens im standartebs, 108 ekonomikuri, socialuri da kulturuli uflebebis Sesaxeb saerTaSoriso paqti. ruseTis federacia, 1997. (E/1998/22 109 ekonomikuri, socialuri da kulturuli uflebebis Sesaxeb saerTaSoriso paqti. urugvai, 1994. (E/1995/22). 110 ekonomikuri, socialuri da kulturuli uflebebis Sesaxeb saerTaSoriso paqti. belgia, 1994. (E/1995/22). 111 Sromis saerTaSoriso organizacia. Ratifikaciebis cxrili htt p://www.ilo.org/ilolex/cgi-lex/rati fce.pl?C087 112 Sromis saerTaSoriso organizacia.daijesti, 2005 113 gaerTianebuli erebis adamianis uflebaTa dacvis tarqtatebi. sisxlis samarTlis braldebulTa uflebebi. 62 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.4 romlebSic daculia jandacvis momsaxurebis momwodebelTa piradi cxovrebis xelSeuxeblobis ufleba, rogorc samuSao adgilas, aseve mis gareT. aseve maTi Rirsebisa da reputaciis dacvis uflebebi. amas garda, mocemulia standartebis mokle ganxilva, romlebic exeba gamoxatvis Tavisuflebasa da informaciis miRebis uflebas. aRniSnuli gansakuTrebiT mniSvnelovania, radganac isini uzrunvelyofen aqtiuri moqalaqeebis dacvas, romlebsac surT garkveuli informaciis sajarod gamoqveyneba. aRniSnuli dacva mniSvnelovania, radgan sajaro seqtoris muSakebs, xSirad ar surT informaciis gavrceleba arasasurveli Sedegebis SiSiT. samarTliani sasamarTlo procesis ufleba potenciuri darRvevebis magaliTebi eqims, romlis saqmezec imarTeba aris disciplinaruli sxdoma, ar eZleva saSualeba miiRos mis winaaRmdeg warmodgenili yvela mtkicebuleba sxdomis dawyebamde; meddas, romlis winaaRmdeg ganixileba samedicino daudevrobasTan dakavSirebuli saqme, ar ecnoba sxdomis daniSvnis TariRi adamianis uflebebaTa standartebi da interpretacia muxli 14 (1) saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb: samarTliani sasamarTlo procesi 1. yvela piri Tanasworia sasamarTloebisa da tribunalebis winaSe. TiToeuls aqvs ufleba misTvis wayenebuli yoveli sisxlis samarTlis braldebis ganxilvisas, an romelime samoqalaqo procesSi misi ufleba-movaleobis gansazRvrisas, moiTxovos, rom misi saqme samarTlianad da sajarod ganixilos kanonis safuZvelze Seqmnilma kompetenturma, damoukidebelma da miukerZoebelma sasamarTlom. SeiZleba, rom presa da sazogadoeba ar iqnas daSvebuli mTeli sasamarTlo procesis ganmavlobaSi, sazogadoebrivi wesrigis dacvis, saxelmwifo uSiSroebis mosazrebiT an, mxareTa piradi cxovrebis interesebis gaTvaliswinebiT, an rodesac sasamarTlos azriT sajarooba Selaxavs marTlmsajulebis interesebs; yoveli sasamarTlo dadgenileba sisxlis samarTlisa Tu samoqalaqo saqmis gamo sajaro unda iyos, im SemTxvevebis garda, roca arasrulwlovanTa interesebi sxvas moiTxoven an, roca saqme exeba matrimonialur davas an bavSvTa meurveobas. samoqalaqo da politikuri uflebebis Sesaxeb saerTaSoriso paqtis 14(1) muxlis konteqstSi mocemuli `samoqalaqo procesis~ cneba efuZneba konkretuli uflebis xasiaTs da ara procesis erT-erTi mxaris statuss (iqneba saxelmwifo Tu ara samTavrobo). gansakuTrebuli forumi, romelsac samarTaldacvis sistemebi iyeneben individualuri sarCelebis gansaxilvelad ar gansazRvravs uflebis xasiaTs (gansakuTrebiT mniSvnelovani pirobaa saerTo samarTlis sistemebis SemTxvevaSi).114 114 adamianis uflebaTa dacvis komiteti. #32 zogadi komentari; Y. L. v. kanada. (112/81). unarSezRudulobis pensiis moTxovna uTanabrdeba samarTlebrivi davis cnebas. aseve ix. Casanovas v. safrangeTi. (441/90). ganixilavs samusaxuridan daTxovnis proceduras; Jansen-Gielsen v. niderlandebi. (846/99). sasamarTlo procesi samuSaos SesrulebisaTvis pirovnebebis fsiqiatriuli unaris dadgenaze uTanabrdeboda samarTlebrivi davis cnebas. 63 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi profesiuli organizaciis saqmianobebis regulirebam da sasamarTlos mier amgvari regulirebis Seswavlam SesaZloa warmoSvas me-14 muxliT gansazRvruli sakiTxebi;115 wminda administraciuli saqmeebi ar ganixileba am muxliT, radganac ar gulisxmobs samoqalaqo uflebebisa da movaleobebis gansazRvras;116 14(1) muxlSi mocemuli `tribunalis~ cneba Seexeba organos _ miuxedavad misi denominaciisa, rac gulisxmobs a) kanonis mier dawesebuli; b) xelisuflebis aRmasrulebeli da sakanonmdeblo Stoebisgan damoukidebeli da g) garkveul SemTxvevebSi sargeblobs samarTlebrivi damoukideblobiT samarTlebrivi xasiaTis sakiTxebis gadawyvetisas;117 sajaro samarTlis uflebebis gansazRvra Seesabameba me-14(1) muxls, Tu Sesabamis municipalur samarTlebriv sistemaSi am uflebebis gansazRvra xdeba kanoniT dadgenili da saerTo samarTlis normebiT moqmedi sasamarTlos mier an Tu administraciuli ganxilva eqvemdebareba samarTlebriv gadaxedvas; muxli 14 ar iZleva sajaro samarTlis saqmis administraciuli sasamarTloebis mier administraciuli wesiT ganxilvis uflebis garantias da aseve ar uzrunvelyofs, rom amgvar gadaxedvas mohyveba saqmis arsis Sefaseba. samoqalaqo saqmeSi samarTliani sasamarTlo procesis ufleba moicavs: Ö Tanasworoba sasamarTlos winaSe118: es cneba ufro viwro gagebas moicavs, vidre kanonis winaSe Tanasworoba, romelic mocemulia samoqalaqo da politikur uflebaTa Sesaxeb saerTaSoriso paqtis 26 muxlSi, radganac es ukanaskneli exeba samarTlebriv administrirebSi CarTul yvela organos da ara mxolod sasamarTlo xelisuflebas119. Ö sasamarTlos xelmisawvdomoba120: xelmisawvdomoba moicavs samarTlebrivi daxmarebis gawevas121. samoqalaqo da politikur uflebaTa Sesaxeb saerTaSoriso paqtis me-14 muxli moiTxovs, rom `garkveuli garemoebebis~ arsebobisas saxelmwifoebma uzrunvelyon qmedebis garkveuli mizezebi da uflebamosilma sasamarTloebma gansazRvron am qmedebis mizezebi, Tumca ar aris mocemuli Tu ra garemoebebzea saubari122. saproceso Tanasworobis uzrunvelyofaSi, muxli 14 ver ganixileba, rogorc Sedegebis Tanasworobis an Secdomis ar arsebobis garanti uflebamosili tribunalis mxridan123; samarTliani sasamarTlo procesis elementebi samoqalaqo saqmis ganxilvisas moicavs mxareTa Tanasworobis princips124, dapirispirebul mxareTa procedurebis pativiscemas, 115 J. L. v. avstralia. (491/92). 116 kolanovski poloneTis winaaRmdeg (837/98). 117 adamianis uflebaTa dacvis komiteti. zogadi komentari 32, par: 18,19 118 Ibid., par:. 3 da 7 119 I bid., par:. 65 120 I bid., par:. 8, 9 da 12. 121 bahamonde ekvatoruli gvineis winaaRmdeg (Bahamonde v. Equatorial Guinea) (468/91); avelaneli perus winaaRmdeg (Avellanal v. Peru) (202/86); da adamianis uflebaTa dacvis komiteti. zogadi komentari 32, par: 10 122 mahuika axali zelandiis winaaRmdeg (547/93). 123 adamianis uflebaTa dacvis komiteti. zogadi komentari 32, par:. 26; b.d. holandia (273/88). 124 uflebaTa dacvis komiteti. zogadi komentari 32 par. 13. 64 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.4 wina verdiqtis damZimebis aRkveTasa da daCqarebul proceduras125; samoqalaqo saqmeTa sajaro mosmena aRiarebulia adamianis uflebaTa dacvis komitetis mier. gamonakliss warmoadgens mxolod sajaro interesebis Semcveli sakiTxebi126; samoqalaqo saqmeTa ganxilvisas dasaSvebia mopasuxeebs daekisros mtkicebis tvirTi127; me-14 muxlis darRvevis magaliTebi moicavs Semdegs: mosarCele mxares ar mieces neba daeswros sasamarTlo sxdomas da hqondes SesaZlebloba Sesabamisi informacia miawodos mis kanonier warmomadgenlebs128. mxareTaTvis sasamarTlo procesis TariRis ar Setyobineba129, administraciuli sasamarTlos uari mniSvnelovani mtkicebulebebis warmodgenaze130, da uari erTi mxarisTvis meore mxaris mier wardgenil dokumentaciaze komentaris gakeTebaze131. muxli 26, saerTaSoriso paqti samoqalaqo da politikur uflebaTa Sesaxeb: yvela adamiani Tanasworia kanonis winaSe da yovelgvari diskriminaciis gareSe aqvs kanonis Tanaswori dacvis ufleba. muxli 5(a) saerTaSoriso konvencia rasobrivi diskriminaciis yvela formis likvidaciis Sesaxeb am konvenciis me-2 muxlSi formulirebul ZiriTad valdebulebaTa Sesabamisad, mxare-saxelmwifoebi valdebulebas kisruloben, akrZalon da aRmofxvran yvela formis rasobrivi diskriminacia da uzrunvelyon yvela ufleba, ganurCevlad rasisa, kanis ferisa, an erovnuli Tu eTnikuri warmomavlobisa, Tanasworuflebianobaze kanonis winaSe, gansakuTrebiT Semdegi uflebebiT: sasamarTloebisa da marTlmsajulebis aRmasrulebeli yvela sxva organoebis winaSe Tanasworobis ufleba; muxli 15(1) konvencia qalTa yvela formis diskriminaciis aRkveTis Sesaxeb: monawile saxelmwifoebi aRiareben kanonis winaSe qalTa Tanasworobas mamakacebTan. samarTlebrivi dacvis efeqtiani saSualebis ufleba132 potenciuri darRvevebis magaliTebi eqims ar eZleva Sesabamisi kompensacia mas Semdeg, rac mis reputacias miadga ziani samedicino daudevrobis usafuZvlo da yalbi braldebebis niadagze, romlebic gaCnda presaSi; meddas ar eZleva SesaZlebloba dasaqmebis tribunalis gadawyvetileba gaasaCivros sasamarTloSi. 125 moraeli safrangeTis winaaRmdeg (207/86). ix. aseve fei kolumbiis winaaRmdeg (514/92); adamianis uflebaTa dacvis komiteti. zogadi komentari 32, par:. 27 126 adamianis uflebaTa dacvis komiteti. zogadi komentari 32, par:. 28 da 29. ix. niderlandebi. (215/1986). 127 adamianis uflebaTa dacvis komiteti. zogadi komentari 32, para. 9.4 128 volf v. panama (289/88). 129 Tomas v. iamaika (272/88). 130 jansen-gielen v. niderlandebi (846/99). sasamarTlo procesi samuSaos SesrulebisaTvis pirovnebebis fsiqiatriuli unaris dadgenaze 131 Aaarela da anor v. fineTi (779/97). 132 gaero. adamianis uflebaTa damcvelis deklaracia, muxli 9. 65 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi adamianis uflebaTa standartebi da Sesabamisi ganmartebebi muxli 2.3. saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb: am paqtis monawile TiToeuli saxelmwifo kisrulobs valdebulebas: a) yvela piri, romlis, am paqtiT aRiarebuli uflebani da Tavisuflebani Selaxulia, uzrunvelyos samarTlebrivi dacvis efeqtiani saSualebiT, im SemTxvevaSic ki, Tu es darRveva dauSves oficialurma pirebma; b) uzrunvelyos, rom TiToeuli piris samarTlebrivi dacvis ufleba, vinc ki aseT dacvas moiTxovs, daadginos kompetenturma sasamarTlom da ganaviTaros sasamarTlo dacvis SesaZleblobani; g) uzrunvelyos kompetentur xelisuflebaTa mier maTTvis mocemuli samarTlebrivi dacvis saSualebaTa gamoyeneba. • aSkara kavSiri arsebobs samarTlebrivi dacvis efeqtian saSualebasa da samarTlian sasamarTlos da/an samarTalwarmoebis uflebas Soris. zogadad unda moxdes am debulebis pativiscema, rodesac adgili eqneba me-14 muxlis darRvevas133; • samarTlebrivi dacvis saSualeba unda iyos xelmisawvdomi da efeqturi. miuxedavad imisa, rom samarTlebrivi dacvis saSualeba zogadad gulisxmobs Sesabamis kompensacias, zogierT SemTxvevebSi anazRaureba SeiZleba gulisxmobdes restitucias, reabilitacias da dakmayofilebis zomebis gatarebas, rogoricaa sajarod bodiSis moxda, sajaro memorandumi, garantia, rom SemdgomSi igive qmedebis ar ganmeordeba da Sesabamis kanonebsa da praqtiqaSi cvlilebebis Setana da qmedebebis gatareba, rom adamianis uflebaTa damrRvevni warsdgnen sasamarTlos winaSe134. • samoqalaqo da politikuri uflebebis Sesaxeb saerTaSoriso paqtis 2(3)(a) muxlis Tanaxmad saxelmwifoebs moeTxovebaT uzrunvelyon kompetentur samarTlebrivi, administraciuli an sakanonmdeblo xelisuflebis mier samarTlebrivi dacvis efeqtian saSualebaTa gamoyeneba135. im SemTxvevebSi Tu samoqalaqo da politikuri uflebebis saerTaSoriso paqtis debulebebis darRvevas adgili ar aqvs, mocemul garantias samarTlebrivi Zala daekargeba. saxelmwifo ar aris valdebuli xelmisawvdomi gaxados amgvari procedurebi136. • ekonomikuri, socialuri da kulturuli uflebebis Sesaxeb saerTaSoriso paqti muxli 2(1) • winamdebare paqtis TiToeuli monawile saxelmwifo kisrulobs valdebulebas, damoukideblad da saerTaSoriso daxmarebisa da TanamSromlobis gziT, gansakuTrebiT ekonomikur da teqnikur sferoSi, (maTTvis xelmisawvdomi resursebis maqsimaluri gamoyenebiT) miiRos zomebi am paqtiT aRiarebuli uflebebis progresulad sruli realizaciisaTvis, yvela saTanado saSualebiT, sakanonmdeblo zomebis miRebis CaTvliT. 133 adamianis uflebaTa dacvis komiteti. zogadi komentari 32 par. 58. 134 adamianis uflebaTa dacvis komiteti. zogadi komentari 31 par. 15 da 16. 135 I bid., par. 15. 66 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.4 • xSir SemTxvevaSi administraciuli samarTlebrivi dacvis efeqtiani saSualebebi adekvaturia. nebismieri samarTlebrivi dacvis saSualebebi unda iyos xelmisawvdomi, finansurad xelmiswvdomi, drouli da efeqturi. arsebobs garkveuli valdebulebebi, romlebic Seexeba ara-diskriminacias (da ara mxolod), romlis mimarTac garkveuli formis samarTlebrivi dacvis effeqtiani saSualebis gamoyeneba savaldebuloa137. ` gaeros deklaracia pirTa, jgufebis da sazogadoebrivi uwyebebis uflebebisa da movaleobebiis Sesaxeb uzrunvelyon da daicvan sayovelTaod aRiarebuli adamianis uflebebi da ZiriTadi Tavisuflebebi, (adamianis uflebaTa damcvelTa deklaracia) 1998, muxli 9138. adamianis uflebaTa yvela damcvels, maTi uflebebis darRvevis SemTxvevaSi aqvT samarTlebrivi dacvis efeqtiani saSualebebis gamoyenebis ufleba. es ufleba gulisxmobs samTavrobo organoebisa da oficialuri pirebis qmedebebsa da politikaze ukmayofilebis gamoTqmas. Tavis mxriv saxelmwifom unda Caataros dauyovnebeli da miukerZoebeli gamoZieba an uzrunvelyos rom gamoZieba Catardeba yovelTvis, rodesac gonivruli safuZveli iqneba, maszed rom moxda darRveva mis iurisdiqcias daqvemdebarebul teritoriaze. piradi da ojaxuri cxovrebis da reputaciis pativiscemis ufleba potenciuri darRvevebis magaliTebi saavadmyofos direqtoris telefoni ismineba winaswari kanonieri sanqcirebis gareSe; eqimi, romelic dasaqmebulTa usamarTlo gaTavisuflebisaTvis CarTulia samoqalaqo saqmeSi saavadmyofos winaaRmdeg, aRmoaCens, rom misi korespondencia yoveldRiurad mowmdeba da ikiTxeba misi Tanxmobis gareSe. adamianis uflebaTa standartebi da Sesabamisi ganmartebebi saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, muxli 17: 1. aravin ar unda ganicados TviTneburi an ukanono Careva Tavis pirad da ojaxur cxovrebaSi, misi sacxovreblis Seuvalobis an misi korespondenciis saidumloebis TviTneburi an ukanono xelyofa, an misi Rirsebisa da reputaciis ukanono xelyofa. 2. TiToeul adamians aqvs ufleba, rom kanonma daicvas aseTi Carevisa Tu xelyofisagan. adamianis uflebaTa komitetis zogadi komentari #16: piradi cxovrebis xelSeuxebloba …termini `sacxovrebeli~ (“home~ inglisurad, `manzel~ arabulad, `zhuzhai~ Cinurad, `domicile~ frangulad, `жилище~ rusulad da `domicilio~ espanurad) romelic naxsenebia paqtis me-17 muxlSi, gagebuli unda iyos, rogorc adgili, sadac pirovneba cxovrobs an axorcielebs misi yoveldRiur saqmianobas... 136 kazantzis kviprosis winaaRmdeg. (972/01). 137 ekonomikuri, socialuri da kulturuli uflebebis Sesaxeb saerTaSoriso paqti, zogadi komentari 9. (E/C.12/1998/24, CES CR). dekemberi 3, 1998 138 gaeros generaluri asambleis rezolucia 53/144. dekemberi 9, 1998 67 Tavi 2: saerTaSoriso gamocdileba adamianis uflebebze janmrTelobis dacvis sferoSi • iseTi Carevebis SemTxvevaSic ki, romlebic SesabamisobaSia paqtis debulebebTan, Sesabamisi kanonmdebloba unda iZleodes detalur ganamrtebas, Tu romeli garemoebebis dros aris dasaSvebi amgvari Careva. gadawyvetileba amgvari sanqcirebuli Carevis gamoyenebaze miRebuli unda iyos mxolod kanoniT uflebamosili organos mier calkeuli saqmeebis safuZvelze. me-17 muxli moiTxovs mimoweris mTlianobisa da konfidencialurobis dacvis, rogorc de iure, aseve de faqto uzrunvelyofas. korespondencia mitanili unda iyos daniSnul misamarTze Seferxebisa da gaxsnis an misi sxvagvarad wakiTxvis gareSe. akrZaluli unda iyos rogorc eleqtronuli, aseve satelefono, telegrafiuli da komunikaciis sxva formebis meTvalyureoba, aseve satelefono saubrebis Cawera. pirovnebis saxlis Cxreka unda Semoifarglebodes saWiro mtkicebulebebis moZiebiT da ar unda hqondes Seuracxmyofeli xasiaTi. Tu adgili eqneba pirad (sxeulis) Cxrekas, miRebuli unda iyos efeqturi zomebi, raTa uzrunvelyofil iqnas Cxrekisas pirovnebis Rirsebis dacva. saxelmwifo oficialuri Tanamdebobis pirebis an saxelmwifos moTxovnis safuZvelze moqmedi samedicino personalis mier ganxorcielebuli pirovnebis Cxreka unda ganxorcieldes igive sqesis pirebis mier, romel sqessac miekuTvneba Cxrekas daqvemdebarebuli pirovneba. • sajaro moxeleebisa Tu kerZo pirebis mier piradi informaciis mogroveba da misi kompiuterSi, monacemTa bazebSi Tu sxva mowyobilobebSi Senaxva kanoniT unda regulirdebodes. saxelmwifom unda gaataros efeqturi zomebi, raTa uzrunvelyos, rom adamianis piradi cxovrebis Sesaxeb informacia ar CauvardebaT xelSi iseT pirebs, romlebic kanoniT uflebamosilni ar arian mis miRebaze, damuSavebasa da gamoyenebaze; aseve uzrunvelyos, rom informacia ar iqneba paqtis debulebebTan Seusabamo miznebisTvis gamoyenebuli. • imisaTvis, rom yvela adamianma efeqturad daicvas misi piradi cxovreba, mas unda hqondes ufleba icodes inaxeba Tu ara da ra piradi monacemebi inaxeba avtomatur monacemTa arqivSi da ra mizniT. yvela pirovnebas unda SeeZlos daadginos Tu romeli sajaro moxeleebi Tu kerZo pirebi akontroleben an SeuZliaT akontrolon mis Sesaxeb informacia. Tu arqivi Seicavs araswor pirad monacemebs an Segrovebul Tu damuSavebul iqna kanoniT gaTvaliswinebuli normebis darRveviT, yvela pirs unda hqondes ufleba moiTxovos koreqtireba an informaciis waSla; • muxli 17 uzrunvelyofs piradi Rirsebisa da reputaciis dacvas da saxelmwifoebi valdebulni arian am mizniT uzrunvelyon Sesabamisi sakanonmdeblo garantiebi. kanoniT gaTvaliswinebuli normebi saSualebas unda aZlevdes yvela pirovnebas efeqturad daicvas Tavi ukanono Setevebisagan da isargeblos efeqturi samarTlebrivi dacviT. xelmomwerma qveynebma maT angariSebSi unda aCvenon Tu ramdenad icavs kanoni adamianis Rirsebasa Tu reputacias da Tu rogor xdeba Sesabamisi dacvis miRweva maTi samarTlebrivi sistemis saSualebiT. saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, muxli 19 (3) gamoxatvis Tavisuflebis SezRdva sxvaTa uflebebisa da Rirsebis dasacavad am muxlis me-2 punqtiT gaTvaliswinebuli uflebebiT sargebloba gansakuTrebul movaleobas da pasuxismgeblobas akisrebs mxareebs. maSasadame, igi SeiZleba dakavSirebuli iyos zogierT SezRudvasTan, romlebic unda iyos kanoni dadgenili da aucilebeli: a) sxva pirTa uflebebisa da reputaciis pativiscemisaTvis; b) saxelmwifo usafrTxoebis sazogadoebrivi wesrigis, mosaxleobis janmrTelobisa Tu zneobis dasacavad. 68 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 2.4 gamoxatvis da informaciis Tavisufleba139 potenciuri darRvevebis magaliTebi sajaro moxeleebi winaaRmdegobas uweven TanamSromlebisTvis informaciis miwodebas maT saavadmyofoSi radiaciis maRali donis arsebobis Sesaxeb. adamianis uflebaTa standartebi da Sesabamisi ganmartebebi saerTaSoriso paqti samoqalaqo da politikuri uflebebis Sesaxeb, muxli 19 (2) informaciis ufleba TiToeul adamians ufleba aqvs Tavisuflad gamoTqvas sakuTari azri; es ufleba Seicavs Tavisuflebas, rom saxelmwifo sazRvrebis miuxedavad eZios, miiRos da gaavrcelos yovelgvari informacia zepirad, werilobiT Tu presisa da gamoxatvis mxatvruli formebis saSualebiT an sxva saSualebiT sakuTari arCevaniT. muxli 5(d)(viii) Sexedulebebisa da gamoxatvis Tavisuflebis ufleba; am konvenciis me-2 muxlSi formulirebul ZiriTad valdebulebaTa Sesabamisad, mxare-saxelmwifoebi valdebulebas kisruloben, akrZalon da aRmofxvran yvela formis rasobrivi diskriminacia da uzrunvelyon yvela ufleba, ganurCevlad rasisa, kanis ferisa, an erovnuli Tu eTnikuri warmomavlobisa, Tanasworuflebianobaze kanonis winaSe, gansakuTrebiT Semdegi uflebebiT: Sexedulebebisa da gamoxatvis Tavisuflebis ufleba gaeros deklaracia pirTa, jgufebis da sazogadoebrivi uwyebebis uflebebisa da movaleobebiis Sesaxeb uzrunvelyon da daicvan sayovelTaod aRiarebuli adamianis uflebebi da ZiriTadi Tavisuflebebi, (adamianis uflebaTa damcvelTa deklaracia) 1998140 muxli 6: individualurad an sxvebTan erTad yvelas aqvs ufleba: (a) icodes, moiZios, miiRos da Seinaxos informacia adamianis uflebaTa da TavisuflebaTa Sesaxeb, maT Soris informacia Tu rogor aisaxeba es uflebebi da Tavisuflebebi qveynis kanonmdeblobaSi, samarTlebriv Tu administraciul sistemebSi; (b) gamoaqveynos, miiRos an gaavrcelos informacia da codna adamianis uflebaTa da fundamentalur TavisuflebaTa Sesaxeb, rogorc es mocemulia adamianis uflebebis dacvisa da sxva saerTaSoriso instrumentebSi; (g) iswavlos, ganixilos, Camoayalibos da iqonios Sexedulebebi yvela adamianis uflebaTa da fundamentalur TavisuflebaTa dacvaze rogorc kanonSi aseve praqtikaSi da am da sxva Sesabamisi saSualebebiT miapyros sazogadoebis yuradReba am sakiTxebisaken. 139 laptseviCi belorusiis winaaRmdeg (780/97). 140 gaeros generaluri asambleis rezolucia 53/144; 9 dekemberi 1998 69 3.1 Sesavali 3.2 ZiriTadi wyaroebi 3.3 pacientis uflebebi Tavisuflebis da usafrTxoebis ufleba piradi cxovrebis xelSeuxeblobis ufleba informaciis miRebis ufleba fizikuri xelSeuxeblobis ufleba sicocxlis ufleba ufleba janmrTelobis umaRles xelmisawvdom standartebze wamebis da sastiki, araadamianuri da damamcirebeli mopyrobis akrZalva sajaro politikaSi monawileobis ufleba diskriminaciis akrZalva da Tanasworobis ufleba 3.4 janmrTelobis dacvis momsaxurebis mimwodebelTa uflebebi normalur samuSao pirobebSi muSaobis ufleba gaerTianebis Tavisufleba samarTalwarmoebis ufleba da Sesabamisi uflebebi 70 adamianis uflebebi janmrTelobis dacvis sferoSi 3 pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba 3.1 Sesavali es Tavi ganixilavs ZiriTad standartebs, romlebic gamoiyeneba adamianis uflebaTa dasacavad jandacvis sistemaSi evropul kontinentze (evropis sabWos wevr-saxelmwifoebis geografiul arealSi) da ikvlevs, Tu rogor axdenen am standartebis interpretacias saerTaSoriso organizaciebi, gansakuTrebiT adamianis uflebaTa evropuli sasamarTlo da socialuri uflebebis evropuli komiteti. TiToeuli Tavis qveseqcia ganixilavs Sesabamis standartebs, romlebic ukavSirdeba calkeul uflebas (mag. Tavisuflebisa da usafrTxoebis ufleba) da mohyavs uflebis potenciur darRvevaTa magaliTebi. winamdebare TavSi Sesuli standartebi moicavs rogorc samarTlebrivad savaldebulo Zalis mqone xelSekrulebebs, rogorebicaa adamianis uflebaTa da ZiriTad TavisuflebaTa dacvis evropuli konvencia da evropis socialuri qartia, agreTve evropis sabWosa da samoqalaqo sazogadoebis mier SemuSavebul standartebs, maT Soris gansakuTrebuli mniSvnelobis mqone dokuments pacientis uflebaTa evropuli qartias. 71 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba 3.2 ZiriTadi wyaroebi evropis sabWo ` biologiasa da medicinaSi adamianis uflebebis dacvis Sesaxeb konvencia: konvencia adamianis uflebebisa da biomedicinis Sesaxeb (1997)1 asaxavs pacientis uflebaTa calkeul principebs, romlebic efuZneba winapirobas, rom arsebobs `adamianis, rogorc individis pativiscemis da misi adamianuri Rirsebis dacvis aucilebloba.~ konvencia iuridiulad savaldebuloa wevri saxelmwifoebisTvis. ZiriTadi debulebebi moicavs Semdegs: • • • saTanado da xelmisawvdomi janmrTelobis dacva (mux.3); Tanxmobis uflebis dacva (Tavi II, mux. 5-9); piradi cxovrebis da informaciis miRebis ufleba (Tavi III, mux. 10). ` adamianis uflebaTa evropuli konvencia2 (ECHR) adaminis uflebaTa evropuli konvencia aris mTavari instrumenti uflebaTa dasacavad, romelic ratificirebulia evropis sabWos yvela wevr-saxelmwifos mier. misi aRsruleba xdeba adamianis uflebaTa evropuli sasamarTlos mier, romlis iuridiulad savaldebulo Zalis mqone gadawyvetilebebi xSirad moicavs fulad kompensacias dazaralebulisTvis. Sesabamisi muxlebi moicavs: • • • • • • • mux. mux. mux. mux. mux. mux: mux. 2 (sicოcxlis ufleba); 3 (wamebis, araadamianuri da Rirsebis Semlaxavi mopyrobis akrZalva); 5 (Tavisuflebisa da xelSeuxeblobis ufleba); 6 (samarTliani sasamarTlo ganxilvis ufleba); 8 (piradi cxovrebis pativiscemis ufleba); 13 (efeqturi samarTlebrivi dacvis ufleba); 14 (diskriminaciis akrZalva); ` wamebis da araadamianuri an damamcirebeli mopyrobis an dasjis aRkveTis evropuli konvencia muxli 1: afuZnebs wamebisa da araadamianuri an damamcirebeli mopyrobis an dasjis aRkveTis evropul komitets, romelic vizitebis saSualebiT monitorings uwevs Tavisuflebis aRkveTis adgilebSi arsebuli pirobebisa da mopyrobis Sesabamisobas konvenciasTan. ` evropuli socialuri qartia 1961 w. da 1996 w. evropuli socialuri qartia aris wamyvani regionuli ekonomikuri da socialuri uflebebis dacvis instrumenti da masze zedamxedvelobas axdens socialuri uflebebis evropuli komiteti, perioduli saxelmwifo angariSebis ganxilviTa da koleqtiuri saCi- 1 teqsti ixileT http://conventions.coe.int/Treaty/EN/Treaties/Html/164.htm. 2 teqsti ixileT http://www.hri.org/docs/ECHR50.html 72 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.2 vrebiT. qartia Tavdapirvelad SemuSavda 1961 wels da Zireulad gadaisinja 1996 wels, Tumca, zogierT saxelmwofos ar mouxdenia qartiis bolo variantis ratificireba da aqvT ufleba airCion maTTvis misaRebi muxlebi. Tu mxedvelobaSi miviRebT bevri debulebis zogad xasiaTs, agreTve socialuri uflebebis evropuli komitetis progresul/liberalur midgomas, pacientis uflebaTa dacva SeiZleba rigi debulebebis WrilSi im SemTxvevaSic ki, rodesac saxelmwifos ar uRiarebia specialuri janmrTelobis dacvis garantiebi. Sesabamisi muxlebi moicavs: • • • • • • • • mux. 11 (janmrTelobis dacvis ufleba); mux. 13 (socialuri da samedicino daxmarebis miRebis ufleba); mux. 14 (socialuri dacvis samsaxuriT sargeblobis ufleba); mux.15 (SezRuduli SesaZleblobebis mqone pirTa damoukideblobis, socialuri integraciisa da sazogadoebriv cxovrebaSi monawileobis ufleba); mux. 16 (ojaxis socialuri, samarTlebrivi da ekonomikuri dacvis ufleba); mux. 17 (bavSvebis da axalgazrdebis socialuri, samarTlebrivi da ekonomikuri dacvis ufleba); mux. 19 (migranti muSebis da maTi ojaxis dacva da daxmareba); mux. 23 (xandazmulTa socialuri dacvis ufleba). socialuri uflebebis evropulma komitetma ganacxada, rom janmrTelobis dacvasTan dakavSirebuli uflebebi ganuyoflad ukavSirdeba maT Sesabamis garantiebs adamianis uflebaTa evropul konvenciaSi, radgan ,,adamianis Rirseba aris fundamenturi Rirebuleba da evropuli adamanis uflebaTa pozitiuri samarTlis arsi. janmrTelobis dacva ki adamianis Rirsebis pativiscemis winapirobaa.~3 CarCo konvencia erovnul umciresobaTa dacvis Sesaxeb 19954 es iuridiulad savaldebulo Zalis mqone xelSekruleba uzrunvelyofs yvela eTnikuri da sxva saxis umciresobaTa Tanaswor mopyrobas. Sesabamisi debulebebi moicavs: • mux. 4(2) (saTanado zomebis miReba erovnul umciresobaTa ekonomikuri, socialuri, politikuri da kulturuli cxovrebis yvela sferoSi sruli da efeqturi Tanasworobis xelis Sesawyobad, maTi specifiuri mdgomareobis gaTvaliswinebiT). ` ministrTa komitetis rekomendacia #R (2000) 5 wevr saxelmwifoebs: struqturebis Camoyalibeba moqalaqeebis da pacientebis monawileobisTvis maT janmrTelobasTan dakavSirebul gadawyvetilebaTa miRebis procesSi. 5 miuxedavad maTi arasavaldebulo xasiaTisa, rekomendaciebs aqvT Zlieri politikuri da moraluri mniSvneloba. rekomendaciebi xazs usvams yvela adamianis efeqturi monawile- 3 adamianis uflebaTa saerTaSoriso federacia safrangeTis winaaRmdeg (FIDH - Fédération Internationale des Droits de l’Homme) v France (14/2003) § 31 4 teqsti ixileT http://conventions.coe.int/treaty/en/Treaties/Html/157.htm 5 https://wcd.coe.int/ViewDoc.jsp?id=1062769&BackColorInternet=9999CC&BackColorIntranet 73 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba obis saWiroebas, gansakuTrebiT ki mravalferovan da multikulturul sazogadoebebSi, sadac xSirad xdeba eTnikuri umciresobebis marginalizeba. evrokavSiri ` evrokavSiris fundamentur uflebaTa qartia6, romelsac xeli moewera safrangeTis qalaq nicaSi 2000 wlis 7 noembers, evrokavSiris istoriis manZilze pirvelad, erT teqstSi moicavs evrokavSiris moqalaqeTa da mis teritoriaze mcxovreb pirTa mTel rig samoqalaqo, politikur, ekonomikur da socialur uflebebs. igi Sevida evropis 2004 wlis 18 ivnisis konstituciis proeqtis meore nawilSi. evrokavSiris konstituciis proeqtis uaryofis Semdeg moxda qartiis adaptireba da gamocxadda 2007 wlis 12 dekembers strasburgSi lisabonis xelSekrulebis xelmoweris win, romelic qartias aniWebs iuridiulad savaldebulo Zalas. qartiis sruli moqmedeba evrokavSiris wevri saxelmwifoebisTvis kvlav gaurkvevelia, Tumca, evrokavSiris arawevri saxelmwifoebisTvisac igi aris mniSvnelovani saxelmZRvanelo dokumenti, gansakuTrebiT ki im qveynebisTvis, romlebic kavSirSi Sesvlis procesSi arian. mTavari debuleba: • mux. 35 (janmrTelobis dacvis ufleba, rogorc ,,prevenciuli janmrTelobis dacvis xelmisawvdomobis ufleba da samedicino mkurnalobiT sargeblobis ufleba erovnuli kanonmdeblobisa da praqtikis Sesabamisad~. muxli azustebs, rom evrokavSirma ,,adamianis janmrTelobis dacvis maRali xarisxi~ unda uzrunvelyos~) sxva Sesabamisi debulebebi moicavs: • • • • • • • • • • • mux. mux. mux. mux. mux. mux. mux. mux. mux. mux. mux. 1 (adamianis Rirsebis xelSeuxebloba); 2 (sicocxlis ufleba); 3 (adaminis fizikuri xelSeuxeblobis ufleba); 6 (usafrTxoebis ufleba); 8 (piradi monacemebis dacvis ufleba); 21 (diskriminaciis akrZalva); 24 (bavSvis uflebebi); 25 (xandazmulTa uflebebi); 34 (socialuri dacvisa da socialuri daxmarebis ufleba); 37 (dacul garemoSi cxovrebis ufleba); 38 (momxmareblis uflebaTa dacva) ` evrokavSiris mier SeTavazebuli direqtiva pacientis uflebebis Sesaxeb janmrTelobis saerTaSoriso dacvaSi7 did xniani dayovnebis Semdeg, direqtivis es proeqti, wevr-saxelmwifoebs Soris janmrTelobis dacvis mxriv TanamSromlobis gaumjobesebis winadadebasTan erTad, evropu- 6 teqsti ixileT http://www.europarl.europa.eu/charter/default_en.htm 7 ec.europa.eu/health/ph_overview/co_operation/health care/cross-border_health care_en.htm 74 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.2 li kavSiris komisiam 2008 wlis 2 ivliss miiRo. misi mizania moaxdinos samarTlebrivi ganmarteba am sakiTxis Sesaxeb da Tavidan aicilos potenciuri sasamarTlo procesebi, radganac evrokavSiris xelSekruleba uflebas aZlevs kerZo pirebs isargeblon janmrTelobis dacviT sxva wevr-saxelmwifoebSi (es principi damtkicda evropuli marTlmsajulebis sasamarTlos ramdenime gadawyvetilebiT). xelSekrulebis ZiriTadi debulebebi moicavs Semdegs: • pacientebs aqvT ufleba, mkurnalobisTvis mimarTon sxva wevr-saxelmwifos gadaxdis imave pirobebSi, rac maT eqnebodaT sakuTar qveyanaSi. direqtiva ganmartavs, Tu rogor unda moxdes am uflebebis realizacia, maT Soris miuTiTebs im SezRudvebis Sesaxeb, romlebic wevr-saxelmwifoebma SeiZleba daaweson sakuTari sazRvrebis gareT janmrTelobis dacvasTan da Sesabamis materialur anazRaurebasTan dakavSirebiT. • wevri saxelmwifoebi pasuxs ageben maT teritoriaze janmrTelobis dacvaze. pacientebs unda hqondeT imis garantia, rom sxva wevr-saxelmwifoSi miRebuli mkurnalobis xarisxi da usafrTxoeba regularulad mowmdeba da efuZneba jansaR samedicino praqtikas. pres-relizSi komisiam ganacxada, rom direqtiva `uzrunvelyofs myar safuZvels imisTvis, rom moxdes evropuli TanamSromlobis uzarmazari potencialis stimulireba da gaumjobesdes evrokavSiris jandacvis sistemis efeqturoba da qmediToba.~ sazogadoebrivi janmrTelobis evropulma aliansma (EPHA) direqtivis proeqtis ramdenime sakiTxze gamoTqva ukmayofileba, maT Soris pacientis uflebebTan dakavSirebiT. komisia SiSobs, rom direqtivam SeiZleba finansebis dazogvis saSualeba misces mxolod garkveul mcire jgufs, romelTac ukve aqvT sakmarisi saxsrebi `jandacvis turizmisTvis~ da ver uzrunvelyos jandacvis xelmisawvdomoba yvela adamianisTvis. arasaxelSekrulebo instrumentebi ` pacientis uflebaTa evropuli qartia8 ,,Cven, evropis moqalaqeebi, ar davuSvebT, rom uflebebi ganmtkicdes Teoriulad, magram dairRves praqtikaSi arasakmarisi finansebis gamo. finansuri SezRudva, raoden gamarTlebulic ar unda iyos igi, ver moaxdens pacientis uflebaTa uaryofis, an am mxriv daTmobebze wasvlis legitimacias. Cven ver SevurigdebiT imas, rom es uflebebi daawesos kanonebma, magram Semdeg ar moxdes maTi dacva, Caidos saarCevno programebSi, magram daviwyebas mieces axali xelisuflebis mosvlis Semdeg.~9 2002 wels evropuli samoqalaqo, samomxmareblo da pacientTa organizaciebis qselis _ aqtiuri moqalaqeobis qseli _ mier SemuSavebuli es qartia aris pacientis uflebaTa yovlismomcveli gancxadeba. es gancxadeba iyo nawili evropaSi pacientTa moZraobis, raTa maT eTamaSaT ufro aqtiuri roli jandacvis servisebis formirebasa da uzrunvelyofaSi. agreTve iyo mcdeloba, rom regionaluri dokumentebi janmrTelobis dacvis Sesaxeb gamoxatuliyo specifikuri debulebebis saxiT.10 8 teqsti ixileT http://www.activecitizenship.net/health/european_charter.pdf. 9 preambula 10 mniSvnelovania aRiniSnos, rom farmacevtuli kompania Merck & Co. agreTve afinansebda moZraobas. 75 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba qartia gansazRvravs 14 riskis qveS arsebul uflebas: prevenciuli RonisZiebebis gatarebis ufleba, xelmisawvdomoba, informaciis miRebis ufleba, pacientis Tanxmoba, Tavisufali arCevani, piradi cxovrebis xelSeuxebloba, konfidencialoba, pacientis drois pativiscema, xarisxis standartebis dacva, usafrTxoeba, ganaTleba, tanjvis da tkivilis acileba, personaluri mkurnaloba, saCivrebis Setana da kompensacia. miuxedavad imisa, rom qartia iuridiulad savaldebulo ar aris, pacientis uflebaTa damcveli jgufebis Zlieri qseli evropis masStabiT warmatebiT lobirebda xelisuflebasTan, raTa ecno da mieRo qartiaSi CamTvlili uflebebi. qartia agreTve gamoiyeneba, rogorc saxelmZRvanelo evropaSi jandacvis sistemis monitoringisa da SefasebisTvis. ` jandacvis msoflio organizaciis deklaracia evropaSi pacientTa uflebebis xelSewyobis Sesaxeb: evropuli konsultaciebi pacientis uflebaTa Sesaxeb, amsterdami11 `Tavisi kompetenciiTa da regulirebis sferoTi, es dokumenti miznad isaxavs gamoxatos adamianTa miswrafeba ara mxolod janmrTelobis dacvis gaumjobesebis kuTxiT, aramed maTi, rogorc pacientebis, uflebaTa ufro meti pativiscemiT. amisaTvis, dokumenti mxedvelobaSi iRebs ara mxolod jandacvis dawesebulebaTa TvalTaxedvas, aramed pacientebisasac. es gulisxmobs uflebaTa da movaleobaTa erTmaneTis Semavsebel xasiaTs: pacientebs aqvT sakuTar Tavze mzrunvelobis valdebuleba da valdebuleba jandacvis dawesebulebis mimarT. jandacvis momwodeblebic, Tavis mxriv, sargebloben imave uflebebiT, riTac yvela adamiani. teqstis Tanaxmad, pacientis uflebaTa xelSewyoba ubiZgebs pirebs, ufro meti pasuxismgeblobiT moekidon TavianT valdebulebebs, rodesac iReben an gascemen samedicino servisebs. es xels Seuwyobs pacientebsa da samedicino dawesebulebebs Soris urTierTpativiscemasa da mxardaWeras.~ deklaracia SeimuSava jandacvis msoflio organizaciis evropis regionalurma ofisma 1994 wels. igi ar aris iuridiulad savaldebulo dokumenti, magram imis gaTvaliswinebiT, rom jandacvis msoflio organizaciis mier aris SemuSavebuli, deklaracia warmoadgens mniSvnelovan saxelmZRvanelo dokuments. deklaraciis ideologiuri safuZvelia adamianis uflebaTa saerTaSoriso bili, adamianis uflebaTa evropuli konvencia da evropuli socialuri qartia. amitom, deklaracia gansakuTrebul yuradRebas uTmobs informaciis miRebis uflebas, informirebul Tanxmobas, konfidencialurobas, piradi cxovrebis uflebas, mzrunvelobisa da mkurnalobis miRebis uflebebs. ` 1996 wlis jandacvis msoflio organizaciis liublianas qartia 12 es qartia aregulirebs mTel rig fundamentur principebs, raTa uzrunvelyos, rom ,,jandacvis sistema, upirveles yovlisa, mimarTul iqnas adamianebis janmrTelobisa da sicocxlis xarisxis gaumjobesebisken.~13 konkretulad, iZleva rekomendacias, rom 11 teqsti ixileT www.who.int/genomics/public/eu_declaration1994.pdf 12 teqsti ixileT: http://www.bmj.com/cgi/content/full/312/7047/1664 13 paragrafi 2 76 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.3 janmrTelobis dacvis sistema iyos adamianis saWiroebebze mimarTuli da mouwodebs pacientebs, TavianTi wvlili Seitanon pozitiuri cvlilebebis danergvaSi (paragrafi 5.3) 3.3 pacientis uflebebi iseve rogorc wina TavSi, romelic saerTaSoriso gamocdilebas exeba, winamdebere Tavic pacientis cxra ZiriTad uflebas exeba. esenia: pirovnebis Tavisuflebisa da usafrTxoebis ufleba; piradi cxovrebis xelSeuxebloba; informaciis miRebis ufleba; fizikuri xelSeuxeblobis ufleba; sicocxlis ufleba; ufleba janmrTelobis umaRles xelmisawvdom standartze; wamebis da sastiki, araadamianuri da damamcirebeli mopyrobis akrZalva; sajaro politikaSi monawileobis ufleba; diskriminaciis akrZalva da Tanasworobis ufleba. adamianis uflebaTa evropul konvenciaSi pacientis janmrTelobis uflebis damcavi specialuri normis ararseboba, xels ar uSlis adamianis uflebaTa evropul sasamarTlos pacientis uflebaTa saqmeebis ganxilvis dros. fsiqikuri aSlilobis gamo Tavisufleba SezRuduli pirebis uflebaTa dasacavad adamianis uflebaTa evropuli sasamarTlo iyenebs konvenciis me-5 muxls, romliTac garantirebulia Tavisuflebisa da usafrTxoebis ufleba. me-3 muxli krZalavs dakavebulebis wamebas da sastik, araadamianur da damamcirebel mopyrobas, maT Soris fsiqikuri aSlilobis niadagze dakavebul pirTa mimarT. me-8 muxli, romelic piradi cxovrebas icavs, sasamarTlom warmatebiT gamoiyena piradi samedicino monacemebis gamoaSkaravebis SemTxvevebSi. am magaliTebis miuxedavad, unda aRiniSnos, rom sasamarTlo Tavs aridebs arapirdapir cnos janmrTelobis pozitiuri ufleba, Tumca, es uflebis darRveva aris sicicxlis uflebis xelyofis winapiroba. am uflebisTvis Tavis arideba sasamarTlos mier gamowveulia evropuli sasamarTlos zogadi tendenciiT, ar miiRos gadawyvetilebebi, romlebic moaxdenen mniSvnelovan ekonomikur an/da socialur zegavlenas politikasa da resursebze. socialuri uflebebis evropulma komitetma ganmarta evropis socialuri qartiis me-11 muxli (janmrTelobis dacvis ufleba) Tanmdevi garantiebiT, rogoricaa me-13 muxli (socialuri da samedicino daxmarebis ufleba). Tumca, radgan evropuli socialuri qartiis gamoyeneba ar SeuZliaT kerZo pirebs, komitetis analizi eyrdnoba saxelmwifoTa moxsenebebs an koleqtiur saCivrebs, da amitom, aris zogadi xasiaTis (mag. jandacvis sistema yvelasTvis xelmisawvdomi unda iyos kvalificiuri samedicino personaliT da unda arsebobdes saTanado pirobebi). dResdReobiT, koleqtiuri saCivrebis meqanizmiT, komitetma ganixila mxolod erTi, janmrTelobis dacvis uflebasTan dakavSirebuli saqme _ Raribi ukanono imigrantebisTvis samedicino daxmarebaze uaris Tqma. ase rom, precedentuli samarTali am mimarTulebiT ganviTarebis procesSia. kidev erTi mniSvnelovani standarti, romelic am TavSi ganixileba, aris pacientis uflebaTa evropuli qartia, romelic moicavs saTanado specialur garantiebs, Tumca, ar arsebobs am standartebis ganxorcielebaze sameTvalyureo organo. amitom, maTi ganxorcieleba ar SeuZliaT uSualod dazaralebulebs sakuTar uflebaTa dasacavad. miuxedavad amisa, maTze miTiTeba SeiZleba savaldebulo Zalis mqone xelSekrulebebis gamoyenebis dros, rogoricaa magaliTad adamianis uflebaTa evropuli konvencia. socialuri uflebebis evropuli komitetis analizis gamoyeneba SeiZleba adamianis uflebaTa evropuli kon- 77 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba venciis debulebebis ukeTesi ganmartebisTvis. arasavaldebulo dokumentebze dayrdnoba (rogoricaa pacientTa uflebebis evropuli qartia), am dokuments aniWebs met Zalasa da avtoritets da xels uwyobs misi debulebebisTvis saerTaSoriso CveulebiTi samarTlis normebis statusis miniWebas. Tavisuflebisa da usafrTxoebis ufleba uflebis potenciur darRvevaTa magaliTebi piris TviTneburi dakaveba fsiqikuri avadmyofobis safuZvelze eqimis diagnozis gareSe; instituciebSi pacientebs ar acnobeben sakuTar uflebebs, rom mimarTon sasamarTlos; narkotikebis momxmarebeli qali, mSobiarobis Semdeg dakavebulia samSobiaroSi da ar aZleven bavSvze mzrunvelobis uflebas. adamianis uflebaTa standartebi da interpretacia ` adamianis uflebaTa evropuli konvencia, mux. 5(1) (e): yvelas aqvs Tavisuflebis da piradi xelSeuxeblobis ufleba. aravis SeiZleba aRekveTos Tavisufleba, garda Semdegi SemTxvevebisa da kanoniT gansazRvruli proceduris Sesabamisad: ... pirTa kanonierad dapatimreba infeqciur daavadebaTa gavrcelebis Tavidan asacileblad, an suliT avadmyofebis, alkoholikebis, narkomanebis an mawanwalebis kanonieri dakaveba. • adamianis uflebaTa evropuli sasamarTlo ar ganmartavs ,,suliT avadmyofobis~ cnebas, radgan misi mniSvneloba ganviTarebis procesSia.14 Tumca: dadgenilia, rom unda arsebobdes obieqturi samedicino Cveneba, rom piri gansazRvrul dros avlens suliT avadmyofobas (sagangebo mdgomareobebis garda).15 aqedan gamomdinare, prokuroris brZanebiT eqimis diagnozis gareSe piris dakaveba arRvevs me-5(1)(e) muxls, maSinac ki, roca dakavebis mizania eqimisgan diagnozis miReba.16 • adamianis uflebaTa evropulma sasamarTlom daawesa proceduruli garantiebi me5(1)(e) muxlis gamoyenebasTan dakavSirebiT: piris izolireba SesaZlebelia mxolod saTanado samarTlebrivi proceduris gamoyenebiT da ar SeiZleba iyos TviTneburi. ,,suliT avadmyofobasTan~ dakavSirebiT sasamarTlom ganmarta, rom adamians unda hqondes damtkicebuli fsiqikuri aSliloba da unda saWiroebdes izolirebas mkurnalobis mizniT.17 14 ixileT litva poloneTis winaaRmdeg (2001) 33, evropis adamianis uflebaTa angariSi (EHRR) 53alkoholizmis ganmarTebisaTvis, muxli 5(1)(e). 15 Herci germaniis winaaRmdeg (No. 44672/98, 12/06/03) da rakeviCi ruseTis winaaRmdeg (No 58973/00, 28/10/03). 16 varbanovi bulgareTis winaaRmdeg (No 31365/96, 5/10/00) 17 vinterverpi niderlandebis winaaRmdeg, adamianis uflebaTa evropuli sasamarTlo (ser. A) (1979). ixileT aseve HL v UK (No 45508/99, 5/10/04) 78 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.3 • unda xdebodes nebismieri moqmedebis perioduli Semowmeba, rac unda moicavdes samarTliani ganxilvis ZiriTad elementebs.18 im SemTxvevebSi, rodesac ar xdeba am garantiebis dacva, sasamarTlo saxelmwifos akisrebs zianis anazRaurebis valdebulebas adamianis Tavisuflebis darRvevisTvis me-5(1)(e) muxlidan gamomdinare. • me-5 (1)(e) muxlis mixedviT dakaveba SeiZleba gamarTlebuli iyos, rogorc individualuri ise sajaro interesebis dacvis safuZvelze. dakavebis kanonierebis gansazRvrisTvis mniSvneloba eniWeba agreTve imas, dakaveba moxda saavadmyofoSi, klinikaSi Tu sxva saTanado instituciaSi. Tumca, faqti, rom dakaveba moxda Sesabamis instituciaSi, ar aris garantia imisa, rom pacients saTanadod epyrobian da uzrunvelyofen normaluri pirobebiT. me-5(1)(e) muxlis darRveva dafiqsirda, rodesac daakaves aiv infeqciis matarebeli piri mas Semdeg, rac man gadasca virusi sxva pirovnebas seqsualuri kontaqtis Sedegad.19 piradi cxovrebis xelSeuxeblobis ufleba uflebis potenciuri darRvevis magaliTebi eqimi sajarod aaSkaravebs pacientis narkotikebis moxmarebis istorias pacientis Tanxmobis gareSe; mTavroba moiTxovs konkretul SemTxvevebSi SidsiT daavadebulTa statusis informaciis gamJRavnebas; jandacvis muSakebi moiTxoven axalgazrdebisgan, moipovon mSoblebis Tanxmoba sqesobrivad gadamdebi daavadebebis mkurnalobasTan dakavSirebuli momsaxurebis gawevaze; dawesebulebaSi ganTavsebul pirebs ar aaqvT piradi nivTebis Sesanaxad gamoyofili adgili. adamianis uflebaTa standartebi da interpretacia ` adamianis uflebaTa evropuli konvencia mux. 8(1): yvelas aqvs ufleba pativi scen mis pirad da ojaxur cxovrebas, sacxovrebels da mimoweras. adamianis uflebaTa evropulma sasamarTlom aRniSna, rom: `piradi informaciis dacva, maT Soris samedicino informaciis, aris fundamenturi mniSvnelobis piradi da ojaxuri cxovrebis uflebis dasacavd. samedicino monacemebis konfidencialoba aris wevr-saxelmwifoebis samarTlebrivi sistemebis mniSvnelovani principi.. umniSvnelovanesia ara mxolod piradi cxovrebis pativiscema, aramed pacientis ndobis SenarCuneba samedicino profesiis da, zogadad, jandacvis servisebis mimarT.~20 18 X gaerTianebuli samefos winaaRmdeg (X v. United Kingdom), 46, adamianis uflebaTa evropuli sasamarTlo (ser. A) (1981) 19 enhorni SvedeTis winaaRmdeg 25.01 2005, no. 56529/00 (meore seqcia). 20 m.s. SvedeTis winaaRmdeg (27/08/1997/ da z. fineTis winaaRmdeg (1998) 25 evropis adamianis uflebaTa angariSi (EHRR) 371 79 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba amgvari dacvis meqanizmis arseboba aucilebelia. sxvagvarad pirebi, romelTac samedicino daxmareba sWirdebaT, ar gascemdnen piradi da intimuri xasiaTis iseT informacias, romelic saWiroa maTi saTanado mkurnalobisTvis. agreTve, aris SemTxvevebi, roca piri ar mimarTavs samedicino dawesebulebebs da safrTxes uqmnis sakuTar Tavs, xolo gadamdebi daavadebebis SemTxvevaSi sazogadoebis janmrTelobasac.21 adamianis uflebaTa evropulma sasamarTlom aRniSna, rom janmrTelobasTan dakavSirebuli monacemebis gamJRavnebam `SeiZleba uaryofiTi zegavlena moaxdinos adamianis pirad da ojaxur cxovrebaze, aseve mis socialur da samuSao garemoze, radgan aman SeiZleba gamoiwvios pacientSi sircxvilis grZnoba da sazogadoebisgan gandevna~22 adamianis sxeuli aris piradi cxovrebis yvelaze intimuri aspeqti23. amgavarad, piradi cxovrebis xelSeuxeblobasa da fizikur xelSeuxeblobis uflebas Soris arsebobs aSkara kavSiri. ` adamianis uflebebisa da biomedicinis evropuli konvencia mux. 10(1): yvelas aqvs piradi cxovrebis pativiscemis ufleba mis janmrTelobasTan dakavSirebuli informaciis miRebis TvalsazrisiT. ` evropis sabWos rekomendacia (COE REC(2004)10) mux. 13: yovelgvari informacia, romelic pirovnebis fsiqikur problemebs ukavSirdeba, unda iyos konfidencialuri. aseTi informaciis Segroveba, damuSaveba da gadacema unda moxdes mxolod profesiuli saidumloebis da piradi monacemebis Segrovebis wesebis safZvelze. pacientis uflebaTa evropuli qartia ` mux. 6: yvela adamians aqvs piradi informaciis saidumloebis ufleba. maT Soris informaciis, romelic ukavSirdeba mis janmrTelobas, potenciur diagnozs an nebismier samedicino proceduras, agreTve diagnostikur Semowmebas, specialistTan vizits da, zogadad, samedicino da qirurgiul mkurnalobas. ` evropaSi pacientis uflebaTa xelSewyobis deklaracia: mux. 4(1) da (8): yovelgvari informacia pacientis janmrTelobis mdgomareobis Sesaxeb unda iyos konfidencialuri, pacientis gardacvalebis Semdegac ki janmrTelobis dacvis dawesebulebebSi moTavsebul pacientebs aqvT ufleba, hqondeT piradi sivrce. ` evropuli konvencia `personaluri monacemebis avtomaturi gziT damuSavebisas fizikuri pirebis dacvis Sesaxeb~ awesebs damatebiT garantiebs adamianis personaluri monacemebis avtomaturi damuSavebisas piradi cxovrebis pativiscemis uflebis dacvisaTvis: 21 z. fineTis winaaRmdeg (1998) 25 EHRR 371, par: 95 22 Ibid. 23 YF TurqeTis winaaRmdeg (YF v Turkey) (# 24209/94, 22/07/03) § 33 _ iZulebiTi ginekologiuri Semowmeba policiaSi dakavebis dros ramac gamoiwvia adamianis uflebaTa evropuli konvenvenciis me-8 muxlis darRveva 80 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.3 muxli 5. monacemTa xarisxi: personaluri monacemebi, romlebic eqvemdebareba avtomatizirebul damuSavebas: miRebuli da damuSavebuli unda iyos pirdapiri da kanonieri gziT; Senaxuli unda iqnas zustad gansazRvruli kanonieri miznebisaTvis da ar unda iyos gamoyenebuli maTTan SeuTavsebeli gziT; unda iyos adekvaturi da ar unda aRematebodes im miznebs, romlebisTvisac isini inaxeba; unda iyos zusti da saWiroebisamebr ganaxlebadi; daculi unda iyos im formiT, romelic iZleva monacemTa subieqtis identifikaciis saSualebas mxolod im droSi, rac saWiroa im miznebisaTvis, risTvisac inaxeba es monacemebi. muxli 6. monacemTa specialuri kategoriebi: personaluri monacemebi, romlebic Seexeba rasobriv warmomavlobas, politikur, religiur an sxva mrwamss, iseve rogorc janmrTelobis mdgomareobasa Tu seqsualur cxovrebasTan dakavSirebul personalur monacemebs, ar eqvemdebareba avtomatizirebul damuSavebas garda im SemTxvevisa, roca adgilobrivi kanonmdebloba uzrunvelyofs maTi dacvis Sesabamis garantiebs. igive exeba sisxlis samarTlebriv pasuxismgeblobasTan dakavSirebul monacemebsac. muxli 7. monacemTa dacva: avtomatizirebul failebSi Senaxuli monacemebis dacvis mizniT, miRebul unda iqnas usafrTxoebis Sesabamisi zomebi maTi SemTxveviTi Tu arasanqcirebuli darRvevis, SemTxveviTi dakargvis, aseve maTTan arasanqcirebuli SeRwevis, Secvlis an gavrcelebis winaaRmdeg. muxli 8. damatebiTi garantiebi monacemTa subieqtebisaTvis: nebismier pirs unda SeeZlos: a) monacemTa avtomatizirebuli failis arsebobis faqtis dadgena, romelic Seicavs informacias failis, misi ZiriTadi miznebis, aseve mocemuli failis administratoris pirovnebis, mudmivi sacxovrebeli adgilis an ZiriTadi samuSao adgilis Sesaxeb; b) saWiroebis SemTxvevaSi, garkveuli periodulobiTa da gadaWarbebuli dagvianebisa Tu danaxarjebis gareSe, monacemTa avtomatizirebul failSi masTan dakavSirebuli personaluri monacemebis arsebobis faqtis dadastureba, aseT monacemTa miwodeba misaRebi formiT; g) saWiroebis SemTxvevaSi, SeeZlos moiTxovos am monacemTa gasworeba an waSla Tu maTi damuSaveba moxda qveyanaSi moqmedi kanonmdeblobis darRvevis gziT, da romelic eTanadeba aRniSnuli konvenciis me-5 da me-6 muxlebSi gadmocmul ZiriTad principebs; d) Tavisi uflebebis realizaciis mizniT, miiRos zomebi sakuTar ganacxadze pasuxis miuReblobis SemTxvevaSi, romelic avtomatizirebul failSi personaluri monacemebis arsebobis faqtis dadasturebas Seexeba, Tu monacemTa miwodeba, Secvla an waSla ganxorcielda mocemuli muxlis „b“ da „g“ punqtebis moTxovnaTa darRveviT. 81 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba informaciis miRebis ufleba uflebis potenciur darRvevaTa magaliTebi mTavroba krZalavs publikaciebs narkotikebis gamoyenebasa da zianis Semcirebaze, radgan acxadebs, rom amgvari informacia arakanonier saqmianobas uwyobs xels; axalgazrdebs ganzrax ar awvdian informacias sqesobrivi gziT gadamdebi daavadebebis da prezervativis gamoyenebis Sesaxeb; boSa qalebs ar aqvT sakmarisi informacia seqsualuri da reproduqciuli janmrTelobis Sesaxeb. adamianis uflebaTa standartebi da interpretacia ` adamianis uflebaTa konvencia, muxli 8(1) _ yvelas aqvs ufleba pativi scen mis pirad da ojaxur cxovrebas, mis sacxovrebelsa da mimoweras. adamianis uflebaTa evropulma sasamarTlom daadgina, rom saxelmwifos akisria pozitiuri valdebuleba, miawodos informacia maT, visi ojaxis da piradi cxovrebis uflebas, konvenciis me-8 muxlis Sesabamisad, SeiZleba safrTxe Seeqmnas garemos dabinZurebis gamo24. sasamarTlom agreTve aRniSna, rom nebismeir sarCels jandacvasTan dakavSirebiT informaciis miRebis uflebaze warmatebis meti Sansi eqneba, Tu ganixileba me-8 da ara me-10 muxlis WrilSi. ` adamianis uflebaTa konvencia, muxli 10(1) _yvelas aqvs ufleba gamoxatvis Tavisuflebisa. es ufleba moicavs piris Tavisuflebas, hqondes Sexedulebebi, miiRos an gaavrcelos informacia Tu mosazrebebi sajaro xelisuflebis Caurevlad da saxelmwifo sazRvrebis miuxedavad. es muxli xels ar uSlis saxelmwifoebs, ganaxorcielon radiomauwyeblobis, satelevizio an kinematografiul sawarmoTa licenzireba. adamianis uflebaTa evropulma sasamarTlom viwrod ganmarta konvenciis me-10 muxli da aRniSna, rom igi krZalavs xelisuflebis mier pirovnebis SezRudvas miiRos informacia, romlis gavrcelebac sxvebs surT da ar gulisxmobs saxelmwifos pozitiuri valdebuleba sakuTari iniciativiT Seagrovos da gaavrcelos informacia.25 ` pacientis uflebaTa qartia, muxli 3: yvela pirs aqvs ufleba, miiRos yvela saxis infor- ` macia misi janmrTelobis mdgomareobis, jandacvis servisebis da maTi gamoyenebis Sesaxeb da yvela saxis informacia, xelmisawvdomi samecniero da teqnologiuri novaciebis meSveobiT. evropis sabWos ministrTa komitetis rekomendacia (2000)5 wevri saxelmwifoebisTvis instituciebis ganviTarebis Sesaxeb moqalaqis da pacientTa monawileobisaTvis im gadawyvetilebaTa miRebaSi, romlebic maT janmrTelobaze axdens zegavlenas. 24 ix. mak jinli da egani didi britaneTis winaaRmdeg(27 evropis adamianis uflebaTa angariSi (EHRR) 1) 25 guerra italiis winaaRmdeg (26 evropis adamianis uflebaTa angariSi (EHRR) 357) 82 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.3 informacia 9 9 9 informacia jandacvisa da gadawyvetilebaTa miRebis procesis meqanizmebis Sesaxeb farTod unda gavrceldes moqalaqeTa monawileobis xelSesawyobad. informacia unda iyos advilad xelmisawvdomi, drouli, advilad gasagebi da saTanado; mTavrobebma unda gaaumjobeson da gaaZlieron komunikacia, xolo sainformacio strategia unda iyos samizne jgufebze gaTvlili; regularuli sainformacio kampaniebi da sxva meTodebi (rogoricaa informaciis miwodeba satelefono cxeli xazebiT) unda iqnes gamoyenebuli pacientis uflebebis Sesaxeb sazogadoebis informirebulobis asamaRleblad. adekvaturi miTiTebis sistema unda SemuSavdes im pacientebisTvis, romelTac surT damatebiTi infomaciis miReba TavianTi uflebebisa da aRsrulebis meqanizmebis Sesaxeb. ` adamianis uflebaTa da biomedicinis Sesaxeb evropuli konvencia mux. 10 (2): yvelas aqvs ufleba, gaecnos misi janmrTelobis mdgomareobis Sesaxeb Segrovebul informacias. ` evropaSi pacientTa uflebebis xelSewyobis deklaracia mux. 2 (2) da (6): pacientebs aqvT ufleba, hqondeT sruli informacia sakuTari janmrTelobis statusis Sesaxeb arsebuli samedicino faqtebis CaTvliT, SemoTavazebuli samedicino procedurebis Sesaxeb TiToeuli proceduris riskisa da sargeblis CaTvliT, alternatiuli procedurebis Sesaxeb, maT Soris mkurnalobis ar CatarebiT gamowveuli efeqtebis Sesaxeb; diagnozis, prognozis da mkurnalobaSi miRweuli progresis Sesaxeb. ufro metic, `pacientebs aqvT ufleba airCion, Tu vis unda miewodos informacia maTi janmrTelobis mdgomareobis Sesaxeb~. fizikuri xelSeuxeblobis ufleba uflebis potenciur darRvevaTa magaliTebi boSa qalis sterilizacia xSirad xdeba misi nebis sawinaaRmdegod; eqimi aiZulebs narkotikebis momxmarebel fexmZime qals, gaikeTos aborti; instituciebSi myof pacientebs mkurnaloben maTgan nebarTvis miRebis gareSe, radgan miaCniaT, rom aseT pacientebs ar aqvT unari, Tavad miiRon gadawyvetileba mkurnalobis Sesaxeb; fsiqiatriuli saavadmyofoebis pacientebs rTaven samedicino kvlevaSi maTi Tanxmobis gareSe; pacientebs utardebaT eleqtro-konvulsiuri Terapia (ECT), maT ki eubnebian, rom es aris `Zilis Terapia~. adamianis uflebaTa standartebi da interpretacia 83 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba ` adamianis uflebaTa da biomedicinis evropuli konvencia mux. 5: janmrTelobis sferoSi intervencia SesaZlebelia mxolod da mxolod piris Tavisufali, informirebuli Tanxmobis Semdeg. ` evropis sabWos gzamkvlevi fsiqikuri aSlilobis mqone adamianebis uflebebisa da Rirsebis pativiscemis Sesaxeb mux. 18, rekomendacia # (2004) 10: aranebayoflobiTi mkurnaloba dasaSvebia mxolod im SemTxvevaSi, Tu:L a) pirs aqvs fsiqikuri aSliloba, romelic `warmoadgens mniSvnelovan risks da seriozul safrTxes misi da sxva adamianebis janmrTelobisaTvis;~ b) naklebi Carevis saSualebebi ar arsebobs saTando mkurnalobisTvis; g) `moxda pasuxismgebeli piris Sexedulebis gaTvaliswineba.~ pacientis uflebaTa evropuli qartia mux. 4 da 5: pacients aqvs ufleba uari Tqvas mkurnalobasa da samedicino Carevaze, Secvalos gadawyvetileba mkurnalobis procesSi, uari Tqvas mis gagrZelebaze, Tavisuflad airCios mkurnalobis sxva procedurebi da dawesebulebebi adekvaturi informaciis safuZvelze. ` deklaracia evropaSi pacientis uflebaTa xelSewyobis Sesaxeb mux. 3(1) da (2): nebismieri samedicino Carevis safuZvelia pacientis informaciuli Tanxmoba. pacients ufleba aqvs mkurnalobis nebismier etapze uari Tqvas samedicino momsaxurebis gawevaze. ` evrokavSiris uflebaTa qartia mux. 3: 1. yvelas aqvs fizikuri da fsiqikuri xelSeuxeblobis ufleba. 2. medicinisa da biologiis dargSi, daculi unda iyos Semdegi uflebebi: a) piris nebayoflobiTi da informirebuli Tanxmoba kanonis Sesabamisad; b) eugenuri praqtikis akrZalva, gansakuTrebiT iseTis, romlebic miznad isaxavs adamianebis seleqcias; g) adamianis sxeulis da sxeulis nawilebis finansuri gamorCenisTvis gamoyeneba; d) adamianebis reproduqciuli klonirebis akrZalva. ` adamianis uflebaTa evropuli sasamarTlo: fizikuri xelSeuxeblobis/erTianobis uflebas ar cnobs adamianis uflebaTa evropuli konvencia, magram interpretaciiT igi aris adamianis usafrTxoebis damcveli muxlis nawili (mux. 5). agreTve, wamebis, sastiki, arahumanuri da madegradirebeli mopyrobis akrZalvis (mux. 3), piradi cxovrebis uflebis (mux. 8) da uflebis janmrTelobis umaRles miRwevad standartebze (evropuli socialuri qartia, mux.11) nawili. adamianis uflebaTa evropulma sasamarTlom adamianis uflebaTa evropuli konvenciis me-8 muxlTan mimarTebiT aRniSna, rom adamianis sxeuli warmoadgens piradi cxovrebis yvelaze intimur aspeqts26 da ganmarta, rom fizikuri da fsiqikuri xel- 26 if TurqeTis winaaRmdeg (No 24209/94, 22/07/03) par: 33 84 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.3 Seuxeblobis uflebis darRveva aRiniSna, maSin, rodesac dedis Tanxmobis gareSe mis vaJiSvils gaukeTes morfini (dimorphine), ris Semdegac pacientis pirad CanawerebSi, misi dedis informirebis gareSe, Caido brZaneba pacients ar Cautardes reanimacia (DNR).27 inglisis sasamarTloebma ganixiles, arRvevs Tu ara evropuli konvenciis me-8 da me-3 muxlebs qmedunariani pacientisTvis savaldebulo mkurnalobis Catareba (maSinac ki, rodesac mkurnaloba xdeba kanonis moTxovnebis Sesabamisad). gansaxilveli faqtorebia is Sedegebi, romlebic gamoiwvia mkurnalobis ar Catarebam, mkurnalobis SesaZlebeli ukuCvenebebi da Tu iyo sxva, uflebebis ufro nakleb xelmyofi, arCevani.28 ` wamebis, arahumanuri da damamcirebeli mopyrobis an sasjelis prevenciis evropulma komitetma ganacxada, rom yvela kompetentur pacients unda mieces mkurnalobaze da sxva samedicino Carevaze uaris Tqmis saSualeba. am fundamenturi pronciidan yovelgvari gadaxveva unda efuZnebodes kanons da gamoiyenebodes mxolod mkacrad gansazRvrul gamonaklis SemTxvevebSi. sicocxlis ufleba uflebis potenciur darRvevaTa magaliTebi aravin iZaxebs saswrafo samedicino daxmarebas piris mier gadaWarbebuli doziT narkotikuli saSualebis moxmarebis dros, radgan eSiniaT dapatimrebis (Sedegad pirovneba gardaicvala); narkotikebis momxmareblebi kvdebian saavadmyofos Caketil palataSi; mTavroba awesebs gaumarTlebel samarTlebriv SezRudvebs sicocxlis SemanarCunebel aiv-prevenciis da mkurnalobis saSualebebze; zamTris periodSi izrdeba sikvdilianobis maCvenebeli daxurul instituciebSi Senobis cudi pirobebis, arasaTanado sanitariis, gaTbobis da arasaTanado mzrunvelobis gamo; TviTmkvlelobis aSkara zRvarze myofi fsiqiatriuli saavdmyofos pacientis saTanado meTvalyureoba ar xdeba (Sedegad, igi Tavs iklavs). adamianis uflebaTa standartebi da interpretacia ` adamianis uflebaTa evropuli konvencia mux. 2(1): TiToeuli adamianis sicocxlis ufleba daculia kanoniT. aravis SeiZleba waerTvas sicocxle ganzrax, garda kanoniT gaTvaliswinebuli danaSaulisTvis, piris msjavrdebis Semdgom sasamarTlos ganaCenis aRsrulebisas. 27 if TurqeTis winaaRmdeg (No 24209/94, 22/07/03) par 33 28 R on the application of PS and others [2003] EWHC 2335 (Admin) 85 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba vinaidan adamianis uflebaTa evropuli sasamarTlo Tavs ikavebs daawesos sanqciebi, romlebic qveynebis ekonomikur gadawyvetilebebze imoqmedebs, me-2 muxlis darRvevis cnoba mxolod gamonaklis SemTxvevebSi xdeba.29 `ar SeiZleba imis uaryofa, rom xelisuflebis moqmedeba da umoqmedoba janmrTelobis dacvis politikis sferoSi, calkeul SemTxvevebSi, warmoSobs pozitiur valdebulebas me-2 muxlTan dakavSirebiT. Tumca, xelSekrulebaze xelis momwerma saxelmwofoebma miiRes saTanado zomebi, raTa mieRwiaT maRali standartebisTvis da moemzadebinaT profesionalebi. jandacvis profesionalTa mosamzadeblad da pacientis sicocxlis dasacavad, jandacvis profesionalis araswori gadawyvetileba an profesionalTa araefeqturi koordinacia gansazRvruli pacientis mkurnalobis dros, ar aris sakmarisi safuZveli, rom saxelmwifos daekisros pasuxismgebloba me-2 muxliT garantirebuli sicocxlis uflebis darRvevisTvis.~30 Tumca: adamianis uflebaTa evropulma sasamarTlom daadgina, rom meore muxlis gamoyenebis pirobebi SeiZleba dadges, roca `dasturdeba, rom xelisuflebam piris sicocxle safrTxis qveS daayena mkurnalobaze uaris TqmiT, romliTac danarCen mosaxleobas SeuZlia isargeblos.~31 adamianis uflebaTa evropulma sasamarTlom daadgina, rom sicocxlis uflebam SeiZleba warmoSos dakavebul pirTa dacvis valdebuleba, gansakuTrebiT roca dakavebulis mier TviT-dazianebis riski arsebobs. sasamarTlo ganixilavs, icodnen, an evalebodaT Tu ara scodnodaT xelisuflebis warmomadgenlebs, rom piri iyo `TviTmkvlelobis realuri riskis qveS da, Tu asea, miiRes Tu ara yvela SesaZlebeli zoma riskis Tavidan asacileblad.~32 samedicino CareviT gamowveul sikvdilTan mimarTebiT, saxelmwifoebs me-2 muxli uwesebT valdebulebas, SeimuSaon regulaciebi sajaro da kerZo saavadmyofoebisTvis: 1) miiRon zomebi pacientis uflebaTa dasacavad da 2) uzrunvelyon, rom sikvdilis mizezis gansazRvra SeiZleba `efeqturi da damoukidebeli sasamarTlo sistemiT,~ raTa yvela damnaSavem agos pasuxi. samedicino daudevrobis dros mxolod samoqalaqo warmoeba SeiZleba sakmarisi iyos, magram mxolod im SemTxvevaSi, rodesac am gziT SesaZlebelia pasuxismgeblobis gansazRvrac da zianis saTanado anazRaurebac.33 dResdReobiT ar arsebobs myari pozicia evTanaziis Sesaxeb, garda evropuli sasamarTlos ganmartebisa, rom sicocxlis ufleba Tavis TavSi ar gulisxmobs sikvdilis uflebasac.34 29 niteki poloneTis winaaRmdeg (Nitecki v Poland) (# 65653/01 (21/03/02) 30 oveli didi britaneTis winaaRmdeg (No 45305/99) (4/05/00)par: 1 31 kviprosi TurqeTis winaaRmdeg (2002) 35 evropis adamianis uflebaTa angariSi (EHRR) 731 par 219 32 kenani didi britaneTis winaaRmdeg [2001] 33 evropis adamianis uflebaTa angariSi (EHRR) 913 33 kalveli da siglio italiis winaaRmdeg (No 32967/96) (71/1/02) par 51 34 preti didi britaneTis winaaRmdeg (2002) 35 evropis adamianis uflebaTa angariSi (EHRR) 1 86 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.3 sasamarTlom Riad datova me-2 muxlis gamoyenebis SesaZlebloba iseT SemTxvevebSi, sadac terminaluri mdgomareobis avadmyofis samSobloSi dabrunebam SeiZleba Seamoklos misi sicocxlis xangrZlivoba. agreTve, roca es qmedeba SeiZleba dakvalificirdes, rogorc sastiki da araadamianuri mopyroba samSobloSi pacientis arasaTanado samedicino dawesebulebaSi moxvedris SesaZleblobis gamo.35 ufleba janmrTelobis umaRles xelmisawvdom standartebze uflebis potenciur darRvevaTa magaliTebi saxelmwifo ver dgams progresul nabijebs, raTa gaxados xelmisawvdomi antiretroviruli wamlebi dedidan bavSvze aiv-infeqciis gadacemis Tavidan asacileblad; eqimebi da samedicino momsaxurebis centrebi geografiulad xelmiuwvdomelia zogierT soflebSi; saxelmwofo ver amzadebs samedicino personals paliatiuri mzrunvelobis sferoSi; bavSvebi socialuri mzrunvelobis saxlSi ejaWvebian sawolebs cudi kvebis gamo; zogierT fsiqiatriul saavadmyofoSi bavSvebi moTavsebuli arian palataSi mozrdilebTan erTad; fsiqikuri daavadebis mqone qalebs ar sTavazoben reproduqciuli janmrTelobis servisebs. adamianis uflebaTa standartebi da interpretacia ` evropis socialuri qartia, mux. 11: janmrTelobis dacvis ufleba janmrTelobis dacvis uflebis efeqturi realizaciisTvis monawile saxelmwifoebi valdebulebas iReben, uSualod an sxvadasxva sajaro Tu kerZo organizaciasTan TanamSromlobiT, miiRon Sesabamisi zomebi, raTa: (1) ramdenadac SesaZlebelia aRmofxvran janmrTelobis darRvevis gamomwvevi mizezebi; (2) uzrunvelyon sakonsultacio da saganmanaTleblo obieqtebis arseboba janmrTelobis xelSewyobis da masTan dakavSirebuli individualuri pasuxismgeblobis wasaxaliseblad; (3) Tavidan aicilon, ramdenadac SesaZlebelia, epidemiuri, endemuri da sxva daavadebebi, aseve ubeduri SemTxvevebi. evropis socialuri uflebebis komitetma ganacxada, rom mux. 11 moicavs fizikur da fsiqikur keTildReobas jandacvis msoflio organizaciis (W) konstituciis gansazRvrebis Tanaxmad.36 saxelmwifoebma unda uzrunvelyon mosaxleobis janmrTelobis saukeTeso SesaZlebeli mdgomareoba arsebuli codnis Sesabamisad. aseve, jandacvis sistemebma Sesabamisi rea- 35 d. didi britaneTis winaaRmdeg (1997) 24 evropis adamianis uflebaTa angariSi (EHRR) 36 gadawyvetileba XVII-2 da gadawyvetileba 2005 87 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba gireba unda moaxdinon Tvidan acilebad riskebze. mag. iseT riskebze, romalTa gakontroleba adamianis moqmedebiT SeiZleba.37 jandacvis sistema yvelasTvis xelmisawvdomi unda iyos. xelmisawvdomoba unda efuZnebodes gamWvirvale kriteriumebs, romelTa SeTanxmebac xdeba erovnul doneze, klinikuri mdgomareobis an sicocxlis xarisxis gauaresebis riskis mxedvelobaSi miRebiT;38 unda arsebobdes Sesabamisi personali da saTanado pirobebi (saavadmyofos palatebSi unda iyos naklebi simWidrove da unda Semcirdes rigebi), raTa aRmoifxvras xelmisawvdomobis potenciuri barieri bevri adamianisTvis;39 sakonsultacio da saganmanaTleblo dawesebulebebTan dakavSirebiT, ESCR-m gansazRvra ori ZiriTadi valdebuleba: 1) individualuri pasuxismgeblobis Segnebis ganviTareba cnobierebis amaRlebis kampaniebis meSveobiT da 2) ufaso da regularuli skriningis uzrunvelyofa gansakuTrebiT seriozuli avadmyofebisTvis;40 ` pacientis uflebaTa evropuli qartia, mux. 8-10: exeba `xarisxobrivi standartebis dacvis~ uflebas, `usafrTxoebas~ da `novaciebs.~ ` jandacvis msoflio organizaciis deklaracia evropaSi pacientis uflebaTa xelSewyobis Sesaxeb, mux. 5 (3): pacientebs aqvT xaisxiani mzrunvelobis miRebis ufleba, rac unda aRiniSnos maRali teqnikuri standartebis dacviT da adamianuri damokidebulebiT pacientsa da eqims Soris. ` evrokavSiris qartia fundamenturi uflebebis Sesaxeb, mux. 36: yvelas aqvs ufleba miiRos prevenciuli jandacva da isargeblos erovnuli samarTliTa da praqtikiT garantirebuli sargebliT. adamianis janmrTelobis dacvis maRali done garantirebuli unda iyos kavSiris politikis da aqtovobebis dasaxvisa da ganxorcielebis dros. pacientis uflebaTa evropuli qartiis mixedviT, 35-e muxliT garantirebuli janmrTelobis ufleba aRiqmeba, rogorc individualuri, aseve socialuri sikeTe da miznad isaxavs daawesos saxelmZRvanelo standarti erovnuli mTavrobebisTvis, rogoricaa _ ar dajerde `minimalur garantirebul standartebs~. ` adamianis uflebaTa evropulma sasamarTlom aRniSna, rom saxelmwifoebs aqvT pasuxismgebloba izrunon dakavebulTa janmrTelobis mdgomareobaze, xolo ar mkurnalobam SeiZleba gamoiwvios me-3 muxlis darRveva.41 37 gadawyvetileba XV-2, dania, gv:126-129 38 gadawyvetileba XV-2, gaerTianebuli samefo, gv: 559 39 gadawyvetileba XV-2, dania,gv:128 40 ixileT http://www.coe.int/t/e/human_rights/esc/7_resources/Digest_en.pdf , gv: 93 41 hurtado Sveicariis winaaRmdeg (seria a N 280-a, 28/01/94); ilhani TurqeTis winaaRmdeg (2002) 34 EHRR 36 88 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.3 wamebis da sastiki, araadamianuri da Rirsebis Semlaxavi mopyobis da sasjelis akrZalva uflebis potenciur darRvevaTa magaliTebi eqimi uars ambobs tkivilis Sesamsubuqeblad pacientisTvis opioidebis gamoweraze, radgan saxelmwfos mxridan eSinia devnis; kiboTi daavadebul patimars uars eubnebian mkurnalobaze; dakavebul narkotikebis momxmarebels uars eubnebian fsiqiatriul daxmarebaze; instituciebSi moTavsebul pirebs ar aqvT adgili piradi nivTebis Sesanaxad; instituciebSi moTavsebul pacientebs ar aqvT ufleba ataron sakuTari tansacmeli. tansacmeli saerTo moxmarebisaa; daxurul instituciebSi myof qal pacientebs moeTxovebaT erTad miiRon Sxapi mamrobiTi sqesis personalis meTvalyureobis qveS. adamianis uflebaTa standartebi da interpretacia adamianis uflebaTa evropuli konvencia, mux. 3: aravin SeiZleba daeqvemdebaros wamebas, araadamianur an Rirsebis Semlaxvel mopyrobas an dasjas. adamianis uflebaTa evropulma komisiam aRniSna, rom ar gamoricxavs, mkurnalobis ar Catareba pirisTvis, romelsac aqvs seriozuli daavadeba, SeiZleba CaiTvalos konvenciis me-3 muxlis darRvevad.42 samedicino saqmeebi, romlebic adamianis uflebaTa evropulma sasamarTlom konvenciis me-3 muxlis WrilSi ganixila, ZiriTadad ukavSirdeba sisxlis samarTlis saqmeebs an fsiqikur janmrTelobas. orive formiT Tavisufleba SezRuduli pirebisTvis adekvaturi mkurnalobis ar Catareba SeiZleba ganxiluli iyos me-3 muxlis darRvevad, romelic ZiriTadad Seesabameba araadamianur an Rirsebis Semlaxav mopyrobas vidre wamebas. me-3 muxli yvela SemTxvevaSi ar warmoSobs valdebulebas, gaaTavisuflos piri janmrTelobis mdgomareobis gamo. Tumca, Tavisufleba aRkveTil pirebTan mimarTebaSi, konvenciis me-3 muxli saxelmwifos avaldebulebs, rom uzrunvelyos yvela dakavebuli piri sasjels ixdides iseT pirobebSi, sadac pativs cemen adamianis Rirsebas, xolo sasjeli aRsrulebis meTodi ar unda iwvevdes piris tanjvas da wamebas.43 patimarTa janmrTelobisa da keTildReobisaTvis aucieleblia saTanado samedicino daxmareba.44 im SemTxvevaSi, Tu amgvari daxmarebis argaweva iwvevs janmrTelobis gauaresebas an xels uwyobs dazaralebulis mZime da xangrZliv tkivils, darRveva SeiZleba dakvalificirdes me-3 muxliT gaTvaliswinebul araadamianur mopyrobad.45 im SemTxvevaSic, rodesac aseTi Sedegi ar dgeba, samedicino daxmarebis ar arsebobiT gamowveuli stresi SeiZleba ganixilos, rogorc Rirsebis Semlaxavi mopyroba.46 magaliTad, patimrisTvis mkurnalobis ar Catarebam, romelsac hqonda sxvadasxva daavadeba, maT Soris cixeSi yofnis periodSi SeZenili tuberkuliozi, miayena mas 42 tanko fineTis winaaRmdeg Tanko v. Finland (23634/94) 43 mouiseli safrangeTis winaaRmdeg (38 evropis adamianis uflebaTa angariSi (EHRR)) 44 kudla poloneTis winaaRmdeg (Kudla v. Poland) (30210/96) 45 mak glinCi gaerTianebuli samefos winaaRmdeg (Mc Glinchey v. UK) (37 EHRR 821) 46 sarbani moldoveTis winaaRmdeg (Sarban v. Moldova) (3456/05) 89 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba mniSvnelovani fsiqikuri tanjva, Sesabamisad Seilaxa aRniSnuli patimris Rirseba.47 im SemTxvevaSi, Tu patimars esaWiroeba adekvaturi samedicino daxmareba, romlis aRmoCenac SeuZlebelia cixis pirobebSi, patimari SeiZleba gaTavisufldes sazogadoebrivi interesis gaTvaliswinebiT misTvis Sesabamisi SezRudvebis dawesebiT.48 Tu dakavebul pirs ukve hqonda daavadebaTa garkveuli simptomebi, Znelia imis gansazRvra, Tu ramdenad iyo aRniSnuli simtomebi dakavebis pirobebiT gamowveuli. Tumca aRniSnuli ar aris ganmsazRvreli imis Sesafaseblad, Tu ramdenad Sesrula saxelmwifom me-3 muxliT gaTvaliswinebuli valdebulebebi. aqedan gamodinare, mtkiceba imisa, rom Sedegi gamowveulia patmrobis pirobebiT ar aris mniSvnelovani faqtori.49 me-3 muxlis darRvevaTa magaliTebi moicavs: simsivniT daavadebuli piris dakavebis periodis gagrZeleba, rodesac igi ganicdis gansakuTrebiT mZime tanjvas;50 fsiqikuri problemebis mqone piris, romelic aris TviTmkvlelobis riskis qveS, mkurnaloba mniSvnelovani xarvezebiT;51 cixeSi heroinze damokidebuli piris gardacvaleba sistematurad arasaTanado mkurnalobis gamo.52 ukrainis winaaRmdeg saqmeSi adamianis uflebaTa evropulma sasamarTlom daadgina konvenciis me-3 muxlis darRveva ori mizezis gamo: winaswari dakavebis sakanSi ar iyo patimrobis saTanado pirobebi (gadatvirTuloba, ZilisTvis pirobebis ararseboba da arasakmarisi bunebrivi sinaTle da haeri); ganmcaxdebels, romelsac hqonda aivinfeqcia da tuberkuliozi, ar Cautarda drouli da saTanado mkurnaloba.53 Tu patimrobaSi myof pirs aqvs ramdenime daavadeba, am SemTxvevaSi romelime daavadebasTan asocirebuli riski da masTan dakavSirebuli SiSi SeiZleba gaizardos. aseT pirobebSi kvalificiuri da drouli samedicino daxmarebis ar arsebobas, rasac Tan axlavs saxelwifos mxridan uari, pirs Cautardes damoukidebeli samedicino Semowmeba, fizikur tanjvasTan erTad iwvevs patimarSi daucvelobis SegrZnebas da utoldeba Rirsebis Semlaxav mopyrobas.54 zogadad, savaldebulo samedicino Careva, rac piris janmrTelobis interesebSi Sedis, ar arRvevs konvenciis me-3 muxls.55 magram, Carevis aucilebloba unda iyos dasabuTebuli, gonviruli da unda iyos warmodgenili Sesabamisi proceduruli garantiebi, radgan gadaWarbebulma qmedebam SeiZleba gamoiwvio me-3 muxlis darRveva.56 patimrobis pirobebiT da arasaTanado mkurnalobiT damdgarma Sedegma SeiZleba gamowvios me-3 muxlis darRveva.57 faqti, rom eqimma moinaxula patimari da daudgina mkurnalobis garkveuli forma, ar gulisxmobs avtomaturad, rom samedicino daxmareba iyo adekvaturi.58 47 humatovi azerbaijanis winaaRmdeg (Hummatov v. Azerbaijan) (9852/03) da (13413/04) 48 vadleri poloneTis winaaRmdeg (Wadler v. Poland) (44115/98). ix. aseve: musie safrangeTis winaaRmdeg (Mousiel v. France_ (38 EHRR 34) 49 qineni gaerTianebuli samefos winaaRmdeg (Keenan v. UK) (33 EHRR 48) 50 musie safrangeTis winaaRmdeg (Mouisel v. France) (38 EHRR 34) 51 qineni gaerTianebuli samefos winaaRmdeg (Keenan v. UK) (33 EHRR 34) 52 mak glinCi gaerTianebuli samefos winaaRmdeg (Mc Glinchey and Ors v. UK) (37 EHRR 821) 53 iakovenko ukrainis winaaRmdeg (Yakovenko v. Ukraine) (15825/06) 54 xudobini ruseTis winaaRmdeg (Khudobin v. Russia) (59696/00) 55 ialo germaniis winaaRmdeg (Jalloh v. Germany) (44 EHRR 667) 56 ialo germaniis winaaRmdeg Jalloh v. Germany (44 EHRR 667) 57 popovi ruseTis winaaRmdeg (Popov v. Russia) (26853/04); lindi ruseTis winaaRmdeg (Lind v. Russia) (25664/05); kalaSnikovi ruseTis winaaRmdeg (Kalashnikov v. Russia) (47095/99) da (adamianis uflebaTa evropuli konvencia 2002-VI) 58 humatovi azerbaijanis winaaRmdeg (Hummatov v. Azerbaijan )(9852/03) da (13413/04); malenko ukrainis winaaRmdeg (Malenko v. Ukraine) (18660/03) 90 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.3 saxelmwifom unda uzrunvelyos patimris janmrTelobis mdgomareobasa da Catarebul mkurnalobasTan dakavSirebuli detaluri samedicino Canawerebis arseboba59, aseve diagnozis da mkurnalobis adekvaturoba.60 Canawerebi unda moicavdes Semdegi saxis informacias: ra saxis mkurnaloba daeniSna pacients da rogor ganxorcielda igi, vin, rogor da rodis uwevda mkurnalobas zedamxedvelobas da a.S. amgvari informaciis ar arsebobis SemTxvevaSi, sasamarTlom SeiZleba Sesabamisi daskvna gamoitanos.61 samedicino CanawerebTan dakavSirebuli xarvezebi SeiZleba CaiTvalos me-3 muxlis darRvevad.62 winaswari Tanxmobis gareSe Catarebuli samedicino eqsperimenti SeiZleba CaiTvalos araadamianur mopyrobad.63 konvenciis SemuSavebis procesSi savaldebulo sterilizacia iTvleboda darRvevad. samedicino daudevroba, romelic ar iwvevs tanjvas, stress, tkivils, adamianis uflebaTa evropuli sasamarTlos ganmartebiT, ar CaiTvleba konvenciis me-3 muxlis darRvevad. ` evropuli konvencia wamebis da araadamianuri an Rirsebis Semlaxavi mopyrobis an dasjis winaaRmdeg. konvenciis monitoringis meqanizmi _ wamebis prevenciis komiteti (CPT) monitorings uwevs adamianis uflebaTa evropuli konvenciis me-3 muxlTan Sesabamisobas Tavisuflebis aRkveTis adgilebSi regularuli vizitebis meSveobiT. misi mandati moicavs: cixeebs, arasrulwlovanTa dakavebis adgilebs, fsiqiatriul saavadmyofoebs, policiis da saimigracio dakavebis adgilebs. wamebis prevenciis komitets SemuSavebuli aqvs cixeebSi adamianis uflebebze dafuZnebuli politikis implementaciis da monitoringis meqanizmis Sesaxeb detaluri standartebi. wamebis prevenciis komiteti xazgasmiT aRniSnavs, rom cixeebSi arsebuli gadatvirTuloba, aseve bunebrivi ganaTebisa da Jangbadis ar arseboba, gavlenas axdens patimarTa janmrTelobaze. ` pacientis uflebaTa evropuli qartia, mux. 11: yvela pirs aqvs ufleba Tavidan aicilos tkivili da tanjva, ramdenadac es SesaZlebelia, avadmyofobis TiToeul etapze. jandacvis momsaxurebis gamwevebma unda miiRon yvela zoma, rac saWiroa am miznis misaRwevad, magaliTad paliatiuri mzrunvelobis miwodeba da mkurnalobis xelmisawvdomobis gamartiveba. ` deklaracia evropaSi pacientis uflebaTa xelSewyobis Sesaxeb, mux. 5(10) da (11): pacientebs ufleba aqvT Seimsubuqon tanjva arsebuli codnis Sesabamisad. maTi uflebaa terminalur stadiaze isargebon paliatiuri mzrunvelobis servisebiT. ` evropis socialuri uflebebi komitetma, ganacxada, rom saavadmyofebis, maT Soris fsiqiatriuli saavadmyofoebis pirobebi unda iyos damakmayofilebeli da adamianis Rirsebis Sesabamisi.64 59 xudobini ruseTis winaaRmdeg (Khudobin v. Russia) (59696/00) 60 aleqsaniani ruseTis winaaRmdeg (Aleksanyan v. Russia) (46468/06) 61 humatovi azerbaijanis winaaRmdeg (Hummatov v. Azerbaijan) (9852/03) da (13413/04); melniki ukrainis winaaRmdeg (Melnik v. Ukraine) (72286/01). ix. aseve: holomiovi moldoveTis winaaRmdeg (Holomiov v. Moldova) (30649/05) 62 radu rumineTis winaaRmdeg (Radu v. Romania) (34022/05) 63 X daniis winaaRmdeg (X v. Denmark) (32 DR 282) 64 daskvnebi XVII-2 da 2005, me-11 muxlis interpretacia; daskvnebi, 2005, rumineTi, pp 600-601 91 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba sajaro politikaSi monawileobis ufleba uflebis potenciur darRvevaTa magaliTebi ZirZvel mosaxleobas saSualebas ar aZleven gamoTqvan azri TavianTi janmrTelobis da keTildReobis Sesaxeb; lgbt (lesboseli, gei, biseqsuali da transgenderuli) pirebs ganzrax ar aZleven SesaZleblobas monawileoba miiRon maTi aiv infeqcia/Sidsis winaaRmdeg brZolis Sesaxeb gadawyvetilebis miRebis procesSi; samoqalaqo sazogadoebis organizacebs ar eZlevaT saSualeba monawileoba miiRon saxelwifos mier warmoebul globaluri fondisTvis warsadgeni ganacxadis ganxilvis procesSi, romelic ukavSirdeba Sidsis, tuberkuliozis da malariis winaaRmdeg brZolosTvis dafinansebis mopovebas. adamianis uflebaTa standartebi da interpretacia ` jandacvis reformirebis Sesaxeb liublianas qartiis ZiriTadi principebi, mux. 5.3: jandacvis reformam unda daakmayofilos mosaxleobis saWiroebebi maTi janmrTelobis da jandacvis Sesaxeb molodinis gaTvaliswinebiT. reformam unda uzrunvelyos moqalaqeTa Sexedulebebis mniSvnelovnad gaTvaliswineba jandacvis servisebis Seqmnasa da muSaobaSi. moqalaqeebma aseve unda gainawilon pasuxismgebloba TavianTi janmrTelobis Sesaxeb. ` nawili III, pacientis uflebaTa evropuli qartia: Tavi aqtiuri moqalaqeobis uflebebis Sesaxeb _ moqalaqeTa ufleba monawileoba miiRon, TavianTi jandacvis uflebis dasacavad sajaro politikis gansazRvraSi, implementaciasa da SefasebaSi. ` wevr-saxelmwifoTa ministrTa komitetis rekomendacia Rec (2000)5 da axsna-ganmartebis memorandumi struqturebis ganviTarebis Sesaxeb moqalaqeTa da pacientTa monawileobisTvis maT jandacvasTan dakavSirebuli gadawyvetilebebis miRebaSi: wevr-saxelmwifoTa mTavrobebs urCevs Semdegs: 92 uzrunvelyfili iyos moqalaqeTa monawileoba jandacvis sistemis yvela aspeqtSi erovnul, regionul da adgilobriv doneze janmrTelobis dacvis sistemis yvela monawilis, maT Soris eqimebis, damzRvevebis da xelisuflebis mier; gadaidgas nabijebi rekomendaciiT gaTvaliswinebuli gaidlainebis erovnul kanonmdeblobaSi asaxvis mizniT; Seiqmnas samarTlebrivi struqturebi da gaataros politika, rac xels Seuwyobs moqalaqeTa CarTulobas da pacientis uflebaTa dacvas; SemuSavdes iseTi politika, rac xels Seuwyobs jandacvis sferoSi momuSave arasamTavrobo organizaciebis wevrTa da maTi saqmianobis zrdas; saxelmwifoebma xeli Seuwyon rekomendaciebis da misi ganmartebiTi baraTis farTo gavrcelebas; gansakuTrebuli yuradReba dauTmon yvela im adamians da organizacias, romlebsac surT gadawyvtilebis procesSi CarTvas. adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.3 aRniSnuli rekomendaciis gaidlainebi moicavs: moqalaqeTa da pacientTa monawileobas, rogorc demokratiuli procesis nawils; aqtiur monawileobaze orientirebul mxardamWer politikas da saTanado meqanizmebs. ` ministrTa komitetis rekomendacia Rec(2006)18 wevri saxelmwifoebis mimarT multikulturul sazogadoebaSi janmrTelobis servisebis Sesaxeb 5.1. unda Seiqmnas da dainergos pacientTa treningebis programebi, romlis mizani iqneba mkurnalobasTan dakavSirebuli gadawyvetilebis miRebis procesSi maTi monawileobis gazrda da multikulturul mosaxleobaSi janmrTelobis dacvis kuTxiT Sedegebis gaumjobeseba; 5.2. unda SemuSavdes da dainergos kulturul TaviseburebebTan Sesabamisi jandacvis da daavadebaTa prevenciis iseTi programebi, rac aucilebelia eTnikur umciresobaTa jgufebis informirebulobistvis jandacvis sakiTxebze. 5.3. eTnikur umciresobaTa warmomadgenlebi unda CaerTon jandacvis servisebis dagegmvaSi, implementaciasa da SefasebaSi. diskriminaciis akrZalva da Tanasworobis ufleba uflebis potenciur darRvevaTa magaliTebi TavSesafris maZieblebs uars eubnebian mkurnalobaze, garda gadaudebeli samedicino daxmarebisa; saavadmyofoebi isev da isev aTavseben boSa qalebs qalTa calke gamoyofil palatebSi; narkotikebis momxmareblebi naklebad arian warmodgenili Sidsis samkurnalo programebSi, miuxedavad imisa, rom isini warmoadgenen SidsiT daavadebuli mosaxleobis umetesobas. qals, romelsac aqvs Sizofreniis diagnozi, eubnebian, rom tkivili, romelsac igi ganicdis muclis areSi, ubralod eCveneba misi fsiqikuri mdgomareobidan gamomdinare. Semdeg ki, avadmyofs saSvilosnos kibos diagnozs usvamen.mamrobiTi sqesis personalis meTvalyureobis qveS. adamianis uflebaTa standartebi da interpretacia ` adamianis uflebaTa evropuli konvencia: muxli 14: diskriminaciis akrZalva: am konvenciiT gaTvaliswinebuli uflebebiTa da TavisuflebebiT sargebloba uzrunvelyofilia yovelgvari diskriminaciis gareSe, ganurCevlad sqesis, rasis, kanis feris, enis, religiis, politikuri Tu sxva Sexedulebebis, erovnuli Tu socialuri warmoSobis, erovnuli umciresobisadmi kuTvnilebis, qonebrivi mdgomareobis, dabadebisa Tu sxva niSnisa. konvenciis me-14 muxli ar aris gancalkevebuli, damoukidebeli norma _ misi darRvevis mtkiceba unda moxdes konvenciis sxva ZiriTad muxlTan erTobliobiT. aqedan gamomdinare, sasamarTlo yovelTvis ar ganixilavs me-14 muxlis moTxovnebs, rodesac igi daadgens sxva ZiriTadi muxlis darRvevas. dReisaTvis sasamarTlos ar aqvs miRebuli me- 93 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba 14 muxlidan gamomdinare raime mniSvnelovani, janmrTelobis dacvasTan dakavSirebuli gadawyvetileba. gamomdinare iqidan, rom bolo wlebis ganmavlobaSi gaumjobesda me-14 muxlTan dakavSirebuli sasamarTlo praqtika rasobrivi diskriminaciis da seqsualuri orientaciis sferoSi, savaraudod, momavalSi janmrTelobis dacvis kuTxiTac moxdeba cvlileba. me-14 muxliT saCivris ganxilvis mTavari principia: mtkicebuleba, rom adgili qonda gansxvavebul mopyrobas romelime dauSvebeli niSniT da aseT SemTxvevaSi amgvari gansxvavebis obieqturi da gonivruli dasabuTebis arseboba. bolo periodSi sasamarTlom daiwyo statistikis gamoyeneba arapirdapiri gziT diskriminaciis dasadgenad _ praqtika, romelic SeiZleba uSualod ar moicavdes diskriminacias, Tumca arapirdapiri gziT axdendes uaryofiT zegavlenas konkretuli jgufebis wevrebze. ` ეvropis socialuri qartiis me-11 muxli: janmrTelobis dacvis uflebis efeqturad ganxorcielebis mizniT, mxareebi valdebulebas iReben uSualod an saxelmwifo an kerZo organizaciebTan TanamSromlobiT, miiRon zomebi, romlebic, inter alia, miznad isaxavs: 1. avadmyofobis gamomwvevi mizezebis maqsimalurad aRmofxvras; 2. sakonsultacio da saganmanaTleblo saSualebebis uzrunvelyofas janmrTelobis ganmtkicebisa da jandacvis sakiTxebSi individualuri pasuxismgeblobis dadgenis mizniT; 3. maqsimalurad SesaZlo doneze epidemiur, endemur da sxva daavadebaTa, iseve rogorc ubedur SemTxvevaSi aRkveTs. ` evropis socialuri qartia, mux. 15: asakisa da unarSezRudulobis miuxedavad, Sromisuunaro pirTa damoukideblobis, socialuri integraciisa da sazogadoebriv cxovrebaSi monawileobis uflebis efeqturad ganxorcielebis mizniT, mxareebi valdebulebas iReben: 1. miiRon aucilebeli zomebi Sromisuunaro an naxevrad Sromis uunaro pirTa swavlebisa da profesiuli momzadebisaTvis; 2. miiRon yvela saWiro zoma aseT pirTa dasaqmebis mizniT; uzrunvelyon damsaqmebelTa mier fizikuri SezRuduli SesaZleblobebis mqone pirTa daqiravebisaTvis da maTTvis samuSao pirobebis SeqmnisaTvis. calkeul SemTxvevebSi, SesaZlebelia saWiro gaxdes SezRuduli SesaZleblobebis mqone pirTaTvis arsebuli specialuri samsaxurebis gamoyeneba; 3. xeli Seuwyon maT srul socialur integraciasa da monawileobas sazogadoebriv cxovrebaSi, teqnikuri daxmarebis gawevis gziT, romelic moicavs komunikaciisa da gadaadgilebis sferoSi arsebuli barierebis aRmofxvras, transportiTa da sacxovrebeli adgilebiT uzrunvelyofas, kulturuli saqmianobaSi monawileobis miRebasa da dasvenebas. 94 evropis socialur uflebaTa komitetma daadgina, rom jandacvis sitema xelmisawvdomi unda iyos yvelasaTvis da rom socialuri qartiis me-11 muxliT gaTvaliswinebuli SezRudvebi ar unda iyos interpretirebuli imgvarad, rom daucvel jgufebs uSlides xels janrTelobis uflebiT sargeblobaSi. janmrTelobis dacvis xelmisawvdomobis uflebis realizaciisaTvis aucilebelia momsaxureba iyos xelmisawvdomi da unda gadaidgas nabijebi, rom SeRavaTebi dawesdes gansakuTrebulad daucveli jgufebisTvis. evropis socialuri uflebebis komitetSi saCivari Sevida safrangeTis winaaRmdeg imis Taobaze, rom 2002 wlis sakanonmdeblo reformebis Sedagad safrangeTma daarRvia Ra- adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.3 rib aralegalur imigrantTa ufleba samedicino daxmarebaze Sesworebuli evropuli socialuri qartiis me-13 muxlis sawinaaRmdegod, kerZod: ar gaaTavisufla isini gadasaxadebisgan. aseve, daarRvia imigrantTa Svilebis ufleba, rac daculia me-17 muxliT. komitetma daakmayofila mxolod bavSvTa sakiTxi. me-13 muxlis Sesaxeb, komitetma aRniSna, rom samedicino daxmarebasTan dakavSirebuli garantiebi unda gavrceldes arakanonier, iseve rogorc kanonier migrantebze. es gancxadeba gansakuTrebiT mniSvnelovania evropaSi mcxovrebi marginaluri jgufebis uflebaTa dasacavad. miuxedavad amisa, kometitma ar gamoavlina me-13 muxlis darRveva, radgan aralegalur imigrantebs SeeZloT mieRoT garkveuli saxis samedicino daxmareba qveyanaSi cxovrebidan 3 Tvis gasvlis Semdeg. yveka ucxo qveynis moqalaqes ki ufleba qonda gaevlo mkurnaloba `gadaudebel da sicocxlisTvis safrTxis Semqmnel~ SemTxvevebSi. amis sapirispirod, komitetma gamoavlina me-17 muxlis darRveva miuxedavad imisa, rom bavSvebisTvis jandacvis xelmisawvdomoba igive iyo, rac mozrdilTaTvis. gadawyvetilebis miRebis mizezi iyo is, rom me-17 muxli miiCneva ufro mravlismomcvelad, vidre mxolod samedicino daxmarebis miRebis ufleba. komitetis gadawyvetilebis sapasuxod safrengeTis mTavrobam Secvala politika migrant bavSvebTan mimarTebiT. ` evropuli konvencia adamianis uflebebis da biomedicinis Sesaxeb, mux. 3: (janmrTelobis dacvis sistemis Tanabari xelmisawvdomoba): mxareebma, Tavisi iurisdiqciis farglebSi, janmrTelobis dacvaze moTxovnilebebisa da arsebuli resursebis gaTvaliswinebiT, unda gaataron saTanado RonisZiebebi Sesaferisi xarisxis janmrTelobis dacvis Tanabari xelmisawvdomobis uzrunvelsayofad. ` konvencia moqalaqeobis armqone pirTa statusis Sesaxeb mux. 23: xelmomweri saxelmwifoebi valdebulni arian iseve moepyron moqalaqeobis armqone, maT teritoriaze kanonierad mcxovreb pirebs, rogorc sakuTar moqalaqeebs. ` erovnul umciresobaTa dacvis CarCo konvencia; mux. 4: 1.mxareebi iReben valdebulebas uzrunvelyon erovnuli umciresobebisadmi kuTvnili pirebis kanonis winaSe Tanasworoba da kanonis mier Tanabari dacva. am mimarTebiT akrZalulia erovnuli umciresobisadmi kuTvnilebaze dafuZnebuli nebismieri diskriminacia. 2. aucileblobis SemTxvevaSi, mxareebi iReben valdebulebas miiRon adekvaturi zomebi imisaTvis, rom ekonomikuri, socialuri, politikuri da kulturuli cxovrebis yvela sferoSi xeli Seuwyon mTliani da efeqturi Tanasworobis damkvidrebas im pirebs Soris, romlebic miekuTvnebian erovnul umciresobas da imaT Soris, romlebic miekuTvnebian umravlesobas. am mxriv, isini saTanadod gaiTvaliswineben im pirebis specifikur mdgomareobas, romlebic miekTvnebian erovnul umciresobebs. 3. me-2 punqtis Sesabamisad miRebuli zomebi ar iqnebian ganxilulni, rogorc diskriminaciis aqti. ` ministrTa komitetis rekomendacia Rec(2006)18 wevri saxelmwifoebis mimarT mravalkulturul sazogadoebaSi janmrTelobis servisebis Sesaxeb es rekomendacia moicavs multikultur mosaxleobaSi janmrTleobis da jandacvis xelSewyobis strategiebs. maT Soris: diskriminaciis akrZalva da pacientis uflebaTa pativiscema; jandacvis Tanabari xelmisawvdomoba; enobrivi barierebis gadalaxva; erovnul umciresobaTa janmrTelobis da socialur-ekonomikur saWiroebaTa mimarT mgrZnobeloba; uflebebis gazrda; ufro meti monawileoba da saTanado sainformacio bazis ganviTareba mravalkulturuli mosaxleobis janmrTelobis sakiTxebze. 95 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba ` evropis sabWo, saparlamento asamblea 1626 (2003) evropaSi jandacvis sistemis reformis ASesaxeb: samarTlianobis, Tanasworobis da efeqtianobis aRdgena wevrma saxelmwifoebma jandacvis sistemis reformis warmatebis Sesafaseblad unda ixelmZRvanelon iseTi kriteriumebiT, rogoricaa jandacvis xelmisawvdomoba yvelasTvis, diskriminaciis gareSe da jandacvis miCneva adamianis ZiriTad uflebad. ` pacientis uflebaTa QAqartia, mux. 2 _ xelmisawvdomobis ufleba yvela pirs aqvs jandacvis xelmisawvdomobis ufleba misi janmrTelobis saWiroebis gaTvaliswinebiT. jandacvis servisebma unda uzrunvelyon yvelasaTvis Tanabari xelmisawvdomoba, materialuri resursebis safuZvelze diskriminaciis, sacxovrebeli adgilis, avadmyofobis tipis Tu xelmisawvdomobis drois mixedviT. 3.4 janmrTelobis dacvis momsaxurebis mimwodebelTa uflebebi winamdebare nawili warmoadgens evropis Sesabamis regionalur standartebs, rogorc es mocemulia evropis adamianis uflebebaTa dacvis konvenciasa da evropis socialur qartiaSi. igi aseve ganmartavs, Tu rogor aris interpretirebuli es standartebi jandacvis momsaxurebis momwodebelTa sam ZiriTad uflebasTan mimarTebiT: (i) muSaobasTan dakavSirebuli uflebebi, maT Soris muSaobisa da Tanaswori SesaZleblobebis ufleba genderuli diskriminaciis gareSe; (ii) Sekrebisa da gaerTianebis ufleba, maT Soris ufleba Camoayalibon profesiuli kavSirebi da moawyon gaficvebi; da (iii) samarTalwarmoebis ufleba da masTan dakavSirebuli uflebebi, rogoricaa samarTliani sasamarTlo procesi, dacvis efeqturi saSualebebi, piradi cxovrebisa da reputaciis dacva da gamoxatvisa da informaciis Tavisufleba. Tavi dayofilia sam ZiriTad nawilad. pirveli nawili ganixilavs saTanado pirobebSi muSaobis uflebas; meore nawili ganixilavs Sekrebisa da gaerTianebis Tavisuflebas; xolo mesame nawili _ samarTalwarmoebis uflebas da masTan dakavSirebul uflebebs. TiToeuli nawili mokled mimoixilavs jandacvis momsaxurebis momwodebelTa uflebebis mniSvnelobas da iZleva potenciuri darRvevebis magaliTebs. warmodgenilia Sesabamisi standartebi evrosabWos konvenciebidan. sabolood Sejamebulia sakvanZo ganmartebiTi saxelmZRvanelo principebi precendentuli samarTalze dayrdnobiT da monitoringis ganmaxorcielebeli organoebis mier gamocemuli daskvniTi dakvirvebebi saxelmwifo angariSebidan. saTanado pirobebSi muSaobis ufleba muSaobis ufleba da muSaobasTan dakavSirebuli uflebebi garantirebulia evropis socialuri qartiiT (ES C). miuxedavad imisa, rom am nawilSi yuradReba ar maxvildeba xsenebulze, evropis adamianis uflebebis konvenciis Sesabamisi standartebi SeiZleba moicavdes 2 (sicoxlis ufleba) da 3 muxlebs (wamebis, araadamianuri an damamcirebeli mopyrobis an dasjis akrZalva), radganac isini uzrunvelyofen dacvas samuSao adgilas arasaTanado mopyrobis winaaRmdeg. 96 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.4 evropis socialuri uflebebis komisiam farTo ganmarteba mogvca sakadris pirobebSi muSaobis uflebis Sesaxeb evropis socialur qartiaSi, kerZod ki Semdeg oTx sferoSi: muSaobis ufleba (muxli 1[2]) da Tanaswori SesaZleblobebi genderuli diskriminaciis gareSe (muxli 20); keTilgonivruli yoveldRiuri da yovelkvireuli samuSao saaTebis ufleba (muxli 2[1]); usafrTxo da jansaRi samuSao pirobebSi muSaobis ufleba (muxli 3); da samarTliani anazRaurebis qonis ufleba.65 TiToeuli maTgani ganxilulia am nawilSi. miuxedavad imisa, rom ar aris jandacvis seqtoris personalze pirdapiri miTiTeba, isini igive uflebebiT sargebloben rogorc sxva momuSave pirebi. muSaobisa da Tanaswori SesaZleblobebis ufleba genderuli diskriminaciis gareSe uflebis potenciur darRvevaTa magaliTebi miuxedavad mamakac kolegebTan SedarebiT qali eqimis ukeTesi Sesabamisi gamocdilebisa da kvalifikaciisa, mas ar awinaureben; zogierTi qveynis moqalaqeebs ekrZalebaT jandacvis seqtorSi dasaqmeba teritoriuli dapirispirebis safuZvelze, rac Sedegad gansaxilvelad gadaecema marTlmsajulebis saerTaSoriso sasamarTlos; mdedrobiTi sqesis TanamSromlebi xSirad diskriminebuli arian mamrobiTi sqesis TanamSromlebis mier da Sesabamisi zomebi ar miiReba amis aRmosafxvrelad. adamianis uflebaTa standartebi da interpretacia • muxli 5.3 1(2) evropis socialuri qartia: muSaobis ufleba _ muSaobis uflebis efeqturi gamoyenebis uzrunvelsayofad mxareebi kisruloben valdebulebas efeqturad daicvan momuSave piris nebayoflobiT arCeuli samuSaos Sesrulebis gziT sacxovrebeli saxsrebis gamomuSavebis SesaZlebloba. • muxli 1(2) evropis socialuri qartia, muSaobis uflebis efeqturi gamoyenebis uzrunvelsayofad igi dayofilia sam calkeul sakiTxad: a) yovelgvari saxis diskriminaciis akrZalva samsaxurSi (rac moicavs genderze dafuZnebuli Tanaswori SesaZleblobebis qonis uflebas); b) nebismieri saxis qmedebis akrZalva, romelic ewinaaRmdegeba dasaqmebuli piris nebayoflobiT arCeuli samuSaos Sesrulebis gziT sacxovrebeli saxsrebis gamomuSavebis SesaZleblobas;66 g) iZulebiT an ZaldatanebiT muSaobis akrZalva. 65 evropis socialuri uflebebis komisiis precendentuli samarTlis daijesti mudmivad ganaxlebadia da mocemulia Semdeg misamarTze: http://www.coe.int/t/dghl/monitoring/socialcharter/Digest/DigestIndex_en.asp. 66 evrosabWo. socialuri uflebebis evropis komisiis daskvnebi. daskvnebi (II da XVI-1). muxli§2 ganmartebebi. 97 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba pirveli ori sakiTxi ganxilulia qvemoT, sadac xazgasmulia diskriminaciis gansazRvreba da moqmedebis sferoebi. aseve mokled mimoxilulia misaRebi saxelmwifo politika, mimarTuli iseTi diskriminaciuli saqmianobis winaaRmdeg, romelic zRudavs muSaobis uflebas, rogorc es mocemulia muxlSi 1. dasaqmebisas yvela formis diskriminaciis akrZalva • evropis socialuri qartia gansazRvravs diskriminacias, rogorc pirovnebis gansxvavebul mopyrobas iseT situaciebSi, sadac amgvari mopyroba ar isaxavs legitimur miznebs, ar efuZneba obieqtur da keTilgonivrul miznebs an dasaxuli miznis ara proporciulia.67 Sefaseba imisa, Tu ramdenad eqvemdebareba gansxvavebuli mopyroba legitimur mizans da misi proporciulia, mocemulia evropis socialuri qartiis G muxlSi (SezRudvebi). • 1(2) muxlis Tanaxmad kanonmdebloba unda krZalavdes dasaqmebisas nebismieri saxis diskriminacias, maT Soris sqesis, rasis, eTnikuri warmomavlobis, religiis, unarSezRudulobis, asakis, seqsualuri orientaciisa da politikuri Sexedulebebis niadagze diskriminacias.68 es debuleba Tavisi arsiT dakavSirebulia evropis socialuri qartiis sxva debulebebTan, kerZod ki muxli 20 (dasaqmebisa da profesiuli saqmianobis sferoSi Tanabari SesaZleblobebiTa da Tanaswori mopyrobiT sargeblobiT ufleba, sqesobrivi diskriminaciis gareSe) da muxli 15(2) (Sromis uunaro pirebis dasaqmebis ufleba). • kanonmdebloba unda krZalavdes rogorc pirdapir aseve irib diskriminacias.69 • irib diskriminacias adgili aqvs, rodesac qmedeba an praqtika, romelic identuria yvelasTvis, legitimuri miznebis gareSe ara proporciulad moqmedebs gansxvavebuli religiis an rwmenis, unarSezRudulobis, asakis, seqsualuri orientaciis, politikuri Sexedulebis, an eTnikuri warmomavlobis mqone pirebze.70 • diskriminacias SesaZloa adgili hqondes, Tu ver xerxdeba yvela Sesabamisi gansxvavebebis gaTvaliswineba an Sesabamisi zomebis miReba, raTa uzrunvelyofil iqnas, rom uflebebi da saerTo upiratesobebi, romlebic yvelasTvis Riaa, namdvilad xelmisawvdomia yvelasaTvis da yvelas mier.71 • diskriminaciul qmedebebs da am debulebiT akrZalul qmedebebs SesaZloa adgili hqondes zogadad samsaxurSi ayvanis an dasaqmebis pirobebTan dakavSirebiT. gansakuTrebiT mniSvnelovania anazRaureba, treningi, dawinaureba, gadayvana da gaTavisufleba an sxva saziano qmedebebi.72 67 turzmis profesionalTa profkavSiri safrangeTis winaaRmdeg (Syndicat national des Professions du Tourisme v. France). (6/1999). 2000 wlis 10 noembris gadawyvetileba. 68 evrosabWo. daskvnebi: islandia. (XVIII -1); daskvnebi 2006 (albaneTi). 69 evrosabWo. daskvnebi: avstria. (XVIII -1). 70 devid harisi da sxvabi. evropis adamianis uflebebis konvenciis kanoni (oqsfordi: oqsfordis universitetis presa, 2009), 607 71 autizmis saerTaSoriso asociacia-evropa (AIAE ) safrangeTis winaaRmdeg (13/2002). 2003 wlis 4 noembris gadawyvetileba. 72 evrosabWo. daskvnebi: avstria. (XVI-1). 98 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.4 • diskriminaciis akrZalvis efeqturobisaTvis, qveynis kanonmdebloba sul mcire unda moicavdes: nebismieri debulebis gadadebis, gauqmebis, an cvlilebebis Setanis Zala, romelic ewinaaRmdegeba Tanaswori mopyrobis principebs, romlebic asaxulia saerTo samuSao xelSekrulebebSi, dasaqmebis kontraqtebsa Tu kompaniis sakuTar normebSi;73 daqiravebuli piris dacva, damqiraveblis mier gaTavisuflebis an sxva represiuli qmedebisagan, romelmac sarCeli Seitana an sxva kanonieri qmedeba miiRo; dacvis Sesabamisi da efeqturi saSualebebi, romlebic Seefereba da proporciuli da xelmisawvdomia dazaralebulTaTvis diskriminaciis Sesaxeb gancxadebisas. kompensaciis winaswar gansazRvruli zeda zRvaris daweseba ewinaaRmdegeba muxls 1(2).74 Sida kanonmdebloba aseve unda unda uzrunvelyofdes mosarCeleze dakisrebuli mtkicebis tvirTis Semsubuqeba. Semdegi zomebi aseve mimarTulia diskriminaciasTan brZolisaken evropis socialuri qartiis 1(2) muxlis Sesabamisad: aRiarebs profesiuli kavSirebis uflebas imoqmedon dasaqmebis dros diskriminaciis SemTxvevebSi, maT Soris kerZo pirebis saxeliT;75 gaasaCivron diskriminaciuli praqtika, romelic saerTo qmedebis ganxorcielebis uflebas arRvevs; Camoayalibon, gansakuTrebuli, damoukidebeli organo, romelic xels Seuwyobs Tanaswor mopyrobas, kerZod diskriminaciis msxverpl pirebs gauwevs saWiro mxardaWeras sasamarTlo saqmis warmoebisas; evropis socialuri qartiis xelmomwer saxelmwifoebs SeuZliaT sxva qveynis moqalaqeebs maT teritoriaze muSaobis ufleba miscen. miuxedavad amisa, maT ufleba ar aqvT sxva qveynebis moqalaqeebs aukrZalon muSaoba garda G muxlSi mocemuli mizezebisa. sxva qveynis moqalaqeebs SeiZleba aekrZaloT mxolod iseTi Tanamdebobebis dakaveba, romlebic dakavSirebulia sazogadoebrivi interesebis dacvasTan an erovnuli usafrTxoebis sakiTxebTan da romlebic sajaro moxelis saqmianobas gulisxmobs;76 dauSvebelia piris samsaxurSi ar miReba an Tanamdebobidan gaTavisufleba misi warsuli politikuri saqmianobis gamo, garda im SemTxvevebisa Tu Tanamdeboba dakavSirebulia samarTalwesrigis dacvasTan da erovnul usafrTxoebasTan an amgvari pasuxismgeblobebis Semcvel saqmianobasTan.77 73 evrosabWo. daskvnebi: islandia. (XVI-1). 74 evrosabWo. daskvnebi 2006: albaneTi 75 evrosabWo. daskvnebi: islandia. (XVI-1). 76 evrosabWo. daskvnebi: 2006: albaneTi 77 evrosabWo. daskvnebi: 2006: litva 99 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba socialuri uflebebis evropis komisia mcire ganmartebas iZleva Semdeg standartze: `dauSvebelia nebismieri praqtikis akrZalva, ramac SeiZleba SezRudos piris muSaobis ufleba.~ qmedebebi, romlebmac SesaZloa daarRvios es standarti moicavs: - naxevar ganakveTze muSaobasTan mimarTebiT adekvaturi samarTlebrivi dacvis nakleboba. kerZod, unda arsebobdes wesebi, raTa Tavidan iqnas acilebul ara deklarilebuli damatebiTi samuSao saaTebis arseboba da Tanabari anazRaureba rogorc srul aseve naxevar ganakveTze momuSave TanamSromlebisTvis.78 - ukanono Careva dasaqmebulis pirad cxovrebaSi, romelic dakavSirebuli an momdinareobs maTi saqmianobidan, kerZod ki eleqtronuli komunikaciisa da monacemebis Segrovebis teqnikis saSualebiT.79 ¾ veropis socialuri qartia _ muxli 20: Tanabari SesaZleblobebi sqesobrivi diskriminaciis gareSe dasaqmebisa da saqmianobis sakiTxebSi yvela momuSave pirs aqvs Tanabari SesaZleblobebisa da Tanswori mopyrobis ufleba yovelgvari sqesobrivi diskriminaciis gareSe. dasaqmebisa da profesiuli saqmianobis sferoSi sqesobrivi diskriminaciis gareSe, Tanabari SesaZleblobebisa da Tanaswori mopyrobiT sargeblobis uflebis efeqturad ganxorcielebis mizniT, mxareebi valdebulebas iReben aRiaron es ufleba da miiRon saTanado zomebi Semdeg sferoebSi: a) dasaqmebis xelmisawvdomoba, samsaxuridan daTxovnisagan dacva da profesiuli reintegracia; b) profesiuli orientaciis gansazRvra, profesiuli momzadeba, gadamzadeba da reabilitacia; g)dasaqmebis vadebi da samuSao pirobebi, anazRaurebis CaTvliT; d) samsaxurebrivi winsvla, dawinaurebis CaTvliT. yoveldRiuri da yovelkvireuli samuSao saaTebi da adamianis uflebebi uflebis potenciur darRvevaTa magaliTebi eqimi regularulad muSaobs kviraSi 100 saaTs, dro da dro 18 saaTian cvlebs; medda iZulebulia imuSaos damatebiTi saaTebi winaswari SeTanxmebis gareSe. adamianis uflebaTa standartebi da interpretacia ¾ evropis socialuri qartia, muxli 2(1): Sromis samarTliani pirobebiT sargeblobis ufleba 78 evrosabWo. daskvnebi: avstria (XVI-1). 79 evrosabWo. daskvnebi: norvegia (XIV-2). 100 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.4 Sromis samarTliani pirobebiT uzrunvelyofis uflebis efeqturad ganxorcielebis mizniT, mxareebi valdebulebas iReben daadginon yoveldRiuri da yovelkvireuli samuSao saaTebis gonivruli raodenoba da uzrunvelyon samuSao kviris Tanmimdevruli Semcireba, ramdenadac amis SesaZleblobas iZleva Sromis produqtiulobis zrdisa da sxva Sesabamisi faqtorebi; • evropis socialuri qartiis muxli 2(1) uzrunvelyofs momuSave piris uflebas dawesebul iqnas gonivruli yoveldRiur da yovelkvireul samuSao saaTebi, damatebiTi samuSao saaTebis CaTvliT. kanonmdebloba, debulebebi, saerTo xelSekrulebebi an nebismieri sxva savaldebulo Zalis mqone saSualebebi unda uzrunvelyofdes am uflebas. raTa uzrunvelyofil iqnas, rom limitebi praqtikaSic moqmedebs, Sesabamisi uflebamosilebis mqone Tanmdebobis piri zedamxedvelobas unda uwevdes samuSao saaTebis dacvas. • evropis socialuri qartia konkretulad ar gansazRvravs Tu raSi mdgomareobs gonivruli samuSao saaTebi da afasebs situaciebs TiToeuli SemTxvevis safuZvelze: gansakuTrebiT xangrZlivi samuSao saaTebi (dReSi 16 saaTze meti an kviraSi 60 saaTze met xans) iTvleba aragonivrulad da Sesabamisad ewinaaRmdegeba evropis socialuri qartiis moTxovnebs. • damatebiTi samuSo saaTebi ar unda ganixilebodes rogorc mxolod damqiraveblis an daqiravebulis gadawyvetilebis sagani. damatebiTi samuSo saaTebis mizezebi da maTi xangrZlivoba unda eqvemdebarebodes dadgenil wesebs.80 • muxli 2(1) aseve ganixilavs kviris samuSao saaTebis Tanmimdevrul Semcirebas, ramdenadac amis SesaZleblobas iZleva Sromis produqtiulobis zrdisa da sxva Sesabamisi faqtorebi. es `Sesabamisi faqtorebi~ SesaZloa moicavdes Sesasrulebeli samuSaos xasiaTs da usafrTxoebisa da janmrTelobis riskebs, romelTac momuSave piri eqvemdebareba.81 • gamoZaxebiT muSaobis periodebi, rodesac TanamSromels ar moeTxoveba damsaqmeblisaTvis samuSaos Sesruleba, iTvleba samuSao drod da igi ver ganixileba rogorc dasvenebis periodi, rogorc es mocemulia evropis socialur qartiis me-2 muxlSi, garda gansakuTrebuli saqmianobebis SemTxvevisa an konkretuli garemoebebis dros da saTanado procedurebis dacviT. ara-efeqturi muSaoba ver ganixileba rogorc Sesabamisi kriteriumi amgvari periodis dasvenebis periodad miCnevisaTvis.82 80 evrosabWo. daskvnebi: niderlandebi. (XIV-2). 81 I bid. 82 Confйdйrati on Franзaise de l’Encadrement CFE-CGC v. France. (16/2003). 2004 wlis 12 oqtombris gadawyvetileba. 101 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba usafrTxo da higienuri samuSao pirobebiT sargeblobis ufleba uflebis potenciur darRvevaTa magaliTebi rendgenologiis ganyofilebaSi momuSave samedicino personali xSirad unda gadiodes samedicino Semowmebas, vinaian muSaobs safrTxis Semcvel, maRali donis radiacias matarebel aparaturasTan, romlis Semowmeba an gamocvla ar momxdara; medda inficirebulia aiv virusiT mas Semdeg rac ar moxda samedicino aRWurvilobis standartebis Sesabamisad sterilizeba; personalis sasadilo, kvlav funqcionirebs higienur standartebTan Seusabamobis miuxedavad. adamianis uflebaTa standartebi da interpretacia ¾ evropis socialuri qartia, muxli 3: usafrTxo da higienuri samuSao pirobebiT sargeblobis ufleba _ usafrTxo da higienuri samuSao pirobebi sargeblobis uflebis efeqturi ganxorcielebis mizniT, muSakTa da damsaqmebelTa organizaciebTan konsultaciebis gziT, mxareebi valdebulebas iReben: uzrunvelyon Sromis usafrTxoebis, samuSao higienisa da SromiTi garemos Sesaxeb Sesabamisi erovnuli pilitikis formulireba, ganxorcieleba da perioduli gadaxedva, am politikis ZiriTadi mizania Sromis usafrTxoebisa da higienis gaumjobeseba da avariebisa da janmrTelobis dazianebis Tavidan acileba, SromiT garemoSi arsebuli safrTxis minimizaciis gziT;1.miiRon usafrTxoebisa da higienis dacvasTan dakavSirebuli normebi; 2.daaweson zedamxedveloba aseTi normebis Sesrulebaze; 3. xeli Seuwyon prevenciuli da sakonsultacio funqciebis mqone SromiTi higienis samsaxurebis ganviTarebas. • yoveli piris ufleba imuSaos usafrTxo da jansaR samuSao garemoSi `farTod aRiarebuli principia, romelic pirdapir momdinareobs piradi xelSeuxeblobis uflebidan, romelic adamianis uflebebis erT-erTi fundamentaluri principia~.83 • amgvarad evropis socialuri qartiis me-3 muxlis mizani pirdapir kavSirSia evropis adamianis uflebebis konvenciis me-2 muxlTan, romelic aRiarebs sicocxlis uflebas.84 • evropis socialuri qartiis me-3 muxli exeba rogorc sajaro aseve kerZo seqtors.85 • sawarmoo riskis prevencia prioritetuli sakiTxi unda iyos. igi yvela doneze sajaro moxeleebis saqmianobis nawili unda gaxdes da iyos saxelmwifo politikis nawili (dasaqmebaze, unarSezRudul pirebze, Tanabar SesaZleblobebze da sxva)86. miRebuli politika da strategiebi regularulad Sefasebul da gadaxedil unda iqnas, kerZod cvalebad riskebTan mimarTebiT. 83 evrosabWo. daskvnebi I. muxli 3 ganmartebebi 84 evrosabWo. daskvnebi (XIV-2). muxli 3 ganmartebebi 85 evrosabWo. daskvnebi II . muxli 3 ganmartebebi 86 evrosabWo. daskvnebi 2005: litva 102 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.4 • damcav wesebTan SesabamisobasTan erTad adgili unda hqondes samuSaosTan dakavSirebuli riskebis regularul Sefasebas da riskebis xasiaTidan gamomdinare prevenciuli zomebi miRebas, momuSave personalisTvis informaciis miwodebasa da treningebTan erTad. damqiraveblebs aseve moeTxovebaT Sesabamisi informaciiT, treningiTa da samedicino meTvalyureobiT uzrunvelyon droebiT momuSave personali da grZelvadiani kontraqtis safuZvelze momuSave TanamSromlebi (mag.mTliani periodis aRricxva, rodesacdaqiravebuli piri muSaobs sxvadasxva damqiraveblebTan da adgili aqvs saSiSi nivTierebebis zegavlenas).87 • veropis socialuri qartia ar gansazRvravs regulirebas daqvemdebarebul riskebs. zedamxedveloba xdeba arapirdapiri formiT saerTaSoriso sawarmoo usafrToebis standartebis Sesabamisad (rogoricaa saerTaSoriso Sromis organizaciis (ILO) konvenciebi da evropis Temis direqtivebi jansaRi da usafrTxo muSaobis pirobebis Sesaxeb); • qveynis Sida kanonmdebloba unda moicavdes sakanonmdeblo struqturas (xSirad SromiT kodeqss) romelic ayalibebs damsaqmeblis pasuxismgeblobebs, daqiravebulis uflebebsa da valdebulebebs da konkretul debulebebs. riskebi romelzec socialuri uflebebis evropis komisia (ECSR) yuradRebas amaxvilebs moicavs: _ samuSao adgilebis (aRWurvilobis, higienis) Camoyalibeba, Secvla da momsaxureba; _ saSiSi nivTierebebi; _ konkretul seqtorebTan dakavSirebuli riskebi (jandacvis seqtori ar aris konkretulad naxsenebi). • umetesoba zemoxsenebuli riskebisa unda regulirdebodes specialuri debulebebiT _ isini unda ayalibebdnen wesebs, romlebic sakmarisad detalurad iqneba mocemuli maTi sworad da efeqturad gamoyenebisaTvis.88 Sesabamisad, socialuri uflebebis evropis komisia miiCnevs, imisaTvis rom iyos 3(2) muxlTan Sesabamisoba, saxelmwifoebs ar moeTxovebaT warmoadginon dazRveva okupaciuri daavadebebisa da ubeduri SemTxvevebisaTvis;89 • okupaciuri jandacvisa da usafrTxoebis debulebebi unda moicavdes yvela dasawmebul pirs, samuSao adgils da saqmianobis seqtors;90 • saWiroa regularuli Semowmeba da darRvevebze efeturi jarimebis daweseba. 87 evrosabWo. daskvnebi 2003: bulgareTi. 88 evrosabWo. daskvnebi norvegia. (XIV-2). 89 arangopoulos adamianis uflebebis fondi (MFHR) v. saberZneTi. (30/2005). 2006 wlis 6 dekembris gadawyvetileba. 90 evrosabWo. daskvnebi 2005: estoneTi. 103 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba samarTliani anazRaurebis ufleba uflebis potenciur darRvevaTa magaliTebi zogierTi jandacvis TanamSromlebis anazRaureba, mis qveyanaSi arsebuli saSualo anazRaurebis 40% warmoadgens, xolo damxmare personals saSualo minimumze naklebi xelfasi aqvs; damatebiT saaTebze momuSave medda igive anazRaurebas iRebs, rasac Cveuli samuSao saaTebis sazRaurad miiRebda. adamianis uflebaTa standartebi da interpretacia ¾ evropis socialuri qartia, muxli 4-Sromis samarTliani anazRaurebis miRebis ufleba Sromis samarTliani anazRaurebis miRebis uflebis efeqturi ganxorcielebis mizniT, mxareebi valdebulebas iReben: (1) aRiaron muSakTa mier iseTi anazRaurebis miRebis ufleba, romelic uzrunvelyofs maTi cxovrebis Rirseul dones; (2)aRiaron muSakTa mier zeganakveTuri samuSaos SesrulebisaTvis damatebiTi anazRaurebis miRebis ufleba, calkeuli gamonaklisebis gaTvaliswinebiT; (3)aRiaron qalTa da mamakacTa mier Tanabari Rirebulebis samuSaosaTvis Tanabari anazRaurebis miRebis ufleba; (4) aRiaron TiToeuli muSakis mier dasaqmebis Sewyvetis Sesaxeb Setyobinebis winaswari miRebis ufleba; (5) dauSvan xelfasebidan daqviTvebi mxolod erovnuli kanonmdeblobiT an sakanonmdeblo aqtebiT, aseve koleqtiur xelSekrulebaSi an saarbitraJo gadawyvetilebaSi gaTvaliswinebul SemTxvevebSi. zemoaRniSnuli uflebebi ganxorcieldeba koleqtiuri xelSekrulebebis, xelfasis dadgenis kanoniT gaTvaliswinebuli meqanizmis an sxva saSualebebiT. • imisaTvis rom, veropis socialuri qartiis 4(1) muxlis Tanaxmad xelfasi samarTlianad CaiTvalos igi unda aRematebodes siRaribis zRvars mocemul qveyanaSi _ anu qveyanaSi saSualo anazRaurebis 50%. amas garda xelfasi zedmetad ar unda gansxvavdebodes qveynaSi saSualo anazRaurebisagan. evropis socialuri uflebebis komisiis mier dadgenili zRvaria 60%.91 • TanamSromlebs, romlebic damatebiT saaTebs muSaoben, unda mieceT anazRaureba damatebiTi saaTebisaTvis.92 4(2) muxli uflebas iZleva TanamSromels mieces Svebulebis aRebis saSualeba damatebiTi samuSao saaTebis kompensaciis saxiT. im pirobiT, rom Svebulebis xangrZlivoba aRemateba namuSevari saaTebis xangrZlivobas. amgvarad ar aris sakmarisi TanamSromels SevTavazoT damatebiTi samuSao saaTebis toli Svebuleba.93 4(2) muxlis gamonaklisi SemTxvevebi SesaZloa avtorizebul iqnas konkretul SemTxvevebSi. es `gansakuTrebuli SemTxvevebi~ gansazRvrulia evropis socialuri uflebebis komisiis mier 91 evrosabWo. daskvnebi (XIV-2). muxli 4§1 ganmarteba. komisiis gamoTvleba emyareba neto odenobebs (gadasaxadebisa da sociluri Senatanebis gamoklebis Semdeg). socialuri gadaricxvebi (mag. socialuri daxmareba an benefiti) mxedvelobaSi miiReba mxolod im SemTxvevaSi Tu maT pirdapiri kavSiri aqvT xelfasTan. 92 evrosabWo. daskvnebi I 4§2 muxlis ganmarteba. 93 evrosabWro. daskvnebi. belgia. (XIV-2). 104 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.4 rogorc `sajaro moxeleebi, aRmasrulebeli menejerebi da sxva~.94 sajaro moxeleebTan mimarTebiT gamonaklisebi Seesabameba 4(2) muxls.95 damatebiTi samuSaosaTvis ufro maRali anazRaurebis miRebis gamonaklisi ar gamoiyeneba saxelmwifo TanamSromlebsa Tu sajaro moexeleebze, miuxedavad maTi pasuxismgeblobis xarisxisa.96 gamonaklisi SeiZleba daSvebul iqnas umaRlesi menejerebis SemTxvevaSi. evropis socialuri uflebebis komisiam daadgina ara anazRaurebadi damatebiT namuSaveri saaTebis limiti, romelzec ar xdeba ufro maRali tarifiT anazRaureba.97 • qalebi da kacebi Tanabar anazRaurebas unda iRebdnen erTsa da imave samuSaosTvis da es ufleba gansakuTrebiT xazgasmuli unda iyos kanonmdeblobaSi.98 Tanabari anazRaurebis principi unda moqmedebdes qalisa da kacis mier Sesrulebuli yvela samuSaosTvis. Tanasworobis principi unda vrceldebodes anazRaurebis yvela aspeqtze, maT Soris minimalur xelfasze da yvela im sargebelze, romelic pirdapir Tu ara pirdapir anazRaurdeba damqiraveblis mier.99 igi aseve unda exebodes srul da naxevar ganakveTze momuSave TanamSromlebs, moicavdes saaTobrivi anazRaurebis gamoTvlas, xelfasis matebas da gadaxdis komponentebs.100 • diskriminaciuli anazRaurebis SemTxvevaSi qveynis Sida kanonmdebloba unda uzrunvelyofdes saTanado da efeqtur dacvas.101 TanamSromlebs, romelTac ganicades diskriminacia, unda SeeZloT sasamarTlosTvis mimarTva. • qveynis Sida kanonmdebloba aseve unda uzrunvelyofdes mosarCeleze mtkicebis tvirTis Semsubuqebas, diskriminaciis sakiTxebTan dakavSirebul saqmeebSi. nebismierma pirma, romelic ganicdis saxelfaso diskriminacias genderul niadagze, unda miiRos sakmarisi kompensacia, rac aanazRaurebs miyenebul zarals.102 araTanabari anazRaurebis SemTxvevaSi kompensacia sul mcire unda faravdes anazRaurebaSi arsebul sxvaobas.103 Sekrebis da gaerTianebis Tavisufleba profesiuli kavSirebis Seqmnis Tavisufleba aRiarebulia evropis adamianis uflebaTa konvenciis 11-e muxliT. miuxedavad imisa, rom evropis adamianis uflebaTa dacvis sasamarTlos, aRniSnuli muxliT mcire raodenobis saqmeebi aqvs ganxiluli, man gansazRvra, rom es ufleba gulisxmobs adamianis uflebas Tavi Seikavos raime kavSirSi gawevrianebisagan. amas garda, evropis adamianis uflebaTa dacvis sasamarTlom gansazRvra, rom maregulirebeli organoebis wevrebs ar exebaT es debuleba. es gansakuTrebiT mniSvnelovania samedicino sferoSi momuSave pirebisaTvis, radgan es uwyebebi kanonis Sesabamisadaa dafuZnebuli da gaaCnia uflebamosileba gaataros disciplinaruli zomebi misi wevrebis mimarT.104 94 evrosabWro. daskvnebi: irlandia. (IX-2). 95 evrosabWro. daskvnebi: irlandia. (X-2). 96 evrosabWro. daskvnebi: poloneTi. (XV-2). 97 Confйdйrati on Franзaise de l’Encadrement CFE-CGC v. France. (9/2000). 2001 wlis 16 noembris gadawyvetileb 98 evrosabWo: daskvnebi, slovaketis respublika (XV-2, damateba). 99 evrosabWo: daskvnebi, I. 4§3 ganmartebiTi nawili. 100 evrosabWo: daskvnebi: portugalia. (XVI-2). 101 evrosabWo: daskvnebi: I. 4§3 ganmartebiTi nawili. 102 evrosabWo daskvnebi. (XIII -5). damatebiTi protokolis muxli 1 ganmartebiTi nawili 103 evrosabWo; daskvnebi: malta. (XVI-2). 104 aseve ix. samarTlebrivi uflebebis dacvis saerTaSoriso centre. saerT. uflebebi saxelmZRvanelo iuristebisaTvis. evropis adamianis uflebebis konvenciis 11 muxli: Tavyrilobisa da kavSirebis Seqmnis Tavisufleba. htt p://www.interights.org/view-document/index. htm?id=520. iZleva informacias Tu rogor ganmartavs evropis adamianis uflebebis konvenciis 11 muxls veopis adamianis uflebebis saerTaSoriso sasamarTlo. 105 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba evropis socialuri qartia iZleva gaficvis uflebis yvelaze srulyofil analizs. evropis adamianis uflebebis sasamarTlo ufro SezRudulad iyo CarTuli profesiul kavSirebis saqmianobis SeswavlaSi, romelic aseve gulisxmobs dasaqmebulTa uflebas gaficvaze. es nawili moicavs gaerTianebis Tavisuflebis or aspeqts: Sekrebisa da gaerTianebis Tavisuflebas, romelic mocemulia evropis adamianis uflebaTa dacvis konvenciis 11 mulxSi da profesiuli kavSirebis Camoyalibebisa da gaficvis uflebas, romelic daculia evropis socialuri qartiis 5, 6, 21 da 22 muxlebiT. Sekrebisa da gaerTianebis ufleba uflebis potenciur darRvevaTa magaliTebi profesiuli samedicino kavSiri ar aris jandacvis saministros mier damtkicebuli, radgan misi prezidenti opoziciuri politikuri partiis wamyvani wevria; yovelgvari gamarTlebis gareSe, uflebamosili pirebi xels uSlian anazRaurebis gazrdis da pirobebis gaumjobesebis mizniT Sekrebis Catarebas. adamianis uflebaTa standartebi da interpretacia ¾ adamianis uflebeaTa dacvis evropuli konvencia, muxli 11 _ (1)yvelas aqvs ufleba mSvidobiani Sekrebis Tavisuflebisa, agreTve sxvebTan gaerTianebis Tavisuflebisa, maT Soris, ufleba profesiuli kavSirebis Seqmnisa da masSi gaerTianebisa sakuTari interesebis dasacavad. (2) dauSvebelia raime SezRudvis daweseba am uflebaTa ganxorcielebaze, garda iseTi SemTxvevisa, romelic gaTvaliswinebulia kanoniT da aucilebelia demokratiul sazogadoebaSi erovnuli uSiSroebis an sazogadoebrivi usafrTxoebis interesebisaTvis, uwesrigobis an danaSaulis aRsakveTad, janmrTelobisa Tu zneobis an sxvaTa uflebaTa da TavisuflebaTa dasacavad. es muxli xels ar uSlis saxelmwifos, daawesos kanonieri SezRudvebi am uflebaTa ganxorcielebaze SeiaraRebuli Zalebis, policiis an saxelmwifo administraciis warmomadgenlebis mimarT. • me-11 muxlis Tanaxmad, `Sekreba~ avtonomiuri koncefciaa, romelic ar aris damokidebuli saxelmwifos Sida kanonmdeblobaSi miRebul klasifikaciaze. aRniSnuli aris Sesabamisi, magram ara gadamwyveti faqtori.105 • me-11 muxliT gaTvaliswinebuli Sekrebis Tavisufleba mxolod kerZo samarTlis pirebs exeba. sajaro samarTlis pirebi (kanonis safuZvelze dafuZnebuli) ar ganixileba rogorc `kavSirebi~ im gagebiT, romelsac 11 muxli gulisxmobs. es SezRudva SesaZloa 105 kasangou da ors safrangeTis winaaRmdeg (29 EHRR 615). monadireTa gaerTianeba safrangeTSi iTvleba `kavSirad~ romelsac muxli 11 gulisxmobs, Tumca mTavrobaSi iyo diskusiebi, rom igi sajaro samarTlis institutia. 106 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.4 dakavSrebuli iyos jandacvis profesionalebTan da erovnul profesiul organoebSi maT iZulebiT wevrobasTan.106 • ufleba aseve moicavs Tavisufal arCevans gaerTianebebsa Tu profesiul kavSirSi gawevrianebasTan dakavSirebiT.107 • muxli 11 (2) saSualebas iZleba `kanonieri SezRudvebi~ dawesdes konkretul sajaro moxeleebze (magaliTad SeiaraRebul Zalebsa da policiaze) da aseve `saxelmwifo administraciis~ wevrebze.108 am ukanasknel termins viwro interpretacia gaaCnia. evropis adamianis uflebaTa dacvis sasamarTlom Riad datova sakiTxi exeba Tu ara igi maswavleblebs.109 profesiuli kavSirebi da gaficvis mowyobis ufleba uflebis potenciur darRvevaTa magaliTebi meddas uari uTxres dawinaurebaze im mizeziT, rom igi xelmZRvanelobas problemebs uqmnida profesiul kavSirSi misi saqmianobebiT; SeTanxmeba profesiul kavSirsa da jandacvis uwyebis mmarTvelobas Soris uzrunvelyofs, rom vakanturi adgilebis 30% Senaxuli iqneba kavSiris wevrebisaTvis. adamianis uflebaTa standartebi da interpretacia ¾ evropis socialuri qartia: muxli 5-organizebis ufleba TavianTi ekonomikuri da socialuri interesebis dasacavad muSakTa da damsaqmebelTa mier adgilobrivi, erovnuli an saerTaSoriso organizaciebis Seqmnis da am organizaciebSi gaerTianebis Tavisuflebis uzrunvelyofis mizniT, mxareebi valdebulebas iReben, rom isini TavianT qveynebSi moqmed Sesabamis kanomdeblobaSi ar Seitanen iseT normebs, da aseve ar gamoiyeneben sakanonmdeblo normebs iseTi formiT, romelic SezRudavs zemoaRniSnuli TavisuflebiT sargeblobas. SeiaraRebuli Zalebis wevrTa mimarT am garantiebis gamoyenebis wesi da farglebi ganisazRvreba erovnuli kanonmdeblobiT an kanonqvemdebare aqtebiT. 106 le kompti belgiis winaaRmdeg (Le Compte v. Belgium). (4 EHRR 1). maTi profesiis gamo maregulirebeli orgnos mier Sewyvetis Semdeg, eqimebi warumateblad asaCivrebdnen iZulebiTi wevrobasa da maTi disciplinaruli organoebis iurisdiqciaze daqvemdebarebas. radganac maregulirebel organos sajaro samarTlis statusi hqonda miniWebuli _ igi integrirebuli iyo saxelmwifo struqturaSi da mis umetes organoebSi mosamarTleebi iniSneboda saxelmwifos mier - samedicino praqtikis maregulireblis funqcia da eqimebis registraciis warmoeba, misi administraciuli, da disciplinaruli uflebamosilebebi, sasamarTlom daaskvna, rom ar unda yofiliyo SezRudvebi, rom eqimebs CamoeyalibebinaT da gawevrianebuliyvnen maT sakuTar profesiul kavSirebSi. aseve ix. Sesabamisi saqmeebi Albert and Le Compte belgiis winaaRdeg (7299/75, etc.) eqimebTan dakavSirebiT; Revert and Legallais safrangeTis winaaRmdeg (14331/88 and 14332/88) arqiteqtorebi; A. da sxvebi espaneTis winaaRmdeg (13750/88) advokatTa kolegia; da bartoldi germaniis winaaRdeg (8734/79) veterinar qirurgebTan dakavSirebiT. aseve ix. O. VR. ruseTis winaaRmdeg (44139/98) da A espaneTis winaaRmdeg (6 DR 188). 107 iangi da ors. didi britaneTis winaaRmdeg (4 EHRR 38). `daketili maRazia,~ rkinigzis profesiuli kavSiris iZulebiTi wevroba, sadac darRveul iqna muxli 11. aseve ix. Sigurjonsson v. islandia. (A264). 108 es midgoma mowonebuli iyo evropis socialuri uflebebis komisiis mier, Tumca saerTaSoriso Sromis organizaciis kavSirebis Seqmnis Tavisuflebis komisias ar daumtkicebulia igi. miuxedavad amisa, saerTaSoriso Sromis organizaciis 87 konvenciis muxli 9(1) romelic zRudavs sajaro moxeleebi uflebas ar Seexeba `saxelmwifo administracias~. 109 vogti germaniis winaaRmdeg (Vogt v. Germany). (21 EHRR 205). sasamarTlom Riad datova is sakiTxi arian Tu ara msawavleblebi `saxelmwifo administraciis~ wevrebi. 107 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba • evropis socialuri qartiis me-5 muxli exeba rogorc sajaro, aseve kerZo seqtors. 110 saxelmwifos Sida kanonmdebloba unda uzrunvelyofdes dasaqmebulTaTvis profesiul kavSirebSi gaerTianebis uflebas da moicavdes efeqtur sanqciebs da samarTalebrivi daccvis meqanizmebs uflebis darRvevis SemTxvevaSi; • me-5 muxlis Tanaxmad, dasaqmebul pirs unda hqondes Tavisufali arCevanis ufleba gawevriandes Tu ara profesiul kavSirSi. nebismieri saxis iZulebiTi wevroba profesiul kavSirSi ewinaaRmdegeba me-5 muxls.111 • saxelmwifos Sida kanonmdebloba naTlad unda krZalavdes profesiul kavSirebSi yvela saxis sawevro da wevrobis Semdgom Senatanebs da avtomatur daqviTvebs xelfasidan112. Sesabamisad, xelSekrulebaSi an sxva iuriduli Zalis mqone dokumentSi gaTvaliswinebuli nebismieri norma, romelic samuSao adgilebs akavebs konkretuli profesiuli kavSirisaTvis, arRvevs me-5 muxls.113 • profesiuli kavSirebis wevrebi daculni unda iyvnen nebismieri saziano zegavlenisagan, rac SeiZleba axldes maT muSaobas, gansakuTrebiT samsaxurSi ayvanis, gaTavisuflebis an dawinaurebis dros diskriminaciisagan. Tu msgavs diskriminacias adgili eqneba, qveynis kanonmdebloba unda uzrunvelyofdes kompensacias, romelic miyenebuli zianis Sesabamisi da proporciulia.114 • profesiuli kavSirebi da damsaqmebeli organizaciebi daculni unda iyvnen saxelmwifos mxridan aramarTlzomieri Carevisagan maT infrastruqturasa da efeqtur funqcionirebasTan dakavSirebiT.115 magaliTad, profesiuli kavSirebi uflebamosilni arian Tavad airCion maTi wevrebi da warmomadgenlebi. ar unda arsebobdes gaumarTlebeli SezRudvebi im mizezebze, romlis gamoc profkavSirs SeuZlia gaataros disciplinaruli qmedebebi wevris mimarT.116 profesiuli kavSirebis uflebamosil pirebs unda hqondeT samuSao adgili da kavSiris wevrebs, damsaqmeblis moTxovnebidan gamomdinare117 SeeZloT samsaxurSi Sexvedrebis mowyoba, • profesiul kavSirebsa da damsaqmebel organizaciebs unda SeeZloT nebismieri Sexvedris martivad organizeba, winaswari nebarTvisa da formalobebis gareSe, rogoricaa deklaracia da registracia. Tu dawesebulia gadasaxadi organizaciis registraciasa Tu Camoyalibebaze, igi unda iyos gonivruli da emsaxurebodes mxolod wminda administraciuli xarjebis dafarvas.118 • registraciis moTxovnebi, rogoricaa wevrebis minimaluri raodenoba, Seesabameba me-5 muxlis moTxovnebs, Tu raodenoba gonivrulia da xels ar uSlis organizaciis Camoyalibebas.119 110 evrosabWo. daskvnebi I. muxli 5 ganmarteba. 111 evrosabWo. daskvnebi III . muxli 5 ganmarteba. 112 evrosabWo. daskvnebi. VIII . 5 muxlis ganmartebebi 113 evrosabWo. daskvnebi: dania. (XV-1). 114 evrosabWo. daskvnebi. 2004: bulgareTi. 115 evrosabWo. daskvnebi. germania. (XII -2). 116 evrosabWo. daskvnebi. didi britaneTi. (XVII ). 117 evrosabWo. daskvnebi: safrangeTi. (XV-1). 118 evrosabWo. daskvnebi: didi britaneTi (XV-1). 119 evrosabWo. daskvnebi: portugalia. (XIII -5). 108 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.4 • saxelmwifs Sida kanonmdeblobam SesaZloa SezRudos sxvadasxva konsultaciebsa da koleqtiur molaparakebebSi monawileoba calkeuli profesiuli kavSirebisTvis, im SemTxvevaSi Tu akmayofilebs konkretul kriteriumebs.120 • SesaZloa SezRudul iqnas gaficvis ufleba, im SemTxvevaSi Tu SezRudva akmayofilebs G muxlSi mocemul pirobebs, romelSic warmodgenilia qartiis mier uzrunvelyofili uflebebis SezRudvis kanonieri garemoebebi. nebismieri SezRudva unda emsaxurebodes legitimur mizans da warmoadgendes saWiroebas demokratiul sazogadoebaSi adamianis uflebebisa da Tavisuflebebis an sazogado interesebis, erovnuli usafrTxoebis, sazogado janmrTelobis an moralis dasacavad.121 • gaficvis akrZalva iseT seqtorebSi, romlebsac arsebiTi mniSvneloba aqvT TemisaTvis, unda emsaxurebodes legitimur mizans, radganac am seqtorebSi gaficva SesaZloa safrTxes uqmnides sazogadoebriv interesebs, erovnul usafrTxoebas da/an janmrTelobas. ubralod gaficvebis akrZalva, Tundac sasicocxlod mniSvnelovan seqtorebSi _ magaliTad „energetika“ an „jandacva“ _ TiToeuli seqtoris konkretuli moTxovnebis araproporciulia. ukidures SemTxvevebSi, minimaluri momsaxurebis moTxovnebis warmodgena am seqtorebSi SesaZloa Seesabamebodes 6(4) muxls.122 ¾ evropis socialuri qartia, muxli 19 (4) _ migrant muSakTa da maTi ojaxebis ufleba dacvasa da daxmarebaze dacvasa da daxmarebaze migrat muSakTa da maTi ojaxebis uflebis efeqturad ganxorcielebis mizniT, mxareebi valdebulebas iReben: (4)kanoniT regulirebul an administraciuli organoebis kontrols daqvemdebarebul sferoebSi, TavianT teritoriaze kanonierad myofi aseTi muSakebis mimarT gamoiyenon iseTi xelsayreli reJimi, rogoric sakuTari moqalaqeebis mimarT, Semdeg sakiTxebTan dakavSirebiT: b)profesiuli kavSirebis wevroba da koleqtiur xelSekrulebebTan dakavSirebuli upiratesobebiT sargebloba; ¾ evropis socialuri qartia, muxli 6 _ koleqtiuri molaparakebebis warmoebis ufleba koleqtiuri molaparakebebis warmoebis uflebis efeqturi ganxorcielebis mizniT, mxareebi valdebulebas iReben: (1) xeli Seuwyon muSakebsa da damsaqmeblebs Soris erToblivi konsultaciebis Catarebas; (2) aucileblobis da mizanSewonilobis SemTxvevaSi, xeli Seuwyon damsaqmebelTa an muSakTa organizaciebs Soris nebayofilobiT konsultaciebis Catarebis meqanizmis amoqmedebas, koleqtiuri xelSekrulebebis dadebis gziT, dasaqmebis vadebisa da pirobebis gansazRvris mizniT; (3) xeli Seuwyon morigebisa da nebayoflobiTi saarbitraJo meqanizmis gamoyenebas SromiTi davebis gadawyvetis mizniT; da aRiareben: (4) muSakTa da damsaqmebelTa uflebas miiRon koleqtiuri zomebi interesTa konfliqtis SemTxvevaSi gaficvis uflebis CaTvliT, im valdebulebebis gaTvaliswinebiT, romlebic SesaZlebelia gamomdinareobdes adre dadebuli koleqtiuri xelSekrulebebidan. 120 evrosabWo. daskvnebi: belgia. (XV-1); daskvnebi: safrangeTi. (XV-1). 121 evrosabWo. daskvnebi: norvegia. (X-1). qartiis 31 muxlTan dakavSirebiT. 122 evrosabWo. daskvnebi I. 6§4 muxlis ganmarteba; bulgareTis damoukidebeli profesiuli kavSirebis konfederacia, Sromis konfederacia`Podkrepa~ da veropis profesiuli kavSirebis konfederacia v. bulgareTi (32/2005). 2006 wlis 16 oqtombris gadawyvetileba. 109 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba • 6(4) muxlis Tanaxmad sajaro moxelebi sargebloben uflebiT moawyon gaficva. dauSvebelia am uflebiT sargeblobis akrZalva. miuxedavad amisa SesaZloa SezRudul iqnas garkveuli kategoriis sajaro moxeleebis gaficva. G muxlis Tanaxmad, es SezRudvebi unda Semofarglul iqnas im sajaro moxeleebiT, romelTa valdebulebebi da funqciebi, maTi pasuxismgeblobis xasiaTisa da xarisxidan gamomdinare, pirdapir dakavSirebulia erovnul usafrTxoebsaTan an zogad sazogadoebriv interesebTan. • gaficva ar unda ganixilebodes rogorc gaficuli TanamSromlebis mier xelSekrulebiT gansazRvruli valdebulebebis darRveva, rac gulisxmobs maTi dasaqmebis xelSekrulebis darRvevas; monawileobas unda Tan erTvodes gaTavisuflebis akrZalva. Tu gaficvis dasrulebis Semdeg gaficulebs srulad SeunarCundebaT manamde arsebuli mdgomareoba (mag. pensiebi, Svebulebebi), am SemTxvevaSi dasaqmebis xelSekrulebis oficialuri Sewyveta ar arRvevs 6(4) muxls.123 nebismieri daqviTva gaficulebis xelfasebidan ar unda aRematebodes maTi gaficvaSi monawileobis xangrZlivobis periodSi misaReb xelfass.124 is TanamSromlebi, romlebic ar arian gaficuli profesiuli kavSiris wevrebi, magram monawileobdnen gaficvaSi, unda sargeblobdnen igive dacviT rogorc profesiuli kavSiris wevrebi. ¾ evropis socialuri qartia, muxli 21 _ informaciiTa da konsultaciebiT sargeblis ufleba SromiT dawesebulebaSi momuSave pirTa mier informaciaTa da konsultaciebiT sargeblobis uflebis efeqturad ganxorcielebis mizniT, mxareebi valdebulebas iReben miiRon an mxari dauWiron iseT zomebs, romlebic saSualebas miscems muSakebs an maT warmomadgenlebs, erovnuli kanonmdeblobisa da praqtikis Sesabamisad: a) regularulad an saTanado dros da amomwuravad iyvnen informirebuli maTi damsaqmebeli SromiTi dawesebulebis ekonomikuri da finansuri mdgomareobis Sesaxeb, imis gaTvaliswinebiT, rom garkveuli informacia, romlis gamJRavnebac zians moutans SromiT dawesebulebas, SeiZleba gamocxaddes konfidecialurad; da b) saTanado dros gaewioT konsultacia iseT gadawyvetilebebTan dakavSirebiT, romlebmac SeiZleba mniSvnelovani zegavlena iqonios muSakTa interesebze, kerZod SromiT dawesebulebaSi maTi dasaqmebis mdgomareobaze. ¾ evropis socialuri qartia, muxli 22 _ samuSao pirobebisa da samuSao garemos Seqmnasa da gaumjobesebaSi monawileobis miRebis ufleba samuSao pirobebisa da samuSao garemos Seqmnasa da gaumjobesebaSi muSakTa mier monawileobis miRebis uflebis efeqturad ganxorcielebis mizniT, mxareebi valdebulebas iReben gaataron iseTi zomebi, romlebic saSualebas miscems muSakebsa da maT warmomadgenlebs, erovnuli kanonmdeblobisa da praqtikis Sesabamisad, monawileoba miiRon: (a) samuSao pirobebis, muSaobis organizaciisa da samuSao garemos gansazRvrasa da gaumjobesebaSi; (b)SromiT dawesebulebaSi higienisa da usafrTxoebis dacvaSi; (g) SromiT dawesebulebaSi socialuri da social-ekonomikuri samsaxurebis organizebaSi; (d) am sakiTxebze miRebuli aqtebis Sesrulebis zedamxedvelobaSi; 123 evrosabWo. daskvnebi: I. 6§4 muxlis ganmarteba 124 evrosabWo. daskvnebi: safrangeTi. (XIII -1); Confйdйrati on Franзaise de l’Encadrement (CFE CGC) v. France. (16/2003). gadawyvetileba 12.11.2004 110 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.4 ¾ adamianis uflebaTa dacvis konvencia, muxli 11 _ Sekrebisa da gaerTianebis Tavisufleba (1) yvelas aqvs ufleba mSvidobiani Sekrebis Tavisuflebisa, agreTve sxvebTan gaerTianebis Tavisuflebisa, maT Soris, ufleba profesiuli kavSirebis Seqmnisa da masSi gaerTianebisa sakuTari interesebis dasacavad. • profesiuli kavSirebis Camoyalibebisa da maTSi gawevrianebis ufleba gaerTinanebis Tavisuflebis Semadgeneli nawilia da ar gancalkevebul da damoukidebel uflebas.125 • me-11 muxli calke ar uzrunvelyofs profesiuli kavSirebis raime konkretul uflebas, rogoricaa magaliTad gaficvis an mTavrobasTan konsultaciebis warmoebis ufleba.126 profesiuli kavSirebis azri gaTvaliswinebul unda iqnas da maT unda hqondeT ufleba miiRon zomebi raTa daicvan maTi wevrebis samuSao interesebi.127 • es dacva SeiZleba moicavdes gaficvis uflebas, romlis SezRudva mxolod garkveuli garemoebebis gaTvaliswinebiT SeiZleba.128 samarTalwarmoebis ufleba da masTan dakavSirebuli uflebebi jandacvis provaiderebs aqvT samarTalwarmoebis ufleba, rodesac maT winaaRmdeg (mxare samedicino dawesebuleba da ara fizikuri piri) Setanilia sarCeli. adamianis uflebaTa evropuli sasamarTlo, samarTliani sasamarTlo procesis farTo ganmartebas iZleva, romelic garantirebulia evropis adamianTa uflebebis dacvis konvenciiT. naTelia, rom es ufleba moicavs iseT sakiTxebs, rogoricaa saavadmyofos winaaRmdeg licenzirebasa da samedicino daudevrobasTan dakavSirebuli saqmeebi. ar aris aucilebeli, rom administraciuli procedurebi akmayofilebdes me-6 muxls, radganac garkveulwilad arsebobs SesaZlebloba apelireba moxdes samarTlebriv procesebze, romlebic ar ukavSirdeba me_6 muxlis standarts. msgavsad ar aris aucilebeli rom samarTalwarmoeba eTanxmebodes samarTliani sasamarTlos standartebs procesis TiToeul etapze. sasamarTlo Seafasebs aris Tu ara mTlianobaSi samarTalwarmoeba samarTliani. es nawili ganixilavs samarTalwarmoebisa da masTan dakavSirebuli uflebebis oTx aspeqts: samarTliani sasamarTlos uflebis ganmarteba evropis adamianis uflebaTa dacvis konvenciis 6(1) muxlSi; samarTlebrivi dacvis efeqtiani saSualeba romelic formulirebulia evropis adamianTa uflebebis dacvis konvenciis 13 muxlSi; piradi cxovrebisa da reputaciis dacvis ufleba _ evropis adamianTa uflebebis dacvis konvenciis 8 muxli; da gamoxatvisa da informaciis Tavisufleba _ evropis adamianTa uflebebis dacvis konvenciis 10 muxli. 125 belgiis policiis erovnuli kavSiri belgiis winaaRmdeg (National Union of Belgian Police v. Belgium). (1 EHRR 578). 126 Smidti da dalStromi SvedeTis winaaRmdeg (Schmidt and Dahlstrom v. Sweden). (1 EHRR 632). 127 belgiis policiis erovnuli kavSiri belgiis winaaRmdeg (National Union of Belgian Police v. Belgium). (1 EHRR 578). 128 vilsoni da orsi didi britaneTis winaaRmdeg (35 EHRR 20). sasamarTlom daadgina 11 muxlis darRveva sadac kanoni nebas aZlevda damsaqmebels uareyo profesiuli kabSirebis aRiareba saerTo molaparakebebis mizniT da SeeTavazebina wamaxalisebeli faqtorebi TanamSromlebisaTvis raTa maT daeTmoT profesiuli kavSiriT miniWebuli garkveuli uflebebi. 111 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba aRsaniSnavia, rom evropis adamianTa uflebebis dacvis konvenciaSi ar arsebobs informaciis TavisuflebasTan dakavSirebuli calke ufleba da muxli 10 (gamoxatvis Tavisufleba) mxolod SezRudul dacvas uzrunvelyofs informaciasTan dakavSirebiT. ar aris mocemuli informaciis gavrcelebis ufleba, xolo misi miRebis ufleba Zalzed viwrod aris ganmartebuli. gamoxatvis Tavisufleba SesaZloa legitimurad SezRudul iqnas, muxli 8 gamoyenebiT, rac gulisxmobs sxvaTa uflebebisa da reputaciis dacvas. magaliTad, medias ar aqvs sruli ufleba gamoaqveynos usafuZvlo Setevebi sajaro moxeleebis mimarT. samarTliani sasamarTlo ganxilvis ufleba uflebis potenciur darRvevaTa magaliTebi eqims, romelis winaaRmdegac mimdinareobs disciplinaruli saqmis ganxilva, saSualeba ar mieca edava mis winaaRmdeg wayenebul braldebebze; yovelgvari ganmartebebis gareSe disciplinarulma organom gadawyvita, rom misi sxdomebi unda iyos daxuruli; meddis disciplinarul gadacdomaze, ganxilva sam welze met xans grZeldeba, romlis ganmavlobaSi igi droebiT CamoSorebulia saqmianobas. adamianis uflebaTa standartebi da interpretacia ¾ evropis adamianTa uflebebis dacvis konvenciis 6(1) muxli _ samarTliani sasamarTlo ganxilvis ufleba samoqalaqo uflebaTa da movaleobaTa gansazRvrisas an wardgenili sisxlis samarTlebrivi nebismieri braldebis safuZvlianobis gamorkvevisas yvelas aqvs gonivrul vadaSi misi saqmis samarTliani da saqveyno ganxilvis ufleba kanonis safuZvelze Seqmnili damoukidebeli da miukerZoebeli sasamarTlos mier. sasamarTlo gadawyvetileba cxaddeba saqveynod, Tumca mTel sasamarTlo procesze an mis nawilze presa da sazogadoeba SeiZleba ar dauSvan, demokratiul sazogadoebaSi zneobis, sazogadoebrivi wesrigis an erovnuli uSiSroebis interesebidan gamomdinare, agreTve, rodesac amas moiTxovs arasrulwlovanTa interesebi an mxareTa piradi cxovrebis dacva, an ramdenadac, sasamarTlos azriT, es mkacrad aucilebelia gansakuTrebuli garemoebebis arsebobis gamo, vinaidan saqveynooba zians miayenebda marTlmsajulebis interesebs. • evropis adamianTa uflebebis dacvis konvenciis 6(1) muxli vrceldeba samoqalaqo an sisxlis samarTlis saqmeebze. igi aseve moicavs saxelmwifosa da kerZo pirebs an mxareebs Soris yvela proceduras, romlis Sedegic „gadamwyvetia“ samoqalaqo uflebebisa da movaleobebis dacvisaTvis.129 129 ringeiseni avstriis winaaRmdeg (1 EHRR 466). 112 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.4 • saqmeSi konigi germaniis federaciuli respublikis winaaRmdeg, sasamarTlom daadgina: „miuxedavad imisa unda miekuTvnos Tu ara ufleba samoqalaqo uflebebs... es unda ganisazRvrebodes konkretuli saqmis SinaarsiTa da ara Sesabamisi saxelmwifos kanonmdeblobaSi misi klasifikaciis mixedviT“.130 • ubralo sagamomZieblo procedura ar ukavSirdeba 6(1) muxls.131 • evropis adamianis uflebebis dacvis sasamarTlom daadastura, rom samoqalaqo uflebebi da movaleobebi nagulisxmebia disciplinarul samarTalwarmoebaSi, romelic gansazRvravs profesiuli saqmianobis uflebas. evropis adamianis uflebebis dacvis sasamarTlo xelmZRvanelobda samedicino sferos warmomadgenelTa sarCelebiT.132 aseve mocemulia licenzirebis Sesaxeb gadawyvetilebebi.133 • 6(1) muxli Cveulebriv gamoiyeneba rodesac kerZo piri kompensacias iTxovs sajaro moxelisagan ukanono qmedebisaTvis. samedicino daudevrobis gamo saavadmyofos winaaRmdeg samarTlebrivi procedurebi aseve eqvemdebareba aRniSnul muxls.134 • kerZo samarTlebriv urTierTobebTan dakavSirebuli davebi kerZo damqiraveblebsa da daqiravebul muSakebs Soris 6(1) muxliT regulirdeba.135 miuxedavad amisa, rogorc zogadi wesi, mocemuli muxli ar vrceldeba sajaro moxeleebis dasaqmebasTan dakavSirebul davebze.136 samoqalaqo procesSi mxares ufleba aqvs: 1. hqondes realuri da efeqturi xelmisawvdomoba sasamarTloze; 2. miiRos Setyobineba procesis drosa da adgilis Sesaxeb;137 3. hqondes realuri SesaZlebloba warmoadginos sakuTari saqme; • samoqalaqo saqmeebSi ar arsebobs samarTlebrivi daxmarebis gansakuTrebuli saWiroeba. Tumca, imisaTvis, rom uzrunvelyofili iyos xelmisawvdomobis ufleba da samarTlianoba, konkretul SemTxvevebSi SesaZloa saWiro gaxdes garkveuli daxmareba.138 • saqmis wardgena ar warmoCindeba ise efeqturad samoqalaqo konteqstSi, rogorc es xdeba sisxlis samarTlis konteqstSi. sasamarTloze daswrebasa da zepir ganxilvaze ar arsebobs avtomaturi moTxovna. am SemTxvevaSi moqmedebs „mxareTa Tanasworuflebianobis“ principi.139 130 koning v. germaniis federaluri respublikis winaaRmdeg (2 EHRR 170). 131 faiedi didi britaneTis winaaRmdeg (18 EHRR 393). 132 konigi germaniis winaaRmdeg (Konig v. Germany). (2 EHRR 170). disciplinuri RonisZiebebis Sedegad ganmcxadebels SeuCerda samedicino klinikis muSaobis ufleba 133 konigi germaniis winaaRmdeg (Konig v. Germany). (2 EHRR 170); uikramsingi gaerTianebuli samefos winaaRmdeg (Wickramsinghe v. UK). (31503/96). 134 H safrangeTis winaaRmdeg (H v. France). (12 EHRR 74). 135 obermaieri avstriis winaaRmdeg (Obermeier v. Austria). (13 EHRR 290). 136 lombardo italiis winaaRmdeg (Lombardo v. Italy). (21 EHRR 188). 137 de la pradeli safrangeTis winaaRmdeg (De La Pradelle v. France). (A 253-B). 138 aieri irlandiis winaaRmdeg (A irey v. Ireland). (2 EHRR 305); P da Ors gaerTianebuli samefos winaaRmdeg (P and Ors v. UK). (35 EHRR 31). 139 ruis-marti espaneTis winaaRmdeg (Ruiz-Marti n v. Spain). (16 EHRR 505). 113 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba • orive mxares ufleba aqvs informirebuli iyos meore mxaris mier warmodgenili ganacxadisa da sxva werilobiTi masalebis Taobaze da aqvs ufleba gasces pasuxi.140 • miuxedavad imisa, rom sasamarTlo ar aris valdebuli miiRos eqspertis daskvna mxolod imitom, rom erTi mxare amas iTxovs,141 im SemTxvevebSi rodesac iniSneba eqsperti, daculi unda iqnas „mxareTa Tanasworuflebianobis“ principi.142 • imisaTvis, rom gamotanili iyos gonivruli gadawyvetilebis, sasamarTlo ar aris valdebuli detaluri pasuxi gasces TiToeul arguments, igi unda Seexos saqmis arsebiT sakiTxebs.143 • disciplinaruli an administraciuli wesiT saqmis ganxilvis SemTxvevaSi ar aris aucilebeli procesi yvela etapze akmayofilebdes me_6 muxls.144 • msgavsad, im SemTxvevaSic Tu sasamarTlo organo ar aris miukerZoebeli da damoukidebeli igi ar daarRvevs 6(1) muxls Tu ganxilva eqvemdebareba kontrols im organos mier, romelsac gaaCnia uflebamosileba gaauqmos misi gadawyvetileba.145 • sajaro sasamarTlo sxdomis ufleba moicavs eqimTa disciplinarul sxdomebs.146 • gansazRvra procesi ramdenad gonivrul vadebSi Catarda, damokidebulia Sesabamis garemoebebze, maT Soris saqmis sirTuleze, momCivanis qcevaze da aseve gansaxilveli saqmis mniSvnelobaze.147 drois periodi iwyeba sarCelis Setanidan148 da ar sruldeba manam sanam yvela sakiTxi _ maT Soris apelacia da xarjebis gansazRvra _ ar dasruldeba.149 140 dombo beeri b. v. niderlandebis winaaRmdeg (Dombo Beheer B. V. v. The Netherlands). (18 EHRR 213). 141 H safrangeTis winaaRmdeg (H v. France). (12 EHRR 74). 142 m antuaneli safrangeTis winaaRmdeg (M antovanelli v. France). (24 EHRR 370). mosarCeles samedicino daudevrobis braldebis saqmeze ar mieca saSualeba instruqcia mieca sasamarTlos mier daniSnuli eqspertisaTvis. 143 heli fineTis winaaRmdeg (Helle v. Finland). (26 EHRR 159). 144 le kompti belgiis winaaRmdeg (Le Compte v. Belgium). (5 EHRR 533). samedicino disciplinaruli organos warmodgenili kasaciis ganxilva arasakmarisi iyo 6(1) muxlisaTvis radganac sasamarTlom ar ganixila saqmis garemoebebi radganac isini misi iurisdiqciis gareT imyofebodnen. 145 kingsli gaerTianebuli samefos winaaRdeg (Kingsley v. UK). (35 EHRR 10). 146 dineti safrangeTis winaaRmdeg (Diennet v. France). (21 EHRR 554). daskvnil iqnas rom eqimis Seusabamo qcevis gansaxilveli sxdoma unda Catarebuliyo sajarod, garda im SemTxvevis Tu konfidencialuri, piradi an profesiuli sakiTxebi warmoiSveboda saqmis warmoebisas. 147 gasti da popi germaniis winaaRdeg (Gast and Popp v. Germany). (33 EHRR 37). 148 skopeliti italiis winaaRmdeg (Scopelliti v. Italy). (17 EHRR 493); darneli gaerTianebuli samefos winaaRmdeg (Darnell v. UK) (18 EHRR 205). mTeli cxra wlis ganmavlobaSi _ mosarCelis samsaxuridan gaTavisuflebis Sesaxeb dava, romelsac mohyva ramdenime samarTlebrivi gadaxedvebi, samewarmeo tribunalis sxdoma da dasaqmebis saapelacio tribunalis sxdoma _ CaiTvala ara keTilgonivrulad. 149 somie gaerTianebuli samefos winaaRmdeg (Somjee v. UK). (36 EHRR 16). 114 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.4 efeqturi samarTlebrivi dacvis ufleba uflebis potenciur darRvevaTa magaliTebi eqims ar eZleva Sesabamisi kompensacia mas Semdeg, rac mis reputacias miadga ziani samedicino daudevrobis usafuZvlo da yalbi braldebebis niadagze, romlebic gaCnda presaSi; meddas ar SeuZlia dasaqmebis tribunalis gadawyvetileba gaasaCivros sasamarTloSi. adamianis uflebaTa standartebi da interpretacia ¾ evropis adamianTa uflebebis dacvis konvenciis muxli 13 _ samarTlebrivi dacvis efeqtiani saSualebis ufleba yvelas, visac daerRva am konvenciiT gaTvaliswinebuli uflebebi da Tavisuflebebi, unda hqondes samarTlebrivi dacvis efeqtiani saSualeba erovnuli xelisuflebisagan, Tundac es darRveva Caidinos pirma, romelic samsaxurebriv uflebamosilebas axorcielebda. • me_13 muxlSi mocemuli gansazRvrebebis Tanaxmad, samarTladacvis xelmisawvdomoba unda moicavdes sarCelis gansazRvras da misi dakmayofilebis SesaZleblobas. Seswavlil unda iqnas yvela procedura, maT Soris samarTlebrivi da ara samarTlebrivi.150 • samarTlebrivi dacvis oficialuri saSualebebi, romlebic unda akmayofilebdnen me_13 muxlis moTxovnebs,151 damokidebulia savaraudo darRvevis xasiaTze. umetesoba SemTxvevebSi, kompensacia sakmarisi iqneba. yvela SemTxvevaSi samarTlebrivi dacvis saSualeba unda iyos efeqturi rogorc praqtikulad aseve samarTlebrivad, rac gulisxmobs, rom ar unda hqondes adgili Seusabamo Carevas saxelmwifo moxeleebis mxridan.152 • uflebamosili piri, romelsac SeuZlia uzrunvelyos samarTlebrivi dacva, damoukidebeli unda iyos darRvevis Camdeni organosagan.153 150 silveri gaerTianebuli samefos winaaRmdeg (Silver v. UK). (5 EHRR 347). 151 peki gaerTianebuli samefos winaaRmdeg (Peck v. UK). (36 EHRR 41). 152 aqsoi TurqeTis winaaRmdeg (Aksoy v. Turkey). (23 EHRR 553). 153 qhani gaerTianebuli samefos winaaRmdeg (Khan v. UK). (31 EHRR 45); teilor-sabori gaerTianebuli samefos winaaRmdeg (Taylor-Sabori v. UK). (36 EHRR 17). 115 Tavi 3: pacientze zrunvisas adamianis uflebebis dacvis evropuli gamocdileba piradi cxovrebis da reputaciis pativiscemis ufleba uflebis potenciur darRvevaTa magaliTebi saavadmyofos direqtoris telefoni ismineba winaswari kanonieri sanqciis arsebobis gareSe; eqimi, romelic monawileobs samoqalaqo saqmeSi saavadmyofos winaaRmdeg (vinaidan samsaxuridan gaTavisuflebuli iqna usamarTlod) aRmoaCens, rom misi korespondencia yoveldRiurad mowmdeba da ikiTxeba misi Tanxmobis gareSe. adamianis uflebaTa standartebi da interpretacia ¾ adamianis uflebaTa dacvis konvencia, muxli 8 _ piradi da ojaxuri cxovrebis pativiscemis ufleba (1) yvelas aqvs ufleba, pativi scen mis pirad da ojaxur cxovrebas, mis sacxovrebelsa da mimoweras. (2) dauSvebelia am uflebis ganxorcielebaSi sajaro xelisuflebis Careva, garda iseTi SemTxvevisa, rodesac aseTi Careva xorcieldeba kanonis Sesabamisad da aucilebelia demokratiul sazogadoebaSi erovnuli uSiSroebis, sazogadoebrivi usafrTxoebis an qveynis ekonomikuri keTildReobis interesebisaTvis, uwesrigobis an danaSaulis Tavidan asacileblad, janmrTelobis an zneobisa Tu sxvaTa uflebaTa da TavisuflebaTa dasacavad. adamianis uflebaTa dacvis konvenciis, me_8 muxlis konteqstSi, termini `piradi cxovreba~ SeiZleba moicavdes pirovnebis ofiss, mag. uzrunvelyofdes dacvas telefonis ukanono mosmenisagan.154 dacva SeiZleba exebodes konkretul qcevasa da saqmianobasas, romelsac SesaZloa sazogadoebaSi hqondes adgili, rac damokidebulia pirovnebas ramdenad aqvs piradi cxovrebis xelSeuxeblobis molodini~ da iyo Tu ara es molodini nebayoflobiT daTmobili.155 ¾ adamianis uflebaTa dacvis konvencia, muxli 10 (2) gamoxatvis Tavisuflebis SezRudva sxvaTa uflebebisa da reputaciis dasacavad am TavisuflebaTa ganxorcieleba, ramdenadac is ganuyofelia Sesabamisi valdebulebisa da pasuxismgeblobisagan, SeiZleba daeqvemdebaros iseT wesebs, pirobebs, SezRudvebs an sanqciebs, romlebic gaTvaliswinebulia kanoniT da aucilebelia demokratiul sazogadoebaSi erovnuli uSiSroebis, teritoriuli mTlianobis an sazogadoebrivi usafrTxoebis interesebisaTvis, uwesrigobisa Tu danaSaulis aRsakveTad, janmrTelobis an zneobis dacvis mizniT, sxvaTa reputaciis an uflebaTa dasacavad, saidumlod miRebuli informaciis gamJRavnebis Tavidan asacileblad an sasamarTlo xelisuflebis avtoritetisa da miukerZoeblobis uzrunvelsayofad. 154 halfordi didi britaneTis winaaRmdeg (20605/92). ofisis telefoni mosmena arRvevs 8 muxls. 155 von hanoveri germaniis winaaRmdeg (43 EHRR 7). 116 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 3.4 informaciisa da gamoxatvis Tavisuflebis ufleba uflebis potenciur darRvevaTa magaliTebi Tanamdebobis pirebi ar awvdian TanamSromlebs informacias, rom maT saavadmyofoSi radiaciis saSiSad maRali donea. adamianis uflebaTa standartebi da interpretacia ¾ adamianis uflebebis dacvis konvencia, muxli 10 _ Tavisufali gamoxatvis ufleba maT Soris informaciis ufleba yvelas aqvs ufleba gamoxatvis Tavisuflebisa. es ufleba moicavs piris Tavisuflebas, hqondes Sexedulebebi, miiRos an gaavrcelos informacia Tu mosazrebebi sajaro xelisuflebis Caurevlad da saxelmwifo sazRvrebis miuxedavad. es muxli xels ar uSlis saxelmwifoebs, ganaxorcielon radiomauwyeblobis, satelevizio an kinematografiul sawarmoTa licenzireba. • adamianis uflebaTa dacvis konvenciis me_10 muxlSi ar aris mocemuli informaciis gavrcelebis ufleba. informaciis miRebis ufleba viwrod ganmartebulia, rogorc uflebamosili pirebisaTvis akrZalva, SezRudon pirovneba im informaciis miRebaSi, romlis gavrcelebac sxvebs surT. saxelmwifos ar aqvs pozitiuri valdebuleba informaciis mogrovebasa da gavrcelebaze.156 • vinaidan sajaro moxeleebi unda sargeblobnen sazogadoebis ndobiT, isini SeiZleba daculni iqnan `Seuracxmyofeli sityvieri Setevebisagan~. amgvar SemTxvevaSic ki sajaro moxeleebi valdebulni arian maTTvis miniWebuli Zalaufleba gamoiyenon mxolod samsaxureobrivi daniSnulebiT da ara piradi miznebisaTvis.157 156 guera da ors italiis winaaRmdeg (26 EHRR 357). 157 iankovi bulgareTis winaaRmdeg (39084/97). 117 4.1 Sesavali 4.2 saerTaSoriso sistema 4.3 evropuli sistema 4.4 gasaCivrebis procedura: adamianis uflebaTa evropuli konvencia 118 adamianis uflebebi janmrTelobis dacvis sferoSi 4 saerTaSoriso da regionuli procedurebi 4.1 Sesavali adamianis uflebaTa saerTaSoriso da regionaluri meqanizmebi mniSvnelovan rols asrulebs uflebaTa realizaciis saqmeSi. es meqanizmebi saxelmwifoebma SeimuSaves maT mier ratificirebuli adamianis uflebaTa saerTaSoriso da regionaluri xelSekrulebebis Sesrulebis uzrunvelsayofad. aRniSnuli xelSekrulebebi qmnis adamianis uflebaTa saerTaSoriso e.w. „myar samarTals“, xolo saxelSekrulebo meqanizmebis ganmartebebi qmnis e.w. „rbil samarTals“, romelsac xelisuflebis mimarT pirdapiri samarTlebrivad mboWavi Zala ar gaaCnia. arsebobs aRsrulebis meqanizmebis ori ZiriTadi saxe: • sasamarTloebi, romlebic moqmedeben sasamarTlo uflebamosilebis farglebSi da iReben gadawyvetilebas, romlebic xelisuflebisaTvis tradiciuli gagebiT savaldebulo dokuments warmoadgens; da • komitetebi, romlebic ganixilaven mTavrobaTa mier wardgenil angariSebs maT mier adamianis uflebaTa xelSekrulebebis Sesrulebis Sesaxeb da, zogierT SemTxvevaSi, ganixilaven adamianis uflebebis darRvevasTan dakavSirebul individualur saCivrebs. 119 Tavi 4: saerTaSoriso da regionuli procedurebi 4.2 saerTaSoriso sistema adamianis uflebaTa komiteti (HRC) mandati adamianis uflebaTa komiteti (HRC) zedamxedvelobas uwevs mTavrobis mier samoqalaqo da politikur uflebaTa Sesaxeb saerTaSoriso paqtis (ICCPR) Sesrulebas. komitets gaaCnia ori mandati: monitoringi gauwios saxelmwifos mier paqtis Sesrulebas mTavrobis mier wardgenili perioduli angariSis ganxilvis saxiT da Seiswavlos adamianis uflebebis darRvevasTan dakavSirebuli individualuri saCivrebi paqtis fakultaturi oqmis Sesabamisad. samoqalaqo sazogadoebis monawileoba arasamTavrobo organizaciebs SeuZliaT adamianis uflebaTa komitets warudginon „Crdilovani angariSebi“ mTavrobis mier paqtis Sesrulebis nebismier aspeqtTan dakavSirebiT. Crdilovani angariSebis wardgena unda moxdes komitetis samdivnos meSveobiT, romelic JenevaSi adamianis uflebaTa umaRlesi komisris ofisTan arsebobs da awarmoebs ganrigs, Tu rodis unda wardgnen mTavrobebi komitetis winaSe. komiteti ikribeba weliwadSi samjer. fizikur pirebsa da arasamTavrobo organizaciebs aseve SeuZliaT warudginon komitets saCivrebi paqtis fakultaturi oqmis Sesabamisad. sakontaqto informacia patris Jiliberi komitetis mdivani, UN OG-OHCHR CH 1211 Jeneva 10, Sveicaria tel: +41 22 917 9249; Fax: +41 22 917 9006 el-fosta: [email protected] veb gverdi: htt p://www2.ohchr.org/english/bodies/hrc/index.htm Patrice Gillibert HRC Secretary, UN OG-OHCHR CH 1211 Geneva 10, Switzerland Tel: +41 22 917 9249; Fax: +41 22 917 9006 Email: [email protected] Web: htt p://www2.ohchr.org/english/bodies/hrc/index.htm ekonomikuri, socialuri da kulturuli uflebebis komiteti mandati ekonomikuri, socialuri da kulturuli uflebebis komiteti zedamxedvelobas uwevs mTavrobis mier ekonomikuri, socialuri da kulturuli uflebebis Sesaxeb saerTaSoriso paqtis Sesrulebas. komiteti monitorings uwevs saxelmwifos mier am sferoSi ganxorcielebul progress mTavrobebis mier wardgenili perioduli angariSebis ganxilvis gziT. 120 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 4.2 samoqalaqo sazogadoebis monawileoba arasamTavrobo organizaciebs SeuZliaT ekonomikuri, socialuri da kulturuli uflebebis komitets warudginon „Crdilovani angariSebi“ mTavrobis mier paqtis Sesrulebis nebismier aspeqtTan dakavSirebiT. Crdilovani angariSebis wardgena unda moxdes komitetis samdivnos meSveobiT, romelic JenevaSi adamianis uflebaTa umaRlesi komisris ofisTan arsebobs da awarmoebs ganrigs, Tu rodis unda wardgnen mTavrobebi komitetis winaSe. komiteti ikribeba weliwadSi orjer. sakontaqto informacia van-hi li komitetis mdivani oTaxi 1-025, vilsonis sasaxle, erTa sasaxle 8-14 mSvidobis gamziri CH 1211 Jeneva 10, Sveicaria tel: +41 22 917 9321; Fax: +41 22 917 9046 el-fosta: [email protected] veb gverdi: htt p://www2.ohchr.org/english/bodies/cescr/index.htm Wan-Hea Lee CES CR Secretary Offi ce 1-025, Palais Wilson, Palais des Nati ons 8_14 Avenue de la Paix CH 1211 Geneva 10, Switzerland Tel: +41 22 917 9321; Fax: +41 22 917 9046 Email: [email protected] Web: htt p://www2.ohchr.org/english/bodies/cescr/index.htm rasobrivi diskriminaciis aRmofxvris komiteti mandati rasobrivi diskriminaciis aRmofxvris komiteti (CERD) warmoadgens damoukidebeli eqspertebisagan dakompleqtebul organos, romelic axorcielebs saxelmwfoTa mier rasobrivi diskriminaciis yvela formis aRmofxvris Sesaxeb saerTaSoriso konvenciis Sesrulebis monitorings. is zedamxedvelobas uwevs am kuTxiT saxelmwifoTa mier ganxorcielebul progress mTavrobaTa mier wardgenili perioduli angariSebis ganxilvis gziT. komiteti SemdgomSi SeniSvnebsa da rekomendaciebs warudgens saxelmwifos „daskvniTi mosazrebebis“ formiT. garda saxelmwifoTa mier wardgenili angariSebis komentirebisa, komiteti monitorings axorcielebs aseve adreuli gafrTxilebis procedurisa da saxelmwifoTSorisi da individualuri saCivrebis ganxilvis meSveobiT. 121 Tavi 4: saerTaSoriso da regionuli procedurebi samoqalaqo sazogadoebis monawileoba arasamTavrobo organizaciebs SeuZliaT komitets warudginon „Crdilovani angariSebi“ mTavrobis mier konvenciis Sesrulebis nebismier aspeqtTan dakavSirebiT. Crdilovani angariSebis wardgena unda moxdes komitetis samdivnos meSveobiT, romelic JenevaSi adamianis uflebaTa umaRlesi komisris ofisTan arsebobs da awarmoebs ganrigs, Tu rodis unda wardgnen mTavrobebi komitetis winaSe. komiteti ikribeba weliwadSi orjer. sakontaqto informacia natali pruve rasobrivi diskriminaciis aRmofxvris komitetis mdivani xelSekrulebebisa da komisiis ganyofileba adamianis uflebaTa umaRlesi komisris ofisi, vilsonis sasaxle 52 pbkis quCa CH 1201 Jeneva 10, Sveicaria, safosto misamarTi: UN OG-OHCHR, CH 1211 Jeneva 10, Sveicaria tel: +41.22.917.93.09; Fax: +41.22.917.90.22 el-fosta: [email protected] veb gverdi: htt p://www2.ohchr.org/english/bodies/cerd/ International Labour Organization Nathalie Prouvez Secretary of the Committ ee on the Eliminati on of Racial Discriminati on Treati es and Commission Branch Offi ce of the High Commissioner for Human Rights, Palais Wilson 52 rue des Pвquis CH 1201 Geneva 10, Switzerland ,Mailing address: UN OG-OHCHR, CH 1211 Geneva 10, Switzerland Tel: +41.22.917.93.09; Fax: +41.22.917.90.22 Email: [email protected] htt p://www2.ohchr.org/english/bodies/cerd/ Sromis saerTaSoriso organizacia mandati Sromis saerTaSoriso organizacia (ILO), romelic gaeroSi mdebareobs, ZiriTadad dainteresebulia adamianis uflebaTa dacvis kuTxiT SromiT sferoSi. 1989 wels maT miiRes konvencia damoukidebel qveynebSi mkvidri mosaxleobisa da tomebis Sesaxeb. saxelmwifoebma unda warudginon konvenciis SesrulebasTan dakavSirebuli perioduli angariSebi Sromis saerTaSoriso organizacias, aseve dasaqmebulTa da muSaTa Sidasaxelmwifoebriv asociaciebs. dasaqmebulTa da muSaTa erovnul gaerTianebebs SeuZliaT waradginon Sromis saerTaSoriso organizaciaSi komentarebi aRniSnuli angariSebis Sesaxeb. Sromis saerTaSoriso organizaciis eqspertTa komiteti afasebs angariSebs da SeuZlia gaugzavnos mTavrobebs „pirdapiri moTxovnebi“ damatebiTi informaciis miRebis mizniT. eqspertTa komiteti SemdgomSi aqveynebs „daskvnebs“ angariSSi, romlis wardgena xdeba Sromis saerTaSoriso konferenciaze. am angariSis safuZvelze, konferenciis standartebis gamoyenebis komitets SeuZlia miiRos gadawyvetileba calkeuli individualuri saqmeebis ufro detalurad Seswavlis Sesaxeb 122 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 4.2 da gamoaqveynos Sesabamisi daskvnebi. garda amisa muSaTa da dasaqmebulTa asociacebs SeuZliaT waradginon Sromis saerTaSoriso organizaciaSi gancxadeba imis Taobaze, rom wevrma saxelmwifom ver SeZlo konvenciasTan Sesabamisobis uzrunvelyofa, aseve wevr saxelmwifos SeuZlia Seitanos organizaciaSi saCivari sxva wevri saxelmwifos winaaRmdeg. samoqalaqo sazogadoebis monawileoba konvencia mouwodebs mTavrobebs konsultacia gawion mkvidr mosaxleobasTan angariSebis momzadebis procesSi. mkvidr mosaxleobas SeuZlia aseve SeuerTdes muSaTa gaerTianebas an Camoayalibos sakuTari muSaTa gaerTianeba imisaTvis, rom pirdapir daamyaros kontaqti Sromis saerTaSoriso organizaciasTan. eqspertTa komiteti xvdeba yoveli wlis noembersa da dekemberSi, Sromis saerTaSoriso konferencia tardeba ivnisSi. sakontaqto informacia ofisTan urTierTobis ganyofileba 4 moRilonis quCa CH 1211 Jeneva 22, Sveicaria tel. +41.22.799.7732; faqsi: +41.22.799.8944 el-fosta: [email protected] veb gverdi: www.ilo.org/public/english/index.htm Contact Office Relations Branch 4 ruedes Morilons CH 1211 Geneva 22, Switzerland Tel. +41.22.799.7732; Fax: +41.22.799.8944 Email: [email protected] Web: www.ilo.org/public/english/index.htm qalTa winaaRmdeg diskriminaciis yvela formis aRmofxvris komiteti mandati qalTa winaaRmdeg diskriminaciis yvela formis aRmofxvris komiteti zedamxedvelobas uwevs mTavrobis mier qalTa winaaRmdeg diskriminaciis yvela formis aRmofxvris Sesaxeb konvenciis (CEDAW) Sesrulebas. komitets aqvs sami mandati: saxelmwifos mier CEDAW-s Sesrulebis progresis monitoringi mTavrobaTa mier wardgenili perioduli angariSebis ganxilvis meSveobiT, qalTa uflebebis darRvevebis Sesaxeb individualuri saCivrebis Seswavla CEDAW-s fakultaturi oqmis Sesabamisad, da saxelmwifoebSi misiebis ganxorcieleba im problemebidan gamomdinare, romlebic ukavSirdeba konvenciiT gaTvaliswinebuli uflebebis sistemur an mZime darRvevebs. 123 Tavi 4: saerTaSoriso da regionuli procedurebi samoqalaqo sazogadoebis monawileoba arasamTavrobo organizaciebs SeuZliaT warudginon komitets „Crdilovani angariSebi“ saxelmwifos mier CEDAW-s Sesrulebis nebismier aspeqtTan dakavSirebiT. Crdilovani angariSebis wardgena unda moxdes qalTa gaZlierebis ganyofilebis meSveobiT, romelic niu_iorkSi mdebareobs da awarmoebs ganrigs, Tu rodis unda wardgnen mTavrobebi komitetis winaSe. komiteti ikribeba weliwadSi orjer. fizikur pirebsa da arasamTavrobo organizaciebs SeuZliaT aseve waradginon komitetSi saCivrebi fakultaturi oqmis Sesabamisad, an SeuZliaT SesTavazon komitets, ganaxorcielos misia konkretul saxelmwifoSi, rogorc mis mier warmoebuli gamoZiebis proceduris nawili. sakontaqto informacia cu-vei Cangi koordinaciisa da sazogadoebasTan urTierTobis departamenti, qalTa gaZlierebis ganyofileba ekonomikuri da socialuri sakiTxebis departamenti ori gaeros plaza oTaxi DC2, 12 sarTuli niu iorki, NY 10017 tel: +1 (212) 963-8070; faqsi: +1 (212) 963-3463 el-fosta: [email protected] vebgverdi: htt p://www.un.org/womenwatch/daw/cedaw/cedaw38/NG Onote.pdf Contact Tsu-Wei Chang Coordinati on and Outreach Unit, Division for the Advancement of Women Department of Economic and Social Aff airs Two UN Plaza Room DC2, 12th Floor New York, NY 10017 Tel: +1 (212) 963-8070; Fax: +1 (212) 963-3463 Email: [email protected] Web: htt p://www.un.org/womenwatch/daw/cedaw/cedaw38/NG Onote.pdf bavSvis ulebaTa komiteti mandati bavSvis ulebaTa komiteti zedamxedvelobas uwevs saxelmwifos mier bavSvis uflebaTa konvenciis Sesrulebas. is axorcielebs saxelwifos mier konvenciis Sesrulebis progresis monitorings mTavrobaTa mier wardgenili perioduli angariSebis ganxilvis meSveobiT. 124 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 4.2 samoqalaqo sazogadoebis monawileoba arasamTavrobo organizaciebs SeuZliaT warudginon komitets „Crdilovani angariSebi“ saxelmwifos mier konvenciis Sesrulebis nebismier aspeqtTan dakavSirebiT. Crdilovani angariSebis wardgena unda moxdes bavSvis uflebaTa konvenciis samdivnos meSveobiT, romelic JenevaSi adamianis uflebaTa umaRlesi komisris ofisTan mdebareobs da awarmoebs ganrigs, Tu rodis unda wardgnen mTavrobebi komitetis winaSe. sakontaqto informacia maia andiaeviC-boko komitetis mdivani, 8-14 mSvidobis gamziri, CH 1211 Jeneva 10, Sveicaria tel: +41 22 917 9000; faqsi: +41 22 917 9022 el-fosta: [email protected] www2.ohchr.org/english/bodies/crc/index.htm Maja Andrijasevic-Boko CRC Secretary, 8_14 Avenue de la Paix, CH 1211 Geneva 10, Switzerland Tel: +41 22 917 9000; Fax: +41 22 917 9022 Email: [email protected] www2.ohchr.org/english/bodies/crc/index.htm gaeros qartiis Sesabamisad dafuZnebuli organoebi zemoT CamoTvlil saxelSekrulebo organoebTan erTad, arsebobs aseve rigi organoebi, romlebic Seqmnilia adamianis uflebaTa dacvisa da popularizaciis mizniT gaeros qartiis Sesabamisad. qartiis Sesabamisad Seqmnili ZiriTadi organoa adamianis uflebaTa sabWo (HRC), romelmac Secvala adamianis uflebaTa komisia (CHR) 2006 wels. sabWo gaeros generaluri asambleis damxmare organoa, romlis mandati iTvaliswinebs „adamianis uflebaTa darRvevebTan, maT Soris mniSvnelovan da sistemur darRvevebTan dakavSirebuli situaciis daregulirebas“. sabWos movaleobebi moicavs: universalur periodul gadaxedvas (UPR), specialur procedurebs, adamianis uflebaTa sabWos mrCevelTa komitets (adamianis uflebaTa popularizaciisa da dacvis yofil qve-komisias) da saCivrebis proceduras. es funqciebi Sejamebulia Semdeg veb gverdze: htt p://www2.ohchr.org/english/bodies/hrcouncil/. universaluri perioduli gadaxedva UPR 2008 wlidan adamianis uflebaTa sabWo periodulad ganaxorcielebs saxelmwifoTa mier adamianis uflebebTan dakavSirebuli movaleobebisa da valdebulebebis gadaxedvas. gaeros wevri yvela saxelmwifo gaivlis am kontrols oTxi weliwadSi erTxel. gadaxedvis gansaxorcieleblad samuSao jgufi Seikribeba weliwadSi samjer ori kviriT. gadaxedvisas mxedvelobaSi iqneba miRebuli Sesabamisi saxelmwifos mier wardgenili angariSi, specialuri procedurebisa da saxelSekrulebo organoebis rekomendaciebi da arasamTavrobo organizaciebisa da adamianis uflebaTa erovnuli institutebis mier wardgenili informacia. 125 Tavi 4: saerTaSoriso da regionuli procedurebi specialuri procedurebi „specialuri procedurebi“ aris zogadi termini, romliTac moixsenieben im fizikur pirebs (specialur momxseneblebs, specialur warmomadgenlebs, an damoukidebel eqspertebs) an jgufebs (samuSao jgufebi), romlebsac adamianis uflebaTa sabWos mier miniWebuli aqvT mandati Seiswavlon konkretul qveynebSi arsebuli specifiuri situaciebi an Tematuri sakiTxebi mTeli msoflios masStabiT. sabWoSi amJamad gaTvaliswinebulia 28 Tematuri da 10 saxelmwifoebrivi specialuri procedura. specialuri procedurebis saqmianoba moicavs individualur saCivrebze reagirebas, kvlevebis ganxorcielebas, saxelmwifoebriv doneze teqnikur TanamSromlobasTan dakavSirebiT rCevebis gawevas da uflebaTa ganmtkicebisaken mimarTul zogad saqmianobaSi monawileobas. specialuri procedurebi ganixileba rogorc „yvelaze efeqturi, moqnili da qmediTi meqanizmebi gaeros sistemaSi“. specialuri procedurebi, romlebic winamdebare praqtikosTa saxelmZRvaneloSia moxseniebuli moicavs: • samuSao jgufi TviTneburi dakavebis sakiTxebze; • specialuri momxsenebeli eqstrasasamarTlo, gamartivebuli an TviTneburi aRsrulebis sakiTxebis Sesaxeb • specialuri momxsenebeli yvelas uflebaze isargeblos fizikuri da fsiqikuri janmrTelobis yvelaze maRali standartiT • specialuri momxsenebeli qalTa winaaRmdeg Zaladobis, misi mizezebisa da Sedegebis sakiTxebze • detaluri informaciisaTvis specialuri procedurebis Sesaxeb ixileT htt p://www.ohchr. org/english/bodies/chr/special/index.htm. adamianis uflebaTa sabWos mrCevelTa komiteti adamianis uflebaTa sabWos mrCevelTa komiteti funqcionirebs rogorc think tank, uzrunvelyofs sabWosaTvis eqspertizisa da rCevebis miwodebas, axorcielebs aseve Temtur kvlevebs sabWosaTvis saintereso sakiTxebze, misive moTxovniT. komiteti 18 eqspertisagan Sedgeba, romelTa uflebamosilebis vada 3 welia. saCivrebis procedura saCivrebis konfidencialuri procedura fizikur pirebsa da organizaciebs aZlevs SesaZleblobas adamianis uflebaTa sabWos warudginon saCivrebi „adamianis uflebaTa mniSvnelovan da sarwmunod dadasturebul darRvevebze“. proceduris mizania iyos „msxverplze orinetirebuli“ da ivaraudeba, rom gamoZiebebi Catardeba droulad. saCivrebs ganixilavs ori samuSao jgufi, romelic ikribeba weliwadSi sul cota orjer, xuTi dRiT. 126 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 4.3 ekonomikuri da socialuri sabWo gaeros ekonomikuri da socialuri sabWo (ECOSOC) koordinacias uqevs gaeros im 14 specializirebuli saagentos, funqcionaluri komisiebis da regionuli komisiebis saqmianobas, romlebic sxvadasxva saerTaSoriso ekonomikur, socialur, kulturul, saganmanaTlebo da jandacvis sakiTxebze muSaoben. sabWo weliwadSi atarebs ramdenime mokle sxdomas da ZiriTad yovelwliur sxdomas ivlissSi, romelic oTxi kvira grZeldeba. sabWo regularulad axorcielebs konsultacias samoqalaqo sazogadoebasTan, daaxloebiT 3 000 arasamTavrobo organizacias miniWebuli aqvs sakonsultacio statusi. sabWos mier akreditirebul arasamTavrobo organizaciebs ufleba aqvT monawileoba miiRon, waradginon werilobiTi mosazrebebi da gancxadebebiT wardgnen sabWosa da misi damxmare organoebis winaSe. informacia arasamTavrobo organizaciebze, romlebsac sakonsultacio statusi aqvT miniWebuli, ixileT veb gverdze htt p://www.un.org/esa/coordinati on/ngo/. sabWos saagentoebi da komisiebi, romlebic SeiZleba moxseniebulni iyvnen an ukavSirdebodnen winamdebare praqtikosTa saxelmZRvanelos: • komisia qalTa statusis Sesaxeb • komisia narkotikul saSualebebze • komisia danaSaulis prevenciasa da sisxlis samarTalze • ekonomikuri, socialuri da kulturuli uflebebis komiteti • narkotikebis kontrolis saerTaSoriso sabWo 4.3 evropuli sistema adamianis uflebaTa evropuli sasamarTlomandati mandati adamianis uflebaTa evropuli sasamarTlo (ECtHR), evropis sabWos organoa, romelic uzrunvelyofs adamianis uflebaTa evropuli konvenciis (ECHR) debulebebis Sesrulebas. sasamarTlo ganixilavs davebs saxelmwifoTa Soris da saCivrebs adamianis uflebaTa individualur darRvevebze. evropis sabWos ministrTa komiteti pasuxismgebelia sasamarTlos mier gamotanili ganCinebebis aRsrulebis monitoringze (ixileT ministrTa komitetTan dakavSirebuli, qvemoT mocemuli informacia). samoqalaqo sazogadoebis monawileoba nebismier fizikuri pirs an saxelmwifos SeuZlia Seitanos saCivari uSualod sasamarTloSi konvenciiT gaTvaliswinebuli romelime uflebis darRvevis Sesaxeb im SemTxvevaSi, Tu man amowura samarTlebrivi dacvis yvela Sidasaxelmwifoebrivi saSualeba. ganacxadis formis mopoveba SesaZlebelia sasamarTlos veb gverdze (www.echr.coe.int/echr/). 127 Tavi 4: saerTaSoriso da regionuli procedurebi evropis sabWom Seqmna samarTlebrivi daxmarebis sistema ganmcxadebelTaTvis, romlebsac ar aqvT SesaZlebloba isargeblon iuridiuli warmomadgenlobiT. arasamTavrobo organizaciebs SeuZliaT waradginon informacia konkretul saqmeebTan dakavSirebiT sasamarTlos prezidentis miwvevis safuZvelze an amici curiae (`sasamarTlos megobrebi~) formiT, Tu maT SeuZliaT daamtkicon, rom aqvT interesi saqmeSi an floben specialur codnas ganxilvis sakiTxTan dakavSirebiT da SeuZliaT aseve uCvenon, rom maTi CarTva ganxilvaSi xels Seuwyobs marTlmsajulebis ganxorcielebas. sasamarTlo mosmena, rogorc wesi, Riaa. sakontaqto informacia adamianis uflebaTa evropuli sasamarTlo evropis sabWo F-67075 strasburgi-Cedex, safrangeTi tel: +33 3 88 41 20 18; faqsi: + 33 3 88 41 27 30 veb gverdi: www.echr.coe.int socialuri uflebebis evropuli komiteti mandati socialuri uflebebis evropuli komiteti (ECSR), aseve evropis sabWos organoa, romelic axorcielebs mTavrobaTa mier evropis socialuri qartiis (ES C) debulebaTa Sesrulebis regularul samarTlebriv Sefasebas. es Sefasebebi efuZneba angariSebs, romelTa wardgena xdeba mTavrobaTa mier periodulad oridan oTx wlamde intervalebiT, rasac zedamxedvelobis ciklebi ewodeba. samTavrobo komiteti da evropis sabWos ministrTa komiteti aseve afaseben mTavrobis mier wardgenil angariSebs (ixileT ministrTa komitetTan dakavSirebuli qvemoT mocemuli informacia). samoqalaqo sazogadoebis monawileoba mTavrobaTa mier qartiis farglebSi wardgenili angariSebi sajaroa da maTze komentaris gakeTeba SeuZliaT fizikur pirebs an arasamTavrobo organizaciebs. saerTaSoriso arasamTavrobo organizaciebs, romlebic evropis sabWoSi sakonsultacio statusiT sargebloben da Sidasaxelmwifoebriv arasamTavrobo organizaciebs, romlebsac amis ufleba miniWebuli aqvT mTavrobis mier, aseve SeuZliaT evropis sabWoSi waradginon koleqtiuri saCivrebi qartiis darRvevasTan dakavSirebiT. sakontaqto informacia veb gverdi: www.humanrights.coe.int/cseweb/GB /index.htm ministrTa komiteti ministrTa komiteti (www.coe.int/cm) evropis sabWos gadawyvetilebis mimRebi organoa. is Sedegeba evropis sabWos yvela wevri saxelmwifos sagareo saqmeTa ministrebisagan (an am 128 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 4.3 saxelmwifoTa mudmivi warmomadgenlebisagan). sasamarTlos gadawyvetilebebis Sesrulebis zedamxedvelobisa da socialuri uflebebis evropuli komitetis farglebSi wardgenili angariSebis Sefasebis garda, ministrTa komiteti aseve amzadebs calke rekomendaciebs wevri saxelmwifoebisaTvis im sakiTxebze, romlebzec komiteti SeTanxmda „saerTo politikaze“ _ maT Soris iseT sakiTxebze, romlebic janmrTelobasa da adamianis uflebebs ukavSirdeba. aRniSnuli rekomendaciebis nawilis wardgena xdeba evropis sabWos saparlamento asambleis (www.assembly.coe.int) mier, romelic wevri saxelmwifoebis parlamentebis warmomadgenlebisagan Semdgari sakonsultacio organoa. mrCevelTa komiteti mandati mrCevelTa komiteti (AC) exmareba ministrTa komitets erovnul umciresobaTa dacvis CarCo konvenciis (FCNM) Sesrulebis monitoringSi. is monitorings uwevs saxelmwifos mier konvenciis Sesrulebas mTavrobaTa mier wardgenili perioduli angariSebis ganxilvis meSveobiT. aRniSnuli angariSebis ganxilvis garda, komitets SeuZlia Caataros Sexvedrebi mTavrobebTan da moiTxovos damatebiTi informacia sxva wyaroebisagan. komiteti Semdeg amzadebs moxsenebas, romelic waredgineba ministrTa komitets. aRniSnuli moxsenebis safuZvelze, ministrTa komiteti gamoscems daskvnebs TiToeuli wevri saxelmwifos mier gatarebuli zomebis adekvaturobis Sesaxeb. ministrTa komitets SeuZlia mrCevelTa komitetis CarTva daskvnebisa da rekomendaciebis Semdgomi Sesrulebis monitoringSi. sakontaqto informacia adamianis uflebaTa generaluri direqtorati erovnul umciresobaTa dacvis CarCo konvenciis samdivno F-67075 strasburgi _ Cedex, safrangeTi tel: +33/(0)3 90 21 44 33; Fax: +33/(0)3 90 21 49 18 el-fosta: [email protected] veg gverdi: www.coe.int/minorities samoqalaqo sazogadoebis monawileoba arasamTavrobo organizaciebs SeuZliaT warudginon mrCevelTa komitets „Crdilovani angariSebi“ mTavrobis mier konvenciis Sesrulebis nebismier aspeqtTan dakavSirebiT. Crdilovani angariSebis wardgena unda moxdes konvenciis samdivnos meSveobiT (htt p://www.coe.int/t/dghl/ monitoring/minoriti es/2_Monitoring/NG O_Intro_en.asp). 129 Tavi 4: saerTaSoriso da regionuli procedurebi 4.4 gasaCivrebis procedura: adamianis uflebaTa evropuli konvencia winamdebare seqcia Seicavs amonaridebsa da ganaxlebul informacias publikaciidan gacxadebuli mkvlelobebi, rogorc adamianis uflebaTa darRvevebi keit tompsonisa da kamil gifardis avtorobiT (gamoqveynebulia adamianis uflebaTa centris mier, esseqsis universiteti). cxrili: ZiriTadi faqtebi adamianis uflebaTa evropuli sasamarTlos Sesaxeb istoria: rogor Seiqmna? 1950 wels adamianis uflebaTa evropuli konvencia, romlis gadaxedvac moxda 11 oqmis meSveobiT, 1994 rodis daiwyo funqcionireba? ganaxlebuli sistemis mixedviT 1998 wels Semadgenloba: ramdeni pirisgan Sedgeba igi? imdeni mosamarTlea, ramdeni wevri saxelmwifoc hyavs konvencias es pirebi damoukidebeli eqspertebi arian Tu saxelmwifos warmomadgenlebi? damoukidebeli eqspertebi ZiriTadi amocana adamianis uflebaTa evropuli konvenciis darRvevaTa Sesaxeb saCivrebis ganxilva funqcia saxelmwifoTSorisi saCivrebi (savaldebulo) (adamianis uflebaTa evropuli konvencia, muxli 33) istoria: individualuri saCivrebi (savaldebulo) (adamianis uflebaTa evropuli konvencia, muxli 34) faqtebis dadgena (mxolod individualuri saCivrebis konteqstSi da rogorc fakultaturi proceduruli nabiji) 130 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 4.4 ra aris dasaSvebobis moTxovnebi? ganacxadi gamocxaddeba dauSveblad Tu: • ganacxadi aris anonimuri; • ganacxadis wardgena ar momxdara saqmeze Sidasaxelmwifoebrivi saboloo gadawyvetilebis gamotanis TariRidan eqvis Tvis ganmavlobaSi; • ganacxadi aSkarad dausabuTebelia, an warmoadgens sasamarTlosaTvis mimarTvis uflebis borotad gamoyenebas; • ganacxadi ar Sesabameba konvenciis debulebebs; • ganacxadi arsebiTad igivea rac sakiTxi, romelic ukve ganxiluli iyo sasamarTlos mier an gadaeca saerTaSoriso gamoZiebis sxva instancias da ar Seicavs Sesatyvis axal informacias; • ar aris amowuruli samarTlebrivi dacvis Sidasaxelmwifoebrivi saSualebebi, garda im SemTxvevebisa, rodesac es saSualebebi araefeqturi an umizezod gaWianurebulia. 2010 wlis 1 ivnisis mdgomareobiT, konvenciis me_14 oqmiT (evropis sabWos xelSekrulebaTa seriebi No. 194), dadgenili dasaSvebobis axali moTxovna SesaZleblobas aZlevs sasamarTlos, rom dauSveblad cnos ganacxadi, Tu ganmcxadebels ar midgomia mniSvnelovani ziani, garda im SemTxvevisa, rodesac adamianis uflebaTa dacva moiTxovs ganacxadis arsebiTad ganxilvas da imis gaTvaliswinebiT, rom dauSvebelia iseTi saqmis ukugdeba, romelic saTanadod ar ganxilula Sidasaxelmwifoebrivi sasamarTlos mier (me_14 oqmis me_ 12 muxli, romelic cvlis konvenciis 35 muxls). imisaTvis, rom Tavidan iqnas acilebuli iseTi saqmeebis ukugdeba, romlebic arsebiT ganxilvas saWiroebs, erT mosamarTlesa da komitetebs ar SeuZliaT am axali kriteriumis gamoyeneba me_14 oqmis ZalaSi Sesvlidan pirvli ori wlis ganmavlobaSi (oqmis me_20 muxli). ras unda moicavdes Tqveni ganacxadi/sarCeli? Tqveni Tavdapirveli ganacxadi/sarCeli unda moicavdes: • Tqveni saCivrebis mokle Sejamebas; • miTiTebas, konvenciis romeli muxli dairRva Tqveni azriT; • miTiTebas, samarTlebrivi dacvis saSualebebze, romlebic Tqven gamoiyeneT; • Tqvens saqmesTan dakavSirebuli oficialuri gadawyvetilebebis CamonaTvals, informacias vis mier iqna miRebuli es gadawyvetilebebi da rogoria maTi Sinaarsi (Tan daurTeT TiToeuli gadawyvetilebis asli). Tu mogvianebiT Tqvn miiRebT ganacxadis formas, unda miyveT im instruqciebs, romlebic miTiTebulia formasa da TandarTul werilSi. 131 Tavi 4: saerTaSoriso da regionuli procedurebi cxrili: konvenciiT gaTvaliswinebuli individualuri saCivris Setanis proceduris ZiriTadi qronologia Tqveni Tavdapirveli ganacxadi, romelic moicavs informaciis mokle reziumes, igzavneba sasamarTloSi. z Tqven SeiZleba mogTxovon damatebiTi informaciis wardgena; Tu dadgindeba, rom SesaZlebelia, saqme sasamarTlos ganxilvas daeqvemdebaros, Tqven gamogegzavnebaT ganacxadis forma. z Tqvens mier Sevsebuli forma, miRebisTanave daregistrirdeba da waredgineba sasamarTlos. z darRvevis Sesaxeb gancxadebebi waredgineba mTavrobas, romelsac sTxoven warmoadginos Suamdgomlobebi ganacxadis dasaSvebobasTan dakavSirebiT. z Tqven pasuxobT mTavrobis Suamdgomlobebs. z sasamarTlo iRebs gadawyvetilebas ganacxadis dasaSvebobasTan dakavSirebiT (zogierT SemTxvevaSi, sasamarTlom SeiZleba gamarTos mosmena dasaSvebobis sakiTxis gadasawyvetad). z morigebis SesaZlebloba z mxareebs sTxoven nebismieri Semdgomi Suamdgomlobis wardgenas saqmis arsebiT mxaresTan an damatebiT mtkicebulebebTan dakavSirebiT. z sasamarTlo ganixilavs saqmis arsebiT mxares da iRebs ganCinebas, SesaZlebelia Ria sasamarTlo mosmenis gamarTvis Semdeg. z rogorc wesi, ganCinebis gamotanisas, sasamarTlo iRebs gadawyvetilebas samarTliani dakmayofilebis Sesaxeb, Tumca, SeuZlia gadados am gadawyvetilebis miReba Semdgomi etapisaTvis. z wevrma saxelmwifom unda aRasrulos ganCineba evropis sabWos ministrTa komitetis zedamxedvelobiT. 132 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 4.4 cxrili: ZiriTadi faqtebi adamianis uflebaTa evropuli sasamarTlos Sesaxeb vis SeuZlia am proceduriT gaTvaliswinebuli ganacxadis Setana? arsebobs raime SezRudva ganacxadis SetanasTan dakavSirebiT? SeiZleba Tu ara am proceduriT gaTvaliswinebuli ganacxadis Setana, Tu Tqvens mier ukve Setanilia ganacxadi sxva proceduris farglebSi imave faqtebTan dakavSirebiT? gWirdebaT Tu ara iuridiuli warmomadgenloba? fizikur pirebs, arasamTavrobo organizaciebs da fizikur pirTa jgufebs, romlebic acxadeben, rom arian adamianis uflebaTa darRvevis msxverplni; ganacxadi SesaZlebelia Seitanos msxverplis axlo naTesavma, rodesac uSualod msxverpls ar SeuZlia amis gakeTeba, magaliTad, Tu is daikarga an gardaicvala. ganacxadi Setanil unda iqnas saqmeze Sidasaxelmwifoebrivi saboloo gadawyvetilebis gamotanis TariRidan eqvsi Tvis vadaSi. ara iuridiuli warmomadgenloba ar aris saWiro ganacxadis Setanis dros, Tumca saWiroa procedurebisaTvis, romelic mosdevs saqmis dasaSvebad cnobas, garda im SemTxvevisa, rodesac sasamarTlos prezidenti iZleva gamonaklisis saxiT nebarTvas, rom ganmcxadebeli Tavad iyos warmomadgeneli sakuTari saqmeSi. aris Tu ara finansuri daxmarebis miReba SesaZlebeli? diax, mxolod im SemTxvevaSi, Tu ganacxadis Sesaxeb ecnoba mTavrobas; ganmcxadebelma unda Seavsos deklaracia misi saarsebo wyaroebis Sesaxeb, romelsac xels moawers Sidasaxelmwifoebrivi iuridiuli daxmarebis sabWo, radgan iuridiuli daxmarebis gaweva xdeba mxolod im SemTxvevaSi, rodesac arsebobs amis saWiroeba finansuri TvalsazrisiT. miiReba Tu ara informacia amicus curia formiT? diax, Sesabamisi nebarTvis arsebobisas (sasamarTlos procedurebi, wesi 61) visTvis aris xelmisawvdomi informacia ganacxadis Sesaxeb? ramden xans grZeldeba procedura? ra zomebis miRebaa SesaZlebeli sasamarTlosaTvis gadawyvetilebis miRebaSi daxmarebis gawevis mizniT, Tu aseTi ram saerTod dasaSvebia? aris Tu ara droebiTi an saswrafo zomebis miReba SesaZlebeli? rogorc wesi, samarTalwarmoeba Riaa, garda im SemTxvevisa, Tu palatis Tavmjdomarem sxva ram ar gadawyvita. gamonaklis SemTxvevebSi, rodesac ganmcxadebels ar surs, rom misi vinaoba sajarod iyos cnobili da is waradgens gancxadebas, romliTac axsnis amis mizezebs, prezidentma SesaZlebelia dauSvas anonimuroba. ramdenime wlis ganmavlobaSi. faqtis damdgeni mosmenebi, mowmeTa Cvenebebi, werilobiTi Sesageblebi da zepiri mosmenebi. diax, Tumca es aris praqtika, romelic sasamarTlom ganaviTara da romelsac ar gaaCnia raime safuZveli konvenciaSi. es praqtika gamoiyeneba mxolod Zalian specifiur SemTxvevebSi, ZiriTadad imigraciis/deportaciis dros, rodesac piri dgas „realuri riskis“ winaSe (sasamarTlos procedurebi, wesi 39). 133 Tavi 4: saerTaSoriso da regionuli procedurebi sasargeblo saxelmZRvanelo principebi • Tavdapirveli proceduris Sesabamisad, romelic 1998 wels Seicvala, saqmis ganxilva sawyis etapebs adamianis uflebaTa evropul komisiaSi gadioda. Tu Tqven gsurT moiZioT romelime konkretul sakiTxi konvenciasTan dakavSirebul precedentul samarTalSi, daimaxsovreT, rom unda moZebnoT komisiis angariSebi da aseve sasamarTlos ganCinebebi. • Tu eqvs Tviani vada, romlis ganmavlobaSic ganacxadi unda iyos wardgenili ukve gadis, da aRar rCeba dro sruli ganacxadis mosamzadeblad, unda gaagzavnoT e.w. „SeaCereT dro“ ganacxadi, romelic aRwers Tqveni saCivris mokle Sinaarss. amgvari ganacxadis gagzavnas rac SeiZleba swrafad unda moyves sruli ganacxadis wardgena. • sasamarTlos mier dadgenili bolo vadis dacvis mizniT, gaiTvaliswineT, rom sasamarTlo ganacxadis Setanis TariRad miiCnevs ara miRebis TariRs, aramed gagzavnis TariRs. Tumca, sasurvelia bolo vadis gasvlamde el_fostiT, telefoniT an ganacxadis Tavfurcelis saxiT darTuli werilis aslis faqsiT gagazavnis meSveobiT moxdes sasamarTlos gafrTxileba imis Sesaxeb, rom ganacxadi ukve gaigzavna. • sasamarTlos SeuZlia, sakuTari iniciativiT an romelime mxaris moTxovniT, miiRos nebismieri mtkicebuleba, romelsac is saqmisaTvis sasargeblod miiCnevs, maT Soris SeuZlia faqtebis dasadgenad Caataros sasamarTlo mosmena. Tu amgvari zomebis miRebas moiTxovs romelime mxare, rogorc wesi, es mxare anazRaurebs Sesabamis xarjebs, Tumca palatas SeuZlia sxvagvari gadawyvetilebis miRebac. Tu am xarjebis gaReba ar gsurT, sasurvelia Tqveni werilis formulireba frTxilad moaxdinoT _ magaliTad, SesTavazoT sasamarTlos, rom SesaZloa mas surdes ganaxorcielos diskrecia im mizniT, rom miiRos zomebi mtkicebulebaTa mosapoveblad. • sasamarTlo Tavisi saqmianobis umetes nawils axorcielebs Svidi mosamarTlisagan Semdgari palatebis meSveobiT. rodesac saqme ukavSirdeba mniSvnelovan sakiTxs, an SesaZloa exebodes konkretul sakiTxTan mimarTebiT sasamarTlos SexedulebaTa cvlilebas, is SeiZleba gadaeces 17 mosamarTlisagan Semdgar did palatas. mas Semdeg, rac palata saqmes ganixilavs da gamoitans gadawyvetilebas, gamonaklis SemTxvevebSi, gadawyvetilebis miRebidan sami Tvis vadaSi SesaZlebelia moTxovnil iqnas saqmis didi palatisaTvis gadacema gadasinjvisaTvis (sasamarTlos procedura, wesi 73). • 2010 wlis 1 ivnisis mdgomareobiT, adamianis uflebaTa evropuli konvenciis me_14 damatebiTi oqmis Sesabamisad (muxli 6), sasamarTlo ganaxorcielebs saqmianobas Semdegi struqturis mixedviT: (1) saqmis erTpirovnulad ganmxilveli mosamarTle, romelsac daexmareba momxsenebeli samdivnodan, SeZlebs dauSveblad cnos an amoricxos sasamarTlos gansaxilveli saqmeebis nusxidan individualuri ganacxadi zustad gansazRvrul SemTxvevebSi, rodesac ganacxadis dauSvebloba aSkaraa dasawyisSive. (adamianis uflebaTa evropuli konvenciis me_14 oqmis me_7 muxli, romelic gaxdeba 27 muxli); (2) sami mosamarTlisagan Semdgari komitetebi miiReben gadawvetilebas gamartivebuli proceduriT, rogorc ganacxadis dasaSvebobasTan, ise saqmis arsebiTad ganxilvasTan dakavSirebiT, Tu saqmis ZiriTadi sakiTxi ukve gadawyvetilia sasamarTlos mier myarad dadgenili precedentuli samarTliT, anu saqmeebze, romlebsac palata erTgvarovnad wyvets (me_14 oqmis me_8 muxli, romelic gaxdeba konvenciis 28 muxli); (3) Svidi mosamarTlisagan Semdgari palata gamoitans erTobliv gadawyvetilebas im individualuri 134 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 4.4 ganacxadebis rogorc dasaSvebobaze ise arsebiTad ganxilvaze, romelTa ganxilvac ar momxdara 27 an 28 muxlebis Sesabamisad (14 damatebiTi oqmis me_9 muxli, romelic cvlis konvenciis moqmed 29 muxls). (4) Cvidmeti mosamarTlisagan Semdgari didi palata gamoitans gadawyvetilebs im saqmeebTan dakavSirebiT, romlebic mas gadaeca palatis mier da exeba konvenciis an misi oqmebis ganmartebasTan dakavSirebul seriozul sakiTxs, an Tu palatis mier sakiTxis gadawyvetas SeiZleba mohyves sasamarTlos mier manamde miRebul gadawyvetilebasTan SeuTavsebeli Sedegi (konvenciis 30 da 31 muxlebi). • konvenciis me_14 oqmis Sesabamisad, evropis sabWos adamianis uflebaTa komisars SeuZlia werilobiTi komentarebis wardgena da saqmis mosmenaSi monawileobis miReba palatisa da didi palatis winaSe wardgenil yvela saqmesTan dakavSirebiT. (me_13 muxli, romelic cvlis konvenciis 31 muxls). es faqtori mniSvnelovania im saqmeebTan mimarTebiT, sadac komisris gamocdileba SesaZloa daexmaros sasamarTlos respodenti an sxva maRali xelSemkvreli mxaris struqturuli an sistemuri problemebis gamovlenaSi. (oqmis me_13 muxli). • SesaZlebelia ganCinebis ganmartebis moTxovna misi gamotanidan erTi wlis ganmavlobaSi (sasamarTlos procedura, wesi 79). aseve SesaZlebelia ganCinebis gadasinjvis moTxovna, Tu arsebobs mniSvnelovani axlad aRmoCenili garemoebebi, romlebsac SeeZloT gavlena moexdinaT sasamarTlos gadawyvetilebaze, moTxovna SesaZlebelia amgvari garemoebebis aRmoCenidan eqvis Tvis ganmavlobaSi (sasamarTlos procedura, wesi 80). 135 5.1 saerTaSoriso da regionuli kanonmdeblobis statusi 5.2 precendentis statusi 5.3 samarTlebrivi da jandacvis sistema 136 adamianis uflebebi janmrTelobis dacvis sferoSi 5 qveynis Sesabamisi SeniSvnebi 5.1 saerTaSoriso da regionuli kanonmdeblobis statusi saqarTveloSi pacientis uflebaTa kanonmdeblobis ganviTarebaze didi gavlena moaxdina moZraobam jandacvis reformirebisTvis evropaSi. Sedegad, Zalian miniSvnelovani mTavrobaTaSorisi instrumentebi ganaviTares iseTma avtoritetulma saerTaSoriso organizaciebma, rogorebicaa: gaero (UN), jandacvis msoflio organizacia (WHO), iunesko (UNESCO), evropis sabWo, eqimTa msoflio asociacia da a.S. ufro metic, pacientis uflebaTa damcavi specialuri aqtebi evropis zogierT qveyanaSic1 miiRes. janmrTelobis da adamianis uflebaTa principebisa da savaldebuli Zalis mqone debulebebis, aseve rbili samarTlis normebis inkorporacia moxda erovnul samarTalSi. zemoTaRniSnuli organizaciebis mier ganviTarebulma strategiebma mniSvnelovani zegavlena moaxdines saqarTveloSi pacientis uflebaTa kanonmdeblobis ganviTarebaze. mxedvelobaSi misaRebia aseve saerTaSoriso kvlevebi, daskvnebi da im qveynebis gamocdileba, romelTac aqvT pacientis uflebaTa specialuri kanonmdebloba. dokumentebi, romlebmac mTavari roli iTamaSes saqarTveloSi pacientis uflebaTa kanonmdeblobis SeqmnaSi aris evropaSi pacientis uflebebis xelSewyobis Sesaxeb deklaracia da konvencia adamianis uflebebis da biomedicinis Sesaxeb. mogvianebiT saqarTvelom aseve moaxdina konvenciis da misi sami oqmis ratifikacia. 1 pirveli aseTi qveyana iyo fineTi 137 Tavi 5: qveynis Sesabamisi SeniSvnebi ixileT mTavari dokumentebis (savaldebulo da arasavaldebulo Zalis) CamonaTvali, romelic warmoadgens saqarTveloSi pacientis uflebaTa kanonmdeblobis ideologiur safuZvels: • adamianis uflebaTa sayovelTao dekleracia (1948); • adamianis uflebaTa da fundamentur TavisuflebaTa dacvis konvencia (1950); • evropuli socialuri qartia (1961); • saerTaSoriso paqti samoqalaqo da politikur uflebaTa Sesaxeb (1966); • saerTaSoriso paqti ekonomikur, socialur da kulturul uflebaTa Sesaxeb (1966); • bavSvis uflebaTa konvencia (1989); • konvencia adamianis uflebebis da biomedicinis Sesaxeb (CHRB); • adamianis uflebebis da biomedicinis Sesaxeb konvenciis damatebiTi oqmi adamianis klonirebis akrZalvis Sesaxeb (1998); • adamianis uflebebis da biomedicinis Sesaxeb konvenciis damatebiTi oqmi adamianuri warmoSobis organoebis da qsovilebis gadanergvis Sesaxeb (2001); • adamianis uflebebis da biomedicinis Sesaxeb konvenciis damatebiTi oqmi biosamedicino kvlevis Sesaxeb (2005); • adamianis genomis da adamianis uflebebis sayovelTao deklaracia; iunesko (1997); • helsinkis deklaracia: rekomendaciebi eqimebisTvis adamianuri subieqtebis biosamedicino kvlevaSi CarTvis dros; eqimTa msoflio asociacia; • samedicino eTikis principebi; gaero (1982); • saerTaSoriso eTikuri gaidlainebi adamianebis biosamedicino kvlevaSi CarTvis Sesaxeb (1982, 1992) da saerTaSoriso gaidlainebi epidemiologiuri kvlevis eTikuri gadasinjvis Sesaxeb (CIOMS; 1991, 2002); • evropaSi pacientis uflebaTa xelSewyobis Sesaxeb deklaracia (WHO; 1994). • konvencia adamianis uflebebis da biomedicinis Sesaxeb (CHRB; evropis sabWo; 1997); • evropis sabWos saparlamento asambleis da ministrTa kabinetis sxvadasxva rezoluciebi da rekomendaciebi; o saparlamento asambleis rekomendacia #1418 (1999) adamianis uflebebis da Rirsebis dacvis Sesaxeb terminalur mdgomareobaSi da sikvdilis piras myofi pacientebisTvis; 138 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 5.2 o ministrTa kabinetis rekomendacia N. rek: (2003)24 paliatiuri mzrunvelobis oranizebis Sesaxeb; o ministrTa kabinetis rekomendacia N. rek: (2004)10 fsiqikuri aSlilobis mqone pirTa adamianis uflebebis da Rirsebis dacvis Sesaxeb; saqarTvelom xeli moawera da ratifikacia moaxdina janmrTelobasTan, biomedicinasTan da adamianis uflebebTan dakavSirebul saerTaSoriso da regionuli (evropuli) instrumentebs. am instrumentTa CamonaTvali da maTi ratifikaciis TariRi mocemulia ratifikaciis cxrilSi.2 5.2 precedentis statusi saerTo samarTlis qveynebisgan gansxvavebiT, saqarTveloSi precedents ar aqvs savaldebulo Zala _ mas ufro didi mniSvneloba eniWeba arsebuli praqtikis interpretaciis dros. mimdinare sasamarTlo reformis erT-erTi mTavari mizania erTgvarovani sasamarTlo praqtikis ganviTareba, rac xels Seuwyobs normaTa mimarT umeteswilad erTgvarovan midgomas da swraf marTlmsajulebas. a) sasamarTlo sistema da reforma3 2005 wlis dasawyisidan saqarTveloSi mimdinare sasamarTlo reforma masStaburia da moicavs sasamarTlo sistemis mowyobasa da gamarTul funqcionirebasTan dakavSirebul yvela sakiTxs. reformis yvela metad Tu naklebad mniSvnelovani nabiji arsebiTad aris dakavSirebuli erTmaneTTan da maTi kompleqsuri, etapobrivi ganxorcieleba aucilebelia dasaxuli miznis _ damoukidebeli sasamarTlo sistemis misaRwevad. reformis ZiriTadi mimarTulebebia: • sasamarTlo sistemaSi korufciis winaaRmdeg brZolis meqanizmebis srulyofa da maTi saqmianobis efeqturobis uzrunvelyofa; • sasamarTlo sistemis instituciuri reorganizacia, mwyobri, funqciurad gamarTuli sistemis Seqmna da, Sesabamisad, Tanmimdevruli instanciurobis principis uzrunvelyofa; • mosamarTleTa specializacia yvela instanciis sasamarTloSi; 2 ix. Tavi I _ Sesavali 3 informacia am seqciaSi gadmotanilia saqarTvelos uzenaesi sasamarTlos oficialuri vebgverdidan www.supremecourt.ge 139 Tavi 5: qveynis Sesabamisi SeniSvnebi • mosamarTleTa raodenobis gazrda aranakleb 400-mde; • mosamarTleTa anazRaurebis gazrda, socialuri da samarTlebrivi dacvis garantiebis gaZliereba da ganmtkiceba; • mosamarTleTa kadrebis SerCevis kriteriumebis daxvewa da maTi Tanamdebobaze gamwesebis sistemis srulyofa; • mosamarTleobis kandidatTa momzadebisa da moqmedi mosamarTleebis mudmivi gadamzadebis sistemis Seqmna, Sesabamisi grZelvadiani programebisa da saswavlo kursis SemuSaveba da amoqmedeba; • karieris principiT mosamarTleTa samsaxurebrivi winsvlis uzrunvelyofa; • sasamarTloebis materialur-teqnikuri da finansuri uzrunvelyofa; • sasamarTloTa organizaciuli muSaobis gaumjobeseba, sasamarTloTa menejmentis sistemis daxvewa sasamarTlo aparatis moxeleTa kvalifikaciis amaRleba da maTi saqmianobis gaumjobeseba; • sasamarTlo sistemis erTiani kompiteruli qselis Seqmna, Sesabamisad, saqmiswarmoebis xarisxis amaRleba da srulyofa, sasamarTloTa saqmianobis gamWvirvalobisa da sajaroobis uzrunvelyofa sajaro informaciis qselSi ganTavsebiT; • gaWianurebuli sasamarTlo ganxilvebis problemis gadawyveta, saqmeTa wreze brunvis SemTxvevis minimumamde dayvana; • iusticiis umaRlesi sabWosa da sadisciplino samarTalwarmoebis meqanizmis daxvewa, maTSi mosamarTleTa raodenobis sul mcire naxevramde gazrda da maTi saqmianobis efeqturobis uzrunvelyofa; • sasamarTlosa da mediis urTierTobis gafarToeba da gaumjobeseba, sasamarTlo xelisuflebis saqmianobaze sazogadoebrivi kontrolis gaZliereba. raionuli (saqalaqo) sasamarTlo rogorc aRiniSna, reformis erT-erTi ZiriTadi mimarTulebaa sasamarTlo sistemis instituciuri reorganizacia, mwyobri, funqciurad gamarTuli sistemis Seqmna da, Sesabamisad, Tanmimdevruli instanciurobis principis uzrunvelyofa. am mizniT gaTvaliswinebulia raionuli (saqalaqo) sasamarTloebis modernizacia, rac gamoixateba rogorc maT gansjadobas mikuTvnebul sakiTxebTan mimarTebaSi, ise mosamarTleTa specializaciaSi. saqarTvelos prezidentis 2005 wlis 12 aprilis brZanebulebiT, 2005 wlis 5 maiss, likvidirebul iqna gldani-naZaladevis, isani-samgoris, didube-CuRureTis, krwanisi-mTawmindis da vake-saburTalos raionuli sasamarTloebi da Seiqmna Tbilisis saqalaqo sasamarTlo, romlis samoqmedo teritoria ganisazRvra q. Tbilisis administraciul-teritoriuli sazRvrebiT. magistrati mosamarTle _ marTlmsajulebis erT-erTi ZiriTadi principis _ xelmisawvdomobis uzrulvelsayofad iqmneba magistrati mosamarTlis instituti. igi Sedis raionuli 140 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 5.2 (saqalaqo) sasamarTlos SemadgenlobaSi da samosamarTlo uflebamosilebas axorcielebs im administraciul-teritoriul erTeulSi, sadac ar moqmedebs gamsxvilebuli raionuli (saqalaqo) sasamarTlo. magaliTad, gamsxvilebuli raionuli sasamarTlo Seiqmneba zestafonSi, romlis iurisdiqciac gavrceldeba saCxeris, WiaTuris, xaragaulis, Terjolisa da tyibulis raionebze, xolo TiToeul am raionSi imoqmedebs TiTo magistrati mosamarTle. magistrati mosamarTle saqmes ganixilavs erTpirovnulad. aucileblobis SemTxvevaSi, marTlmsajulebis Seferxebis Tavidan asacileblad, raionuli (saqalaqo) sasamarTlos Tavmjdomarem magistrat mosamarTles SeiZleba daavalos saqmis ganxilva misi samoqmedo teritoriis farglebs gareT _ raionuli (saqalaqo) sasamarTlos sxva administraciul-teritoriul erTeulSi. magistrati mosamarTleebis gansjadobas ganekuTvneba naklebad rTuli saqmeebi. konkretulad, magistrati mosamarTleebi saqarTvelos samoqalaqo saproceso kodeqsis me-14 muxlis Sesabamisad, pirveli instanciiT ganixilaven Semdeg samoqalaqo saqmeebs: 1. qonebriv davebs, Tu sarCelis fasi ar aRemateba 2000 lars; 2. udavo da gamartivebuli warmoebis saqmeebs, garda Svilad ayvanis, agreTve gamartivebuli wesiT gadaxdis da qonebis upatronod cnobis saqmeebisa, Tu moTxovnis an qonebis Rirebuleba aRemateba 2000 lars; 3. saojaxo-samarTlebrivi urTierTobidan gamomdinare davebs, garda Svilad ayvanis, mSoblis uflebis CamorTmevis, mamobis dadgenisa da ganqorwinebis saqmeebisa, Tu meuRleebs Soris arsebobs dava bavSvis mikuTvnebis Taobaze; 4. Sromis-samarTlebrivi urTierTobidan warmoSobil davebs. magistrati mosamarTleebi, saqarTvelos administraciuli saproceso kodeqsis me-6 muxlis Tanaxmad, pirveli instanciiT ganixilaven Semdeg administraciul saqmeebs: 1. soflis, Temis, dabisa da qalaqis, romelic Sedis raionis SemadgenlobaSi, warmomadgenlobiTi da aRmasrulebeli organoebis administraciul-samarTlebrivi aqtebis kanonierebis Taobaze; 2. administraciuli samarTaldarRvevebis Taobaze gamotanili. individualuri administraciul-samarTlebrivi aqtebis kanonierebis Sesaxeb (winamdebare norma amoqmeddeba 2006 wlis 1 ianvridan); 3. saxelmwifo socialuri dacvis sakiTxis Taobaze; 4. sasamarTlos kanonier ZalaSi Sesulia gadawyvetilebis aRsrulebasTan dakavSirebiT warmoSobili davis Taobaze; 5. sajaro samsaxurSi SromiTi urTierTobidan warmoSobil davasTan dakavSirebiT; 6.mewarmis saqmianobis Semowmebis Sesaxeb makontrolebeli organos Suamdgomlobis safuZvelze brZanebis gamocemis Taobaze. 141 Tavi 5: qveynis Sesabamisi SeniSvnebi magistrati mosamarTleebi, saqarTvelos sisxlis samarTlis saproceso kodeqsis 46-e muxlis Sesabamisad, pirveli instanciiT ganixilaven Suamdgomlobebs saproceso-samarTlebrivi iZulebis RonisZiebaTa gamoyenebisa da maTi Secvlis Taobaze. sarCelebi (gancxadebebi) da Suamdgomlobebi magistrat mosamarTleTa gansjad samoqalaqo da administraciul saqmeebze, aseve Suamdgomlobebi piris mimarT saproceso-samarTlebrivi iZulebis RonisZiebis gamoyenebis da Secvlis Taobaze, Seitaneba sasamarTloSi magistrati mosamarTlis adgilsamyofelis mixedviT. saapelacio sasamarTlo institucionaluri cvlilebebis TvalsazrisiT reforma iTvaliswinebs saqarTveloSi wmida saapelacio sasamarTlos institutis Seqmnas. 2005 wlis pirvel naxevarSi ganxorcielebuli sakanonmdeblo cvlilebebis Sesabamisad, 1 noembridan amoqmedda saapelacio sasamarTlo instancia, riTac Zireulad Seicvala arsebuli saolqo sasamarTloebis modeli saerTo sasamarTloebis erTian sistemaSi. aqamde moqmedi sistemis Sesabamisad e. w. meore instanciis, anu saolqo sasamarTlo ar warmoadgenda wminda saapelacio tipis sasamarTlos imdenad, ramdenadac, am sasamarTloSi arsebobdnen Sesabamisi kolegiebi, romelnic pirveli instanciiT ganixilavdnen maT gansjadobas mikuTvnebul saqmeebs. ganxorcielebuli cvlilebiT erTmaneTisagan mkveTrad gaimijna sasamarTlo instanciebis principi, riTac zustad aris daculi dasavleTSi gabatonebuli Instanzenzug-is, anu Tanamimdevruli instanciurobis principi. saapelacio sasamarTloSi aRar arsebobs saqmeTa pirveli instanciis wesiT ganmxilveli kolegiebi da yvela saqmes sasamarTlo ganixilavs mxolod apelaciis wesiT. ufro konkretulad, saapelacio saCivrebs pirveli instanciis, anu raionuli (saqalaqo) sasamarTloebis (maT Soris magistrati mosamarTleebis) mier gamotanil Semajamebel gadawyvetilebebze, ganixilavs mxolod saapelacio sasamarTlo. swrafi da efeqturi marTlmsajulebis ganxorcielebis mizniT saapelacio wesiT ar saCivrdeba im kategoriis saqmeebi, romelTa davis sagnis Rirebuleba samoqalaqo davebis dros ar aRemateba 1000 lars. sisxlis samarTlis saqmeebze sapelacio wesiT ar saCivrdeba sasamarTlos ganaCeni iseTi kategoriis danaSaulze, romlis sanqciac Tavisuflebis aRkveTas ar iTvaliswinebs. magram, aqac gaTvaliswinebulia gamonaklisi adamianis ZiriTadi uflebebis dacvis TvalsazrisiT, kerZod pirs ufleba aqvs waradginos saapelacio saCivari da moiTxovos wardgenil braldebaSi gamarTleba. sakasacio sasamarTlo saqarTvelos uzenaesi sasamarTlo Camoyalibda wminda sakasacio instanciis sasamarTlod. uzenaes sasamarTloSi gauqmda sisxlis samarTlis saqmeTa kolegia, romelic pirveli instanciiT wesiT ganixilavda gansakuTrebiT mZime kategoriis saqmeebs. amJamad uzenaesi sasamarTlo ganixilavs mxolod sakasacio saCivrebs, rac niSnavs, rom am instanciaSi ar xdeba saqmis faqtobrivi garemoebebis gamokvleva-Sefaseba. marTalia, saqarTvelo ar ganekuTvneba anglo-saqsonuri samarTlis ojaxis qveyanaTa kategorias, sadac sasamarTlo gadawyvetilebebs preiudiciuli da savaldebulo Zala gaaCniaT, magram erTgvarovani sasamarTlo praqtikis dadgenasa da mis ganzogadebas Zalian didi mniSvneloba eniWeba evropis kontinenturi samarTlis qveynebSic samarTlis normaTa Sefardebisa da ganmartebis TvalsazrisiT. zemoaRniSnuli cvlileba swored am mizans emsaxureba. SemoRebulia sakasacio saCivris dasaSvebobis kriteriumebi. ZiriTadad isini identuria samarTlis samive (sisxlis, administraciuli da samoqalaqo) sferosaTvis da mdgomareobs imaSi, rom uzenaesi sasamarTlo saqmes dasaSvebad miiCnevs da gansaxilvelad miiRebs mxolod im SemTxvevaSi, Tu saqme mniSvnelovania samarTlis ganviTarebisa da erTgvarovani sasamarTlos praqtikis CamoyalibebisTvis, an Tu saapelacio sasamarTlos gadawyvetileba arsebiTad gansxvavdeba am kategoriis saqmeebze uzenaes sasamarTloSi manamde arsebuli praqtikisagan. garda amisa, mimdinare reformam gaiTvaliswina demokratiul qveynebSi damkvidrebuli reviziis safuZvlebi da daadgina, rom saCivars sakasacio sasamarTlo aucileblad ganixilavs, Tuki 142 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 5.2 saapelacio sasamarTlos mier saqme ganxilulia mniSvnelovani saproceso darRveviT da am darRvevas SeeZlo arsebiTad emoqmeda saqmis Sedegze. aRsaniSnavia, rom samoqalaqo samarTalSi sakasacio saCivari qonebriv davebSi upirobod daiSveba, Tu davis sagnis Rirebuleba aRemateba 50 000 lars, xolo araqonebriv davebSi ki _ sityvisa da gamoxatvis TavisuflebasTan dakavSirebul davebze. aRniSnuli cvlilebebiT uzenaesi sasamarTlo xdeba marTlac doqtrinaluri sasamarTlo, romelsac samarTlis normaTa dasabuTebuli ganmartebisa da Sefardebis Sedegad ufro efeqturad SeuZlia samarTlis ganviTareba da erTgvarovani sasamarTlo praqtikis Camoyalibeba, rac, Tavis mxriv, saerTod sasamarTlo sistemis swraf da gamarTul funqcionirebas uzrunvelyofs. meore mxriv, am cvlilebebis Sedegad Seqmnil sasamarTlo sistemaSi mniSvnelovnad aRmoifxvreba saqmeTa gaWianurebis umwvavesi problema, radgan uzenaes sasamarTloSi gansaxilvelad aRar iqneba daSvebuli dRes gansaxilvel saqmeTa sul cota 35-40% mainc, Sesabamisad, igive raodenobis saqmeebze ZalaSi darCeba saapelacio sasamarTloTa gadawyvetilebebi. da bolos, reformirebul sasamarTlo sistemaSi gansakuTrebiT efeqturad iqneba uzrunvelyofili e.w. Tanmimdevruli instanciurobis principi, romelic sasamarTlo xelisuflebis Sida kontrolis mniSvnelovani meqanizmia. am principis mixedviT, pirveli instanciis sasamarTloTa gadawyvetilebebze dadgenili saproceso formebiT _ jer apelaciiT da Semdeg ukve kasaciiT, saapelacio da sakasacio (uzenaesi) sasamarTlos mier xorcieldeba saproceso zedamxedveloba, anu xdeba gadawyvetilebaTa Semowmeba, rac sasamarTlo sistemaSi mosamarTleTa mier kanonis darRvevaTa gamovlenis, maT Soris korufciasTan brZolis umniSvnelovanesi meqanizmia. es meqanizmi kidev ufro qmediTi gaxdeba droTa ganmavlobaSi, roca TandaTanobiT Camoyalibdeba da mkveTr konturebs SeiZens uzenaesi sasamarTlos erTgvarovani praqtika samarTlis yvela normasTan dakavSirebiT. marTalia uzenaesi sasamarTlos gadawyvetilebebs ar eqneba precedentuli, savaldebulo Zala, magram uzenaesi sasamarTlos praqtikisagan gansxvavebuli gadawyvetileba qveda instanciis sasamarTlom Zalian myarad unda daasabuTos, raTa es gadawyvetileba gaxdes uzenaesi sasamarTlos msjelobis sagani da Tavidanve ar dadges gauqmebis safrTxis winaSe. saqarTvelos iusticiis umaRlesi sabWo reformis erT-erTi umniSvnelovanesi prioritetia iusticiis umaRlesi sabWos reformireba masSi mosamarTleTa raodenobis gazrdisa da, saerTod, mosamarTleTa `xmis~ gaZlierebis mizniT. sasamarTlo xelisuflebaSi udidesi uflebamosilebebis mqone am organoSi, romlis kompetenciaSi Sedis sasamarTlo biujetis Sedgena, materialur-teqnikuri uzrunvelyofa da misi kontroli, mosamarTlis Tanamdebobaze dasaniSnad kandidatis. SerCeva wardgena prezidentisaTvis, prezidentTan winadadebebis Setana mosamarTlis Tanamdebobidan gaTavisuflebis Tu dawinaurebis Sesaxeb, disciplinuri samarTalwarmoebis ganxorcieleba mosamarTleebis mimarT, sasamarTlos moxeleTa samsaxurSi miReba da a.S., iusticiis umaRlesi sabWoSi dRemde mosamarTleebi yovelTvis umciresobaSi iyvnen. mimdinare wlis Semodgomaze sakanonmdeblo aqtebSi Setanili cvlilebebiT ki 2006 wlis 1 martidan iusticiis umaRlesi sabWos Semadgenloba gaizrdeba da ganisazRvreba 18 wevriT, romelTagan 9 iqneba mosamarTle. sabWos SemadgenlobaSi eqs-oficio Sedian saqarTvelos uzenaesi sasamarTlos Tavmjdomare, saqarTvelos parlamentis iuridiul sakiTxTa komitetis Tavmjdomare, saqarTvelos iusticiis ministri da saqarTvelos generaluri prokurori. sabWos or wevrs niSnavs saqarTvelos prezidenti, xolo oTx wevrs, romelTagan sami saqarTvelos parlamentis deputatia, irCevs saqarTvelos parlamenti. iusticiis umaRlesi sabWos 8 wevrs, saerTo sa- 143 Tavi 5: qveynis Sesabamisi SeniSvnebi samarTloebis mosamarTleTagan, saqarTvelos uzenaesi sasamarTlos Tavmjdomaris wardginebiT airCevs saqarTvelos mosamarTleTa konferencia. am cvlilebebis Sedegad iusticiis umaRlesi sabWos yvela zemoaRniSnuli umniSvnelovanesi uflebamosilebis ganxorcielebisas mosamarTleebs eqnebaT xmaTa sakmarisi raodenoba. aseve aRsaniSnavia, rom cvlilebebis mixedviT, amieridan mosamarTleTa mimarT disciplinuri samarTalwarmoebis sakiTxebze saqarTvelos iusticiis umaRlesi sabWos sxdomebs Tavmjdomareobs TviT sasamarTlo xelisuflebis meTauri saqarTvelos uzenaesi sasamarTlos Tavmjdomare. iusticiis umaRlesi sabWos formirebisa da saqmianobis wesi Seesabameba saqarTvelos sisxlis samarTlis kanonmdeblobis reformis strategiis ZiriTad mimarTulebebs, romelic damtkicebulia saqarTvelos prezidentis 2004 wlis 19 oqtombris ¹914 gankargulebiT. disciplinuri samarTalwarmoeba reformis kidev erTi, gansakuTrebiT mniSvnelovani mimarTuleba disciplinuri samarTalwarmoebis arsebuli modelia. `saqarTvelos saerTo sasamarTloebis mosamarTleTa disciplinuri pasuxismgeblobisa da disciplinuri samarTalwarmoebis Sesaxeb~ saqarTvelos kanoniT gansazRvruli meqanizmi, faqtobrivad, sasamarTlos sistemis Sida monitoringis erTaderTi meqanizmia. aqamde arsebuli modeli ramdenjerme Seicvala, Tumca miRebuli Sedegi mainc ar Seesabameboda evropis ministrTa komitetis mier 1994 wlis 13 oqtombers miRebul rekomendacias `mosamarTleTa damoukidebloba, efeqtianoba da roli~, romlis mixedviT mosamarTleTa mier Cadenili disciplinuri darRvevebi unda Semowmdes Sesabamisi damoukidebeli da kompetenturi organos mier, imavdroulad, es Semowmeba unda ganxorcieldes gonivrul vadaSi da ara gaWianurebuli proceduris Sesabamisad. swored am midgomas iziarebs mimdinare reformis farglebSi ganxorcielebuli cvlilebebi, romliTac mniSvnelovnad Seicvala disciplinuri samarTalwarmoebis arsebuli modeli, rac am meqanizmis swraf da efeqtur moqmedebas uzrunvelyofs. amasTan erTad, ganmtkicda disciplinur samarTalwarmoebaze sasamarTlo zedamxedvelobis principi _ sadisciplino kolegiis gadawyvetileba saCivrdeba uzenaes sasamarTloSi da saqmeze saboloo gadawyvetilebas iRebs uzenaesi sasamarTlos sadisciplino palata, romelic sami mosamarTlisagan Sedgeba. aRsaniSnavia, rom arsebuli modelisagan gansxvavebiT, axal sistemaSi sadisciplino palatas saqmis arsebiTi gamokvleva-Sefasebis uflebamosilebac aqvs. cvlilebebis Sedegad, dgindeba mosamarTleTa mimarT disciplinuri samarTalwarmoebis dawyebisa da winaswari Semowmebis procedura. uqmdeba disciplinuri devnis aRZvris stadia da disciplinuri samarTalwarmoebis dawyebis safuZvlebis arsebobisas iwyeba disciplinuri saqmis gamokvleva. winaswari Semowmebis Sedegad saapelacio an uzenaesi sasamarTlos Tavmjdomare an iusticiis umaRlesi sabWos mdivani iRebs gadawyvetilebas disciplinuri samarTalwarmoebis Sewyvetis an mosamarTlisaTvis axsna-ganmartebis CamorTmevis Taobaze. saqmis ganxilvis Sedegad iusticiis umaRlesi sabWo wyvets saqmis sadisciplino kolegiisaTvis gadacemis, anu mosamarTlis disciplinur pasuxisgebaSi micemis sakiTxs. Tavis mxriv, aseve icvleba saerTo sasamarTloebis mosamarTleTa sadisciplino samarTalwarmoebis struqtura. sadisciplino sabWo uqmdeba da mis nacvlad iusticiis umaRles sabWoSi iqmneba sadisciplino kolegia. igi Sedgeba eqvsi wevrisagan, romelTagan sami mosamarTlea. kolegiis wevrebs Tavisi Semadgenlobidan ori wlis vadiT irCevs iusticiis umaRlesi sabWo. disciplinur sakiTxze gamarTul sxdomaSi da gadawyvetilebis miRebaSi ar monawileobs iusticiis umaRlesi sabWos is wevri, romelic aris sadisciplino kolegiis wevri. 144 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 5.2 rogorc aRiniSna, sadisciplino kolegiis gadawyvetilebis gasaCivreba SeiZleba saqarTvelos uzenaesi sasamarTlos sadisciplino palataSi. sadisciplino palatas (igi Sedgeba sami mosamarTlisagan), romelic, Tavis mxriv, warmoadgens mosamarTleTa discilinuri sakiTxebis ganmxilvel sakasacio sasamarTlos, irCevs uzenaesi sasamarTlos plenumi uzenaesi sasamarTlos Tavmjdomaris wardginebiT. aq kidev erTxel unda aRiniSnos is mniSvnelovani siaxle, rom sadisciplino palata kolegiis gadawyvetilebas Seamowmebs ara mxolod samarTlebrivi procedurebis darRvevis safuZvelze (rogorc aqamde arsebul modelSia), aramed mTlianad saCivris farglebSi, rogorc faqtobrivi, ise samarTlebrivi safuZvlebiT, aseve dakisrebuli saxdelis samarTlianobis TvalsazrisiTac. saqarTveloSi moqmedi kanonmdebloba janmrTelobis dacvis sferoSi saqarTvelos kanonmdebloba janmrTelobis dacvis sferoSi Sedgeba saqarTvelos konstituciis, saerTaSoriso xelSekrulebebis da SeTanxmebebis, saqarTvelos sakanonmdeblo da kanonqvemdebare normatiuli aqtebisagan. saqarTveloSi moqmedi samarTliT, sasamarTlo precedents ara aqvs savaldebulo Zala, rac damaxasiaTebelia saerTo samarTlis iurisdiqciebisTvis.Aamdenad, sasamarTlos gadawyvetilebebi mxolod samarTlebrivi normebis Sinaarsis gagebis arsebuli praqtikis Sesaswavlad gamoiyeneba. kanonmdebloba janmrTelobis dacvis sferoSi - saqarTvelos konstitucia • kanoni saeqimo saqmianobis Sesaxeb • kanoni janmrTelobis dacvis Sesaxeb /10.12.1997/; • kanoni narkotikuli saSualebebis, fsiqotropuli nivTierebebis, prekursorebisa da narkologiuri daxmarebis Sesaxeb /12.05.2002 _ 23.03.2003/; • kanoni adamianis imunodeficitis virusiT infeqciiT /Sidsis/ profilaqtikis Sesaxeb /08.11.2000 _ 01.01.2001/; • kanoni pacientis uflebebis Sesaxeb /05.05.2000/; • kanoni sisxlisa da misi komponentebis donorobis Sesaxeb /30.04.1997/; • kanoni adamianis organoTa gadanergvis Sesaxeb; • kanoni samedicino socialuri eqspertizis Sesaxeb /07.12.2001 _ 07.03.2002/; • kanoni samedicino dazRvevis Sesaxeb /18.04.1997/; • kanoni bavSvTa bunebrivi kvebis dacvis da xelSewyobis, xelovnuri sakvebis moxmarebis Sesaxeb /09.09.1999/; 145 Tavi 5: qveynis Sesabamisi SeniSvnebi konvenciebi ratificirebis TariRi adamianis uflebaTa dacvis deklaracia 15.09.1991 samoqalaqo da politikuri uflebebis saerTaSoriso paqti ((ICCPR) 25.01.1994 samoqalaqo da politikuri uflebebis saerTaSoriso paqtis fakultaturi oqmi 25.01.1994 ekonomikuri, socialuri da kulturuli uflebebis saerTaSoriso paqti 25.01.1994 bavSvTa uflebebis dacvis konvencia 21.04.1994/ wamebisa da sxva sastiki, araadaminauri Rirsebis Semlaxavi mopyrobis da dasjis winaaRmdeg saerTaSoriso konvencia 22.09.1994 narkotikuli saSualebebisa da fsiqotropuli nivTierebebis ukanono brunvis winaaRmdeg brZolis Sesaxeb gaerTianebuli erebis organizaciis konvencia 28.05.1997 fsiqotropuli nivTierebaTa Taobaze gaerTianebuli erebis organizaciis konvencia 28.05.1997 adamianis uflebaTa da ZiriTadi TavisuflebaTa dacvis evropis konvencia 12.05.1999 1961 wlis narkotikul saSualebaTa Sesaxeb erTiani konvencia 23.02.2000 1971 wlis 21 Tebervali konvencia fsiqotropul nivTierebaTa Taobaze; adamianis uflebaTa da ZiriTadi TavisuflebaTa evropis konvenciis me-4 oqmi 23.02.2000 bavSvTa uflebebis dacvis Sesaxeb gaeros generaluri asambleis mier miRebuli #50/155 rezolucia 23.02.2000 wamebis da araadamianuri an damamcirebeli mopyrobis an dasjis aRkveTis evropuli konvencia 23.02.2000 bavSvTa Sromis ukiduresi formebis akrZalvisa da dauyovnebliv aRmofxvris RonisZiebebis Sesaxeb konvenciis ratificirebis Taobaze 18.05.2002 “bavSvebiT vaWrobis, bavSvTa prostituciisa da bavSvTa pornografiis Sesaxeb~ bavSvis uflebebis konvenciis damatebiT oqmTan SeerTebis Taobaze 27.09.2002 konvencia adamianis uflebebisa da biomedicinis Sesaxeb; ratificirebulia 2000 wels da konvencia saqarTveloSi ZalaSia 2001 wlis 1 martidan. adamianis uflebebisa da biomedicinis Sesaxeb konvenciis `adamianis organoebisa da qsovilebis gadanergvis~ Sesaxeb damatebiTi oqmis ratificirebis Sesaxeb 27.09.2002 `biologiasa da medicinaSi adamianis uflebebisa da Rirsebis dacvis Sesaxeb~; qalTa politikuri uflebebis Sesaxeb jandacvis msoflio organizaciis CarCo konvencia Tambaqos kontrolis Sesaxeb 146 adamianis uflebebi janmrTelobis dacvis sferoSi 16.06.2005 qveTavi 5.2 saqarTvelos konstitucia muxli 15 1. sicocxle adamianis xelSeuvali uflebaa da mas icavs kanoni. muxli 37 yvelas aqvs ufleba isargeblos janmrTelobis dazRveviT, rogorc xelmisawvdomi samedicino daxmarebis saSualebiT. kanoniT dadgenili wesiT gansazRvrul pirobebSi uzrunvelyofilia ufaso samedicino daxmareba. mniSvnelovani yuradReba unda daeTmos konvencias `adamianis uflebebisa da biomedicines Sesaxeb~, rac Tavidan agvacilebs adamianis uflebebis darRvevis im faqtebs, romlebic medicinis da biomedicinis sferoSi warmoebul kvlevebs ukavSirdeba. `adamianis uflebebisa da biomedicinis Sesaxeb~ konvenciisa da misi oqmebis mTavari mizania, uzrunvelyos evropis sabWos wevr qveynebSi, romlebic konvencias miurTdebian, adamianis uflebebis, Rirsebisa da individualobis dacva biologiisa da medicinis konteqstSi. konvenciis sruli saxelwodebaa `konvencia biologiasa da medicinaSi adamianis uflebebisa da Rirsebis dacvis Sesaxeb~. konvencia adamianis uflebebisa da biomedicinis Sesaxeb jerjerobiT erTaderTi savaldebulo saerTaSoriso dokumentia, romlis mizania adamianis uflebebisa da Rirsebis dacva biologiisa da medicinis sferoSi. konvenciaSi mocemuli debulebebis realizacia savaldebuloa im qveynebisaTvis romlebmac misi ratificireba moaxdines. masSi miTiTebulia, rom qveynebi, romlebic am dokuments miuerTdnen, movaleni arian daicvan `TiToeuli adamianis Rirseba da individualoba, yovelgvari diskriminaciis gareSe uzrunvelyon maTi xelSeuxebloba da sxva uflebebi da ZiriTadi Tavisuflebebi biologiisa da medicinis sferoSi~. konvencia exeba adamianis uflebebs samedicino momsaxurebis (daavadebaTa profilaqtikis, maTi gamovlena-diagnostirebis da mkurnalobis) sferoSi da aregulirebs biosamedicino kvlevebs (eqsperimentebis). konvencia aRiarebs da xazs usvams iseT mniSvnelovan uflebebs jandacvisa da biomedicinis sferoSi, rogoricaa: Tanxmobis gacxadebis ufleba nebismieri Carevis win medicinisa da biosamedicino kvlevebis sferoSi; informaciis miRebis ufleba sakuTari janmrTelobis Sesaxeb; pirad cxovrebaSi Caurevlobis ufleba. amasTan, konvencia gansakuTrebiT miuTiTebs mowyvladi, daucveli pirebebis uflebebis dacvis aucielblobaze da qmnis damatebiT meqanizmebs aseTi prebis uflebebis dacvis garantiebis gasamyareblad. upirveles yovlisa, es exeba arasrulwlovnebs da fsiqikuri daavadebis mqone pirebs. erTi mxriv, konvencia exeba yvela dargs biologiis da medicinis sferoSi. meore mxriv, is specifikurad exeba iseT dagebs, rogorebicaa: adamianis genomi; adamianis organoTa gadanergva; adamianze Catarebuli biosamedicino kvleva. 147 Tavi 5: qveynis Sesabamisi SeniSvnebi konvencia adamianis uflebebisa da biomedicinis Sesaxeb saqarTvelos mier xelmowerili da ratificirebulia 2000 wels da konvencia saqarTveloSi ZalaSia 2001 wlis 1 martidan. saqarTvelo meSvide qveyanaa, sadac am konvencias kanonis Zala aqvs. konvenciasTan erTad saqarTvelom xeli moawera damatebiT oqms `adamianis klonirebis akrZalvis Sesaxeb~. aseve erTad moxda saqarTvelos parlamentSi konvenciisa da misi damatebiTi oqmis ratificireba. sainteresoa is faqti, rom konvenciis damatebiTi oqmis amoqmedeba evropaSi SesaZlebeli gaxda mxolod masTan saqarTvelos mierTebis Semdeg; aRniSnuli oqmi saqarTvelos mier mis ratifikaciamde arc erT qveyanaSi ar iyos ZalaSi Sesuli. misi amoqmedebisaTvis saWiro iyo ratifikacia kidev erTi qveynis mier. ase, rom saqarTvelos mier konvenciis damatebiTi oqmis ratifikaciis Sedegad evropis 5 qveyanaSi, maT Soris saqarTveloSi, 2001 wlis martidan aikrZala nebismieri Careva, romlis mizania sxva adamianis, cocxalis an gardacvlilis, ganetikurad identuri adamianis Seqmna. amasTan, aRsaniSnavia, rom konvenciis da misi oqmebis ZalaSi SesvlisaTvis aucilebelia, rom is xelmowerili da ratificirebuli iyos, sul mcire, 5 qveynis mier, romelTagan 4 qveyana evropis sabWos wevri iqneba. sadReisod konvencia `adamianis uflebebisa da biomedicines Sesaxeb~ ZalaSia evropis 21 qveyanaSi (xelmowerisa da ratifikaciis monacemebi ix. cxrilSi 1). Tavidan gansazRvruli iyo damatebiTi oqmebis momzadeba or konkretul sakiTxze _ transplantaciasa da biosamedicino kvlevebis Sesaxeb. dRes ukve dasrulebulia da xelmosawerad `gaxsnilia~ Semdegi oqmebi: 1. oqmi `adamianis klonirebis akrZalvis Sesaxeb~ (1998); 2. oqmi `adamianis organoebisa da qsovilebis gadanergvis Sesaxeb~ (2001); 3. oqmi `biosamedicino kvlevis Sesaxeb~ (2005); 2008 wlis 7 maiss evropis sabWos ministrTa komitetma daamtkica kidev erTi oqmi _ `oqmi genetikuri testirebis Sesaxeb janmrTelobis miznebisaTvis~. adamianis uflebebisa da biomedicinis Sesaxeb konvenciisa~ da misi damatebiTi oqmebis ratifikaciis ricxobrivi maCveneblebi cxrilis saxiT mocemulia qvemoT: cxrili #1 xelmowera ratifikaciis gareSe ratifikacia sul `konvencia adamianis uflebebisa da biomedicinis Sesaxeb~ 13 21 34 oqmi `adamianis klonirebis akrZalvis Sesaxeb~ 15 16 31 oqmi `adamianis qsovilebisa da organoebis gadanergvis Sesaxeb~ 12 8 20 oqmi `biosamedicino kvlevebis Sesaxeb~ 16 5 21 konvencia/oqrmi 148 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 5.2 amrigad, dRes ZalaSi Sesulia konvenciis samive damatebiTi oqmi, romlebic xelmosawerad aris gaxsnili. saqarTvelos mier xelmowerilia yvela aRniSnuli oqmi, magram ratificirebulia mxolod ori _ oqmi `adamianis klonirebis akrZalvis Sesaxeb~ da oqmi `adamianis qsovilebisa da organoebis gadanergvis Sesaxeb~. amasTan, aRsaniSnavia isic, rom oqmi `adamianis klonirebis akrZalvis Sesaxeb~ evropaSi ZalaSi Sevida saqarTvelos ratifikaciis Sedegad, radgan maSin saqarTvelo aRmoCnda me-5 qveyana, romelmac evropis sabWos aRniSnuli instrumentis ratifikacia moaxdina. cxrilSi #2 mocemulia saqarTvelos mier konvenciisa da misi oqmebis xelmoweris, ratificirebisa da maTi ZalaSi Sesvlis TariRebi. cxrili #2 TariRi konvencia/oqrmi xelmoweris ratifikaciis ZalaSi Sesvlis `konvencia adamianis uflebebisa da biomedicinis Sesaxeb~ 11.05.2000 22.11.2000 01.03.2001 oqmi `adamianis klonirebis akrZalvis Sesaxeb~ 11.05.2000 22.11.2000 01.03.2001 oqmi `adamianis qsovilebisa da organoebis gadanergvis Sesaxeb~ 25.03.2002 18.12.2002 01.05.2006 oqmi `biosamedicino kvlevebis Sesaxeb~ 21.02.2005 - - konvencia gansazRvravs biomedicinis sferoSi adamianis uflebebis mxolod ZiriTad, umniSvnelovanes principebs. SedarebiT dawvrilebiTi da konkretul SemTxvevebTan misadagebuli standartebi aRwerilia konvenciis damatebiT oqmebSi. konvenciis umniSvnelovanesi principebia: adamianis interesebis uzenaesoba (sazogadoebisa da mecnierebis interesebTan SedarebiT); informirebuli Tanxmobis gacxadebis aucilebloba nebismieri Carevis win; konfidencialurobis dacvis moTxovnis ufleba da pirad coxvrebaSi Caurevloba; sakuTar janmrTelobasTan dakavSirebuli sakiTxebis Sesaxeb informaciis miRebis ufleba; profesiuli standartebis dacvis garantiebis Seqmnis aucilebloba biomedicinis sferoSi; momsaxurebis Tanabari xelmisawvdomobis uzrunvelyofis aucilebloba jandacvis sferoSi; dacvis damatebiTi garantiebis Seqmna mowyvladi jgufebisaTvis, gansakuTrebiT pirebisaTvis, romlebsac ar SeuZliaT Tanxmobis gacxadeba (bavSvebi, janmrTelobis mdgomareobis gamo Tanxmobis gacxadebis unaris armqone pirebi, maT Soris, fisqikurad daavadebulni); diskriminaciis akrZalva genetikuri memkvidreobis safuZvelze; adamianis organizmis da misi nawilebis finansuri sargeblobis wyarod gaxdomis akrZalva; samarTliani kompensaciis miRebis ufleba Carevis Sedegad miRebuli zaralisaTvis; konvenciisadmi mierTebuli qveynebis mier sanqciebis dawesebis aucilebloba konvenciaSi asaxuli debulebebis darRvevisaTvis; konvenciisadmi mierTebuli qveynebis mier adamianis uflebebis dacvis ufro maRali garantiebis SemoRebis SesaZleblobis SeuzRudaoba. 149 6.1 pacientis uflebebi ufleba prevenciul RonisZiebebze samedicino momsaxurebis xelmisawvdomoba informaciis miRebis ufleba informirebuli Tanxmoba Tavisufali arCevanis ufleba piradi cxovrebis xelSeuxebloba da konfidencialuroba pacientis ufleba gaufrTxildnen mis dros xarisxiani samedicino momsaxurebis miRebis ufleba usafrTxoebis ufleba Tanamedrove medicinis miRwevebiT sargeblobis ufleba tanjvisa da tkivilis Semsubuqebis ufleba saCivris Setanis ufleba kompensaciis miRebis ufleba nebis winaswar gamoxatvis ufleba Tavisufleba aRkveTil pirTa uflebebi genetikasTan dakavSirebuli uflebebi 6.2 pacientis valdebulebebi samedicino Carevaze Tanxmobis valdebuleba informaciis miwodebis valdebuleba informaciis miRebis valdebuleba 150 adamianis uflebebi janmrTelobis dacvis sferoSi 6 pacientis uflebebi da movaleobebi saqarTveloSi 6.1 pacientis uflebebi saqarTvelos kanonSi pacientis uflebebis Sesaxeb ganmartebulia, rom pacienti SeiZleba iyos `nebismieri piri, romelic miuxedavad misi janmrTelobis mdgomareobisa, sargeblobs, saWiroebs an apirebs isargeblos janmrTelobis dacvis sistemis momsaxurebiT~. pacientad igulisxmeba nebismieri moqalaqe dabadebidan sicocxlis bolomde, anu, pirovneba, romelic elodeba, iRebs, an ukve miiRo momsaxureba jandacvis sferoSi. 2000 wels saqarTvelos parlamentma miiRo kanoni `pacientis uflebebis Sesaxeb~, romelsac saqarTvelos janmrTelobis dacvis sferos kanonmdeblobaSi erT-erTi mTavari adgili ukavia. kanonis `pacientis uflebebis Sesaxeb~ me-9 muxlis Tanaxmad: saqarTvelos moqalaqes, romelic imyofeba sxva saxelmwifoSi, agreTve ucxo qveynis moqalaqesa da moqalaqeobis armqone pirs, romlebic imyofebian saqarTveloSi, janmrTelobis dacvis ufleba garantirebuli aqvT saqarTvelos saerTaSoriso xelSekrulebebisa da SeTanxmebebis Sesabamisad, xolo maTi ararsebobisas moqmedebs im qveynis kanonmdebloba, sadac piri imyofeba. 151 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi adamianis uflba, cxovrobdes janmrTelobisaTvis uvnebel garemoSi da saxelmwifos aucilebeli Carevis an Caurevlobis Sedegad daculi iyos misi janmrTeloba (saqarTvelos konstitucia 37-e muxli), ar SeiZleba SeizRudos an gamoiricxos pirTa garkveuli wris mimarT moqalaqeobis niSniT. moqalaqeoba Sinaarsobrivad samarTlebriv _ politikuri institutia da igi gavlenas ar unda axdendes samarTliT daculi sikeTis _ janmrTelobis dacvis xarisxze. adamians janmrTelobis dacvis ufleba garantirebuli aqvs adamianis da ara moqalaqis statusiT. winaaRmdeg SemTxvevaSi adgili eqneba saerTaSoriso xelSekrulebebis (saerTaSoriso sajaro samarTlis) darRvevas, romelTac saqarTvelos konstituciasTan mimarTebiT upiratesi Zala aqvT, Tuki isini ar ewinaaRmdegeba saqarTvelos konstitucias. mocemul SemTxvevaSi saqme gvaqvs ara winaaRmdegobasTan, aramed sruliad erTgvarovan regulirebasTan, radgan saerTaSoriso SeTanxmebebis Sidasaxelmwifoebriv samarTalSi implementacia xdeba konstituciasa da mimdinare kanonmdeblobaSi aRniSnuli normebis gadmotanis gziT. aRsaniSnavia, rom saqarTvelos konstituciis meore Tavi dasaTaurebulia, rogorc `adamianis ZiriTadi uflebani da Tavisuflebani~ da ara moqalaqis ZiriTadi uflebani. winamdebare muxli ganavrcobs janmrTelobis dacvis uflebis garantirebulobis moqmedebis farglebs da ganmartavs, rom sxva saxelmwifoSi myofi saqarTvelos moqalaqis janmrTelobis dacvis ufleba, aseve daculia saqarTvelos saerTaSoriso xelSekrulebebiT (ormxrivi an mravalmxrivi), xolo maTi ararsebobis SemTxvevaSi, moqmedebs adgilsamyofeli qveynis kanonmdebloba. pacientis qmedunarianoba da uflebaunarianoba pacientis qmedunarianobis sakiTxi regulirdeba saqarTvelos samoqalaqo kodeqsis Sesabamisad, kerZod: me-12 muxlis Tanaxmad qmedunarianoba aris fizikuri piris unari, თavisi nebiTa da moqmedebiT sruli moculobiT SeiZinos da ganaxorcielos samoqalaqo uflebebi da movaleobebi. qmedunaruanoba warmoiSoba srulwlovanebis miRwevisTanave. srulwlovania piri, romelmac miaRwia 18 wlis asaks. amave dros qmedunarianad iTvleba piri, romelic iqorwinebs 18 wlis asakis miRwevamde. 7 wlamde asakis arasrulwlovani (mcirewlovani) aris qmeduunaro. qmeduunarod miiCneva aseve piri, romelic Wkuasustobis an suliTavadmyofobis gamo sasamarTlos mier aseTad iqneba aRiarebuli. am piris uflebebs axorcielebs misi kanonieri warmomadgeneli (meurve). qmeduunarod aRiarebuli piris gankurnebis an janmrTelobis mniSvnelovnad gaumjobesebis SemTxvevaSi sasamarTlo aRiarebs mas qmedunarianad. amave kodeqsis me-14 muxlis Tanaxmad, arasrulwlovani 7-18 wlamde SezRuduli qmedunarianobis mqoned iTvleba. SezRuduli qmedunarianobis mqoned iTvleba aseve srulwlovani, romelsac sasamarTlom dauwesa mzrunveloba. aseTi piri Tavis qmedunarianobaSi uTanabrdeba arasrulwlovans. pacientis uflebebis Sesaxeb kanonis VIII Tavi eZRvneba swored arasrulwlovanis uflebebs. /muxlebi: 39, 40, 41, 42, 43/ sayuradReboa, rom am kanonis 40-e muxlis Tanaxmad `mSobels an kanonier warmomadgenels ufleba aqvs mkurnali eqimisagan miiRon sruli, obieqturi, drouli da gasagebi informa- 152 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 cia arasrulwlovanis janmrTelobis mdgomareobis Sesaxeb~, Tumca arsebobs gamonaklisic, romlis Tanaxmadac `mSobels an kanonier warmomadgenels am muxlis pirveli punqtiT gaTvaliswinebuli informacia ar miewodeba, Tu informaciis miwodebis winaaRmdegia: a) arasrulwlovani pacienti, romelic saqarTvelos kanonmdeblobiT dadgenili wesiT qmedunarianad iTvleba; b) 14-dan 18 wlamde asakis arasrulwlovani pacienti, romelic samedicino momsaxurebis gamwevis SexedulebiT sworad afasebs sakuTari janmrTelobis mdgomareobas da romelmac eqims mimarTa sqesobrivad gadamdebi daavadebis an narkomaniis mkurnalobis, kontracefciis araqirurgiuli meTodebis Sesaxeb konsultaciis miRebis an orsulobis xelovnurad Sewyvetis mizniT~. (muxli 40, punqti 2.) aseT dros pacients ufleba aqvs ganacxados informirebuli Tanxmoba samedicino momsaxurebaze. pacientis uflebebi iyofa socialur da individualur uflebebad. socialuri uflebebi: samedicino momsaxurebis xelmisawvdomoba amonaridi `adamianis uflebaTa sayovelTao deklaraciidan~ (gaeros generaluri asamblea, 1948 weli) `yvela adamianis aqvs ufleba cxovrebis iseT doneze, romelic adekvaturi iqneba misi da misi ojaxis janmrTelobisa da keTidReobisaTvis, sakvebis, tansacmlis, sacxovrebeli adgilis, samedicino daxmarebis da aucilebeli socialuri samsaxurebis CaTvliT~ socialur uflebebs miekuTvneba samedicino momsaxurebis xelmisawvdomoba, romelic iyofa Semdeg qvekategoriebad: samedicino momsaxurebis finansuri xelmisawvdomoba; samedicino momsaxurebis xelmisawvdomoba momsaxurebis saxeebis mixedviT; samedicino momsaxurebis xelmisawvdomoba geografiuli (teritoriuli) TvalsazrisiT; samedicino momsaxurebis xelmisawvdomoba raime niSniT diskriminaciis gareSe (asaki, sqesi, eTnikuri warmomavloba, rasa da a.S.) samedicino momsaxurebis xarisxi; cneba `samedicino daxmarebis xelmisawvdomoba~ qveynis SesaZleblobebiT, resursebiT da mravali faqtoris balansiT aris warmodgenili. es faqtorebia: kadrebi, dafinanseba, satransporto saSualebebi, arCevanis Tavisufleba, sazogadoebis informirebuloba, teqnikuri resursebis xarisxi da ganawileba. es elementebi gansazRvraven mosaxleobis mier realurad miRebuli daxmarebis moculobas da xarisxs, xolo maTi balansi _ daxmarebis xelmisawvdomobis xasiaTsa da xarisxs. 153 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi termini `janmrTelobis dacvis Tanabari xelmisawvdomoba~ naxsenebia konvenciaSi `adamianis uflebebisa da biomedicines Sesaxeb~, rac aq gagebuli ar unda iyos, rogorc absoluturad Tanabari momsaxurebis (saprofilaqtiko, sadiagnozo, samkurnalo da sarebilitacio Carevebis) xelmisawvdomobis uzrunvelyofa yvelasaTvis. upirveles yovlisa, is gulisxmobs gaumarTlebeli diskriminaciis gamoricxvas. pacientis uflebebis Sesaxeb kanonis me-6 muxlis Tanaxmad: `1. pacientis diskriminacia rasis, kanis feris, enis, sqesis, genetikuri memkvidreobis, rwmenisa da aRmsareblobis, politikuri da sxva Sexedulebebis, erovnuli, eTnikuri da socialuri kuTvnilebis, warmoSobis, qonebrivi da wodebrivi mdgomareobis, sacxovrebeli adgilis, daavadebis, seqsualuri orientaciis an piraduli uaryofiTi ganwyobis gamo akrZalulia. 2. ama Tu im daavadebasTan dakavSirebiT pacientis uflebebis SezRudvis pirobebs gansazRvravs saqarTvelos kanonmdebloba~. saxelmwifo aRiarebs yvela pacientis Tanasworobis princips da arc erTs ar aniWebs upirates uflebas. ufro metic, am kanonis me-6 muxlis pirveli nawilis mixedviT, akrZalulia pacientis diskriminacia rasis, kanis feris, enis, sqesis, genetikuri memkvidreobis, rwmenisa da aRmsareblobis, politikuri da sxva Sexedulebis, erovnuli, eTnikuri da socialuri kuTvnilebis, warmoSobis, qonebrivi da wodebrivi mdgomareobis, sacxovrebeli adgilis, daavadebis, seqsualuri orientaciis an piraduli uaryofiTi ganwyobis gamo. amasTan, `pacientis uflebebis Sesaxeb~ saqarTvelos kanonis Tanaxmad, daculia zogadad pacientis uflebebi, anu rogorc saqarTvelos moqalaqis, ise sxva saxelmwifos moqalaqisa Tu moqalaqeobis armqone piris. niSandoblivia isic, rom es principi fundamenturi principia da misma darRvevam SesaZlebelia garkveuli saxis, maT Soris, sisxlissamarTlebrivi pasuxismgebloba gamoiwvios. ase magaliTad: saqarTvelos sisxlis samarTlis kodeqsis 142-e muxlis Sesabamisad, adamianis Tanasworuflebianobis darRveva danaSauls warmoadgens, anu adamianis Tanasworuflebianobis darRveva rasis, kanis feris, enis, sqesis, religiisadmi damokidebulebis, aRmsareblobis, politikuri an sxva Sexedulebis, erovnuli, eTnikuri, socialuri, romelime wodebisadmi an sazogadoebrivi gaerTianebisadmi kuTvnilebis, warmoSobis, sacxovrebeli adgilis an qonebrivi mdgomareobis gamo isjeba jarimiT an gamasworebeli samuSaoTi vadiT erT wlamde anda Tavisuflebis aRkveTiT vadiT or wlamde, xolo am muxlis me-2 nawilis Tanaxmad, igive qmedeba, Cadenili samsaxurebrivi mdgomareobis gamoyenebiT an dasrulebuli mZime SedegiT, isjeba jarimiT an Tavisuflebis aRkveTiT vadiT sam wlamde, Tanamdebobis dakavebis an saqmianobis uflebis CamorTmeviT vadiT sam wlamde an uamisod. Tumca calsaxad aRsaniSnavia isic, rom sisxlis samarTlis kodeqsis 142-e muxlis Sesabamisad, adamianTa Tanasworuflebianobis darRveva mxolod im SemTxvevaSi warmoadgens danaSauls, rodesac am qmedebam arsebiTad xelyo adamianis ufleba, anu am dros gadamwyveti mniSvneloba eniWeba im faqtis dadgenas, adamianTa Tanasworuflebianobis darRveviT arsebiTad xelyofili iqna Tu ara adamianis ufleba. mxolod aRniSnuli garemoebis dadasturebis SemTxvevaSi SesaZlebelia dadges konkretuli piris sisxlissamarTlebrivi pasuxismgeblobis sakiTxi. aseve mniSvnelovania sisxlis samarTlis kodeqsis 1421 muxli, romlis mixedviT, danaSauls warmoadgens aseve rasobrivi diskriminacia, ese igi qmedeba, Cadenili erovnuli an rasobri- 154 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 vi mtrobis an ganxeTqilebis Camogdebis, erovnuli pativisa da Rirsebis damcirebis mizniT, agreTve rasis, kanis feris, socialuri kuTvnilebis, erovnuli an eTnikuri warmomavlobis niSniT adamianis uflebebis pirdapiri an arapirdapiri SezRudva, anda imave niSniT adamianisaTvis upiratesobis miniWeba da igi isjeba sasjeliT _ Tavisuflebis aRkveTis saxiT. gansakuTrebiT aRsaniSnavia sisxlis samarTlis kodeqsis 1422 muxli, romlis mixedviTac, sisxlissamarTlebrivi wesiT dasjad qmedebas warmoadgens SezRuduli SesaZleblobis mqone piris uflebebis SezRudva, anu invalidobis motiviT SezRuduli SesaZleblobis mqone pirisaTvis kanoniT an/da saerTaSoriso xelSekrulebiT miniWebuli uflebis ganxorcilebaze uaris Tqma, Tumca mxolod maSin, rodesac am qmedebam arsebiTad xelyo am piris ufleba. aRniSnulisaTvis kanonmdeblobiT dadgenilia sasjeli _ jarima an Tavisuflebis SezRudva vadiT sam wlamde anda Tavisuflebis aRkveTa sam wlamde vadiT. am muxlis me-2 nawilis Tanaxmad ki, igive qmedeba, Cadenili araerTgzis, samsaxurebrivi mdgomareobis gamoyenebiT da a.S., isjeba jarimiT an Tavisuflebis SezRudviT vadiT xuT wlamde anda Tavisuflebis aRkveTiT oridan xuT wlamde vadiT. `pacientis uflebebis Sesaxeb~ saqarTvelos kanonis me-6 muxlis me-2 punqtis mixedviT, SesaZlebelia saqarTvelos kanonmdeblobiT ganisazRvros ama Tu im daavadebasTan dakavSirebiT pacientis uflebebis SezRudvis pirobebi. ase magaliTad: `adamianis imunodeficitis virusiT infeqciis (Sidsis) profilaqtikis Sesaxeb~ saqarTvelos kanonis me-8 muxlis me-10 punqtis Tanaxmad, aiv inficirebul/SidsiT daavadebul pirebs ara aqvT SromiTi mowyobis ufleba im specialobebze, sadac arsebobs TviT misi an masTan kontaqtSi myofi piris kanisa da lorwovani garsis mTlianobis darRvevis SesaZlebloba da meore piris inficirebis safrTxe, magram dResReobiT saminitros mier gamocemul arc erT brZanebaSi ar weria rom dainficirebuli adamiani SezRudulia imuSaos nebismieri profesiiT. dainficirebul adamians SeuZlia imuSaos nebismier profesiaSi Tuki daculi iqneba usafrTxoebis zomebi. aseTia midgomaa Tanamedove msoflioSi Sidsian pacientebTan mimarTebaSi. `kanoni pacientis uflebebis Sesaxeb~ _ muxli 5 ganmartavs, rom: `saqarTvelos TiToeul moqalaqes ufleba aqvs samedicino momsaxurebis yvela gamwevisagan miiRos qveyanaSi aRiarebuli da danergili profesiuli da samomsaxureo standartebis Sesabamisi samedicino momsaxureba~. aRniSnuli muxli iTvaliswinebs imas, rom saqarTvelos TiToeul moqalaqes ufleba aqvs samedicino momsaxurebis yvela gamwevisagan (anu nebismieri pirisagan, romelic saqarTvelos kanonmdeblobiT dadgenili wesiT axorcielebs samedicino momsaxurebas _ diagnostikis, mkurnalobis, profilaqtikis an samedicino reabilitaciis mizniT pacientisaTvis Catarebul nebismier manipulacias da proceduras) miiRos qveyanaSi aRiarebuli da danergili profesiuli da samomsaxureo standartebis Sesabamisi samedicino momsaxureba. `pacientis uflebebis Sesaxeb~ saqarTvelos kanoni adgens garantiebs saqarTvelos moqalaqeebisaTvis, raTa maT aranairi samarTlebrivi problemebi ar hqondeT imisaTvis, rom saxelmwifoSi miiRon samedicino momsaxureba. moqalaqeebi samedicino momsaxurebis sferoSi kanoniT gaTvaliswinebuli garkveuli uflebebiT sargebloben. es uflebebi, raTqmaunda, samedicino momsaxurebis finansur xelmisawvdomobasac exeba. kerZod, moqalaqe yovelTvis ar ixdis momsaxurebis srul Rirebulebas; zogjer moqalaqe momsaxurebis safasuris mxolod nawils faravs, ar saerTod arafers ixdis. 155 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi saqarTveloSi samedicino momsaxurebis Tanabrad xelmisawvdomoba xorcieldeba saxelmwifo samedicino programebis saSualebiT. rogorc avRniSneT janmrTelobis dacvis sistemis ZiriTadi mizania mosaxloebis janmrTelobis mdgomareobis donis amaRleba. efeqturad momuSave jandacvis sistemam yovelmxriv unda uzrunvelyos mosaxleoba xarisxiani samedicino momsaxurebiT. saxelmwifo samedicino programebi emsaxureba xelmisawvdomobis princips. saxelmwifo samedicino programis farglebSi saxelmwifo afinasebs beneficiarebs, raTa maT miiRon bazisuri samedicino momsaxureoba. zog SemTxvevaSi es aris sruli dafinaseba, zogjer Tanagadaxda. pacientis individualuri uflebebi adaminis uflebebis sayovelTao deklaraciis I muxlis mixedviT `yvela adamiani dabadebiT Tavisufalia da Tanabari Rirsebisa da uflebebis mqonea~ pacientis individualuri uflebebia: informaciis miRebis ufleba; informirebuli Tanxmoba; konfidencialuroba; piradi cxovrebis xelSeuxebloba; meore azris moZiebis ufleba; samedicino personalisa da samedicino dawesebulebis arCevis ufleba; ufleba prevenciul zomebze a) ufleba pacientis uflebaTa evropuli qartiis mixedviT (ECPR) yvela adamians aqvs ufleba miiRos saTanado momsaxureba daavadebis Tavidan asacileblad. saqarTvelos kanonmdebloba uSualod ar iTvaliswinebs „uflebas prevencieul zomebze“. Tumca, zogierTi debulebis interpretaciis meSveobiT SeiZleba davaskvnaT, rom es ufleba aRiarebulia (mag: jansaR garemoSi cxovrebis ufleba, samedicino momsaxurebis miRebis ufleba). 156 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 b) ufleba saqarTvelos konstituciis/kanonebis mixedviT saqarTvelos konstitucia konstituciis arc erTi debuleba pirdapir ar iTavliswonebs uflebas prevenciul zomebze, iseve rogorc ar iTvaliswinebs janmrTelobis uflebas. Tumca, konstituciis 37.3 muxls, romlis Tanaxmad, `yvelas aqvs jansaR garemoSi cxovrebis ufleba..(...)~, aqvs kavSiri prevenciis erT specifikur aspeqtTan _ daavadebis Tavidan acileba jansaRi garemos SeqmniT/ SenarCunebiT (mag. Tambaqos kvamlisgan, parazitebisgan, daavadebuli cxovelebisgan da a.S. Tavisufali garemo). aRniSnul uflebasTan kavSirSia aseve konstituciis zogadi debuleba jandacvis xelmisawvdlmobis Sesaxeb (ix. seqcia xelmisawvdomobis uflebis Sesaxeb). kanonebi saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: kanoni ZiriTadad exeba saxelmwifos pasuxismgeblobas uzrunvelyos gansazRvruli servsiebi da ara pacientis uflebas miiRos es servisebi. kanonis mixedviT, janmrTelobisaTvis usafrTxo garemos uzrunvelyofa saxelmwifos movaleobaa (mux. 70) kanoni aseve aRniSnavs, rom `saqarTvelos janmrTelobis dacvis saministro gansazRvravs gadamdebi da gansakuTrebiT gavrcelebuli aragadamdebi daavadebebis nusxas, SeimuSavebs maTi epidemiologiuri Seswavlis, mkurnalobisa da profilaqtikis farTomasStabian programebs, xelmZRvanelobs maT ganxorcielebas.~ (mux. 74) prevenciuli servisebis uzrunvelyofis valdebuleba aRniSnulia aseve vaqcianaciis Sesaxeb muxlSi (mux. 78). `saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministro SeimuSavebs da amtkicebs profilaqtikuri acrebis erovnul kalendars da misi ganxorcielebisaTvis saWiro saxelmwifo samedicino programas.~ kanoni aseve aregulirebs Ciyvis prevencias maRalmTian raionebSi: `maRalmTian regionebSi saxelmwifo pirdapir afinansebs QCiyvis da sxva endokrinuli daavadebebis prevencias da mkurnalobas.~ kanonis aseTi speciqika gamowveulia saqarTvelos zogierT mTian regionSi daavadebis farTo gavrcelebiT. kanoni agreTve aRiarebs mosaxleobis uflebas `radiaciul usafrTxoebaze~. (mux. 71) dabolos, kanonis Tanaxmad, saxelmwifom unda `mosaxleobisaTvis samedicino daxmarebis sayovelTao da Tanabari xelmisawvdomoba saxelmwifos nakisri saxelmwifo samedicino programebiT gaTvaliswinebuli valdebulebis farglebSi~. (mux. 4) 157 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi mniSvnelovania is faqti, rom momsaxurebis xelmisawvdomobis ufleba SemosazRvrulia mxolod saxelmwifos mier dafinansebuli programebiT, romlebic mowonebulia parlamentis mier, rogorc qveynis biujetis nawili. ase rom, mosaxleoba damokidebulia samedicino programebis arsebobaze, rac yovelwliurad icvleba. kanonis 16.4 muxlis mixedviT, saxelmwifo mier jandacvis menejmentis erT-erTi meqanizmia `wamlis, farmaciis da farmakologiuri industriis kontroli.~ saqarTvelos kanoni pacientis uflebebis Sesaxeb kanoni gansazRvravs samedicino Carevas Semdegnairad: `nebismieri manipulacia, procedura, romelsac atarebs eqimi an sxva samedicino personali diagnostikis, mkurnalobis, profilaqtikis, reabilitaciisa da paliatiuri mzrunvelobis mizniT.~ me-5 muxlis mixedviT, saqarTvelos moqalaqeebs ufleba aqvT `isargeblon dadgenili wesiT damtkicebuli janmrTelobis dacvis saxelmwifo programebiT gaTvaliswinebuli samedicino daxmarebiT. rasac ganxorcielebs saTanado samedicino saqmianobis samarTalsubieqti,ganurCevlad sakuTrebisa da organizaciul-samarTlebrivi formisa.~ aqdan gamomdinare, es muxli iTvaliswinebs profilaqtikis RoniZiebebs, rac unda iyos Sesabamisi xarosxis. janmrTelobis dacvis Sesaxeb kanonis msgavsad, kanoni pacientis uflebaTa Sesaxeb exeba mxolod saxelmwifos mier dafinansebul samedicino programebs. kanonis me-11 muxlis Tanaxmad, `samedicino momsaxurebis Tanabrad xelmisawvdomoba xorcieldeba saxelmwifo samedicino programebis saSualebiT.~1 saqarTvelos kanoni aiv infeqcia/Sidsis Sesaxeb ra aris aiv da rogor iSifreba is? es aris virusi, romelic iwvevs daavadeba Sidss. a _ adamianis i- imunodeficitis v- virusi ra aris Sidsi da rogor iSifreba is? Sidsi aris daavadeba, romelic gamowveulia aiv -iT. daavadeba gamoxatulia garkveuli simptomebiT da saWiroebs eqimis droul meTvalyureobas. Sidsi aris daavadeba, romelic gamowveulia aiv -iT. daavadeba gamoxatulia garkveuli simptomebiT da saWiroebs eqimis droul meTvalyureobas. S- SeZenili i _ imuno d- deficitis s- sindromi ra gansxvavebaa aiv inficirebulTa da SidsiT daavadebulTa Soris? adamianis organizmSi adamianis imunodeficitis virusis SeWris dRidan, es piri aiv inficirebulia. Tumca garkveuli wlebis manZilze infeqcias ar gaaCnia rame klinikuri gamovlineba, rac niSnavs, rom infeqcia mimdinareobs usimptomod. mxolod mas Semdeg, rodesac xdeba garkveuli simptomebis gamovlena, inficirebuli pirs SeiZleba vuwodoT SidsiT daavadebuli. aiv infeqciidan Sidsis stadiaze gadasvla dasturdeba specifikuri laboratoriuli gamokvlevebiT. 1 saxelmwifo programebi SegiZliaT ixiloT www.moh.gov.ge 158 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 saxelmwifo valdebulia SeimuSavos da gaataros zomebi aiv/Sidsis prevenciisTvis. kanonis mixedviT, yvelas aqvs ufleba `gaiaron nebayoflobiTi konsultireba da testireba aiv infeqciaze, maT Soris, anonimurad da konfidencialurad.~ (mux. 6.1) kanoni gansazRvravs saxelmwifos politikis principebs aiv/Sidsis sferoSi (mux. 5), rac moicavs aiv/Sidsis prevenciasac: • aiv infeqcia/Sidsis prevenciisa da mkurnalobis saxelmwifo programebis SemuSaveba da ganxorcieleba; • fizikur pirTa informireba aiv infeqciaze nebayoflobiTi testirebis Sesaxeb, agreTve saqarTvelos kanonmdeblobiT gaTvaliswinebuli im gamonaklisebis Taobaze, roca savaldebulo testireba kanonmdeblobiTaa daSvebuli; • fizikur pirTa informireba masobrivi informaciis saSualebebiT an/da individualurad, moTxovnisamebr, aiv infeqcia/Sidsis prevenciis, diagnostikis, mkurnalobis, profilaqtikis, mxardaWeris/xelSewyobisa da movlis, maT Soris, saxelmwifo programebiT gaTvaliswinebuli daxmarebis formebisa da misi miRebis SesaZleblobis Sesaxeb; • aiv infeqciaze nebayoflobiTi konsultirebisa da testirebis servisebis, aiv infeqcia/ Sidsis prevenciis, diagnostikis, mkurnalobis, profilaqtikis, mxardaWeris/xelSewyobisa da movlis universaluri xelmisawvdomobis xelSewyoba; • aiv infeqcia/Sidsis prevenciis, diagnostikis, mkurnalobis, profilaqtikis, mxardaWeris/xelSewyobisa da movlis, agreTve zianis Semcirebis xelSewyoba sasjelaRsrulebis dawesebulebebSi; • aiv infeqciaze eqspoziciis Semdgomi profilaqtikis RonisZiebebis danergva. momsaxurebis mimwodebeli dawesebuleba valdebulia SesTavazos pirs da, misi informirebuli Tanxmobis SemTxvevaSi, uzrunvelyos aiv infeqciaze testis wina da Semdgomi konsultireba (mux. 8.4) meore mxriv, momsaxurebis mimwodebeli dawesebuleba valdebulia diagnozTan erTad pirs miawodos informacia aiv infeqcia/Sidsis gavrcelebis prevenciis uzrunvelyofis RonisZiebebis Sesaxeb, romlebic savaldebuloa sxvaTa usafrTxoebisaTvis da romelTa darRvevisTvisac saqarTvelos kanonmdeblobiT dadgenilia Sesabamisi pasuxismgebloba (mux. 8.3). saqarTvelos kanoni sazogadoebrivi janmrTelobis Sesaxeb am kanonis mizania jansaRi cxovrebis wesis xelSewyoba da mosaxleobis janmrTelobis dacva, adamianis janmrTelobisaTvis usafrTxo garemos uzrunvelyofa; ojaxis reproduqciuli janmrTelobis dacvis xelSewyoba; gadamdebi da aragadamdebi daavadebebis gavrcelebis Tavidan acileba. kanoni specialurad aRniSnavs saxelmwifos da Sromis, janmrTelobis da socialuri dacvis 159 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi saministros pasuxismgeblobas organizeba gaukeTos da Caataros vaqcinacia, profilaqtikuri acrebi, gamoavlinos gadamdebi daavadebebi da a.S (mux. 6 da 7). me-5 muxlis me-2 punqtis mixedviT, saqarTveloSi myof yvela adamians aqvs ufleba: a) samedicino momsaxurebis mimwodebel dawesebulebaSi daculi iyos gadamdebi daavadebebisagan; b) uari Tqvas profilaqtikuri RonisZiebebis Catarebaze, Tu saqme ar exeba epidemias an pandemias. profilaqtikuri RonisZiebebis Catarebaze uaris Tqmis ufleba ar aqvs im pirs, romlis saqmianobac dakavSirebulia gadamdebi daavadebebis gavrcelebis maRal riskTan; g) cxovrobdes janmrTelobisaTvis uvnebel garemoSi; d) droulad miiRos amomwuravi informacia profilaqtikuri acris arsisa da aucileblobis, mosalodneli klinikuri gamosavlis, acrasTan dakavSirebuli riskisa da acraze uaris Tqmis SemTxvevaSi SesaZlo Sedegebis Sesaxeb. kanoni aRniSnavs, rom moasaxleobas unda hqondes ufaso vaqcinaciis ufleba acrebis erovnuli kalendris mixedviT. sxva kanonebi saxelmwifo biujetis Sesaxeb kanonis Tanaxnmad, mosaxleobisTvis xelmisawvdomi ubda iyos ufaso vaqcina acrebis erovnuli kalendris mixedviT. es ar vrceldeba im vaqcinebze, romlebic saxelmwifos mier ar aris mowodebuli. jandacvis dawesebuleba pasuxismgebelia pirs pirvel rigSi SesaTavazos ufaso vaqcina. g) damxmare aqtebi Sromis, janmrTelobis da socialuri dacvis ministris brZaneba, 4 ivnisi, 2003 N122 vaqcinaciis erovnuli prevenciuli kalendris miRebis Sesaxeb gansazRvravs detalur gegmas, vaqcinaciis usafrTxoebis zomebs saqarTvelos mosaxleobisTvis. Sromis, janmrTelobis da socialuri dacvis ministris brZaneba #215/n, 11.07.2007. brZanebis mixedviT, saWiroa TanamSromelTa regularuli Semowmeba daavadebis Tavidan asacileblad, rac, Tavis mxriv, prevenciis rogorc pirdapiri, ise arapirdapiri formaa. d) Sesabamisi muxlebi eTikis kodeqsidan eqimTa eTikis kodeqsi ar Seicavs specialur debulebebs prevenciis Sesaxeb. Tumca, kodeqsis mixedviT, eqimma unda miiRos yvela zoma, raTa mosaxleobas miawodos informacia im garemoebaTa Sesaxeb, ramac garkveuli jgufis adamianebis janmrTelobis gauareseba SeiZleba gamoiwvios. eqimi Tavad unda iRebdes monawilebas aseTi garemoebebis SecvlaSi. 160 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 e) sxva wyaroebi evropis sabWos konvenciis `adamianis uflebebi da biomedicine~ Sesaxeb, saxelmwifom, saWiroebebisa da arsebuli resursebis gaTvaliswinebiT, unda uzrunvelyos saTanado xarisxis jandacvis uzrunvelyofa (mux. 3). amaSi unda igulisxmebodes prevenciuli servisebic. informaciis miRebis ufleba saqarTvelos kanonis `pacientis uflebebis Sesaxeb~, me-16 muxlis Tanaxmad: `1. saqarTvelos TiToeul moqalaqes ufleba aqvs miiRos sruli, obieqturi, drouli da gasagebi informacia im faqtorebis Sesaxeb, romlebic xels uwyobs misi janmrTelobis SenarCunebas an uaryofiTad moqmedebs masze. 2. saxelmwifo valdebulia masobrivi informaciis saSualebebiT an individualurad, moTxovnisamebr, saqarTvelos kanonmdeblobiT dadgenili wesiT, miawodos moqalaqes am muxlis pirvel punqtSi miTiTebuli informacia. aRniSnuli muxlis I da II nawilebiT gaTvaliswinebuli pacientis uflebebis darRvevam SesaZlebelia gamoiwvios saqarTvelos ssk-is 247-e muxliT gaTvaliswinebuli sisxlis samarTlebrivi pasuxismgebloba. kerZod, saqarTvelos ssk-is 247-e muxli iTvaliswinebs pasuxismgeblobas sicocxlisaTvis an janmrTelobisaTvis safrTxis Semqmnel garemoebis Sesaxeb informaciis damalvis an gayalbebisaTvis. aRniSnuli muxlis pirveli nawiliT im garemoebis, faqtis an movlenis Sesaxeb informaciis damalva an gayalbeba, romelic safrTxes uqmnis sicocxles, janmrTelobas an garemos, Cadenili imis mier, vinc valdebuli iyo miewodebina es informacia mosaxleobisTvis _ isjeba jarimiT an Tavisuflebis aRkveTiT vadiT or wlamde, Tanamdebobis dakavebis an saqmianobis uflebis CamorTmeviT vadiT sam wlamde an uamisod. aRsaniSnavia, rom kanoniT gaTvaliswinebuli informaciis sazogadoebisTvis miwodeba ZiriTadad evaleba Sromis, janmrTelobisa da socialuri dacvis saministros, romelic valdebulia uzrunvelyos adamianis janmrTelobisaTvis usafrTxo garemos Seqmna. sicocxlisaTvis an janmrTelobisaTvis safrTxis Semqmneli garemoebis Sesaxeb informacia SeiZleba Seicavdes monacemebs garkveuli teritoriis sanitarul-epidemiologiuri mdgomareobis, kvebis produqtebisa da sasmeli wylis xarisxis gauaresebis Sesaxeb, aseve monacemebs radiaciuli, qimiuri, biologiuri da ekologiuri usafrTxoebis, mosalodneli miwisZvrebisa da sxva stiqiuri ubedurebebis Sesaxeb, Senoba-nagebobebis avariuli mdgomareobis Sesaxeb da sxva. kanonmdeblobis mixedviT danaSaulis Cadena SeiZleba gamoixatebodes ori saxis qmedebis ganxorcielebaSi, kerZod informaciis damalvaSi an informaciis gayalbebaSi. informaciis damalva niSnavs, rom mosalodneli safrTxis Sesaxeb mosaxleobisTvis ar iqna miwodebuli araviTari informacia. 161 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi informaciis gayalbebaSi ki igulisxmeba araswori an arasruli monacemebis miwodeba faqtis an movlenis Sesaxeb, romelic safrTxes uqmnis adamianis sicocxlesa da janmrTelobas. aqve unda ganimartos, rom arasruli informacia niSnavs medicinaSi (an sxva dargSi) specialuri codnis ar mqone pirisaTvis sruli warmodgenis Seuqmnelobas garemoebis, faqtis an movlenis Sesaxeb, romelic safrTxes uqmnis mis janmrTelobas. danaSauli damTavrebulad CaiTvleba informaciis damalvis an gayalbebis momentidan. saqarTvelos ssk-is 247-e muxlis meore nawilisTvis makvalificirebelia igive qmedebis Cadena moxelis mier, ramac gamoiwvia janmTelobis dazianeba an sxva mZime Sedegi. aRniSnuli qmedeba isjeba jarimiT an Tavisuflebis aRkveTiT vadiT samidan Svid wlamde, Tanamdebobis dakavebis an saqmianobis uflebis CamorTmeviT vadiT sam wlamde. TvalnaTliv Cans, rom kanoniT ufro mkacri pasuxismgebloba ekisreba moxeles, romelmac damala an gaayalba informacia. gasaTvaliswinebelia, rom kanoniT ar aris dakonkretebuli piris mier miRebuli dazianebis xarisxi, gamomdinare aqedan janmrTelobisTvis miyenebuli ziani nebismieri simZimis SeiZleba iyos. rac Seexeba kanoniT gaTvaliswinebul sxva mZime Sedegs, igi SefasebiTia da yovel konkretul SemTxvevaSi garemoebebis gaTvaliswinebiT unda ganisazRvros. magaliTad sxva mZime SedegSi SeiZleba igulisxmebodes daavadebebis masobrivad gavrceleba, sacxovrebeli da samuSao adgilidan dauyovneblivi evakuacia da sxv. am SemTxvevebSi aucilebelia informaciis damalvas an gayalbebas da damdgar Sedegs Soris iyos mizezobrivi kavSiri. kanoni `pacientis uflebebis Sesaxeb~ me-18 muxli ganmartavs, rom pacients ufleba aqvs icodes yvelaferi sakuTari janmrTelobis da misTvis samedicino momsaxurebis gawevasTan dakavSirebuli sakiTxebis Sesaxeb, kerZod: • ra saxis sadiagnozo Tu samkurnalo meTodebs iyenebs, anu ra resursebs flobs samedicino dawesebuleba; • ra Rirs samedicino momsaxureba da rogoria gadaxdis wesi; • ra uflebebi da movaleobebi aqvs pacients dawesebulebis Sinaganawesis mixedviT (gasaTvaliswinebelia, rom Sinaganawesi ver SezRudavs pacientis kanoniT gansazRvrul uflebebs); • vin aris pacientis mkurnali eqimi da aqvs Tu ara mas sakmarisi gamocdileba; • ra mizniT igegmeba esa Tu is samedicino Careva, ra Sedegia mosalodneli, ramdenad riskis matarebelia Careva pacientis janmrTelobisa da sicocxlisaTvis; 162 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 • arsebobs Tu ara mkurnalobis sxva, alternatiuli meTodi, rogoria am meTodis mosalodneli Sedegi da ra riski axlavs mas; • ra Sedegebi iqna miRebuli samedicino gamokvlevebiT; • rogoria diagnozi da ras niSnavs es pacientisaTvis (rogoria avadmyofobis gamosavali). zemoaRniSnuli muxli ganmartavs, rom: pacients ufleba aqvs icodes yvelaferi sakuTari janmrTelobisa da misTvis samedicino momsaxureobis gawevasTan dakavSirebuli sakiTxebis Sesaxeb. pacientma unda icodes Tu ra resursebs flobs samedicino dawesebuleba, da ra saxis samkurnalo da sadiagnozo meTodebs iyenebs. pacients aqvs ufleba winaswar icodes ra Rirs esa Tu is samedicino momsaxureba da rogoria gadaxdis wesi. saqarTvelos kanonmdeblobiT dadgenlia pacientis uflebebi da movaloebani, magram aseve arsebobs samedicino dawesebulebis Sinaganawesi, romelic damatebiT gansazRvravs pacientis uflebebsa da movaleobebs, romlis gacnobis uflebac aqvs pacients. pacients aqvs ufleba icodes ra mizniT igegmeba samedicino Careva da mosalodneli Sedegebi ramdenad sariskoa misi janmrTelobisaTvis. aseve mkurnalobaze uaris Tqmis SemTxvevaSi ra mosalodeneli Sedegi SeiZleba dadges. profilaqtikuri momsaxureba gulisxmobs yvela im RonisZiebas, romlebic mimarTulia nebismieri daavadebis Tu mdgomareobis prevenciisaken. saqarTvelos kanoni sazogadoebrivi janmrTelobis Sesaxeb profilaqtikur mkurnalobas ganmartavs rogorc samedicino intervenciebis ganxorcielebas (vaqcinacia, specifikuri medikamentebis miReba) gadamdebi daavadebebis gavrcelebis prevenciis mizniT risk-jgufis pacientebSi. am kanonis mixedviT (Tavi II, muxli 5, punqti 1), saqarTvelos teritoriaze myofi yvela adamiani valdebulia gadamdebi daavadebebis aRmocenebisa da gavrcelebis saSiSroebis SemTxvevaSi, kompetenturi organoebis moTxovniT, Caitaros yvela samedicino procedura, romelic aucilebelia sxva piris janmrTelobasTan dakavSirebuli safrTxis Tavidan asacileblad, da samedicino ukuCvenebebis ararsebobis SemTxvevaSi Caitaros vaqcinacia gadamdebi daavadebebis afeTqebis an farTod gavrcelebis, anda epidemiis dawyebis saSiSroebisas. amave kanonis mixedviT (Tavi II, muxli 5, punqti 2), saqarTvelos teritoriaze myofi yvela adamianis uflebaa uari Tqvas profilaqtikuri RonisZiebebis Catarebaze, Tu saqme ar exeba epidemias an pandemias. mraval qveyanaSi, maT Soris saqarTveloSi, daSvebulia pacientisaTvis informaciis an misi nawilis armiwodeba (kanoni `pacientis uflebebis Sesaxeb~, muxli 18). amasTan, saqarTvelos kanonmdeblobiT aucilebelia, rom informaciis armiwodebis gadawyvetileba eqims daudasturos eTikis komisiam an sxva eqimma. eTikis komisia aris damoukidebeli erTeuli, romelic funqcionirebs samedicino dawesebulebaSi. misi wevrebi SeiZleba iyvnen: eqimebi, eqTnebi, iuristi, socialuri muSaki, fsiqologebi, sazogadoebasTan urTierTobis menejeri da sxva. eTikis komisias SeuZlia gadawyvitos yvela adgilobrivi sakiTxi samedicino dawesebulebaSi, romelic eqim-pacientis urTierTobas exeba. saqarTvelos kanonmdebloba agreTve iTvaliswinebs informaciis miwodebis aucileblobas yvela SemTxvevaSi, roca pacienti amas daJinebiT moiTxovs (kanoni `pacientis uflebebis 163 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi Sesaxeb~, muxli 18). `pacientis uflebebis Sesaxeb~ kanonis Tanaxmad pacientisTvis miwodebuli informacia unda iyos sruli, obieqturi, drouli da gasagebi. amave dros, eqimis valdebulebaa gaiTvalisiwnos pacientis aRqmis unari da Tavi aaridos specialuri terminebis gamoyenebas, raTa pacientma naTlad aRiqvas yvela is detali, rac mis janmrTelobasTan aris dakavSirebuli. amave kanonSi gacxadebulia pacientis ufleba uari Tqvas informaciis miRebaze. aRniSnul wess aqvs gamonaklisebic. kerZod, Tu informacia exeba maRal riskTan dakavSirebul samedicino Carevas, risTvisac aucilebelia pacientis Tanxmoba, pacientisaTvis informaciis miwodeba gardauvalia. eqimi valdebulia pacients miawodos amomwuravi informacia misi janmrTelobis Sesaxeb, magram aris iseTi SemTxvevebic, roca informaciis miwodebam SeiZleba uaryofiTad imoqmedos pacientis janmrTelobis mdgomareobaze. kanonis Tanaxmad, pacientisaTvis informaciis miwodebisas gaTvaliswinebuli unda iyos misi mdgomareoba. Tu es informacia zians moutans mas, igi unda miewodeos SezRuduli moculobiT. am gadawyvetilebas iRebs eTikis komisia an misia ar arsebobis SemTxvevSaSi unda moZiebul iqnas sxva eqimi, romelic daadasturebs inforamciis miwodebis formas da moculobas. es yvelaferi asaxuli unda iyos pacientis samedicino dokumentaciaSi. aRniSnuli ZiriTadad mZime daavadebebs exeba. sazogadoebrivi janmrTelobis Sesaxeb kanonis mixedviT (Tavi II, muxli 5, punqti 1), saqarTvelos teritoriaze myofi yvela adamiani valdebulia ar ganaxorcielos iseTi saqmianoba, romelic qmnis gadamdebi da aragadamdebi daavadebebis gavrcelebis safrTxes, iwvevs janmrTelobasTan dakavSirebuli riskebis warmoqmnas. aqedan gamomdinare, pacients ufleba ar aqvs uari ganacxados im informaciis miRebaze, romelic dakavSirebuli iqneba gadamdebi daavadebebis afeTqebis an farTod gavrcelebis, anda epidemiis dawyebis saSiSroebasTan. pacientis Tanxmoba da informirebuli Tanxmoba kanonSi pacientis uflebebis Sesaxeb aris specialuri Tavi `Tanxmoba~, romelSic detalurad aris gansazRvruli eqimisa da pacientis urTierTobis iseTi mniSvnelovani momenti, rogoricaa samedicino momsaxurebis gawevisas pacientis Tanxmobis miRebis pirobebi. informirebuli Tanxmoba samedicino eTikis `uaxlesi~ principis _ `pacientis avtonomiis~ pativiscemis realizaciis mTavari instrumentia. cneba `pacientis avtonomia~ qarTul jandacvis sferos kanonmdeblobaSi Semdegnairad aris ganmartebuli: `avtonomia pacientis _ pacientis ufleba damoukideblad gansazRvros misTvis samedicino daxmarebis aRmoCenis yvela sakiTxi~ (kanoni `janmrTelobis dacvis Sesaxeb~,muxli 3. `a~). aucilebelia, rom informirebuli Tanxmoba: 164 win uswrebdes nebismier Carevas samedicino momsaxurebis gawevisas da biosamedicino kvlevis warmoebisas; adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 iyos Tavisufali, nebayoflobiTi (gamoricxuli unda iyos nebismieri saxis zewola); iyos gaazrebuli, risTvisac pacients an kvlevis subieqts winaswar unda miewodos informacia Carevis Sesaxeb; Tanxmobis win misawodebeli informacia unda iyos pacientisaTvis (Tu saubaria samedicino kvlevaze, maSin kvlevis subieqtisaTvis) da/an misi kanonieri warmomadgenlisaTvis gasagebi, advilad aRsaqmeli; informaciis miwodebisas gamoyenebuli unda iqnes naTeli, martivi ena, xolo TviT informacia unda Seicavdes monacemebs: Carevis miznis Sesaxeb (ratom aris Careva saWiro; magaliTad, diagnozisTvis, mkurnalobis meTodis SerCevisaTvis an mkurnalobis Sedegebis SefasebisTvis, uSualod mkurnalobisTvis, daavadebis prognozis gansazRvrisaTvis, reabilitaciisaTvis da a.S.). mosalodneli Sedegebis Sesaxeb; safrTxis Sesaxeb: ra diskomforti SeiZleba axdes Carevas (mag. tkivili, uxerxuloba, didi xangrZlivoba da a.S.), ramdenad mosalodnelia garTulebebi (garTulebebis xasiaTi da sixSire), xom ar aris saSiSi sicocxlisaTvis (sikvdilis riski); SesaZlo alternativebis Sesaxeb (pacientma da/an kvlevis subieqtma unda icodes SeTavazebuli Carevis garda kidev ra saxis Careva aris xelmisawvdomi da ra sargeblobis motana SeuZlia mas, agreTve ra safrTxe SeiZleba Seuqmnas man adamians). Tanxmobis Tavisuflebas xazs usvams is moTxovnac, rom adamians SeuZlia nebismier dros gaauqmos mis mier adre gacxadebuli Tanxmoba. amasTan, aucilebelia, rom am adamians dawvrilebiT ganemartos Tanxmobis gauqmebis mosalodneli Sedegebi. zogierT SemTxvevaSi Tanxmobis gauqmebis gacxadebas miuxedavad samedicino personali valdebulia ixelmZRvanelos profesiuli standartebiT (magaliTad, eqimi ver SeZlebs ukve dawyebuli qirurgiuli operaciis Sewyvetas, Tu es pacientis janmrTelobasa da sicocxles safrTxes Seuqmnis). kanoni `pacientis uflebebis Sesaxeb~ aRniSnul cnebas ufro srulyofilad ganmartavs (muxli 4, punqti `b~): `b) informirebuli Tanxmoba _ pacientis, xolo misi qmeduunarobis SemTxvevaSi, naTesavis an kanonieri warmomadgenlis Tanxmoba ama Tu im samedicino momsaxurebaze, mas Semdeg, rac maT miewodaT informacia: b.a) samedicino momsaxurebis arsisa da saWiroebis Sesaxeb; b.b) samedicino momsaxurebis mosalodneli Sedegebis Sesaxeb; b.g) pacientis janmrTelobisa da sicocxlisaTvis am momsaxurebasTan dakavSirebuli riskis Sesaxeb; b.d) ganzraxuli samedicino momsaxurebis sxva, alternatiuli variantebisa da am ukanasknelTa Tanmxlebi riskisa da SesaZlo efeqtianobis Sesaxeb; b.e) samedicino momsaxurebaze uaris Tqmis mosalodneli Sedegebis Sesaxeb; 165 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi b.v) `b.a~-`be~ qvepunqtebSi CamoTvlilTan dakavSirebuli finansuri da socialuri sakiTxebis Sesaxeb~. saqarTvelos kanonis `pacientis uflebebis Sesaxeb~, muxli 22-is Tanaxmad: 1. samedicino momsaxurebis gawevis aucilebeli pirobaa pacientis, xolo misi qmeduunarobis an gacnobierebuli gadawyvetilebis miRebis uunarobis SemTxvevaSi, naTesavis an kanonieri warmomadgenlis informirebuli Tanxmoba. informirebuli Tanxmoba win uZRvis samedicino momsaxurebas. 2. werilobiTi informirebuli Tanxmoba aucilebelia Semdegi samedicino momsaxurebis gawevisas: a) nebismieri qirurgiuli operacia, garda mcire qirurgiuli manipulaciebisa; b) aborti; g) qirurgiuli kontracefcia _ sterilizacia; d) magistraluri sisxlZarRvebis kaTeterizacia; e) hemodializi da peritoneuli dializi; v) eqstrakorporuli ganayofiereba; z) genetikuri testireba; T) genuri Terapia; i) sxivuri Terapia; k) avTvisebiani simsivneebis qimioTerapia; l) yvela sxva SemTxvevaSi, Tu samedicino momsaxurebis gamwevi saWirod Tvlis werilobiT informirebul Tanxmobas. 3. samedicino momsaxurebis gawevisas werilobiTi informirebuli Tanxmoba aucilebelia qmeduunaro an gacnobierebuli gadawyvetilebis miRebis unars moklebuli pacientisaTvis. xazi unda gaesvas im garemoebas, rom informirebuli Tanxmoba aucieleblia yvela zemoT CamoTvlil SemTxvevaSi, mixedavad imisa Tu ra SedegiT SeiZleba dasruldes samedicino manipulacia. anu, im SemTxveaSic ki, rodesac manipulaciis Sedegad adgili aqvs karg gamosavals, pacientis uflebis darRvevad iTvleba is faqti, Tu werilobiTi informirebuli Tanxmoba ar aris miRebuli winaswar. am SemTxvevaSi mTavaria rom pacienti an misi kanonieri warmomadgeneli flobdes srul informacias yvela SesaZlo (rogorc saxarbielo ise arasaxarbielo) gamosavlis Sesaxeb, romlebic dakavSirebulia am konkretul manipulaciasTan, imisaTis rom pacientma an misma kanonierma warmomadgenelma miiRos informirebuli gadawyvetileba. 166 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 mocemuli muxlis darRvevam, mkurnalobis /manipulaciis Sedegis/ gamosavlis gaTvaliswinebiT SeiZleba daayenos sisxlissamarTlebrivii pasuxismgebloba. Tu pacienti arasrulwlovania an raime sxva mizezis (mag. daavadebis) gamo ar aqvs gadawyvetilebis miRebis unari, maSin informirebul Tanxmobas acxadebs pacientis naTesavi an e.w. kanonieri warmomadgeneli. saqarTvelos kanonmdeblobiT dadgenili SemTxvevebi, rodesac pacients ufleba ar aqvs uari ganacxados samedicino momsaxurebis miRebaze iTvaliswinebs samedicino intervenciebis ganxorcielebas (vaqcinacia, specifikuri medikamentebis miReba) gadamdebi daavadebebis gavrcelebis prevenciis mizniT risk-jgufis pacientebSi. sazogadoebrivi janmrTelobis Sesaxeb kanonis mixedviT (Tavi II, muxli 5, punqti 1), saqarTvelos teritoriaze myofi yvela adamiani valdebulia gadamdebi daavadebebis aRmocenebisa da gavrcelebis saSiSroebis SemTxvevaSi, kompetenturi organoebis moTxovniT, Caitaros yvela samedicino procedura, romelic aucilebelia sxva piris janmrTelobasTan dakavSirebuli safrTxis Tavidan asacileblad (igulisxmeba epid afeTqeba, epidemia, pandemia).. kanoni `pacientis uflebebis Sesaxeb~ iTvaliswinebs adamianis uflebas, uari ganacxados samedicino momsaxurebaze an Sewyvitos ukve dawyebuli momsaxureba. amasTan, `samedicino momsaxurebaze uaris Tqmis an misi Sewyvetis mosalodneli Sedegebis Sesaxeb pacienti amomwuravad unda iyos informirebuli~ (kanoni `pacientis uflebebis Sesaxeb~, muxli 23, punqti 1) saqarTvelos kanonSi `adamianis organoTa gadanergvis Sesaxeb~ me-2 Tavi eTmoba organoTa gacemis nebayoflobiTobas, kerZod me-4 muxlis Tanaxmad: `qmedunarian pirs ufleba aqvs nebayoflobiT ganacxados Tanxmoba an uari sicocxleSive an sikvdilis Semdeg misi organos aRebaze~. am muxlSi Tanxmobis an uaris nabayoflobiToba gulisxmobs piris Tavisuflebas gadawyvetilebis miRebisas. nebismieri samedicino Carevis Catarebaze, maT Soris organos gacemaze, Tanxmoba nebayoflobiTad SeiZleba CaiTvalos im SemTxvevaSi, Tu piri gadawyvetilebis miRebisas Tavisufalia yovelgvari zewolisagan. Tu adamiani Tanaxmaa gasces organo sxvisTvis gadasanergad garkveuli safasuris miRebis pirobiT (materaluri daintereseba) an raime sxva garemoebis gamo (fsiqologiuri zewola, samsaxurebrivis interesebi, msjavrdebulisaTvis sasjelis Semsubuqebis dapireba da a.S.) aseT gadawyvetileba ar SeiZleba CaiTvalos Tavisuflad, xolo Tanxmoba nebayoflobiTad. aqedan gamomdinare `nebayoflobiTi Tanxmoba~ SeiZleba miCenul iqnes `Tavisufali Tanxmobis~ sinonimad. am SemTxvevaSic aucilebeli pirobaa pacientis qmedunarianoba, gacnobierebuli gadawyvetilebis miRebis unari, agreTve is garemoeba, Tu ramdenad gaiTvaliswina samedicino personalma pacientis inteleqtualuri done da miawoda Tu ara informacia misTvis gasagebi eniT, srulad da amomwuravad. amrigad, samedicino Carevaze, maT Soris organos aRebaze, Tanxmobis an uaris nebayoflobiTobis/Tavisuflebis aucilebeli pirobebia: pacientis qmedunarianoba da gacnobierebuli gadawyvetilebis miRebis unari; samedicino personalis mier pacientisaTvis sruli informaciis miwodeba misTvis gasagebi eniTa da terminologiiT, ise, rom pacientma aRiqvas miwodebuli informacia; 167 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi ararseboba garemoebebisa, romelTac SeiZleba zegavlena moaxdinon pacientis mier gadawyvetilebis miRebaze (mag., materialuri daintereseba da a.S.). aRsaniSnavia is garemoebac, rom transplantaciis nebayoflobiTobis aucileblobaze miTiTeba aris saqarTvelos kanonSic janmrTelobis dacvis Sesaxeb (Tavi 20. adamianis organoebis, organoTa nawilebis, qsovilebis aReba da gamoyeneba~, muxli 114); saxeldobr, kanoni adgens, rom: adamianis mier organoebis, organoTa nawilebis, qsovilebis (Semdgom _ `organo~) gacema sicocxleSi an sikvdilis Semdeg, maTi sxva adamianisaTvis gadanergvis, mkurnalobis, mecnieruli kvlevisa da swavlebis mizniT, nebayoflobiTi aqtia.~ igive prinacipi (nebayoflobiToba) asaxulia imave kanonis 115-e muxlSi, romelSic miTiTebulia, rom `saqarTvelos yvela moqalaqes aqvs organos sicocxleSi an sikvdilis Semdeg gacemaze Tanxmobis an uaris werilobiT gacxadebis ufleba. Tanxmobis damadasturebeli gancxadeba miiReba mxolod im SemTxvevaSi, Tu ganmcxadebeli qmedunariania. dauSvebelia pirovnebaze raime formiT zemoqmedeba zemoT aRniSnulis Sesaxeb gadawyvetilebis misaRebad~. Tanxmoba an uari sikvdilis Semdeg adamianis organos aRebaze sisxlis samarTlis kodeqsis 134 muxlis Tanaxmad danaSauls warmoadgens adamianis organos, organos nawilis an qsovilis aRebis iZuleba. amasTan aRniSnuli qmedeba mxolod maSin aris danaSauli Tu adamianis organos, organos nawilis an qsovilis aRebis motivi aris misi samkurnalod, gadasanergad, eqsperimentisaTvis an samkurnalo preparatis dasamzadeblad aReba. aRniSnuli qmedeba isjeba Tavisuflebis aRkveTiT vadiT oridan oTx wlamde, Tanamdebobis dakavebis an saqminobis uflebis CamorTmeviT sam wlamde an uamisod. kanonmdebeli damamZimebel garemoebad miiCnevs adamianis organos, organos nawilis an qsovilis aRebis iZulebas, Cadenils damnaSavisaTvis winaswari SecnobiT orsuli qalis, arasrulwlovnis, umweo mdgomareobaSi myofis anda damnaSaveze materialurad an sxvagvarad damokidebulis mimarT, rac isjeba Tavisuflebis aRkveTiT vadiT samidan xuT wlamde, Tanamdebobis dakavebis an saqminobis uflebis CamorTmeviT vadiT sam wlamde. sisxlis samarTlis kodeqsis 135¹ muxlis Tanaxmad adaminis organoebiT vaWroba danaSauls warmoadgens da isjeba Tavisuflebis aRkveTiT vadiT eqvsidan cxra wlamde, xolo igive qmedeba Cadenili araerTgzis _ Tavisuflebis aRkveTiT rvidan Tormet wlamde. Adamianis organoebiT vaWroba organizebuli jgufis mier isjeba Tavisuflebis aRkveTiT vadiT TerTmetidan TxuTmet wlamde. aRsaniSnavia isic, rom SesaZlebelia adamianiT vaWrobis (trefikingis) miznebisaTvis eqspluataciad miCneuli iqnes adamianis iZuleba sxeulis organos, organos nawilis an qsovilis gadanergvis anda sxvagvarad gamoyenebis mizniT. (sisxlis samartlis kodeqsis 143¹ da 143² muxlebiT). gardacvlili adamianis organoebis gamoyeneba, cxadia, SesaZlebelia mxolod im SemTxvevebSi, roca gadasanergad gamiznuli organo dazianebuli ar aris. eWvs ar iwvevs is garemoeba, rom organoTa gadanergvis sistemaSi gvamuri organoebis gamoyeneba mniSvnelovania, vinaidan: 168 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 a) cocxali donorisaTvis ama Tu im organos aReba yovelTvis aris dakavSirebuli garkveul riskTan donoris sicocxlisa da janmrTelobisaTvis; aRwerilia SemTxvevebi, rodesac donori daiRupa saoperacio magidaze an operaciis dasrulebidan cota xnis Semdeg; b) mxolod cocxlai donorebisagan miRebuli organoebi arasodes iqneba sakmarisi organoebze moTxovnis dasakmayofileblad. amitomac qveynebi, romlebSic mkurnalobis es meTodi SedarebiT farTod aris danergili, mniSvnelovan resursebs iyeneben gvamuri organoebis moZiebis SesaZleblobis gasazrdelad. miuxedavad amisa, jerjerobiT arc erT qveyanaSi ar aris damakmayofilebeli gadasanerg organoebze arsebuli moTxovna, TumcaRa gvamuri organoebis gamoyenebam mniSvnelovnad gazarda gadanergvebis raodenoba mTel msoflioSi. potenciuri gvamuri donorebis didi nawilis sikvdili ubeduri SemTxveviT an tvinis sisxlZarRvTa daavadebebiT aris ganpirobebuli. am pacientebs aReniSnebaT tvinis sikvdili da, amave dros, ugrZeldebaT gulis cema da sunTqva xelovnuri ventilaciis wyalobiT, rac imas niSnavs, rom Sinagani organoebis sisxliT momarageba grZeldeba. amdenad, organo funqciurad vargisia da SeiZleba misi gamoyeneba gadanergvisaTvis. sayuradReboa, rom 1997 wlidan moyolebuli saqarTvelos jandacvis knonmdeblobaSi asaxulia samedicino momsaxurebis Sesaxeb nebis winaswar gacxadebis SesaZlebloba da am nebis gaTvaliswinebis aucilebloba (kanoni `janmrTelobis dacvis Sesaxeb~, muxlebi 10, 11, 149). mogvianebiT, igive ufleba aisaxa kanonebSi `pacientis uflebebis Sesaxeb~ da `saeqimo saqmianobis Sesaxeb~. xazi unda gaesvas imasac, rom saqarTvelos kanonmdeblobis mixedviT, samedicino momsaxurebis Sesaxeb nebis winaswari gacxadeba SeiZleba Seexos mxolod iseT situaciebs, roca pacienti ukurnebeli daavadebis terminalur (sikvdilis wina) stadiaze aRmoCndeba an, ganuviTardeba daavadeba, romelmac SeiZleba gamoiwvios mZime invalidoba (kanoni `pacientis uflebebis Sesaxeb~, muxli 24, punqti 1). amasTan, aRsaniSnavia isic, rom saqarTvelos jandacvis kanonmdeblobis mixedviT moqalaqes SeuZlia daasaxelos piri, romelic miiRebs gadawyvetilebas aRniSnuli moqalaqis samedicino momsaxurebis Sesaxeb, roca am ukanasknels ar eqneba gadawyvetilebis miRebis unari. zogadad winaswar (adre) gamoxatuli neba exeba konvencias `adamianis uflebebisa da biomedicinis Sesaxeb~ me-8 muxlSi aRweril SemTxvevebsac, roca pacients ar aqvs Tanxmobis gacxadebis unari da saqme exeba samedicino momsaxurebis gadaudeblad gawevis aucileblobas. meore mxriv nebis winaswari gamoxatva SeiZleba Seexos iseT mdgomareobebs, roca qronikuli daavadebis gamo, janmrTelobis progresuli gauaresebis Sedegad, adamiani TandaTanobiT samudamod kargavs gadawyvetilebis miRebis unars (mag., alcheimeris daavadeba, seniluri demencia). zemoxsenebuli winaswar gacxadebuli nebis erTgvari formaa da inglisurenovan qveynebSi aRniSnuli instituti cnobilia, rogorc `gaxangrZlivebuli uflebamosileba~ (Durable Power of Attorney, ingl.). terminologiuri sizustisaTvis aRvniSnavT, rom inglisurenovan literaturaSi zogadad nebis winaswar gamoxatvas uwodeben `winaswar miTiTebas~ an `winaswar direqtivas~ _ Advanced Directive. es ukanaskneli gulisxmobs: 169 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi 9 werilobiT gaformebul miTiTebas, Tu ra saxis samedicino momsaxurebas isurvebda an ar isurvebda piri, romelsac uwodeben `sicocxleSi gacxadebul nebas~ _ Living Will; 9 sxva pirisaTvis gadawyvetilebis miRebis mindobas, romelsac uwodeben `ganxagrZlivebul uflebamosilebas~ an `jandacvis uflebamosilebas~ _ Durable Power of Attorney or Health Care Power of Attorney. yovelive zemoaRniSnuls kavSiri aqvs gardacvlili adamianisagan organos aRebis procedurasTanac. saqarTveloSi moqmedebs gacxadebuli Tanxmobis sistema (kanoni adamianis organoTa gadanergvis Sesaxeb. muxli 8). kanonis `adamianis organoTa gadanervis Sesaxeb~ me-5 muxlis Tanaxmad: Tanxmoba an uari SeiZleba exebodes erT an met organos. gadawyvetileba formdeba werilobiT da mas adasturebs samkurnalo dawesebulebis xelmZRvaneli~. rac Seexeba werilobiTi Tanxmobas, amis Taobaze miTiTeba aris kanonSi janmrTelobis dacvis Sesaxeb, romlis 155-e muxlis Tanaxmad `saqarTvelos yvela moqalaqes aqvs organos sicocxleSi an sikvdilis Semdeg gacemaze Tanxmobis an uaris werilobiT gacxadebis ufleba. Tanxmobis damadasturebeli gancxadeba miReba mxolod im SemTxvevaSi, Tu ganmcxadebeli qmedunariania~. zemoT moyvanil amonaridSi gancxadebis werilobiTi formis gamoyeneba uflebis saxiT aris mocemuli. `adamianis organoTa gadanergvis Sesaxeb~ kanonis me-5 muxlis Tanaxmad gadawyvetileba formdeba werilobiT. werilobiTi gancxadebis samedicino dawesebulebis xelmZRvanelis da ara notarialurad damowmeba miznad isaxavs proceduris gamartivebas. konvencia `adamianis uflebebisa da biomedicinis Sesaxeb~, muxli 6, adgens im pirTa dacvis meqanizmebs, romelTac ar SeuZliaT Tanxmobis gacxadeba. 1. pirs, romelsac ara aqvs Tanxmobis gacxadebis unari, Careva SeiZleba Cautardes, Tu es mas pirdapir sargeblobas moutans; (aRniSnuli sakiTxi, agreTve, regulirdeba konvencia `adamianis uflebebisa da biomedicinis Sesaxeb~, me-17 da me-20 muxlebiT); 2. im SemTxvevaSi, roca mcirewlovans, kanonis Sesabamisad, ara aqvs Tanxmobis gacxadebis unari, Careva SeiZleba Catardes misi warmomadgenlis an kanoniT gansazRvruli xelisuflebis an piris an dawesebulebis nebarTviT; asakis matebisa da momwifebis Sesabamisad gadawyvetilebis miRebisas mcirewlovanis azrs ufro meti mniSvneloba eniWeba. 3. im SemTxvevaSi, roca mozrdils, kanonis Sesabamisad, ara aqvs Tanxmobis gacxadebis unari fsiqikuri moSlilobis, daavadebis an sxva msgavsi mizezis gamo, Careva SeiZleba ganxorcieldes misi warmomadgenlis an kanoniTT gansazRvruli xelisuflebis an piris an dawesebulebis nebarTviT; 170 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 pirma SeZlebisdagvarad unda miiRos monawileoba gadawyvetilebis miRebaSi. 4. me-2 da me-3 punqtebSi moxseniebul warmomadgenls, xelisuflebas, pirs an dawesebulebas unda miewodos, imave pirobebis dacviT, me-5 muxliT gaTvaliswinebuli informacia; 5. me-2 da me-3 punqtebSi aRniSnuli nebarTva SeiZleba gauqmdes nebismier dros, piris janmrTelobis interesebis gaTvaliswinebiT. zogierT pirs asakis (arasrulwlovanebi) an janmrTelobis mdgomareobis gamo (mag., fsiqikuri daavadebis gamo) SeiZleba ar hqondes Tanxmobis gacxadebis unari. aseT SemTxvevaSi kanonma unda gansazRvros pirobebi, romelTa dakmayofileba aucilebelia Carevis ganxorcielebisaTvis samedicino momsaxurebis an biosamedicino kvlevebis farglebSi. konvenciis me-6 muxlis pirveli punqti mniSvnelovan damcav debulebas Seicavs zemoaRniSnuli pirebisaTvis. am debulebis mixedviT, Tanxmobis gacxadebis unaris armqone adamianisaTvis raime Carevis ganxorcieleba mxolod maSin aris dasaSvebi, roca es Careva maTTvis pirdapiri sargeblobis momtania. Tumca, aqve miTiTebulia muxlebi, romlebic gamonaklisebs uSvebs (muxlebi 17 da 20). me-17 muxli exeba gamonaklis SemTxvevebSi biosamedicino kvlevis Catarebas Tanxmobis gacxadebis unaris armqone adamianebze, xolo me-20 muxlSi saubaria aseve gamonaklisis saxiT regeneraciis unaris mqone qsovilebis aRebaze Tanxmobis gacxadebis unaris armqone pirebisagan. rogorc arasrulwlovnebis, aseve Tanxmobis gacxadebis unaris armqone pirebisaTvis Carevis ganxorcielebaze Tanxmobas iZlevian maTi warmomadgenlebi, an kanoniT gansazRvreuli saxelisuflebo struqturebi an pirebi, an dawesebulebebi. qarTul kanonmdeblobaSi pacientis an kvlevis subieqtis qmeduunarobis an gacnobierebuli gadawyvetilebis arqonis SemTxvevaSi Tanxmobas iZleva naTesavi an kanonieri warmomadgeneli. Tanxmobis gacxadebaSi arasrulwlovanTa rolis gansazRvrisas konvecniaSi ar aris miTiTebuli asaki, radgan qmedunarianobis da gadawyvetilebis miRebaSi CarTvis asakobrivi kriteriumebi erovnuli kanonmdeblobebiT ganisazRvreba. saqarTvelos kanonmdeblobiT 16 wlis da meti asakis arasrulwlovans (18 wlamde asakis pirs) SeuZlia damoukideblad `ufleba aqvs informirebuli Tanxmoba an uari ganacxados samedicino momsaxurebaze, Tu igi samedicino momsaxurebis gamwevis SexedulebiT sworad afasebs sakuTari janmrTelobis mdgomareobas. pacientis gadawyvetilebis Sesaxeb ecnobeba mis naTesavs an kanonier warmomadgenels~ (kanoni `pacientis uflebebis Sesaxeb~, muxli 41, punqti 3). mozrdil pirs Tanxmobis gacxadebis uanri SeiZleba ar hqondes fsiqikuri daavadebis gamo, an travmis gamo, an raime daavadebiT ganpirobebuli komis gamo. aseT SemTxvevebSi adamiani an saerTod ver afasebs an srulyofilad ver afasebs sakuTar mdgomarebas da/an ar Seswevs Tavisi survilis Camoyalibebis unari. yvela SemTxvevaSi gadawyvetilebis miRebaSi SeZlebisdagvarad unda iyvnen CarTulni pirebi, romlebsac ar aqvT Tanxmobis gacxadebis unari. konvencia `adamianis uflebebisa da biomedicinis Sesaxeb, `muxli 7. adgens fsiqikurad daavadebul pirTa dacvis meqanizmebs. 171 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi muxli 7 `kanoniT gansazRvruli damcavi meqanizmebis, zedamxedvelobisa da gasaCivrebis procedurebis CaTvliT, mkurnalobis qveS myofi mZime xasiaTis fsiqikuri daavadebis mqone pirs mxolod im SemTxvevaSi SeiZleba Cautardes am daavadebis mkurnalobasTan dakavSirebuli Careva misi Tanxmobis gareSe, rodesac am Carevis gareSe mis janmrTelobas seriozuli safrTxe emuqreba.~ am muxlis mizania Seqmnas damatebiTi dacvis meqanizmebi fsiqikuri daavadebis mqone pirebisaTvis, roca saubaria fsiqikuri daavadebis mkurnalobasTan dakavSirebul Carevebze. am muxlis moTxovnebis Sesabamisad dauSvebelia piris Tanxmobis gareSe fsiqikuri daavadebis mkurnalobasTan dakavSirebuli Carevis ganxorcieleba, Tu am Carevis mizani ar aris janmrTelobisaTvis seriozuli safrTxis Tavidan acileba. amrigad, fsiqikuri daavadebis mkurnalobisaken mimarTuli Careva rom ganxorcieldes piris Tanxmobis gareSe aucilebelia Semdegi pirobebis dakmayofileba: a) fsiqikuri SesaZleblobebis daqveiTebis faqti unda iyos dadgenili; b) gamoyenebuli unda iqnes kanoniT gansazRvruli yvela sxva damcavi meqanzimi (mag., pacientis CarTvis mcdeloba gadawyvetilebis miRebaSi da kanonieri warmomadgenlis Tanxmobis moZieba); g) pacientis uari mxolod maSin SeiZleba iyos ugulebelyofili, roca Carevis ganuxorcielebloba safrTxes Seuqmnis mis janmrTelobas. sayuradReboa, rom fsiqikuri daavadebis mqone pirebisaTvis fsiqikuri daavadebis iZulebiTi mkuranlobis sakiTxebze evropis sabWos ministrTa komitetma 2004 wels moamzada specialuri rekomendacia romelic winamdebare konvencias efuZneba. konfidencialuroba da pacientis piradi cxovrebis pativiscema konfidencialuroba aris yvelaze mniSvnelovani aspeqti eqimisa da pacientis urTierTobaSi. janmrTelobasTan dakavSirebuli informacia sakmaod specifikuria da gansakuTrebul dacvas saWiroebs. bevr qveyanas aqvs kanonmdebloba piradi monacemebis dacvis Sesaxeb, sadac janmrTelobasTan dakavSirebuli informaciis mopoveba, damuSaveba, Senaxva da gadacema detalurad regulirdeba. `pacientis uflebebis Sesaxeb~ saqarTvelos kanoni eqims avalebs saidumlo Seinxos pacientis Sesaxeb mis xelT arsebuli informacia. es piroba eqimma pacientis gardacvalebis Semdegac ki ar unda daarRvios. amave kanonis 26-e da 30-e muxlebiT daculia samedicino momsaxurebis gamwevisaTvis profesiuli saqmianobis ganxorcielebisas gamJRavnebuli an xelmisawvdomi da mis xelT arsebuli informaciis konfidencialoba (saidumloeba). Aadamianis piradi cxovrebis xelSeuxeblobis konstituciuri ufleba (konstituciis me-20 muxli) gansakuTrebuli riskis qveS dgeba jandacvis sferoSi, radgan arakeTilsindisieri miznebiTa da ganzraxviT momsaxurebis gamwevis 172 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 mier informaciis gamoyenebam, SesaZlebelia gamousworebeli ziani miayenos uSualod pacients an mesame pirs. amdenad, pacientis Tanxmoba warmoadgens erT-erT aucilebel pirobas konfidencialuri informaciis gasamJRavneblad, xolo pacientis swavlebis obieqtad gamoyenebisaTvis, aucilebelia misi `informirebuli Tanxmobis~ miReba (26-e da 27-e muxlebi). gamonaklisia SemTxveva, rodesac informaciis gaumJRavnebloba safrTxes uqmnis mesame piris sicocxles an janmrTelobas. aseT SemTxvevaSi informaciis gamJRavnebaze pacientis Tanxmobis miReba aucilebeli ar aris, oRond cnobili unda iyos im piris vinaoba (saxeli da gvari), visTvisac safrTxis acilebac warmoadgenda informaciis gamJRavnebis mizans. zemoaRniSnuli kanonis 28-e muxli miuTiTebs garkveul pirobebze, romlis SemTxvevaSic SesaZlebelia konfidencialurobis darRveva. 1. samedicino momsaxurebis gamwevis mier konfidencialuri informaciis gamJRavneba dasaSvebia, Tu: a) miRebulia pacientis Tanxmoba; b) informaciis gaumJRavnebloba safrTxes uqmnis mesame piris (romlis vinaobac cnobilia) sicocxles an/da janmrTelobas; g) saswavlo an samecniero mizniT pacientis Sesaxeb informaciis gamoyenebisas monacemebi isea warmodgenili, rom SeuZlebelia pirovnebis identifikacia; d) amas iTvaliswinebs saqarTvelos kanonmdebloba. 2. samedicino momsaxurebis gamwevis mier samedicino momsaxurebaSi monawile sxva pirebisaTvis pacientis janmrTelobis mdgomareobasTan dakavSirebuli konfidencialuri informaciis gamJRavnebaze pacientis Tanxmoba nagulisxmevad SeiZleba CaiTvalos. kanonis Tanaxmad, pacientis Sesaxeb informaciis gacema nebadarTulia, roca pacienti Tanaxmaa an moiTxovs ecnobos mesame pirs an pirebs mis Sesaxeb mopovebuli faqtebis Taobaze. igive kanonis mixedviT informaciis gacema eqims SeuZlia maSinac, roca am informaciis damalva sxva adamianis sicocxles an janmrTelobas uqmnis safrTxes. eqimi valdebulia gasces informacia pacientis Sesaxeb Tu amas moiTxovs sasamarTlo. eqimma aseve informacia unda miawodos sxva kolegebs, romlebic avadmyofis mkurnalobaSi monawileoben. aRsaniSnavia is garemoebac, rom samedicino momsaxurebis gawevisas dasaSvebia mxolod masSi uSualod monawile pirTa daswreba, garda im SemTxvevebisa, roca pacienti Tanaxmaa an moiTxovs sxva pirTa daswrebas. specifikuri jgufebis warmomadgenelTa uflebebi kanonSi `pacientis uflebebis dacvis Sesaxeb~ ori Tavi eTmoba orsuli da meZuZuri qalebis uflebebs. 173 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi muxli 35 orsuls da meZuZur dedas ufleba aqvT samedicino momsaxurebis gamwevisagan miiRon sruli, obieqturi, drouli da gasagebi informacia orsulobis, mSobiarobis an loginobis periodSi dagegmili nebismieri samedicino Carevis SemTxvevaSi nayofze an axalSobilze SesaZlo pirdapiri an iribi mavne zemoqmedebis Sesaxeb. winamdebare muxliT orsul da mSobiare qals, meZuZur dedas ufleba aqvs Tavad gadawyvitos, Cautardes Tu ara mas esa Tu is samedicino momsaxureba. misi Tanxmoba am SemTxvevaSic aucilebelia. amasTan, Tanxmoba miRebul unda iqnas mas Semdeg, rac mas miewodeba srul informacia dagegmili Carevis nayofze an axalSobilze SesaZlo mavne zemoqmedebis Sesaxeb. samedicino momsaxurebaze uaris gacxadeba qalis uflebaa. kanonSi 36 muxlis saxiT aris erTi gamonaklisic, romelic qals ar aZlevs uflebas uari ganacxados samedicino momsaxurebaze. muxli 36 1. mSobiares ufleba aqvs miiRos gadawyvetileba misTvis da nayofisTvis samedicino momsaxurebis gawevis Sesaxeb, garda am muxlis me-2 punqtiT gaTvaliswinebuli SemTxvevebisa. 2. mSobiares ara aqvs ufleba uari Tqvas iseT samedicino momsaxurebaze, romelic uzrunvelyofs cocxali nayofis dabadebas da romelic mSobiaris janmrTelobisa da sicocxlisaTvis minimaluri riskis matarebelia. zemoaRniSnuli muxlis Tanaxmad mSobiares ar aqvs ufleba uari Tqvas sakeisro kveTaze misi absolituri Cvenebis SemTxvevaSi, anu iseT SemTxvevaSi rodeasac sakeisro kveTa uzrunvelyofs cocxali nayofis dabadebas da mSobiaris janmrTelobisa da sicocxlisaTvis minimaluri riskis matarebelia. magaliTisTvis ganvixiloT situacia, rodesac mSobiare qals aucileblad sWirdeba sisxlis gadasxma imisTvis, rom nayofi cocxlad daibados, is ki uars acxadebs gadasxmaze. cxadia, nayofi aseT SemTxvevaSi daiRupeba. zemoaRniSnuli muxli icavs aradabadebuli nayofis uflebas sicocxleze. rogorc avRniSneT sicocxlis ufleba ZiriTadia uflebaTa Soris. adamianis uflebaTa komiteti moixseniebs mas, rogorc `uzenaes uflebas~, romlis gauqmebac dauSvebelia saxelmwifoSi gansakuTrebuli mdgomareobis arsebobis SemTxvevaSic ki. samoqalaqo da politikur uflebaTa paqti arapirdapir moixseniebs daubadebeli bavSvis uflebas, ramdenadac me-6(5) muxlis Tanaxmad sasikvdilo ganaCenis gamotana ar SeiZleba orsuli qalisaTvis. raTqmaunda amas aqvs humanitaruli dasabuTeba (sxva saerTaSoriso dokumentebi adasturebs gansakuTrebul yuradRebas, romelic unda mieces orsul qalebs). Tumca, aseve SeiZleba gagrZelebuli iqnes, rogorc daubadebeli bavSvis sikvdilis Tavidan acileba. mxolod amerikuli konvencia acxadebs sicocxlis uflebas yvelasTvis `zogadad, Casaxvis momentidan~ (muxli 4). 174 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 bavSvebi arasrulwlovanad saqarTvelos kanonmdeblobiT iTvleba 18 wlamde asakis piri. 1994 wels saqarTvelo gaxda gaeros bavSvTa uflebebis dacvis 1989 wlis konvenciis wevri saxelmwifo. aRniSnuli konvenciis safuZvelze saqarTvelom ikisra valdebuleba, yovel 5 weliwadSi erTxel gaeros bavSvTa uflebebis dacvis komitets warudginos angariSi bavSvTa uflebaTa dacvis sferoSi arsebuli viTarebisa da gatarebuli RonisZiebebis Sesaxeb. am sferoSi arsebuli kanonmdebloba: 1980 wlis 25 oqtombris haagis konvencia. „bavSvTa saerTaSoriso gatacebis samoqalaqo aspeqtebis Sesaxeb~; ganmartebiTi moxseneba haagis „bavSvTa saerTaSoriso gatacebis samoqalaqo aspeqtebis Sesaxeb~. konvenciasTan dakavSirebiT; saqarTvelos samoqalaqo kodeqsis is normebi, romlebic bavSvebisa da mSoblebis samarTlebriv urTierTobas da meurveobisa da mzrunvvelobis organoebis rols exeba; `pacientis uflebebis Sesaxeb~ kanonis mixedviT, arasrulwlovanisaTvis samedicino daxmarebis aRmoCenisas `mSobels an kanonier warmomadgenels ufleba aqvs miiRos sruli, obieqturi, drouli da gasagebi informacia arasrulwlovanis janmrTelobis mdgomareobis Sesaxeb. 16 wlamde arasrulwlovan pacients samedicino momsaxureba utardeba mxolod mSoblis an kanonieri warmomadgenlis TanxmobiT. kanoni pacientis ufelebebis Sesaxeb, kanonis me-18 muxlis Tanaxmad: 1. 14-dan 18 wlamde asakis arasrulwlovan pacients, romelic samedicino momsaxurebis gamwevis SexedulebiT sworad afasebs sakuTari janmrTelobis mdgomareobas, ufleba aqvs ganacxados informirebuli Tanxmoba samedicino momsaxurebaze, Tu man samedicino momsaxurebis gamwevs mimarTa am kanonis me-40 muxlis me-2 punqtis „b~ qvepunqtiT gaTvaliswinebul mizezTa gamo. 16 wlamde asakis arasrulwlovan pacients samedicino momsaxureba utardeba mxolod mSoblis an kanonieri warmomadgenlis TanxmobiT, garda am kanonis me-40 muxlis me-2 punqtis „b~ qvepunqtiT gaTvaliswinebuli SemTxvevebisa. amasTan, samedicino momsaxurebis gawevis Sesaxeb gadawyvetilebis miRebisas aucilebelia pacientis monawileobac asakisa da gonebrivi ganviTarebis gaTvaliswinebiT. aRniSnuli muxlis Tanaxmad, mSobels an kanonier warmomadgenels arasrulwlovnis janmrTelobis Sesaxeb informacia ar miewodeba Tu amis winaaRmdegia Tavad qmedunariani pacienti an eqimisaTvis sqesobrivad gadamdebi daavadebisa, narkomaniis, kontracefciisa da orsulobis xelovnurad SewyvetisaTvis mimarTvis SemTxvevebSi. winaswar patimrobaSi an sasjelaRsrulebis dawesebulebaSi myofi piris uflebebi kanoni pacientis uflebebis Sesaxeb moicavs muxlebs, romlebic exeba winaswar patimrobaSi an sasjelaRsrulebis dawesebulebaSi myofi piris uflebebs. 175 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi zemoaRniSnuli kanonis 45 muxlis Tanaxmad: 1. samedicino momsaxurebis xelmisawvdomoba winaswar patimrobaSi an sasjelaRsrulebis dawesebulebaSi myofi pirisaTvis xorcieldeba saxelmwifo samedicino programebis saSualebiT. 2. sasjelaRsrulebis dawesebulebaSi moTavsebisTanave pirs ufleba aqvs moiTxovos saTanado samedicino gamokvleva, damoukidebeli samedicino eqspertizis Catareba da saWiroebisas _ samedicino momsaxureba. amave kanonis 46 da 47 muxlebis Tanaxmad winaswar patimrobaSi an sasjelaRsrulebis dawesebulebaSi myofi piri sargeblobs am kanoniT gaTvaliswinebuli yvela uflebiT. winaswari patimrobis an sasjelaRsrulebis dawesebulebis administracias SeuZlia SezRudos dakavebuli, winaswar patimrobaSi an patimrobaSi myofi piris ufleba _ airCios samedicino momsaxurebis gamwevi. es gadawyvetileba SeiZleba gasaCivrdes sasamarTloSi. zemoaRniSnuli muxlebiT kanoni icavs winaswar patimrobaSi an sasjelaRsrulebis dawesebulebaSi myofi piris uflebebs, kerZod: winaswar patimrobaSi an sasjelaRsrulebis dawesebulebaSi myofi piri sargeblobs `pacientis uflebebis Sesaxeb~ saqarTvelos kanoniT gaTvaliswinebuli yvela uflebiT, Tumca winaswari patimrobis an sasjelaRsrulebis dawesebulebis administracias SeuZlia SezRudos dakavebuli, winaswar patimrobasa Tu patimrobaSi myofi piris ufleba _ airCios samedicino momsaxurebis gamwevi, magram Tavad igive kanoni adgens imis SesaZleblobas, rom aRniSnuli gadawyvetileba gasaCivrdes sasamarTloSi, anu winaswar patimrobasa Tu patimrobaSi myofi piris ufleba mainc daculia, rameTu mas SeuZlia am uflebis usafuZvlod da ukanonod SezRudvis SemTxvevaSi, sasamarTlos meSveobiT aRidginos es ufleba. sasjelaRsrulebis dawesebulebaSi moTavsebisTanave pirs ufleba aqvs moiTxovos saTanado samedicino gamokvleva, aseve damoukidebeli samedicino eqspertizis Catareba, xolo saWiroebis SemTxvevaSi _ samedicino momsaxureba. amasTan, `pacientis uflebebis Sesaxeb~ saqarTvelos kanonis 45-e muxliT dadgenilia, rom winaswar patimrobaSi an sasjelaRsrulebis dawesebulebaSi myofi pirisaTvis samedicino momsaxurebis xelmiswvdomoba unda ganxorcieldes saxelmwifo samedicino programebis saSualebiT, riTac calsaxad aris xazgasmuli saxelmwifos Sesabamisi valdebulebis Taobaze. pacientis ufleba gaufrTxildnen mis dros a) ufleba pacientis uflebaTa evropuli qartiis mixedviT (ECPR) yvela adamians aqvs ufleba miiRos saWiro mkurnaloba swrafad da winaswar gansazRvrul droSi. es ufleba moqmedebs mkurnalobis yvela fazaSi. es ufleba ar aris gaxiluli saqarTvelos kanonmdeblobaSi. ar arsebobs debulebebi pacientTa rigis Sesaxeb. Zalian SezRudulia saxelmwifos pasuxismgebloba, daafinansos samedicino momsaxureba. 176 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 miuxedavad amisa, saqarTvelos kanonmdebloba iTvaliswinebs imas, rom kritikul SemTxvevebSi samedicino Careva unda moxdes gadaudeblad, pacientis Tanxmobis gareSec ki (mag. rodesac pacienti komaSia). aseve, pacientis kanonieri wermomadgenlis Tanxmobis miuReblad (roca warmomadgeneli miuwvdomelia). jandacvis samarTali aseve iTvaliswinebs pacientis informirebis valdebulebas mkurnalobis sxvadasxva aspeqtebis Sesaxeb. informaciis gadacema da axsna saWiroebs dros. dabolos, pacientis drois pativiscema SeiZleba imgvarad, rom pacienti ar idgens rigSi didi xnis ganmavlobaSi. ufleba saqarTvelos konstituciis/kanonebis mixedviT saqarTvelos konstitucia konstituciis me-17 muxli acxadebs: `adamianis pativi da Rirseba xelSeuvalia.~ pacientis drois pativiscema SeiZleba ganixilebodes, rogorc TviT pacientis, rogorc adamianis, pativiscema. kanonmdebloba: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb qmeduunaro da gacnobierebuli gadawyvetilebis miRebis unars moklebuli pacientisaTvis gadaudebeli daxmarebis aucileblobis an sicocxlisaTvis saSiSi mdgomareobis dros samedicino Carevis Sesaxeb gadawyvetileba miiReba mxolod pacientis interesebis gaTvaliswinebiT (mux. 12). saqarTvelos kanoni pacientis uflebaTa Sesaxeb kanoni pacientis uflebaTa Sesaxeb (mux. 12) gansakuTrebviT aRniSnavs uflebas gadaudebel samedicino momsaxurebaze (“saxelmwifo icavs pacientis uflebas samedicino momsaxurebaze, romlis gadaudeblad ganxorcielebis gareSe gardauvalia pacientis sikvdili, dainvalideba an janmrTelobis mdgomareobis mniSvnelovani gauareseba~). Tumca, es ufleba kanonSi damatebiT ar aris ganxiluli. meore mxriv, imave kanonis mixedviT, jandacvis momwodebelma SeiZleba moiTxovos gadaudebeli samedicino momsaxureba qmeduunaro pacientisTvis pacientis kanonieri warmomadgenlis Tanxmobis gareSe Semdeg 2 SemTxvevaSi: • Tu qmeduunaro an gacnobierebuli gadawyvetilebis miRebis unars moklebuli pacienti gadaudeblad saWiroebs samedicino momsaxurebas, romlis ganxorcielebis gareSe gardauvalia pacientis sikvdili, dainvalideba an janmrTelobis mdgomareobis mniSvnelovani gauareseba, xolo misi naTesavis an kanonieri warmomadgenlis moZieba ver xerxdeba, samedicino momsaxurebis gamwevi iRebs gadawyvetilebas pacientis janmrTelobis interesebis Sesabamisad. 177 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi • Tu qmeduunaro an gacnobierebuli gadawyvetilebis miRebis unars moklebuli pacienti gadaudeblad saWiroebs samedicino momsaxurebas, romlis gawevis gareSe gardauvalia pacientis sikvdili, xolo misi naTesavi an kanonieri warmomadgeneli samedicino momsaxurebis winaaRmdegia, samedicino momsaxurebis gamwevi iRebs gadawyvetilebas pacientis janmrTelobis interesebis Sesabamisad. g) damxmare aqtebi ar arsebobs damxmare aqtebi am uflebaTan dakavSirebiT. d) eqimis eTikis kodeqsi saqarTvelos eqimis eTikis kodeqsis mixedviT, rodesac pacienti gadaudeblad saWiroebs samedicino daxmarebas, eqimi unda daexlaros `nebismier pirs Tavisi SesaZleblobebis farglebSi arasamuSao garemoSic ki~ (Tavi `eqimi da pacienti~, paragrafi 5) e) sxva wyaroebi aRniSnul sakiTxze ar arsebobs sxva damatebiTi wyaro. xarisxiani samedicino momsaxurebis miRebis ufleba a) ufleba pacientis uflebaTa evropuli qartiis mixedviT (ECPR) yvelas aqvs ufleba xeli miuwvdebodes marali xarisxis janmrTelobis servisebze specialuri da zusti standartebis dacviT. es ufleba garkveulwilad ganvixileT xelmisawvdomobis uflebasTan erTad, radgan momsaxurebis xelmisawvdomoba gulisxmobs pacientis uflebas miiRos xarisxiani momsaxureba. saqarTvelos kanonmdebloba xarisxiani samedicino momsaxurebis miRebis uflebas ZiriTadad aRwers Sesabamisi valdebulebebis mixedviT (am valdebulebebs Seicavs kanoni janmrTelobis dacvis Sesaxeb da kanoni saeqimo saqmianobis Sesaxeb). b) ufleba pacientis uflebaTa evropuli qartiis mixedviT (ECPR) saqarTvelos konstitucia konstituciis 37-e muxlis 2 punqtis mixedviT: `saxelmwifo akontrolebs janmrTelobis dacvis yvela dawesebulebas, samkurnalo saSualebaTa warmoebas da am saSualebebiT vaWrobas.~ es punqti gulisxmobs saTanado xarisxis uzrunvelyofas jandacvis dawesebulebebSi. 178 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 kanonebi saqarTvelos kanoni janmrTelobis dacvis Sesaxeb kanoni gansazRvravs saxelmwifos pasuxismgeblobas janmrTelobis dacvis xarisxTan mimarTebiT (mux. 4 da 16). Sromis, jandacvis da socialuri uzrunvelyofis saministro awarmoebs `yvela samedicino dawesebulebis samedicino saqmianobis xarisxis kontrols dadgenili wesiT~. (mux. 63) meore mxriv, samedicino dawesebulebebi valdebuli arian daicvan samedicino da farmacevtuli saqmianobis maregulirebeli kanonmdeblobiT dadgenili standartebi, wesebi da normebi. (mux. 53) saTanado xarisxis uzrunvelyofis instrumentebia eqimTa sertificireba, samedicino saqmianobis licenzireba, samedicino dawesebulebaze nebarTvis gacema da samedicino saqmianobis Sesaxeb gaidlainebis da protokolebis SemuSaveba. (mux. 16, 23-33, 53-63) dauSvebelia samedicino saqminoba licenzirebis gareSe (mux.56). kanoni licenziebisa da nebarTvebis Sesaxeb gansazRvravs saqmianobaTa sias, romlebic eqvemdebareba licenzirebas. (mux. 6, punqti 42-84). gaidlainebi da protokolebi mniSvnelovani saSulebaa imis dasadgenad, aris Tu ara momsaxureba xarisxiani da damakmayofilebeli. erovnuli gaidlainebis SemuSaveba xdeba janmrTelobis dacvis saministros mier (mux. 16). saministrom unda Seqmnas specialuri sabWo, romelic gaidlainTa SemuSavebas da miRebas adevnebs Tvalyurs. dResdReobiT, ministries individualuri aqtiT miRebulia 80-ze meti gaidlaini. kanoni gansazRvravs jandacvis dawesebulebebSi eTikis komitetebis arsebobas pacientis uflebebis da samedicino eTikis dasacavad (mux. 62). saqarTvelos kanoni pacientis uflebebis Sesaxeb kanonis me-5 muxlis mixedviT, saqarTvelos yvela moqalaqes `ufleba aqvs samedicino momsaxurebis yvela gamwevisagan miiRos qveyanaSi aRiarebuli da danergili profesiuli da samomsaxureo standartebis Sesabamisi samedicino momsaxureba.~ `profesiuli da samomsaxureo standartebi~ aRniSnavs Sesabamisi xarisxis momsaxurebis miRebas samedicino momsaxurebis nebismieri gamwevisgan. saqarTvelos kanoni saeqimo saqmianobis Sesaxeb kanoni eqimebs akisrebs samarTlebriv valdebulebas uzrunvelyon jandacvis saTanado xarisxi.2 2 damatebiTi informaciisTvis ixileT Tavi VII, xarisxiani momsaxurebis gawevis valdebuleba 179 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi saqarTvelos kanoni adamianis organoTa gadanergvis Sesaxeb xarisxiani momsaxureba gansakuTrebiT mniSvnelovania organoTa gadanergvis sferoSi, raTa es procesi did risks uqmnis rogorc donors, ise recipients. 27-e muxlis mixedviT, saqarTvelos janmrTelobisa da socialuri dacvis saministro: • SeimuSavebs organoTa moZiebis, aRebis, Senaxvisa da gadanergvis standartebs; • gansazRvravs organoebis xarisxis kontrolis standartebs, awarmoebs organoebis aRebis, transportirebisa da Senaxvis wesebis dacvis, organoebis vargisobis da histoSeTavsebis dadgenis kontrols; • periodulad amowmebs saTanado licenziis mqone dawesebulebebis, transplantaciis bankebis saqmianobis standartebTan Sesabamisobas da transplantaciis sferoSi maT mier ganxorcielebuli samedicino daxmarebis xarisxis kontrols, Tu saWiroa aCerebs licenziis moqmedebas an auqmebs mas; • uzrunvelyofs donorebisa da recipientebis Sesaxeb informaciis gacvlas saTanado licenziis mqone dawesebulebebsa da transplantaciis bankebs Soris, agreTve zemoaRniSnuli dawesebulebebisaTvis saavadmyofoebidan informaciis miwodebas; g) damxmare aqtebi adamianis organoTa gadanergvis Sesaxeb kanonis safuZvelze, Sromis, janmrTelobis da socialuri dacvis ministris brZaneba N419/n, 29.11.2001 gamoica, romlis mixedviTac organoTa gadanergvis dros xarisxis kontroli unda moxdes Semdegi gzebiT: • • • adamianis organoTa mopovebis, aRebis, Senaxvis da gadanergvis standartebis daweseba; organoTa xarisxis gakontroleba; organoTa ganadgurebis wesebis dacva. d) Sesabamisi muxlebi eTikis kodeqsidan xarisxis dacvas uzrunvelyofs eqimis eTikis kodeqsis Semdegi debulebebi: • eqimi cdilobs iseTi samuSao garemos Seqmnas, romelic aucilebelia pacientisaTvis adekvaturi samedicino daxmarebis gasawevad. ( `eqimi da pacienti~, mux. 8). • saeqimo saqmianobis aRsrulebisas eqimis gzamkvlevia mxolod profesiuli standartebi da sayovelTaod aRiarebuli eTikuri normebi. (“zogadi debulebebi~, mux. 2) • profesiuli codnis ganaxleba da srulyofa, Sesabamisi unar-Cvevebis daxvewa eqimis yoveldRiuri sazrunavia mTeli misi profesiuli saqmianobis manZilze. (“zogadi debulebebi~, mux. 8) • eqimi Tavisi SesaZleblobis farglebSi yovel Rones xmarobs, raTa daexmaros sxva eqims profesiuli movaleobis aRsrulebaSi. (“eqimi da kolega~, mux. 2) 180 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 • eqims gacnobierebuli aqvs sakuTari profesiuli SesaZleblobebi. Tu mas aklia saTanado codna da gamocdileba, is dasaxmareblad sxva eqims uxmobs. (“eqimi da kolega~, mux. 3) • eqimi pacients kolegasTan gzavnis mxolod im SemTxvevaSi, Tu darwmunebulia am ukanasknelis kompetenciaSi. amasTan, konsultaciis win igi kolegas awvdis pacientis saTanado samedicino daxmarebisaTvis saWiro yvela informacias. (“eqimi da kolega~, mux. 4) • pacientis uari swavlebis procesSi monawileobaze aranair gavlenas ar axdens samedicino daxmarebis xarisxsa da eqimis damokidebulebaze pacientis mimarT. (“eqimi _ maswavlebeli,~ mux. 2) e) sxva wyaroebi aRniSnul uflebas exeba evropis sabWos konvencia adamianis uflebebis da biomedicinis Sesaxeb (mux. 3, 4) da misi damatebiTi oqmebi adamianis organosa da qsovilis gadanergvis (mux. 3, 4) da biosamedicino kvlevis Sesaxeb (mux. 23, 14). evropis sabWos instrumenti Sesabamisi muxlebi konvencia adamianis uflebebis da biomedicinis Sesaxeb mux. 3, 4: xarisxis da profesiuli valdebulebebis dacvis moTxovna damatebiTi oqmi adamianis organosa da qsovilis gadanergvis Sesaxeb mux. 3, 4: xarisxis da profesiuli valdebulebebis dacvis moTxovna damatebiTi oqmi biosamedicino kvlevis Sesaxeb mux. 23, 24: Caurevlobis moTxovna profilaqtikur, sadiagnostiko da Terapevtul procedurebSi biosamedicino kvlevis dros usafrTxoebis ufleba a) ufleba pacientis uflebaTa evropuli qartiis mixedviT (ECPR) yvelas aqvs ufleba daculi iyos zianisgan, romelic gamowveulia jandacvis servisebis arasaTanado funqcionirebis da samedicino Secdomebisgab, afreTve, yvelas aqvs ufleba xeli miuwvdebodes servisebsa da mkurnalobaze, romelic akmayofilebs usafrTxoebis maRal standartebs. erTi mxriv, pacientis usafrTxoeba miiRweva momsaxurebis saTanado xarisxis dacviT. meore mxriv, usafrTxoeba SeiZleba ganixilebodes rogorc mkurnalobis minimaluri savaldebuli standarti. aqedan gamomdinare, es ufleba kavSirSia Tanamedrove samedicino eTikis oTxi principidan erT-erTTan _ nonmaleficence (`ar avno~). saqarTvelos kanonmdebloba specialurad aregulirebs samedicino usafrTxoebis sakiTxs. miuxedavad imisa, rom es ar aris jandacvis kanonmdeblobiT gansazRvruli, pacientis usa- 181 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi frTxoebis ufleba SeiZleba ganixilebodes rogorc fizikuri Seuracxyofgisgan/Tavdasxmisgan Tavisufleba samedicino dawesebulebaSi yofnis dros. cxadia, rom am uflebis WrilSi daculi unda iyves sicocxlisa da fizikuri xelSeuxeblobis uflebebic. b) ufleba saqarTvelos konstituciis/kanonebis mixedviT saqarTvelos konstitucia: konstitucia ar Seicavs specilur debulebebs jandacvis momsaxurebis usafrTxoebis Sesaxeb. Tumca, konstitucia zogadad icavs piris usafrTxoebas (mux. 15.1): `sicocxle adamianis xelSeuvali uflebaa da mas icavs kanoni.~ kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: muxlebi, romlebic xarisxian momsaxurebas exeba, pirdapir kavSirSia usafrTxoebasTan. agreTve, kanoni specilurad exeba saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministros da Sesabamisi saxelmwifo organoebis mier samedicino teqnikuri nakeTobebis da samedicino teqnologiebis xarisxisa da usafrTxoebis standartebis SemuSavebasa da danergvas. (mux. 67) igive kanoni specilurad usvams xazs saxelmwifos zogad pasuxismgeblobas uzrunveloyos usafrTxo garemo, awarmoos saxelmwifo sanitariuli zedamxedveloba, higienuri normireba da epidemiologiuri kontroli. (mux. 70-79) kanoni agreTve icavs kvlebis subieqtebis usafrTxoebis uflebas (Tavi XIX). saqarTvelos kanoni pacientis uflebaTa Sesaxeb: ix. seqcia xarisxiani samedicino momsaxurebis miRebis uflebis Sesaxeb. saqarTvelos kanoni saeqimo saqmianobis Sesaxeb: damoukidebeli saeqimo saqmianobis subieqts ufleba aqvs Caerios pacientis ojaxur da pirad cxovrebaSi, Tu Caurevloba seriozul safrTxes uqmnis pacientis ojaxis wevrebis janmrTelobas an/da sicocxles.(mux.49) aRniSnuli kanonis debulebebi xarisxiani samedicino momsaxurebis miRebis uflebis Sesaxeb aseve Seesabameba pacientis usafrTxoebas. 182 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 saqarTvelos kanoni adamianis organoTa gadanergvis Sesaxeb ix. seqcia xarisxiani samedicino momsaxurebis miRebis uflebis Sesaxeb. saqarTvelos kanoni sazogadoebrivi janmrTelobis Sesaxeb kanoni exeba usafrTxo garemos (Tavi 6), biousafrTxoebas (Tavi 5), vaqcinis usafrTxoebas (mux. 7). samedicino momsaxurebis mimwodeblis valdebulebebs gadamdebi daavadebebis profilaqtikis sferoSi (mux. 8) da gansakuTrebiT aRniSnavs saqarTvelos teritoriaze yvela piris uflebas daculi iyves infeqciuri daavadebebisgan samedicino dawesebulebaSi (mux. 5.2). kanoni aseve awesebs saxelmwifos pasuxismgeblobas sisxlis da sisxlis komponentebis usafrTxoebasTan dakavSirebiT (mux. 15.2). saqarTvelos kanoni wamlisa da farmacevtuli saqmianobis Sesaxeb kanonis mTavari mizania wamlis usafrTxoebis uzrunvelyofa. igi aregulirebs wamlis miwodebasa da gamoyenebaSi Cabmuli pirebis da dawesebulebebis saqmianobasa da axali wamlebis klinikur gamocdas. saqarTvelos kanoni fsiqiatriuli daxmarebis Sesaxeb kanoni awesebs eqimisTvis usafrTxo garemos uzrunvelyofas pacientis gasinjvis dros (mux. 13). kanoni aseve gansazRvravs garemoebebs, rodesac fsiqikuri daavadebis mqone pacientis uflebebi SeiZleba SeizRudos sxva pirTa usafrTxoebisTvis (mux. 16, 18, 19). kanoni sisxlisa da misi komponentebis donorobis Sesaxeb kanoni Seicavs debulebebs sisxlisa da sisxlis komponentebis xarisxis Sesaxeb. g) damxmare aqtebi Sromis, janmrTelobis da socialuri dacvis ministris brZaneba 215/n, 11.07.2007, romelic exeba TanamSromelTa savaldebulo samedicino Semowmebis dafinansebas damqiraveblis mier. ix. agreTve qveseqcia xarisxiani samedicino momsaxurebis miRebis uflebis Sesaxeb. d) Sesabamisi muxlebi eTikis kodeqsidan eTikis kodeqsi ar seicavs aRniSnul uflebasTan dakavSirebul debulebebs. 183 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi e) sxva wyaroebi ar arsebobs damatebiTi wyaroebi aRniSnuli uflebis Sesaxeb. Tanamedrove medicinis miRwevebiT sargeblobis ufleba a) ufleba pacientis uflebaTa evropuli qartiis mixedviT (ECPR) yvela pirs aqvs ufleba xeli miuwvdebodes novaciur procedurebze, maT Soris sadiagnostiko procedurebze, saerTaSoriso standartebis mixedviT da ekonomikuri faqtorebisgan damoukideblad. miuxedavad imisa, rom saqarTvelos konstitucia ar axsenebs Tanamedrove medicinis miRwevebiT sargeblobis uflebas, kanoni uzrunvelyofs msgavs uflebas iSviaTi, uCveulo daavadebis mqone pacientebisTvis (kanoni pacientis uflebaTa Sesaxeb). kanoni aseve aregulirebs adamianis biosamedicino kvlevas ( kanoni janmrTelobis dacvis Sesaxeb, kanoni wamlisa da farmacevtuli saqmianobis Sesaxeb). dabolos, Tanamedrove medicinis miRwevebiT sargeblobis ufleba arapirdapir kavSirSia uwyvet samedicino ganaTlebasTan da personalis profesiul ganviTarebasTan, rac maT saSualebas miscemT umkurnalon pacients Tanamedrove standartebiT. b) ufleba saqarTvelos konstituciis/kanonebis mixedviT saqarTvelos konstitucia: konstitucia ar Seicavs debulebebs aRniSnul sakiTxze. kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: kanoni ar cnobs konkretulad aRniSnul uflebas. kanonis me-19 Tavi aregulirebs miosamedicino kvlevas, maT Soris adamianis kvlevas (mux. 10-15) saxelmwifo qmnis pirobebs samedicino personalis profesiuli codnis gaRrmavebisa da, Sesabamisad, profesiuli statusis amaRlebis uzrunvelsayofad. (mux. 48) saqarTvelos kanoni pacientis uflebaTa Sesaxeb pacientis uflebaTa Sesax kanonis mixedviT, `saxelmwifo uzrunvelyofs iSviaTi daavadebebis mqone pacientebs qveyanaSi aRiarebuli da danergili profesiuli da samomsaxureo 184 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 standartebis Sesabamisi samedicino momsaxurebiT. iSviaTi daavadebebis CamonaTvals gansazRvravs saqarTvelos janmrTelobisa da socialuri dacvis saministro.~ (mux. 13). amgvari daavadebebis sia gansazRvrulia Sromis, janmrTelobis da socialuri uzrunvelyofis ministris brZanebiT. saqarTvelos kanoni saeqimo saqmianobis Sesaxeb kanonis 29-e muxlis mixedviT, `damoukidebeli saeqimo saqmianobis subieqts SeuZlia monawileoba miiRos uwyveti profesiuli ganviTarebis sistemaSi, Tavisi praqtikuli saeqimo saqmianoba miusadagos Tanamedrove medicinis miRwevebs da gaaumjobesos am saqmianobis yvela aspeqti.~ uwyveti samedicino ganaTlebis mizania, rom eqimebs hqondeT unarebi isargeblon Tanamedrove medicinis miRwevebiT. unda aRiniSnos, rom 2001 wlidan (rodesac miRebul iqna kanoni saeqimo saqmianobis Sesaxeb) 2007 wlamde, uwyveti samedicino ganaTleba savaldebulo iyo eqimebisTvis. Tumca, 2007 wles kanonSi Sevida cvlilebebi, romlis Tanaxmadac uwyveti samedicino ganaTleba nebayoflobiTi Seiqmna. g) damxmare aqtebi pacientis uflebaTa Sesaxeb kanonis me-13 muxlis safuZvelze, janmrTelobis dacvis ministrma gamosca brZaneba N199 iSviaT daavadebaTa siis miRebis Sesaxeb (14.05.2001). 2004 wels brZanebaSi Setanili cvlilebis Sedegad sia Seicavs 23 daavadebas. d) Sesabamisi muxlebi eTikis kodeqsidan eqimis eTikis kodeqsis Semdegi debulebebi exeba biosamedicino kvlevaSi adamianis CarTvas (`eqimi _ mkvlevari~) 1. `mecnieruli kvleva eqimis saqmianobis erT-erTi mniSvnelovani Semadgenelia da misi profesiuli srulyofis saSualebaa. kvlevis dagegmvisa da ganxorcielebis procesSi eqimi sayovelTaod aRiarebuli samecniero principebiT xelmZRvanelobs. kvlevis Catarebis dros da misi Sedegebis gamoqveynebisas eqimi obieqturia. 2. adamianze mecnieruli kvlevis warmoebisas pacientis interesebi uzenaesia; kvlevis miznebi da mosalodneli Sedegebi arc erT SemTxvevaSi ar axdens gavlenas eqimis ZiriTad mowodebaze _ emsaxuros pacientis janmrTelobasa da sicocxles.~ e) sxva wyaroebi evropis sabWos konvenciis `adamianis uflebebi da biomedicine~ damatebiTi oqmis `biosamedicino kvlevis Sesaxeb~ mixedviT specifikurad regulirdeba adamianis kvleva. dResdReobiT, oqmi ufro specifikuria, vidre Sesabamisi debulebebi saqarTvelos kanonmdeblobidan (kanoni janmrTelobis dacvis Sesaxeb da kanoni wamlisa da farmacevtuli saqmianobis Sesaxeb). 185 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi mosalodnelia parlamentis mier axali kanonproeqtis ganxilva biosamedicino kvlevaSi adamianis CarTvis Sesaxeb, rac, miRebis SemTxvevaSi, iqneba yvelaze specifikuri kanoni biosamedicino kvlevis Sesaxeb saqarTveloSi. tanjvisa da tkivilis Semsubuqebis ufleba a) ufleba pacientis uflebaTa evropuli qartiis mixedviT (ECPR) yvelas aqvs ufleba Semsubuqdes misi tanjva da tkivili, ramdenadac es SesaZlebelia daavadebis TiToeul stadiaze. saqarTvelos jandacvis kanonmdeblobaSi ar aris specialuri debuleba tkivilis Semsubuqebis uflebis Sesaxeb. Tumca, tkvivilis Tavidan acileba da Semsubuqeba aris paliatiuri mzrunvelobis erT-erTi principi, rac aRniSnulia saqarTvelos kanonebSi (ix. qvemoT). debulebebi fsiqitriuli pacientebis aranebayoflobiTi mkurnalobis Sesaxeb mWidrod aris dakavSirebuli am uflebasTan. am WrilSi xvdeba aseve Zaladoba cixeSi da fsiqitriul dawesebulebebSi. dabolos, es ufleba ukavSirdeba xelmisawvdomobis uflebas, usafrTxoebisa da Tavisufali arCevnis uflebebs. didi xani ar aris, rac Cveni qveynis janmrTelobis dacvis sistema paliatiuri mzrunvelobasac moicavs. mravali wlis manZilze CvenSi im pirebisaTvis, romlebic paliatiuri mzrunvelobas saWiroebdnen, maT Soris, terminalur stadiaze myofi pacientebisaTvis, ar arsebobda adekvaturi resursebi. aq vgulisxmobT saTando kvalifikaciis mqone samedicino personalsa da momsaxurebis im formebs, romlebsac aseT pacientebs SesTavazebdnen. sabednierod, msgavsad mravali sxva qveynisa, CvenSic daiwyo paliatiuri mzrunvelobis ganviTareba da, erTi SexedviT, `uimedo~ pacientebsac imedi gamouCnda _ tkivlis da sxva mtanjveli simptomebis Semsubuqeba, zrunva maT fsiqosocialur problemebze. dRes pacientebisaTvis garkveul farglebSi ukve xelmisawvdomia paliatiuri mzrunveloba, rogorc binaze movlis, ise stacionarSi (saavadmyofoSi) gaweuli samedicino momsaxurebis saxiT. mniSvnelovania imis gageba, Tu ras iTvaliswinebs paliatiuri mzrunveloba, rogor SeiZleba paliatiuri mzrunvelobiT gaTvaliswinebuli momsaxurebis miReba saxelmwifos mier dafinansebuli programebis farglebSi. meore mxriv, pacientebisaTvis mniSvnelovania, gaerkvnen maT individualur uflebebSi, romelic paliatiuri mzrunvelobasTan aris dakavSirebuli exeba iseT sakiTxebs rogoricaa srulyofili informaciis miReba sakuTari janmrTelobis Sesaxeb, pacientis axloblebis roli gadawyvetilebis miRebisas, konfidencialurobis dacvis sakiTxi da sxva. saqarTvelos kanonmdeblobaSi, kerZod, kanonebSi `janmrTelobis dacvis Sesaxeb~ da `pacientis uflebebis Sesaxeb~3 paliatiuri mzrunveloba Semdegnairad aris ganmartebuli: 3 paliatiuri mzrunvelobis sakiTxebze cvlilebebi kanonebSi `janmrTelobis dacvis Sesaxeb~ da `pacientis uflebebis Sesaxeb~ Sevida 2007 wlis 8 maiss, saqarTveloSi paliatiuri mzrunvelobis ganviTarebis iniciatorebis Zalisxmevis Sedegad. 186 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 `aqtiuri, mravalprofiluri mzrunveloba, romlis upirvelesi amocanaa tkivilisa da sxva paTologiuri simptomebis moxsna, avadmyofTa socialuri da fsiqologiuri daxmareba, sulieri Tanadgoma. igi vrceldeba im pacientebze, romelTa daavadeba mkurnalobas aRar eqvemdebareba; aseTi mzrunvelobiT SesaZlebelia avadmyofisa da maTi ojaxebis cxovrebis xarisxis gaumjobeseba~. paliatiuri mzurnveloba SeiZleba ganxorcieldes saavadmyofoSi (paliatiuri mzrunvelobis ganyofilebaSi an hospiSi) an binaze. dRes saqarTveloSi paliatiuri mzrunveloba ukve danergilia, Tumca misi sayovelTao xelmisawvdomoba qveynis mosaxleobisaTvis uzrunvelyofili ar aris. ramdenad xelmisawvdomia paliatiuri mzrunveloba mxolod xuTiode welia, rac Cvens qveyanaSi SesaZlebeli gaxda Tanamedrove standartebis paliatiuri mzrunvelobis (rogorc saavadmyofoSi, ise binaze movlis saxiT) miReba. b) ufleba saqarTvelos konstituciis/kanonebis mixedviT saqarTvelos konstitucia: me-17 muxlis debulebebis dakavSireba SeiZleba tkvilis da tanjvis Semcirebis uflebasTan: 1. `adamianis pativi da Rirseba xelSeuvalia. 2. dauSvebelia adamianis wameba, arahumanuri, sastiki an pativisa da Rirsebis Semlaxveli mopyroba da sasjelis gamoyeneba.~ kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: kanonis gansazRvrebiT, paliatiuri mzrunveloba, aris `aqtiuri, mravalprofiluri mzrunveloba, romlis upirvelesi amocanaa tkivilisa da sxva paTologiuri simptomebis moxsna, avadmyofTa socialuri da fsiqologiuri daxmareba, sulieri Tanadgoma. igi vrceldeba im pacientebze, romelTa daavadeba mkurnalobas aRar eqvemdebareba; aseTi mzrunvelobiT SesaZlebelia avadmyofebisa da maTi ojaxebis cxovrebis xarisxis gaumjobeseba~. pacientis uflebebTan dakavSirebuli yvela debuleba vrceldeba aseve paliatiur mzrunvelobazec (mag. mux. 8) zog SemTxvevaSi paliatiuri mzrunveloba specialurad aris aRniSnuli. janmrTelobis dacvis Sesaxeb kanonis me-10 muxlis mixedviT, `yvela qmedunarian pirs ufleba aqvs winaswar werilobiT gamoxatos neba ganukurnebeli daavadebis terminalur stadiaSi aRmoCenis SemTxvevaSi misTvis sareanimacio, sicocxlis SemanarCunebeli an paliatiuri mkurnalobis an/ da paliatiuri mzrunvelobis Catarebis Sesaxeb.~ amasTanave, `ugono mdgomareobaSi myof 187 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi avadmyofs utardeba saTanado mkurnaloba, Tu avadmyofs winaswar, roca mas hqonda gacnobierebuli gadawyvetilebis miRebis unari, ar hqonia gancxadebuli uari sareanimacio, sicocxlis SemanarCunebel an paliatiur mkurnalobaze an/da paliatiur mzrunvelobaze.~ (mux. 149) saqarTvelos kanoni pacientis uflebaTa Sesaxeb kanoni `pacientis uflebebis Sesaxeb~ detalurad ganmartavs, Tu ra saxis informacia unda miewodos pacients (muxli 18); 1. pacients ufleba aqvs samedicino momsaxurebis gamwevisagan miiRos sruli, obieqturi, drouli da gasagebi informacia: ... g) ganzraxuli profilaqtikuri, diagnostikuri, samkurnalo da sareabilitacio momsaxurebis, maTi Tanmxlebi riskisa da SesaZlo efeqtianobis Sesaxeb; d) samedicino gamokvlevebis Sedegebis Sesaxeb; e) ganzraxuli samedicino momsaxurebis sxva, alternatiuli variantebis, maTi Tanmxlebi riskisa da SesaZlo efeqtianobis Sesaxeb: v) ganzraxul samedicino momsaxurebaze gacxadebuli uaris mosalodneli Sedegebis Sesaxeb; z) diagnozisa da savaraudo prognozis, agreTve mkurnalobis mimdinareobis Sesaxeb. aq xazi unda gaesvas im garemoebasac, rom imave kanonSi yuradReba gamaxvilebulia samedicino personalis mier pacientisaTvis informaciis gasagebi eniT mowodebaze. kerZod kanonis me-19 muxlSi gacxadebulia Semdegi: `pacients, mis naTesavs an kanonier wamomadgenels informacia miewodebaT maTi aRqmis unaris gaTvaliswinebiT. ganmartebebis micemisas specialuri terminebi minimalurad unda iqnes gamoyenebuli.~ amrigad, rogorc erTi, ise meore kanoni uflebas aZlevs pacients miiRos sruli informacia sakuTari janmrTelobis mdgomareobis Sesaxeb. zemoaRniSnulTan erTad pacients ufleba aqvs gaecnos samedicino Canawerebs (samedicino istorias) Tavis Tavze. `pacientis uflebebis Sesaxeb~ kanonis me-17 muxlis Tanaxmad pacients, xolo misi Tanxmobis an qmeduunarobis SemTxvevaSi, naTesavs an kanonier wamomadgenels ufleba aqvT gaecnon samedicino Canawerebs da moiTxovon samedicino Canawerebis nebismieri nawilis asli. pacientis uflebaTa Sesaxeb kanonis mixedviT, saqarTvelos moqalaqes ufleba aqvs winaswar werilobiT gamoxatos neba (Tanxmoba an uari) ugono mdgomareobaSi aRmoCenisas an gacnobierebuli gadawyvetilebis miRebis unaris dakargvisas misTvis sareanimacio, sicocxlis Sema- 188 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 narCunebeli an paliatiuri mkurnalobis an/da paliatiuri mzrunvelobis Catarebis Sesaxeb (mux. 24.1). Tumca, amgvari survilis gamoTqma SesaZlebelia Semdgom or SemTxvevaSi: Tu miTiTebuli garemoebebi gamowveulia: a) ganukurnebeli daavadebis terminaluri stadiiT; b) daavadebiT, romelic aucileblad gamoiwvevs mZime invalidobas. saqarTvelos kanoni saeqimo saqmianobis Sesaxeb saeqimo saqmianobis Sesaxeb kanonis mixedviT, paliatiuri mzrunveloba aris mzrunvelobis erT-erTi forma. paliatiuri mzrunvelobis Sesaxeb aRniSnulia 39-e muxlSi (pacientisTvis informaciis miwodeba) da 29 (pacientis pirad cxovrebaSi Careva). saqarTvelos kanoni narkotikuli saSualebebis, fsiqotropuli nivTierebebis, prekursorebisa da narkologiuri daxmarebis Sesaxeb metadonis programa exmareba pacientebs Tavidan aicilon tkivili da tanjva narkotikze damokidebulebis gadaCvevis procesSi. aqdan gamomdinare, metadonis programis xelmisawvdomoba tkivilis da tanjvis Semcirebis uflebis mniSvnelovani aspeqtia. kanoni miiCnevs narkomaniis CanacvlebiTi speciluri programebis ganxorcielebas, rogorc narkotikze damokidebulebis mkurnalobis gzas (mux. 38.3). Canacvlebis Terapiis meTodebi unda ganisazRvros Sromis, janmrTelobis da socialuri dacvis ministris brZanebiT. (mux. 38.4) g) sxva wyaroebi dRes eqims SeuZlia daniSnos da gamoweros qronikuli ganukurnebeli daavadebiT Sepyrobili pacientebisaTvis tkivilis gasayuCeblad aucilebeli narkotikuli saSualebebis saTanado raodenoba, romelic 7 dRis manZilze iqneba samyofi pacientisaTvis. amasTan, eqims SeuZlia gamowerili narkotikebis gaxarjvamde Secvalos narkotikuli saSualeba an misi forma an doza, Tuki amas pacientis mdgomareoba moiTxovs. janmrTelobis dacvis Sesaxeb kanonis 154-e muxlis mixedviT, gamoica Sromis, janmrTelobis da socialuri dacvis ministris brZaneba N 157/n _ qronikuli inkurabeluri daavadebiT Sepyrobili pirebis paliatiuri mzrunvelobiT uzrunvelyofis Sesaxeb instruqciis damtkicebis Taobaze (10.07.2008) faqtobrivad, brZaneba aris gaidlaini paliatiuri mzrunvelobis sxvadasxva aspeqtebis Sesaxeb. brZaneba aseve exeba opiatebis, rogorc tkivilis kontrolis saSualebebis, gamoyenebas paliatiuri mzrunvelobis dros. brZanebis debulebebis meSveobiT izrdeba opiatebis xelmisawvdomoba, rac gaaumjobesebs tkivilis kontrols qronikuli, ukurnebeli seniT daavadebul avadmyofebSi da mniSvnelovnad gaaumjobesebs Zlieri tkivilebis mqone pacientebis, aseve maTi ojaxis wevrebis mdgomareobas. brZanebiT dadgenilia, rom: `a) qronikuli inkurabeluri pacientisTvis gamowerili erTi recepti (forma) SeiZle- 189 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi ba Seicavdes narkotikuli saSualebis 7 dRis samyof raodenobas; b) preparatis marTebuli daniSvnis da gamoweris Taobaze pasuxismgebelia eqimi, romelic gascems recepts da dawesebulebis xelmZRvaneli, an xelmZRvanelis mier oficialurad daniSnuli pasuxismgebeli piri, romelic awarmoebs monitorings; g) Tuki mkurnalobis ganmavlobaSi pacientis mdgomareoba Seicvala, rac saWiroebs narkotikis, an misi dozis an formis Secvlas, maSin eqimma unda gasces axali recepti; d) receptiT gamowerili narkotikuli saSualeba unda gaices 5 samuSao dRis ganmavlobaSi. xuTi samuSao dRis Semdeg farmacevts aRar aqvs ufleba gasces medikamenti. saWiroebis SemTxvevaSi gaicema axali recepti.~ Canacvlebis Terapiis meTodebi unda ganisazRvros Sromis, janmrTelobis da socialuri dacvis ministris normatiuli aqtiT (mux. 38.4). Sesabamisi aqti gamoica 2005 wels. masSi cvlielebebi Sevida 2006 wels: brZaneba N302, 24.11.2005 `metadoniT Canacvlebis piloturi proeqtebis meTodologia da implementacia.~ d) Sesabamisi muxlebi eTikis kodeqsidan ukurnebeli seniT daavadebuli Tu sasikvdilod ganwiruli avadmyofisaTvis saTanado samedicino daxmarebas da sulier Tanadgomas eqimi agrZelebs pacientis sicocxlis bolomde. (zogadi debulebebi, mux. 4) e) sxva wyaroebi aRniSnuli uflebis Sesaxeb ar arsebobs damatebiTi wyaroebi. saCivris Setanis ufleba a) ufleba pacientis uflebaTa evropuli qartiis mixedviT (ECPR) yvela pirs aqvs ufleba iCivlos, rodesac mas miayeneben zians da aqvs ufleba miiRos pasuxi, an sxvagvari gamoxmaureba Civilis da gasaCivrebis ufleba gansazRvrulia saqarTvelos kanonmdeblobiT.4 Tumca, es ufleba jandacvis konteqstSi specialuradac aris ganxiluli. 4 detalebisTvis ix. Tavi VIII 190 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 b) ufleba saqarTvelos konstituciis/kanonebis mixedviT saqarTvelos konstitucia: konstitucia yvela pirs aniWebs uflebas `Tavis uflebaTa da TavisuflebaTa dasacavad mimarTos sasamarTlos~ (mux. 42.1). cxadia, rom es ufleba moqmedebs jandacvis konteqstSic. am sakiTxs konstituciis arc erTi sxva debuleba ar exeba. Tumca, saxalxo damcvelis ofisi (romelic daarsda konstituciis 43 muxlis safuZvelze) uflebamisilia gamoavlinos faqtebi, romlebic exeba adamianis uflebaTa da TavisuflebaTa darRvevebs. saxalxo damcveli uflebamosialia Seatyobinos amis Sesaxeb `Sesabamis organoebs da pirebs.~ aseve, sakonstitucio sasamarTlos SeuZlia wvlili Seitanos jandacvis sferoSi (iseve rogorc sxva sferoebSi) adamianis uflebaTa dacvaSi 89-e muxlis safuZvelze. kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: kanonis mixedviT, `pacients, mis naTesavs an kanonier warmomadgenels ufleba aqvs eqims, eqTans, medicinis sxva muSaks an samedicino dawesebulebas uCivlos samedicino dawesebulebis administraciaSi, janmrTelobis dacvis marTvis organoSi, sasamarTloSi, an davis gamrCev sxva organoSi.~ (mux. 104) zemoTnaxsenebis damatebiTi regulireba ar arsebobs, garda im SemTxvevisa, rodesac saCivris Setana xdeba sasamrTloSi. ase rom, Civilis uflebis gamoyenebis alternatiuli sistema ar aris kargad ganviTarebuli. saqarTvelos kanoni pacientis uflebaTa Sesaxeb kanonis mixedviT, pacients aqvs ufleba mimarTos sasamarTlos (mux. 10). sasamarTlosStvis mimarTvis safuZveli seiZleba sxvadasxva iyos. pacienti an mis warmomadgeneli SeiZleba moiTxovdes: a) kompensacias qonebrivi da araqonebrivi zianisa, romlebic gamowveulia: a.a) pacientis uflebebis darRveviT; a.b) mcdari samedicino qmedebiT; a.g) samedicino dawesebulebis funqcionirebis sxva xarvezebiT; a.d) saxelmwifos mier arasworad ganxorcielebuli zedamxedvelobiTa da regulirebiT; b) samedicino personalis saqmianobis licenziis SeCereba an gauqmeba; g) saxelmwifo samedicino da sanitariuli standartebis Secvla. 191 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi pacientis uflebaTa Sesaxeb kanonis mixedviT, `samedicino momsaxurebis gamwevs ufleba aqvs sasamarTloSi gaasaCivros qmeduunaro an gacnobierebuli gadawyvetilebis miRebis unars moklebuli pacientis naTesavis an kanonieri warmomadgenlis gadawyvetileba, Tu igi ewinaaRmdegeba pacientis janmrTelobis interesebs.~ sasamarTlosTvis mimarTvis dros, samedicino momsaxurebisa gamwevi uCivis paceintis naTesavs an kanonier warmomadgenels da cdilobs daamtkicos, rom misi midgoma, pacientis naTesavis an kanonieri warmomadgenlisgan gansxvavebiT, pacientis saukeTeso interesebs Seesabameba. nebismier SemTxvevaSi, samedicino momsaxurebis gamwevis es ufleba arsebobs pacientis sicocxlisa da janmrTelobis dasacavad. saqarTvelos kanoni saeqimo saqmianobis Sesaxeb msgavsi debulebebi gvxvdeba saeqimo saqminobis Sesaxeb kanonSic. mux. 45.4-is mixedviT, `Tu pacientis naTesavis an kanonieri warmomadgenlis gadawyvetileba ewinaaRmdegeba qmeduunaro an SezRuduli qmedunarianobis mqone an/da gacnobierebuli gadawyvetilebis miRebis unars moklebuli pacientis janmrTelobis interesebs, damoukidebeli saeqimo saqmianobis subieqts ufleba aqvs es gadawyvetileba gaasaCivros sasamarTloSi da moiTxovos pacientisaTvis Sesabamisi samedicino momsaxurebis gawevis nebarTva.~ saqarTvelos organuli kanoni saxalxo damcvelis Sesaxeb saxalxo damcvelis Sesaxeb organuli kanoni SemuSavda konstituciis 43-e muxlis safuZvelze. kanonis Tanaxmad, moqalaqeebs, ucxoelebs da moqalaqeobis armqone pirebs Tanabrad SeuZliaT Seitanon saCivari saxalxo damcvelis aparatSi, Tu isini miiCneven, rom maTi uflebebi da Tavisuflebebi (konstituciiT, erovnuli kanonmdeblobiT da saerTaSoriso xelSekrulebebiT gansazRvruli) dairRva (mux. 13). es muxli ra Tqma unda exeba adamianis uflebebs jandacvis sferoSi. saqarTvelos saxalxo damcvelis mier gancxadebisa da saCivris ganxilvam ar SeiZleba daabrkolos analogiuri gancxadebis an saCivris ganxilva Sesabamis saerTaSoriso organizaciaSi (mux. 14.3). aqedan gamomdinare, saxalxo damcvelis procedura ar aris Sidasaxelmwifoebrivi dacvis saSualeba, romelic unda amoiwuros saerTaSoriso organoebisTvis mimarTvamde. gancxadeba da saCivari ar ibegreba saxelmwifo gadasaxadiT da saqarTvelos saxalxo damcvelis mier dainteresebuli pirisaTvis gaweuli samsaxuri ufasoa (mux. 16). gancxadebisa da saCivris miRebis Semdeg saqarTvelos saxalxo damcveli damoukideblad iRebs gadawyvetilebas Semowmebis dawyebis Taobaze. miRebuli gadawyvetilebis Sesaxeb saqarTvelos saxalxo damcveli acnobebs ganmcxadebels da im saxelmwifo organos, Tanamdebobis an iuridiul pirs, romlis qmedebac an gadawyvetilebac aris gasaCivrebuli (mux. 17). 192 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 saqarTvelos kanoni saqarTvelos sakonstitucio sasamarTlos Sesaxeb: nebismier fizikur pirs aqvs ufleba Seitanos sakonstitucio saCivari, Tu igi miiCnevs, rom normatiuli aqti arRvevs konstituciis me-2 TaviT misTvis garantirebul uflebebs. amis msgavsad, saerTo sasamarTloebsac SeuZliaT mimarTon sakonstitucio sasamarTlos, Tu eWvi eparebaT im mormatiuli aqtis konstituciurobaSi, romelzec unda daafuZnon gadawyvetileba. g) damxmare aqtebi ar arsebobs damxmare aqtebi aRniSnul eflebasTan dakavSirebiT. d) Sesabamisi muxlebi eTikis kodeqsidan eTikis kodeqsis debulebebi am sakiTxs ar exeba. e) sxva wyaroebi saqarTvelos sisxlis samarTlis saproceso kodeqsi: TavisuflebaSezRuduli pirebisTvis sisxlis samarTlis saproceso kodeqsi uzrunvelyofs saCivris Setanis damatebiT meqanizmebs. adamianis uflebaTa evropuli konvencia: adamianis uflebaTa evropul sasamarTloSi SeiZleba saCivris Setana evropuli konvenciiis safuZvelze, romlis ratificireba saqarTvelom moaxdina 1999 wlis 12 maiss (rodesac saqarTvelo gaxda evropis sabWos wevri). konvenciis 34-e muxlis mixedviT, `sasamarTlos SeuZlia miiRos ganacxadebi nebismieri fizikuri piris, arasamTavrobo organizaciis an calkeul pirTa jgufisagan, romlebic amtkiceben, rom isini arian erT-erTi maRali xelSemkvreli mxaris mier konvenciiT an misi oqmebiT gaTvaliswinebuli uflebebis darRvevis msxverplni. maRali xelSemkvreli mxareebi kisruloben valdebulebas, arafriT SeuSalon xeli am uflebis efeqtian ganxorcielebas.~ saCivris dasaSvebobis kriteriumebi gansazRvrulia konvenciis 35-e muxliT: 1. `sasamarTlos SeuZlia saqme miiRos gansaxilvelad mxolod mas Semdeg, rac amoiwureba samarTlebrivi dacvis yvela Sidasaxelmwifoebrivi saSualeba saerTaSoriso samarTlis sayovelTaod aRiarebuli normebis Tanaxmad, da Tu gasuli ar aris eqvsi Tve, saqmeze Sidasaxelmwifoebrivi saboloo gadawyvetilebis gamotanis TariRidan. 2. sasamarTlo ar ganixilavs 34-e muxlis Sesabamisad wardgenil arc erT ganacxads, romelic: 193 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi a) anonimuria; an b) arsebiTad igivea da sasamarTlos mier ukve ganxilulia, an gadaeca saerTaSoriso gamoZiebis an mogvarebis sxva instancias da ar Seicavs Sesatyvis axal informacias. 3. sasamarTlo dauSveblad acxadebs 34-e muxlis Sesabamisad wardgenil individualur ganacxads, romelsac miiCnevs SeuTavseblad konvenciasa da misi oqmebis debulebebTan, aSkarad dausabuTeblad, an sasamarTlosaTvis mimarTvis uflebis borotad gamoyenebad. 4. sasamarTlo ukuagdebs nebismier ganacxads, romelsac igi miiCnevs dauSveblad am muxlis safuZvelze. amis ufleba mas aqvs samarTalwarmoebis nebismier stadiaze.~ kompensaciis miRebis ufleba a) ufleba pacientis uflebaTa evropuli qartiis mixedviT (ECPR) yvelas aqvs ufleba miiRos sakmarisi kompensacia gonivrulad mokle droSi , Tu ganicdis fizikur ar moralur da fsiqologiur zians, rac gamowveulia jandacvis momsaxurebis gamwevis mier. saqarTvelos kanonmdeblobis Tanaxmad, pacinetisaTvis miyenebuli zianis anazRaurebis sakiTxis specializirebuli samarTlebrivi regulireba ar arsebobs da miyenebuli zianis SemTxvevaSi davis gadawyvetis erTaderTi meqanizmi mxolod sasamarTloa da isic samoqalaqo samarTlis kodeqsiT gaTvaliswinebuli zogadi normebis safuZvelze. saqarTvelos kanoni `janmrTelobis dacvis Sesaxeb~ Seicavs Canawers, romlis mixedviT `samedicino personalis qmedebiT an umoqmedobiT gamowveuli pacientis fizikuri an fsiqikuri mdgomareobis gauaresebis an sikvdilis, an pacientisaTvis miyenebuli moraluri an materialuri zianisaTvis pasuxismgebloba ganisazRvreba saqarTvelos kanonmdeblobiT.~4 saqarTvelos kanoni pacientis uflebebis Sesaxeb, romelic pacientis uflebebs samarTlebrivad unda skurpulozurad aregulirebdes da icavdes _ pacients amisamarTebs sasamarTloze qonebrivi an araqonebrivi zianis dadgomis SemTxvevaSi.5 samedicino Secdomis gamo zianis anazRaurebisTvis saWiroa minimum samedicino standartebis arseboba, romliTac ixelmZRvaneleben mxareebi warmoSobili davis SemTxvevaSi. jandacvis sferoSi moqmedi kanonmdeblobidan, cxadi xdeba, rom samedicino Secdomis da zianis sakiTxebis regulirebisas kanonmdebeli calsaxad ar uTiTebs samedicino standartebis mniSvnelobasa da daniSnulebaze. kanoni `samedicino socialuri eqspertizis Sesaxeb~ ar icnobs samedicino Secdomas, amiT gamowveul zians, samedicino Secdomas da eqimis daudevrobas ar moixseniebs piris SesaZleblobis SezRudvis kategoriebSi. 4 muxli 103, saqarTvelos kanoni janmrTelobis dacvis Sesaxeb, 1997. 5 muxli 10, saqarTvelos kanoni pacientis uflebebis Sesaxeb, 2000. 194 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 kompensaciis miRebis erTaderTi SesaZlebloba (sadac sistema kargad aris Camoyalibebuli) aris sasamarTlosTvis mimarTvis saSualebiT. gansxvavebuli midgoma da samarTlebrivi gamocdileba arsebobs ganviTarebul qveynebSi. kerZod, skandinaviis qveynebSi pacientisaTvis miyenebuli zianis anazRaurebis sakmaod moqnili samarlebrivi meqanizmi moqmedebs. magaliTisaTvis, sainteresoa SvedeTis gamocdileba am kuTxiT. SvedeTSi moqmedebs aqti pacientisaTvis miyenebuli zianis Sesaxeb, romelic 1997 wels iqna miRebuli. aqtis mixedviT jandacvis servisebis mimwodeblebi valdebulni arian SeiZinon pacientis sadazRvevo paketi, romelic pacientisaTvis miyenebuli zianis SemTxvevaSi iqneba gamoyenebuli kompensaciis mizniT. kompencia zianis dadgomis SemTxvevaSi vrceldeba mxolod pacientebze. termini `pacienti~ definirebulia, rogorc nebismieri piri, romelmac daamyara kavSiri jandacvis personalTan maTi janmrTelobis mdgomareobis gamo. aqtiT aseve gansazRvrulia mniSvnelovani termini `piradi ziani~, romelic moicavs, rogorc fizikur, aseve fsiqikur ziansac. aqtiT pacientisaTvis miyenebuli zianis 6 tipia gansazRvruli: 1. mkurnalobasTan dakavSirebuli zianis aRniSnul kategoriaSi xvdeba ziani, romelic gamowveulia samedicino Semowmebis, mzrunvelobis, mkurnalobis an msgavsi procedurebis Sedegad (magaliTisaTvis sisxlis donacia) da rom aRniSnuli zianis Tavidan acileba SesaZlebeli iyo sxva saxis naklebi riskis Semcveli procedurebis Catarebis SemTxvevaSi. kvlevas imasTan dsakavSirebiT, Tu ramdenad SeiZleboda damdgari zianis Tavidan acileba atarebs gamocdili specialisti, romelmac mxedvelobaSi ar unda miiRos eqimis gamocdileba da kvalifikacia, aramed unda imoqmedos dadgenili samedicino standartebis mixedviT. magaliTisaTvis nervis dazianebis SemTxvevaSi man unda ixelmZRvanelos dadgenili samedicino standartiT, Tu rogor unda imoqmedos gamocdilma orTopedma im konkretul SemTxvevaSi. jandacvis provaideris mxridan resursebis simwire an ararseboba, ramac gamoiwvia ziani aseve SeiZleba gamoyenebul iqnas kompensaciis miRebis safuZvlad. 2. samedicino-teqnikuri ziani pacients warmoeSoba kompensaciis miRebis ufleba, Tu mas ziani miadga samedicino dawesebulebis samedicino-teqnikuri aRWurvilobis defetis an defeturi gamoyenebis Sedegad. 3. diagnostikuri ziani pacients kompensaciis miRebis ufleba aqvs araswori diagnoziT gamoqveuli zianis SemTxvevaSic. am konkretul SemTxvevaSi kompensacia pacientis realuri daavadebis Sedegad damdgari zianis gamoa. 4. infeqciuri ziani kompensaciis miRebis ufleba dgeba pacientisaTvis misi gamokvlevis, daTvalierebis, mzrunvelobis, mkurnalobis an msgavsi procedurebis dros. kompensaciis dros mxedvelobaSi miiReba infeqciis tipi da misgan miyenebuli zianis simkacre. 5. ubedur SemTxvevasTan dakavSirebuli ziani 195 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi kompensaciis miRebis ufleba pacients eZleva maSin, roca misi gamokvlevis, daTvalierebis, mzrunvelobis, mkurnalobis, gadayvanis an msgavsi procedurebis dros, xanZris da sxv. dadga ubeduri SemTxveva. 6. medikamenturi ziani kompenaciis miRebis ufleba dgeba maSin, roca pacients ziani miadga arasworad an specialuri saxelmZRvanelo principebis darRveviT gamowerili medikamentebis moxmarebis gamo. aseve mniSvnelovania iseTi zianis kompensaciis sakiTxi, romelic warmoiSva samedicino dawesebulebis mxridan pacientisaTvis arasrowi informaciis miwodebis an samedicino mkurnalobaze pacientisgan Tanxmobis miuReblobis gamo. aqtiT es sakiTxi ar aris regulirebuli, Tumca specialuri samarTlebrivi komentaris mixedviT6, Sveduri samarTalwarmoebis gamocdilebiT msgavsi zianisaTvis kompenaciis miRebis uflebis realizaciis praqtika arsebobs aqtiT deliqtebis Sesaxeb. kompensaciis daangariSebisas yuradReba eqceva, rogorc ekonomikur mxares (magaliTisaTvis, Semosavlis dakargva, mkurnalobis xarjebi miyenebili zianis gamo da sxv.), aseve araekonomikur danakargebsac (kerZod _ xanmokle an xangrZlivi tkivili da tanjva, daZabuloba muSaobis dros, funciebis dakargva da sxv.). b) ufleba saqarTvelos konstituciis/kanonebis mixedviT saqarTvelos kanonmdebloba: saqarTvelos konstituciis 42-e muxlis me-9 punqtis Tanaxmad. `yvelasTvis garantirebulia saxelmwifo da TviTmmarTvelobis organoTa da mosamsaxureTagan ukanonod miyenebuli zaralis sasamarTlo wesiT sruli anazRaureba saxelmwifo saxsrebidan.~ kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: `mcdari samedicino qmedebisaTvis eqimi pasuxs agebs kanonmdeblobiT dadgenili wesiT~ (mux. 50) `samedicino dawesebulebaSi SeiZleba Seiqmnas fondi mcdari samedicino qmedebis gamo samedicino personalis mimarT saCivris aRZvris SemTxvevisaTvis.fondi iqmneba samedicino personalis Senatanebisa da kanonmdeblobiT nebadarTuli saxsrebisagan~ (mux. 58). damatebiTi detalebi am fondebis funqcionorebis Sesaxeb ar aris gansazRvruli da amgvari findebis arseboba realobaSi xSiri ar aris. 6 komentari pacientisaTvis miyenebuli zianis Sesaxeb aqtze, karl espersoni, SvedeTis pacientTa dazRvevis asociacia, 2000. 196 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 janmrTelobis dacvis Sesaxeb kanoni gansazRvravs mcdar samedicino qmedebas Semdegnairad: `eqimis mier uneblied pacientis mdgomareobisaTvis Seusabamo sadiagnozo da/an samkurnalo RonisZiebebis Catareba, rac miyenebuli zianis uSualo mizezi gaxda~ (mux. 3) saqarTvelos kanoni `pacientis uflebaTa Sesaxeb~ rogorc ukve aRiniSna, me-10 muxlis farglebSi pacientebs da maT kanonier warmomadgenlebs aqvT ufleba mimarTon sasamarTlos materialuri da aramaterialuri zianis anazRaurebisTvis, romelic SeiZleba gamowveuli iyos: • pacientis uflebebis darRveviT; • mcdari samedicino qmedebiT; • samedicino dawesebulebis funqcionirebis sxva xarvezebiT; • saxelmwifos mier arasworad ganxorcielebuli zedamxedvelobiTa da regulirebiT; saqarTvelos samoqalaqo kodeqsi saqarTvelos samoqalaqo kodeqsis 992-e muxlis Tanaxmad, `piri, romelic sxva pirs marTlsawinaaRmdego, ganzraxi an gaufrTxilebeli moqmedebiT miayenebs zians, valdebulia aunazRauros mas es ziani.~ kanonis darRveva aris saWiro winapiroba saeqimo saqmianobis Sedegad gamowveuli zianis anazRaurebisTvis. mux. 1007 gansazRvravs, rom `samedicino dawesebulebaSi mkurnalobisas (qirurgiuli operaciis an araswori diagnoziT damdgari Sedegi da sxv.) piris janmrTelobisaTvis miyenebuli ziani anazRaurdeba saerTo safuZvlebiT. zianis mimyenebeli Tavisufldeba pasuxismgeblobisagan, Tu daamtkicebs, rom zianis dadgomaSi mas brali ar miuZRvis.~ samoqalaqo kodeqsi awesebs xandazmulobis vadas 3 wels im momentidan, roca dazaralebulma Seityo zianis an zianis anazRaurebaze valdebuli piris Sesaxeb (mux. 1008). g) damxmare aqtebi ar arsebobs damxmre aqtebi am sakiTxTan dakavSirebiT. d) Sesabamisi muxlebi eTikis kodeqsidan eTikis kodeqsi ar Seicavs Sesabamis debulebebs. e) sxva wyaroebi ar arsebobs sxva wyaroebi aRniSnul uflebaze. 197 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi nebis winaswar gamoxatvis ufleba miuxedavad imisa, rom saqarTveloSi es ufleba farTod aRiarebula ar aris, jandacvis kanonmdebloba uzrunvelyofs nebis winaswari gamoxatvis uflebas mkurnalobasa da mzrunvelobasTan dakavSirebiT (kanoni janmrTelobis dacvis Sesaxeb da kanoni pacientis uflebebis Sesaxeb). winaswari nebis sxva aspeqtia organoTa donaciis Sesaxeb survilis gamoTqma winaswar. a) ufleba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: konstituciis 17.1 muxlis Tanaxmad, `adamianis pativi da Rirseba xelSeuvalia.~ adamianis ufleba miiRos winaswari gadawyvetilebebi Tavisi janmrTelobis Sesaxeb mWidrod aris dakavSirebuli adamianis Rirsebis pativiscemasTan, radgan winaswari neba Zalian xSirad exeba pacientis survils, rogor icocxlos an mokvdes. kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: `yvela qmedunarian pirs ufleba aqvs winaswar werilobiT gamoxatos neba ganukurnebeli daavadebis terminalur stadiaSi aRmoCenis SemTxvevaSi misTvis sareanimacio, sicocxlis SemanarCunebeli an paliatiuri mkurnalobis an/da paliatiuri mzrunvelobis Catarebis Sesaxeb~ (mux. 10). winaswar gacxadebuli nebis arseboba aucilebelia Semdeg SemTxvevaSic _ roca xdeba qmeduunaro an gacnobierebuli gadawyvetilebis unars moklebuli pacientisaTvis samedicino Carevis ganxorcieleba, misi CarTva samedicino ganaTlebisa da samecniero kvlevis procesSi (mux. 11). msgavs debulebas Seicavs mux. 149, romlis mixedviTac ugono mdgomareobaSi myof avadmyofs utardeba saTanado mkurnaloba, Tu avadmyofs winaswar, roca mas hqonda gacnobierebuli gadawyvetilebis miRebis unari, ar hqonia gancxadebuli uari sareanimacio, sicocxlis SemanarCunebel an paliatiur mkurnalobaze an/da paliatiur mzrunvelobaze. saqarTvelos kanoni pacientis uflebaTa Sesaxeb pacientis uflebaTa Sesaxeb kanonis mixedviT, saqarTvelos moqalaqes ufleba aqvs winaswar werilobiT gamoxatos neba (Tanxmoba an uari) ugono mdgomareobaSi aRmoCenisas an gacnobierebuli gadawyvetilebis miRebis unaris dakargvisas misTvis sareanimacio, sicocxlis SemanarCunebeli an paliatiuri mkurnalobis an/da paliatiuri mzrunvelobis Catarebis Sesaxeb, Tu miTiTebuli garemoebebi gamowveulia (mux. 24.1): a) ganukurnebeli daavadebis terminaluri stadiiT; b) daavadebiT, romelic aucileblad gamoiwvevs mZime invalidobas. amasTanave, imave kanonis Tanaxmad, saqarTvelos moqalaqes ufleba aqvs winaswar daasaxelos 198 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.1 piri, romelic miiRebs gadawyvetilebas misTvis saWiro samedicino momsaxurebis aRmoCenis Sesaxeb. (mux. 24.2) damatebiT detalebs nebis winaswar gamoxatvis uflebis implementaciis Sesaxeb kanonmdebloba ar azustebs. saqarTvelos kanoni adamianis organoTa gadanergvis Sesaxeb kanonis Tanaxmad, yvela qmedunarian pirs aqvs ufleba nebayoflobiT gamoxatos winaswari survili sikvdilis Semdeg organoTa donaciis Sesaxeb. (mux. 4-6) damatebiTi detalebi am Temaze ixileT informirebuli Tanxmobis sesaxeb seqciaSi. b) damxmare aqtebi ar arsebobs damxmre aqtebi am sakiTxTan dakavSirebiT. g) Sesabamisi muxlebi eTikis kodeqsidan eTikis kodeqsi ar Seicavs Sesabamis debulebebs. d) sxva wyaroebi ar arsebobs sxva wyaroebi aRniSnul uflebaze. genetikasTan dakavSirebuli uflebebi klinikuri genetika SedarebiT axali dargia jandacvis sistemaSi da igi mniSvnelovan safrTxes uqmnis adamianis Rirsebas SesaZlo diskriminaciisa da pirad cxovrebaSi Carevis gamo. a) ufleba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: konstituciis Semdegi muxlebi SeiZleba ganixilebodes genetikasTan dakavSirebul uflebebTan mimarTebiT: • `adamianis pativi da Rirseba xelSeuvalia~ (mux. 17.1). • `yvela adamiani dabadebiT Tavisufalia da kanonis winaSe Tanasworia ganurCevlad rasisa, kanis ferisa, enisa, sqesisa, religiisa, politikuri da sxva Sexedulebebisa, erovnuli, eTnikuri da socialuri kuTvnilebisa, warmoSobisa, qonebrivi da wodebrivi mdgomareobisa, sacxovrebeli adgilisa~ (mux. 14). • `yoveli adamianis piradi cxovreba, piradi saqmianobis adgili, piradi Canaweri, mimowera, saubari satelefono da sxva saxis teqnikuri saSualebiT, agreTve teqnikuri saSualebebiT miRebuli Setyobinebani xelSeuxebelia. aRniSnuli uflebebis SezRudva daiSveba sasamarTlos gadawyvetilebiT an mis gareSec, kanoniT gaTvaliswinebuli gadaudebeli aucileblobisas~ (mux. 20.1) 199 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: janmrTelobis dacvis Sesaxeb kanoni aris pirveli kanoni, romelic aregulirebs genur Terapias da adamianis klonirebas. 52-e muxlis Tanaxmad, genuri Terapia daSvebulia im SemTxvevaSi, Tu: • misi mizania fataluri daavadebis profilaqtika, diagnostika, mkurnaloba; • ar arsebobs mkurnalobis sxva, ufro martivi da usafrTxo meTodi; • miRebulia pacientis, xolo misi qmeduunarobis SemTxvevaSi,naTesavis an kanonieri warmomadgenlis werilobiT gaformebuli informirebuli Tanxmoba; • mecnierebis ganviTarebis Tanamedrove done SesaZleblobas iZleva dadgindes, rom mkurnaloba ar gamoiwvevs adamianis STamomavlobis genomis arasasurvel Secvlas. mux. 142.1 krZalavs adamianis klonirebas. janmrTelobis dacvis Sesaxeb kanonze (romelic miRebul iqna 1997 wlis 10 dekembers) zegavlena moaxdina evropis sabWos oqmma adamianis klonirebis akrZalvis Sesaxeb jer kidev maSin, sanam oqmi xelmosawerad gaixsneboda. aRniSnuli muxlis saqarTvelos kanonmdeblobaSi Semotanaze ki zegavlena moaxdina evropis sabWos debatebma oqmis proeqtze 1997 wels. aqedan gamomdinare, saqarTvelo erT-erTi pirvelia im qveynebidan, romlebic krZalaven adamianis klonirebas. Tumca, saqarTvelos kanonis teqsti ar emTxveva oqmisas. klonirebis amkrZalavi oqmi saqarTvelosTvis ZalaSi Sevida 2001 wlis 1 marts, iseve rogorc 4 qveynisTvis, romlebsac qondaT ratificirebuli oqmi. saqarTvelo iyo me-5 qveyana, romelmac moaxdina oqmis ratificireba da amiT ratifikaciebis minimaluri raodenoba mogrovda mis ZalaSi Sesasvlelad. saqarTvelos kanoni pacientis uflebaTa Sesaxeb kanoni pacientis uflebaTa Sesaxeb Seicavs calke Tavs (VI) `uflebebi genetikuri konsultaciisa da genuri Terapiis sferoSi~. am Tavis debulebebi mWidro kavSirSia evropis sabWos konvenciasTan adamianis uflebebis da biomedicinis Sesaxeb (ix. qvemoT). kanoni pacientis uflebaTa Sesaxeb krZalavs adamianis diskriminacias misi genetikuri memkvidreobis niSniT (mux. 31). mux. 32 gansazRvravs genetikuri testirebis or SesaZlo mizans: pacientis janmrTelobis dacva da janmrTelobis dacvasTan dakavSirebuli samecniero kvleva. kanoni nebadarTulad acxadebs Carevas mxolod diagnostikis, mkurnalobis an prevenciis mizniT da Tu igi ar iTvaliswinebs pacientis STamomavlobis genomis Secvlas (mux. 33). dabolos, kanoni krZalavs sqesis xelovnur SerCevas garda im SemTxvevebisa, `roca aucilebelia sqesTan SeWiduli memkvidreobiTi daavadebis Tavidan acileba~ (mux. 34). 200 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.2 b) damxmare aqtebi ar arsebobs damxmre aqtebi am sakiTxTan dakavSirebiT. g) Sesabamisi muxlebi eTikis kodeqsidan eTikis kodeqsi ar Seicavs Sesabamis debulebebs. d) sxva wyaroebi konvencia adamianis uflebebis da biomedicinis Sesaxeb krZalavs adamianis nebismieri formiT diskriminacias misi genetikuri memkvidreobis mixedviT (mux. 11). `genetikuri daavadebis ganviTarebis SesaZleblobis an daavadebis ganmapirobebli genis, an daavadebisadmi winaswarganwyobis an midrekilebis gansazRvra dasaSvebia mxolod im SemTxvevaSi, Tu misi mizania janmrTelobis dacva an janmrTelobis dacvasTan dakavSirebuli samecniero kvleva da saWiroebs saTanado konsultacia genetikis sakiTxebze~ (mux. 12). me-13 muxli moiTxovs, rom `adamianis genomis modificirebisaTvis gansazRvruli Careva dasaSvebia mxolod diagnostikis, mkurnalobis an prevenciis mizniT da mxolod ima SemTxvevaSi, Tu es ar iTvaliswinebs pacientis STamomavlobis genomis nebismieri saxiT Secvlas.~ dabolos, konvencia krZalavs sqesis SerCevis mizniT xelovnuri Casaxvis meTodebis gamoyenebas. erTaderTi gamonaklisi am wesidan aris is SemTxvevebi, `roca aucilebelia sqesTan dakavSirebuli mZime memkvidreobiTi daavadebis Tavidan acileba~. (mux, 14) rogorc zemoT ganvixileT, evropis sabWos sxva instrumenti _ damatebiTi oqmi adamianis klonirebis akrZalvis Sesaxeb _ saqarTvelosTvis ZalaSi Sevida 2001 wlis 1 marts. 6.2 pacientis valdebulebebi saqarTvelos kanonmdeblobaSi pacientis uflebebis specifikuri regulirebis cota SemTxveva arsebobs. umetsewilad, es SemTxvevebia gamonaklisebi garkveuli uflebebidan (mag: gamonaklisi informaciis miRebaze uaris Tmis uflebidan, gamonaklisi mkurnalobaze uaris Tqmis uflebidan). samedicino Carevaze Tanxmobis valdebuleba samedicino Carevaze Tanxmobis valdebuleba, rogorc aseTi, ar aris gansazRvruli saqarTvelos kanonmdeblobiT; igi ganxilulia, rogorc gamonaklisi samedicino Carevaze uaris Tqmis uflebidan. 201 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi a) valdebuleba saqarTvelos konstituciis/kanonebis mixedviT saqarTvelos konstitucia: konstitucia ar Seicavs debulebas aRniSnul valdebulebasTan dakavSirebiT. kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: samedicino Carevaze Tanxmobis valdebuleba dakavSirebulia mkurnalobaze uaris Tqmis uflebasTan. kanoni janmrTelobis dacvis Sesaxeb (mux. 9) iTvaliswinebs gamonakliss pacientis uflebidan uari Tqvas samedicino Carevaze, Tu kanoni gansazRvravs amas. igive muxlis mixedvoT, aseTi gamonaklisi SeiZleba ukavSirdebodes imunizacias, sakarantino RonisZiebebs, samkurnalo da sakarantino zomebs gadamdebi daavadebebis ganviTarebis maRali riskis mqone moqalaqeTaTvis. saqarTvelos kanoni pacientis uflebaTa Sesaxeb: kanonis 23-e muxlis Tanaxmad, `akrZalulia qmedunariani da gacnobierebuli gadawyvetilebis miRebis unariani pacientis nebis winaaRmdeg samedicino momsaxurebis ganxorcieleba, garda saqarTvelos kanonmdeblobiT dadgenili SemTxvevebisa~ (mux. 23). pacientis uflebaTa Sesaxeb kanoni gansazRvravs erT gansakuTrebul SemTxvevas, roca pacients ar aqvs ufleba uari Tqvas samedicino Carevaze: `mSobiares ara aqvs ufleba uari Tqvas iseT samedicino momsaxurebaze, romelic uzrunvelyofs cocxali nayofis dabadebas da romelic mSobiaris janmrTelobisa da sicocxlisaTvis minimaluri riskis matarebelia~ (mux. 36.2) saqarTvelos kanoni sazogadoebrivi janmrTelobis Sesaxeb: kanoni ar gansazRvravs pacientis/moqalaqis valdebulebas gairos mkurnaloba/samedicine Careva. igi awesebs gamonaklisebs mkurnalobaze uaris Tqmis uflebidan (sxva ganxiluli kanonebis msgavsad). `profilaqtikuri RonisZiebebis Catarebaze uaris Tqmis ufleba ar aqvs im pirs, romlis saqmianobac dakavSirebulia gadamdebi daavadebebis gavrcelebis maRal riskTan~ (mux. 5.2, b). aseTi SezRudvebi SeiZleba dawsdes epidemiebis da pandemiebis dros. meore mxriv, sazogadoebrivi janmrTelobis samsaxursa da samedicino momsaxurebis mimwodebels ufleba aqvT fizikur pirs mosTxovon Caitaros saTanado samedicino Semowmeba an/ da saTanado mkurnaloba, Tu pirs daudasturdeba gadamdebi daavadebis arseboba (mux. 10.3). gansakuTrebuli uflebebi aqvs miniWebuli sagangebo situaciebis marTvis samTavrobo komisias epidemiebis da pandemiebis kontrolisTvis (mux. 12). es komisia valdebulia mosTxovos epidemiis regionebSi myof pirebs gaiaron samedicino Semowmeba. gadawyvetilebas adamianis izolaciis an/da mis mimarT sakarantino RonisZiebebis gamoyenebis Sesaxeb iRebs sazogadoebrivi janmrTelobis samsaxuri „adamianis uflebaTa da ZiriTad 202 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.2 TavisuflebaTa dacvis“ evropuli konvenciis principebis dacviT (mux. 11.3). pirs ufleba aqvs saamarTloSi gaasaCivros es gadawyvetileba (mux. 11.2). sagangebo situaciis SemTxvevaSi fizikuri piris izolaciis an/da karantinSi moTavsebis Sesaxeb gadawyvetilebis aRsrulebas uzrunvelyofs saqarTvelos Sinagan saqmeTa saministros sagangebo situaciaTa marTvis departamenti (mux. 11.1). saqarTvelos kanoni aiv infeqcia/Sidsis Sesaxeb: kanoni aiv infeqcia/Sidsis Sesaxeb (miRebuli 2009 wlis 17 noembers) gansazRvravs specialur SemTxvevebs, sadac aiv infeqciaze testireba savaldebuloa (mux. 6.3): • sisxlisa da sisxlis komponentebis donorTaTvis; • organoebisa da organoTa nawilebis donorTaTvis; • qsovilebis donorTaTvis; • kvercxujredisa da spermis donorTaTvis. aseTi valdebuleba warmoiSoba moqalaqis gadawyvetilebis Semdeg, gaxdes donori (sisxlis, organoebis da a.S.). rogorc ki piri gadawyvets aRar iyos donori, aiv infeqciaze testirebis valdebuleba wydeba. mux. 6.5-is mixedviT, aiv infeqciaze savaldebulo testirebis sxva SemTxvevebi ganisazRvreba saqarTvelos kanonmdeblobiT. es niSnavs imas, rom dauSvebelia brZanebis gamocema aiv infeqciaze arasavaldebulo testirebis Sesaxeb, Tu aseTi ram aris gaTvaliswinebuli kanoniT. b) damxmare aqtebi ar arsebobs damxmre aqtebi am sakiTxTan dakavSirebiT. g) sxva wyaroebi evropis sabWos konvencia adamianis uflebebis da biomedicinis Sesaxeb7 zogadad dasaSvebad miiCnevs konvenciiT moculi uflebebis (maT Soris Tanxmobis uflebis) SezRudvas, Tu `es aucilebelia demokratiul sazogadoebaSi mosaxleobis usafrTxoebisaTvis, danaSaulis Tavidan asacileblad, sazogadoebrivi janmrTelobis dacvis an sxva pirebis uflebebisa da Tavisuflebebis dasacavad.~ (mux. 26 _ SezRudva uflebebis ganxorcielebaze). 7 saqarTvelosTvis ZalaSi Sesvlis TariRi 01.03.2001 203 Tavi 6: pacientis uflebebi da movaleobebi saqarTveloSi informaciis miwodebis valdebuleba pacientis valdebuleba miawodos informacia Tavisi janmrTelobis Sesaxeb upirveles yovlisa miznad isaxavs sxva adamianebis janmrTelobis dacvas. . a) valdebuleba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: konstitucia ar Seicavs debulebebs aRniSnuli valdebulebis Sesaxeb. kanonebi: saqarTvelos kanoni aiv infeqcia/Sidsis Sesaxeb: aiv inficirebuli/SidsiT daavadebuli, romlisTvisac cnobilia sakuTari aiv dadebiTi statusi, valdebulia dadgenili wesiT acnobos meuRles/sqesobriv partniors sakuTari aiv inficirebis Sesaxeb (mux. 11.2). mux. 8.7 da mux. 11.2-is mixedviT, Tu aiv inficirebulis/SidsiT daavadebuli piri ar Seasrulebs valdebulebas informaciis miwodebis Sesaxeb, momsaxurebis mimwodebeli dawesebuleba, romelic axorcielebs aiv inficirebulTa/SidsiT daavadebulTa diagnostikas, mkurnalobas, profilaqtikas, mxardaWeras/xelSewyobas an/da movlas, valdebulia piris meuRles/ sqesobriv partniors saqarTvelos kanonmdeblobiT dadgenili wesiT miawodos informacia piris aiv dadebiTi statusis Sesaxeb, Tu cnobilia misi meuRlis/sqesobrivi partnioris vinaoba. kanonSi ar xdeba am wesebis specifikuri ganxilva, garda 8.6 muxlisa: `momsaxurebis mimwodebeli dawesebuleba, romelic axorcielebs aiv inficirebulTa/SidsiT daavadebulTa diagnostikas, mkurnalobas, profilaqtikas, mxardaWeras/xelSewyobas an/da movlas, valdebulia aiv inficirebuls/SidsiT daavadebuls mosTxovos informacia im piris/pirTa Sesaxeb, romelTanac/romlebTanac mas hqonda epidemiologiuri TvalsazrisiT riskis Semcveli kontaqti.~ kanonmdebloba ar iTvaliswinebs raime saxis sanqcias pacientisTvis, romelic Tavisi statusis Sesaxeb ar Seatyobinebs meuRles an seqsualur partniors. Tumca, sisxlis samarTlis kodeqsis 131.1-e muxli dasjadad acxadebs Sidsis Seyris safrTxis Seqmnas. b) damxmare aqtebi ar arsebobs damxmre aqtebi am sakiTxTan dakavSirebiT. 204 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 6.2 informaciis miRebis valdebuleba informaciis miRebis valdebuleba aris gamonaklisi pacientis uflebidan, ar miiRos informacia. a) valdebuleba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: konstitucia ar Seicavs debulebebs aRniSnuli valdebulebis Sesaxeb. kanonebi: saqarTvelos kanoni pacientis uflebaTa Sesaxeb: pacientis uflebaTa Sesaxeb saqarTvelos kanonis me-20 muxlis mixedviT, pacientis ufleba ar miiRos informacia Tavisi janmrTelobis da masTan dakavSirebuli sakiTxebis Sesaxeb, SeiZleba daeqvemdebaros SezRudvebs, Tu `informaciis miuwodeblobam SeiZleba seriozuli ziani miayenos pacientis an/da mesame piris janmrTelobas an/da sicocxles.~ aqedan gamomdinare, pacienti valdebulia miiRos informacia, romelic aucilebelia TviT pacientis an sxva adamianebisTvis zianis asacileblad. b) damxmare aqtebi ar arsebobs damxmre aqtebi am sakiTxTan dakavSirebiT. g) sxva wyaroebi evropis sabWos mier miRebuli adamianis uflebebis da biomedicinis Sesaxeb konvenciis8 10.3 muxlis Tanaxmad, SezRudvebi SeiZleba dawesdes piris uflebaze ar miiRos informacis misi janmrTelobis Sesaxeb. aqedan gamomdinare, gamonaklis SemTxvevebSi pacients SeiZleba miewodos informacia misi nebis sawinaaRmdegod. 8 saqarTvelosTvis konvencia ZalaSi Sevida 2001 wlis 1 marts. 205 7.1 samedicino dawesebulebebis uflebebi saTanado pirobebSi muSaobis ufleba Sekrebisa da gaerTianebis Tavisufleba samarTliani sasamarTlo ganxilvis ufleba profesiuli saqmianobis ganxorcielebis ufleba ? 7.2 samedicino dawesebulebebis valdebulebebi pacientis interesebis gaTvaliswinebis valdebuleba mkurnalobis valdebuleba xarisxiani mkurnalobis valdebuleba pacientisTvis da/an misi warmomadgenlisTvis informaciis miwodebis valdebuleba informirebuli Tanxmobis miRebis valdebuleba konfidencialobis dacvis da pacientis piradi cxovrebis pativiscemis valdebuleba samedicino Canawerebis warmoebis valdebuleba informaciis gacemis/miwodebis valdebuleba pasuxismgebloba da movaleobebi kolegebisa da profesiis mimarT 206 adamianis uflebebi janmrTelobis dacvis sferoSi 7 samedicino dawesebulebebis uflebebi da movaleobebi samedicino momsaxurebis gamwevi aris nebismieri saxelmwifo an kerZo samedicino dawesebuleba, romelic axorcielebs samedicino serviss samedicino dawesebulebi gvevlinebian sajaro da kerZo samarTlis iuridiul pirebad. 1999 wlis prezidentis brZanebulebis Tanaxmad samedicino dawesebulebebis samarTlebrivi statusi ZiriTadad aris s.s. da S.p.s; aseTi organizaciebis mflobelia s.s.i.p sawarmoTa marTvis saagento /saqarTvelos ekonomikuri ganviTarebis saministro/ da q. Tbilisis meria. mflobeloba gamoixateba teqnikuri nawilis, kerZod Senoba-nagebobaTa flobaSi. marTva mTlianad menejerTa kompetencias warmoadgens. poliklinikebis, ambulatoriebis, hospitlebis da sxva samedicino dawesebulebebis menejerebi valdebulni arian CaerTon organizaciis yoveldRiur saqmianobaSi, gaanawilon finansebi da gamovidnen warmomadgenlebad sazogadoebisa da mesame pirebis wainaSe. es is SemTxvevaa, roca saxelmwifo partnioris saxiT monawileobs samewarmeo sazogadoebaSi. aq saxelmwifo gamodis Sps-s partniorad da/an s.s aqcionerad. Sromis, janmrTelobisa da socialuri dacvis saministro axorcielebs samedicino dawesebulebebis saqmianobis kontrols. maSasadame, saxelmwifo, rogorc sajaro samarTlis upir- 207 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi velesi iuridiuli piri, samewarmeo sazogadoebebSi partniorad monawileobs rogorc kerZo samarTlis iuridiuli piri. es niSnavs, rom mas yvelgan SeuZlia gamosvla, garda sps-sa da komanditur sazogadoebaSi komplementarad yofnisa. saqarTvelos kanoniT `janmrTelobis dacvis Sesaxeb~, muxli 15-is Tanaxmad: `janmrTelobis dacvis sferoSi saxelmwifo politikis gatarebas uzrunvelyofs saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministro, romelic SeimuSavebs da gamoscems Sesabamiss samarTlebriv aqtebs~. saqarTvelos kanonmdeblobis Tanaxmad samedicino dawesebuleba aris saqarTvelos kanonmdeblobiT daSvebuli organizaciul-samarTlebrivi formis iuridiuli piri, romelic dadgenili wesiT axorcielebs samedicino saqmianobas. samedicino momsaxurebiT da sxva ekonomikuri saqmianobiT miRebuli Semosavlis 100% rCeba samedicino dawesebulebis gankargulebaSi, romlis ganawilebasac ekonomikuri klasifikatoris mixedviT, rogorc wesi, axdens dawesebulebis xelmZRvaneli /menejeri, generaluri direqtori. rogorc zemoT avRniSneT samedicino dawesebuleba SeiZleba iyos samewarmeo an arasamewarmeo iuridiuli piri. samewarmeo samedicino dawesebuleba Tavis saqmianobas axorcielebs `mewarmeTa Sesaxeb~ saqarTvelos kanonis Sesabamisad, xolo arasamewarmeo samedicino dawesebuleba Tavis saqmianobas axorcielebs saqarTvelos kanonmdeblobis Sesabamisad. samedicino dawesebuleba saqmianobas warmarTavs Tavisi wesdebisa da saqarTvelos kanonmdeblobis Sesabamisad. menejerebis prerogativaa gansazRvron Sromis organizacia da anazRaurebis wesi, forma Tu odenoba. kanonis 59 muxlis 3) punqtis Tanaxmad: `samedicino personalis Sromis anazRaureba nardoblivia. misi odenoba da pirobebi ganisazRvreba: a) calkeul specialobaSi maqsimaluri datvirTvis normativiT, rasac dadgenili wesiT amtkicebs saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministro; b) Sromis xelSekrulebiT (kontraqtiT) samedicino dawesebulebasa da calkeul muSaks Soris. `sazogadoebrivi jandacvis Sesaxeb kanonis meore Tavis me-5 muxlis Tanaxmad: yvela sawarmo valdebulia: a) daicvas sazogadoebrivi janmrTelobis sferoSi moqmedi saqarTvelos kanonmdebloba; b) sazogadoebrivi janmrTelobis samsaxurs miawodos informacia warmoebasa da teqnologiur procesebSi sanitariuli normebis darRveviT gamowveuli yvela sagangebo situaciis Sesaxeb. 4. am muxlis moTxovnaTa Seusrulebloba isjeba saqarTvelos kanonmdeblobiT. 208 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 dReisaTvis kanoni `licenzirebisa da nebarTvebis Sesaxeb~ adgens 42 saxis licenzias samedicino momsaxurebis gamwevisaTvis. mas Semdeg, rac samedicino dawesebuleba srulad daakmayofilebs salicenzio moTxovnebs, samedicino saqmianobebze licenzias gascems samedicino saqmianobis regulirebis saagento (kanoni `licenzirebis da nebarTvebis Sesaxeb~ me-10 (3) muxli). saqarTvelos administraciul samarTaldarRvevaTa kodeqsis 44 muxlis Tanaxmad administraciul gadacdomad iTvleba samedicino, saeqimo an farmacevtuli saqmianoba saxelmwifo nebarTvis (licenziis, sertifikatis) gareSe. amave kodeqsis 445(5’) muxlis Tanaxmad administraciul gadacdomas warmoadgens, samedicino saqmianobis licenziis mflobelis mier kanoniT dadgenili salicenzio pirobebis Seusrulebloba. saqarTvelos kanonis `saeqimo saqmianobis Sesaxeb~ me-5 muxlis Tanaxmad, eqimi specialisti aris: `piri, romelmac gaiara rezidenturis kursi erT-erT saeqimo specialobaSi da miiRo am dargSi damoukidebeli saeqimo saqmianobis uflebis damadasturebeli saxelmwifo sertifikati; v) damoukidebeli saeqimo saqmianobis subieqti _ piri, romelic saqarTvelos kanonmdeblobiT dadgenili wesiT axorcielebs damoukidebel saeqimo saqmianobas; kanoniT janmrTelobis dacvis Sesaxeb, muxli 3 gansazRvrulia Tu ra aris damoukidebeli saeqTno saqmianoba. „damoukidebeli saeqTno saqmianoba-Sesabamisi samedicino ganaTlebis mqone piris profesiuli saqmianoba, romlis Sedegebzedac is pasuxs agebs saqarTvelos kanonmdeblobiT dadgenili wesiT; g) samedicino personali-samedicino da arasamedicino ganaTlebis mqone pirebi, romlebic ewevian samedicino saqmianobas. samedicino saqmianobis ganxorcielebisas samedicino personalma unda ixelmZRvanelos eTikuri faseulobebiT-adamianis pativisa da Rirsebis aRiarebis, samarTlianobis, TanagrZnobis principebiT da eTikis normebis dacviT. samedicino personali valdebulia imoqmedos mxolod pacientis interesebis Sesabamisad, aseve: a) ar gamoiyenos Tavisi profesiuli codna da gamocdileba humanizmis principebis sawinaaRmdegod; b) pacientis interesebTan dakavSirebuli profesiuli gadawyvetilebebis miRebisas iyos Tavisufali da damoukidebeli, ar imoqmedos angarebiT; g) izrunos profesiuli saqmianobis prestiJis amaRlebaze, pativiscemiT moepyras kolegebsa da xelmZRvanelebs. 209 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi pacientisaTvis misi janmrTelobis mdgomareobis Sesaxeb sruli informaciis miwodeba gansazRvrulia kanoniT `pacientis uflebebis dacvis Sesaxeb~ da iseT mniSvnelovan saerTaSoriso dokumentSi, rogoricaa jandacvis msoflio organizaciis deklaracia `evropaSi pacientis uflebebisaTvis xelSewyobis Sesaxeb~. eqimis (damukidebeli saeqimo saqmianobis subieqtis) ufleba-movaleobani saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministrosTan Seqmnilia profesiuli ganviTarebis sabWo, romelic iRebs gadawyvetilebas samedicino personalisaTvis saxelmwifo sertifikatis miniWebis Taobaze. sabWo agreTve ganixilavs samedicino personalis saqmianobasan dakavSirebul gancxadebassaCivrebs, samedicino saqmianobis saxelmwifo regulirebis saagentos mier Seswavlili masalebis safuZvelze iRebs gadawyvetilebas samedicino personalis profesiuli pasuxismgeblobis Taobaze. sabWos aqvs Tavisi muSaobis wesi da garda zemoaRniSnuli funqciebisa debulebiT sxva funqciebic gaaCnia. saTanado pirobebSi muSaobis ufleba jandacvis muSakebs aqvT mTeli rigi uflebebi saTanado, usafrTxo da jansaR garemoSi muSaobisTvis. saTanado pirobebSi muSaoba aris xarisxiani samedicino momsaxurebis miwodebis winapiroba. saqarTvelos kanonmdeblobis Tanaxmad, eqims ufleba aqvs damsaqmebels moTxovos misTvis adekvaturi samuSao garemis Seqmna. ufro metic, kanonmdebloba yvela damsaqmebels avaldebulebs usafrTxo garemo Seuqmnas Tavis dasaqmebulebs. a) ufleba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: konstituciis 30.4 muxlis Tanaxmad, `SromiTi uflebebis dacva, Sromis samarTliani anazRaureba da usafrTxo, jansaRi pirobebi, arasrulwlovanisa da qalis Sromis pirobebi ganisazRvreba kanoniT.~ kanonebi: saqarTvelos kanoni saeqimo saqmianobis Sesaxeb damoukidebeli saeqimo saqmianobis subieqts ufleba aqvs damqiraveblisagan moiTxovos profesiuli saqmianobis adekvaturi samuSao pirobebis Seqmna. (mux. 93.1). 210 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 saqarTvelos Sromis kodeqsi damsaqmebeli valdebulia uzrunvelyos dasaqmebuli sicocxlisa da janmrTelobisaTvis maqsimalurad usafrTxo samuSao garemoTi (mux. 35.1). damsaqmebeli valdebulia gonivrul vadaSi miawodos dasaqmebuls mis xelT arsebuli sruli, obieqturi da gasagebi informacia yvela im faqtoris Sesaxeb, romlebic moqmedebs dasaqmebulis sicocxlesa da janmrTelobaze an bunebrivi garemos usafrTxoebaze (mux 35.2). damsaqmebeli valdebulia danergos Sromis usafrTxoebis uzrunvelmyofi prevenciuli sistema da droulad miawodos dasaqmebuls saTanado informacia Sromis usafrTxoebasTan dakavSirebuli riskebisa da maTi prevenciis zomebis, agreTve safrTxis Semcvel aRWurvilobasTan mopyrobis wesebis Sesaxeb, aucileblobis SemTxvevaSi uzrunvelyos dasaqmebuli personaluri damcavi aRWurvilobiT, saxifaTo mowyobiloba teqnologiur progresTan erTad droulad Secvalos usafrTxoTi an naklebad saxifaToTi, miiRos yvela sxva gonivruli zoma dasaqmebulis usafrTxoebisaTvis da misi janmrTelobis dasacavad (mux 35.4). dasaqmebuls ufleba aqvs uari ganacxados im samuSaos, davalebis an miTiTebis Sesrulebaze, romelic ewinaaRmdegeba kanons, an Sromis usafrTxoebis pirobebis daucvelobis gamo aSkara da arsebiT safrTxes uqmnis mis an mesame piris sicocxles, janmrTelobas, sakuTrebas an bunebrivi garemos usafrTxoebas (mux. 35.3). damsaqmebeli valdebulia srulad aunazRauros dasaqmebuls samuSaos SesrulebasTan dakavSirebuli, janmrTelobis mdgomareobis gauaresebiT miyenebuli ziani da aucilebeli mkurnalobis xarjebi (mux. 35.6). kodeqsis mixedviT, mis amoqmedebamde unda mZime, mavne da saSiSpirobebian samuSaoTa nusxa, agreTve damsaqmeblis xarjiT dasaqmebulis savaldebulo perioduli samedicino Semowmebis SemTxvevaTa CamonaTvali da wesebi (mux. 54. 1 (b). aseTi nusxa miRebulia Sromis, janmrTelobis da socialuri dacvis ministris brZanebiT. g) damxmare aqtebi Sromis, janmrTelobis da sociluri dacvis ministries brZaneba 215 (11.07.2007), saqarTvelos Sromis kodeqsis safuZvelze (mux. 54.1.b) gansazRvravs SemTxvevebs, romelTa drosac dasaqmebulebma unda gaiaron regularuli samedicino Semowmeba, ris xarjebsac damsaqmebeli iRebs. d) Sesabamisi muxlebi eTikis kodeqsidan eTikis kodeqsi ar Seicavs aRniSnul uflebasTan dakavSirebul debulebebs. e) sxva wyaroebi ar arsebobs sxva wyaroebi ganxilul uflebasTan dakavSirebiT. 211 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi Sekrebis da gaerTianebis Tavisufleba jandacvis muSakebisTvis Sekrebis da gaerTianebis Tavisufleba mniSvnelovania TavianTi uflebebis efeqturad dasacavad da xarisxiani momsaxurebis gawevisTvis. Sekrebis da gaerTianebis Tavisufleba zogadad yvela saqarTvelos moqalaqis uflebaa. jandacvis kanonmdebloba aZlierebs profesiuli gaerTianebebis rols standartebis dawesebis, jandacvis muSakTa serTificirebis da jandacvis saTanado xarisxis uzrunvelyofis sakiTxebSi. a) ufleba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: konstitucia Seicavs zogad debulebas gaerTianebebis Seqmnis uflebis Sesaxeb. 26-e muxlis 1 punqtis mixedviT: `yvelas aqvs sazogadoebrivi gaerTianebebis, maT Soris profesiuli kavSirebis Seqmnisa da maTSi gaerTianebis ufleba.~ kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: profesiul gaerTianebebs, iseve rogorc sxva organizaciebs (mag. akademiur, kerZo Tu saxelmwifo organizaciebs) ufleba aqvT monawileoba miiRon qveynis jandacvis marTvis sistemaSi (mux. 18): `janmrTelobis dacvis sistemis saxelmwifo marTvaSi, saqarTvelos kanonmdeblobiT gansazRvrul farglebSi, monawileoben profesiuli asociaciebi,akademiebi da sxva sazogadoebrivi organizaciebi,saxelmwifo da kerZo samedicino dawesebulebebi.~ 49-e muxlis Tanaxmad, eqims ufleba aqvs daeswros da monawileoba miiRos kanonmdeblobiT daSvebul profesiul SekrebaSi, miuxedavad misi Catarebis adgilisa, sakuTari, saxelmwifo an sxva kanonieri dafinansebis xarjze. saqarTvelos kanoni saeqimo saqmianobis Sesaxeb: kanoni iTvaliswinebs eqimebis profesiuli gaerTianebebis monawileobas profesiis regulirebaSi. eqimTa profesiul gaerTianebebs aqvT Semdegi miznebi: • • • • 212 eqimTa diplimisSemdgomi ganaTleba/treiningi da sertificireba (mux. 12, 20, 37); eqimTa profesiuli saqmianobis monitoringi (mux. 66); eqimTa profesiuli pasuxismgebloba (mux. 94); sxva qveynebidan specialistebis mowveva (mux. 11). adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 b) damxmare aqtebi ar arsebobs damxmare aqtebi ganxilul uflebasTan dakavSirebiT. d) Sesabamisi muxlebi eTikis kodeqsidan eTikis kodeqsis debulebebi ar exeba ganxilul uflebas. e) sxva wyaroebi ar arebobs sxva wyaroebi ganxilul uflebasTan dakavSirebiT. samarTliani sasamarTlo ganxilvis ufleba jandacvis sferoSi dasaqmebulebs ufleba aqvT saTanado da samarTlian sasamarTlo ganxilvaze. b) ufleba saqarTvelos konstituciis/kanonebis mixedviT konstitucia konstituciis arc erTi debuleba ar uzrunvelyofs samarTliani ganxilvis uflebas specialurad eqimebisTvis, Tumca, es ufleba garantirebulia konstituciis mier yvela pirisTvis: udanaSaulobis prezumfcia (mux. 40), sasamarTlos xelmisawvdomoba, dacvis ufleba, principi Nullum crimen sine lege _ ar arsebobs danaSauli kanonis gareSe, nulla poena sine lege _ ar arsebobs sasjeli kanonis gareSe, Ne bis in idem _ ar SeiZleba orjer msjavrdeba erTi da imave danaSaulisTvis (mux. 42); Tavisuflebis ukanono SezRudvis akrZalva (mux. 18) da sagangebo an specialuri sasamarTloebis daarsebis akrZalva (mux. 83.4). kanonebi: saqarTvelos kanoni saeqimo saqmianobis Sesaxeb: eqimis profesiuli saqmianoba eqvemdebareba zedamxedvelobas da xarisxis kontrols, romelsi monawileobis uflebac, kanonis mixedviT, eqims aqvs. saministro periodulad, weliwadSi erTxel mainc, SerCeviT akontrolebs damoukidebeli saeqimo saqmianobis subieqtis mier warmoebuli samedicino momsaxurebis xarisxsa da samedicino dokumentacias. Semowmebis Sedegebis amsaxveli dokumentis momzadebisa da ganxilvis yvela etapze aucilebelia im damoukidebeli saeqimo saqmianobis subieqtis monawileoba, romlis saqmianobac Semowmda. damoukidebeli saeqimo saqmianobis subieqts, Tavisi SexedulebiT, ufleba aqvs dokuments daurTos axsna-ganmartebiTi baraTi, romelSic aisaxeba misi damokidebuleba dokumentSi mocemuli SeniSvnebisadmi (mux. 68). 213 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi Sromis, janmrTelobis da socialuri dacvis saministro, gansakuTrebiT samedicino saqmianobis maregulirebeli saagento, pasuxismgebelia kontroli gauwios da daareguliros jandacvis momsaxurebis gamwevebi. amasTanave, pacientebi, maTi warmomadgenlebi, damsaqmeblebi da kolegebi uflebamosili arian Seitanon saCivari an gancxadeba profesuli ganviTarebis sabWoSi serTificirebuli eqimis winaaRmdeg. sabWo awesebs sanqciebs darRvevis aRmoCenis SemTxvevaSi (mux. 75-79). gancxadebis an saCivris miRebis SemTxvevaSi sabWo mis asls erTi kviris vadaSi ugzavnis damoukidebeli saeqimo saqmianobis subieqts, romelsac exeba gancxadeba an saCivari (mux. 84). damoukidebeli saeqimo saqmianobis subieqtma gancxadebaSi an saCivarSi miTiTebul garemoebebze werilobiT unda gasces pasuxi, garda im SemTxvevisa, roca sabWo gadawyvets, rom sakmarisia zepiri pasuxi (mux, 85.1). sabWos mier gadawyvetilebis miRebisas mxareebs aqvT daswrebis ufleba (mux. 87). damoukidebeli saeqimo saqmianobis arasworad warmarTvisa-Tvis gaTvaliswinebulia profesiuli pasuxismgeblobis Semdegi saxeebi: werilobiTi gafrTxileba; saxelmwifo sertifikatis moqmedebis SeCereba; saxelmwifo sertifikatis gauqmeba; narkotikuli, fsiqotropuli da alkoholis Semcveli medi-kamentebis gamoweris SezRudva; saqarTvelos kanonmdeblobiT gaTvaliswinebuli profe-siuli pasuxismgeblobis sxva zomebi (mux, 74.1) eqimebs SeuZliaT gaasaCivron nebismieri zemoTaRniSnuli, aseve nebismieri gadawyvetileba profesiuli saqmianobis darRvevebis Sesaxeb (mux. 74.3, 77.4, 80 da 89). b) damxmare aqtebi profesiuli ganviTarebis sabWos daarseba, funqciebi da procedurebi asaxulia Sromis, janmrTelobis da socialuri dacvis ministris #122/n brZanebaSi (16.05.2008) brZaneba N 122/n _ saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministrosTan profesiuli ganviTarebis sabWos Seqmnisa da misi debulebis damtkicebis Sesaxeb.~ Sromis, janmrTelobis da socialuri dacvis ministris #24/n brZaneba (30.01.2005) aregulirebs samedicino saqmianobis maregulirebeli saxelmwifo saagentos statuts. igi gansazRvravs saagentos, rogorc makontrolebel organos, romelic meTvalyureobs saqarTvelos teritoriaze yvela fizikuri da iuridiuli piris samedicino saqmianobas. d) Sesabamisi muxlebi eTikis kodeqsidan eTikis kodeqsis debulebebi ar exeba ganxilul uflebas. e) sxva wyaroebi ar arebobs sxva wyaroebi ganxilul uflebasTan dakavSirebiT. 214 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 Sromis samarTliani anazRaurebis ufleba jandacvis momsaxurebis gamwevebs ufleba aqvT miiRon Sromis samarTliani anazRaureba. a) ufleba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: saqarTvelos konstituciis 30-e muxlis me-4 punqtis Tanaxmad, `SromiTi uflebebis dacva, Sromis samarTliani anazRaureba da usafrTxo, jansaRi pirobebi ….. ganisazRvreba kanoniT~. kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: Tu janmrTelobis dacvis romelime specialobaSi, dawesebulebaSi an organizaciaSi saTanado anazRaurebis miReba ar aris eqimisa da pacientis SeTanxmebis sagani, dawesebuleba Sromis xelSekrulebis (kontraqtis) Sesabamisad uzrunvelyofs eqims adeqvaturi anazRaurebiT (mux. 46). saxelmwifo interesebidan gamomdinare,medicinis calkeul specialobebSi,agreTve, zogierT regionebSi momuSave samedicino pesonalisaTvis SeiZleba dawesdes SeRavaTebi da danamatebi xelfasze (mux. 47). saqarTvelos kanoni saeqimo saqmianobis Sesaxeb: damoukidebeli saeqimo saqmianobis subieqts ufleba aqvs damqiraveblisagan moiTxovos profesiuli saqmianobis adekvaturi anazRaurebiT uzrunvelyofa (mux. 93.2). ufro metic, zogierT saeqimo specialobaSi da calkeul regionSi momuSave damoukidebeli saeqimo saqmianobis subieqtisaTvis centraluri da adgilobrivi mmarTvelobis organoebi aweseben xelfasze danamatebsa da sxva SeRavaTebs, sacxovrebeli farTobisa da satelefono kavSiriT uzrunvelyofis CaTvliT (mux. 95). b) damxmare aqtebi ar arsebobs damxmare aqtebi ganxilul uflebasTan dakavSirebiT. g) Sesabamisi muxlebi eTikis kodeqsidan eTikis kodeqsis debulebebi ar exeba ganxilul uflebas. d) sxva wyaroebi ar arebobs sxva wyaroebi ganxilul uflebasTan dakavSirebiT. 215 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi damoukidebeli profesiuli gadawyvetilebebis miRebis ufleba damoukidebeli profesiuli gadawyvetilebebis miRebis ufleba jandacvis profesionalebs aZlevs SesaZleblobas miiRon damoukidebeli, Zaldautanebeli gadawyvetilebebi mkurmnalobis Sesaxeb pacientis saukeTeso interesebis gaTvaliswinebiT. a) ufleba saqarTvelos konstituciis/kanonebis mixedviT saqarTvelos konstitucia: saqarTvelos konstitucia ar seicavs am uflebis amsaxvel debulebebs. kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: eqimi valdebulia mkurnalobis dros pacientis interesebTan dakavSirebuli profesiuli gadawyvetilebebis miRebisas iyos Tavisufali da damoukidebeli, ar imoqmedos angarebiT (mux. 30). kanoni aRiarebs eqimis profesias, rogorc `Tavisufal profesias.~ nebismier viTarebaSi dauSvebelia, xelisuflebis warmomadgenelma an kerZo pirma mosTxovos eqims am kanonSi mocemuli principebis, saeqimo saqmianobis eTikuri normebis sawinaaRmdego moqmedeba, miuxedavad momTxovni piris Tanamdebobisa da sazogadoebrivi mdgomareobisa. yovelgvari qmedeba, rac xels uSlis samedicino personals profesiuli movaleobis SesrulebaSi, iwvevs kanonmdeblobiT gaTvaliswinebul pasuxismgeblobas (mux. 34). dabolos, eqims ufleba aqvs, pacientis janmrTelobis dacvis interesebidan gamomdinare, gamoweros da/an daniSnos nebismieri aprobirebuli medikamenti da mkurnalobis meTodi (mux. 51). saqarTvelos kanoni saeqimo saqmianobis Sesaxeb: eqimi gadawyvetilebis miRebisas ubda iyos damoukidebeli da Tavisufali (mux. 6 da 38). aravis ar aqvs ufleba moTxovos eqims imoqmedos profesiuli standartebis da eTikis sawinaaRmdegod (mux. 6). b) damxmare aqtebi ar arsebobs damxmare aqtebi ganxilul uflebasTan dakavSirebiT. g) Sesabamisi muxlebi eTikis kodeqsidan eTikis kodeqsis debulebebi ar asaxavs ganxilul uflebas. 216 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 d) sxva wyaroebi ar arebobs sxva wyaroebi ganxilul uflebasTan dakavSirebiT. samedicino momsaxurebaze uaris Tqmis ufleba eqimebs garkveul SemTxvevebSiufleba aqvT uari uTxran pacientebs mkurnalobaze. es ufleba SezRudulia SemTxvevebiT, rodesac ar arsebobs saswrafo samedicino daxmarebis saWiroeba da arsebobs samedicino daxmarebis uwyvetobs uzrunvelyofis SesaZlebloba, an roca mniSvnelovani riski eqmneba momsaxurebis gamwevis sicocxlesa da samedicino daxmarebis aRmoCenisas. a) ufleba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: konstitucia ar Seicavs mocemul sakiTxTan dakavSirebul debulebebs. kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: kanonis 37-e muxlis mixedviT, eqims ufleba aqvs uari Tqvas pacientisaTvis samedicino daxmarebis aRmoCenaze mxolod im SemTxvevebSi, Tu: arsebobs pacientisaTvis samedicino daxmarebis uwyvetobis uzrunvelyofis SesaZlebloba da ar aRiniSneba sicocxlisaTvis saSiSi mdgomareoba an pacienti ar saWiroebs gadaudebel samedicino daxmarebas, an samedicino daxmarebis aRmoCenisas eqimis sicocxles realuri safrTxe emuqreba. b) damxmare aqtebi ar arsebobs damxmare aqtebi ganxilul uflebasTan dakavSirebiT. g) Sesabamisi muxlebi eTikis kodeqsidan eqims SeuZlia uari Tqvas ama Tu im saxis samedicino Carevaze, Tu aseTi Careva ewinaaRmdegeba eqimis moralur da kulturul faseulobebs da SesaZlebelia, rom pacients samedicino daxmareba gauwios sxva eqimma. amis Sesaxeb eqimi acnobebs kidevac pacients (eqimi da pacienti, mux. 7). e) sxva wyaroebi ar arebobs sxva wyaroebi ganxilul uflebasTan dakavSirebiT. 217 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi pacientis interesebis gaTvaliswinebis valdebuleba jandacvis momsaxurebis gawevisas, jandacvis profesionalebi valdebuli arian gaiTvaliswinon pacientis interesebi. es valdebuleba, saqarTvelos kanonmdeblobis mixedviT, aris jandacvis personalis profesiuli saqmianobis erT-erTi proncipi. a) uvaldebuleba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: konstituciaSi ar arsebobs specifikuri debulebebi aRniSnuli valdebulebis Sesaxeb. kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: samedicino momsaxurebis gamwevi valdebulia daxmarebis aRmoCenisas imoqmedos mxolod pacientis interesebis Sesabamisad (mux. 30). saqarTvelos kanoni saeqimo saqmianobis Sesaxeb: damoukidebeli saeqimo saqmianobis subieqti profesiuli movaleobis aRsrulebisas unda maqsimalurad iTvaliswinebdes pacientis janmrTelobis interesebs (mux. 38). b) damxmare aqtebi ar arsebobs damxmare aqtebi ganxilul valdebulebasTan dakavSirebiT g) Sesabamisi muxlebi eTikis kodeqsidan `adamianze mecnieruli kvlevis warmoebisas pacientis interesebi uzenaesia; kvlevis miznebi da mosalodneli Sedegebi arc erT SemTxvevaSi ar axdens gavlenas eqimis ZiriTad mowodebaze _ emsaxuros pacientis janmrTelobasa da sicocxles~ (“eqimi _ mkvlevari,~ muxli 2). d) sxva wyaroebi ar arebobs sxva wyaroebi ganxilul valdebulebasTan dakavSirebiT. 218 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 xarisxiani mkurnalobis valdebuleba eqimebi valdebuli arian saTanado xarisxiT umkurnalon pacientebs. a) valdebuleba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: konstituciaSi ar arsebobs specifikuri debulebebi aRniSnuli valdebulebis Sesaxeb. kanonebi: saqarTvelos kanoni saeqimo saqmianobis Sesaxeb: samedicino momsaxurebis xarisxis uwyveti gaumjobeseba aris eqimis uwyveti profesiuli ganviTarebis nawili (mux. 29’). kanoni gansazRvravs eqimis ganaTlebis, licenzirebis da a.S. wesebs, rac mniSvnelovania xarisxiani samedicino momsaxurebis gasawevad (mux. 7-37’5). me-7 muxlis Tanaxmad, . damoukidebeli saeqimo saqmianobis ufleba aqvs saqarTvelos an ucxo qveynis moqalaqes an moqalaqeobis armqone pirs, romelmac daamTavra saqarTvelos saxelmwifo akreditaciis mqone umaRlesi samedicino saswavlebeli da am kanoniT dadgenili wesiT miiRo damoukidebeli saeqimo saqmianobis uflebis damadasturebeli saxelmwifo sertifikati. profesiuli ganviTarebis sabWo valdebulia gasces licenzia (mux. 20). momsaxurebis xarisxi aseve aRniSnulia saeqimo saqmianobis Sesaxeb kanonSi, roca xdeba samedicino momsaxurebis gadabareba sxva samedicino personalisTvis. am SemTxvevaSi, uzrunvelyofli unda iyves xarisxiani momsaxureba (mux. 50). dabolos, patimris, dakavebulis an datyvevebulisaTvis samedicino momsaxurebis gawevisas damoukidebeli saeqimo saqmianobis subieqti valdebulia misi fizikuri da fsiqikuri janmrTelobis dacva da mkurnaloba uzrunvelyos iseTive xarisxiTa da samedicino standartebiT, rogoriTac im adamianebisa, romlebic ar arian patimrebi, dakavebulebi an datyvevebulebi (mux. 53). ix. agreTve seqciebi: xarisxiani momsaxurebis miRebis ufleba, personaluri mkurnalobis ufleba, Tanamedrove medicinis miRwevebiT sargeblobis ufleba me-6 TavSi pacientis uflebebis da movaleobebis Sesaxeb. b) damxmare aqtebi ar arsebobs damxmare aqtebi ganxilul valdebulebasTan dakavSirebiT. 219 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi g) Sesabamisi muxlebi eTikis kodeqsidan profesiuli codnis ganaxleba da srulyofa, Sesabamisi unar-Cvevebis daxvewa eqimis yoveldRiuri sazrunavia mTeli misi profesiuli saqmianobis manZilze (`zogadi debulebebi~, mux. 8). d) sxva wyaroebi ar arebobs sxva wyaroebi ganxilul valdebulebasTan dakavSirebiT. gadaudebeli samedicino daxmareba pacientis uflebebis Sesaxeb kanonis me-12 muxlis Tanaxmad: 1. saxelmwifo icavs pacientis uflebas samedicino momsaxurebaze, romlis gadaudeblad ganxorcielebis gareSe gardauvalia pacientis sikvdili, dainvalideba an janmrTelobis mdgomareobis mniSvnelovani gauareseba. 2. Tu pacienti gadaudeblad saWiroebs samedicino momsaxurebas, romlis gareSe gardauvalia pacientis sikvdili, dainvalideba an janmrTelobis mdgomareobis mniSvnelovani gauareseba, xolo samedicino momsaxurebis gamwevs ara aqvs SesaZlebloba aRmouCinos pacients aseTi momsaxureba, igi valdebulia miawodos pacients, mis naTesavs an kanonier warmomadgenels sruli informacia, Tu sad SeiZleba gadaudebeli samedicino momsaxurebis miReba. aRniSnuli muxlis I an/da II nawilebiT gaTvaliswinebuli pacientis uflebebis darRvevam SesaZlebelia gamoiwvios medicinis muSakis (eqimi, eqTani, bebia qali an sxva) sisxlissamarTlebrivi pasuxismgebloba, rac gaTvaliswinebulia saqarTvelos ssk-is 130-e muxliT. kerZod, saqarTvelos ssk-is 130-e muxlis (avadmyofis ganacdelSi mitoveba) I nawili iTvaliswinebs sicocxlisaTvis saSiS mdgomareobaSi myofi avadmyofisaTvis arasapatio mizeziT medicinis muSakis mier gadaudebeli samedicino daxmarebis gauwevlobas moqmedi kanonmdeblobiT aRniSnuli danaSaulis Cadena isjeba jarimiT an gamasworebeli samuSaoTi vadiT TxuTmet Tvemde, Tanamdebobis dakavebis an saqmianobis uflebis CamorTmeviT vadiT sam wlamde an uamisod. unda aRiniSnos, rom avadmyofis dauxmareblobisaTvis medicinis muSaks sisxlissamarTlebrivi pasuxismgebloba daekisreba im SemTxvevaSi Tu igi arasapatio mizeziT uars ityvis daxmarebis gawevaze. sapatio mizezad SeiZleba CaiTvalos iseTi obieqturi damabrkolebeli garemoebebis arseboba, rogoricaa stiqiuri ubedureba, utransportoba, saWiro samkurnalo saSualebebis arqona. gasaTvaliswinebelia janmrTelobis dacvis Sesaxeb kanonis 37-e muxliT gaTvaliswinebuli eqimis uflebebic. kerZod eqims ufleba aqvs uari Tqvas pacientis daxmarebis aRmoCenaze im SemTxvevaSi Tu arsebobs pacientisaTvis samedicino daxmarebis uwyvetobis uzrunvelyofis SesaZlebloba da ar aRiniSneba sicocxlisaTvis saSiSi mdgomareoba; an pacienti ar saWiroebs gadaudebel samedicino daxmarebas. aseve Tu samedicino daxmarebis aRmoCenisas eqimis sicocxles realuri safrTxe emuqreba. 220 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 im SemTxvevaSi Tu eqims uxdeba ori (an meti) mZime avadmyofisTvis gadaudebeli daxmarebis aRmoCena, ra drosac eqimma SesZlo mxolod erTis gadarCena, meore ki daiRupa, adgili aqvs movaleobaTa kolizias da eqimi Tavisufldeba sisxlissamarTlebrivi pasuxismgeblobisagan. saqarTvelos ssk-is 130 muxlis I nawiliT gaTvaliswinebuli danaSauli damTavrebulad iTvleba medicinis muSakis mier gadaudebel samedicino daxmarebaze ganzrax uarTqmis momentidan. igive qmedeba, ramac gamoiwvia avadmyofis janmrTelobis mZime dazianeba an sicocxlis mospoba, kvalificirdeba saqarTvelos ssk-is 130-e muxlis II nawiliT da osjeba Tavisuflebis aRkveTiT vadiT samidan xuT wlamde, Tanamdebobis dakavebis an saqmianobis uflebis CamorTmeviT vadiT sam wlamde. gadaudebeli samedicino daxmareba gulisxmobs iseT samedicino momsaxurebas, roca misi droulad aRmoCenis gareSe seriozuli safrTxe eqmneba adamianis janmrTelobas da sicocxles. gadaudebeli samedicino daxmarebis magaliTebia sisxlisa da sainfuzio xsnarebis gadasxma didi raodenobiT sisxlis dakargvis dros, defibrilacia (gulis eleqtroSokuri Terapia) gulis e.w. fataluri ariTmiebis dros (mag. parkuWTa fibrilacia), sasunTq gzebSi milis Seyvana (intubacia) da xelovnuri sunTqvis Catareba sunTqvis mwvave ukmarisobis dros da sxva. xSirad, gadaudebeli moqmedeba saWiroa wuTebSi, zogjer ki wamebSi. aseT SemTxvevebSi, Tu pacienti Tavad ver axerxebs Tanxmobis gacxadebas (magaliTad, komur mdgomareobaSi yofnis gamo, an qmeduunarobis gamo) da iqve ar imyofeba misi kanonieri warmomadgeneli, am ukanasknelis moZieba SeuZlebeli xdeba drois simciris gamo da pacients dauyovnebliv unda Cautardes yvela saWiro samedicino RonisZieba misi sicocxlisa da janmrTelobis interesebis Sesabamisad. zemoT moxseniebul SemTxvevebSi irRveva informirebuli Tanxmobis miRebis piroba da eqimi samedicino Carevas axorcielebas Tanxmobis miRebis gareSe. aqve unda aRiniSnos, rom Tanxmobis miRebis principis darRveva xdeba obieqturi garemoebebis gamo, pacientis interesebidan gamomdinare da is ar gulisxmobs pacientis pirovnebis upativecmulobasa da misi avtonomiis ugulebelyofas. unda aRiniSnos, rom zemoxsenebuli gamonaklisi (Carevis ganxorcieleba Tanxmobis gareSe) dasaSvebia mxolod gadaudebeli mdgomareobebis arsebobisas da is ar SeiZleba Seexos iseT SemTxvevebs, roca dayovneba dasaSvebia da dro iZleva pacientis kanonieri warmomadgenlis moZiebis SesaZleblobas. gadaudebeli daxmarebis aRmoCenis problemas exmianeba saqarTvelos kanonmdeblobac. kerZod, kanonSi `pacientis uflebebis Sesaxeb~ miTiTebulia, rom zemoR aRweril situaciebSi (roca pacients ar SeuZlia Tanxmobis gacxadeba da is gadaudeblad saWiroebs samedicino momsaxurebas, xolo misi naTesavis an kanonieri warmomadgenlis moZieba ver xerxdeba) `samedicino momsaxurebis gamwevi iRebs gadawyvetilebas pacientis janmrTelobis interesebis Sesabamisad~ (muxli 25, punqti 2). igivea gacxadebuli saqarTvelos kanonSi saeqimo saqmianobis Sesaxeb (muxli 45, punqti 2). adamianTa garkveuli kategoria maTi religiuri, msoflmxedvelobrivi an sxva mosazrebebis 221 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi gamo xSir SemTxvevaSi uars acxadebs sxvadasxva sicocxlisaTvis aucilebel samedicino Carevaze (magaliTad sisxlis gadasxmaze) maSinac ki, roca samedicino daxmarebis es saxe aucilebelia pacientis sicocxlis gadasarCenad. samedicino personali aseT SemTxvevaSi dilemis winaSe aRmoCndeba xolme: erTi mxriv, misi valia daxmareba aRmouCinos pacients; meore mxriv, Tavad pacienti an misi ojaxis wevri, an kanonieri warmomadgeneli ar aZlevs samedicino personals profesiuli valis moxdis SesaZleblobas; aseT SemTxvevaSi samedicino daxmarebis aRmoCena (mag: sisxlis gadasxma) aucileblad iqneba dakavSirebuli `ZaladobasTan~, iZulebasTan. rac agreTve dauSvebelia eqimisa da pacientis urTierTobaSi. zemoT moxseniebul dilemmas, samarTlisa da samedicino eTikis TvalsazrisiT, ori gansxvavebuli aspeqti aqvs: 1. konfliqti, erTi mxriv, pacientis avtonomiis sayovelTaod, maT Soris saqarTvelos kanonmdeblobiT aRiarebul principsa da, meore mxriv, eqimis movaleobas Soris daexmaros pacients; im SemTxvevevebSi ki rodesac pacientis uars safuZvlad udevs religiuri an msoflmxedvelobiTi Sexedulebebi saqme gvaqvs konfloqtTan pacientis janmrTelobis interesebsa da adamianis arCevanis Tavisuflebas, gamoxatvis Tavisuflebas, azris, sindisisa da aRmsareblobis Tavisuflebebs Soris. aRniSnul konfliqtSi umeteswilad aRiarebulia adamianis janmrTelobis dacvis prioriteti. 2. gansxvavebuli midgoma: qmedunarianisa da araqmedunarianis mimarT; gadaudebeli samedicino momsaxurebis aucileblobisas an am ukanasknelis ararsebobis SemTxvevaSi. saqarTvelos moqmedi kanonmdebloba, romelic miesadageba SemTxvevebs, roca pacienti samedicino momsaxurebis gawevis winaaRmdegia1, warmodgenilia Semdegi kanonebiT: saqarTvelos kanoni `janmrTelobis dacvis Sesaxeb~ saqarTvelos kanoni `pacientis uflebebis Seasxeb~ pacientisaTvis samedicino Carevis ganxorcielebamde aucilebelia misi (pacientis) informirebuli Tanxmobis miReba. saqarTvelos janmrTelobis dacvis sferos kanonmdeblobaSi, kerZod zemoT moxseniebul kanonebSi calsaxad aris gacxadebuli, rom qmedunarian, gacnobierebuli gadawyvetilebis miRebis unaris mqone pacients ufleba aqvs Tavad gadawyvitos, Cautardes Tu ara mas esa Tu is samedicino Careva. amasTan, pacientis gadawyvetileba sabolooa. samedicino personals ara aqvs ufleba Zalis gamoyenebiT an motyuebis gziT Caataros samedicino Careva, romlis winaaRmdegia pacienti. saqarTvelos kanonSi `janmrTelobis dacvis Sesaxeb~ aRniSnulia, rom `samkurnalo, sadiagnozo, sareabilitacio, saprofilaqtiko procesebSi pacientis monawileobis aucilebeli pirobaa zepiri an werilobiTi informirebuli Tanxmoba~. 222 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 `pacientis uflebebis Sesaxeb~ kanonis 23-e muxlSi naTqvamia, rom: muxli 23 1. qmedunarian da gacnobierebuli gadawyvetilebis miRebis unarian pacients ufleba aqvs mkurnalobis nebismier etapze uari ganacxados samedicino momsaxurebaze, agreTve Sewyvitos ukve dawyebuli samedicino momsaxureba. samedicino momsaxurebaze uaris Tqmis an misi Sewyvetis mosalodneli Sedegebis Sesaxeb pacienti amomwuravad unda iyos informirebuli. 2. akrZalulia qmedunariani da gacnobierebuli gadawyvetile-bis miRebis unariani pacientis nebis winaaRmdeg samedicino momsaxurebis ganxorcieleba, garda saqarTvelos kanonmdeblobiT dadgenili SemTxvevebisa. kanonSi `janmrTelobis dacvis Sesaxeb~ (muxli 76) miTiTebulia, rom `gansakuTrebiT saSiSi gadamdebi daavadebis arsebobaze dasabuTebuli eWvis dasadastureblad moqalaqeTa Semowmebis saWiroebisas es ukanasknelni valdebulni arian Caitaron yvela saTanado gamokvleva; gamokvlevis Catarebisas daculi unda iqnas moqalaqeTa Rirseba da maTi ZiriTadi uflebebi~. garda zemoT naTqvamisa, saqarTvelos kanoni `fsiqiatriuli daxmarebis Sesaxeb~ iTvaliswinebs fsiqikurad daavadebulis iZulebiT mkurnalobas, Tu is safrTxes uqmnis garemomcvelebs. amrigad, saqarTvelos kanonmdeblobiT akrZalulia qmedunariani da gacnobierebuli gadawyvetilebis miRebis unaris mqone pacientisaTvis misi nebis winaaRmdeg, `iZulebiTi wesiT~ raime samkurnalo proceduris, maT Soris, sisxlis gadasxmis, Catareba. es ki niSnavs, rom qmedunariani, gacnobierebuli gadawyvetilebis miRebis unaris mqone konkretuli pirisTvis, sisxlis gadasxmis ufleba samedicino personals ara aqvs, Tu pacienti uars acxadebs sisxlis gadasxmaze. sxvagvarad wydeba sakiTxi im SemTxvevaSi, Tu pacienti qmeduunaroa (arasrulwlovania, an sasamarTlos mier aris miCneuli qmeduunarod fsiqikuri daavadebis an Wkuasustobis gamo) da saWiroebs gadaudebel samedicino daxmarebas, an sicocxlisaTvis saSiS mdgomareobaSia. aseT dros `janmrTelobis dacvis Sesaxb~ kanonis me-12 muxlis mixedviT, `samedicino Carevis Sesaxeb gadawyvetileba miiReba mxolod pacientis interesebis gaTvaliswinebiT~.kanoni `pacientis uflebebis Sesaxeb~ ufro detalurad ganixilavs aseT SemTxvevebs, kerZod 25-e muxlis meore punqtis Tanaxmad: `Tu qmeduunaro an gacnobierebuli gadawyvetilebis miRebis unars moklebuli pacienti gadaudeblad saWiroebs samedicino momsaxurebas, romlis ganxorcielebis gareSe gardauvalia pacientis sikvdili, dainvalideba an janmrTelobis mdgomareobis mniSvnelovani gauareseba, xolo misi naTesavis an kanonieri warmomadgenlis moZieba ver xerxdeba, samedicino momsaxurebis gamwevi iRebs gadawyvetilebas pacientis janmrTelobis interesebis Sesabamisad~. imave muxlis me-3 punqtSi miTiTebulia, rom: `Tu qmeduunaro an gacnobierebuli gadawyvetilebis miRebis unars moklebuli pacienti gadaudeblad saWiroebs samedicino momsaxurebas, romlis gawevis gareSe gardauvalia pacientis sikvdili, xolo misi naTesavi an kanonieri warmomadgeneli samedicino momsaxurebis winaaRmdegia, samedicino momsaxurebis gamwevi iRebs gadawyvetilebas pacientis janmrTelobis interesebis Sesabamisad~. 223 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi amrigad, Tu konkretuli piri arasrulwlovania an sasamarTlos mier miCneulia qmeduunarod, amasTan, mas aReniSneba sicocxlisaTvis saSiSi mdgomareoba an is saWiroebs gadaudebel samedicino daxmarebas, romlis gareSec gardauvalia sikvdili, samedicino personali uflebamosilia gadausxas mas sisxli. es ufleba ZalaSia im SemTxvevaSic, roca samedicino personalma ver moiZia pacientis naTesavi an kanonieri warmomadgeneli (anu ar icis maTi azri) da maSinac, roca es ukanasknelni samedicino Carevis winaaRmdegi arian. ra gzas unda daadges samedicino personali im SemTxvevebSi, roca qmeduunaro da gacnobierebuli gadawyvetilebis miRebis unaris armqone pacienti, romelsac ar aReniSneba arc sicocxlisaTvis saSiSi mdgomareoba da arc gadaudebeli samedicino daxmarebis aucilebloba, saWiroebs ama Tu im samedicino Carevas (maT Soris sisxlis gadasxmas) romlis Catarebazec uars acxadebs pacientis naTesavi an kanonieri warmomadgeneli? kanonSi `pacientis uflebebis Seasxeb~ gacxadebulia, rom `samedicino momsaxurebis momwodebels ufleba aqvs sasamarTloSi gaasaCivros qmeduunaro, an gacnobierebuli gadawyvetilebis unars moklebuli pacientsi naTesavis an kanonieri warmomadgenlis gadawyvetileba, Tu igi ewinaaRmdegeba pacientis janmrTelobis interesebs~ (muxli 25, punqti 1). ieRovas mowmeebTan mimarTebaSi am muxlis interpretacia Semdegnairad SeiZleba: Tu pacienti qmeduunaroa an ara aqvs gacnobierebuli gadawyvetilebis miRebis unari da mas esaWiroeba sisxlis gadasxma, risi winaaRmdegicaa pacientis naTesavi an kanonieri warmomadgeneli, amave dros, pacientis janmrTelobis mdgomareoba ar aris sicocxlisaTvis saSiSi da ar moiTxovs gadaudeblad sisxlis gadasxmas, samedicino personals ufleba aqvs mimarTos sasamarTlos, moiTxovos pacientisaTvis sisxlis gadasxmis ufleba. ieRovas mowmeTa mier sisxlis gadasxmaze uaris gacxadeba kidev erT problemas moicavs. mxedvelobaSi gvaqvs mSobiaris mier hemotransfuziaze (sisxlis gadasxmaze) uaris Tqma. aris SemTxvevebi, roca mSobiaresaTvis sisxlis gadasxma nayofis sicocxlis SenarCunebis erTaderTi gzaa. aseTi garemoebis arsebobisas saxezea konfliqti dedis avtonomiasa da nayofis sicocxles Soris. saqarTvelos moqmedi kanonmdeblobis mixedviT mSobiare ver ganacxadebs uars iseT samedicino momsaxurebaze, romelic nayofs sicocxles SeunarCunebs, xolo dedis janmrTelobas da sicocxles araviTar safrTxes ar uqmnis. saqarTvelos kanonSi `pacientis uflebebis Sesaxeb~ am problemis maregulirebeli norma Semdegi formiT aris mocemuli: `mSobiares ara aqvs ufleba uari Tqvas iseT samedicino momsaxurebaze, romelic uzrunvelyofs cocxali nayofis dabadebas da romelic mSobiaris janmrTelobisa da sicocxlisaTvis minimaluri riskis matarebelia~. (muxli 36, punqti 2). amrigad, saqarTvelos kanonmdebloba, aRiarebs ra pacientis avtonomiis uzenaesobis princips, uflebas aZlevs qmedunarian da gacnobierebuli gadawyvetilebis unaris mqone pirebs Tavad gansazRvron, CautardeT Tu ara maT esa Tu is samedicino Careva, maT Soris, sisxlis gadasxma. meore mxriv, kanoni icavs qmeduunaro pirebs, maT Soris arasrulwlovanebs, agreTve gacnobierebuli gadawyvetilebis unaris armqone moqalaqeebs maTi naTesavebis an kanonieri warmomadgenlis gadawyvetilebisagan (uaris gacxadeba sisxlis gadasxmaze), romelic safrTxes uqmnis maT sicocxles. xazgasasmelia is garemoeba, rom kanonmdebloba, agreTve icavs ardabadebuli nayofis sicocxles, roca mSobiare sisxlis gadasxmis winaaRmdegia. sicocxlis uflebasa da adamianis arCevanis Tavisuflebas Soris konfliqti gansakTrebul 224 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 saimwvaves iZens abortis ufelebasTan mimarTebaSi. abortis ufleba arsebobs mxolod kanoniT gansazRvruli pirobebis dakmayofilebis SemTxvevaSi. saqarTvelos kanonis `janmrTelobis dacvis Sesaxeb~, 139, 140 muxlebi gansazRvravs abortis marTlzomierebis pirobebs. kerZod, orsulobis xangrZlivoba ar unda aRematebodes Tormet kviras. orsuls operaciis Catarebamde 3 adre mainc unda Cautardes winaswari gasaubreba da unda mieces mosafiqrebeli vada. amasTan, saboloo gadawyvetilebis miReba orsulis prerogativaa. abortis gakeTeba dasaSvebia mxolod licenzirebul dawesebulebaSi da mxolod licenzirebuli eqimis mier. 140-e muxlis Tanaxmad, abortis reklama akrZalulia. amave muxliT, Tormet kviraze meti xnis orsulobis SemTxvevaSi aborti nebadarTulia mxolod samedicino da socialuri Cvenebebis safuZvelze. samedicino Cvenebebi ganisazRvreba janmrTelobis dacvis saministros mier, xolo socialuri Cvenebebi _ kanoniT. zemoaRniSnuli pirobebidan erTi pirobis darRvevac ki iwvevs sisxlis samarTlis kodeqsis 133 muxliT gaTvalisiwnebul sisxlisamaRTlebriv pasuxismgeblobas. informaciis miwodebis valdebuleba pacientisaTvis `janmrTelobis dacvis Sesaxeb~ kanonis 41-e muxlSi miTiTebulia, rom `eqimi valdebulia miawodos pacients sruli informacia misi janmrTelobis mdgomareobis Sesaxeb, garda im SemTxvevbisa, roca igi darwmunebulia, rom es mniSvnelovan zians moutans pacients~. igive movaleoba, Tumca ufro detalurad ganxilulia kanonSi `saeqimo saqmianobis Sesaxeb~ _ muxli 39. muxli 39. pacientisaTvis informaciis miwodeba 1. damoukidebeli saeqimo saqmianobis subieqti valdebulia pacients misTvis misaRebi formiT miawodos sruli, obieqturi, drouli da gasagebi informacia: a) misi janmrTelobis mdgomareobis Sesaxeb, maT Soris: a.a) ganzraxuli profilaqtikuri, diagnostikuri, samkurnalo, sareabilitacio, paliatiuri Carevebisa da maTi alternatiuli variantebis, Tanmxlebi riskisa da efeqtianobis Sesaxeb; (8.05.2007 N4721) a.b) samedicino gamokvlevebis Sedegebis Sesaxeb; a.g) ganzraxul samedicino Carevaze gancxadebuli uaris mosalodneli Sedegebis Sesaxeb; a.d) diagnozisa da savaraudo prognozis, agreTve mkurnalobis mimdinareobis Sesaxeb; b) janmrTelobis SenarCunebis xelSemwyobi an uaryofiTi zegavlenis momxdeni faqtorebis Sesaxeb; g) pacientisaTvis saWiro samedicino momsaxurebis arsebuli saxeebisa da maTi gamoyenebis 225 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi SesaZleblobaTa Sesaxeb, agreTve gaweuli Tu ganzraxuli samedicino momsaxurebis safasurisa da misi anazRaurebis wesis Taobaze. pacientis ufleba eqimis movaleoba ufleba xarisxian samedicino momsaxurebaze profesiuli mzadeba, sertificireba, uwyveti samed. ganaTleba, resertificireba informaciis miRebis ufleba informaciis miwodebis movaleoba Tanxmobis an uaris gacxadebis ufleba informirebuli Tanxmobis miRebis movaleoba konfidencialurobis ufleba saeqimo saidumlos Senaxvis movaleoba eqims samedicino momsaxurebis gawevamde pacientisagan informirebuli Tanxmobis miRebas avaldebulebs kanonebi `janmrTelobis dacvis Sesaxeb~, `pacientis uflebebis dacvis Sesaxeb~ da `saeqimo saqmianobis Sesaxeb.~ `saeqimo saqmianobis Sesaxeb~ kanoni avaldebulebs eqims, rom miiRos pacientisagan informirebuli Tanxmoba werilobiT an zepirad. igive kanoni gansazRvravs Tu ra SemTxvevaSia saWiro werilobiTi Tanxmobis miReba. saqarTvelos kanonmdebloba aregulirebs iseT problemebsac, romlebic warmoiqmneba pacientis axloblis mier iseTi gadawyvetilebis miRebisas, romelic sazianoa pacientis janmrTelobisa da sicocxlisaTvis. roca qmeduunaro an gacnobierebuli gadawyvetilebis unaris armqone pacientsi axloblis gadawyvetileba ewinaaRmdegeba pacientis janmrTelobis interesebs, eqims `saeqimo saqmianobis Sesaxeb~ kanonis 45-e muxliT SeuZlia: 226 mimarTos sasamarTlos da moiTxovos samedicino Carevis ganxorcielebis nebarTva, Tu dro amis saSualebas iZleva; imoqmedos pacientis sicocxlis da janmrTelobis interesebis sesabamisad, roca sakmarisi dro ar aris da samedicino Carevis gadavadeba safrTxes Seuqmnis pacientis sicocxles. adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 konfidencialobis dacvis valdebuleba da pacientis piradi cxovrebis pativiscema samedicino momsaxurebis gamwevis valdebuleba daicvas konfidencialoba da pativi sces pacientis pirad cxovrebas dakavSirebulia pacientis piradi cxovrebis xelSeuxeblobis uflebasTan. ix. agreTve seqcia konfidencialobisa da piradi cxovrebis xelSeuxeblobis Sesaxeb me-6 TavSi _ pacientis uflebebi da movaleobebi. a) pasuxismgebloba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: konstituciaSi ar arsebobs specialuri debuleba am sakiTxTan dakavSirebiT. kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: jandacvis dawesebulebis yvela TanamSromeli valdebulia daicvas samedicino saidumloeba, romlis gamJRavneba SeiZleba mxolod maSin, roca `konfidencialuri informaciis gamJRavnebas moiTxovs gardacvlilis naTesavi an kanonieri warmomadgeneli, sasamarTlo, sagamoZiebo organoebi, an es aucilebelia sazogadoebrivi usafrTxoebis uzrunvelsayofad, sxvaTa uflebebisa da Tavisuflebebis dasacavad.~ (mux. 42). amasTanave, 152-e muxlis mixedviT, gardacvlilis samedicino dokumentacia warmoadgens saeqimo saidumlos 42-e muxliT gaTvaliswinebuli gamonaklisebis garda (mux. 42). saqarTvelos kanoni saeqimo saqmianobis Sesaxeb: kanoni avaldebulebs saeqimo saqmianobis subieqts daicvas pacientis janmrTelobis mdgomareobisa da piradi cxovrebis Sesaxeb informaciis konfidencialoba rogorc saeqimo saqmianobis ganxorcielebisas, ise misi Sewyvetis Semdeg, rogorc pacientis sicocxleSi, ise misi sikvdilis Semdeg (mux. 48.1). kanoni specialurad gansazRvravs SemTxvevebs, rodesac damoukidebeli saeqimo saqmianobis subieqts ufleba aqvs gaamJRavnos pacientis janmrTelobis mdgomareobisa da piradi cxovrebis Sesaxeb konfidencialuri informacia (mux. 48.2). es SeiZleba moxdes im SemTxvevaSi, Tu: • pacienti aZlevs informaciis gamJRavnebis uflebas; • informaciis gaumJRavnebloba safrTxes uqmnis mesame piris (romlis vinaobac cnobilia) janmrTelobas an/da sicocxles; • Tu arsebobs dasabuTebuli eWvi savaldebulo aRricxvas daqvemdebarebul daavadebaze; 227 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi • informacia miewodeba samedicino momsaxurebis monawile sxva samedicino personals; • informaciis gamJRavneba aucilebelia sasamarTlo-samedicino eqspertizisaTvis; • informaciis gamJRavnebas, sasamarTlos gadawyvetilebis Sesabamisad, moiTxoven samarTaldamcveli organoebi; • informacia miewodeba saxelmwifo organoebs pacientisaTvis socialuri SeRavaTebis dawesebis mizniT. am SemTxvevaSi aucilebelia informaciis gamJRavnebaze pacientis Tanxmoba; • saswavlo-samecniero mizniT informaciis gamoyenebisas monacemebi isea warmodgenli, rom SeuZlebelia pirovnebis identifikacia. dabolos, saeqimo saqmianobis Sesaxeb kanoni SesabamisobaSia kanonTan pacientis uflebaTa Sesaxeb, radgan orive kanoni gansazRvravs gamonaklisebs pacientis piradi cxovrebis dacvis valdebulebidan. saeqimo saqmianobis Sesaxeb kanonis 49-e muxlis mixedviT, damoukidebeli saeqimo saqmianobis subieqts ufleba aqvs Caerios pacientis ojaxur da pirad cxovrebaSi, Tu: a) Careva aucilebelia pacientis daavadebis prevenciisaTvis, diagnostikis, mkurnalobis, reabilitaciisa da paliatiuri mzrunvelobisaTvis. am SemTxvevaSi saWiroa pacientis Tanxmoba; b) Caurevloba seriozul safrTxes uqmnis pacientis ojaxis wevrebis janmrTelobas an/da sicocxles. saqarTvelos kanoni pacientis uflebaTa Sesaxeb kanonis 27-e muxlis mixedviT, samedicino momsaxurebis gamwevi valdebulia pacientis Sesaxeb mis xelT arsebuli informaciis konfidencialoba daicvas rogorc pacientis sicocxleSi, ise misi sikvdilis Semdeg. 28.1 muxli gansazRvravs gamonaklisebs am zogadi wesidan. gamJRavneba dasaSvebia, Tu miRebulia pacientis Tanxmoba; informaciis gaumJRavnebloba safrTxes uqmnis mesame piris (romlis vinaobac cnobilia) sicocxles an/da janmrTelobas; saswavlo an samecniero mizniT pacientis Sesaxeb informaciis gamoyenebisas monacemebi isea warmodgenili, rom SeuZlebelia pirovnebis identifikacia; amas iTvaliswinebs saqarTvelos kanonmdebloba. dabolos, samedicino momsaxurebis gamwevis mier samedicino momsaxurebaSi monawile sxva pirebisaTvis pacientis janmrTelobis mdgomareobasTan dakavSirebuli konfidencialuri informaciis gamJRavnebaze pacientis Tanxmoba nagulisxmevad SeiZleba CaiTvalos (mux. 28.2). saqarTvelos kanoni aiv infeqcia/Sidsis Sesaxeb kanoni iTvaliswinebs aiv infeqciis matarebeli adamianebis konfidencialobis dacvas. me-9 muxlis mixedviT: `momsaxurebis mimwodebeli dawesebuleba, romelic axorcielebs aiv inficirebulTa/SidsiT daavadebulTa diagnostikas, mkurnalobas, profilaqtikas, mxardaWeras/xelSewyobas an/da 228 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 movlas, aseve nebismieri iuridiuli da fizikuri pirebi, romlebsac aqvT informacia piris aiv inficirebis/SidsiT daavadebis Sesaxeb, valdebuli arian saqarTvelos kanonmdeblobiT dadgenili wesiT daicvan informaciis konfidencialuroba.~ es valdebuleba ZalaSia `rogorc aiv inficirebulis/SidsiT daavadebulis sicocxleSi, ise misi sikvdilis Semdeg~ (mux. 9.2). kanoni iTveliswinebs gamonaklisebs konfidencialobis dacvis valdebulebidan (mux. 9.3): • Tu aiv inficirebulisagan/SidsiT daavadebulisagan miRebulia informirebuli Tanxmoba; • Tu arsebobs aiv inficirebulis/SidsiT daavadebulis winaswargancxadebuli werilobiTi Tanxmoba misi gardacvalebis SemTxvevaSi informaciis gacemis Sesaxeb; • saqarTvelos kanonmdeblobiT gaTvaliswinebul sxva SemTxvevebSi. aiv inficirebulis/SidsiT daavadebulis Sesaxeb informaciis saswavlo an samecniero mizniT gacema dasaSvebia, Tu informaciis gamoyenebisas monacemebi isea warmodgenili, rom SeuZlebelia piris identifikacia (mux 9.4). saqarTvelos kanoni fsiqiatriuli daxmarebis Sesaxeb piris fsiqikuri mdgomareobis Sesaxeb konfidencialuri informacia xelmisawvdomia misi mkurnalobisa da samecniero kvlevis procesSi uSualod CarTuli pirebisaTvis (mux. 26.2). informaciis gacema mesame pirze SesaZlebelia pacientis an misi kanonieri warmomadgenlis TanxmobiT, anda sasamarTlos gadawyvetilebiT (mux. 26.3). dabolos, konfidencilobis uflebis darRveva dasaSvebia, Tu safrTxe emuqreba pacientis an mesame piris sicocxles an janmrTelobas. darRveva aseve SesaZlebelia, Tu safrTxe eqmneba pacientis an mesame piris sicocxles an/da janmrTelobas. am SemTxvevaSi gadawyvetilebas pacientis fsiqikuri janmrTelobis gamJRavnebis Sesaxeb iRebs fsiqiatriuli dawesebulebis administracia; aseTi informacia miewodeba mxolod pacientis kanonier warmomadgenels, xolo misi ararsebobisas _ naTesavs (mux. 26.4). g) damxmare aqtebi Sromis, janmrTelobis da sociluri dacvis ministris brZaneba #217/o (23.07.2010) aiv/Sidsis rutinuli zedamxedvelobis Sesaxeb Seicavs specialur muxls monacemebis konfidencialobis Sesaxeb (mux. 11). d) Sesabamisi muxlebi eTikis kodeqsidan eqimi saidumlod inaxavs pacientis janmrTelobasTan da pirad cxovrebasTan dakavSirebul faqtebs, pacientis sikvdilis Semdegac ki, Tu saidumlos gamJRavnebas mas kanoni ar avalebs. am ukanasknel SemTxvevaSi eqimi acnobebs pacients (an mis Wirisufals) saidumlos gamJRavnebis ganzraxvis Sesaxeb (eqimi da pacienti, mux. 4). 229 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi e) sxva wyaroebi ar arebobs sxva wyaroebi ganxilul uflebasTan dakavSirebiT. samedicino Canawerebis warmoebis valdebuleba jandacvis momsaxurebis gamwevebma unda awarmoon samedicino Canawerebi arsebuli wesebis mixedviT. es ufleba dakavSirebulia pacientis uflebasTan miiRos informacia. a) pasuxismgebloba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: konstitucia ar Seicavs aRniSnul valdebulebas. kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: eqimi da sxva samedicino personali valdebulia dadgenili wesiT awarmoos Canawerebi samedicino dokumentaciaSi; arasamuSao adgilze samedicino daxmarebis aRmoCenisas werilobiT asaxos da daniSnulebisamebr gadasces informacia gaweuli samedicino daxmarebis Sesaxeb (mux. 43). saqarTvelos kanoni samedicino saqmianobis Sesaxeb da saqarTvelos kanoni pacientis uflebaTa Sesaxeb: damoukidebeli saeqimo saqmianobis subieqti valdebulia TiToeuli pacientisaTvis awarmoos samedicino Canawerebi saqarTvelos kanonmdeblobiT dadgenili wesiT (56.1). damoukidebeli saeqimo saqmianobis subieqtis mier samedicino Canawerebis warmoebisas aucilebelia samedicino Canawerebi Sesruldes saxelmwifo enaze, mkafiod da gasagebad. ucxo qveynis specialistis Canaweri unda iTargmnos saxelmwifo enaze; samedicino Canawerebis yoveli axali nawili damoukidebeli saeqimo saqmianobis subieqtma daamowmos mkafio xelmoweriT, arsebuli wesis mixedviT (mux. 56.2). damoukidebeli saeqimo saqmianobis subieqti valdebulia pacientis samedicino dokumentaciaSi Seitanos Sesabamisi Canaweri, romelSic miTiTebuli iqneba informaciis miuwodeblobis safuZveli. (mux. 39.4) damoukidebeli saeqimo saqmianobis subieqti valdebulia pacientis dasabuTebuli moTxovniT Seitanos Sesworeba, damateba an ganmarteba pacientis samedicino dokumentaciaSi, agre- 230 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 Tve ganaaxlos piradi cxovrebisa da samedicino monacemebi subieqts ufleba aqvs pacientis, misi naTesavis an kanonieri Secvalos samedicino dokumentaciaSi arsebuli informacia, bloba saqarTvelos kanonmdeblobiT aris gaTvaliswinebuli (mux. 42.1). saeqimo saqmianobis warmomadgenlis moTxovniT ar Tu misi dafiqsirebis aucile(42.3). aRniSnuli valdebuleba ufro dawvrilebiT aRwerilia saqarTvelos kanonSi pacientis uflebaTa Sesaxeb. b) damxmare aqtebi Sromis, janmrTelobis da socialuri dacvis ministries brZaneba #198/n (17.07.2002) `samedicino Canawerebis Senaxvis wesebi samedicino dawesebulebebSi) gansazRvravs Canawerebis Senaxvis vadas da pirobebs. g) Sesabamisi muxlebi eTikis kodeqsidan eTikis kodeqsis debulebebi ar asaxavs ganxilul uflebas. d) sxva wyaroebi ar arebobs sxva wyaroebi ganxilul uflebasTan dakavSirebiT. informaciis gadacemis/miwodebis valdebuleba jandacvis momsaxurebis gamwevi valdebulia gadasces saTanado informacia jandacvis dawesebulebis administracisas an Sesabamis organos, romelic pasuxismgebelia jandacvis sistemis menejmentze. a) pasuxismgebloba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: konstitucia ar gamnixilavs aRniSnul valdebulebas. kanonebi: saqarTvelos kanoni janmrTelobis dacvis Sesaxeb: samedicino saqmianobis samarTalsubieqti valdebulia dadgenili wesiT miawodos samedicino statistikuri informacia janmrTelobisa da socialuri dacvis saministros (mux. 20.2). 231 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi saqarTvelos kanoni saeqimo saqmianobis Sesaxeb: Tu samedicino momsaxurebis gawevisas pacientis janmrTelobas raime ziani miadga an arsebobs zianis miyenebis riski, damoukidebeli saeqimo saqmianobis subieqti valdebulia acnobos amis Sesaxeb samedicino dawesebulebis xelmZRvanelobas (mux. 51). saqarTvelos kanoni sazogadoebrivi janmrTelobis Sesaxeb: Sesabamisi samedicino momsaxurebis mimwodebeli valdebulia saqarTveloSi mcxovreb pirs droulad miawodos amomwuravi informacia profilaqtikuri acris arsisa da aucileblobis, mosalodneli klinikuri gamosavlis, acrasTan dakavSirebuli riskisa da acraze uaris Tqmis SemTxvevaSi SesaZlo Sedegebis Sesaxeb (mux. 8). samedicino momsaxurebis mimwodebeli valdebulia gadamdebi daavadebis gamovlenis TiToeuli SemTxvevis Sesaxeb saministros mier dadgenili wesis Sesabamisad Seatyobinos sazogadoebrivi janmrTelobis Sesabamis samsaxurs (mux. 10). am movaleobis Sesasrulebalad, gadamdebi daavadebis matareblobis dadasturebis SemTxvevaSi sazogadoebrivi janmrTelobis samsaxursa da samedicino momsaxurebis mimwodebels ufleba aqvT fizikur pirs mosTxovon Caitaros saTanado samedicino Semowmeba an/da saTanado mkurnaloba an/da miiRos saTanado konsultacia; daasaxelos is pirebi, romlebic masTan axlo kontaqtSi imyofebodnen an/da imyofebian gadamdeblobis periodis ganmavlobaSi (mux. 10.3). saqarTvelos kanoni aiv infeqcia/Sidsis Sesaxeb: momsaxurebis mimwodebeli dawesebuleba, romelic axorcielebs aiv inficirebulTa/SidsiT daavadebulTa diagnostikas, mkurnalobas, profilaqtikas, mxardaWeras/xelSewyobas an/da movlas, valdebulia saqarTvelos kanonmdeblobiT dadgenili wesiT awarmoos aRricxva (mux. 8.5). amasTanave, momsaxurebis mimwodebeli dawesebuleba valdebulia aiv inficirebuls/SidsiT daavadebuls mosTxovos informacia im piris/pirTa Sesaxeb, romelTanac/romlebTanac mas hqonda epidemiologiuri TvalsazrisiT riskis Semcveli kontaqti (mux. 8.6). b) damxmare aqtebi Sromis, janmrTelobis da socialuri dacvis ministris brZaneba N 101/n (5 aprili, 2005). Sromis, janmrTelobis da socialuri dacvis ministris brZaneba N 122/n (4 ivnisi, 2003). Sromis, janmrTelobis da socialuri dacvis ministris brZaneba #217/o (23.07.2010). g) Sesabamisi muxlebi eTikis kodeqsidan eqimi yovel Rones xmarobs, raTa sazogadoebas miawodos informacia misTvis cnobil im garemoebaTa Sesaxeb, romlebic mTlianad sazogadoebis Tu misi calkeuli jgufebis janmr- 232 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 Telobis gauaresebas iwvevs da romelTa Tavidan acileba SesaZlebelia (“eqimi da sazogadoeba~, mux. 1) d) sxva wyaroebi ar arebobs sxva wyaroebi ganxilul uflebasTan dakavSirebiT. pasuxismgebloba da movaleobebi kolegebisa da profesiis mimarT eqimis profesiis reputacias didi mniSvneloba da sazogadoebrivi Rirebuleba aqvs. usafuZvlo da arasaTanado kritikam SesaZloa daazianos es Rirebulebebi. a) pasuxismgebloba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: konstitucia ar Seicavs debulebebs arniSnuli sakiTxis Sesaxeb. kanonebi saqarTvelos kanoni janmrTelobis dacvis Sesaxeb samedicino da farmacevtuli dawesebulebebi valdebuli arian daicvan samedicino da farmacevtuli saqmianobis maregulirebeli kanonmdeblobiT dadgenili standartebi, wesebi da normebi (mux. 53). saqarTvelos kanoni saeqimo saqmianobis Sesaxeb damoukidebeli saeqimo saqmianobis subieqti valdebulia saeqimo saqmianobis ganxorcielebisas daicvas profesiuli eTikis normebi, pacientis interesebi, saeqimo saqmianobis prestiJi, daamkvidros kolegebs Soris urTierTpativiscemis atmosfero (mux. 57). damoukidebeli saeqimo saqmianobis subieqti valdebulia, Tavisi SesaZleblobis farglebSi, maqsimalurad daexmaros kolegas, romelic mas mimarTavs momsaxurebis gawevis mizniT (mux. 58). pacientis mkurnalobisas eqimma unda gaiTvaloswinos Semdegi principebi: • Tu damoukidebeli saeqimo saqmianobis subieqts samedicino momsaxurebis gawevis mizniT mimarTa pacientma, romelsac manamde imave specialobis sxva damoukidebeli saeqimo saqmianobis subieqti meTvalyureobda, pirveli valdebulia yvela Rone ixmaros imisaTvis, rom pacientma, misma naTesavma an kanonierma warmomadgenelma Seatyobinon amis Sesaxeb im damoukidebeli saeqimo saqmianobis subieqts, romelic pacients adre meTvalyureobda. akrZalulia pacientisaTvis samedicino momsaxurebis gawevaze uaris Tqma im mizeziT, rom mas adre imave specialobis sxva damoukidebeli saeqimo saqmianobis subieqti mkurnalobda. 233 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi • sxva damoukidebeli saeqimo saqmianobis subieqtis mier gamogzavnili pacientis mkurnalobis damTavrebis Semdeg damoukidebeli saeqimo saqmianobis subieqti valdebulia ukan gaugzavnos pacienti imave damoukidebeli saeqimo saqmianobis subieqts, Tu SemdgomSi saWiroa mkurnalobis an/da meTvalyureobis gagrZeleba. am SemTxvevaSi aucilebelia pacientis Tanxmoba; • Tu damoukidebeli saeqimo saqmianobis subieqtma gadaudebeli samedicino momsaxureba gauwia pacients, romelsac manamde mkurnalobda an/da meTvalyureobda sxva damoukidebeli saeqimo saqmianobis subieqti, momsaxurebis gamwevi damoukidebeli saeqimo saqmianobis subieqti valdebulia SeZlebisdagvarad swrafad Seatyobinos amis Sesaxeb adrindel damoukidebeli saeqimo saqmianobis subieqts da pacientis TanxmobiT masve gadaabaros avadmyofis Semdgomi mkurnaloba an/da meTvalyureoba; • damoukidebeli saeqimo saqmianobis subieqti valdebulia Sesabamisi samedicino momsaxureba gauwios pacients, romelsac mkurnalobs an/da meTvalyureobs imave dawesebulebaSi momuSave kolega, Tu es ukanaskneli raime mizezis gamo ver axerxebs samedicino momsaxurebis ganxorcielebas. kolegis saqmianobis Sefasebisas eqimma unda imoqmedos keTilsindisierad (mux. 63). ufrosma eqimma unda izrunos Tavisi xelqveiTi kolegis uwyveti profesiuli ganviTarebis sistemaSi dadgenili wesiT monawileobaze (mux. 64). kanoni awesebs garkveul akrZalvebs kolegebs Soris samarTlianobis da urTierTpativiscemis uzrunvelsayofad (mux. 65). eqims ekrZaleba: • kolegis saeqimo saqmianobis araobieqturi kritika, misi pirovnuli Tvisebebis damamcirebeli gamonaTqvamebi; • kolegisaTvis saeqimo saqmianobaSi xelis SeSla, misi gaZevebis mcdeloba an konkurenciis gamo gaZeveba; • damoukidebeli saeqimo saqmianobis subieqtis mier saeqimo praqtikis dawyeba 2 welze naklebi drois ganmavlobaSi im damoukidebeli saeqimo saqmianobis subieqtis saeqimo praqtikis teritoriaze (regionSi, dasaxlebul punqtSi an mis nawilSi), romelTanac is muSaobda umcros eqimad an gadioda masTan rezidenturis kurss an swavlobda diagnostikur an/da samkurnalo meTodebs aranakleb 3 Tvisa. gamonaklisi dasaSvebia mxolod im SemTxvevaSi, Tu miRebulia zemoxsenebuli damoukidebeli saeqimo saqmianobis subieqtis Tanxmoba; • umuSevari kolegis mdgomareobiT sargebloba da masTan SromiTi xelSekrulebis gaformeba saqarTvelos kanonmdeblobiT dadgenil satarifo normebze naklebi anazRaurebis gaTvaliswinebiT; • sazRauris miReba sxva damoukidebeli saeqimo saqmianobis subieqtisaTvis an sxva samedicino dawesebulebaSi pacientis an gamosakvlevi masalis gagzavnisaTvis, agreTve sazRauris gacema im SemTxvevebSi, roca mas ugzavnian pacients an gamosakvlev masalas. 234 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 b) damxmare aqtebi ar arsebobs damxmare aqtebi ganxilul uflebasTan dakavSirebiT. g) Sesabamisi muxlebi eTikis kodeqsidan saqarTvelos eqimis eTikis kodeqsi Seicavs specialur Tavs `eqimi da kolega~, romelic eZRvneba kolegebs Soris urTierTobas. kodeqsi mouwodebs eqimebs, rom, daicvan Semdegi debulebebi: • eqimi ufrTxildeba Tavisi profesiis prestiJs, iseve rogorc eqimsa da pacients Soris damkvidrebul ndobas. igi ise warmarTavs saeqimo saqmianobas, rom Crdili ar miayenos Tavis profesias. eqimi uyoymanod uTiTebs kolegas mis profesiul naklsa da araeTikur saqcielze. saWiroebisamebr eqimi kolegis saqmianobaSi SemCneul profesiul nakls gansjis kolegebis wreSic. miuRebelia sxva eqimis saeqimo Secdomaze sajarod (saxalxod) msjeloba, Tu amas kanonmdebloba ar moiTxovs; • eqimi Tavisi SesaZleblobis farglebSi yovel Rones xmarobs, raTa daexmaros sxva eqims profesiuli movaleobis aRsrulebaSi; • eqims gacnobierebuli aqvs sakuTari profesiuli SesaZleblobebi. Tu mas aklia saTanado codna da gamocdileba, is dasaxmareblad sxva eqims uxmobs; • eqimi pacients kolegasTan gzavnis mxolod im SemTxvevaSi, Tu darwmunebulia am ukanasknelis kompetenciaSi. amasTan, konsultaciis win igi kolegas awvdis pacientis saTanado samedicino daxmarebisaTvis saWiro yvela informacias; • eqimi dawvrilebiT informacias da daskvnas awvdis kolegas, romelic pacients masTan gzavnis sakonsultaciod; • eqimi exmareba kolegas, romelic cdilobs imoqmedos profesiuli eTikis uzenaesi principebis Sesabamisad da romelsac aiZuleben ugulebelyos aRniSnuli principebi. d) sxva wyaroebi ar arebobs sxva wyaroebi ganxilul uflebasTan dakavSirebiT. 235 Tavi 7: samedicino dawesebulebebis uflebebi da movaleobebi samedicino Semowmebis gavlis valdebuleba garkveul SemTxvevebSi jandacvis momsaxurebis gamwevi valdebulia gaiaros samedicino Semowmeba. es valdebuleba arsebobs imis uzrunvelsayofad, rom jandacvis momsaxurebis gamwevs janmrTelobis mdgomareoba saSualebas aZlevs pacients aRmouCinos saTanado samedicino daxmareba. a) valdebuleba saqarTvelos konstituciis/kanonebis mixedviT konstitucia: saqarTvelos konstitucia ar Seicavs debulebebs mocemul sakiTxze. kanonebi: saqarTvelos Sromis kodeqsi kanonis Tanaxmad, zogierTi profesiis warmomadgenlebma unda gaiaron regularuli samedicino Semowmeba (mux. 54.1.b). Sromis, janmrTelobis da socialuri dacvis ministris brZanebis Tanaxmad, eqimebo da eqTnebi eqvemdebarebian regularul samedicino Semowmebas. saqarTvelos kanoni saeqimo saqmianobis Sesaxeb: Tu arsebobs dasabuTebuli varaudi, rom damoukidebeli saeqimo saqmianobis subieqts janmrTelobis mdgomareobis gamo aRar SeuZlia ganaxorcielos profesiuli saqmianoba, saministros ufleba aqvs daavalos damoukidebeli saeqimo saqmianobis subieqts samedicino dawesebulebaSi gaiaros Sesabamisi samedicino Semowmeba (mux. 70.1). Tu damoukidebeli saeqimo saqmianobis subieqti uars acxadebs misi janmrTelobis mdgomareobis Sefasebaze, sabWos ufleba aqvs SeaCeros saxelmwifo sertifikatis moqmedeba kanonis Sesabamisi procedurebis dacviT (mux. 71). b) damxmare aqtebi Sromis, janmrTelobis da socialuri dacvis ministries brZaneba # 215/n, 11.07, romelic gansazRvravs im dasaqmebulTa sias, romelTa savaldebulo regularuli samedicino Semowmeba finansdeba damsaqmeblis mier. sia Seicavs eqimebs da eqTnebsac (danarTi 1, paragrafi 1). 236 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 7.1 g) Sesabamisi muxlebi eTikis kodeqsidan eTikis kodeqsis debulebebi ar asaxavs ganxilul uflebas. d) sxva wyaroebi ar arebobs sxva wyaroebi ganxilul uflebasTan dakavSirebiT. 237 8.1 sasamarTloSi mimarTvis meqanizmebi 8.2 samoqalaqo procedurebi 8.3 sisxlis samarTlis procedurebi 8.4 uflebaTa dacvis alternatiuli meqanizmebi/saqarTvelos saxalxo damcveli 238 adamianis uflebebi janmrTelobis dacvis sferoSi 8 pacientis uflebebis dacvis procedurebi 239 Tavi 8: pacientis uflebebis dacvis procedurebi 8.1 erovnuli procedurebi erovnuli procedurebi sasamarTloSi uflebebisa da valdebulebebis dacvisaTvis saWiro meqanizmebi (samoqalaqo da administraciuli saqmeebi) sakasacio sasamarTlo (uzenaesi sasamarTlo) Sesagebeli sakasacio sarCeli saapelacio sasamarTlo saapelacio sarCeli uflebebisa da valdebulebebis dacvisaTvis saWiro alternatiuli meqanizmebi ombudsmenis (saxalxo damcvelis) ofisi Sromis, janmrTelobisa da socialuri dacvis saminstro pacientebTan urTierTobis administraciuli momsaxureba an msgavsi organo (arsebobs zogierT saavadmyofoSi/ klinikaSi) pirvelad Camoyalibda sadazRveo kompaniebis asociaciis mier; SemdgomSi Seiqmna kanonis safuZvelze rogorc sajaro uwyeba jandacvis institutebi mediaciis samsaxuri Sesagebeli saavadmyofos eTikis komiteti raionuli da saqalaqo sasamarTlo sarCeli 240 Sesagebeli adamianis uflebebi janmrTelobis dacvis sferoSi saCivari qveTavi 8.2 pacientis da/an misi kanonieri warmomadgenlis ufleba mimarTos sasamarTlos `pacientis uflebebis Sesaxeb~ saqarTvelos kanonis me-10 muxliT gansazRvrulia pacientis an misi kanonieri warmomadgenlis sasamarTlosadmi mimarTvisa da Sesabamisi moTxovnis ufleba; kerZod: pacients an mis kanonier warmomadgenels ufleba aqvs, moiTxovos qonebrivi zianisa da araqonebrivi zianis kompensacia, rac SesaZlebelia gamowveuli iyos rogorc pacientis uflebebis darRveviT, ise mcdari samedicino qmedebiT, agreTve, samedicino dawesebulebis funqcionirebis sxva xarveziTa da saxelmwifos mier arasworad ganxorcielebuli zedamxedvelobiTa da regulirebiT. aRsaniSnavia isic, rom aucilebelia dadasturdes Tavad faqti (vTqvaT, pacientis uflebis darRvevisa) da Sesabamisad unda moTxovnili iqnes kompensacia. mag: mcdari samedicino qmedeba Tu ar iqna Sesabamisad (eqspertiziT da a.S.) dadasturebuli, bunebrivia sasamarTlo ver imsjelebs am qmedebidan gamomdinare zianis SesaZlo miyenebisa da aRniSnulidan gamomdinare misi anazRaurebis Taobaze. pacients an mis kanonier warmomadgenels aseve ufleba aqvs mimarTos sasamarTlos da moiTxovos samedicino personalis saqmianobis licenziis SeCereba an gauqmeba da saxelmwifo samedicino da sanitaruli standartebis Secvla. Tumca aRsaniSnavia isic, rom samedicino personalis saqmianobis licenziis gauqmebis moTxovniT pacients SeuZlia mimarTos regulirebis saagentos, xolo sanitaruli kodeqsi gauqmebulia. 8.2 sisxlissamarTlebrivi procedurebidan gamoyofis Rirsia eWvmitanilis ufleba, moiTxovos ufaso samedicino Semowmeba. saqarTvelos sisxlis samarTlis saproceso kodeqsis 73-e muxlis pirveli nawilis `v~ qvepunqtis Tanaxmad, eWvmitanils ufleba aqvs, dakavebisTanave an eWvmitanilad cnobis Sesaxeb dadgenilebis gamotanisTanave moiTxovos ufaso samedicino Semowmeba da Sesabamisi werilobiTi daskvna. mas agreTve ufleba aqvs, moiTxovos samedicino eqspertizis daniSvna Tavisi janmrTelobis mdgomareobis Sesamowmeblad. eWvmitanili valdebuli ar aris, warmoadginos raime mtkicebuleba (dokumenti) janmrTelobis mdgomareobis Sesaxeb, an raime sxva formiT amtkicos samedicino Semowmebis an eqspertizis Catarebis aucilebloba. dakavebisTanave an eWvmitanilad cnobis Sesaxeb dadgenilebis gamotanisTanave eWvmitanils yovelgvari safuZvlis gareSec SeuZlia, moiTxovos ufaso samedicino Semowmeba da Sesabamisi werilobiTi daskvna, an samedicino eqspertizis daniSvna Tavisi janmrTelobis mdgomareobis Sesamowmeblad da aseT SemTxvevaSi Suamdgomloba dauyovnebliv unda dakmayofildes, radgan faqtobrivad ar arsebobs Suamdgomlobis dakmayofilebaze uaris Tqmis Uufleba. miuxedavad imisa, rom zemoaRniSnul SemTxvevaSi eqspertizis daniSvna imperatiuli valdebulebaa, Tu gamomZiebelma igi ar Seasrula, eqspertizis daniSvnaze uari SeiZleba gasaCivrdes gamoZiebis adgilis mixedviT _ raionul (saqalaqo) sasamarTloSi, sadac saCivari ganixileba misi miRebidan 24 saaTSi. amasTan, sasamarTlo valdebulia, daakmayofilos saCivari. am SemTxvevaSi sasamarTlosaTvis saCivriT mimarTva mxolod erTxel SeiZleba, anu raionuli (saqalaqo) sasamarTlos gadawyvetileba zemdgom sasamarTloSi aRar saCivrdeba. 241 Tavi 8: pacientis uflebebis dacvis procedurebi 8.3 samoqalaqo samarTlebrivi procedurebi samoqalaqo kodeqsis 992 muxlis Tanaxmad piri romelic sxva pirs, marTlsawinaaRmdego, ganzraxi an gaufrTxilebeli moqmedebiT miayenebs zians valdebulia aunazRauros mas es ziani. Aam muxlis dispoziciaSi gamoyenebuli cneba marTlwinaaRmdegoba zianis anazRaurebis TvalsazrisiT warmoadgens anazRaurebis aucilebel pirobas da eqimis an samedicino dawesebulebis mier gaweuli momsaxurebiT damdgari Sedegi CaiTvleba marTlsawinaaRmdegod Tuki is aseTad gaTvaliswinebulia janmrTelobis dacvis sferoSi moqmedi kanonmdeblobiT. am muxliT gaTvaliswinebuli gazraxi da gaufrTxilebeli moqmedebebis cnebebi warmoadgens samoqalaqo bralis formebs rac gansxvavebulia sisxlis samarTlebrivi bralisagan da dadis marTlsawinaaRmdego Sedegis gaTvaliswinebis da ganWvretis SesaZleblobamde, aseve piris movaleobamde imoqmedos amgvari Sedegis dadgomis Tavidan asacileblad da aRniSuli movaleobis Seusruleblobamde. 1007 muxlis Tanaxmad ki samedicino dawesebulebaSi mkurnalobisas (qirurgiuli operaciis an araswori diagnoziT damdgari Sedegi da sxv) piris janmrTelobisaTvis miyenebuli ziani anazRaurdeba saerTo safuZvlebiT. Zianis mimyenebeli Tavisufldeba pasuxismgeblobisagan, Tu daamtkicebs rom zianis miyenebaSi mas brali ar miuZRvis. mtkicebis tvirTi imis Taobaze, rom zianis dadgomaSi samedicino dawesebulebas brali ar miuZRvis akisria Tavad samedicino dawesebulebas. samedicino dawesebulebis mier miyenebuli zianis iseve rogorc nebismieri deliqtis Sedegad warmoSobili zianis anazRaurebis moTxovnis xandazmulobis vada Seadgens 3 wels im momentidan, rodesac pirma Seityo an unda Seetyo zianis miyenebis Sesaxeb. samoqalaqo kodeqsi gansazRvravs sicocxlisa da ubeduri SemTxvevis cnebebs, amasTan ubeduri SemTxvevis dazRvevisas Tu mzRvevelis movaleoba damokidebulia janmrTelobisaTvis zianis (vnebis) ganzrax miyenebaze, maSin ganzraxvis araseboba ivaraudeba manamde sanam ar damtkicdeba sawinaaRmdego. `pacientis uflebebis Sesaxeb~ saqarTvelos kanonis 25-e muxlis Tanaxmad, dadgenilia pacientis uflebebis dacvis gansakuTrebuli garantiebebi; kerZod: Tu qmeduunaro an gacnobierebuli gadawyvetilebis miRebis unars moklebuli pacienti gadaudeblad saWiroebs samedicino momsaxurebas, romlis ganxorcielebis gareSe gardauvalia pacientis sikvdili, dainvalideba an janmrTelobis mdgomareobis mniSvnelovani gauareseba, xolo misi naTesavis an kanonieri warmomadgenlis moZieba ver xerxdeba, samedicino momsaxurebis gamwevi iRebs gadawyvetilebas pacientis janmrTelobis interesebis Sesabamisad. im SemTxvevaSi ki, Tu qmeduunaro an gacnobierebuli gadawyvetilebis miRebis unars moklebuli pacienti gadaudeblad saWiroebs samedicino momsaxurebas, romlis gawevis gareSe gardauvalia pacientis sikvdili, xolo misi naTesavi an kanonieri warmomadgeneli samedicino momsaxurebis winaaRmdegia, samedicino momsaxurebis gamwevi amiT SezRuduli ar aris, miuxedavad sakiTxis specifiurobisa, da man gadawyvetileba unda miiRos pacientis janmrTelobis interesebis Sesabamisad. amasTan, samedicino momsaxurebis gamwevi uflebamosilia (da ara valdebuli) sasamarTloSi gaasaCivros qmeduunaro an gacnobierebuli gadawyvetilebis miRebis unars moklebuli pacientis naTesavis an kanonieri warmomadgenlis gadawyvetileba, Tu igi ewinaaRmdegeba pacientis janmrTelobis interesebs. 242 adamianis uflebebi janmrTelobis dacvis sferoSi qveTavi 8.4 8.4 saqarTvelos saxalxo damcveli saxalxo damcveli (ombudsmeni) aris konstituciuri instituti, romelic zedamxedvelobas uwevs saqarTvelos teritoriaze adamianis uflebaTa da TavisuflebaTa dacvas, avlens maTi darRvevis faqtebs, xels uwyobs darRveuli uflebebis aRdgenas. saxalxo damcvels nebismierma moqalaqem, SeiZleba mimarTos maSin, roca irRveva misi (an sxvisi) uflebebi da Tavisuflebebi, romelic dadgenilia saqarTvelos konstituciiTa da kanoniT, agreTve im saerTaSoriso xelSekrulebebiT da SeTanxmebebiT romelTa monawilec aris saqarTvelo. uflebebis darRvevas SeiZleba adgili hqondes saxelmwifo xelisuflebisa da adgilobrivi TviTmmarTvelobis organoTa, saxelmwifo da arasaxelmwifo organizaciaTa, dawesebulebaTa, sawarmoTa, Tanamdebobisa da iuridiul pirTa mxridan. saxalxo damcvels ufleba aqvs ar ganixilos gancxadeba an saCivari, romlis Taobazec mas miRebuli hqonda gadawyvetileba, Tu ar warmoiqmneba axali garemoebani. uflebebis darRvevis SemTxvevaSi, saxalxo damcvels SeuZlia: • rekomendaciebi gaugzavnos im saxelmwifo organos, Tanamdebobis an iuridiul pirs, romlis moqmedebamac gamoiwvia Tqveni uflebebis darRveva; • danaSaulis niSnebis gamovlenis SemTxvevaSi mis xelT arsebuli masalebi gadasces sagamoZiebo organos; • Seitanos winadadebebi Sesabamis organoebSi im pirTa disciplinaruli an administraciuli pasuxismgeblobis Sesaxeb, romelTa moqmedebamac gamoiwvia Tqveni uflebaTa da TavisuflebaTa darRveva; • acnobos masobrivi informaciis saSualebebs adamianis uflebaTa da TavisuflebaTa darRvevasTan dakavSirebiT; • informacia adamianis uflebaTa darRvevebis Sesaxeb gamoaqveynos specialur moxsenebebsa da yovelwliur angariSebSi;1 gancxadeba da saCivari ar ibegreba saxelmwifo gadasaxadiT. saqarTvelos saxalxo damcvelis mier dainteresebuli pirisaTvis gaweuli samsaxuri ufasoa. saxalxo damcveli ganixilavs moqalaqeTa gancxadebebsa da saCivrebs adamianis uflebaTa da ZiriTad TavisuflebaTa, ekonomikur, socialur da kulturul, samoqalaqo da politikur uflebebTan dakavSirebiT. gancxadeba an/da saCivari unda iyos dawerili saxalxo damcvelis saxelze, garkveviT, qarTul enaze, unda moicavdes ZiriTadi sakiTxis, garemoebebis aRweras da ganmcxadeblis zust misamarTs. 1 meti informaciisTvis SegiZliaT gaecnoT „saqarTvelos organul kanons saxalxo damcvelis Sesaxeb“. 243 Tavi 8: pacientis uflebebis dacvis procedurebi gancxadeba an/da saCivari SeiZleba saxalxo damcvels gamoegzavnos fostiT an moqalaqem uSualod miitanos saxalxo damcvelis ofisSi. saxalxo damcveli gancxadebis an/da saCivris ganxilvisas droSi SezRuduli ar aris. gancxadebis ganxilvisTvis saWiro dro damokidebulia masSi dafiqsirebuli problemis Sinaarssa da sirTuleze. xSirad sxva uwyebebisgan saCivarTan dakavSirebuli damatebiTi dokumentaciis gamoTxovis gamo, saCivris ganxilvisTvis saWiro dro xangrZlivdeba. saqarTvelos nebismier moqalaqes, romelic cxovrobs saqarTvelos sazRvrebs gareT, magram Tvlis rom misi uflebebi dairRva saqarTvelos saxelmwifo xelisuflebis, adgilobrivi TviTmmarTvelobis organoebis, saxelmwifo da arasaxelmwifo organizaciebis, dawesebulebebis, sawarmoebis, Tanamdebobisa da iuridiul pirebis mxridan _ SeuZlia mimarTos saxalxo damcvels. nebismieri moqmedeba, romliTac Tqven sakuTari an sxvisi uflebebis dacvas ecdebiT maSin, roca bavSvis mimarT Zaladoben, roca gansxvavebuli Sexedulebis mqone adamians devnian, xandazmulis uflebebs arRveven, dasaqmebuls usamarTlod epyrobian, patimars awameben an araadamianurad epyrobian, umciresobaSi myof moqalaqeebs aviwroeben, gansxvavebebis gamo uflebas arTmeven, Tavisuflebas ukanonod uzRudaven _ aris moqmedeba adamianis uflebebis dacvisTvis da Sesabamisad mxardaWera ombudsmenis institutis funqcionirebisadmi. 244 adamianis uflebebi janmrTelobis dacvis sferoSi 245 246 adamianis uflebebi janmrTelobis dacvis sferoSi terminTa saZiebeli romelia janmrTelobasa da adamianis uflebebTan dakavSirebuli ZiriTadi terminebi? specialur terminTa leqsikoni qvemoT mocemuli terminebi dakavSirebulia janmrTelobasa da adamianis uflebebTan, iseve rogorc adamianis uflebebTan zogadad. adamianis uflebebi (Human rights) uflebebi, Tavisuflebebi da privilegiebi, romelic yvela adamians ekuTvnis miuxedavad iurisdiqciisa an sxva faqtorebisa, rogoricaa warmomavloba, erovnuloba, religia, Tu sqesi. adamianis uflebebis indikatorebi (Human rights indicators) kriteriumebi, romelsac iyeneben adamianis uflebaTa saerTaSoriso standartebTan Sesabamisobis gasazomad. 247 terminTa saZiebeli anderZi (Will) iuridiuli dokumenti, romelic pirovnebas SesaZleblobas aZlevs sakuTari qonebis nebismieri nawili an nebismieri specifikuri pozicia dautovos nebismier sxva pirovnebas an organizacias. anderZi sicocxlis Sesaxeb (Living will) iuridiuli dokumenti, romelic gansazRvravs samedicino daxmarebis mimarTulebas pacientis survilisda Sesabamisad. anderZi sicocxlis Sesaxeb mxolod im SemTxvevaSi gamoiyeneba, Tu pacients TviTon aRar SeuZlia gadawyvetilebebis miReba da is zedmiwevniT ise xorcieldeba, rogorc amas pacienti dokumentSi uTiTebs. ar gamacocxloT brZanebebi (Do-Not-Resuscitate (DNR) orders) DNR warmoadgens samedicino direqtivas, romlidanac gamomdinareobs pacientis, misi advokatis an eqimis Tanxmoba, rom pacients ar umkurnalon gulis an sunTqvis SeCerebis SemTxvevaSi. es direqtiva gamoiyeneba, rodesac pacientis mkurnaloba pacientis sicocxlis gaxangrZlivebisTvis sasurvel Sedegs an warmatebas ver moitans. rogorc wesi, es mZime da ganukurnebel daavadebebsa da xandazmulTa SemTxvevebs exeba. es direqtivebi ar gulisxmobs, rom maameblur zomebze uari iqneba gacxadebuli. aucilebeli medikamentebi (Essential medicines) medikamentebi, romelic akmayofilebs mosaxleobis janmrTelobis dacvis prioritetul moTxovnilebebs. aucilebeli medikamentebi nebismier dros adekvaturi raodenobiT, saTanado dozirebuli formiT, garantirebuli xarisxiTa da individualuri pirovnebebisa da sazogadoebisaTvis misaReb fasebSi unda iyos xelmisawvdomi. hospisuri mzrunveloba (Hospice care) mzrunveloba, romlis mizania ganukurnebeli daavadebis bolo fazaSi myofi adamianebis mxardaWera, maTTvis komfortis Seqmna da sicocxlis xarisxis gaumjobeseba, vidre gankurneba. mizans warmoadgens is, rom pacientebma komfortulad da tkivilisgan ganTavisuflebulad igrZnon Tavi. hospisis filosofiaa adamianze izrunos pacientis emociuri, socialuri da sulieri moTxovnilebebis dakmayofilebisa da samedicino simptomebze reagirebis meSveobiT. evTanazia (Euthanasia) es aris samedicino daxmarebis gziT mokvdinebis praqtika. umetesoba qveynebSi evTanazia ukanono qmedebaa. 248 adamianis uflebebi janmrTelobis dacvis sferoSi terminTa saZiebeli `ukurnebeli daavadebis sikvdiliswina stadiaSi myofi avadmyofis sicocxlis ganzrax Sewyveta misive TxovniT~.1 globaluri fondi (Global fund) abreviatura Sidsis, tuberkulozisa da malariis winaaRmdeg brZolis globaluri fondis aRsaniSnavad, romelic warmoadgens centralur globalur meqanizms aiv/Sidsis erovnuli reagirebis programebis dasafinanseblad mdidar da Rarib qveynebs Soris fondebis ganawilebis kuTxiT. grZelvadiani mindobiloba (Durable power of attorney) gardacvalebis piras myof adamians SeuZlia daniSnos nebismieri warmomadgeneli, vinc maT finansebs marTavs da maTi saxeliT miiRebs gadawyvetilebebs. aseT adamians moixsenieben, rogorc `agents.~ damatebiTi Terapiebi (Complementary therapies) midgomebi mkurnalobis mimarT, romelic ar jdeba ZiriTad samedicino praqtikaSi. tkivilis sawinaaRmdegod an simSvidis mosagvrelad gamoyenebuli damatebiTi Terapiis mkurnalobis kursebi moicavs: nemsiT Terapia, dabali donis lazeruli Terapia, meditacia, aromatuli Terapia, Cinuri medicina, cekvis Terapia, musikis Terapia, masaJi, samkurnalo mcenareebis medicina, Terapevtuli Sexeba, ioga, osteopaTia, qiropraqtikuli mkurnaloba, naturopaTia da homeopaTia. damokidebuleba (Addiction) farTod gamoyenebuli termini, romelic aRniSnavs medikamentebis gamoyenebis iseT formas, rom aSkaraa fizikuri an fsiqikuri damokidebuleba. es ar aris diagnostikuri termini da amitom mas jandacvis msoflio organizacia aRar iyenebs. eTika (Ethics) moraluri principebisa da wesebis sistema, romelic profesiuli qcevis standartebad gamoiyeneba. mraval saavadmyofosa da jandacvis sxva dawesebulebaSi funqcionireben eTikis komitetebi, romelic exmareba eqimebs, jandacvis sferos sxva muSakebs, pacientebsa da ojaxis wevrebs mkurnalobasTan dakavSirebuli rTuli gadawyvetilebebis miRebaSi. aseTi daxmareba sasuliero da kulturuli aspeqtebis gaTvaliswinebiT SeiZleba gansxvavebulic iyos. 1 kanoni `janmrTelobis dacvis Sesaxeb~, muxli 3 249 terminTa saZiebeli maqsimaluri xelmisawvdomi resursebi (Maximum available resources) ekonomikuri, socialuri da kulturuli uflebebis saerTaSoriso paqtis me-2 muxlis ZiriTadi debuleba, romelic avaldebulebs saxelmwifoebs moaxmaron maqsimaluri xelmisawvdomi resursebi ekonomikuri, socialuri da kulturuli uflebebis dacvasa da realizebas. mzrunvelobis Sewyveta (Withdrawing care) pacientTan mimarTebaSi ukve dawyebuli mkurnalobis procesis Sewyveta. monitoringi/faqtebis moZieba/gamoZieba (Monitoring/fact finding/investigation) xSirad sinonimebad gamoyenebuli terminebi, romelic zogadad aRniSnavs adamianis uflebebTan dakavSirebuli xelisuflebis praqtikisa da qmedebebis Sesaxeb informaciis moZiebasa da/an Segrovebas. negatiuri uflebebi (Negative rights) saxelmwifoTa valdebuleba Tavi Seikavon pirovnebis mxridan raimes gakeTebis mcdelobaSi Carevisgan. opioidi (Opioid) opiumTan dakavSirebuli narkotikuli medikamentis saxeoba. opioidebi warmoadgens Zlier tkivilgamayuCebel saSualebas, romelsac mwvave da qronikuli tkivilebis dros iyeneben. opioidebi moicavs morfs, kodeins da sinTetiuri (adamianis mier gamogonili) narkotikuli saSualebebis did raodenobas, rogoricaa metadoni da fentanili. paliatiuri mzrunveloba (Palliative Care) aqtiuri, mravalprofiluri mzrunveloba, romlis upirvelesi amocanaa tkivilisa da sxva paTologiuri simptomebis moxsna, avadmyofTa socialuri da fsiqologiuri daxmareba, sulieri Tanadgoma. igi vrceldeba im pacientebze, romelTa daavadeba mkurnalobas aRar eqvemdebareba; aseTi mzrunvelobiT SesaZlebelia avadmyofisa da maTi ojaxebis cxovrebis xarisxis gaumjobeseba pativiscema, dacva da Sesruleba (Respect, protect, and fulfill) saxelmwifoTa valdebulebebi uflebebTan mimarTebaSi. pativiscema: saxelmwifoebma ar unda imoqmedon pirdapir adamianis uflebaTa standartebis sawinaaRmdegod. dacva: saxelmwifom unda imoqmedos, raTa SeaCeros sxvebi adamianis uflebaTa standartebis darRvevebisgan. Sesruleba: saxelmwifos aqvs pozitiuri valdebuleba miiRos Sesabamisi zomebi raTa uzrunvelyos, rom adamianis uflebaTa standartebi iyos miRweuli. 250 adamianis uflebebi janmrTelobis dacvis sferoSi terminTa saZiebeli pozitiuri uflebebi (Positive rights) saxelmwifoTa valdebuleba moimoqmedon raime vinmesaTvis. progresuli realizacia (Progressive realization) valdebuleba, rom saxelmwifoebma SeZlebisdagvarad Tanmimdevrulad da efeqturad imoqmedon ekonomikuri, socialuri da kulturuli uflebebis realizebisaTvis da uzrunvelyon, rom adgili ar hqondes movlenaTa regresul ganviTarebas. saxelmZRvanelo principebi (Guidelines) abreviatura aiv/Sidsisa da adamianis uflebaTa Sesaxeb saerTaSoriso saxelmZRvanelo principebis aRsaniSnavad. es principebi warmoadgens arasavaldebulo samarTlebriv da politikis formirebis rekomendaciebis avtoritetul krebuls, romelic 1998 wels UNAIDS-ma da adamianis uflebaTa umaRlesi komisris ofisma (OHCHR) gamosces. stigma da diskriminacia (Stigma and discrimination) aiv/SidsTan dakavSirebul stigmasa da diskriminacias gaerTianebuli erebis organizaciam uwoda `udidesi barieri, romelic xels uwyobs Semdgom inficirebas da xels uSlis adekvaturi movlis, mxardaWerisa da mkurnalobis uzrunvelyofas~. diskriminacia stigmatizaciis Sedegia. stigma `warmoadgens Zlier madiskreditirebel socialur iarliys, romelic radikalurad cvlis individTa Sexedulebas sakuTari Tavisa da sxvaTa Sexedulebas am pirovnebebis Sesaxeb~. stigmatizirebuli adamianebi, rogorc wesi iTvlebian gansxvavebulad an sasircxvilod ama Tu im mizezis gamo, da Sedegad isini arian diskreditirebulni, uaryofilni, SezRudulebi an dasjilni. rogorc aseTi, stigma warmoadgens socialuri da kulturuli normebis gamoxatvas, romelic ayalibebs adamianTa Soris urTierTobebs am normaTa Sesabamisad. stigma aRniSnavs sazRvrebs, romelsac sazogadoeba `normalurebsa~ da `gariyulTa~, `Cvensa~ da `maT~ Soris qmnis. diskriminacia aiv/Sidsis konteqstSi ganmartebulia, rogorc `nebismieri zoma, romelsac moyveba pirovnebaTa nebismieri TviTneburi gansxvaveba maTi damtkicebuli Tu saeWvo aiv serostatusis an janmrTelobis mdgomareobis safuZvelze~. diskriminacia SeiZleba iyos legitimuri da aralegitimuri: aralegitimuri diskriminacia aris gaumarTlebeli, araproporciuli da TviTneburi. • • • zoma an qmedeba gaumarTlebelia, Tu mas ar axlavs racionaluri da obieqturi mizezebi. zoma an qmedeba araproporciulia, Tu gamoyenebuli saSualebebi da maTi Sedegebi scdeba an ver aRwevs dasaxul miznebs. zoma an qmedeba TviTneburia, Tu adamianis uflebebs mZimed arRvevs da is sxvaTa janmrTelobis dasacavad saWiro ar aris. 251 terminTa saZiebeli urTierTdamokidebuli/ganuyofeli (Interdependent/indivisible) termini, romelic gamoiyeneba samoqalaqo da politikur uflebebsa da ekonomikur da socialur uflebaTa Soris urTierTobis aRsaniSnavad. urTierTdamokidebuleba da ganuyofloba gulisxmobs, rom uflebaTa erT nawils ar aqvs upiratesoba meoresTan SedarebiT, da rom uflebaTa erTi nawilis dacva damokidebulia meore nawilis dacvaze. Rirseba (Dignity) Rirebulad, pativSi an dafasebulad yofnis Tviseba. adamianis uflebebi pirovnebis xelSeuval Rirsebas efuZneba da miznad mis dacvasa da xelSewyobas isaxavs. winaswari samedicino direqtivebi (Advance medical directives) gamoiyeneba, raTa sxva adamianebs, maT Soris jandacvis sferoSi momsaxurebis mimwodeblebs gadascen informacia pacientis survilis Sesaxeb samedicino daxmarebasTan dakavSirebiT. winaswari direqtivebi Zalze mniSvnelovania im SemTxvevaSi, Tu pacientebs fizikuri an fsiqikuri SezRudvebis gamo ar SeuZliaT TviTon metyveleba da sakuTari survilebis gadmocema. winaswari direqtivebis yvelaze farTod gavrcelebuli formaa anderZi sicocxlis Sesaxeb da grZelvadiani mindobiloba jandacvis sferoSi. `ar gamacocxloT~ aseve winaswari samedicino direqtivis erT-erTi formaa. jandacvis sferoSi rwmunebuli (Health care proxy) werilobiTi dokumenti, romlis meSveobiTac piri kanonierad axdens sxva pirovnebaze uflebamosilebis delegirebas, miiRos maTi saxeliT janmrTelobasTan dakavSirebuli garkveuli gadawyvetilebebi. janmrTelobis dacvis dawesebuleba (Health care establishment) jandacvis nebismieri dawesebuleba, rogoricaa saavadmyofo, kerZo klinika, an dawesebuleba SezRuduli SesaZleblobebis mqone pirTaTvis (WHO). janmrTelobis dacvis momsaxurebis mimwodeblebi (Health care providers) eqimebi, medda, stomatologi an jandacvis sferos sxva profesionalebi (WHO). janmrTelobis dacvis sistema (Health care system) janmrTelobis dacvis sferoSi momsaxurebaTa organizebuli uzrunvelyofa. 252 adamianis uflebebi janmrTelobis dacvis sferoSi praqtikuli saxelmZRvanelo `adamianis uflebebi janmrTelobis dacvis sferoSi~ aris praqtikuli gzamkvlevi iuristebisTvis adamianis uflebebis Sesaxeb jandacvis sferoSi. TiToeuli Tavi moicavs informacias rogorc pacientebis, ise jandacvis provaiderebis uflebebisa da movaleobebis Sesaxeb, aseve am uflebebis realizaciisa da dacvis procedurebs saerTaSoriso, evropul da erovnul doneze. saxelmZRvanelo warmoadgens sxvadasxva konsituciuri debulebebis, sakanonmdeblo aqtebisa da regulaciebis pirvel krebuls, romelic dalagebulia uflebebisa da movaleobebis mixedviT da Seicavs Sesabamis praqtikul magaliTebs. wignSi mocemulia davis gadaWris rogorc sasamarTlo, ise sxva alternatiuli meqanizmebi, rogoricaa ombudsmeni da eTikis komitetebi. praqtikuli saxelmZRvanelo warmoadgens sasargeblo sainformacio wyaros im regionSi moRvawe iuristebisa da sxva specialistebisaTvis, romlisTvisac damaxasiaTebelia sakanonmdeblo bazis xSiri cvla. saxelmZRvanelos sruli seriis naxva SesaZlebelia vebgverdze www.health-rights.org foto ydaze: robert lizaki
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