On October 28, 2021, an international scientific and Practical conference "Medicine and Law: Regulation and Judicial practice" was held online, organized as part of the celebration of the 30th anniversary of Independence of the Republic of Kazakhstan." The organizers of the conference were: Astana Medical University (NAO MUA), Novosibirsk State University of Economics and Management (NSUEU), Volga Institute of Economics, Pedagogy and Law, Institute of Legislation and Legal Information of the Republic of Kazakhstan.

More than 80 people took part in the conference: deputies of the Majilis of the Parliament of the Republic of Kazakhstan, judges, representatives of the Ministry of Health of the Republic of Kazakhstan, public organizations, scientists, teachers, students, undergraduates and doctoral students of medical and law universities of Kazakhstan and foreign universities, medical workers, lawyers, mediators of the Republic of Kazakhstan, the Russian Federation, Ukraine, the Republic of Abkhazia, Lithuania, the UAE.

The issues of legal protection of the main values of a person - his life and health always remain in the spotlight of society. The relevance of this event is dictated by the current situation in the healthcare sector. The growing number of lawsuits in the field of healthcare does not allow anyone to remain indifferent at the present time. Medical law is in the process of formation and in order to further develop this branch of national legislation, it is necessary to determine priorities, main directions of development, extensive and in-depth scientific search, communication, exchange of opinions are needed, the purpose of which is to conduct this event. The conference became a unique platform for the exchange of views and collective discussion of the most pressing problems of regulation of medical activity, bioethics and medical law, modern judicial practice in cases against medical workers and medical organizations, pre-trial settlement of disputes with patients, criminal liability in the field of healthcare.

The plenary session of the conference was opened by the Acting Rector of the NAO "Astana Medical University", MD PhD M.A. Dauletyarova, who welcomed all participants on behalf of the teaching staff of the Astana Medical University and noted the relevance of the issues raised at the conference and the importance of holding such events in order to exchange experience and best practices, as well as consolidate efforts for the scientific search for solutions to problems in the field of healthcare.

On behalf of the Ministry of Health of the Republic of Kazakhstan, the Director of the Department of Science and Human Resources D.K. Aldyngurov made a welcoming speech. Noting the relevance of the discussion platform, he stressed that this conference is of a practical nature, and the conference program is of professional interest. The speaker wished all participants fruitful work and to make an innovative contribution to the development of domestic medicine.

Deputy of the Majilis of the Parliament of the Republic of Kazakhstan G.A. Nurumova made a report on the topic "Measures of responsibility of medical workers according to the legislation of the Republic of Kazakhstan: problems and ways to solve them". The deputy noted the importance of the conference, which is timed to the Day of the celebration of the 30th anniversary of Independence of the Republic of Kazakhstan.

The judge of the Judicial Board for Civil Cases of the Supreme Court of the Republic of Kazakhstan, E.T. Maksyuta, in her report noted that the problems of civil cases in the field of healthcare are primarily related to the complexity of this category of cases, the lack of judges' deep understanding of the specifics of medical activity. E.T. Maksyuta, at the same time explained that in developed countries most of the conflicts and disputes are resolved out of court through mediation and called for the services of mediators.

Corresponding member of the National Academy of Sciences of the Republic of Kazakhstan, Doctor of Law, Professor B.Zh. Abdirayym in his report "On the issues of providing insurance guarantees to medical workers in the conditions of COVID-19: problems of law enforcement" drew the attention of participants to the need to introduce a system of professional liability insurance for medical workers. In his opinion, the main reason for the shortage of personnel is staff turnover, imperfection of the remuneration system, low motivation, legal insecurity, insufficient social support for medical workers. He also focused on statistics, according to which about 600-800 cases are initiated annually in Kazakhstan under articles 317-323 of the Criminal Code of the Republic of Kazakhstan, of which only 5% come to the courts, that is, the overwhelming number of cases are terminated for lack of evidence. He sees possible solutions in the generalization by the Supreme Court of the Republic of Kazakhstan of judicial practice in this category of cases and the adoption of a regulatory resolution. He also recommended that the Ministry of Health consider the issues of professional liability insurance for medical workers and create conditions for the protection of medical workers who have committed unintentional acts against the health and life of patients, the development of medical mediation.

The Vice-Rector for Research and Additional Education of the Novosibirsk State University of Economics and Management, PhD, Associate Professor A.A. Makartsev stressed the need for comprehensive coverage of the problems of realizing the right to health protection, that the set of measures taken by the state today in the field of health protection is aimed primarily at improving the quality and accessibility of medical care for the population of the Russian Federation. He also noted that the decisions of the Constitutional Court of the Russian Federation also reflect the main directions of development of medical law.

The report of the Director of the Institute of Parliamentarism M.M. Makhambetov was devoted to the review of topical issues of the realization of citizens' rights to health protection. He focused on the problems related to the quality of medical care and stressed the need for an in-depth analysis of legislation in the field of healthcare and the development of proposals for its improvement, taking into account the appeals of citizens, law enforcement practice and positive international experience.

The chief researcher of the Department of Criminal, Criminal Procedure and Penal Enforcement Legislation of the RSE at the Institute of Legislation and Legal Information of the Republic of Kazakhstan of the Ministry of Justice of the Republic of Kazakhstan, Doctor of Law, Professor S.M. Rakhmetov described in great detail the existing problems of criminal liability of medical workers. The attention of the conference participants was attracted by the statistical data provided by him on the number of registered criminal cases and convicted in such cases in recent years. So, in 2019, 229 criminal cases were registered in Kazakhstan, 11 people were convicted, in 2020 - 255 cases, 15 people were convicted. That is, the overwhelming number of cases were dismissed before the trial. He opposed the opinions expressed by individual experts on the exclusion of Article 317 of the Criminal Code of the Republic of Kazakhstan in order to ensure the implementation of the principle of inevitability of punishment for crimes in the field of medicine.

Concluding the plenary session, Vice-Rector for Scientific Work of the Volga Institute of Economics, Pedagogy and Law, Ph.D., Associate Professor I.V.Aparina in her report "Moral, legal and medical aspects of surrogacy" shared her vision of the existing problems of the surrogacy program in the Russian Federation, which is a social problem and therefore should attract the attention of physicians. She noted that the legal regulation on surrogacy is insufficient, inconsistent and contradictory. Many States either exclude this institution or significantly restrict it. Currently, a bill has been developed in Russia to ban adoption by foreign citizens, which does not contradict the norms of the Constitution. As one of the possible solutions to the problems, she proposed at the legislative level to resolve the issue of guarantees for the transfer of a child to his biological parents.

The report was delivered by the Deputy Chairman of the Constitutional Court of the Republic of Abkhazia, Candidate of Law, Associate Professor D.E. Pilia on the topic "The constitutional right to life and the legal status of the embryo under the legislation of the Republic of Abkhazia". She dwelt on the problems of the legal status of the embryo and stressed that such an indisputable fact of the birth of a new life has a different consolidation of the right to life in international legislation and legislation of different countries.

Director of the Expert Institute of European Law and Human Rights, Doctor of Law, Professor M.S. Bashimov in his report "Constitutional and legal foundations of the right to health protection in the Republic of Kazakhstan guarantees of implementation" assessed the state of the modern health care system, pointing out the most pressing problems of the realization of the right to health protection and medical care in Kazakhstan. He also noted the importance and timeliness of holding such conferences with discussion of both theoretical and practical issues of protecting human rights to life and health relevant to society. Bashimov outlined the need to improve judicial practice in the consideration of disputes in the field of healthcare.

Professor of the Higher School of Law and Public Administration of the NAO "Narkhoz University", Ph.D. S.I. Klimkin shared the results of his analysis of the norms of the Code of the Republic of Kazakhstan "On Health and Health Systems" and his vision. He noted that, despite the absence of signs of "contiguity", the symbiosis of the norms of civil and medical law will only expand in connection with the further development of the sphere of paid provision of medical services on the basis of contracts.

The head of the Department of Medical Law and Ethics of the NAO "Astana Medical University", PhD, Associate Professor Zh.U Tlembayeva highlighted some issues of medical ethics, deontology, medical law as components of the system of social regulation of the activities of medical workers. The development of new medical technologies, in her opinion, revealed a large number of moral and ethical problems that can be solved within the framework of bioethics as an interdisciplinary science dealing with the study of moral, ethical and legal problems of medical activity in the context of human rights protection. She also noted that violations of medical ethics and deontology by employees of a medical organization in the provision of services, proven in accordance with the procedure established by law, indicate that the service does not comply with the mandatory requirements provided by law. However, in accordance with the current legislation, such violations do not relate to defects in medical services.

Dean of the Faculty of Law of the Novosibirsk State University of Economics and Management, Ph.D., Associate Professor O.N. Sherstoboev, very thoroughly revealed the issues of qualification of individual administrative offenses, the specifics of the implementation of the principle of doctor's integrity as an element of the qualification of offenses in the field of healthcare, the number of which has recently increased.

Head of the Department of Constitutional, Administrative Legislation and Public Administration of the RSE at the Institute of Legislation and Legal Information of the Republic of Kazakhstan of the Ministry of Justice of the Republic of Kazakhstan, Candidate of Law Nurgazinov B.K. in his report on "Criminal liability for medical criminal offenses in the Republic of Kazakhstan" pointed out a number of problems in the investigation of criminal cases: insufficiency of the analysis carried out during the investigation, violation of the terms of investigations. He also noted the positive role of the Department of Medical Law and Ethics at the Moscow Medical University, which makes a significant contribution to the legal training of future doctors in order to improve their legal culture.

Associate Professor of the Department of Medical Law and Ethics of the NAO "Astana Medical University", Candidate of Law, A.A. Dauletkhanova acquainted the conference participants with the prospects for the development of artificial intelligence in medicine and put forward for discussion a number of proposals to consolidate the legal regime for the use of artificial intelligence in legislation.

Among the foreign participants, the speech of Y. M. Sadykova, PhD, Associate Professor of the Department of Legal Disciplines of the Sumy Branch of the Kharkiv National University of Internal Affairs on the topic "Judicial decisions and evidence in civil cases arising from disputes over the provision of medical services in Ukraine" also aroused interest. She noted that in Ukraine, the practice in cases related to the provision of medical care is extremely scarce. To take into account the peculiarities of medical activity, she proposed to involve specialists in the field of medicine in the investigation of medical criminal offenses.

The judge of the Saryarkinsky district Court of Nur-Sultan G.S. Sharapatova in her report on the topic "Trends and features of modern judicial practice with the participation of medical workers and medical organizations" described the features of judicial practice in cases in the field of healthcare and provided statistics on the number of cases considered in the Court of Nur-Sultan.

Director of the Scientific and Educational Center of Civil Law Disciplines of the Academy of Justice under the Supreme Court of the Republic of Kazakhstan, Ph.D., Associate Professor E.O. Egemberdiev presented an analysis of judicial practice in civil cases related to the provision of medical services and characterized their features on specific examples.

Associate Professor of the Department of Medical Law and Ethics of the NAO "Astana Medical University", Candidate of Law, Associate Professor E.S. Zhambayev highlighted the foreign experience of administrative and legal regulation of professional liability insurance as a form of legal protection of medical workers and suggested taking it into account in rulemaking.

The chief lawyer of the company "Kazakhstan Investment Development Fund (KIDF) Management Company" Ltd B.B. Askarov focused on the problems of humanization of the legislation of the Republic of Kazakhstan on criminal liability of medical workers. Also, in his opinion, it is necessary to take measures to protect doctors in case of an unfavorable outcome of treatment without the fault of the doctor and the medical institution.

Candidate of Legal Sciences, Professor of the Higher School of Law and Public Administration of the NAO "Narkhoz University" A.S. Zhapparova in her report on "Medical criminal offenses: the current situation and some issues of legislative regulation" outlined a number of legislative problems in this area. She also supported the proposal of a number of leading legal scholars who spoke at this conference on the need to generalize judicial practice in the field of healthcare and the adoption of a special regulatory resolution of the Supreme Court of the Republic of Kazakhstan.

Director of the company "IMB Company", obstetrician-gynecologist N. Isaeva stressed that medical workers need clinical skills, legal knowledge, effective communication skills. However, the heads of medical organizations in Kazakhstan often underestimate the role of the formation of communication skills among employees.

The anesthesiologist-resuscitator of the Central City Hospital of Essentuki, medical lawyer D.A. Kashka, talking about the prospects for the use of mediation in healthcare, noted that the criminal punishment of a doctor does not solve the problem of patients' health. Mediation issues in healthcare should be handled by a mediator doctor with sufficient legal knowledge.

The head of the Reconciliation Center of the NAO "Astana Medical University", director of the Private Institution "International Institute of Mediation" Zh.Zh. Usypbekova, acquainted the participants with the results of the Center's work for one year. The mediators of the Center considered 108 applications of citizens and organizations, of which only in four cases the dispute was considered in court. She voiced the main causes of medical disputes: the low level of legal literacy of medical personnel; shortcomings in the management of medical organizations; citizens' distrust of the healthcare system; the creation of a negative image of a medical worker in the media and social networks; excessive workload of doctors in polyclinics; low salaries of doctors and the lack of a social package of medical personnel.

Judges also took part in the conference (G.R.Rakhmetova, Zh.M. Abayeva, Zh. Duisenova.M), scientists, teachers, doctoral students of Kazakhstani and foreign universities (Kabelkov S.N., Tulepbergeni Zh.T., Kolyabin A.Yu., Zubareva E.V., Gorobets N.A., Bazarova G.S., Usenkov I.A., Gataullina G. I., Sadykova A., Plyushkin V.A., Khamzina M.G., Kudaibergenova M.Zh., Niyazgulov D.T., Smagulova A.S., Tsai E., Alchimbayeva M.A., Nurlumbayeva L.E.), representatives of public organizations (Tazhibai B.A.), mediators (Morozova E.V., Kalieva S.T., Orazkulova N.A.).

Following the results of the conference, recommendations were developed, which will be sent to the relevant state bodies.