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Gglobaluri iniciativa fsiqiatriaSi - Tbilisi

fsiqiatriuli daxmarebis samarTlebrivi regulireba saqarTveloSi: kanonmdebloba da praqtika

situaciuri analizi

2008

GHLBS-Georgian Health

Law and Bioethics Society

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winamdebare analizi momzadda partnioruli proeqtis “adamianis uflebaTa mdgomareobis gaumjobeseba saqarTveloSi fsiqikuri janmrTelobis dacvisa da inkluziuri ganaTlebis ganaxlebis gziT” farglebSi. am proeqtis erT-erTi ZiriTadi amocanaa, fsiqikuri janmrTelobis dacvis gaumjobeseba fsiqiatriis sferoSi arsebuli kanonmdeblobis daxvewisa da praqtikaSi danergvis xelSewyobiT. fondi “globaluri iniciativa fsiqiatriaSi-Tbilisi” am naSromis meSveobiT gamokveTavs kanonmdeblobis sferoSi arsebul winaaRmdegobebsa da problemebs da win wamoswevs im sakiTxebs, romlebic saswrafo gadawyvetas saWiroeben. avtorebi: nana zavradaSvili lali Cxetia proeqti xorcieldeba holandiis sagareo saqmeTa saministros samoqalaqo sazogadoebis (matra) programis finansuri mxardaWeriT

oqtomberi, 2008 Tbilisi

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Sesavali 2 terminologia 4 1 2007 wlis ivlisis sakanonmdeblo cvlilebebamde arsebuli mdgomareoba 5

2 aranebayoflobiTi fsiqiatriuli daxmareba (moqmedi kanonmdebloba) 8 3 msjavrdebulTa fsiqiatriuli daxmareba 19 4 sasamarTlo - fsiqiatriuli eqspertiza 21 5 fsiqiatriis sakiTxebi sss kodeqsisa da patimrobis kodeqsis proeqtebSi 25

sarCevi

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Sesavali

fsiqikuri aSlilobis mqone adamianTaA aranebayoflobiTi mkurnaloba adamianis uflebaTa dacvis TvalsazrisiT umniSvnelovanesi sakiTxia fsiqiatriuli daxmarebis aRmoCenisas. mraval qveyanaSi fsiqiatriaSi iZulebiTi RonisZiebebis gamoyenebis sakanonmdeblo regulacia mimarTulia adamianis uflebebis dacvasa da sazogadoebis usafrTxoebaze zrunvas Soris gonivruli balansis SenarCunebisaken. qveynis mier arCeuli modeli damokidebulia rogorc kulturul da samarTlebriv tradiciebze, aseve arsebuli fsiqiatriuli daxmarebis koncefciasa da struqturaze. saqarTvelos kanonmdeblobis ganviTarebis da daxvewis procesSi, fsiqiatriul mkurnalobasTan dakavSirebuli xakanonmdeblo xarvezebi da saerTaSoriso standartebTan Seusabamoba xangrZlivi periodi kanonmdebelTa yuradRebis miRma rCeboda. aranebayoflobiT fsiqiatriul daxmarebas im pirTa, romlebsac ar CaudeniaT samarTaldarRveva, magram fsiqikuri aSlilobis gamo safrTxes uqmnian garSemomyofebs aregulirebs kanoni “fsiqiatriuli daxmarebis Sesaxeb,” romelic pirvelad 1995 wels miiRo saqarTvelos parlamentma. sasamarTlo fsiqiatriis sakiTxebi, kerZod, sasamarTlo fsiqiatriuli eqspertiza da fsiqikurad daavadebul samarTaldamrRvevTa iZulebiTi mkurnalobis sakiTxebi sabWoTa periodidan moyolebuli 2007 wlis ivlisamde sisxlis samarTlis kodeqsisa da sisxlis samarTlis saproceso kodeqsis prerogativa iyo. axalma kanonma “fsiqiatriuli daxmarebis Sesaxeb,” romelic ZalaSi 2007 wlis 1 ianvridan Sevida, mniSvnelovani cvlileba Seitana fsiqiatriuli mkurnalobis, gansakuTrebiT aranebayoflobiTi mkurnalobis sakanonmdeblo doneze regulirebaSi. kanonis inovacia iyo aranebayoflobiTi mkurnalobis daniSvnis dros da mkurnalobis gaxangrZlivebisas garkveuli periodulobiT sasamarTlo ganxilvis SemoReba. Sesabamisad damateba Sevida administraciul saproceso kodeqsSi, sadac ganisazRvra aranebayoflobiTi mkurnalobis administraciuli wesiT sasamarTlo ganxilvis procedura1. aranebayoflobiTi fsiqiatriuli mkurnalobis procesSi sasamarTlo ganxilvebis SemoRebam, SeiZleba iTqvas, biZgi misca fsiqiatriasTan dakavSirebul sakanonmdeblo cvlilebebs. mxedvelobaSi gvaqvs 2007 wlis 3 ivliss sisxlis samarTlis da sisxlis samarTlis saproceso kodeqsebSi, aseve “fsiqiatriuli daxmarebis Sesaxeb kanonSi” ganxorcielebuli cvlilebebi, romelTa mixedviT, fsiqikurad daavadebul samarTaldamrRvevTa aranebayoflobiTi mkurnalobis sakiTxebi amoiRes sisxlis samarTlis kanonmdeblobidan da dauqvemdebares fsiqiatriuli daxmarebis kanonis regulirebisas. rac logikuria danaSaulisa da

1 “saqarTvelos administraciuli saproceso kodeqsi”, „ÈÀÅÉ VII4. ÀÃÌÉÍÉÓÔÒÀÝÉÖËÉ ÓÀÌÀÒÈÀËßÀÒÌÏÄÁÀ

ÀÒÀÍÄÁÀÚÏ×ËÏÁÉÈÉ ×ÓÉØÉÀÔÒÉÖËÉ ÃÀáÌÀÒÄÁÉÓ ÌÉÆÍÉÈ ÐÉÒÉÓ ÓÔÀÝÉÏÍÀÒÛÉ ÌÏÈÀÅÓÄÁÀÓÈÀÍ ÃÀÊÀÅÛÉÒÄÁÉÈ

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sasjelis saqarTveloSi arsebuli doqtrinis mixedviT da progresuli nabijia adamianis uflebaTa saerTaSoriso standartebTan daaxloebisaTvis. magram aRniSnuli cvlilebebis bundovani, winaaRmdegobrivi da arasrulyofili xasiaTis gamo, muSaobaSi seriozuli sirTuleebi da gaugebroba SeeqmnaT rogorc sisxlis, ise administraciul sasamarTloebs da praqtikos fsiqiatrebs. rogorc ki naTeli gaxda, SemoTavazebuli cvlilebebis xarvezebi da praqtikuli ganxorcielebis sirTuleebi, 2007 wlis 18 oqtombers saqarTvelos parlamentis iuridiul sakiTxTa komitetma waradgina cvlilebebisa da damatebebis kanonproeqti, romelic jer kidev ganxilvis procesSia. winamdebare kvlevis mizania, asaxos da Seafasos fsiqikuri aSlilobis mqone pirTa fsiqiatriuli mkurnalobis sakiTxebi moqmedi kanonmdeblobis mixedviT, damkvidrebuli praqtika, aseve dRis wesrigSi arsebuli kanonproeqtebiT am sakiTxTan mimarTebiT SemoTavazebuli novaciebi.

kvlevis miznebidan gamomdinare, gaanalizebuli iyo fsiqikuri aSlilobis mqone pirTa mimarT moqmedi kanonmdebloba: “kanoni fsiqiatriuli daxmarebis ESesaxeb”, administraciuli saproceso, sisxlis samarTlis, sisxlis samarTlis saproceso kodeqsebi, “patimrobis Sesaxeb saqarTvelos kanoni”, saqarTvelos Sromis, janmrTelobisa da socialuri dacvis ministris, iusticiis ministris brZanebebi, sxva normatiuli dokumentebi. kanonis praqtikaSi muSaobis xarvezebze da problemebze interviu CautardaT sasamarTlo-eqspertizis erovnuli biuros fsiqiatriuli samsaxuris ufross daviT maRraZes, akademikos b. naneiSvilis saxelobis fsiqikuri janmrTelobis erovnuli centris generalur direqtors goCa bakuraZes, iuridiuli daxmarebis saxelmwifo samsaxuris quTaisis biuros ufross gela siordias, iusticiis saministros sasjelaRsrulebis departamentis socialuri samsaxuris ufross anton qelbaqians.

Sefasebis safuZvelze gamokveTil problemebs mivyavarT arsebiT problemamde, moqmedi kanonmdebloba da uaxloesi cvlilebebic gvTavazobs e.w. gardamavali periodis reJims. realurad fsiqiatriuli daxmarebis sakanonmdeblo sistema/modeli bundovani da winaaRmdegobrivia da ver akmayofilebs saerTaSoriso standartebs, amavdroulad arc praqtikulobiT gamoirCeva.

Nnana zavradaSvili, eqsperti Llali Cxetia, eqsperti

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terminologia

dRes ar arsebobs erTiani Camoyalibebuli terminologia romelic ganasxvavebs aranebayoflobiT mkurnalobas fsiqikuri aSlilobis mqone pirebisa, romlebmac Caidines marTlsawinaaRmdego qmedeba da fsiqiatriuli pacientebis, romelTac ar CaudeniaT danaSauli. kanoniT miRebuli definiciis - sisxlis samarTlis saqmeze sasamarTlo gadawyvetilebis safuZvelze aranebayoflobiTi mkurnaloba – teqstSi xSiri gamoyeneba Znelia. mocemul kvlevaSi gamoviyeneT terminebi: zogadi fsiqiatriuli pacienti – piri, romelsac ar Caudenia marTlsawinaaRmdego qmedeba da romlis mkurnaloba regulirdeba fsiqiatriuli daxmarebis Sesaxeb kanoniT; sasamarTlo fsiqiatriuli pacienti – piri, romelsac fsiqiatriuli daxmareba utardeba marTlsawinaaRmego qmedebis Cadenis Semdeg; anu marTlsawinaaRmdego qmedebis Cadenis momentSi Seuracxad cnobili pirebi da danaSaulis Cadenis Semdeg fsiqikurad daavadebulebi (maT Soris msjavrdebuli pirebi); zogadi fsiqiatriuli dawesebuleba/ganyofileba –fsiqiatriuli dawesebuleba/ganyofileba gankuTvnili zogad fsiqiatriul pacientebis samkurnalod; sasamarTlo fsiqiatriuli dawesebuleba/ganyofileba – sasamarTlo fsiqiatriis dawesebuleba/ganyofileba, gaTvaliswinebuli eqspertizisaTvis da sasamarTlo fsiqiatriuli pacientebis mkurnalobisaTvis; Sereuli fsiqiatriuli dawesebuleba/ganyofileba – sadac mkurnaloben orive kategoriis pacientebs erTad. gamoyenebuli Semoklebebi: ssk - sisxlis samarTlis kodeqsi; sssk - sisxlis samarTlis saproceso kodeqsi;

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1. 2007 wlis ivlisis sakanonmdeblo cvlilebebamde arsebuli

mdgomareoba

imisaTvis rom mkiTxvels naTeli warmodgena Seeqmnas fsiqikuri janmrTelobis sferoSi moqmedi kanonmdeblobis Sesaxeb mokled mimovixilavT fsiqikuri aSlilobis mqone pirTa mimarT samarTalwarmoebis 2007 wlis 3 ivlisamde moqmed wess; aseve saqarTveloSi arsebul danaSaulisa da sasjelis doqtrinis gaanalizebisaTvis, Zalian mokled avRwerT danaSaulis, bralisa da sasjelis definiciebs moqmedi kanonmdeblobis Sesabamisad; danaSauli, brali da sasjeli moqmedi kanonmdeblobis Sesabamisad saqarTvelos sisxlis samarTlis kodeqsis me-7 muxli gansazRvravs sisxlissamarTlebrivi pasuxismgeblobis safuZvelis - danaSaulis - cnebas: “danaSauli, ese igi am kodeqsiT gaTvaliswinebuli marTlsawinaaRmdego da braleuli qmedeba”, Sesabamisad danaSauli aris mxolod is qmedeba, romelic danaSaulad aRiarebulia sisxlis samarTlis kodeqsSi, romelsac aqvs marTlsawinaaRmdego xasiaTi da Cadenilia braleulad, mxolod am samive elementis Tanxvedra qmnis danaSauls. kanonmdebloba icnobs bralis or formas: ganzraxva da gaufrTxilebloba da orive SemTxvevaSi, saqme gvaqvs gacnobierebuli qmedebis SesaZleblobasTan da nebis kontrolTan. aseTis ar arseboba gamoricxavs brals da Sesabamisad bralis ar arseboba gamoricxavs danaSauls. danaSaulze zemoqmedebis formad sisxlis samarTlis kanonmdebloba gansazRvravs sisxlissamarTlebrivi pasuxismgeblobas anu sasjels. sisxlis samarTlis kodeqsis 39-e muxlis Tanaxmad, sasjelis miznebia: “1. sasjelis mizania samarTlianobis aRdgena, axali danaSaulis Tavidan acileba da damnaSavis resocializacia. 2. sasjelis mizani xorcildeba msjavrdebulsa da sxva pirze zemoqmedebiT, raTa isini ganimsWvalon marTlwesrigis dacvisa da kanonis winaSe pasuxismgeblobis grZnobiT. msjavrdebulze aseTi zemoqmedebis formebi da saSualebebi gaTvaliswinebulia saqarTvelos sasjelaRsrulebis kanonmdeblobiT. 3. sasjelis mizani ar aris adamianis fizikuri tanjva an misi Rirsebis damcireba.” sasjelis miznebidan naTlad Cans, rom es aris pirvel rigSi danaSaulis Camden pirze zemoqmedebis RonisZieba samarTlianobis aRdgenis, axali danaSaulis Tavidan acilebisa da damnaSavis resocializaciis mizniT. axali danaSaulis acilebis elementSi igulisxmeba danaSaulis rogorc kerZo ise zogadi prevencia, anu uSualod damnaSavis mier momavalSi danaSaulis Cadenis Tavidan acileba da aseve sxva pirTa mier igive

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danaSaulis Cadenis Tavidan acileba. es miznebi ki miRwevadia mxolod im SemTxvevaSi, Tu piri vis mimarTac sasjelis zoma gamoiyeneba acnobierebs mis mimarT gamoyenebuli sadamsjelo RonisZiebis miznobriobas.

2007 wlis 3 ivlisamde arsebuli samedicino xasiaTis iZulebiTi RonisZiebis instituti 2007 wlis 3 ivliss sisxlis samarTlis kodeqsSi, sisxlis samarTlis saproceso kodeqssa da fsiqiatriuli daxmarebis Sesaxeb saqarTvelos kanonSi Sevida rigi cvlilebebisa, romlebiTac arsebiTad Seicvala aranebayoflobiTi fsiqiatriuli daxmarebis wesi. manamde moqmedi kanonmdebloba iTvaliswinebda samedicino xasiaTis iZulebiTi RonisZiebis instituts. sisxlis samarTlis kodeqsis me-6 kari (muxlebi 101-107)2 adgenda samedicino xasiaTis iZulebiTi RonisZiebis saxeebs, maTi gamoyenebis safuZvelsa da wess. kerZod, 101-e muxlis pirveli nawilis Tanaxmad, samedicino xasiaTis iZulebiTi RonisZieba pirs eniSneboda Semdeg SemTxvevebSi: Tu (a) pirma am kodeqsis kerZo nawilis muxliT gaTvaliswinebuli marTlsawinaaRmdego qmedeba Caidina Seuracxaobis mdgomareobaSi; (b) danaSauli Cadenilia SezRuduli Seracxaobis mdgomareobaSi; (g) piri danaSaulis Cadenis Semdeg fsiqiurad daavadda, rac SeuZlebels xdis sasjelis daniSvnas an aRsrulebas; (d) pirs esaWiroeba gankurneba alkoholizmisagan an narkomaniisagan. amave muxliT dadgenili iyo, rom samedicino xasiaTis iZulebiTi RonisZieba pirs eniSneboda mxolod im SemTxvevaSi, rodesac misi fsiqikuri mdgomareoba safrTxes uqmnida TviTon mas an sxvas anda Seicavda sxvagvari arsebiTi zianis saSiSroebas (ssk, muxli 101, nawili.2). im SemTxevaSi, Tu eqspertizis daskvniT fsiqikurad daavadebuli marTlsawinaaRmdego qmedebis Camdeni piri ar warmoadgenda saSiSroebas TavisTvis an sxvebisaTvis, mis mimarT samedicino xasiaTis iZulebiTi RonisZieba ar gamoiyeneboda da sasamarTlos SeeZlo gadaeca Sesabamisi masalebi jandacvis organosTvis, romelic wyvetda Semdgom am piris mkurnalobis sakiTxs (ssk, muxli 101, nawili 4). praqtikulad, es gulisxmobda samarTaldamrRvevis zogad fsiqiatriul saavadmyofoSi nebayoflobiT mkurnalobas an gaTavisuflebas fsiqo-nevrologiuri dispanseris meTvalyureobis qveS. amave kodeqsis 102-e muxlis pirveli nawili gansazRvravda samedicino xasiaTis iZulebiT RonisZiebaTa saxeebs: (a) dispanseruli fsiqiatriuli mkurnaloba; (b) fsiqiatriul saavadmyofoSi moTavseba Cveulebrivi meTvalyureobiT; (g) fsiqiatriul saavadmyofoSi moTavseba gaZlierebuli meTvalyureobiT; (d) fsiqiatriul saavadmyofoSi moTavseba mkacri

2 amoRebulia 2007 wlis ivlisSi

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meTvalyureobiT; (e) specializebul narkologiur samedicino-samkurnalo dawesebulebaSi moTavseba gaZlierebuli meTvalyureobiT. amave muxliT gansazRvruli iyo sasjelTan erTad iZulebiTi fsiqiatriuli mkurnalobis daniSvna maTTvis, visac esaWiroeboda alkoholizmis, narkomaniis an sxva fsiqikuri daavadebis (romelic ar gamoricxavs danaSaulze pasuxismgeblobas) mkurnaloba (ssk, muxli 102, nawili 2). Tumca aRsaniSnavia, rom realuradE102 muxlis meore nawili, iseve rogorc pirveli nawilis (e) qvepunqti (alkoholizmis da narkomaniis iZulebiTi mkurnaloba specializirebul dawesebulebaSi) ar muSaobda, radgan ar arsebobda specializirebuli narkologiuri samkurnalo dawesebulebebi gaZlierebuli meTvalyureobiT da arc sasjelaRsrulebis sitemas gaaCnda specialuri narkologiuri mkurnalobis programebi. ssk-is 105-e muxlis Tanaxmad, samedicino xasiaTis iZulebiTi RonisZiebis gagrZlebis, Secvlis an Sewyvetis sakiTxs eqim-fsiqiatrTa daskvnis safuZvelze wyvetda sisxlis samarTlis sasamarTlo. eqim–fsiqiatrTa komisiaSi monawileoba unda mieRo saxelmwifo-saeqsperto dawesebulebis erT eqspert-fsiqiatrs mainc3. amave muxlis me-2, me-3 da me-4 nawilebis Tanaxmad samedicino xasiaTis iZulebiTi RonisZiebis gagrZelebis/Sewyvetis sakiTxs eqim-fsiqiatrTa komisia ganixilavda garkveuli periodulobiT iZulebiTi mkurnalobis saxeebis mixedviT: Cveulebrivi meTvalyureobis dros aranakleb 6 TveSi erTxel, gaZlierebuli meTvalyureobis dros aranakleb 12 TveSi erTxel, mkacri meTvalyureobis dros aranakleb 18 TveSi erTxel. gamonakliss warmoadgenda fsiqikis droebiTi aSliloba, romlis drosac ar iyo aucilebeli am vadebis dacva. danaSaulis Cadenis Semdeg fsiqiurad daavadebul pirTa mimarT samedicino xasiaTis iZulebiTi RonisZiebis daniSvnis SemTxvevaSi, samedicino dawesebulebaSi yofnis periodi pirs Tavisuflebis aRkveTis vadaSi eTvleboda Semdegi gaangariSebiT: fsiqiatriul saavadmyofoSi yofnis erTi dRe udris Tavisuflebis aRkveTis erT dRes (sisxlis samarTlis kodeqsis muxli 106). aRsaniSnavia, rom gansxvavebuli meTvalyureobis iZulebiTi mkurnalobis reJimis SefardebisaTvis aucilebeli klinikuri an iuridiuli kriteriumebi arc sisxlis samarTlis, arc janmrTelobis kanonmdeblobaSi naTlad SemuSavebuli ar yofila. zogadad aRniSnuli iyo, rom iZulebiTi stacionaruli mkurnalobis safuZvelia fsiqikuri daavadebis simZime da xasiaTi. aseve ssk-Si miTiTebuli iyo, rom “ambulatoriuli (stacionargareTa) iZulebiTi mkurnaloba eniSneba mas, visac ar esaWiroeba fsiqiatriuli stacionaruli daxmareba, gaZlierebuli reJimis iZulebiTi stacionaruli mkurnaloba eniSneba maT visac fsiqikuri mdgomareobis gamo

3 2005 wlis 16 dekembris cvlileba, romelic dakavSirebuli iyo saxelmwifo sasamarTlo fsiqiatriuli eqspertizis samsaxuris reformasTan;

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esaWiroeba mudmivi meTvalyureoba, mkacri meTvalyureoba ki eniSneba maT vinc gansakuTrebul safrTxes uqmnis TavisTavs an sxvas” (ssk, muxli 104). praqtikaSi mkurnalobis reJimebi iniSneboda eqspert-fsiqiatrTa klinikuri gamocdilebis an fsiqiatriuli diagnostirebis arsebuli tradiciis Sesabamisad, rac iZleoda kanonmdeblobis farTo interpretaciis da sxvadasxva eqspert-fsiqiatrTa mier subieqturad gansxvavebuli reJimebis Sefardebis SesaZleblobas. umTavresi problema rac aRweril sistemas gaaCnda iyo is, rom realurad pacientis mimarT procesi mimdinareobda sisxlis samarTalwarmoebis gziT da iniSneboda sisxlis samarTlis kodeqsiT dadgenili iZulebis RonisZieba. Tumca ramdenad aRmofxvra es problema kanonmdebelma 2007 wlis ivlisSi axali wesis SemoTavazebiT, amaze qveviT mogaxsenebT.

2. aranebayoflobiTi fsiqiatriuli daxmareba (moqmedi kanonmdebloba) zogadi fsiqiatriuli pacientebis da fsiqikuri aSlilobis mqone samarTaldamrRvevTa aranebayoflobiTi fsiqiatriuli mkurnalobis sakiTxebi kanonmdeblobis mixedviT gansxvavebulad regulirdeba. fsiqikuri aSlilobis mqone samarTaldamrRvevTa mimarT sisxlis samarTalwarmoebis sakiTxis ganxilvisas unda gavmijnoT ori gansxvavebuli SemTxveva, romelic kanoniTac gamijnulia: 1) samarTalwarmoeba piris mimarT, romelsac daudginda Seuracxaoba marTlsawinaaRdego qmedebis Cadenis momentSi da 2) samarTalwarmoeba im piris mimarT, romelic fsiqiurad daavadda danaSaulis Cadenis Semdeg. 1) samarTalwarmoeba piris mimarT, romelsac daudginda Seuracxaoba (SezRuduli Seracxadoba) marTlsawinaaRdego qmedebis Cadenis momentSi sisxlis samarTlis procesSi sasamarTlo fsiqiatriis erT-erTi umniSvnelovanesi amocanaa Cadenili danaSaulis mimarT piris Seracxadobis dadgena, e.i. Sefaseba SeeZlo Tu ara pirovnebas gaecnobierebina Cadenili qmedeba da gaekontrolebina sakuTari qceva. saqarTvelos kanonmdeblobis mixedviT arsebobs danaSaulis mimarT piris Seracxadoba, SezRuduli Seracxadoba da Seuracxaoba. qvemoT ganvixilavT Seuracxaobis da SezRuduli Seracxadobis sakiTxebs.

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saqarTvelos sisxlis samarTlis kodeqsis moqmedi redaqciis 34-e muxlis4 pirveli nawilis Tanaxmad: “[...] marTlsawinaaRmdego qmedeba ar Seeracxeba bralad imas, visac am qmedebis Cadenis dros qronikuli fsiqikuri avadmyofobis, fsiqikis droebiTi aSlilobis, Wkuasustobis an sxva fsiqikuri daavadebis gamo ar SeeZlo gaecnobierebina Tavisi qmedebis faqtobrivi xasiaTi an marTlwinaaRmdegoba anda exelmZRvanela misTvis.” aRniSnuli muxli sisxlis samarTlis kodeqsis IX TavSia ganTavsebuli, romelic gansazRvravs bralis gamomricxav da Semamsubuqebel garemoebebs. amrigad, fsiqikuri mdgomareobis gamo Seuracxaoba warmoadgens bralis gamomricxav garemoebas; bralis – danaSaulis erTerTi niSnis ar arseboba ki Tavis mxriv danaSauls gamoricxavs. Sesabamisad, SemdgomSi pirebs, romelTac daudgindaT Seuracxaoba ar SeiZleba ewodoT danaSaulis Camdeni piri, aramed unda movixsenioT rogorc marTlsawinaaRmdego qmedebis Camdeni piri. saqarTvelos sisxlis samarTlis saproceso kodeqsiT ganisazRvreba fsiqikuri mdgomareobis gamo Seuracxaobis dadgenis ZiriTadi wesi da Tanmdevi Sedegebi. ganvixiloT Sesabamisi normebi. sssk-is 28-e muxlis5 me-2 nawilis Tanaxmad: “[...] sisxlissamarTlebrivi devna agreTve ar unda daiwyos, xolo dawyebuli unda Sewydes, Tu: e) pirma danaSauli Caidina Seuracxaobis mdgomareobaSi, rac dadasturebulia saxelmwifo sasamarTlo-fsiqiatriuli eqspertizis daskvniT”. aRniSnuli normidan naTlad Cans, rom sisxlissamarTlebrivi devna ar unda ganxorcieldes im piris mimarT, romelsac saxelmwifo sasamarTlo-fsiqiatriuli eqspertizis daskvniT daudginda Seuracxaoba danaSaulis6 Cadenis momentSi. ra xdeba amis Semdeg? sssk-is 499-e muxlis me-3 nawili adgens: “Tu dadginda, rom marTlsawinaaRmdego qmedebis Cadenisas gansasjeli Seuracx mdgomareobaSi iyo, sasamarTlo, sakuTari iniciativiT an mxaris SuamdgomlobiT, wyvets sisxlis samarTlebriv devnas am piris mimarT. mosamarTle uflebamosilia mis mimarT gamoiyenos “fsiqiatriuli daxmarebis Sesaxeb” saqarTvelos kanoniT gaTvaliswinebuli RonisZiebebi.” amave kodeqsis 396-e muxlis me-2 nawilis Tanaxmad ki: “Tu sisxlissamarTlebrivi devna wydeba am kodeqsis 28-e muxlis me-2 nawilis “e” qvepunqtis safuZvelze, prokurors ufleba aqvs mimarTos sasamarTlos

4 saqarTvelos sisxlis samarTlis kodeqsis 34-e muxli – Seuracxaoba fsiqikuri daavadebis gamo; 2007 wlis 3 ivlisis redaqciiT; 5 saqarTvelos sisxlis samarTlis kodeqsis 28-e muxli – sisxlissamarTlebrivi devnisa da winaswari gamoZiebis Sewyvetis safuZvlebi, 2007 wlis 3 ivlisis redaqciiT; 6 termin “danaSaulis” arseboba am formulirebaSi arasworia, vinaidan marTlsawinaaRmdego qmedebis Cadenis momentSi bralis ar arsebobis (anu Seuracxaobis) dadgena gamoricxavs danaSaulis arsebobas, Sesabamisad aq unda iyos termini “marTlsawinaaRmdego qmedebis”;

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“fsiqiatriuli daxmarebis Sesaxeb” saqarTvelos kanoniT gaTvaliswinebuli RonisZiebebis gamoyenebis SuamdgomlobiT.” aq sainteresoa fsiqiatriuli daxmarebis kanoniT gaTvaliswinebul ra RonisZiebebs gulisxmobs kanonmdebeli. 2007 wlis ivlisSi saqarTvelos kanonSi “fsiqiatriuli daxmarebis Sesaxeb” Sevida cvlilebebi, romliTac Camoyalibda sisxlis samarTlis saqmeze sasamarTlo gadawyvetilebis safuZvelze aranebayoflobiTi mkurnalobis gagrZelebis da Seyvetis wesi (muxli 22). am muxlis Tanaxmad, eqim – fsiqiatrTa komisia 3 TveSi erTxel afasebs pacientis mdgomareobas da mkurnalobis gagrZelebis saWiroebis SemTxvevaSi, gadawyvetilebis gamomtan sasamarTlos (rogorc Cans igulisxmeba sisxlis samarTlis sasamarTlo) awvdis werilobiT daskvnas. Tu eqim-fsiqiatrTa komisia gadawyvets aranebayoflobiTi mkurnalobis dasrulebas, am SemTxevvaSi tardeba sasamarTlo sxdoma saboloo gadawyvetilebis misaRebad7. unda vigulisxmoT, rom sssk swored am muxlze apelirebs, radgan sxvagan fsiqiatriuli daxmarebis kanonSi sasamarTlo fsiqiatriuli pacientis mkurnalobasTan dakavSirebuli sakiTxebi arsad gvxvdeba. rac Seexeba fsiqiatriuli daxmarebis Sesaxeb kanonis me-18 muxls aranebayoflobiTi fsiqiatriuli daxmarebis Sesaxeb, exeba pacientebs, romelTac ar CaudeniaT danaSauli, magram fsiqikuri daavadebis gamo maTi qceva seriozul safrTxes qmnis, anu zogad fsiqiatriul pacientebs. am SemTxvevaSi pacientis aranebayoflobiTi mkurnalobisaTvis stacionarSi moTavsebis sakiTxs saeqimo komisiis daskvnis safuZvelze wyvets sasamarTlo administraciuli warmoebis wesiT.8 Tumca gansxvavebiT sasamarTlo fsiqiatriisgan, zogad fsiqiatriuli pacientis gawera saeqimo komisiis gadawyvetilebiT SesaZlebelia nebismier dros, rogorc ki Semcirdeba an moixsneba agresiuli qcevis safrTxe. perioduli sasamarTlo ganxilva (yovel 3 TveSi) savaldebuloa, Tu pacientis aranebayoflobiTi mkurnaloba grZeldeba 3 Tveze met xans. fsiqiatriuli daxmarebis Sesaxeb saqarTvelos kanonis 23-e muxlis Tanaxmad, sisxlis samarTlis saqmeze sasamarTlo gadawyvetilebis safuZvelze mkurnalobaze myofi pacienti sargeblobs pacientis ZiriTadi uflebebiTa da garantiebiT, garda fsiqiatriuli daxmarebis saxis arCevisa da mkurnalobaze uaris Tqmis uflebebisa. es debuleba kidev erTxel adasturebs, rom sasamarTlo fsiqiatriuli pacienti gaTanabrebulia zogad fsiqiatriul pacientTan, romelic aranebayoflobiT stacionarul mkurnalobaze imyofeba. vinaidan ar arsebobs sasamarTlo fsiqiatriuli pacientebisaTvis meTvalyureobis gansxvavebuli reJimebi, gaurkvevlia pacientebs SeuZliaT Tu ara iseirnon saavadmyofos teritoriaze da/an datovon teritoria dacvis TanxlebiT Tu mis gareSe, aseve praqtikaSi

7 “saqarTvelos kanoni fsiqiatriuli daxmarebis Sesaxeb”, muxli 22, 2007 wlis 3 ivlisis redaqciiT; 8 saqarTvelos administraciuli saproceso kodeqsi, 21 Tavi VII4

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garTulebulia saamarTlo fsiqiatriul pacientTa arCevnebSi monawileoba da Riadaa darCenili xanmokle SvebulebaSi gaSvebis sakiTxi. SezRuduli Seracxadoba

mTeli rigi fsiqikuri aSlilobebis dros piris mier sakuTari qcevis sruli gacnobiereba ar xdeba da SesaZloa am pirTa mimarT sasamarTlo fsiqiatriuli eqspertizis daskvnis safuZvelze SezRuduli Seracxadoba dadgindes. saqarTvelos kanonmdeblobiT, piri am dros ar Tavisufldeba sasamarTlo pasuxismgeblobisagan, magram sasamarTlo am garemoebas iTvaliswinebs sasjelis daniSvnis dros, rogorc bralis Semamsubuqebel garemoebas (ssk, muxli 35). 2007 wlis 3 ivlisamde, amave muxlSi aRniSnuli iyo, rom am pirebis mimarT SesaZlebelia iZulebiTi fsiqiatriuli mkurnalobis daniSvna, rac praqtikulad xSirad gamoiyeneboda kidec. dRes eqspertebi aRniSnaven, rom kanonSi ar aris pirdapiri miTiTeba SezRuduli Seracxadobis mqone pirTa mkurnalobis saWiroebisas sad an rogor unda Catardes mkurnaloba. rogorc TavSi avRniSneT, ar arsebobs sasjelis aRsrulebasTan erTad fsiqiatriuli daxmarebis programebi, xolo mkurnalobisaTvis specialur dawesebulebaSi gadayvana seriozuli da aSkara fsiqikuri aSlilobis gareSe praqtikulad SeuZlebelia. amrigad, msjavrdebulebi pirovnuli darRvevebiT, gonebrivi ganviTarebis SeferxebiT an sxva fsiqikuri daavadebebiT (romelic ar gamoricxavs danaSaulze pasuxismgeblobas) sasjels ixdian Cveulebriv sasjelaRsrulebis dawesebulebebSi da moklebulni arian fsiqiatriul daxmarebas. 2007 wlis 3 ivlisis cvlilebebis analizi Tu davubrundebiT, Seuracxi piris mimarT samarTalwarmoebas, aSkaraa, rom 2007 wlis 3 ivlisis cvlilebebis Semdeg piri, romelsac marTlsawinaaRmdego qmedebis Cadenis momentSi Seuracxaoba daudginda, moeqca axal samarTlebriv reJimSi. Znelia ar daveTanxmoT princips, rom piri romlis braleulobac gamoiricxa (Seuracxaobis gamo), ar SeiZleba gaxdes sisxlissamarTlebrivi devnis obieqti da Sesabamisad mis mimarT unda Sewydes sisxlis samarTalwarmoeba. magram moqmedi kanonmdebloba miuTiTebs ra “fsiqiatriuli daxmarebis Sesaxeb” kanonze, marTlsawinaaRmdego qmedebis Camden pirebs aTanabrebs zogad fsiqiatriul pacientebTan, romelTac aranebayoflobiTi stacionaruli mkurnaloba utardebaT. fsiqiatriuli daxmarebis Sesaxeb saqarTvelos kanoniT ar aris gansazRvruli sasamarTlo fsiqiatriuli pacientTaTvis mkurnalobisa da maTze meTvalyureobis raime gansxvavebuli reJimi, sad tardeba sasamarTlo fsiqiatriuli mkurnaloba,

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saerTo Tu specialur dawesebuleba/ganyofilebaSi, rogoria dacvisa da usafrTxoebis zomebi, arsebobs Tu ara gansakuTrebuli SezRudvebis procedura (magaliTad saavadmyofos xanmokle vadiT datovebis ufleba, Svebulebis ufleba), mkurnalobis, riskis Sefasebisa da resocializaciis specialuri programebi da sxva. wlebis ganmavlobaSi, sasamarTlo fsiqiatriuli mkurnaloba regulirdeboda sisxlis samarTliT, emsaxureboda ZiriTadad pacientTa izolacias da metwilad Tavisuflebis aRkveTis zomas warmoadgenda vidre mkurnalobas. dRes jandacvis kanonmdeblobaSi “dabrunebis” Semdeg, aucilebelia pacientTa mxridan safrTxisa da marTlsawinaaRmdego qmedebis ganmeorebis riskis Sefasebis instrumentebis danergva, agresiuli qcevis marTvis, pacientTa resocializaciis programebis da mkurnalobaSi multidisciplinaruli mimarTulebis ganviTareba, romelTa gareSe SeuZlebelia sasamarTlo fsiqiatriul pacientTa adeqvaturi mkurnaloba da sazogadoebaSi dabruneba. swored es sakiTxebia darCenili dRes regulirebis miRma da saWiroa am Temebze diskusia da swraf reJimSi Sesabamisi gadawyvetilebebis miReba. kanonis interpretaciis problema garda am sakiTxebisa, aseve praqtikuli uxerxulobac aris Seqmnili. moqmedi normebidan ar Cans realurad Seuracxaobis dadgenis Semdeg, rogor da ra wesiT xdeba marTlsawinaaRdego qmedebis Camdeni piris mimarT aranebayoflobiTi stacionaruli mkurnalobis daniSvna da aseve is, Tu fsiqiatriuli daxmarebis Sesaxeb saqarTvelos kanonis 22-e muxlis safuZvelze, fsiqiatriuli dawesebuleba romeli sasamarTlos winaSea angariSvaldebuli. kerZod, am muxlis pirvel nawilSi miTiTebulia mkurnalobis damniSvneli sasamarTlo, xolo meore nawilSi aRniSnulia, rom sasamarTlo mkurnalobis Sewyvetis an gagrZelebis Sesaxeb ganaCenis aRsrulebis sakiTxs wyvets sssk meTerTmete karis9 mixedviT. sisxlis samarTlis saproceso kodeqsis 396-e muxlis me-2 nawilis Tanaxmad, sisxlis samarTlebrivi devnis Sewyvetis SemTxvevaSi prokurors aqvs ufleba SuamdgomlobiT mimarTos sasamarTlos da moiTxovos “fsiqiatriuli daxmarebis Sesaxeb” kanoniT gansazRvruli aranebayoflobiTi stacionaruli mkurnalobisTvis piris Sesabamis samkurnalo dawesebulebaSi ganTavseba. am SemTxvevaSi aRniSnuli sakiTxi unda ganixilos Sesabamisi samkurnalo dawesebulebis mixedviT mdebare sasamarTlom/magistrma mosamarTlem administraciuli warmoebis wesiT10. sisxlis samarTlis saproceso kodeqsis 499-e muxlis me-3 nawiliT, mosamarTle uflebamosilia marTlsawinaaRdego qmedebis Camdeni Seuracxi

9 sisxlis samarTlis saproceso kodeqsis meTerTmete kari – sasamarTlo ganaCenis, ganCinebisa da dadgenilebis aRsruleba; 10 saqarTvelos administraciuli saproceso kodeqsis 2116 muxlis pirveli nawili; saqarTvelos administraciuli saproceso kodeqsis me-2 muxlis me-2 nawili; saqarTvelos administraciuli saproceso kodeqsis me-6 muxlis “z” punqti; saqarTvelos administraciuli saproceso kodeqsis 2116 muxlis pirveli nawili;

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piris mimarT gamoiyenos “fsiqiatriuli daxmarebis Sesaxeb” saqarTvelos kanoniT gaTvaliswinebuli RonisZiebebi; es ki is mosamarTlea, romelic sisxlis samarTlis saqmis ganxilvaSi monawileobda da romelmac Sewyvita sisxlis samarTalwarmoeba piris Seuracxaobis gamo. aSkaraa, rom aRniSnuli normebis safuZvelze, SesaZloa erTi da igive sakiTxze imsjelos da gadawyvetileba gamoitanos sxvadasxva sasamarTlom, Tumca gaurkvevelia me-2 SemTxvevaSi sisxlis samarTlis saqmis ganmxilvelma sasamarTlom ra wesiT unda imsjelos aranebayoflobiT stacionaruli mkurnalobis daniSvnis sakiTxze. praqtikaSi arsebuli problemebi (sasamarTlo fsiqiatriul pacientTa moTavsebis, mkurnalobis gagrZelebisa da gaweris wesi praqtikaSi b.naneiSvilis sax. fsiqikuri janmrTelobis erovnuli centris generaluri direqtoris goCa bakuraZis intervius masalebze dayrdnobiT) aranebayoflobiTi fsiqiatriuli mkurnalobis praqtikis analizma da sasamarTlo fsiqiatriuli dawesebulebebis menejerTan intervium gamoavlina sasamarTlo fsiqiatriul pacientebTan dakavSirebuli mTeli rigi seriozuli problema, ris gamoc moSlilia mkurnalobis procesi. vinaidan, rogorc zemoT avRniSneT, sssk-is 499-e muxlis me-3 nawilSi ar aris Camoyalibebuli Tu sisxlis samarTlebrivi devnis Sewyvetis Semdeg ra wesiT xdeba Seuracxi piris mimarT mkurnalobis Sesaxeb gadawyvetilebis gamotana, praqtikulad am pirTa mimarT fsiqiatriuli daxmarebis dawyebis procedura gaurkvevelia. fsiqikuri janmrTelobis erovnuli centri dRes erTaderTi dawesebulebaa, sadac arsebobs sasamarTlo fsiqiatriuli ganyofileba, Sesabamisad, yvela sasamarTlo fsiqiatriuli pacienti aq Tavsdeba mkurnalobisaTvis. dawesebulebis direqtoris goCa bakuraZis zepiri ganmartebis Tanaxmad, realurad sasamarTlo fsiqiatriuli mkurnalobisaTvis piris stacionarSi moTavseba xdeba Semdegi wesiT: Seuracxad cnobili piri, romlis mimarTac Sewyda sisxlis samarTlebrivi devna gadmohyavT sasjelaRsrulebis dawesebulebidan (an samkurnalo dawesebulebidan, sadac is imyofeboda sasamarTlos wina periodSi) da Tan axlavs dadgenileba saqmis Sewyvetis Taobaze. Semdeg dawesebulebis administracia, fsiqiatriuli daxmarebis Sesaxeb kanonis me-18 muxlis mixedviT, 48 saaTSi mimarTavs administraciul sasamarTlos aranebayoflobiTi mkurnalobis Sesaxeb gadawyvetilebis gamotanis Sesaxeb. amrigad, dawesebuleba iyenebs ara 22-e muxls, romelic sasamarTlo fsiqiatriul pacientTa mkurnalobis wess gansazRvravs sssk-is 499-e muxliT gaTvaliswinebul SemTxvevebSi, aramed zogadi fsiqiatriuli pacientis aranebayoflobiTi mkurnalobis Sesaxeb me-18 muxls. Sesabamisad, mkurnalobis gagrZelebis SemTxvevaSi, isev am muxliT xelmZRvaneloben.

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kerZod, yovel 3 TveSi erTxel ewyoba mkurnalobis gagrZelebis Sesaxeb sasamarTlo mosmena (zepir mosmenas atarebs administraciuli sasamarTlo dawesebulebis mdebareobis mixedviT11). amrigad, TiToeul aranebayoflobiT mkurnalobaze myof pacientze sasamarTlo tardeba weliwadSi oTxjer. Tu gaviTvaliswinebT, rom pacientebs yoveli gadawyvetilebis gasaCivrebis ufleba aqvT, es ricxvi SeiZleba rvamde gaizrdos. saSualod dawesebulebaSi 300 sasamarTlo fsiqiatriuli pacienti mkurnalobs, Sesabamisad weliwadSi 2800 sasamarTlo procesia mosalodneli. mTeli simZime am procesebis Catarebis awveba saavadmyofos adgilmdebareobis mixedviT administraciul sasamarTlos. maT zogjer dReSi 10-15 procesis Catareba uwevT. kanonmdeblobis mixedviT gaugebaria aseve sasamarTlo fsiqiatriuli pacientis gaweris sakiTxi. fsiqiatriuli daxmarebis me-18 muxlis mixedviT, pacientis gawera SesaZlebelia nebismier dros saeqimo-komisiis gadawyvetilebis safuZvelze da am dros sasamarTlo mosmena ar tardeba, ubralod unda gaigzavnos sasamarTloSi Setyobineba pacientis gaweris Sesaxeb. vinaidan, 2007 wlis ivlisis cvlilebebis Semdeg, sasamarTlo fsiqiatriuli pacientis gaweris praqtika ar yofila, verc fsiqiatriuli samkurnalo dawesebulebis xelmZRvanelma ganmarta, konkretulad rogor moxdeba Seuracxad cnobili pacientebis gawera. daskvna 3 TveSi erTxel aranebayoflobiT mkurnalobaze myof pacientis mkurnalobis gagrZelebis mizanSewonilobis Sesaxeb sasamarTlo ganxilva zepiri mosmeniT, miznad isaxavs pacientis uflebebis dacvas, magram realurad negatiur efeqts axdens rogorc pacientze aseve mkurnalobis procesze. jer es erTi pacienti weliwadSi oTxjer elodeba sasamarTlo ganxilvas da Sesabamisad, saavadmyofodan gaweras. nacvlad imisa, rom moxdes pacientis ZalTa koncentrireba samkurnalo amocanebze, misi energia mimarTulia rac SeiZleba swraf gaweraze. yoveli sasamarTlo gadawyvetileba mkurnalobis gagrZelebis Sesaxeb misTvis axali stresia. fsiqiatrTa gadmocemiT, yoveli sasamarTlo ganxilvis Semdeg pacientebi agznebulni arian, xSiria eqimis sityvieri Seuracxyofa, muqara, xSirad fsiqikuri mdgomareobis gauaresebis gamo medikamentebiT Careva xdeba saWiro. moSlilia mkurnalobis procesi, radgan pacientsa da eqims Soris urTierTTanamSromlobis miRweva garTulebulia. pacientis mier eqimi aRiqmeba erTpirovnul gadawyvetilebis mimRebad, romelic ”aferxebs” misi gaweris sakiTxs. Sesabamisad, pacientis mTeli agresia mimarTulia eqimis mimarT da maTi Terapiuli urTierToba SeuZlebeli xdeba.

11 saqarTvelos administraciuli saproceso kodeqsi, 21 Tavi VII4

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Zneli misaxvedri ar aris, rom sasamarTlo ganxilvebi metad formaluria, iuridiuli daxmarebis saxelmwifo samsaxuris quTaisis biuros advokatis gadmocemiT, advokatebi saqmis viTarebaSi garkvevasac ver aswreben. realurad, sasamarTlo mxolod adasturebs eqimTa gadawyvetilebas. sasamarTlos formaluri mxare naTelia pacientisa da maTi axloblebisaTvisac. maT TvalSi xdeba sasamarTlos diskreditacia, xSirad pacientebi uars acxadeben “am farsSi” monawileobaze, radgan Tavs motyuebulad grZnoben, xSirad brals deben sasamarTlos da eqimebs aliansSi. yovel 3 TveSi pacientis mdgomareobis Sesaxeb sasamarTlosTvis daskvnebis momzadeba, da sasamarTlo ganxilvaSi monawileoba, ar utovebs eqims arc dros da arc energias, rom pacientis mkurnalobaze izrunos. Sesabamisad, samkurnalo procesi am kuTxiTac zaraldeba. cnobilia, rom Tu ar arsebobs eqimsa da pacients Soris Terapiuli kavSiri, pacientis warmatebuli mkrnalobis Sansi bevrad naklebia. gauTavebeli sasamarTlo ganxilvebi dawesebulebaSi, administraciis gadmocemiT, saavadmyofos efeqtur marTvas problemebs uqmnis. mTeli Zalebi mimarTulia sasamarTlos droulad Catarebaze, radgan nebismier procesualur darRvevas SeiZleba seriozuli garTuleba moyves.

2) samarTalwarmoeba im piris mimarT, romelic fsiqiurad daavadda danaSaulis Cadenis Semdeg

saqarTvelos ssk-is moqmedi redaqciis 34-e muxlis12 me-3 nawilis Tanaxmad: “Tu danaSauli Seracxadma pirma Caidina, magram igi fsiqikurad daavadda ganaCenis gamotanamde, ris gamoc ar SeuZlia angariSi gauwios Tavs an uxelmZRvanelos mas, piri sasamarTlos mier Sefardebul sasjels gamojanmrTelebamde moixdis Sesabamis samedicino (samkurnalo) dawesebulebaSi.” amave kodeqsis 74-e muxlis13 me-2 nawilis Tanaxmad, “sasamarTlos SeuZlia sasjelisagan gaaTavisuflos is, vinc danaSaulis Cadenamde an Cadenis Semdeg daavadda mZime avadmyofobiT, rac xels uSlis sasjelis moxdas.” amave muxlis me-4 nawilis Tanaxmad: “am muxlis me-2 nawilSi aRniSnul pirs gamojanmrTelebis SemTxvevaSi SeiZleba kvlav daekisros sisxlissamarTlebrivi pasuxismgebloba da daeniSnos sasjeli, Tu ar

12 saqarTvelos sisxlis samarTlis kodeqsis 34-e muxli – Seuracxaoba fsiqikuri daavadebis gamo; 2007 wlis 3 ivlisis redaqciiT; 13 saqarTvelos sisxlis samarTlis kodeqsisi 74-e muxli – sasjelisagan gaTavisufleba avadmyofobis an xandazmulobis asakis gamo; 2007 wlis 3 ivlisis redaqcia;

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gasula am kodeqsis 71-e14 da 76-e15 muxlebiT gaTvaliswinebuli xandazmulobis vadebi.” zemoT moyvanili normebidan Cans, rom kanoni sasamarTlos saSualebas aZlevs (1) fsiqiurad daavadebul pirs Seufardos sasjeli da is sasjels moixdis samkurnalo dawesebulebaSi, an (2) avadmyofobis gamo gaaTavisuflos piri sasjelis moxdisgan, Tumca SesaZloa gamojanmrTelebis mere mas kvlav daekisros sasjelis moxda. aSkaraa rom kanonmdebeli farTo diskrecias aniWebs sasamarTlos da rac yvelaze mTavaria, uSvebs imas, rom fsiqiurad daavadebuli piri gasamarTldes, daekisros sasjeli da misi moxda daudgindes samkurnalo dawesebulebaSi. saqarTvelos sssk-ic Seicavs winaaRmdegobriv normebs da modiT ganvixiloT isini. sssk gansxvavebul reJims adgens fsiqiurad daavadebuli braldebulisTvis16 da gansasjelisTvis17. sssk-is 29-e muxlis18 pirveli nawilis Tanaxmad: “sisxlissamarTlebrivi devna SeCerdeba: g) Tu braldebuli mZime avadmyofobiT daavadda, rac dadasturebulia saxelmwifo sasamarTlo-fsiqiatriuli eqspertizis daskvniT – dauyovnebliv am faqtis dadgenidan braldebulis gamojanmrTelebamde”. aRniSnuli normis Tanaxmad, Tu braldebuli fsiqikurad daavadda, mis mimarT devna unda SeCerdes mis gamojanmrTelebamde, SeCerebis Sesaxeb dadgenilebas amave muxlis Tanaxmad, iRebs mosamarTle an prokurori. aqve redaqciuli SeniSvna: vinaidan muxli exeba ara marto fsiqiatriul daavadebebs unda iyos sasamarTlo-samedicino eqspertizis daskvniT. sssk-is 499-e muxlis19 me-2 nawilis Tanaxmad: “Tu dadginda, rom gansasjeli danaSaulis Cadenis dros Seracxad mdgomareobaSi iyo, magram danaSaulis Cadenis Semdeg Seuracxi20 gaxda, sasamarTlos gamoaqvs gamamtyunebeli ganaCeni, romliTac gansazRvravs msjavrdebulis mier sasjelis moxdas Sesabamis samedicino (samkurnalo) dawesebulebaSi mis gamojanmrTelebamde,

14 saqarTvelos sisxlis samarTlis kodeqsis 71-e muxli – sisxlis samarTlebrivi pasuxismgeblobisgan gaTavisufleba xandazmulobis vadis gasvlis gamo; 15 saqarTvelos sisxlis samarTlis kodeqsis 76-e muxli – sasjelis moxdisagan gaTavisufleba gamamtyuvnebeli ganaCenis xandazmulobis gamo; 16 sisxlis samarTlis saproceso kodeqsis 44-e muxlis 24-e nawilis Tanaxmad, braldebuli aris sisxlis samarTlis pasuxisgebaSi micemuli piri; 17 sisxlis samarTlis saproceso kodeqsis 44-e muxlis 25-e nawilis Tanaxmad, gansasjeli aris braldebuli, romlis mimarT sabraldebo daskvnis Sedgenis Semdeg saqme arsebiTad gansaxilvelad an saproceso SeTanxmebis dadebis Semdeg dasamtkiceblad Cabarda sasamarTlos gansjadobis mixedviT; 18 sisxlis samarTlis saproceso kodeqsis 29-e muxli – sisxlissamarTlebrivi devnis SeCerebis safuZvlebi da vadebi; 19 sisxlis samarTlis saproceso kodeqsis 499-e muxli – gansasjelis Seuracxaobis sakiTxis ganxilva, 55-e Tavi – ganaCenis dadgena; 2007 wlis 3 ivlisis mdgomareobiT; 20 termini “Seuracxi” arasworad gamoiyeneba aseT SemTxvevaSi, unda iyos “fsiqiurad daavadda, ris gamoc ar SeuZlia angariSi gauwios Tavs an uxelmZRvanelos mas”.

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ris Semdegac msjavrdebulis mier sasjelis moxda grZeldeba saerTo wesiT.” amave kodeqsis 451-e muxlis21 pirveli nawilis Tanaxmad: “gansasjelis fsiqikuri an sxva mZime avadmyofobiT daavadebis SemTxvevaSi, rac dadasturebuli iqneba saxelmwifo saeqsperto dawesebulebis eqspertis (eqspertebis) mier, mosamarTle (sasamarTlo) gamoitans dadgenilebas (ganCinebas) gansasjelis gamojanmrTelebamde sasamarTlo ganxilvis SeCerebis Sesaxeb.” zemoT mocemuli normebis analizidan Cans, rom winaswari gamoZiebis stadiaze Tu braldebuli piri daavadda, es warmoadgens mis mimarT sisxlis samarTlebrivi devnis SeCerebis safuZvels, mis gamojanmrTelebamde, magram im SemTxvevaSi Tu fsiqiurad daavadda gansasjeli piri (sasamarTlo gamoZiebis stadiaze) mis mimarT sisxlissamarTalwarmoeba grZeldeba, SesaZloa mis mimarT dadges gamamtyunebeli ganaCenic da sasjelis moxda daeniSnos Sesabamis samkurnalo dawesebulebaSi. am ukanasknel wesTan winaaRmdegobaSia sisxlis samarTlis saproceso kodeqsis 451-e muxliT gansazRvruli wesi, romelic adgens, rom gansasjelis daavadebis SemTxvevaSi sasamarTlo uflebamosilia SeaCeros saqmis ganxilva gamojanmrTelebamde, magram es norma ufro Zvelia 499-e muxlis redaqciasTan SedarebiT da Sesabamisad gamoiyeneba 499-e muxliT dadgenili wesi. sssk-is 499-e muxliT gansazRvruli es wesi arakonstituciurad miiCnia saqarTvelos axalgazrda iuristTa asociaciis dacvis qveS myofma pirma, batonma xundaZem da Sesabamisi sakonstitucio sarCeliT mimarTa saqarTvelos sakonstitucio sasamarTlos da moiTxova sisxlis samarTlis saproceso kodeqsis 499-e muxlis me-2 nawilis arakonstituciurad cnoba saqarTvelos konstituciis 42-e muxlTan (dacvis ufleba) mimarTebiT, vinaidan Tvlis, rom fsiqiurad daavadebis arsebobisas pirs ar aqvs SesaZlebloba srulad ganaxorcielos dacvis ufleba da am uflebis SezRudviT SesaZloa mis mimarT dadges gamamtyunebeli ganaCeni. garda amisa, kanonmdebloba ar adgens braldebulis fsiqikurad daavadebis SemTxvevaSi samarTalwarmoebis SeCerebis maqsimalur vadas. swored winaswari gamoZiebis da sasamarTlo ganxilvis stadiaze, samarTalwarmoebis SeCerebis gansazRvruli vadebis ararsebobis gamo, warsulSi arsebobda sasamarTlo ganaCenis/gadawyvetilebis gamotanamde fsiqiatriul dawesebulebaSi xangrZlivi mkurnalobis praqtika. ramac, savaraudod, gamoiwvia 499-e muxlis me-2 nawilis 2007 wlis ivlisis cvlileba, romlis mixedviTac, roca pirs ar aqvs unari wardges sasamarTloSi da daicvas Tavi, mis mimarT SesaZloa dadges gamamtyunebeli ganaCeni. aRsaniSnavia, rom am dros saavadmyofoSi gatarebuli dro am pirs ukve sasjelis vadaSi

21 sisxlis samarTlis saproceso kodeqsis 451-e muxli – sasamarTlo ganxilvis SeCereba da ganaxleba, Tavi 50-e – zogadi debulebani sasamarTlo ganxilvis Sesaxeb; 2006 wlis 28 aprilis redaqcia;

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eTvleba. aRniSnuli xarvezis aRmofxvra SesaZlebelia, Tu dadgindeba braldebulis/gansasjelis fsiqikuri daavadebis SemTxvevaSi, mkurnalobis gansazRvruli vada, romelic amave dros ar CaiTvleba sasjelis moxdis vadaSi, radgan rogorc SesavalSi avRniSneT, am dros ar xdeba sasjelis miznis miRweva. daskvna mimoxilvam gvaCvena, rom fsiqiurad daavadebul gansasjelTa mimarT moqmedi kanonmdebloba sakmaod xarveziani da winaaRmdegobrivia. gansxvavebul reJims gvTavazobs braldebulisa da gansasjelis mimarT da sasamarTlosac farTo diskrecias aZlevs. aseve mniSvnelovania is, rom moqmedi kanonmdebloba uSvebs fsiqiurad daavadebulis gasamarTlebas da misTvis sasjelis saxiT Tavisuflebis aRkveTis Sefardebas samkurnalo dawesebulebaSi moxdiT. yovelive es pirdapir miuTiTebs imaze, rom aucilebelia fsiqiurad daavadebul gansasjelTa mimarT samarTalwarmoebis daxvewili modelis SemuSaveba da danergva, maTi uflebebis maqsimaluri gaTvaliswinebiTa da winaaRmdegobrivi reJimis aRmofxvriT. praqtika aCvenebs, rom fsiqiurad daavadebuli gansasjelebi sasamarTlo fsiqiatriuli eqspertizis daskvnis safuZvelze sasamarTlo dadgenilebiT Tavsdebian Sesabamis samkurnalo dawesebulebaSi. amis Semdeg maT mimarT moqmedebs fsiqiatriuli daxmarebis Sesaxeb saqarTvelos kanonis 22-e da 23-e muxlebi. 22-e muxlis Tanaxmad, eqim-fsiqiatrTa komisia 3 TveSi erTxel awvdis daskvnas mkurnalobis gagrZelebis mizanSewonilobaze gadawyvetilebis gamomtan sasamarTlos. kanoni ar akonkretebs, am SemTxvevaSi, sasamarTlom zepiri mosmeniT unda ganixilos Tu ara mkurnalobis gagrZelebis sakiTxi. magram sasamarTlo praqtika ise ganviTarda, rom mkurnalobis gagrZelebis sakiTxs sasamarTlo zepiri mosmeniT ganixilavs, rac kidev ufro zrdis sasamarTlo ganxilvebis raodenobas22. xSir SemTxvevaSi, gadawyvetilebis gamomtani sisxlis samarTlis sasamarTlo, romelic yovel 3 TveSi ixilavs piris mkurnalobis sakiTxs, teritoriulad samkurnalo dawesebulebidan daSorebulia. Sesabamisad, saWiro xdeba pacientis transportireba dacvis TanxlebiT, rac damatebiT adamianur da finansur resursebs moiTxovs.

22 saqarTvelos iusticiis saministros iuridiuli daxmarebis samsaxuris 2008 wlis 17 seqtembris werilis Tanaxmad, kanonis amoqmedebidan 2008 wlis 17 seqtembramde iuridiuli daxmarebis biuroebis advokatebma monawileoba miiRes 1036 aranebayoflobiTi fsiqiatruli mkurnalobis SefardebasTan dakavSirebul samarTalwarmoebaSi; garda amisa amave samsaxuris Tbilisis, qvemo qarTlisa da imereRis biuroebis advokatTa mier sisxlis samarTlis saqmeebze 69 Seuracxad cnobili piris interesebis dacva ganxorcielda.

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3. msjavrdebulTa fsiqiatriuli daxmareba

dasaregulirebelia aseve msjavrdebulTa fsiqikurad daavadebis SemTxvevaSi, fsiqiatriuli daxmarebis aRmoCenis wesi da procedura samkurnalod moTavsebis, mkurnalobis gagrZelebis da perioduli ganxilvis Sesaxeb. sssk-is 607 muxlis pirveli nawilis a) punqtis mixedviT23, sasamarTlom SeiZleba sasjeli gadaavados sasamarTlo-samedicino eqspertizis daskvnis safuZvelze, Tu msjavrdebuli mZime avadmyofobiT daavadda, rac xels uSlis sasjelis moxdas, mis gamojanmrTelebamde an janmrTelobis mdgomareobis arsebiTad gaumjobesebamde. mZime avadmyofobaSi igulisxmeba fsiqikuri daavadebac. am SemTxvevaSi rogor xdeba aranebayoflobiTi fsiqiatriuli mkurnalobis daniSvnis inicireba, esec kanonmdeblobis regulirebis miRmaa. mas Semdeg rac sasamarTlo imsjelebs daavadebuli piris mimarT sasjelis gadavadebis Sesaxeb, gaurkvevelia rogor da vis mier wydeba misi Semdgomi bedi, anu samkurnalo dawesebulebaSi moTavsebis sakiTxi, aseve arafriT regulirdeba, romel samkurnalo dawesebulebaSi unda moTavsdnen es pirebi da ra periodulobiT da vis awvdis es dawesebuleba informacias pacientis janmrTelobis Sesaxeb. gaugebaria, aseve sasamarTlo-samedicino eqspertiza moicavs Tu ara fsiqiatriul eqspertizas, radgan sasamarTlo eqpertizis erovnuli biuros debulebaSi samedicino da fsiqiatriuli eqspertiza cal-calkea CamoTvlili24. faqtiurad ar arsebobs sasjelaRsrulebis sistemaSi myof pirTa fsiqiatriuli eqspertizisaTvis saeqsperto dawesebulebaSi gadayvanis procedura. sssk-is XXII Tavi25 exeba mxolod braldebulis/gansasjelis moTavsebas samedicino dawesebulebaSi eqspertizis Casatareblad. patimrobis Sesaxeb saqarTvelos kanonis 67-e muxlis26 pirveli punqtis Tanaxmad: “mZime an ganukurnebeli seniT daavadebuli [...] msjavrdebuli piris gasaTavisufleblad msjavrdebuli an/da sasjelaRsrulebis dawesebulebis direqtori, kanoniT dadgenili wesiT, msjavrdebulis gaTavisuflebis Sesaxeb mimarTavs sasamarTlos.” analogiurs adgens ssk-is 74-e muxlis meore nawili27, amave muxlis meoTxe nawilSi aRniSnulia, rom pirs gamojanmrTelebis SemTxvevaSi SeiZleba kvlav daeniSnos sasjeli, Tu ar gasula xandazmulobis vadebi. aseve arsebobs saqarTvelos Sromis,

23 sss kodeqsi, მუხლი 607 - განაჩენის აღსრულების გადავადება 24 saqarTvelos Sromis, janmrTelobisa da socialuri dacvis ministris 2008 wlis 19 ivnisis #142/n brZaneba 25sssk XXII Tavi - პირის მოთავსება სამედიცინო დაწესებულებაში ექსპერტიზის ჩასატარებლად 26 patimrobis Sesaxeb saqarTvelos kanonis 67-e muxli – avadmyofobis an xandazmulobis asakis gamo sasjelisgan gaTavisufleba 27 მუხლი 74. სასჯელისაგან გათავისუფლება ავადმყოფობის ან ხანდაზმულობის ასაკის გამო

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janmrTelobisa da socialuri dacvis ministris 2003 wlis 27 martis #72/n brZaneba, romliTac damtkicebulia im mZime da ganukurnebel daavadebaTa CamonaTvali, romlebic warmoadgens sasjelis moxdisgan gaTavisuflebis wardgenis safuZvels da saqarTvelos iusticiis ministris 2000 wlis 11 Tebervlis #17 brZaneba, avadmyofobis gamo sasjelisagan gaTavisuflebisaTvis msjavrdebulis wardgenis debulebis damtkicebis Sesaxeb. zemoT miTiTebul daavadebaTa CamonaTvalSi miTiTebulia fsiqikuri aSlilobani da maTi calkeuli saxeebi28. sssk-is 608-e muxlis pirveli nawili adgens avadmyofobis gamo, maT Soris fsiqikuri daavadebis gamo TavisuflebaaRkveTili piris vadamde gaTavisuflebis wess. magram samwuxarod, am safuZvliT patimarTa gaTavisuflebis precendentebi dResdReobiT ar arsebobs.

aq miTiTebul sakanonmdeblo bazaze dayrdnobiT Cans, rom fsiqiurad daavadebuli msjavrdebulis mimarT kanonmdebloba gansazRvravs mxolod vadamde gaTavisuflebis sakiTxis ganxilvas. amitomac am sferoSi moRvawe Tanamdebobis pirebi da eqspertebi amtkiceben, rom sakanonmdeblo vakuumia, vinaidan am safuZvliT vadamde gaTavisuflebis praqtika TiTqmis ar arsebobs, amis mizezad ki is saxeldeba, rom ar arsebobs sasjelisagan gaTavisuflebul pirTa fsiqiatriul dawesebulebaSi mkurnalobis gagrZelebis da maTze meTvalyureobis sakanonmdeblo regulireba.

rogor regulirdeba es sakiTxi praqtikaSi? ukanaskneli periodis precedentebze dayrdnobiT irkveva, rom arsebobs Semdegi praqtika: sasjelaRsrulebis departamenti ar eyrdnoba patimris mZime daavadebis gamo vadamde gaTavisuflebis zemoT miTiTebul wess, aramed iyenebs “fsiqiatriuli daxmarebis Sesaxeb” saqarTvelos kanonis me-18 muxls; anu realurad xdeba sasamarTlo-fsiqiatriuli eqspertizis biuros daskvnis safuZvelze administraciuli sasamarTlos dadgenilebiT (SesaZloa aseTi dadgenileba arc arsebobdes da mxolod eqspertizis biuros daskvnis safuZvelze gadaiyvanon patimari) msjavrdebuli piris droebiT aranebayoflobiT samkurnalod gayvana Sesabamis samkurnalo dawesebulebaSi. msjavrdebuli am periodSi kvlav sasjelaRsrulebis departamentis aRricxvaze imyofeba, mas iZulebiT mkurnalobis periodi eTvleba sasjelSi da sasjelis vadis amowurvis Semdeg, Tu aucilebeli iqneba aranebayoflobiTi mkurnalobis gagrZeleba, samkurnalo dawesebuleba moqmedebs fsiqiatriuli daxmarebis Sesaxeb kanonis Sesabamisad. dResdReobiT saqarTvelos sasjelaRsrulebis sistemis fsiqiatriuli samsaxuris centrs warmoadgens saqarTvelos iusticiis saministros sasjelaRsrulebis departamentis samkurnalo dawesebulebis fsiqiatriuli ganyofileba, romelic gaTvlilia 55 mamakac pacientze, qalTa fsiqiatriuli sawolebi penitenciur sistemaSi ar aris. aRniSnuli ganyofilebis fsiqiatrebi konsultacias uweven TbilisTan axlomdebare

28 mocemul brZanebaSi daavadebaTa CamonaTvali ar Seesabameba saerTaSoriso klasifikacias;

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cixeebsa da koloniebs. mwvave fsiqozur mdgomareobaSi patimrebi gadmoyavT zemoTaRniSnul fsiqiatriul ganyofilebaSi. ukve miRebulia gadawyvetileba jandacvis da iusticiis saministroebis doneze, sasjelaRsrulebis departamentis samkurnalo dawesebulebis Tbilisis gareubanSi axalaSenebul cixesTan gaxsna da jandacvis saministrosTvis daqvemdebareba, magram ra vadebSi moxdeba amis ganxorcieleba metad bundovania. daskvna rogorc zeviT davinaxeT, fsiqiurad daavadebul msjavrdebulTa mimarT moqmedi kanonmdeblobac mouqneli da arasrulyofilia. praqtika da moqmedi kanonmdebloba daSorebulia erTmaneTisgan da arsebobs praqtikaSi danergili wesis sakanonmdeblo doneze mowesrigebisa da daxvewis aucilebloba.

4. sasamarTlo - fsiqiatriuli eqspertiza

sasamarTlo fsiqiatriuli eqspertizis Catarebas aregulirebs sisxlis samarTlis kanonmdebloba, sasamarTlo eqspertizis erovnuli biuros debuleba29 da Sromis, janmrTelobisa da socialuri dacvis ministris brZaneba sasamarTlo-fsiqiatriuli eqspertizis Catarebis wesis Sesaxeb30. saxelmwifo sasamarTlo-saeqsperto dawesebulebas warmoadgens l. samxaraulis saxelobis sasamarTlo eqspertizis erovnuli biuro (SemdgomSi biuro), romelic warmoadgens iusticiis saministros moqmedebis sferoSi myof sajaro samarTlis iuridiul pirs. biuros funqciaa moqmedi kanonmdeblobis Sesabamisad samoqalaqo, administraciul da sisxlis samarTlis saqmeze sasamarTlo eqspertizis organizeba da warmoeba. biuros ufross Tanamdebobaze niSnavs da aTavisuflebs iusticiis ministri. biuro Sedgeba qvedanayofebisagan da fsiqiatriuli eqspertizis samsaxuri erT-erTi aseTi qvedanayofia, romelsac xelmZRvanelobs samsaxuris ufrosi. calkea aseve narkologiuri eqspertizis ganyofileba. biuros aqvs 2 regionaluri qvedanayofi-dasavleT saqarTvelos regionaluri eqspertizis da aWaris regionaluri eqspertizis samsaxurebi. fsiqiatriuli eqspertizis samsaxuri atarebs rogorc ambulatoriul aseve stacionarul fsiqiatriul eqspertizas. aRsaniSnavia, rom stacionaruli

29 damtkicebulia saqarTvelos iusticiis ministriq 2006 wlis 4 seqtembris #705 brZanebiT; 30 damtkicebulia saqarTvelos Sromis, janmrTelobisa da socialuri dacvis ministris 2008 wlis 19 ivnisis #142/n brZanebiT;

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saeqsperto-fsiqiatriuli ganyofileba mxolod Tbilisis fsiqiatriuli eqspertizis samsaxurs aqvs.

amJamad momzadebulia da ganxilvis procesSia kanonproeqti, romlis mixedviT, biuro rogorc sajaro samarTlis iuridiuli piri iqmneba iusticiis saministrosgan damoukideblad. biuros xelmZRvanelis daniSvnis uflebamosileba premier ministrs eqneba, xolo biuros wevrebs mTavroba daamtkicebs. es kanonproeqti iusticiis saministrosa da generaluri prokuraturis gaerTianebis Sesaxeb kanonis Tanmdevia da biuros damoukideblobis uzrunvelsayofad, uqvemdebarebs mas mTavrobasa da premier-ministrs. eqsperti sisxlis samarTlis saproceso kodeqsis muxli 96-e pirveli nawilis mixedviT, eqsperti aris piri, romelsac aqvs specialuri codna mecnierebis, teqnikis an xelovnebis dargSi. eqsperts sisxlis samarTlis saqmeze niSnavs gamomZiebeli, prokurori an sasamarTlo, aseve braldebuli, damcveli an dazarebuli. amave muxlis meore nawilSi, aRniSnulia, rom eqsperts unda hqondes specialuri codna, muSaobdes saeqsperto dawesebulebaSi an hqondes licenzia (sssk, muxli 96, nawili 2). dRes saqarTveloSi sasamarTlo-fsiqiatris subspecialoba ar arsebobs, eqsperti SeiZleba gaxdes nebismieri fsiqiatri, romelsac fsiqiatris saxelmwifo sertifikati aqvs da muSaobs saeqsperto dawesebulebaSi. ar aris Camoyalibebuli fsiqiatr-eqspertad muSaobisaTvis saWiro kriteriumebi: fsiqiatriaSi muSaobis wlebi, saeqsperto dawesebulebaSi staJireba, specialuri treningebis kursi. arc arsebobs sasamarTlo fsiqiatriaSi specialuri momzadebis kursebi an programa. Sesabamisad dRes sasamarTlo fsiqiatri SeiZleba gaxdes sruliad axalgazrda, klinikuri gamocdilebis naklebad mqone fsiqiatri. erovnuli biuros fsiqiatriuli eqspertizis samsaxurs hyavs fsiqiatrTa/fsiqologTa xelfasiani Stati, romlebic mxolod sasamarTlo-fsiqiatriul eqspertizas atareben, da klinikur praqtikas ar ewevian. biuros regionalur filialebSi momuSave eqspert-fsiqiatrebi paralelurad klinikaSic muSaoben.. eqsperti valdebulia eqspertizasTan dakavSirebiT misces Cveneba winaswari gamoZiebis an sasamarTlo ganxilvis dros da moamzados werilobiTi daskvna dasmul sakiTxebze31. eqspertis mier yalbi daskvnis an Cvenebis micema isjeba ss kodeqsis 3481 da 370-e muxlebiT.

31 sisxlis samarTlis saproceso kodeqsi, muxli 97 – eqspertis ufleba-movaleobani;

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sasamarTlo-fsiqiatriuli eqspertizis Catareba sssk-is 356-e muxlis, pirveli nawili gansazRvravs, rom eqspertiza tardeba gamomZieblis an prokuroris dadgenilebiT, aseve sasamarTlos dadgenilebiT dacvis mxaris Suamdgomlobis safuZvelze. eqspertizas atarebs saeqsperto dawesebulebis, gansakuTrebul SemTxvevebSi ki sxva dawesebulebis specialisti an kerZo piri, romelsac niSnavs gamomZiebeli an prokurori. eqspertis mowveva SeuZliaT aseve mxareebs Sesabamisi anazRaurebiT.32 aRniSnul muxlSi naxsenebi kerZo piris an sxva dawesebulebis specilistis mier eqspertizis Catareba ewinaaRmdegeba sss kodeqsis 28-e da 29-e muxlebis 2007 wlis 3 ivlisis redaqcias, romlis mixedviTac danaSaulis Cadenis dros piris Seracxadobas an fsiqikurad daavadebas danaSaulis Cadenis Semdeg adasturebs mxolod saxelmwifo sasamarTlo-fsiqiatriuli eqspertiza. sasamarTlo-fsiqiatriuli eqspertizis mizania gamosakvlevi piris fsiqikuri mdgomareobis Sefaseba, rodesac winaswari gamoZiebis, sasamarTlo ganxilvis an sasjelis moxdis dros gamovlinda monacemebi, rom saeWvoa piris Seracxadoba (SezRuduli Seracxadoba) marTlsawinaaRmdego qmedebis Cadenis dros, an SemdgomSi xom ar ganuviTarda fsiqiuri aSliloba, ris gamoc ar SeuZlia angariSi gauwios Tavs an uxelmZRvanelos mas. eqspertiza SeiZleba dainiSnos samarTalwarmoebis yvela etapze (gamoZiebis etapze, sasamarTlo ganxilvis da sasjelis moxdis dros). daavadebis diagnozis formulireba xdeba daavadebaTa saerTaSoriso klasifikaciis me-10 gadasinjvis mixedviT. saamarTlo-fsiqiatriuli eqspertizis amocanebia:

• gaarkvios SeeZlo Tu ara pirs fsiqikuri aSlilobis gamo gaecnobierebina (srulad gaecnobierebina) marTlsawinaaRmdego qmedebis xasiaTi da exelmZRvanela misTvis;

• gaarkvios, SeuZlia Tu ara pirs Tavisi fsiqikuri mdgomareobis gamo sagamoZiebo an sasamarTlo moqmedebaSi monawileoba;

• gaarkvios msjavrdebulis fsiqikuri mdgomareoba SesaZlebels xdis Tu ara sasjelis aRsrulebas;

• gaarkvios saWiroebs Tu ara piri fsiqiatriul daxmarebas da Tu saWiroebs rogori saxiT;

• dazarebulisa da mowmis eqspertizis mizania, daadginos SeuZlia Tu ara pirs Tavisi fsiqikuri mdgomareobis gamo swori Cvenebis micema da sagamoZiebo procesSi an sasamarTlo moqmedebaSi monawileoba;

32 sisxlis samarTlis saproceso kodeqsi, muxli 359- eqspertad daniSnuli piri;

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• gaarkvios, SeeZlo Tu ara pirs samoqalaqo garigebisas (anderZi, xelSekruleba, yidva-gayidva, Cuqeba, qorwineba) Seegno Tavisi moqmedebis mniSvneloba da exelmZRvanela misTvis33.

sasamarTlo-fsiqiatriuli eqspertizis formebia: damatebiTi eqspertiza- rodesac saeqsperto daskvna ar aris sruli, SeiZleba daevalos imave eqsperts an sxvas; ganmeorebiTi eqspertiza – rodesac saeqsperto daskvna saeWvoa an dausabuTebelia, evaleba sxva eqsperts; sakomisio eqspertiza (rTuli eqspertiza) - SeiZleba Caataron erTi specialobis mqone eqspertTa komisiebma. procesSi monawile mxareebma SeiZleba komisiaSi Seiyvanon maT mier mowveuli eqspertebi; uTanxmoebis SemTxvevaSi TiToeuli iZleva calke daskvnas; kompleqsuri eqspertiza – iniSneba, roca aucilebelia sxvadasxva dargis specialistebis monawileoba; alternatiuli eqspertiza – mxares ufleba aqvs sakuTari xarjiT Caataros eqspertiza, romelic misi azriT xels Seuwyobs misi interesebis dacvas. eqspertis daskvna savaldebulo wesiT Tan daerTvis sisxlis samarTlis saqmes da Sefasdeba sxva mtkicebulebebTan erTad; Tu braldebuli an gansasjeli arasmqonea, mas ufleba aqvs mimarTos sasamarTlos an sisxlis samarTlis mwarmoebel organos saxelmwifo xarjze alternatiuli eqspertizis Casatareblad. Tumca aRsaniSnavia, rom saaqarTvelos kanonmdeblobiT (2007 wlis 3 ivlisis cvlileba) danaSaulis Cadenis dros piris Seracxadoba an fsiqikurad daavadeba danaSaulis Cadenis Semdeg dasturdeba saxelmwifo sasamarTlo-fsiqiatriuli. eqspertizis daskvniT, sssk muxli 28, 29. dazaralebulis da mowmis sasamarTlo-fsiqiatriuli eqspertiza nebayoflobiTia, garda im SemTxvevebisa, roca eWvmitanili an braldebuli moiTxovs dazaralebulis Cvenebis Semowmebas, romelic amxels mas danaSaulSi. am dros aucilebelia mosamarTlis brZaneba34. sasamarTlo-fsiqiatriuli eqspertizis saxeebia:

• ambulatoriuli sasamarTlo-fsiqiatriuli eqspertiza;

• stacionaruli sasamarTlo-fsiqiatriuli eqspertiza;

• dauswrebeli sasamarTlo-fsiqiatriuli eqspertiza;

• sikvdilisSemdgomi sasamarTlo-fsiqiatriuli eqspertiza35.

33 saqarTvelos Sromis, janmrTelobisa da socialuri dacvis ministris 2008 wlis 19 ivnisis #142/n brZaneba-sasamarTlo-fsiqiatriuli eqspertizis Catarebis wesis Sesaxeb 34 sisxlis samarTlis saproceso kodeqsi, muxlebi: 361, 362, 363, 364, 368; 35 saqarTvelos Sromis, janmrTelobisa da socialuri dacvis ministris 2008 wlis 19 ivnisis #142/n brZaneba-sasamarTlo-fsiqiatriuli eqspertizis Catarebis wesis Sesaxeb

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Tu sasamarTlo-fsiqiatriuli eqspertizis Casatareblad saWiroa stacionaruli meTvalyureoba, sasamarTlo brZanebis an ganCinebis safuZvelze braldebuli, gansasjeli Tavsdeba Sesabamis samedicino dawesebulebaSi (sss kodeqsi, muxli 177). stacionaruli eqspertizisaTvis braldebulis an gansasjelis dawesebulebaSi moTavsebis vada ar unda aRematebodes 20 dRes. gansakuTrebul SemTvevebSi es vada SeiZleba sasamarTlos dadgenilebiT 10 dRiT gagrZeldes. prokuroris SuamdgomlobiT eqspertizaze stacionarSi moTavsebis vada iTvleba patimrobis vadaSi (sssk muxli 181). eqspertizis samsaxuris ufrosis gadmocemiT, komisia me-20 dRes wyvets piris saeqspertod kidev 10 dRiT datovebis saWiroebis sakiTxs da ver eswreba droulad vadis gagrZeleba (xelaxali sasamarTlo dadgenilebis miReba imave dRes).

daskvna sasamarTlo fsiqiatriuli eqspertizis sakiTxebi aseve Semdgom damuSavebas saWiroebs. kerZod, ar aris naTeli iseTi sakiTxebi, rogoricaa: eqspertad daniSvna, alternatiuli eqspertizis daniSnuleba, sasajelaRsrulebis dawesebulebaSi myof pirTa stacionaruli eqspertiza. Semdgom daxvewas saWiroebs eqpertizis winaSe dasmuli kiTxvebi da eqspertizis iuridiuli da klinikuri kriteriumebi. 5. fsiqiatriis sakiTxebi sisxlis samarTlis saproceso kodeqsisa da

patimrobis kodeqsis proeqtebSi

2006 wlis 4 aprils saqarTvelos mTavrobis iniciativiT saqarTvelos parlamentSi Sevida saqarTvelos sisxlis samarTlis saproceso kodeqsis proeqti, momzadebuli saqarTvelos iusticiis saministros mier. dagegmili iyo kodeqsis miReba 2007 wels, Tumca is dRemde ganxilvebis stadiazea36.

fsiqikuri aSlilobis mqone pirTa mimarT sisxlissamarTlebrivi devnis warmoebis wesi, romelsac gvTavazobs sisxlis samarTlis saproceso kodeqsis proeqti arsebiTad ar gansxvavdeba dRes moqmedi kanonmdeblobiT dadgenili wesisgan, ufro metic, marTlsawinaaRmdego qmedebis Cadenis momentSi Seuracxad cnobili piris mimarT sisxlissamarTalwarmoebis moqmedi kanonmdeblobiT dadgenili wesis analogiuri wesia SemoTavazebuli (proeqtis 112-e muxlis pirveli da me-2 nawilebi, 122-e muxlis me-2 nawilis “b” qvepunqti, 123-e muxlis me-3 nawili). magram Riad rCeba danaSaulis

36 sisxlis samarTlis saproceso kodeqsis proeqtis bolo versia, 2007 wlis 17 oqtombris mdgomareobiT http://www.pog.gov.ge/ge/reformebi/sssk_vrclad.php

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Cadenis Semdeg fsiqiurad daavadebuli piris mimarT samarTalwarmoebis wesi.

sisxlis samarTlis saproceso kodeqsis 112-e muxlis me-3 nawili moqmedi kodeqsis 499-e muxlis me-3 nawilis analogiuria da adgens: “Tu dadginda, rom braldebuli danaSaulis Cadenis dros Seracxad mdgomareobaSi iyo, magram danaSaulis Cadenis Semdeg Seuracxi gaxda, sasamarTlos gamoaqvs gamamtyunebeli ganaCeni, romliTac gansazRvravs msjavrdebulis mier sasjelis moxdas Sesabamis samedicino (samkurnalo) dawesebulebaSi mis gamojanmrTelebamde, ris Semdegac msjavrdebulis mier sasjelis moxda grZeldeba saerTo wesiT.” es norma adgens piris mimarT gamamtyuvnebeli ganaCenis gamotanamde fsiqiurad daavadebis SemTxvevaSi moqmedebis wess, mis mimarT grZeldeba sisxlis samarTlawarmoeba da dgeba ganaCeni. Sesabamisad saproceso kodeqsis proeqti ar Seicavs daavadebis SemTxvevaSi piris mimarT sisxlissaamrTalwarmoebis SeCerebis wess, fsiqikuri aSliloba aRar aris samarTalwarmoebis SeCerebis safuZveli. proeqti kvlav kiTxvis niSnis qveS tovebs fsiqiurad daavadebuli piris mier dacvis uflebis srulad realizebis sakiTxs aTanabrebs ra mas fsiqiurad janmrTel procesis monawileebTan.

saproceso kodeqsis proeqti aseve moqmedi kanonmdeblobis analogiurad awesrigebs msjavrdebuli piris avadmyofobis (maT Soris fsiqiurad daavadebis) SemTxvevaSi misi vadamde gaTavisuflebis sakiTxs (muxli 289), Tumca gvTavazobs aseve novacias, am safuZvliT sasjelis moxdisgan gaTavisuflebis sakiTxi SesaZloa sasamarTlom zepiri mosmenis gareSe ganixilos.

saqarTvelos parlamentSi gansaxilveladaa aseve saqarTvelos patimrobis kodeqsis proeqti37. aRniSnuli proeqtis avtoria saqarTvelos iusticiis saministro da igi parlamentSi saqarTvelos mTavrobis iniciativiT Sevida 2007 wlis 29 marts, Tumca dRemde ar aris miRebuli.

saqarTvelos patimrobis kodeqsis proeqti imeorebs dRes moqmedi “patimrobis kanoniT” dadgenil wess mZime avadmyofobis SemTxvevaSi msjavrdebulTa vadamde gaTavisuflebis wess. patimrobis kodeqsis proeqtis 71-e muxlis (Tavisuflebis aRkveTis dawesebulebidan gaTavisuflebis safuZvlebi) pirveli punqtis “v” qvepunqtis Tanaxmad, avadmyofoba an xandazmulobis asaki warmoadgens vadamde gaTavisuflebis safuZvels. amave muxlis me-2 punqti adgens rom mZime da ganukurnebel daavadebaTa CamonaTvals adgens Sromis, janmrTelobisa da socialuri dacvis ministri. amave kodeqsis proeqtis 73-e muxli adgens avadmyofobis gamo msjavrdebulis vadamde gaTavisuflebis zogad wess. 81-e muxli ki qmnis avadmyofobis gamo msjavrdebulis imave tipis dawesebulebaSi

37 saqarTvelos patimrobis kodeqsis proeqti http://www.civilin.org.ge/parliament/crpcodexg.php

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(aq igulisxmeba Tavisuflebis aRkveTis dawesebuleba38) gadayvanis safuZvels. aRniSnuli normis analogiuri norma moqmed kanonSi ar aris da es SemoTavazebuli redaqcia naTlad ver gansazRvravs fsiqiuri daavadebis SemTxvevaSi ra tipis dawesebulebaSi SeiZleba piri gadayvanil iqnas da rogor SeiZleba fsiqiurad daavadebuls SeunarCundes ama Tu im dawesebulebis tipisTvis dadgenili SezRudvebi. Tumca imedia, rom amave muxlis safuZvelze iusticiis ministris mier damtkicebuli patimris sxva dawesebulebaSi gadayvanis wesi moawesrigebs am sakiTxebs. aucilebelia am kanonproeqtebSic daixvewos normebi, romlebic sasamarTlo fsiqiatriul pacientebs exeba da ar ganmeordes is xarvezebi rac moqmed kanonmdeblobas gaaCnia.

38 saqarTvelos patimrobis kodeqsis proeqtis mTavaria novaciaa Tavisuflebis aRkveTis dawesebulebis tipebi: Ria tipis, naxevrad Ria tipis da daxuruli tipis; moqmedi kanonmdeblobiT dadgenili sasjelis moxdis reJimebi uqmdeba.