How to formalize the refusal of mantu to a child on legal grounds. Legal ways to refuse Mantoux (school) How to refuse Mantoux vaccination

Good afternoon. The country has organized a system of illegal coercion to be tested for tuberculosis. The system is actively protected by local administrations, prosecutors' offices and courts. A typical soup set of pseudo-legal arguments: 1) an unexamined child is dangerous to others. His non-admission is the protection of the right of citizens to a favorable environment 2) Sanpin establishes the mandatory nature of examination 3) Sanpin gives the right to demand examination to employees of educational organizations 4) Sanpin grants the right to prevent an unexamined child from entering an educational organization to the administration of this organization. These arguments do not comply with the current regulatory framework and do not have a judicial perspective if properly considered in accordance with the requirements of the CAS of the Russian Federation. Evidence supporting the stated claims. In accordance with paragraph 9 of Art. 226 CAS RF Unless otherwise provided by this Code, when considering an administrative case challenging a decision, action (inaction) of a body, organization, person vested with state or other public powers, the court finds out: 1) whether the rights, freedoms and legitimate interests of the administrative plaintiff have been violated or persons for whose rights, freedoms and legitimate interests a corresponding administrative claim has been filed; 2) whether the deadlines for going to court have been met; 3) whether the requirements of regulatory legal acts establishing: a) the powers of a body, organization, person vested with state or other public powers to make a contested decision or perform a contested action (inaction) have been met; b) the procedure for making a contested decision, performing a contested action (inaction) if such a procedure has been established; c) the grounds for making a contested decision, performing a contested action (inaction), if such grounds are provided for by regulatory legal acts; 4) whether the content of the contested decision, the contested action (inaction) committed corresponds to the normative legal acts governing the disputed relationship. 11. The obligation to prove the circumstances specified in paragraphs 1 and 2 of part 9 of this article rests with the person who applied to the court, and the circumstances specified in paragraphs 3 and 4 of part 9 and in part 10 of this article - with the body, organization, person , vested with state or other public powers and who made contested decisions or committed contested actions (inaction). Rights violated by the illegal actions of the defendants Rights violated by the illegal actions of persons forcing an examination: to education, freedom of movement, the right to voluntary informed consent or refusal to provide medical care, the right to medical confidentiality. Powers of heads of educational organizations To consider the issue of the powers of the head of an educational organization to gain access to information that constitutes medical confidentiality, determine the danger of students to others due to health conditions, send notifications about mandatory medical examinations, set deadlines for medical examinations, introduce restrictive measures at their discretion, aimed at preventing the spread of infectious diseases (quarantine), the following regulations should be referred to. From clause 2 of Art. 15 of the CAS RF follows that if, when resolving an administrative case, the court establishes a discrepancy between the normative legal act to be applied and the law or other normative legal act of greater legal force, it makes a decision in accordance with the law or other normative legal act of greater legal force. In accordance with Art. 87 – 90 of the Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation”, quality control and safety of medical activities does not fall within the competence of educational organizations and their managers. clause 2 art. 41 of the Federal Law of December 29, 2012 N 273-FZ “On Education in the Russian Federation”, according to which, the organization of health protection for students (with the exception of the provision of primary health care, medical examinations and medical examinations) in organizations engaged in educational activities, carried out by these organizations. In order to specify the procedure for providing medical care to minors, including during the period of training and education in educational organizations, Order of the Ministry of Health of Russia dated November 5, 2013 N 822n approved the corresponding document, which clarifies the provisions of paragraph 2 of Art. 41 of the Education Law. In accordance with paragraph 5 of Order No. 822, direct provision of primary health care to minors under 18 years of age is carried out by executive authorities in the field of health care. To implement this norm, an educational organization is obliged to provide free premises with appropriate conditions for the work of medical workers (clause 3 of Article 41 of the Law on Education). In accordance with paragraph 19 of the order, when organizing medical examinations (screenings) of minors, during the period of training and education in educational organizations, and providing them with primary health care in a planned form, the educational organization can only provide assistance in informing minors or their parents ( legal representatives) in the preparation of informed voluntary consent to medical intervention or their refusal of medical intervention in relation to certain types of medical intervention. clause 46, part 1, art. 12 of the Federal Law of May 4, 2011 N 99-FZ “On licensing of certain types of activities” establishes that medical services (medical activities) are subject to licensing. At the same time, according to clause 3 of the Regulations on licensing of medical activities, approved by Decree of the Government of the Russian Federation of April 16, 2012 N 291, medical activities consist of works (services), which, in particular, include the provision of primary health care, medical examinations, medical examinations and sanitary and anti-epidemic (preventive) measures as part of the provision of medical care. The case materials do not contain any information about whether the educational organization has a license to carry out medical activities. Parents have the right not to carry out the orders and instructions of the head of the educational organization, since they are mandatory for execution by employees of the educational institution. Neither parents nor students have an employment relationship with the kindergarten. Relations between pupils (their legal representatives) and the children's organization are regulated by a concluded agreement. Any disputes arising between the parties to the agreement must be resolved in the manner prescribed by law by contacting the competent state authorities or the court, and not by adopting an internal administrative act. The procedure for making a contested decision, performing a contested action. The procedure for undergoing a medical examination for tuberculosis is determined by Order of the Ministry of Health of Russia dated March 21, 2017 No. 124n: Clause 11, the organization of medical examinations is entrusted to an authorized person appointed by the medical organization, clause 12, lists of citizens with an indication of the duration of the medical examination are compiled by medical workers, clause 14 The calendar schedule of medical examinations is approved by the head of the healthcare organization a month before the start of the calendar year, clause 17, notifications are sent by medical workers (doctors, paramedics) responsible for conducting preventive medical examinations, clause 18, information on the results of the medical examination is entered into the medical documentation, clause. 20 information based on the results of the medical examination is communicated to the citizen or his legal representative. Thus, the current procedure for undergoing medical examinations for tuberculosis does not require the participation of the head or other employee of the educational organization in this event and does not contain a requirement to provide the children's organization and its head with any medical documents. Such a requirement is not contained in the sanitary rules SP 3.1.2.3114-13. The results of medical examinations and examinations are a medical secret (in accordance with Article 13 of the Federal Law of November 21, 2011 N 323-FZ). Access to this information is limited to medical workers, citizens or their legal representatives. Therefore, the TB doctor’s conclusion about the absence of the disease is provided not to the children’s organization, but to the health care organization to which the children’s organization (medical office) is attached. The head of an educational organization does not have the right of access to the specified documentation, and, accordingly, the right to evaluate its content, determine the presence or absence of danger to others, since he does not have a medical education, is not a medical worker, and is not on the staff of a medical organization. Also, the current legislation establishes a procedure for limiting the constitutional rights of citizens, in particular the right to education. P.3. Article 55 of the Constitution of the Russian Federation determines that “The rights and freedoms of man and citizen may be limited by federal law only to the extent necessary in order to protect the foundations of the constitutional system, morality, health, rights and legitimate interests of other persons, ensuring the defense of the country and state security. In accordance with paragraph 1 of paragraph 10 of Article 20 of the Federal Law of November 21, 2011 N 323-FZ, the decision to recognize a citizen as dangerous to others for health reasons is made by a council of doctors, a record of this is made in the medical documentation. In the case of tuberculosis infection, after identifying clinical indications or other risk factors, TB doctors (commission of doctors) have the right established by Articles 9 and 10 of Federal Law No. 77-FZ “On preventing the spread of tuberculosis in the Russian Federation”, and are even obliged to take actions aimed at compulsory examination and registration at a dispensary, and even compulsory treatment (by contacting the authorized bodies, the prosecutor's office or the court). This norm is enshrined in clause 7.3 of SP 3.1.2.3114-13 “Medical workers of medical, recreational, children's and other organizations who have identified (suspected) tuberculosis in individuals shall report by phone within 2 hours, and then within 12 hours in writing send an emergency notification about each patient to the bodies authorized to carry out federal state sanitary and epidemiological supervision at the place of identification, actual residence and work (study) of the patient.” Further actions in relation to this message (compulsion to be examined, restrictive measures (quarantine), examination of contact citizens, disinfection, etc.) are within the competence of the authorized body. The arguments of employees of educational organizations that actions to prevent an unexamined child from entering an educational organization are supposedly aimed at protecting other citizens from an infectious disease do not correspond to reality and are not supported by any facts, which contradicts Article 62 of the CAS of the Russian Federation, according to which “The obligation to prove the legality of decisions , actions (inaction) of bodies, organizations and officials vested with state or other public powers are assigned to the relevant body, organization and official. The specified bodies, organizations and officials are also obliged to confirm the facts to which they refer as the basis for their objections.” Legislation establishes the obligation for citizens to undergo a medical examination. Non-admission of a child to an educational organization is an administrative measure limiting his constitutional rights to freedom of movement and education, as it creates the impossibility of being in an educational organization and the inability to receive education in the form chosen by the parents. In accordance with Art. 44 of Federal Law No. 273-FZ, the right to choose the form of education is assigned to parents, and not to the head of the educational organization. In accordance with Art. 1 of the Federal Law of March 30, 1999 N 52-FZ “On the sanitary and epidemiological welfare of the population” restrictive measures (quarantine) - administrative, medical, sanitary, veterinary and other measures aimed at preventing the spread of infectious diseases and providing for a special regime for economic and other activities ….. Part 2 art. 31 of the said law determines that “Restrictive measures (quarantine) are introduced (cancelled) on the basis of proposals, orders of the chief state sanitary doctors and their deputies...” Thus, the head of an educational organization has the right to issue an order not to admit a child to a children's organization only if there is an order the chief state sanitary doctor or his deputy, or if there is a court decision, where he should have gone to resolve disagreements with the child’s legal representatives. Grounds for making a contested decision, performing a contested action (inaction), if such grounds are provided for by regulatory legal acts. Usually, the reason for not admitting an untested child to an educational organization is to protect the rights of other citizens to a favorable environment - preventing the spread of an infectious disease. In accordance with paragraphs 2 and 3 of paragraph 61 of the Resolution of the Plenum of the Supreme Court of the Russian Federation dated September 27, 2016 N 36 “On some issues of application by courts of the Code of Administrative Procedure of the Russian Federation,” the court does not have the right to recognize as justified a contested decision, action, or inaction with reference to circumstances not which were the subject of consideration by the relevant body, organization, person, thus changing the grounds for the decision made, the action taken, the inaction that took place. For example, if the circumstances specified in the contested decision of the public authority and which served as the basis for its adoption are not proven, the court does not have the right to refuse to recognize such a decision as illegal, citing the presence of other grounds (circumstances) established by it for making such a decision. Thus, the head of an educational organization is obliged to prove the child’s danger to others, but this is not within his competence, since he is not a doctor, and the educational organization does not have a license for medical activities. Inconsistency of the content of the contested actions and decisions with the requirements of regulations. Justifying their illegal demands for mandatory tuberculin diagnostics are usually referred to clause 5.2 of the sanitary rules SP 3.1.2.3114-13. At the same time, paragraph 2 of clause 5.1 of these rules is deliberately omitted, from which it follows that “Children from socially disadvantaged families and children of foreign citizens living on the territory of the Russian Federation who arrived from countries disadvantaged by tuberculosis are required to be examined.” Thus, all other children undergo this examination only on the basis of voluntary informed consent. A similar rule on respecting the right of citizens to voluntary informed consent is found in clause 7 of the Procedure and timing of preventive medical examinations of citizens in order to detect tuberculosis, approved by Order of the Ministry of Health of Russia dated March 21, 2017 N 124n. The absence of mandatory examination requirements in the sanitary rules is confirmed by the decision of the Supreme Court . In addition, the priority of sanitary rules and norms of Federal Law No. 52-FZ of March 30, 1999 is usually declared over the norms set out in Article 20 of Federal Law No. 323-FZ of 21. 11.2011 on the need for voluntary informed consent when conducting tuberculin diagnostics or other examination methods. At the same time, in accordance with paragraphs. 2 tbsp. 2 of Federal Law No. 323-FZ of November 21, 2011 “protecting the health of citizens (hereinafter referred to as health protection) is a system of measures of a political, economic, legal, social, scientific, medical, including sanitary and anti-epidemic (preventive) nature,” B in accordance with paragraph 2 of Article 3 of Federal Law No. 323-FZ of November 21, 2011, “health protection standards contained in other federal laws, other regulatory legal acts of the Russian Federation, laws and other regulatory legal acts of the constituent entities of the Russian Federation must not contradict the norms of this Federal Law." In accordance with clause 3 of Article 3 of Federal Law No. 323-FZ of November 21, 2011, “in case of inconsistency with the health protection standards contained in other federal laws, other regulatory legal acts of the Russian Federation, laws and other regulatory legal acts of the constituent entities of the Russian Federation , the norms of this Federal Law apply the norms of this Federal Law.” Thus, in accordance with paragraph 2 of Art. 15 CAS of the Russian Federation are subject to the application of the provisions of Article 20 of Federal Law No. 323-FZ of November 21, 2011 until evidence of the circumstances listed in clauses 9 and 10 of this article is provided.

Tuberculosis is one of the most serious diseases that affects the human body. Medical scientists are constantly developing new formulas for drugs against tuberculosis.

Mantoux is the introduction of special medications into the child’s body to detect tuberculosis at an early stage of the disease. Mantoux can be waived by one of the parents.

Is it possible to refuse Mantoux? Yes. But before doing this, you should clearly know that the child has not had contact with a person infected or with an open form of the disease. This is especially important when the child is a teenager (14-17 years old).

You can write a refusal if the child is healthy, energetic, and active. There are no symptoms of tuberculosis. But, if there are doubts about the baby’s health (drowsiness, lethargy, paleness, sweating, coughing), then it is necessary to conduct a diagnosis. There is no need to refuse the test. This will primarily help identify the disease in the first steps.

You should also do a Mantoux test if:

The family had relatives with a closed form of tuberculosis and lived in the same house or apartment.
During pregnancy, the mother had contact with an infected person. The mother can be completely healthy, but the child is infected.

When a child is vaccinated, a parent must be present in person. Before introducing the drug into the body, the doctor must give clear instructions on further actions (do not wet it with water, the temperature may rise). And also, before administering antibodies, the parent must sign a document according to which the parent assumes all circumstances related to the diagnosis. In case of complications after vaccination (high temperature), assistance is provided directly by the parents. In a difficult situation, you can call an ambulance. But the doctor does not bear any responsibility after the Mantoux test.

Even if a child has short-term contact with an infected person, a Mantoux test should be done to detect tuberculosis in the body.

Each parent who cares about the health of the child, before giving consent, will study the composition of Mantoux (sodium chloride, phosphorus salts, stabilizers, phenol) introduced into the baby’s body.

The main component is tuberculin. This is an extract from an animal that contains protein, lipids, and other components of the Koch bacillus. This ingredient contains almost all the components of tuberculosis.

The rejection of the Mantoux test is obvious.

This composition may cause side effects in a child:

the temperature rapidly rises to 38 degrees and above;
a rash appears on the baby’s skin;
the child refuses to eat even the most favorite and delicious dishes;
the child’s weakness, lethargy, lack of energetic movements and mood.

When Mantoux is introduced into the body, with a weakened immune system, antibodies injected orally develop. In this case, the immune system does not have enough strength to fight the foreign body. Therefore, various complications may arise.

If the immune system is strong and the child is healthy, Mantoux is tolerated almost unnoticeably.

There are several ways to refuse Mantoux:

having studied the law on vaccinations and vaccinations;
write the refusal on a separate form, which should be in each clinic. The vaccine refusal form will not work because it is not a vaccine. A vaccination waiver form is required;
You should write a statement stating the reasons for refusing Mantoux.

Before writing a refusal to vaccinate, you need to study in more detail all the negative and positive aspects of this test.

The Mantoux test contains phenol and tuberculosis bacillus. With a weakened immune system, the body cannot cope with foreign bodies. The test will give a positive result.

Pros and cons of Mantoux

If we take medical personnel, then we can say with confidence that all doctors strive to protect the child from diseases. They do everything possible for their recovery if pathology is detected.

Positive aspects of Mantoux:

According to doctors, it is not dangerous for the general condition of the baby’s body. And those constituent elements, such as phenol, are introduced into the child’s body in small quantities and are not capable of causing harm.
Reveals predisposition to tuberculosis disease. This will help to prevent the disease in time and draw up a rehabilitation plan in case of pathology.
It is not considered a vaccination - it is a test to detect the tuberculosis bacillus. No changes occur in the child's body.
This test is done once a year. During this time, the young body is completely freed from the previously introduced foreign body. There is no addiction to Mantoux, as well as deposits of components in the body.
This test is performed only on a healthy child with excellent immunity, ready to cope with foreign bodies.

Parents who blindly trust doctors and are confident in their child give permission for vaccination. And the question of refusal automatically disappears.

What to do if there is no trust in medical personnel? What if the doctor doesn’t tell you something? Could there be a medicine or vaccine without side effects?

So:

Mantoux may not be suitable for children with various forms of allergies. Any component included in the sample may cause an allergic reaction;
the child has a chronic disease - the body’s immune system is completely aimed at fighting the disease, and foreign bodies cannot be introduced into the body;
a common cold is also a contraindication for Mantoux because the immune system is weakened;
refusal of the Mantoux test is formalized by the parent due to mistrust of the vaccine;
phenol is poison. Belongs to the second class of danger. In pharmaceuticals, it is used in many medications of various types. It is used in medicines in small quantities, so it is practically invisible in the human body. In a child, phenol can cause various reactions - from skin rashes to vomiting, dizziness and fever. But doctors often turn a blind eye to these symptoms (this is a reaction to Mantoux - it will pass). And in case of exacerbation, the phrase immediately sounds - this is not a reaction to Mantoux, the causes of poisoning should be identified. And the doctor will be right, because before conducting the test, the parents sign a document about the consequences of the vaccination and the doctor’s non-involvement: “The parent assumes all responsibility.”

After weighing the pros and cons of Mantoux, you can decide whether to give Mantoux to your child or write a refusal.

Before writing a refusal to be diagnosed for tuberculosis, you should think carefully about everything. This is a serious action in relation to the child's health.

The correct algorithm for rejecting Mantoux

This algorithm includes several methods with which you can issue a waiver of Mantoux.

The laws of the Russian state very carefully protect the rights and health of the child. These laws take into account all the subtleties and nuances that may arise in the process of implementing the law.

By law, preventive vaccination is a voluntary procedure. Parents’ refusal of this procedure cannot affect the child’s attendance at child care institutions (kindergarten, lyceum, gymnasium, school). An exceptional situation is an epidemic, where vaccination is mandatory to prevent the disease.

One of the parents can voluntarily write a waiver of Mantoux if the child has not had contact with a sick person. The child may not do Mantu and freely attend kindergarten or school. But there may be a restriction if the child has obvious symptoms of the disease.

In 2015, at a congress of phthisiatricians, it was decided to abandon Mantoux and introduce Diaskintest.

This drug is more accurate in detecting tubercle bacilli in the body. Therefore, to diagnose a disease in a child’s body, it can be used less frequently than Mantoux.

However, there is an opinion that Diaskintest can accurately show the presence of the disease only when the tuberculosis bacillus is actively growing. And at the initial stage (the presence of the stick in the body), the result is always negative. The question arises: why use this drug? Indeed, with the active development of the disease, the child exhibits obvious symptoms indicating the presence of the disease.

To summarize, starting from 2014, all children from 7 years to 17 years of age must be given Diaskintest by medical workers, not Mantoux. In fact, in 2017 Mantoux is still applicable.

According to the law, the new drug is also a preventive measure and you can write a refusal from both Mantoux and Diaskintest. An exception to the rule may be either an infected child or a progressive disease.

Questions that arise:

Will they take me to school without Mantoux? According to legislative projects and amendments to them, a school and preschool institution cannot refuse to accept a child without vaccinations, as well as without Mantoux.
Do they make Mantu in the kindergarten? Preschool employees must ask parents for consent to conduct this examination. A sample taken without parental consent is considered a gross violation of the law.
After refusal, a ban on visiting the child care facility arises. The parent, according to the laws of the Russian Federation, has every right to write a refusal of this test, and threats and prohibitions from the institution will be unlawful.

The code of laws of the country clearly states all the rights and responsibilities of medical personnel, as well as the legal protection of the child.

Using this method, you can get a refusal only if you know and quote the laws and amendments to them verbatim.

In case of refusal of a preventive vaccine for your child, in each medical institution, according to the law of the Russian Federation, there must be an accompanying form.

The vaccine refusal form is not correct, since it is not a vaccination, but a preventive action. Therefore, filling out the “vaccination refusal” form is not correct. Doctors can focus their attention on this. The refusal will be invalid.

When filling out the Mantoux waiver form, you should do the following:

Before writing your data, study the document.
You should enter your details and your child’s details legibly and without any marks.
Full name must correspond to the data recorded in the passport and birth certificate. Let’s say Semenov’s last name is written in the passport with the letter “E”, then there is no need to put “E” on the form. This would be a mistake.
In the “reason for refusal” paragraph, the parent has the right to write his attitude towards the vaccine or simply put a link to the law and its changes in 2017.
At the end of the form there is a date with the prescribed month (not 09, but September), and also a signature with a transcript (full name).

This refusal will have full legal force.

After filling out the paper, you should make 2-3 copies to provide it to various authorities upon request. The original is pasted into the child’s medical record.

If a parent does not know the law about refusing Mantoux or other preventive injections, pressure may be put on him by medical personnel, as well as in children's institutions.

Often, after refusal, doctors do not sign medical cards for admission to kindergarten. Or suspension from school.

The vaccination form is the wrong form to fill out a Mantoux waiver. There must be a form with a form for refusing to carry out preventive measures for the child.

Writing a disclosure statement

This is the third step in giving up Mantoux. If the clinic does not have the correct form, the parent writes an application addressed to the chief physician of the clinic.

Contents of the statement:

The document indicates the details of the head physician and your full name. The data must be written, according to the documents, without erasures.
The application describes the specific situation, based on facts, why the refusal is issued. This statement must contain references to laws and their amendments “On the protection of children.”
The application is signed by the chief physician of the clinic, after which the attending physician must sign.

After signing the document, a copy is made. The original must be pasted into the child’s medical record. One copy goes to the educational institution. The second copy remains in hand.

The application in a single copy is lost, after which the entire procedure must be repeated. You should make 2-3 copies of the document.

Without knowing the laws, a parent, having signed a Mantoux waiver, can get into a rut of problems and worries. The child was suspended from attending the preschool for 4 months. Parents are required to go to work, the child remains at home alone or goes with his mother to work. After a little time, they may complain from the commission on juvenile affairs. And so on. A lawyer will help you with this whole matter.

Refusal of Mantoux at school entails:

refusal to participate in the Olympics;
refusal of a trip to the museum;
refusal to attend classes and take tests.

The first step is to go to the bar to see a lawyer to get advice on the rights and protection of the child.

For this case, you must have a copy of the Mantoux waiver on hand. The legal representative will explain in clear terms where the law is being violated.

The second step is to go to the director of the kindergarten or school. All violations committed by school or kindergarten employees are explained to this person.

Basically this should be the last step. Otherwise, you need to contact the police or prosecutor's office and write a statement about threats and other unlawful actions on the part of the child care institution. You should definitely indicate your personal knowledge of the laws of the Russian Federation.

To be sure that you are right, a photocopy of the refusal can be sent by registered mail. In this case, within 10 days, the administration of the school (preschool) education must give a written explanation of the reason for the refusal to attend the institution or a legal justification for its threats.

Depending on the answer, you can proceed further: take the child to kindergarten or go with this letter to the prosecutor’s office or the police.

Suspension from school or kindergarten is unlawful. This is proven in court.

When writing an application to refuse Mantoux, you should, in addition to the laws of the Russian Federation, indicate the reasons for the refusal:

Personal reluctance to undergo examination by introducing foreign bodies into the child’s body.
The components included in the preventive medicine are poisonous and harm the child’s health.
The child has no symptoms of tuberculosis and is in excellent health.
The body's reaction to this examination is unknown.
Manifestation of allergies.

These reasons should be stated clearly and concisely. The health of your own child is most important. The mood of the parent is also important - nervous stress and upset of the baby can negatively affect the general condition of both the child and the parents.

When talking with doctors, as well as with senior people, you should remain calm and confident. If uncertainty is demonstrated, the same director will gain the upper hand, and may intimidate even more or refer to higher authorities (the Ministry). If you refer to the Ministry, you need to ask for the appropriate document (order), which will state the rule for the mandatory Mantoux sample.

If the attending physician or chief physician insists on diagnosing a child for tuberculosis, namely a visit to a TB doctor or tuberculosis clinic, you should also refuse. There is only one reason: in a tuberculosis clinic there may be contact with an infected or sick person.

The phthisiatrician conducts diagnostics, leaning on the results obtained from Mantoux. Therefore, in most cases, this trip to the doctor is unsuccessful.

Parents should monitor their child's health very carefully. Refusing or accepting a diagnosis of tuberculosis is a personal and individual matter.

When making a decision, you should carefully weigh all the negative and positive aspects of Mantoux. Find out the current laws of the country, as well as take an interest in the results of statistics and social opinion.

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Congratulations! The likelihood that you will develop tuberculosis is close to zero.

But don’t forget to also take care of your body and undergo regular medical examinations and you won’t be afraid of any disease!
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There is reason to think.

It is impossible to say with certainty that you have tuberculosis, but there is such a possibility; if this is not the case, then there is clearly something wrong with your health. We recommend that you undergo a medical examination immediately. We also recommend that you read the article on.
Contact a specialist urgently!

The likelihood that you are affected is very high, but it is not possible to make a diagnosis remotely. You should immediately contact a qualified specialist and undergo a medical examination! We also strongly recommend that you read the article on.

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Task 1 of 17

1 .

Does your lifestyle involve heavy physical activity?
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2 .

How often do you take a tuberculosis test (eg Mantoux)?
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3 .

Do you carefully observe personal hygiene (shower, hands before eating and after walking, etc.)?
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4 .

Do you take care of your immunity?
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5 .

Have any of your relatives or family members had tuberculosis?
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6 .

Do you live or work in an unfavorable environment (gas, smoke, chemical emissions from enterprises)?
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7 .

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I wrote this:
Refusal
from preventive anti-tuberculosis care.

I, born _________, am the legal representative of my minor child born _________. I refuse to provide _______________ anti-tuberculosis care, namely: Mantoux biotest, chest x-ray and other medical interventions associated with the introduction of foreign substances and ionizing radiation into the body, as well as visits to a phthisiatrician.

This refusal complies with all norms of current legislation, namely:

1. Federal Law “ON THE BASICS OF CITIZENS’ HEALTH PROTECTION IN THE RUSSIAN FEDERATION” dated November 21, 2011 N 323-FZ:

"Article 20. Informed voluntary consent to medical intervention and refusal of medical intervention.

1. A necessary precondition for medical intervention is the giving of informed voluntary consent of a citizen or his legal representative to medical intervention on the basis of complete information provided by a medical worker in an accessible form about the goals, methods of providing medical care, the risks associated with them, possible options for medical intervention, about its consequences, as well as the expected results of medical care.

3. A citizen, one of the parents or other legal representative of the person specified in part 2 of this article has the right to refuse medical intervention or demand its termination, except for the cases provided for in part 9 of this article. The legal representative of a person recognized as incompetent in accordance with the procedure established by law exercises this right if such person, due to his condition, is unable to refuse medical intervention."

2. Art. 7 Ch. 3 Clause 3 of the Federal Law “On preventing the spread of tuberculosis in the Russian Federation” No. 77-FZ (as amended on July 18, 2011).” “Anti-tuberculosis care for minors under the age of fourteen, as well as citizens recognized as legally incompetent, is provided with the consent of their legal representatives, except for the cases provided for in Articles 9 and 10 of this Federal Law and other federal laws.” Art. 9 and 10 apply only to persons with an established diagnosis of tuberculosis.

3. Art. 17 of the Federal Law "On Radiation Safety of the Population" dated January 9, 1996 N 3-FZ. “A citizen (patient) has the right to refuse medical X-ray and radiological procedures, with the exception of preventive studies carried out to identify diseases that are dangerous in epidemiological terms.”

Preventive tests may be prescribed if the disease is suspected. As long as a person does not show any signs of illness or symptoms of illness, he is considered healthy. The doctor is also required to indicate a preliminary diagnosis. There is information about this in the methodological recommendations “Protection of the population when prescribing and conducting x-ray diagnostic studies.”

4. Resolution of the Chief State Sanitary Doctor of the Russian Federation dated February 18, 2003 No. 8 “On the implementation of SanPiN 2.6.1.1192-03”. P. 7.21. “Children under 14 years of age and pregnant women are not subject to preventive x-ray examinations.”

I know that current legislation does not provide for any consequences for refusing an X-ray examination and the Mantoux test, including preventing a child from attending school. There is also no provision for additional examinations of the child or his parents or visits to specialized specialists (phthisiatrician). Departmental documents that contradict federal law are illegal and cannot be enforced.

The Mantoux test is the simplest and most accessible method for determining the body's response to tuberculosis microbacteria and Availability infection in the body.

The process involves intradermal injection of a certain amount of tuberculin, an extract of microbacteria.

Administration of the drug causes immune response, which manifests itself in different ways. If there are no pathogens in the body, then after a couple of days the injection will leave a barely noticeable trace. At inflammation the site where the sample was introduced or the formation of an abscess, there is a high probability of infection of the patient.

What is Mantoux vaccination?

There is a misconception that the Mantoux reaction is a vaccination. Actually it's allergy test, which can be used to identify tuberculosis at its earliest stage, when there are no obvious symptoms.

By law, parents have the right to refuse a test if they believe that it will harm the child’s health.

Is a tuberculin test required or not?

In the Russian Federation, it is legally determined that the diagnosis and prevention of tuberculosis (which includes the Mantoux test) involves voluntary agreement. Children are examined with the consent of their parents or legal representatives. Examination and treatment in mandatory Only patients with an identified disease and a confirmed diagnosis are subject to the procedure.

Important! No one can force you to perform a tuberculin test. There is no need to prove the absence of a disease if not observed signs of active tuberculosis.

When you can’t refuse a test

The examination is necessary when:

available contact with carriers of the disease;
general weakness;
weight loss;
increase temperatures in the evening;
chronic cough.

It is especially important to timely determine the presence of infection in childhood, since it is precisely in children that there is a very high probability that the invading bacterium will cause further pathological processes in the body. Every parent must understand that only he is responsible for the life and health of his child, and if complications arise, it is the parents who bear all the responsibility.

Is there a law on compulsory vaccination in kindergarten or school?

Article 12 of the Federal Law “On the fundamentals of protecting the health of citizens in the Russian Federation” states that the main thing in the prevention of tuberculosis, which is a socially significant disease, is its early diagnosis. At the same time, in article 20 The same federal law states that any medicinal influence is carried out exclusively on a voluntary basis.

Thus, the legality of refusing the tuberculin test has been confirmed and enshrined in law.

Is it possible to refuse a test in kindergarten: sample application

Refusal from the Mantoux test must be formalized in clinic according to the appropriate form. The fact of familiarization with all consequences refusal, the document is signed by the doctor and the refusing party.

You can legally refuse tuberculin diagnostics, which are done every year in medical and educational institutions, if there was no contact with the carrier tuberculosis. The lack of test results should not prevent you from visiting an educational institution.

Photo 1. Sample of parents refusing to vaccinate their child.

According to SanPiN, restrictions on visiting may occur if there are symptoms of the disease ( SP 3.1.2.3114-13 dated 10.22.2013 No. 60). Children whose parents refused the Mantoux test should undergo a consultation with a phthisiatrician, who will conduct an examination on an individual basis.

Legality of the ban on visiting an educational institution

Difficulties associated with refusing vaccination most often begin at the enrollment stage, when the clinic cannot issue a certificate in the form of the educational institution. This happens when parents refuse a tuberculin test and the TB doctor unreasonably does not want to sign medical report.

In this case, you must send a written application addressed to the chief physician institutions with a request to eliminate the violations that have arisen and issue (sign) a medical card.

If contacting the management of the medical institution does not help, parents have the right to contact prosecutor's office or to the judiciary.

If difficulties arise at the level of an educational institution, when a medical card has been issued, but the student is still denied access, it is worth contacting the to the school principal or head of kindergarten, explain your arguments, prove your position, indicate that such a refusal is unlawful. If this does not change the situation, parents can contact higher educational authorities, the prosecutor's office and the court.

Important! It should be remembered that if such a situation arises, it is necessary not only to provoke a scandal, but to solve the problem. Parents have the right to request other safe examination methods and diagnostics.

Alternative diagnostic methods

Alternative and safe diagnostic methods are polymerase chain reaction(PCR) and analysis sputum

Polymerase chain reaction testing is one of the most effective and is used to identify the disease by searching for microbial DNA.

PCR is used for:

determining availability progressive Koch's bacillus;
quick establishment foci of localization of infection;
diagnostics relapse diseases;
monitoring the course of treatment.

Sputum analysis is also a safe method of research that excludes the introduction of pathogenic bacteria into the body. Infected microbacteria are present in the sputum of a sick person, so examination of the mucous secretions of the lungs allows one to quickly detect the presence of infection.

Advice from lawyers:

1. If I wrote a refusal to accept the Mantoux test for a 2nd grade child at school, may my child not be allowed to attend classes?

1.1. In your situation
obliged to allow

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