The Code of Professional Ethics of the Medical Worker of Healthcare of the Sverdlovsk Region (hereinafter - the Code) is a document that defines the set of ethical standards and principles of behavior of a medical worker in the implementation of professional medical activity.

The norms of professional ethics of a medical worker are established on the basis of cultural norms, constitutional provisions and legislative acts Russian Federation, norms of international law. This Code defines a high moral responsibility of a medical worker to society and the patient for their activities. Every healthcare professional must take all necessary steps to comply with the provisions of the Code.

SECTIONI... General Provisions

Article 1. The concept of "medical worker"

A medical worker in accordance with clause 13 of Article 2 of Federal Law No. 323-FZ "On the Basics of Health Protection of Citizens in the Russian Federation" in this Code means an individual who has a medical or other education, works in a medical organization and in labor (official) whose duties include the implementation of medical activities, or an individual who is an individual entrepreneur directly carrying out medical activities.

Article 2. Purpose of professional activity

The purpose of a medical worker's professional activity is to preserve a person's life, to participate in the development and implementation of measures to protect his health within the competence of a medical worker, to properly provide all types of diagnostic, therapeutic, preventive, rehabilitation and palliative medical care.

Article 3. Principles of Operation

The healthcare professional must use all his knowledge and practical skills, in accordance with the level vocational education and qualifications for protecting the health of citizens, ensuring the quality of the assistance provided to them at a high level.

A medical worker is obliged to provide equally respectful medical care to any person, regardless of gender, age, race and nationality, place of residence, his social status, religious and political beliefs.

The actions of a medical worker, his convictions and orientation during the transplantation of human organs and tissues, intervention in the human genome, in the reproductive function are determined by the ethical, legal and legislative acts of the Russian Federation.

A medical worker is obliged to constantly improve his professional knowledge and skills.

The medical worker bears responsibility, including moral, for providing high-quality and safe medical care in accordance with his qualifications, accepted clinical guidelines, job descriptions and official duties.

Given the role of the healthcare professional in society, he / she should support and participate in community activities, especially to promote healthy lifestyles.

Article 4. Unacceptable actions of a medical worker

The misuse of the knowledge and position of a health worker is incompatible with his professional activity.

A medical worker is not entitled to:

to use their knowledge and capabilities not to protect human health;

use methods of medical influence on the patient at the request of third parties;

to impose their philosophical, religious and political views on the patient;

use unregistered in established order medical equipment;

prescribe and use pharmacological preparations not registered in the Russian Federation;

to impose on patients one or another type of treatment, drugs for personal gain;

cause physical, moral or material damage to the patient, intentionally or through negligence, indifferently to the actions of third parties causing such damage.

Personal prejudices of a healthcare professional and other subjective motives should not influence the choice of diagnostic and treatment methods.

When prescribing a course of treatment, a medical worker is not entitled to provide a patient with inaccurate, incomplete or distorted information about the drugs and medical devices used.

The refusal of the patient from the offered paid medical services cannot be the reason for the deterioration in the quality and availability, decrease in the types and volume of medical care provided to him free of charge under the program of state guarantees, established by law Russian Federation.

Gifts from patients and patients are highly discouraged because they can create the impression that patients who do not give or receive gifts are being given less care. Gifts should not be given or accepted in exchange for services.

A medical worker has no right, taking advantage of his professional position, mental incapacity of the patient, to conclude property transactions with him, to use his labor for personal purposes, as well as to engage in extortion and bribery.

The medical worker has no right to hide information about the patient's health from the patient. In the event of an unfavorable prognosis for the patient's life, the medical professional should inform the patient about this very delicately and carefully, provided that the patient has expressed a desire to receive such information.

A medical worker has no right to hide information about the development of medico-technogenic pathology, unforeseen reactions and complications during treatment from the patient and the immediate supervisor.

Article 5. Professional independence

It is the medical professional's duty to maintain their professional independence. Providing medical care, a medical professional assumes full responsibility for a professional decision, and therefore must reject any attempts to pressure from the administration, patients or other persons.

The medical professional has the right to refuse to cooperate with any physical or legal entityif it requires him to act contrary to legislation, ethical principles, professional duty.

By participating in consultations, commissions, consultations, examinations, etc., a medical worker is obliged to clearly and openly declare his position, defend his point of view, and in cases of pressure on him - resort to public and legal protection, as well as protection from outside professional medical communities.

SECTIONII... The relationship between the healthcare professional and the patient

Article 6. Respect for the honor and dignity of the patient

The medical worker must respect the honor and dignity of the patient, show an attentive and patient attitude towards him and his relatives. A rude and inhumane attitude towards a patient, humiliation of his human dignity, as well as any manifestations of superiority, aggression, hostility or selfishness, or expression of preference for any of the patients on the part of a medical professional is unacceptable.

Article 7. Conditions for the provision of medical care

The medical professional must provide medical care in the conditions of preserving the principles of freedom of choice and human dignity of the patient.

Anyone who requires emergency medical care for conditions requiring emergency medical intervention (in case of accidents, injuries, poisoning and other conditions and diseases that threaten life) must be accepted and examined by medical workers, taking into account the specialty and regardless of the ability to pay and the availability of medical insurance. policy.

Article 8. Conflict of interest

In the event of a conflict of interest, the healthcare professional should give preference to the interests of the patient, unless their implementation causes direct harm to the patient himself or others.

Article 9. Medical secrecy

The patient has the right to count on the fact that the medical professional will keep secret all medical and personal information entrusted to him. A medical worker has no right to disclose information obtained during examination and treatment, including the very fact of seeking medical help, without the permission of the patient or his legal representative. The healthcare professional must take measures to prevent the disclosure of medical confidentiality. The death of a patient does not exempt from the obligation to keep medical confidentiality. The transfer of information containing medical secrets is allowed in cases provided for by the legislation of the Russian Federation.

Article 10. Moral support for a patient near death

A medical worker should not resort to euthanasia, as well as involve other persons in its execution, but must alleviate the suffering of patients in a terminal state by all available, known and authorized methods. A medical worker must assist the patient in exercising his right to benefit from the spiritual support of a minister of any religious denomination; he must respect the rights of citizens regarding the conduct of a posthumous examination, taking into account the current legislation of the Russian Federation.

Article 11. Choice of a medical professional

A medical professional has no right to prevent a patient who decides to entrust his further treatment to another specialist. A healthcare professional may recommend another specialist to a patient in the following cases:

if he feels insufficiently competent, does not have the necessary technical capabilities to provide the proper type of assistance;

this type of medical care is contrary to the moral principles of a specialist;

if there are contradictions with the patient or his relatives in terms of treatment and examination.

SECTIONIII... The relationship of healthcare professionals

Article 13. Relationship between healthcare professionals

The relationship between healthcare providers should be based on mutual respect and trust.

In relations with colleagues, a healthcare professional must be honest, fair, benevolent, decent, respect their knowledge and experience, and also be ready to disinterestedly transfer his experience and knowledge to them.

The moral right to lead other health professionals requires a high level of professional competence and high moral standards.

Criticism against a colleague should be reasoned and not offensive. Professional actions are subject to criticism, but not the personality of colleagues. Attempts to strengthen one's own authority by discrediting colleagues are inadmissible. A healthcare professional has no right to make negative statements about his colleagues and their work in the presence of patients and their relatives.

In difficult clinical cases, experienced healthcare professionals should advise and assist less experienced colleagues in the correct manner. In accordance with the current legislation, only the attending physician bears full responsibility for the treatment process, who has the right to accept the recommendations of colleagues or refuse them, guided solely by the interests of the patient.

SECTIONIV... The scope of the Code, responsibility for its violation, the procedure for its revision

Article 14. Validity of the Code

This Code is valid throughout the Sverdlovsk Region.

Article 15. Liability of a medical worker

The degree of responsibility for violation of professional ethics is determined by the Medical Ethics Commission under the Ministry of Health of the Sverdlovsk Region and ethics commissions in health care organizations.

If the violation of ethical norms simultaneously affects legal norms, the medical professional is liable in accordance with the legislation of the Russian Federation.

Article 16. Revision and interpretation of the Code

Revision and interpretation of certain provisions of this Code is carried out by the Ministry of Health of the Sverdlovsk Region, taking into account the proposals of the trade union of health workers of the region, the Associations of medical workers and the medical professional association of doctors of the Sverdlovsk region

A person spends at least 20% of his life at work. When we come to work, we want to feel comfortable. Unfortunately, not a single working day goes by without stress. Working life and conflicts between employees darken. The employer finds himself in a difficult situation when it is necessary not only to resolve the conflict, but also to punish the instigator.

Today, many employers include ethical provisions in the organization's local regulations, for example, the need to be friendly with clients, respectful of colleagues, etc. And if the first is the responsibility of employees and is not subject to discussion, then the second remains on their conscience and is their personal matter.

It is not within the competence of the employer to regulate relations between employees. Does this mean that you cannot punish an employee, for example, for criticizing a colleague? Consider an example from judicial practice.

Situation

K. worked as deputy director for teaching and educational work in an educational institution. During a regular meeting, she criticized the work of one of her colleagues - V., and after the meeting she expressed her negative attitude towards her during a personal conversation. V., believing that she had been insulted, wrote a memo addressed to the director with a request to bring K. to disciplinary responsibility. The employer issued an order to impose a disciplinary sanction on the deputy director K. in the form of a remark for violating the internal labor regulations (during working hours he distracts workers with extraneous conversations, discusses and criticizes the work of colleagues, makes comments regarding the personal and professional qualities of workers). This was not the first order to impose a disciplinary sanction; earlier K. was also brought to disciplinary responsibility.

K. realized that the administration was preparing documents for her dismissal under paragraph 4 of Art. 42 of the Labor Code of the Republic of Belarus (hereinafter - TC) (for systematic failure by an employee without good reason duties), and applied to the court with a request to remove the last disciplinary sanction from her.

The court of first instance found the employer's actions unlawful and found that K. had not violated labor discipline.

The employer's disciplinary order was revoked. The employer did not agree with the court decision and appealed against it. The regional court upheld the decision of the district court, considering that even if criticism of a colleague violates ethical norms, it is not a misdemeanor for which an employee can be brought to disciplinary responsibility.

Arguments of the parties

In the statement of claim K. asked the court to recognize the order declaring her remarks unlawful, since she had not committed a disciplinary offense. To the court K. explained that the order to impose a penalty on her was issued in connection with the fact that she had allegedly humiliated the honor and dignity of the employee of the educational institution, first at a meeting, and then during communication with her. The deputy director argued that she did not want to offend the honor and dignity of her colleague in any way, but only wanted to find out what claims she had about her work, and therefore considers it illegal to impose a disciplinary sanction on the grounds specified in the order.

At the hearing, representatives of the educational institution did not agree with the plaintiff's claims and asked the court to refuse to satisfy them. At the same time, they explained to the court that during the production meeting K. had criticized V., which affected her honor and dignity.

Then, in a personal conversation with V., the deputy director allowed herself to express a negative attitude towards her, which was the reason for V.'s writing a memorandum addressed to the director of the educational institution on taking measures against K., which was done. The director of the educational institution was sure that K., with her unworthy behavior, had violated the rules of the internal labor regulations of the educational institution. The rules stipulated that it was forbidden to distract workers from fulfilling their job responsibilities conversations on extraneous topics not related to work, insult colleagues, discuss and criticize their work, accuse of ignorance and misunderstanding of the functions assigned to them, job responsibilities... D. was summoned as a witness, who confirmed that the relationship between K. and V. had been tense.

For reference: the employer must submit evidence to the court, indicating not only that the employee committed a disciplinary offense, but also that the severity of this offense and the circumstances in which it was committed were taken into account when imposing a penalty.

The position of the court of first instance

After hearing the explanations of the parties, the testimony of witnesses and examining the case materials, the court found out that the basis for issuing the order to announce the comment was V.'s memorandum addressed to the director of the educational institution, which said that K. had accused her of misbehavior and distracted her from work. All of K.'s statements were perceived by V. as an interference in his personal life, an insult to his personal and business qualities. This circumstance was confirmed in the court session by witness D., who said that V. was brought to tears by a conversation with K.

The court considered that the existence of hostile relations between the workers was in no way connected with the performance of one of them of their labor duties.

Thus, the court, having studied and evaluated the evidence collected in the case, came to the conclusion that the administration of the educational institution brought K. to disciplinary responsibility unlawfully.

The internal labor regulations of the educational institution actually regulate interpersonal relations between employees, and not labor relations between an employer and an employee, therefore, their violation, in the opinion of the court, cannot entail disciplinary action. The court canceled the order to announce K.'s remarks.

The decision of the court of the cassation instance

The administration of the educational institution appealed against the decision of the court of first instance. The Judicial Collegium for Civil Cases of the Regional Court agreed with the findings of the District Court. According to the judicial board, the provisions of the internal labor regulations of an educational institution regulate ethical, interpersonal relations between employees, and therefore their violation is a violation of ethical standards, and not a disciplinary offense, for the commission of which it is possible to bring to disciplinary responsibility.

The deputy director for teaching and educational work belongs to the category of managers, whose duties include, among other things, coordinating the work of teaching staff, as well as submitting comments on the activities of individual employees of the institution to the director of the institution. Considering the above, the conclusion of the court of first instance about the illegality of the order to bring K. to disciplinary liability in the form of a remark for violation of the rules of the internal labor regulations, the regional court considered correct and upheld the decision.

Exception to the general rule

Despite the fact that for most employees, violation of the rules of conduct in the team cannot be regarded as an official misconduct, there are professions in which failure to comply with ethical standards and rules of official conduct should be considered as a violation of the rules of labor discipline.

In any case, when imposing a disciplinary sanction, employers must comply with the requirements of Art. 198, 199, 200 TC.

You can punish an employee:

For unlawful, guilty failure or improper performance by the employee of his job duties;

Violation of labor discipline.

In this case, the severity of the disciplinary offense, the circumstances under which it was committed, the previous work and the employee's behavior in production should be taken into account.

For employees who have committed a disciplinary offense, regardless of the application of disciplinary measures, the deprivation of bonuses, changing the time of granting labor leave and other measures. The types and procedure for applying these measures should be determined by the internal labor regulations, collective bargaining agreements, agreements, and other local regulatory legal acts.

A medical worker is an individual who has a medical or other education, works in a medical organization, whose duties include the implementation of medical activities, or an individual who is individual entrepreneur and conducts activities in the field of medicine. The main task is to improve health and preserve human life. Thus, a respectful attitude towards each patient is determined. Medical workers, carrying out their labor function, in accordance with the Labor Code of the Russian Federation (hereinafter referred to as the Labor Code of the Russian Federation), have certain duties of the employee and are responsible for violation of labor discipline, internal labor regulations.

In carrying out their duties, "guardians of health" must comply with the rules of medical ethics. However, there are problems related to the professional ethics of the healthcare professional, both internationally and nationally. It is believed that the basic principles of medical ethics were formulated by Hippocrates. These principles are as follows1: 1. The principle of harmlessness, concern for the benefit of the patient, dominant interests of the patient. 2. The principle of careful informing of the patient, allowing him to misinform. 3. The principle of respect for life, a negative attitude towards euthanasia, aiding in suicide, and abortion. 4. Obligation to refuse intimate relations with patients. 5. The principle of medical secrecy and confidentiality. 6. Obligation to teachers. 7. Obligation to impart knowledge to students and to consult with colleagues. 8. Commitments to professional and moral self-improvement and decency. It is obvious that the principles indicated by Hippocrates put the rights and interests of citizens at the head. Exploring the legal doctrine, a certain picture of the professional ethics of medical workers is being formed. I.V. Parish, A.A. Rybalchenko in his work "Fundamentals of Medical Ethics and Deontology" notes that for the optimal implementation of the principles of medical deontology, the following conditions are necessary: \u200b\u200bvocation, tact, intelligence, citizenship. A medical worker must always remember the patient, have the ability to conquer and subdue the soul of the patient2. In addition, researcher T.A. Kornaukhova is in solidarity with the attitudes of Hippocrates and believes that the main principle of the model of medical ethics of Hippocrates is the maxim "do no harm." This principle acts as a regulator of the civil component of a doctor's professional ethics3. Also investigated this problem

V. N. Saperov in his work “Bioethics or Medical Ethics? Basic Principles of Medical Ethics ”, where he points out that the principles of professional ethics of medical workers contain the following principles:“ The main thing is not to harm ”,“ Do good ”, the principle of respect for patient autonomy and the principle of justice1.

In addition to the above researchers, the problem of medical ethics was studied by such scientists as A.V. Yaroslavtseva, I.B. Ganshin, N.A. Shergeng, etc. Referring to international acts regulating the professional ethics of medical workers, it must be said that this issue is very considerable attention. Thus, Article 3 of the Global Code of the World Health Organization (hereinafter WHO) on the practice of international recruitment of health personnel states that the health of all people is an essential condition for achieving peace and security2. In addition, WHO emphasizes in its international code of medical ethics that 3: A DOCTOR SHOULD maintain the highest professional standards at all times. A DOCTOR SHOULD not allow considerations of self-interest to influence the freedom and independence of professional judgment, which should be made in the patient's best interest. A DOCTOR SHOULD prioritize compassion and respect for the patient's human dignity and be fully responsible for all aspects of health care, regardless of their professional specialization. A DOCTOR SHOULD be honest in dealing with patients and colleagues and fight those of his colleagues who are incompetent or found to be cheating.

These duties correspond to the principles of ethics established in due time by Hippocrates, where human interests are the highest value. As for the regulation of the issue of professional ethics at the national level, it should be noted that the Russian Federation also pays great attention to this. In accordance with the Constitution of the Russian Federation, a person, his rights and freedoms are the highest value, and everyone has the right to health protection and medical care4. These human and civil rights are exercised through the activities of medical organizations and medical workers who must comply with the rules of professional ethics.

Thus, the Code of Professional Ethics of a Doctor of the Russian Federation states that a doctor must provide high-quality, effective and safe medical care. He is obliged to take into account the advantages, disadvantages and consequences of various diagnostic and therapeutic methods. In the absence of a medical organization necessary conditions and resources, the physician is obliged to refer the patient to the appropriate medical facility1. In our opinion, each medical worker must perform his duties efficiently and effectively, taking into account the peculiarities of each specific situation. In addition, a lot of attention is paid to medical secrecy.

Article 8 of the Code of Professional Ethics of a Doctor of the Russian Federation contains a rule that medical secrecy refers to everything that a doctor becomes aware of while performing his professional duty. It is not allowed to disclose information constituting a medical secret without the permission of the patient or his legal representative, including after the death of a person, with the exception of cases provided for by Russian legislation. IN this actAs in others that regulate the professional ethics of medical workers at various levels, the highest value is the honor and dignity of the patient, and it is indicated that the treatment should take into account all the characteristics of his personality and treat his personal life and the right to confidentiality with respect2. In addition, it should be noted that a draft Code of Professional Ethics of a Medical Worker has been developed, which enshrines the obligation conscientious fulfillment their labor functions 3.

There is also the Federal Law "On the Fundamentals of Citizens' Health Protection", which, in turn, establishes the rules of professional ethics of a medical worker. It is necessary to pay attention to the fact that failure to fulfill any obligation by an employee working under an employment contract, or improper performance of a labor function in accordance with the Labor Code of the Russian Federation entails disciplinary liability in accordance with Article 192 of the Labor Code of the Russian Federation4. Likewise, the failure of a medical worker to comply with the norms of professional ethics provides for disciplinary responsibility for evasion or poor-quality performance of his duties5. But in the latter case, a medical worker can be brought to administrative and criminal liability, in addition to disciplinary, since human life and health are serious. The RF Code of Administrative Offenses establishes in Article 13.11 "Violation of the procedure for collecting, storing, using or disseminating information about citizens (personal data)" 6, administrative responsibility, and Article 137 of the Criminal Code of the Russian Federation provides for liability for "Violation of privacy" 7, where under the inviolability of private life is meant the disclosure of information constituting a medical secret by a person to whom this information became known in connection with the performance of his official or professional duties. However, despite the responsibility, health care workers do not comply with the established norms, which is a huge problem. On this issue there is a wide one. Thus, the Khabarovsk Regional Court issued an appeal ruling No. 33-5145 / 2016 of August 12, 2016 in case No. 33-5145 / 2016 in the case of recognizing an order to bring to disciplinary liability for non-compliance with continuity in treatment, violation of ethical and deontological norms of behavior the doctor is illegal. By the decision of the Industrial District Court of Khabarovsk dated April 26, 2016, the claims were rejected.

The Judicial Collegium of the Khabarovsk Regional Court determined that the decision of the Industrial District Court of Khabarovsk of April 26, 2016 in a civil case on a claim to declare the order to bring disciplinary liability unlawful, to recover compensation for moral harm should be left unchanged, and the appeal without satisfaction1. So, the professional ethics of medical workers is an important component of the legal norms governing their activities, since citizens engaged in labor activities in the field of protecting human health and life must strictly observe the established rules for high-quality and professional care. In order to ensure compliance with the rules of professional ethics of medical workers, we believe that it is necessary to tighten the rules establishing responsibility for their violation.

F.F. Karimova

in professional activities
medical professionals

interpersonal and professional
the relationship of healthcare professionals and their responsibilities

Compliance with ethical standards in the process of professional activity of medical workers in the conditions of modern biomedicine is a complex matter and requires a high level of moral self-awareness from every medical worker. The relationship of a nurse and a medical assistant with patients and colleagues should be built in accordance with the principles of biomedical ethics. This requirement is fixed in the international and Russian codes of nursing.

The Code of Ethics of the International Council of Nurses, in accordance with the principle of respect for the rights and dignity of the patient, says: "When providing care, the nurse tries to create an atmosphere of respect for the values, customs and spiritual beliefs of the patient."
In the Ethical Code of Nurses in Russia, the problem of the relationship between a nurse and patients takes a leading place. All the ethical requirements set out in the section "Nurse and Patient" reveal the fundamental principles of biomedical ethics: respect for the rights and dignity of the patient and the principle of "do no harm".
Responsibility for the patient, the client is the professional and ethical duty of the nurse. The "Code of the International Council of Nurses" says: "The nurse, like other citizens, is responsible for implementing and supporting measures to meet public health needs." Nurse responsibility indicates what she is doing for the patient, whether she is acting for the benefit of the patient. The nurse has the right to make independent decisions in her professional field. This means responsibility in making a professional decision. The Nurse is accountable for the quality of her work to the client, patient, family, work group, leaders and the whole community. The nurse is also legally responsible. She needs to comply with laws and other regulations on health and social protection.
The main ethical requirements include the obligation to maintain professional (medical) secrecy, which implies keeping secret all confidential information about the patient obtained in the course of the nurse's professional activities. Article 9 highlights the ethical requirements for communication and interaction with a dying patient.

There is currently no separate code of ethics for the medical laboratory technician in the field of biomedical ethical knowledge. Professional communication between a medical assistant and a patient has its own specifics. It is, as a rule, short-term, has the purpose of obtaining specific information about certain features of the patient's body, but at the same time should be carried out in accordance with modern ethical principles and norms of health workers.
Compliance with ethical principles and norms in relations with patients and their relatives requires taking into account both the type of disease and various psychological characteristics of the patient's personality, and the level of his education, age, sex, social status, conditions in which interaction and communication with them occurs. These characteristics of patients are well enough studied in medical psychology.

Professional medical and pharmaceutical associations monitor the observance of the principles and norms of professional ethics by medical workers. Article 62 of the "Fundamentals of the legislation of the Russian Federation on the protection of public health" says that these associations "take part in the development of medical ethics standards and the solution of issues related to the violation of these standards."
The Ethical Code of a Nurse of Russia in article 18 explains the issue of a nurse's responsibility for violating the norms and principles of this code. It says that such responsibility is determined by the Charter of the Association of Nurses of Russia and for violation of the Code, “the following penalties may be applied to the members of the Association: 1) a remark; 2) warning about incomplete professional compliance; 3) suspension of membership in the Association for up to one year; 4) expulsion from the members of the Association with the obligatory notification of this to the relevant certification (licensing) commission. "
The system of professional relations of a medical worker in the conditions of modern medicine includes various types of relationships, both with individuals and with various social groups and organizations. These are patients and their relatives, colleagues, representatives public organizations, law enforcement agencies, social assistance and protection agencies, health care institutions and education systems. With such a variety of relationships, a health worker can professionally competently build them only taking into account the psychological characteristics of the person with whom he interacts. Due to the variety of individual personal characteristics of patients, a medical professional must be able to choose and effectively use the model of interaction with a patient that is most suitable for each specific case.
Ethical requirements for the communication of a medical worker with a patient have been developed in medicine since ancient times. Reflections on these problems are contained in the writings of many prominent physicians, from the writings of Hippocrates to modern research in the field of bioethics. The principle of respect for the patient's personality, his rights and dignity was formulated in biomedical ethics relatively recently - in the second half of the 20th century, but it has actually been present in medical ethics since the beginning of its evolution. The ethical requirements of observing "medical secrets", not harming the patient, the direction of all the physician's activities for the benefit of the patient is a manifestation of respect for the patient's personality.

Due to the variety of individual personal characteristics of patients, a medical professional must be able to choose and effectively use the model of interaction with a patient that is most suitable for each specific case.
Relationships with colleagues among medical workers should be based on the principles of respect for the personality of a colleague, mutual assistance, benevolence, and focus on doing the job in the best possible way. The moral motive that unites health workers should be the benefit of the patient, and in a broader sense - the benefit of each person (patient's relative, colleagues, etc.). In reality, the moral principles and norms that guide medical professionals in relations with patients, their relatives and their colleagues are often far from the requirements of professional medical ethics. This sets the task of self-improvement of every medical worker, first of all in the moral sphere, which, in contrast to the area of \u200b\u200bspecial professional knowledge and skills, which makes it possible to occupy a certain position, receives insufficient attention.
The relationship between medical workers and patients, developing in the process of treatment and diagnostic measures, often takes on the character of intimacy, because the paramedic invades the areas of a person's life that hide from other people, their display causes a feeling of awkwardness, shyness, shame. These are both areas of the body and areas of human mental life. In this regard, both trusting relationships that contribute to the most effective treatment and intimate relationships that are considered unacceptable from the standpoint of professional medical ethics can form. This requirement of professional medical ethics was already recorded in the "Oath" of Hippocrates and continues to this day. For example, in 1991, the Committee on Ethical and Legal Issues of the American Medical Association, having considered the ethical aspects of the relationship between doctors and patients, made a special decision: intimate contact between a doctor and a patient that occurs during treatment is immoral.
The activities of a modern medical professional require a high level of personal professional responsibility from him. Professional responsibility of a medical worker is a complex phenomenon, which includes moral, administrative and legal responsibility.

Moral responsibility is a form of human conscience, which includes the analysis of one's own behavior (actions, feelings, relationships, etc.) and correlating it with ethically due. With regard to professional medical activity, moral responsibility is the correlation of real behavior with the standard set by the requirements of professional ethics and deontology.
The discrepancy between real and proper behavior is assessed as a failure to fulfill professional duty. Depending on the degree of inconsistency and the level of development of the moral self-consciousness of the health worker, remorse, actions aimed at eliminating this discrepancy, etc. follow. In case of significant violations of professional duty, punishment in the form of moral, administrative or legal sanctions may follow.
Professional medical associations, the medical community and society as a whole monitor the observance of the principles and norms of professional ethics and deontology by health workers. In the "Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens" in Articles 66 and 68, the responsibility of medical workers for causing harm to the health of citizens and violation of their rights in the field of health protection is fixed. Since harm can also be caused by non-compliance with professional ethical standards, the content of these articles of legislation should be considered as legal criteria for the responsibility of all medical and pharmaceutical workers for the performance of their professional duties in accordance with the principles and norms of medical ethics and deontology.

The problem of harming the patient.
Occupational risk in the activities of a health worker

Do no harm principle became a fundamental ethical requirement for physicians in their professional activities. But the paradox of medical activity lies in the fact that the patient's welfare is achieved through causing him a certain (in each case, its own) degree of harm. "There are patients who cannot be helped, but there are no patients who cannot be harmed."
With regard to medical activity, harm is negative consequencesthat arise as a result of the interaction and communication of medical workers, patients and their relatives.
In the course of medical activity, various types of harm can be caused to both the patient and medical workers. The harm to the patient can be material (costs of treatment, loss of earnings during illness, etc.), physical (damage to health due to professional errors, from the "side effects" of medical and diagnostic tools), psychological (iatrogenism, sorrogenism), social (disability, change in social status, quality of life, etc.), moral (disrespect for the patient's personality, insult, rudeness, neglect, etc.).
Basically harm to the patient inflicted without malice. If there are intentions to harm the patient, the actions of a medical worker move from the field of professional ethics to the field of law. Deliberately causing harm to another person, including a patient, is a crime that is punishable in accordance with applicable law and has a negative moral assessment.
Harm can be caused to a person not only by actions, but also by failure to perform them. Not helping a fallen person to get up (for example, slipping on ice) is to harm him. With regard to the activities of medical workers, this option of causing harm to a patient is manifested in the ethical and legal requirement to provide medical care to those in need in all life situations. Failure to provide medical assistance to a person who needs it is not only a violation of an ethical norm for a medical worker, but also an illegal act, for the violation of which serious punishment is provided. In the Criminal Code of the Russian Federation, such cases are qualified as “failure to provide assistance to the patient” (Article 124). It is a criminally punishable failure to act by medical workers that could (or have resulted in) the death of a person or other serious consequences.

The harm can be direct and indirect. Indirect harm is all the negative impacts on the patient that accompany the main actions of medical professionals. These include all the "side effects" arising from medical manipulations, the use of drugs, all biomedical technologies in general. Pain, allergic reactions, radiation, disturbances in the activity of the cardiovascular, neuro-endocrine, gastrointestinal and other systems of the body caused by the use of drugs and various biomedical technologies are forms of indirect harm caused in the process of providing medical care to people. Indirect harm is currently an integral part of most modern biomedical technologies for the treatment, diagnosis and rehabilitation of patients.
"Primum non nocere!" (“First of all, do not harm!”) Is a moral principle that allows medical workers to choose options for actions in which the greatest degree of benefit and the least degree of harm to the patient would be present.
Currently, there is an unshakable rule in medical practice: the measure of the benefit received must always exceed the measure of the harm caused. In other words: the patient's expected benefit from medical intervention must always exceed the harm caused to him. This rule is reflected in the famous phrase: "The medicine should never be bitter than the disease."
The moral and psychological harm caused to the patient when providing him with medical care is, although less noticeable, but no less significant for a person than physical or material.
Moral harm is inextricably linked with psychological, because awareness of insulting a person, disrespect for her, disregard for any of her rights, etc. is always accompanied by a variety of negative emotions, feelings and experiences.

Forms of behavior of doctors and nurses that cause moral and psychological harm to the patient are usually denoted by the concepts of iatrogenic and sorrogenic.
The concept of "iatrogeny" was introduced at the beginning of the twentieth century by the German psychiatrist O.Bumke. The concept of "iatrogenism" (jatros - doctor, gennao - to do, produce) is currently defined as a method of examination, treatment or preventive measures, as a result of which the doctor harms the patient's health. Iatrogeny is often understood as a physician-induced disease. Based on the literal translation of this word, iatrogenies are all that damage the patient that comes from the doctor. These are actions, words, style of behavior, and lack of attention - all the behavior of the doctor as a whole. Therefore, iatrogeny should be understood as all damage to the mental, somatic and spiritual spheres of the patient's life, resulting from his interaction and communication with the doctor.
Sorror (sister, gennao - to do, to produce) refers to the harm caused by a nurse.
The introduction of an independent concept into biomedical to denote the harm caused by a nurse to a patient and his relatives in the course of her professional activity reflects the degree of importance of nursing in the modern system of providing medical care to people.
Currently, the term "iatrogenism" is often used in a broad sense to refer to all damage to human health caused by the actions of medical professionals. However, more often they talk about iatrogenies in the case of moral and psychological damage, and in cases of physical damage - about "medical errors", misconduct, malfeasance, resulting in harm to health.
Sources of iatrogenism and sorrogenism can be: the circumstances of medical manipulations; inaccurate, inaccurate information of patients about the achievements of medical science and healthcare practice; personality traits of a medical worker, incl. insufficient level of communication skills.
Peremptory statements, recommendations for changing lifestyle, habits, etc. in accordance with their views, but without taking into account the opinion of the patient, his life situation can cause iatrogenism or sorrogenism. Great harm is caused to the patient by criticism by medical workers of their colleagues who have previously treated the patient. As a result, mistrust is formed in doctors, nurses, medical technicians, examinations, and treatment.

There is a well-known expression: “The word heals, but the word can also cripple”. Often, an iatrogenic effect is exerted by careless statements, comments by doctors or other medical workers, students about the nature of the patient's changes, the possible diagnosis, and prognosis of the disease.
Inattention, negligence, dishonesty, a formal attitude to one's duties - these are personality traits, the presence of which in a medical worker can lead to actions that are harmful to the patient's health.
The prevention of iatrogenies and sorrogenies is a difficult, but very important task in the work of medical workers. The largest domestic neuropathologist MI Astvatsaturov, calling for the fight against iatrogenic disorders, demanded from the doctor "mental asepsis" when making a diagnosis. In our time, we should talk about ethical and psychological asepsis aimed at preventing all types of damaging effects of medical workers on patients and their relatives.
Any professional activity carries the risk of causing harm to the person who carries out it. Medical practice carries many risks for the medical professionals themselves. These are physical, material, legal, social, psychological, moral risks.
Legal risks are associated with the likelihood of committing a professional error, for which legal liability is possible. Physical risks are associated with the likelihood of infection, including life-threatening diseases. Psychological risks are associated with psychologically stressful activities in which responsibility for the patient's life and health is combined with stressful factors - pain and suffering of other people, their worries and experiences. Material risks are associated with the likelihood of compensation for damage caused to the patient's health in the process of providing him with medical care in accordance with the decision of the courts. This type of occupational risk increases as the legal literacy of patients and their relatives increases. Social risks are associated with the likelihood of losing a job, social status due to mistakes in professional activity, reorganization of the healthcare system, loss of one's own health, etc. Moral risks are associated with situations of moral choice that arise in the professional activity of a health worker. The risk of making a decision that does not meet the requirements of professional ethics, as a result of which an intrapersonal conflict arises that affects all other areas of a person's life.
A deep conviction in the unconditionality of moral principles and norms of biomedical ethics and their acceptance for themselves as the only guidelines for professional activity can reduce the negative consequences of occupational risk situations for a health worker.

The problem of "medical secrecy"

Medical professionals, especially doctors and nurses, in the course of their professional activities often find themselves the owners of the most intimate, intimate information about the lives of patients. Such information helps to most accurately diagnose, choose treatment methods, and carry out therapeutic and diagnostic measures. Obtaining the most complete information about the patient's health is possible only with a trusting relationship between the patient and the doctor, trust in medical professionals and medicine in general. The choice of methods of treatment and rehabilitation of the patient, prevention of possible diseases depends on the degree of completeness and accuracy of this information. The importance of a trusting relationship between doctor and patient has been recognized by physicians since ancient times.
Among the information that becomes known to medical workers in the process of providing consultative and diagnostic, therapeutic and prophylactic and rehabilitation assistance, there are those that a person under other circumstances would never tell anyone. This is information that relate to the intimate aspects of human life, various physical disabilities, emotional experiences, features of family and professional activities, etc.
In the history of medical ethics and law, this problem has traditionally been designated as "medical secrecy." "Medical secret" is a concept that means the requirement of professional medical ethics and deontology to keep secret all information that becomes known to the doctor in the course of treating a patient. Maintaining "medical confidentiality" is one of the most important issues of medical ethics and deontology.
As the complexity of medical work and the emergence of new specialties - pharmacist, nurse, medical laboratory assistant - the ethical requirement to keep confidential patient information in secret extended to them. Currently, all legal and ethical requirements regarding the preservation of medical (medical) secrecy apply not only to doctors, but also to other medical professionals. This understanding and assessment by society of the problem of the need to keep secret information concerning the patient's life and health was reflected in the change in the name of this problem.
With the change in the structure of medical activity, the emergence of nursing and junior medical personnel, its name was transformed into a "medical secret", which implies the spread of relevant ethical and legal requirements to all medical professionals and non-medical professionals working in medical institutions or entering into communication, interaction with patients.

At present, the requirement to maintain the confidentiality of information about a patient that has become known to medical workers in the course of their professional activities has an ethical and legal status.
In modern medical law, medical (medical) secrecy is understood as "all information obtained from a patient or revealed during a medical examination or treatment, which is not subject to disclosure without the patient's consent."
In biomedical ethics, the concept “ medical secret»Denotes an ethical requirement to keep secret all confidential information about a patient obtained in the course of the professional activity of a medical worker, except for cases stipulated by law.
“From an ethical point of view, the concept of“ medical secret ”, firstly, is the concretization of the principle of humanism in medicine, respect for the patient's human dignity, his legal rights, and secondly, the extension of the principle of non-harm to all aspects of life, the patient's lifestyle, his well-being, which could be prejudiced by the disclosure of confidential professional information by a health worker. "
The concept of "medical secrecy" is narrower, because concerns only the activities of the doctor. Medical secrecy reflects ethical requirements that apply to all healthcare professionals, including physicians. Due to the fact that the doctor is the main actor in the process of diagnosis and treatment of the patient, the observance of "medical confidentiality" requires greater responsibility. It is the doctor who provides information about the patient in cases stipulated by law, it is he who determines the measure of medical information about the diagnosis, treatment and prognosis of the disease of a particular patient, which the nurse should possess.
This ethical requirement was recorded in the "Oath" of Hippocrates. In the "Oath" of Hippocrates it is said: "Whatever during treatment - as well as without treatment - I see or hear about the life of people from what should not be disclosed, I will keep silent about that, considering such things a secret."
Later, it was legislatively enshrined in a number of legal documents in many countries of the world. Maintaining "medical confidentiality" is one of the most important issues of medical ethics and deontology.

By the end of the 20th century, the ethical requirement of observing professional medical secrets ("medical secrets") was recorded in all significant ethical and legal documents of the international level.
In Russia, these are the "Fundamentals of the legislation of the Russian Federation on the protection of public health", the Oath of a doctor of Russia, the Code of Ethics for a nurse in Russia, the Code of Ethics for a pharmaceutical worker in Russia (pharmacist and pharmacist).
In the 61st article of the "Fundamentals of the legislation of the Russian Federation on the protection of citizens' health" it is said that medical secrecy is information about the fact of seeking medical help, the patient's state of health, the diagnosis of his disease and other information obtained during the examination and treatment of the patient. This is information about functional and physical disabilities of the body, hereditary diseases, bad habits, diagnosis, complications, prognosis, family and intimate life, the fact of adoption and adoption, information about the health status of relatives. This also includes information of a non-medical nature, expressed to a doctor or other healthcare professional, a lawyer in the presence of a doctor, concerning his will, the availability of collections or other values, hobbies, personal relationships with close relatives, etc. According to this article, disclosure of information constituting a medical secret is not allowed to persons to whom they became known during training, performance of professional, official and other duties, except for cases established by the Law.
A prerequisite for qualifying the disclosure of information as a medical (medical) secret is to obtain it in the performance of professional duties, regardless of whether it was received in a medical institution or outside it when providing emergency assistance. The legislation stipulates cases when confidential information can be transferred to third parties - representatives of law enforcement agencies or healthcare institutions. These are cases when information helps prevent serious negative consequences for society.

According to the legislation in force in our country, the transfer of information constituting a medical secret is allowed with the consent of a citizen or his legal representatives. Medical (medical) secrets are preserved even after the death of the patient, and can be disclosed only after obtaining permission from close relatives or legal representatives.
In the absence of consequences causing moral or material harm to the patient, disciplinary liability is provided for violation of medical secrets. But “in the event of consequences associated with harm to the health or life of the patient, as well as moral harm, the infliction of moral or physical suffering entails criminal or civil liability. ... Criminal liability occurs if the intentional or reckless infliction of medium or serious harm to health, the death of a patient is associated with a violation of the procedure for providing information constituting a medical secret, in accordance with Art. 61 "Fundamentals of legislation ...".
For the disclosure of medical secrets, disciplinary, administrative and civil liability is provided in accordance with the legislation of the Russian Federation. The doctor may be held liable for civil liability if the patient presents a claim for compensation for moral harm caused by the disclosure of medical secrets. The obligation to preserve medical confidentiality extends not only to doctors, but also to other medical professionals, as well as students of medical universities, schools and colleges.
For the first time, the attitude to the problem of maintaining medical secrecy in the professional activity of a nurse was defined in the Florence Nightingale Oath: "... I will keep secret the information entrusted to me concerning the patient's personality or family relations, which I happened to learn during my visits." In the current Code of Ethics of the International Council of Nurses, among the ethical requirements for the relationship between a nurse and a patient, it is especially highlighted: "The nurse stores the confidential personal information received and shares it with great care."

In the Ethical Code of Russian Nurses, article 8 is devoted to the problem of medical secrecy in relation to the activities of a nurse. In this document, the preservation of professional secrecy is recorded as a moral obligation of a nurse. The content of this article complies with the provisions of article 61 "Fundamentals of legislation of the Russian Federation on the protection of citizens' health", which confirms the unity of moral and ethical principles and norms of medical, nursing, pharmaceutical ethics.
The unity of ethical approaches to the problem of medical secrets in modern ethical codes of medical workers reflects a single moral basis of biomedical ethics in the field of fundamental problems of preserving human life and health.
In the history of medicine, including domestic medicine, the attitude to the problem of "medical secrecy" has repeatedly changed.
In pre-revolutionary Russia, doctors in this matter were guided by the "Faculty Promise", which said: "I promise .... sacredly keep the family secrets entrusted to me and not use the trust placed in me for evil."
During the Soviet period, the doctrine of medical secrecy was assessed in different ways - from complete denial of the need to comply with it to a differentiated approach to information that constitutes confidential information about a patient.
In the conditions of the RSFSR in the 1920s, the People's Commissariat of Health, headed by N.A. Semashko, stood on the position of denying the need to observe medical secrecy. This approach was based on the idea that illness is not a shame, but a misfortune, and in a socialist society with its communist morality, one should not make a secret of one's misfortune, because society is ready to help each of its citizens in his trouble. In 1967, amendments were made to the legislation of the USSR and the Union republics, according to which it becomes mandatory for medical workers to observe medical secrecy and provide for liability for its disclosure.
The importance of compliance with the requirement to maintain confidential information about the patient is due to changes in the field of medicine and health care that have occurred (and continue to occur) in the late 20th - early 21st century. In view of the importance of the problem of maintaining medical secrecy, the WHO European Office has adopted a “Policy Declaration on the Promotion of Patient Rights in Europe”. The provisions of the Declaration regarding confidential information comply with the provisions of article 61 "Medical secrecy" of the "Fundamentals of the legislation of the Russian Federation on the protection of public health", however, it is noted that the components of the human body from which identification information can be extracted must also be stored in compliance with the protection requirements. This provision is important for the activities of all biomedical laboratories, in the work of which biological material is studied and used.
Of particular importance and the corresponding regulation are the issues of maintaining medical secrecy in relation to mental, venereal diseases, HIV infection. So, patients with venereal diseases and HIV-infected are guaranteed anonymous examination and treatment, provided that they comply with a regime that excludes the danger of infecting other persons. In case of violation of the regime and evasion of treatment, they can be forcibly brought to treatment with the participation of law enforcement agencies. In accordance with the Law of the Russian Federation "On psychiatric care and the guarantee of the rights of citizens in its provision" (1993), it is prohibited to provide information about the nature of the disease by telephone, to neighbors and employees of the patient, to government institutions, including non-psychiatric medical ones. The list of authorities and the conditions for giving them information are contained in the Law.
Ethical issuesassociated with the preservation of medical secrets in modern medicine are associated with the fact that information about the patient's health, his life and personal characteristics has many sources and is transmitted through various channels from one person to another.
Due to the peculiarities information processes in modern medicine, information about the state of health, the results of treatment and diagnostic measures, hereditary diseases and other features of the patient's health is recorded in medical documentation, which is stored not only on paper, but also in electronic media, increasingly compiling an electronic database about patients in departments, hospitals, clinics, diagnostic centers, etc. This information is to a greater or lesser extent available to various categories of medical workers, and in some cases to other people. Confidential information becomes known and transmitted in the process of providing medical care to a fairly wide range of medical workers: receptionists, orderlies, medical technicians, nurses, consultants, representatives of the administration of a medical institution, friends and relatives, medical students educational institutions.
Thus, the confidentiality of information about the patient's health occurs in a fairly wide area, the boundaries of which vary in each case. Depending on the health problem of a particular person, a different number of people are involved in the treatment, diagnostic and rehabilitation process. Accordingly, confidential information can be stored at various levels of professional and social relationships of people. These are the micro-level (doctor, nurse, close relatives), the meso-level (several doctors, nurses, nurses, administration representatives, relatives, acquaintances, work colleagues, etc.), the macro-level, at which representatives of several medical institutions are included in the system of relationships and other organizations, and the mega-level at which confidential information is disseminated through the media, scientific and educational publications.
At the meso and macro levels, the principle of presumption of the patient's consent to communicate information about him to all persons on whom the preservation of the patient's health, and most often the life of the patient depends, operates. When disseminating confidential information at the mega-level through the media, there is always the consent of the patient or his relatives, which complies with ethical and legal standards in this matter. When using information about a patient in scientific and educational publications, certain ethical requirements are also observed: the surname and first name are indicated only by initials, personal life features, except for cases from psychiatric practice, are usually skipped, eyes are hidden in photographs.

Compliance with medical secrecy contributes to the creation of an atmosphere of trust in the relationship between medical professionals, the patient and his relatives. Any insincerity and disclosure of confidential information constitutes a disregard for the trust that medical workers have in people who turn to them for help.
The preservation of medical secrecy is of particular importance in cases where a patient has a disease that in the public consciousness has the status of “shameful”, unfavorable for interaction with such a person (mental illness, HIV infection, etc.). As the field of use of biomedical technologies expands, information about artificial insemination, gender reassignment, and genetic characteristics begins to be classified as particularly significant information that constitutes a medical secret.
A nurse who informs the doctor in the presence of third parties that patient N. has received a cleansing enema, thereby discloses information regarding the intimate aspects of his life and health. A medical laboratory assistant who transfers the form with the results of the analysis to the patient through a third party without the consent of the patient violates the confidentiality of medical information about his state of health. A pharmacist working in a pharmacy and pronouncing the name of a medicine needed by a visitor so loudly that other visitors to the pharmacy hear, violates the confidentiality of medical information about the medicines used by this person in the treatment of his disease, and, as a consequence, about his disease (type disease or health conditions).
The greatest harm to the patient and / or his relatives is caused by the violation of the confidentiality of information about the patient's life and health, affecting his spiritual and social values. This is information about sex change, the presence of an incurable disease, facts from the patient's personal life.

The processes of differentiation and specialization in the field of medical science and practice, the introduction of the latest biomedical technologies into practice, the informatization of medicine influenced the process of obtaining, storing and transmitting information about the patient during treatment, diagnostic, preventive and rehabilitation measures. In such conditions, keeping confidential information secret becomes possible only if there is a high level of responsibility and ethical literacy among all medical workers involved in the treatment, diagnostic and rehabilitation processes.
In 1991, the Council of Europe adopted the Principles Relevant to Automated Medical Databanks, which is important in connection with the expansion of the computerization of practical health care. It defines the peculiarities of storing information in automated medical data banks, the rules for access to it for both medical workers and other categories of citizens, including the patients themselves. These principles are based on ethical standards for the preservation of confidential information, established in biomedical ethics.

Literature:

1. Ivanyushkin A.Ya. Khetagurova A.K. History and Ethics of Nursing: Tutorial... - M .: GOU VUNMTs MZ RF, 2003. p. 297.
2. Rigelman R. How to avoid medical errors: Per. from English. - M .: Practice, 1994.S. 109.
3. Akopov V.I. Legal support for the professional activities of nurses. (Fundamentals of Medical Law). - Moscow: ICC "Mart", Rostov-n / D: Publishing Center "Mart", 2005, p. 234.
4. Ivanyushkin A.Ya., Khetagurova A.K. History and Ethics of Nursing: A Study Guide. - M .: GOU VUNMTs MZ RF, 2003, p. 132.
5. Hippocrates. Oath. Doctor's Law. Instructions / Per. from Greek. IN AND. Rudnev. - Minsk: Contemporary writer, 1998, p. 10.
6. Akopov V.I. Legal support for the professional activities of nurses. (Fundamentals of Medical Law). - Moscow: ECC "Mart", Rostov-n / D

Moskaleva's article in the magazine "Labor Law" No. 8/2014 describes the analysis of disputes in the courts of employees and companies.

In order not to burden you with legal terms, he offers to get acquainted with the opinions of leading experts ...

So, do not rush to punish for violation of the rules of conduct in the company ...

Anna Filina, Senior Legal Adviser, JI ES EL - PRAVO LLC:

Violation of the rules of corporate ethics often becomes a reason for bringing an employee to disciplinary responsibility. More often than not, penalties are imposed on employees in the form of remarks or reprimands, but there are cases when a violation of the rules of corporate ethics becomes the basis for dismissal under paragraph 5 of part 1 of article 81 of the Labor Code of the Russian Federation - repeated non-performance by an employee without good reason of labor duties, if he has a disciplinary penalty.

When considering disputes about dismissal on the specified basis, the employer needs to prove exactly what actions that violate the rules of corporate ethics, and at what time the employee committed, how these rules are enshrined, whether the employee is familiar with it.

For this, the employer may provide as evidence memoranda, written customer complaints, local regulations, testimony, and the like.

An example of how the employer could not provide evidence satisfactory to the court is the Decision of the Isilkul City Court of the Omsk Region dated 16.02.2012 in the case
No. 2-116 / 2012. The budgetary health care institution of the Omsk region "Isilkulskaya CRH" dismissed the senior nurse M.L.N. under clause 5 of part 1 of article 81 of the Labor Code of the Russian Federation. The employer blamed the employee for systematic failure to fulfill her job duties, among which he singled out a violation of the rules of ethics of a medical worker, expressed in the discussion of working moments in a public place, which, according to the employer, led to disorganization and nervousness of the clinic staff.

As evidence, the employer presented a memorandum from the nurses about the inappropriate behavior of M.L.N., as well as a number of witness statements.
In particular, the main nurse of the hospital testified that “in April 2011 from the doctor FULL NAME1 received an oral statement that M.L.N. raised her voice to the doctor in the presence of a nurse, about which she personally made a remark to M.L.N. The nurses of the polyclinic also received complaints that the senior nurse M.L.N. behaves incorrectly. She received information that the senior nurse of the polyclinic M.L.N. in public transport discusses the issues that are discussed at planning meetings in the clinic, which violated the rules of ethics of a medical worker. "

However, the court in its decision indicated that the said witnesses questioned at the hearing could not explain why the memo was set out in general phrases, to whom exactly from the staff M.L.N. was rude, when and where it happened.

The court considered that the evidence of exactly what “actions the plaintiff committed that violate the rules of ethics of a medical worker and what moments, and in what public place she discussed working moments that lead to disorganization and nervousness of the clinic staff” was not provided to the court. The court ruled in favor of the employee, satisfying her claim in full, recognizing the dismissal as illegal and reinstating her in office.

However, in judicial practice, there are court decisions that are positive for the employer. K. D. applied to the court with a claim against CJSC "Banca Intesa" to declare illegal and abolish disciplinary sanctions, compensation for moral damage.

By order of the bank, the plaintiff was disciplined in the form of a reprimand for violation of a number of points job description, as well as violation of Article 4 of the Code of Corporate Conduct and the section “Principles of Conduct in Relations with Employees” of the Code of Corporate Ethics, which was expressed in the manifestation of rudeness towards the bank's employees.

The employer managed to confirm the fact of unethical behavior of K.D. with bank employees during the period of requesting explanations from him about the violations of information processing.

At the same time, the employer submitted to the court local regulations: the Code of Corporate Ethics of CJSC Banca Intesa, according to which the employee must respect the personality and human dignity of each employee, and the Code of Corporate Conduct of the Bank, which states that representatives and employees must avoid behavior in a workplace that is not characterized by honesty and utmost respect for the dignity and morality of each employee.

The court took into account the provisions of these acts when making a decision. It is also necessary to pay attention to the fact that the employer fully followed the procedure for bringing the employee to disciplinary responsibility.

Therefore, the Basmanny District Court of the city of Moscow refused K.D. in satisfaction of his claim, and the Moscow City Court upheld this decision unchanged, the appeal of K.D. unsatisfied

(Appellate ruling of the Moscow City Court dated 05.22.2013 in case No. 11-11717).

Artem Denisov, Managing Partner of Genesis Law Firm, Ph.D. in Law: ":

In general, the cognitive article of a colleague is aimed more at a formal approach to the study of such a phenomenon as corporate ethics and generalization of judicial practice on a formal basis. The statement that the rules of corporate ethics, unspoken or approved by a local regulatory act, are in fact exactly the rules of conduct and are recommendatory in nature. Violation of the rules of corporate ethics is not grounds for dismissing an employee.

The manifestation of the phenomenon of corporate ethics can be conditionally divided into two frameworks of relations. First, it can be viewed as a condition for the behavior of employees within the corporate structure, where it is expressed through the issuance of a local labor act.

Second: mandatory conditions compliance of the employee within the professional communities, for example, law education, audit organizations, and so on, where exactly compliance with corporate ethics and rules is a condition and guarantee of proper performance of labor duties and is the basis for dismissal. They are established both within the framework of sectoral laws and within the framework of local acts.

In the first case, you can consider the rule when, as an additional basis for terminating an employment contract with the head of an organization, on the basis of clause 13 of part 1 of article 81 and article 278 of the Labor Code of the Russian Federation, the contract indicates a violation of the requirements of corporate ethics (code of ethics of the organization).

The review of judicial practice on these legal relations is quite extensive and it is the application of these articles of the Labor Code of the Russian Federation in conjunction with the norms of corporate ethics that ensures the proper procedure for dismissal in case of violation of the rules of corporate behavior by the dismissed.

If we consider the second case and use as an example Federal Law No. 63-FZ of May 31, 2002 "On advocacy and the legal profession in the Russian Federation", then the grounds for terminating an employment contract with an advocate's assistant are not only the grounds listed in the Labor Code of the Russian Federation. Also, as the grounds for which the employment contract with the advocate's assistant is terminated, and the assistant is expelled from the assistants of the legal education, there is a case of non-fulfillment or improper performance by the advocate's assistant of his professional duties or non-compliance with decisions of corporate norms governing the activities of the legal profession.

In general, the concept of corporate ethics in Russian legislation is new, but despite this, this phenomenon is a rather powerful regulator of employee behavior, to which various sanctions can be applied, up to and including dismissal.

Tatiana Bekreneva, lawyer:

The moral requirements of service relations, or otherwise corporate ethics, have some peculiarities. And although the Labor Code of the Russian Federation does not have a clear definition of the concept of corporate ethics, nevertheless, certain requirements for the behavior of an employee can be attributed to the rules of corporate ethics, namely, requirements, failure to comply with which is a disciplinary offense.

It is difficult to agree with the author that these requirements are advisory in nature. Citing an example of a litigation on dismissal for disclosing a commercial secret, that is, essentially agreeing that the rule on non-disclosure of commercial secrets is a rule of corporate ethics, the author, at the same time, in his conclusions indicates that it is impossible to dismiss for violating the rules of corporate ethics, which is a clear contradiction. Especially when you consider that violation of the above rule is the basis for dismissal in accordance with the Labor Code (paragraph "c" of paragraph 5 of Article 81).

A clear understanding of the moral requirements, that is, the moral guidelines for the activities of the organization, is necessary for the coordinated work of all divisions. It seems that the legislator should determine the criteria for the compliance of these moral rules with the requirements of the legislation, as well as the requirements of rationality and fairness. It is important that, like any rule, the rule of corporate ethics must be reliably protected by law, local regulations, the conditions established in the employment contract, and also backed up by real actions of the employer to enforce it - punishments, since the establishment of rules requires not only clear fixation, but also sanctions for their violation. In the charters, rules, codes of corporate ethics or other local regulations that an employee gets acquainted with when applying for a job under a personal signature, the employer is obliged to prescribe a clear, reasonable rule of conduct that the employee is obliged to follow, indicating that failure to comply with this rule is equivalent to a violation labor discipline. At the same time, it is important that the norms they contain do not worsen the rights of workers in comparison with the current labor legislation.

The law establishes that employees in terms of non-fulfillment or improper fulfillment of their labor duties, which include the obligation to comply with corporate acts, bear disciplinary responsibility. Of course, you cannot, for example, fire a person with the wording in the order: "For violation of corporate ethics." In the work book, you cannot write: "Fired for violation of corporate ethics." Dismissal for violation of the rules that relate to the rules of corporate ethics presupposes compliance with the dismissal procedure established by the Labor Code of the Russian Federation, indicating in the order and work book the legal basis for dismissal (clause 14 of the Decree of the Government of the Russian Federation of 04.16.2003 No. 225 "On work books"). But if there really is a violation of these rules, the employer, in the order of Articles 192-193 of the Labor Code of the Russian Federation, is obliged to request an explanatory note from the employee, if it is not provided, an appropriate act is drawn up, after which the employee can be fired.

One cannot but agree that if you correctly record the relevant requirements, correctly draw up all the necessary documents to bring an employee to disciplinary responsibility, no court will recognize the employer's requirements as far-fetched and discriminatory.

First, all the rules must be recorded in a local act. Otherwise, there is no reason for the employer to demand anything from employees and then punish them for non-performance. It is impossible to agree with the author of the article that the presence of unspoken rules of conduct can affect the issues of bringing workers to justice - labor legislation does not provide for such a thing as unspoken rules. Therefore, in the event of a dispute, the employer will have to prove that he has familiarized the employee with the rules of corporate ethics (duty not to disclose trade secrets, duty to comply with the dress code, for example, by railway or air transport workers). Secondly, when the employer sets the requirements corporate culture moderation and reasonableness are important, real requirements must be recorded. Thirdly, when punishing for non-observance of the rules, the provisions of Articles 192-193 of the Labor Code of the Russian Federation should be strictly observed. Otherwise, the risk of recognizing the order as illegal as well as a local act increases, since if employers violate the norms of Article 372 of the Labor Code of the Russian Federation on the procedure for coordinating local acts, then this gives the employee the opportunity to challenge them, or challenge the employer's actions based on the illegal norms of the local act. But basically, disputes related to violation of corporate ethics encountered in judicial practice can be divided into two types:

• challenging a disciplinary sanction;
• reinstatement at work in case of dismissal for systematic violation of official duties (paragraph 5 of part 1 of article 81 of the Labor Code of the Russian Federation).

Thus, taking into account the above, it is hardly possible to agree with the author of the article that violation of the rules of corporate ethics cannot be the basis for dismissing an employee. But it is quite obvious that the issues of corporate ethics require special legal consideration, since corporate ethics is increasingly becoming a part of the general policy of the employer.

Vladimir Alistarkhov, legal expert:

An employee cannot be fired for violating the norms of corporate ethics, but the author of the article proposes to figure out "what should be the violation of corporate ethics in order for dismissal to become possible from the point of view of the Labor Code of the Russian Federation?"

The very statement of this question already contradicts the norms of the current labor legislation. Labor legislation, and in particular Article 81 of the Labor Code of the Russian Federation, directly provides for the grounds on which an employee can be dismissed on the initiative of the employer.

The grounds for dismissing an employee on the initiative of the employer have an exhaustive list, and, accordingly, the order for dismissal should clearly state this basis, indicating the article of the Labor Code of the Russian Federation, according to which the employee is dismissed.

Consideration of the issues of dismissal of an employee at the initiative of the employer through the prism of the code of corporate ethics is a kind of “tautology” of the procedure for considering dismissal of an employee on the grounds provided for by law.

For example, for disclosing a secret, access to which is limited by law and so liability is provided -
why then consider a violation of the code of corporate ethics when deciding on the dismissal of an employee?

Currently, there is no judicial practice in which the court would use the fact of violation of corporate ethics norms as necessary evidence in the case of the dismissal of an employee.

The necessary list of evidence in cases of dismissal of employees has long been formed, and if there is one, the employer does not need to be additionally guided in court by violation of corporate ethics by the employee.

The court practice cited by the author of the article shows that for the dismissal of an employee on the initiative of the employer, different evidence is presented, but not once is any information about a violation of corporate ethics used as evidence, since this is not necessary.

At the same time, the absence at the moment of judicial practice, in which the violation of corporate ethics is considered by the court as necessary evidence, does not mean that in the future the courts will not be able to take into account this kind of evidence in justification of the dismissal of an employee by the employer, but for these purposes, it is likely that changes in labor laws will be required.

The conclusion of the author of the article is correct that the rules of corporate ethics are advisory in nature and cannot be the basis for the dismissal of an employee, but the question remains whether violations of the rules of corporate ethics can become the basis for the application of other disciplinary measures (in addition to dismissal), which seems more realistic ...