Latvia:

 

With Amendments of June 20, 2001 included

LAW

"The law of Medicine"

 
The Saeima has enacted and the President of State promulgates the following Law:
 

CHAPTER I

GENERAL PROVISIONS

 
Article 1
 
The following terms are used in the law:
 
     1)     medicine - professional and individual prophylaxis of diseases, diagnostics, treatment, rehabilitation and care of patients;
 
     2)     medical persons - persons who have medical education and who are engaged in medicine;
 
     3) medical institution - in the context of this Law: clinics, institutions of rehabilitation, hospitals, specialized centers, institutions of technical orthopedics, institutions of urgent medical aid, doctors' offices (out-patient clinics), full clinics, health offices, specialized therapy clinics, clinics of medical higher schools, institutes, laboratories of functional, morphological, hematological, bio-chemical, micro-biological and other diagnostic examinations, pathology and court medical examinations, medical practices;
 
     4)     certificate of a medical person - a document issued by the Union of Professional Organizations of Latvian Medical Persons, Latvian Society of Physicians or Latvian Association of Trained Nurses, which certifies the professional training of individuals and indicates that medical person as a specialist who is competent to be engaged in medicine (specialist's practice) in specific fields independently;
 
     5) certification of a medical institution - independent activity of a third party certifying that a medical institution its structural unit or provided services comply to the requirements established by corresponding standards;
 
     6)     council of physicians (consilia) - a meeting of no less than three physicians to determine diagnose and tactics of subsequent treatment;
 
     7)     human infectious disease - a disease stimulated by cause of infectious disease which spreading may cause an epidemic (hereinafter - an infectious disease);
 
     8)     medical education - a totality of knowledge and skills proper to the program of medical education accredited in the Republic of Latvia what is certified by a diploma issued by education institution, as well as further specialization and raising of qualifications at any field of medicine;
 
     9) medical technologies - methods, medical equipment and medical goods to be used in medicine;
 
     10)     urgent medical aid - an aid what is rendered to victims (fallen ill)     in dangerous critical situation for life or health by specially prepared (trained, equipped) persons with proper qualifications in medicine, who according to this qualifications have juridical responsibility on their activity or inactivity and its consequences;
 
     11)     patient - a person who is treated or who is registered to any of medical persons, and, is treated, if necessary;
 
     12)     care of patients - a part of health care what is directly or indirectly connected with maintenance, stimulation, protection and recovering of public, family or human health;
 
     13)     first aid - an aid what is rendered to victims (fallen ill) in critical situation for life or health by persons with qualifications in medicine or without it in the amount of their knowledge and possibilities regardless of training and equipment;
 
     14)     medical rehabilitation - a branch of medicine which is engaged in development or recoverement of human physical, psychological, social, professional and education potential according to his/her physiological or anatomical limitations or - in case of stable health disorders - with accommodation of the patient life to the environment and society;
 
     15)     postgraduate training - further education of medical persons after receiving of diploma of medical education institution in the form of specialization or raising of qualifications;
 
     16)     specialization - a part of postgraduate training what includes a totality of knowledge and skills according to the regulation of specialty affirmed by the Ministry of Welfare in any of the specialties included in the classificator of professions of the Republic of Latvia. A certification at the authorized institution of certification and an acquiring the right of specialist practice follows to the specialization;
 
     17)     raising of qualifications - a part of postgraduate training in the acquired specialty according to the free chosen program. The time and contents of raising of qualifications are not regulated;
 
     18)      obligatory requirements for medical institutions and their structural units - requirements the fulfillment of which must be ensured by medical institutions or their structural units in order to receive a permit to provide medical assistance to patients;
 
     19)      internship - having legal labor relations with a medical institution with the right to qualify physicians, and after the receipt of a diploma the training of a licensed doctor for the acquisition of a specialty according to state accredited education program.
 
Article 2
 
The purpose of this law shall be to regulate the social relations in medicine, to ensure the qualified prophylaxis and diagnostics of diseases and traumas, as well as the qualified treatment and rehabilitation of patient.
 
Article 3
 
Health shall be a physical, mental and social welfare, the organic grounds of existence and surviving of the state and nation. The health care shall be the complex of measures for ensuring and maintaining of health.
 
Article 4
 
The procedure of health care financing, types and amount of medical services which are paid from the state basic budget and the means from the receivers of services, as well as the procedures of this payment shall be determined by the Cabinet of Ministers.
 
Article 5
 
Any shall have the duty to care and any shall be responsible for own health, health of the nation, his/her relatives and persons under support.
 
Article 6
 
A patient, his/her nearest relatives or legitimate representatives (trustees, guardians)     shall have the right to choose medical institution in Latvia and medical person for diagnostics, treatment of diseases and traumas of persons and for the rehabilitation of patient. A patient shall have the right on qualified, kind and respectful treatment and care.
 

CHAPTER II

SUPERVISION OVER MEDICINE

 
Article 7
 
Supervision over medicine in the state shall be performed by the Ministry of Welfare and by other institutions determined in regulatory acts.
 
Article 8
 
The Ministry of Welfare shall perform the following functions in the field of health care:
 
     1)     work out the state politics in the health care, as well as supervise its implementation;
 
     2)     coordinate and conduct on the state scale the rendering of urgent medical aid to victims of the extraordinary situations of regional and the state scale;
 
     3)     approve criteria for the estimation of quality of medical services;
 
     4)     form, supplement and keep in order the registers of medical persons and medical institutions, medical tools and goods, as well as of patients fallen ill with definite diseases;
 
     5)     affirm medical technologies to be used in medicine, as well as procedures for introducing of new technologies;
 
     6)     work out and submit the list of professional (occupational) diseases for approving by the Cabinet of Ministers;
 
     7)     in cooperation with professional organizations of medical persons to develop the drafts of obligatory requirements for medical institutions and their structural units;
 
     8)     approve the lists of those medical institutions and medical persons which under a stipulated procedure have the right to carry out the training of medical persons;
 
     9)     ensure the issuance of term permits to medical personnel of foreign countries for the implementation of specific undertakings.
 
Article 9
 
(1)     Factors of work environment harmful for health and the list of these jobs where the engaged persons before employment and periodically are subordinated to mandatory health examinations shall be affirmed by the Cabinet of Ministers.
 
(2)     The list of those positions in which employees working are required to possess a special knowledge for providing first aid shall be approved by the Cabinet of Ministers.
 
Article 10
 
The quality of professional health care and the expertise of working ability at medical institutions shall be controlled by the Inspection of Control over Quality of Medical Care and Expertise of Working Ability which acts according to regulations of the Cabinet of Ministers.
 
Article 11
 
Announcements and advertisements related to medicine, medical institutions and medical persons shall be inserted in mass media in the procedure stipulated by the regulatory acts.
 
Article 12
 
Persons without medical education and who independently are engaged in treatment of patients, rendering childbirth assistance (except cases when the first aid shall be rendered), hypnosis, encoding and other methods influenced the human psyche, correction of human power fields (biocorrection), accupointing and other methods influencing the power system of human organism, as well as persons who support such persons without medical education or without the right of specialists practice in medical activity shall be charged with liability according to law.
 

CHAPTER III

COMMITTEES OF MEDICAL ETHICS

 
Article 13
 
Committees of medical ethics are consultative institutions established for solving the problems of medical ethics which act according to model regulation affirmed by the Cabinet of Ministers.
 
Article 14
 
Committees of medical ethics shall be formed by medical institutions and professional unions of medical persons. These committees shall review the issues of ethics connected with the activity of medical persons and new medical technologies.
 
Article 15
 
The Central Committee of Medical Ethics acts according to regulations of the Cabinet of Ministers and it shall review the issues of ethics of biomedical progress related to social problems. The membership of the Central Committee of Medical Ethics shall be affirmed by the Cabinet of Ministers according to proposal of the Ministry of Welfare.
 

CHAPTER IV

PERSONS' RIGHTS AND OBLIGATIONS IN THE HEALTH CARE

 
Article 16
 
Any shall have a right to receive an urgent medical aid in the procedure stipulated by the Cabinet of Ministers.
 
Article 17
 
(1)     The amount of medical aid quarantined by the State shall be rendered to Latvian citizens, non-citizens, foreign citizens and stateless persons whose passport has an identity code and who are registered in the Register of Residents, as well as to detained, arrested and sentenced to imprisonment persons in the procedure stipulated by the Cabinet of Ministers. Such aid is rendered in that time and place where it is necessary, and treatment in such cases shall be carried out according to standard affirmed by the Ministry of Welfare.
 
(2)     That any child residing within the territory of Latvia is entitled to receive the state-granted medical assistance specified in the first Part of this Article, including a child who has not been granted a personal identification code and who is not yet registered in the Residents Register.
 
(3)     A child has the right to receive free state-granted medical assistance.
 
Article 18
 
Other medical aid to the persons mentioned in Article 17 of this law shall be rendered for expenses of the insurance company, employer, the personal means of patient and other resources according to regulatory acts.
 
Article 19
 
Foreign citizens and stateless persons, whose passports have not identity code, and who are not registered in the Register of Residents, but legally reside in Latvia, receive the medical aid for pay.
 
Article 20
 
A patient shall have the right to receive an information in understandable way for him/her from physician about diagnosis of his/her disease, plan of examination and treatment, as well as about other methods of treatment and forecast.
 
Article 21
 
A patient shall have the right to receive an information on process of treatment from the other medical persons within the limits of their competence.
 
Article 22
 
A patient shall have the right to receive the estimation of quality of the health care in the procedure stipulated by regulatory acts.
 
Article 23
 
A patient shall have the right to refuse completely or partly from the offered examination or treatment, certifying it with the signature, If a patient is under age or a person who due to health condition is not able to aware consequences of actions, these rights and responsibility about the decision shall have the family members of the patient, but, if they do not exist, - nearest relatives or legitimate representatives (trustees, guardians). The duty of physician shall be to explain to patient, his/her family members, nearest relatives or legitimate representatives (trustees, guardians) consequences of such refusal. If a patient has accepted the plan of treatment, he/she is obliged to observe all instructions of medical persons connected with treatment and care.
 
Article 24
 
A patient shall have the obligation, when registering at medical institution, to present an identity document.
 
Article 25
 
The obligation of patient shall be to observe instructions of medical persons in the process of treatment and internal office regulations of medical institution. During the treatment a patient may not perform activities which could cause harm to his/her health.
 

CHAPTER V

MEDICAL PERSONS AND THEIR ACTIVITY IN MEDICINE     

 
Article 26
 
Medical personnel who are certified and registered in the procedure stipulated in regulatory acts are permitted to operate independently in the medical field within limits of their competence.
 
Article 27
 
The names of specialties of medical personnel, their classification and distribution into basic specialties, subordinate specialties and additional specialties shall be established by the Ministry of Welfare but the regulation for medical persons shall be developed by the professional organizations of medical personnel and shall be approved by the Ministry of Welfare.
 
Article 28
 
The acquiring of diploma of medical education shall allow to the person by the certification in specialty, to operate in medicine only under supervision and guidance of such medical person who has a certificate and who is registered in the procedure stipulated in regulatory acts.
 
Article 29
 
The rights of a specialist's practice are proved by a certificate of the medical person and the registration in the procedure stipulated in regulatory acts. The Cabinet of Ministers shall establish a procedure for the certification of medical personnel.
 
Article 30
 
[Deleted by the law of June 1, 2000]
 
Article 31
 
Persons with a foreign diploma of medical education acquire the right to be engaged in medicine within Latvia after the experts' examination of diploma and its recognition in that procedure stipulated by law. The rights to specialist practice is acquired by such persons in that procedure established in this law.
 
Article 32
 
[Deleted by the law of June 1, 2000]
 
Article 33
 
In medical education institutions students, within the limits of the education program can be engaged in medical activity only under the direct supervision of a certified medical person.
 
Article 34
 
Medical equipment and medicinal goods sales, distribution, registration, exploitation and technical supervision procedure shall be established by the Cabinet of Ministers. The manager of a medical institution is directly responsible for the observance of the established procedure within the medical institution.
 
Article 35
 
The manager of a medical institution shall be held to that liability set forth by law if in the institution managed by him/her medical technologies which are not approved in the procedure established by the Ministry of Welfare are being used.
 
Article 36
 
A medical person shall be responsible for use and caused consequences of chosen medical technology.
 

CHAPTER VI

THE PROFESSION OF PHYSICIAN

 
Article 37
 
A physician is a medical person who has acquired a higher medical education as a physician and who with a scientifically justified medical activity and within the limits of his/her professional activity is directly or indirectly has an effect on human beings:
 
     1)     examines patients for ascertaining or denial of physical, mental or psychic diseases and for their treatment;
 
     2)     estimates diseases and their caused consequences;
 
     3)     treats the diseases mentioned in Paragraph 1 of this Article;
 
     4)     performs prophylactic measures for prevention of diseases;
 
     5)     renders childbirth assistance;
 
     6)     performs rehabilitation;
 
     7)     realizes dentistry;
 
     8)     carries out a post-mortem examination of dead body.
 
Article 38
 
A physician shall be free in his/her professional activity. Every physician shall have a right to give an opinion on the health condition of patient and treatment.
 
Article 39
 
A physician acts in the specialty (specialties can be several), which is determined in the certificate of physician. A physician may act in subspecialty, additional specialty, can use specific method of examination or treatment only then, if he/she has a certificate of physician in a basic specialty.
 
Article 40
 
A physician is responsible for keeping of unborn life and his/her duty shall be to disscade the patient from the interruption of pregnancy unless the pregnancy endangers the health condition of patient and the new-born child is endangered by inherited or acquired disease. A physician has the right to refuse the interruption of pregnancy if that has not medical cause.
 
Article 41
 
A physician must receive consent of patient for treatment, therefore the duty of physician shall be to give an information in understanding way for the patient on the diagnosis of disease, the plan of examination and treatment, as well as on other methods of treatment and forecast. The duty of physician shall be to explain and inform a patient on possible consequence and complications of diseases. A physician must inform a patient on possible adjacent effect of subscribed remedies or methods of treatment. A physician may not to give full information to patient on diagnosis and forecast of disease, if considers that this information can aggravate the health condition of patient.
 
Article 42
 
In cases when the life of patient is not endangered, but the patient fails to observe the determined regime, fails to fulfill instructions of medical persons or knowingly damage the health and in that way directly influence the treatment of specific disease, the physician shall have a right to refuse from the following treatment of patient.
 
Article 43
 
A physician may examine or treat a patient together with other medical persons or inadmit their participation.
 

CHAPTER VII

THE PROFESSION OF NURSE AND PHYSICIAN'S ASSISTANT

 
Article 44
 
(1)     A nurse is the medical person who has acquired medical education and is registered in the register of nurses of medical persons.
 
(2)     A physician's assistant is a medical person who has acquired a medical education and is acting in accordance with the regulations of the specialty.
 
Article 45
 
(1)     A nurse in his/her profession according to qualification shall:
 
     1)     realize the patients care;
 
     2)     participate in medicine;
 
     3)     conduct the patient care;
 
     4)     be engaged in the instruction of patients in the health issues;
 
     5)     perform the professional education work.
 
(2)     A physician's assistant executes the activities mentioned in the first Part of this Article, as well as examines patients, diagnoses illness and according to his/her qualifications executes treatment.
 

CHAPTER VII A

FUNCTIONING SPECIALIST AND ASSISTANT OF A FUNCTIONING SPECIALIS

 
Article 451
 
(1)     A functioning specialist (physiotherapist, ergotherapist, reittherapist, technical podiatrist, clinical speech therapist) is a medical person who has acquired the higher vocational medical education of the second level and is operating in compliance with the regulation of his/her specialty.
 
(2)     Assistant of a functioning specialist (assistant of physiotherapist, assistant of ergotherapist) is a medical person who has acquired the higher vocational medical education of a first level or medical education at least of the third vocational qualification level and is operating in compliance with the regulation of his/her specialty.
 
Article 452
 
(1)     Within his/her specialty a functioning specialist within the limits o his/her authority:
 
     1)     has a knowledge of assessment of functional limitations and principles of rehabilitation of a human;
 
     2)     performs medication by using an appropriate diagnostics, assessment and medical technologies and provide conclusions;
 
     3)     performs activity of vocational education.
 
(2)     Within his/her specialty an assistant of a functioning specialist within the limits o his/her authority:
 
     1)     has a knowledge of assessment of functional limitations and principles of rehabilitation of a human;
 
     2)     performs medication by using an appropriate diagnostics medical technologies under the supervision of a functioning specialist or a doctor.
 

CHAPTER VIII

DUTIES AND RIGHTS OF MEDICAL PERSONS IN MEDICINE

 
Article 46
 
The duty of medical persons is to render the first and urgent medical aid.
 
Article 47
 
A medical person shall have a right to refuse the first and urgent medical aid under circumstances which endanger the life of medical person, as well as then, if medical person is unable because of the health condition.
 
Article 48
 
The duty of medical person shall be to improve his/her qualifications and to acquire the knowledge in the rendering of urgent aid.
 
Article 49
 
In cases when hesitation endangers the life of patient and it is not possible to receive the permit of patient, his/her family members, but, if they are not exist - of nearest relatives or legitimate representatives (trustees, guardians) the duty of medical person in the limits of his/her competence shall be to realize urgent measures - examination, treatment and surgical intervention. The plan of examination in such cases shall be approved and decision shall be passed by the concil of physicians (except the case when the first or urgent medical aid shall rendered). The duty of physician shall be to inform the orphans court or rural district court, for purpose of protection of the interests of the persons under age, on the decision passed by council which is connected with subsequent examination and treatment of patient under age.
 
Article 50
 
(1)     The information on the treatment of patient, diagnosis of disease and forecast (hereinafter - the information on patient), as well as the information what the medical persons have acquired in the process of medicine on the private life of patient or his/her nearest relatives shall be confidential.
 
(2)     The information on patient can be furnished to:
 
     1)     other medical personnel for reaching their medical goals;
 
     2)     Medical Commission for the Health and Working Abilities Expertise (VDEAK);
 
     3)     Inspection of the Control over Quality of Medical Care and Working Abilities Expertise.
 
(3)     Information about a patient can be issued to the courts, police, public prosecutors office, State Childrens' Rights Protection Inspectorate (inspectors), orphan's court (rural district court) and those institutions which conduct inquiries only upon a written request from such institutions if a permit signed by the manager of the medical institution exists.
 
(4)     The information on patient may use in scientific research only if the anonymity of patient is quarantined or his/her agreement is received.
 
(5)     Departments of the state military service of the Ministry of Defense shall be entitled to demand the information of the health condition of persons to be conscripted, reserve soldiers and reservists from medical institutions in the procedure stipulated by the Cabinet of Ministers.
 
Article 51
 
Medical person shall have the right refuse to furnish the information mentioned in Article 50 of this law through the telephone or with help of other means of telecommunications.
 
Article 52
 
Medical personnel on regular basis shall submit medical statistical information to the Central Statistics Administration in the procedure stipulated by law.
 
Article 53
 
The temporary working disability of person shall be ascertained by the physician or physician's assistant. The procedures for issuing of documents certifying temporary working disability shall be determined by the Cabinet of Ministers.
 

CHAPTER IX

MEDICAL INSTITUTIONS

 
Article 54
 
(1)     A medical institution can be formed by state institutions, local governments, physical or legal persons.
 
(2)     Medical institutions can be outpatient institutions where patients, if their placement into inpatient facilities is not required, shall be provided services of primary and secondary health care and inpatient facilities, where patients who are under the permanent care of medical persons for 24 hours are provided medical services of secondary or tertiary medical care until the achievement of a particular medical goal.
 
Article 55
 
(1)     Only those medical institutions which correspond to the obligatory requirements established for medical institutions and their structural units can be engaged in the practice of medicine.
 
(2)     The obligatory requirements for medical institutions and their structural units shall be established by the Cabinet of Ministers. The evaluation of compliance of medical institutions and their structural units shall be performed by institutions authorized by the Cabinet of Ministers.
 
Article 56
 
(1)     Certification of medical institutions and their structural units is voluntary.
 
(2)     The procedure for the certification of medical institutions and their structural units shall be established by the Cabinet of Ministers.
 
(3)     A certificate of a medical institution or its structural unit, in accordance with procedure for the financing of health care established by the Cabinet of Ministers provides advantages for the corresponding medical institution when concluding contracts with health insurers.
 
Article 57
 
The procedure of distribution of residents and the procedure for financing of residentiary shall be determined by the Cabinet of Ministers.
 
Article 58
 
Every medical institution must ensure the facilities necessary for rendering urgent medical aid in the procedure stipulated by the Ministry of Welfare.
 
Article 59
 
The procedure of office work with medical documentation at medical institutions shall be determined by the Ministry of Welfare.
 
Article 60
 
The regulations of producing forms of prescriptions and the procedure for issuing prescriptions shall be regulated by the regulations of the Cabinet of Ministers and other regulatory acts.
 

CHAPTER X

THE TREATMENT OF PATIENTS SUFFERED FROM ALCOHOLISM, DRUG ADDICTION AND TOXIC ADDICTION

 
Article 61
 
The treatment of patients suffered from alcoholism, drug addiction and toxic addiction takes place voluntarily at their request at narcological medical institutions in the procedure stipulated by the Cabinet of Ministers.
 
Article 62
 
In those cases when due to use of alcoholic beverages or other means of intoxication a patient is performing activities dangerous for public, on a regular basis is committing administrative violations, or is endangering him/her self, his/her close relatives or the public by his/her activity, the social and psycho-social compulsory measures established by law shall be applied but for minors - compulsory reformative measures.
 
Article 63
 
The compulsory measures for social and psycho-social rehabilitation of the patient suffered from alcoholism, drug addiction and toxic addiction shall be:
 
     1)     taking to prophylactic register of police and the police warning in written that the patient must stop the excessive use of alcoholic drinks and the committing of administrative violations connected with that, as well as must start treatment in compulsory procedure;
 
     2)     taking to narcological register and forming of motivation to interest a patient in starting voluntary treatment against alcoholism, toxic addiction or drug addiction;
 
     3)     the court decision on the obligation of sentenced person on treatment.
 
Article 64
 
When sentencing conditionally, the court can inflict to sentenced person who has committed a crime under influence of alcoholism, drug addiction or toxic addiction, with his/her consent the duty to treat against alcoholism, drug addiction or toxic addiction at the institution of social and psychological rehabilitation.
 

CHAPTER XI

MENTAL DISEASES

 
Article 65
 
All citizen political, economical and social rights which are envisaged by the law shall be ensured to the persons with mental disturbances and mental diseases. Mental disturbances or mental diseases may not be the reason for human discrimination.
 
Article 66
 
Mentally deranged persons shall have the rights to receive medical aid and care in a quality corresponds to accepted standards of general medicine.
 
Article 67
 
Psychiatric aid shall be based on the principle of voluntarity. In-patient aid at hospitals shall be rendered at psychiatric medical institutions (sections) if due to health condition of patient it is not possible to perform it in out-patient clinics or at the place of residence.
 
Article 68
 
(1)     Out-patient or in-patient examination and treatment may be performed against the will of patient only in the following cases:
 
     1)     if, due to mental disturbances, the behavior of patient is dangerous to himself/herself or to the health or life of other persons;
 
     2)     if, due to mental disturbances and their clinical dynamics, the psychiatrist forecasts such behavior of patient what is dangerous to himself/herself or to the health or life of other persons;
 
     3)     if the mental disturbances of patient are such what do not allow himself/herself to pass deliberate decisions, and refusal of treatment can cause serious aggravation of health and social situation, as well as infringements of public order.
 
(2)     If is realized hospitality against the will of patient, the council of psychiatrists must examine patient within 72 hours and pass the decision on subsequent treatment. The council notifies its decision immediately to the patient, his/her family members, but, if they are not exist, - to nearest relatives or legitimate representatives (trustees, guardians). If it is not possible to realize it immediately by meeting with somebody from those people, the notification must be sent to them in written, introducing the entry of that in the registration card of patient.
 
Article 69
 
(1)     If the person due to mental disturbances or mental disease infringes the public order, his/her detainment, delivery and surveillance at the psychiatrist shall be performed by police employees according to the law "On Police".
 
(2)     Police employees shall submit to psychiatrist the report on anti-social character of behavior of the patient in written.
 
Article 70
 
For persons, who in procedure stipulated by law are recognized incapable to act, the psychiatric aid shall be rendered according to request of their trustees or their consent in written, except cases which are envisaged in Article 68 of this law.
 

CHAPTER XII

THE HEALTH AND WORKING ABILITY, LEGAL MEDICAL AND LEGAL PSYCHIATRIC EXPERTISE

 
Article 71
 
In cases of lasting or permanent restrictions of physical or mental abilities, the health and working ability expertise shall be performed and disability shall be determined by the state authorized Medical Commission for the Health and Working Abilities Expertise (VDEAK) which activity is regulated by regulatory acts.
 
Article 72
 
The legal medical and legal psychiatric experts shall be performed according to the decision of inquirer, public procurator or the court (judge) in the procedure stipulated by the law. The procedure in which the legal medical and legal psychiatric expertise takes place shall be determined by the Cabinet of Ministers.
 
Article 73
 
[Deleted by the law of June 1, 2000]
 

TRANSITIONAL PROVISIONS

 
1.     The medical persons, who have acquired the category of qualification or certificate in any from subspecialties or additional specialties and have practiced in that more than five years, may continue their practice without receiving the certificate in basic specialty. The certification takes place for these specialists in the obtained subspecialty or additional specialty.
 
2.     The medical persons, who have received the category of qualification or certificate in any of basic specialties, subspecialties or additional specialties and have practiced in that more than ten years, when changing the classificator of specialties, may continue their practice without receiving the certificate in basic specialty, if this specialty is recognized as medical or diagnostical method.
 
3.     [Deleted by the law of June 1, 2000]
 
4.     By taking effect of this law the Cabinet of Ministers Regulations No. 177 "The Regulations of Treatment" issued in compliance with the procedure set by Article 81 of the Satversme are recognized as null and void.
 
5.     Medical institutions and their structural units which are formed prior to June 30, 2000 shall be assessed in accordance to the obligatory requirements by December 31, 2000.
 
The law takes effect as of October 1, 1997.
 
The law was enacted by the Saeima on June 5, 1997.
 
The President of State
G.Ulmanis
Riga, July 1, 1997