The Governing Principles of Bioethics Law
Bioethics law governs the circle of relationships that arise where modern medical technology, decisions about the beginning and end of life, genetic research, and patient autonomy intersect. Georgian legislation rests in this field on several firm foundations: the primacy of the patient's informed will, the confidentiality of private life, the prohibition of discrimination based on genetic heritage, and respect for human dignity in medical teaching and research. On this page we explain these rules on the basis of the specific provisions through which this sphere is regulated in Georgia, and we show how patients and their families can protect their rights.
The Advance Written Will and Its Safeguards
A citizen of Georgia has the right to express in advance, in writing, his or her will — consent or refusal — for the situation in which the person is found unconscious or loses the capacity to make an informed decision, and requires resuscitation, life sustaining treatment or palliative treatment, or the provision of palliative care or hospice care. This right applies where such a condition is caused by the terminal stage of an incurable disease, or by a disease that will inevitably result in a severe form of disability. The advance will is therefore not an abstract declaration but a legal instrument that binds the future delivery of medical services to the choice the person makes while still capable of deciding.
Under the same norm, a citizen has the right to designate in advance a person who will make decisions about the medical care needed in those circumstances. This means that a person can determine today who, and on what principles, will safeguard his or her interests when the capacity to decide has been lost. Such an advance will serves as a legal reference point for medical service providers and plays a decisive role in reducing disputes within families and before courts.
Minors and Patients Lacking Decision Making Capacity
The law separately protects minors and patients who lack the capacity to make informed decisions. Where a decision of such a patient's relative or legal representative contradicts the patient's health interests, the medical service provider has the right to appeal that decision to court. This guarantee ensures that the interest of a minor or vulnerable patient is not harmed even when the decision is taken by a close relative.
Emergency situations are also precisely regulated. If a minor or a patient lacking capacity requires emergency medical care without which his or her death or significant deterioration of health is inevitable, but the relative or legal representative cannot be found, the medical service provider takes the decision with regard to the patient's health interests. The same rule applies where emergency care is needed without which death is inevitable and the relative or legal representative objects to that care: in this case too, the provider decides on the basis of the patient's health interests.
The Patient as a Teaching Object and Research Purposes
Medical education and scientific research are impossible without the participation of patients, yet the law draws a clear boundary here: the patient's informed consent is necessary for his or her use as a teaching object, and that consent must precede such use. Questions concerning recipients of support and minor patients as teaching objects are regulated separately by the Georgian Law on Health Care.
Consent is not required only in two situations: where the information used for study purposes comes from the patient's medical documentation and does not allow the patient's identification, and where the material obtained in the process of treatment and diagnostics — urine, blood, other tissues — is used with the patient's anonymity ensured. This standard of anonymity represents the balance that reconciles the interest of science with the personal rights of the human being.
Genetic Heritage and Gene Interventions
In the field of genetics the law establishes four clear rules. First, discrimination against a person on the ground of genetic heritage is prohibited: no one may disadvantage a person in employment, services or any other sphere because of that person's genes. Second, testing to detect a disease causing gene or to determine a genetic predisposition to a disease is admissible only where its purpose is the protection of the patient's health or scientific research related to health protection. Third, an intervention intended to modify a human gene is admissible only for diagnostic, treatment or prevention purposes, and only provided that it does not involve alteration of the genome of the patient's descendants. Fourth, the use of artificial insemination methods for the purpose of sex selection is prohibited, except where it is necessary to prevent a hereditary disease linked to sex.
Together these rules create the frame by which Georgian law places genetic technology in the service of human dignity. With pregnant and nursing mothers, the law also sets a high standard of informedness: they are entitled to receive full, objective, timely and understandable information about any medical intervention planned during pregnancy, childbirth or the postpartum period, including information about possible direct or indirect harmful effects on the fetus or the newborn.
Frequently Asked Questions
Can an advance will refuse treatment?
Yes. A citizen of Georgia may express in advance, in writing, consent or refusal concerning resuscitation, life sustaining or palliative treatment, and palliative or hospice care, where the condition is caused by the terminal stage of an incurable disease or a disease that will inevitably cause severe disability.
Who decides in an emergency if relatives object to treatment?
If emergency medical care is needed without which the patient's death is inevitable and the relative or legal representative objects, the medical service provider decides with regard to the patient's health interests. Providers may also appeal to court a relative's decision that contradicts the patient's interests.
Is consent needed for anonymized material used in teaching?
No. Consent is not required where study purposes involve non identifying information from medical documentation, or biological material obtained during treatment and diagnostics — urine, blood, other tissues — with the patient's anonymity ensured.
Is gene modification affecting future generations allowed?
No. An intervention intended to modify a human gene is admissible only for diagnostic, treatment or prevention purposes, and only where it does not involve alteration of the genome of the patient's descendants.
How We Help on Legal.ge
The advocates and medical law specialists of Legal.ge assist with drafting an advance written will, designating a representative, protecting patient rights in dealings with medical institutions, and litigating bioethics disputes. Contact us — we will assess your case and advise you on the precise legal step.