Gift or bribe: what do doctors and patients need to know in order not to break the law?

06/09/2017 Malfeasance 0 comments

A bribe, if you look at it from the point of view of legislation, is a real crime, and liability is provided not only for those who, taking advantage of their official position, accept and often simply extort it, but also for those who try to bribe an official. Moreover, for each case there is a separate article in the Criminal Code of the Russian Federation and there are many nuances.

Let's understand the terminology: when is it a bribe, and when is it a gift?

A bribe is money given to an official or any material assets that represent a property benefit to the recipient for the fact that he has performed certain actions using his official position. Bribery can also be committed, conversely, for the purpose of inaction of a given person when his direct responsibilities include responding to a certain situation. Bribes are often given for patronage in the service, for assistance in moving up the career ladder, concealing mistakes, etc. They can be expressed not only in monetary terms, but also in the form of services provided free of charge, for example, construction work or organizing a free tourist trip.

When considering the issue of bribery, we must not forget that the Civil Code does not prohibit making small gifts and pleasant surprises to municipal employees and civil servants. But Article 575 introduces a restriction for them: the value of the gift should not exceed 3 thousand rubles, or the official is obliged to transfer what he received in favor of the state. In addition, it is important to understand that the gift should not entail the performance of certain actions or, conversely, inaction on the part of the official, otherwise it will be considered a bribe and then its value does not matter.

Gift or bribe: what do doctors and patients need to know in order not to break the law?

It is a Russian tradition to thank a doctor for successful treatment. But in some cases, even a box of chocolates may be an illegal gift. Natalya Morozova, associate professor of the department of the Institute for Advanced Studies of the Academy of the Investigative Committee of the Russian Federation, told the Sibmeda portal about the cases in which a gift to a doctor is qualified as a bribe.

No thanks for sick leave

Corruption among medical workers is not the most common situation in the total number of cases related to bribery in our country. However, cases of unauthorized gifts being given to doctors from patients regularly occur both in Russia as a whole and in the Novosibirsk region. It happens that they are associated with ignorance of legal requirements - as a rule, on the part of the patient. However, according to Russian law, an illegal transaction entails punishment for both the bribe taker and the bribe giver. At the same time, giving a bribe and receiving it are punishable under different articles, but both offenses are classified as criminal.

According to Natalya Morozova, the most important condition that determines a patient’s gift as a bribe is that the doctor belongs to the category of officials. An official is considered a specialist on whom the future fate of the person entrusted to him depends from a legal point of view. In the field of medicine, this may be a member of the medical-social examination or forensic examination, as well as a doctor issuing a certificate of incapacity for work.

Being officials, these specialists have no right to take absolutely any offerings from the patient, be it a bottle of champagne or a “purely symbolic” chocolate bar. Even 10 kopecks left on an official’s desk can become grounds for assuming a bribe. At the same time, a doctor who is not an official, from the point of view of criminal law, has the right to receive a gift from a grateful patient. We are talking about a doctor who treats or has treated his patient, but does not issue official documents that affect his rights and obligations.

“The patient needs to remember: thanking the doctor financially for performing his official duties is an absolute taboo,” says Natalya Morozova. – If a doctor issues a sick leave, you can only say “thank you.” You can be grateful for quality treatment. A doctor is categorically prohibited from accepting gifts for official duties, that is, he must differentiate for himself when he is an official and when he is just a doctor.”

When planning to give a gift to a doctor as a thank you for treatment, it is worth remembering that not all medical institutions allow their employees to accept gifts from patients - in some organizations this is strictly prohibited. If such a prohibition is violated, the employer has the right to apply certain penalties to the employee in accordance with the internal rules of the organization. But the patient will not suffer any punishment.

“To prevent a doctor from getting into an undesirable situation, he should know the local regulations of his medical institution, the institution’s policy regarding receiving gifts

, continues Natalya Morozova.
“ As a rule, the doctor knows what is accepted in his hospital, because he is introduced to the necessary documents upon signature.”

The cost of the gift and the “price” of the bribe

The expert emphasizes: contrary to the common misconception that any gift in the amount of up to 3 thousand rubles. is not a bribe (according to the Civil Code of the Russian Federation, giving gifts in excess of this amount was indeed not allowed), the determining condition in any case remains that the doctor belongs to the category of officials, regardless of the amount.

And yet the 3 thousand mark matters. For example, in accordance with Article 575 of the Civil Code of the Russian Federation, it is this amount that doctors are prohibited from exceeding as the value of the gift received. According to the specialist, ethical standards also require keeping within it when thanking the doctor for professional services.

The amount is 3 thousand rubles. can become decisive in “controversial” cases. For example, in a situation where a doctor is presented with a gift by a representative of a pharmaceutical company. First of all, in this case, what matters is what services the pharmacist thanks the doctor for. If the reason for the gift was the doctor’s cooperation with a commercial organization, the gift may be considered a bribe. But if we are talking about a gift for participation in a conference organized by a company, then the cost of this gift should not exceed that same 3 thousand rubles. If the gift is more expensive, the law requires it to be handed over or returned to the donor.

How to estimate the real value of a gift? According to Natalia Morozova, there are no universal methods here. Sometimes they look at the market value of a donated item, sometimes they determine its average price based on monitoring the prices of similar items in open sources, and in some organizations a special evaluation commission is created.

The actual subject of the bribe can be anything - from banknotes to any service (for example, washing a car). The latter, like an object gift, will be valued according to its value. Anything that cannot be valued in money is not a bribe. As a rule, this is a handmade gift, unless it is made of expensive materials.

It is worth considering that recently a bribe is considered to be something that benefits not only the bribe recipient, but also the institution in which he works. In this case, only the bribe-taker himself, as well as the one who gave the bribe, will remain guilty. For example, repair or finishing work carried out in a hospital in exchange for the service of an official will entail punishment for this official and the bribe-giver.

The severity of the penalty for bribery varies depending on the amount transferred or the value of the illegal gift. Thus, the least punishment is a small bribe - up to 10 thousand rubles, a bribe in an insignificant amount - up to 25 thousand rubles. A more serious punishment is expected for a bribe in a significant amount - from 25 thousand rubles, and those accused of large and especially large bribes are subject to the most serious punishment - 150 thousand rubles. and 1 million rubles. respectively.

The concept of a small bribe has appeared in Russian legislation since July 2021. In the case of receiving (transferring) a small bribe, a simplified investigation procedure and a less severe punishment are established in comparison with other types of bribes.

The minimum punishment for charges in bribery cases is a fine of 200 thousand rubles. or imprisonment for up to one year. The maximum penalty includes a fine of 3 million rubles. up to 5 million rubles with deprivation of the right to hold certain positions or engage in certain activities for a term of up to 15 years, or imprisonment for a term of 8 to 15 years with a fine of up to seventy times the amount of the bribe or without it, with deprivation of the right to occupy certain positions or engage in certain activities for a term of up to 15 years or without it.

When transferring illegal remuneration to a medical worker of a non-state health care institution, the actions of the giver and taker will be qualified as commercial bribery.

Extenuating circumstances

No special mitigating circumstances are considered for those accused of bribing a doctor. Neither the motivation of the patient nor the existence of an advance agreement matters: if an illegal transaction takes place, the offense is punished to the fullest extent of the law.

Moreover, if there was an agreement for a certain amount, but only part of it was transferred, the violators will be charged with the entire agreed figure. So, if the doctor and the patient agreed on the transfer of 5 thousand rubles, and only 500 rubles were transferred as a deposit, then from the point of view of the law the transaction took place for the entire 5 thousand rubles.

However, an unsavory idea can be abandoned in time. Even after an agreement with the doctor, the patient can contact law enforcement agencies, with whom in this case he agrees to cooperate. After the bribe is handed over, the police confiscate the money transferred. In this case, a patient who cooperates with the police is exempt from criminal liability. According to Natalya Morozova, this is basically how such crimes are solved.

The patient is also exempt from criminal liability if he has already given the bribe, but then contacted law enforcement agencies. The law qualifies such an act as active repentance.

If law enforcement officers have information that a particular doctor is illegally receiving money from patients, operational search activities are carried out with the involvement of any person willing to cooperate with the police. However, if representatives of law enforcement agencies do not have such information, it will be a question of provoking a bribe. In this case, the person provoked to take a bribe is exempt from criminal liability.

“From the position of the European Court of Human Rights and the Supreme Court of the Russian Federation, provocation of a bribe means a situation in which there is no certainty that the crime would have been committed if not for the intervention of law enforcement agencies

, explains Natalya Morozova.
– Accordingly, if a person comes from the police and induces an official to accept a bribe, while there is no evidence that he has previously taken a bribe, it is recognized that there was a provocation of a bribe.
Therefore, he should be exempt from criminal liability.” Anyone can complain about a bribe-taker in the form of a statement. Today, government agencies have regulations obliging employees to report corruption to law enforcement agencies. There are such regulations in some private organizations.

So, if a person approaches a doctor with a proposal to give a bribe, the doctor can contact the management of the institution or law enforcement agencies with a report of this fact. In this case, the doctor will be released from criminal liability, and the person who incited the commission of a crime will bear criminal liability.

Extortion of a bribe

There are often cases of extortion of bribes. However, we can talk about extortion of money only when the patient has the right to purchase a particular benefit. So, if a doctor demands to pay for a certificate of incapacity for work for a healthy patient, that is, who actually does not have the right to a document temporarily releasing him from work, this is not considered extortion of a bribe.

If a doctor forces a patient to pay for a service that the patient has the right to receive for free, including through compulsory health insurance, the doctor’s behavior will be regarded either as extortion of a bribe - when it comes to the use of official powers (for example, when issuing the same “sick leave” ), or as fraud – when it comes to treatment. In this case, not only requests and persuasion, but also refusal to provide a service, implying unauthorized payment, will be considered extortion of a bribe.

Despite the relative small number of “corruption” cases against doctors and their patients in Russia, a certain pattern can still be traced in such offenses: most of these cases concern the issuance of various types of certificates. Basically, we are talking about a certificate of incapacity for work. As a rule, patients themselves offer the doctor to “sell” the opportunity to rest under the guise of “sick leave.”

According to Natalya Morozova, criminal cases related to bribery among doctors are becoming even smaller. The lawyer believes that the reason for this is the coverage of such facts in the media.

What does the Criminal Code of the Russian Federation tell us?

A bribe is a transaction in which two parties take part - the giver and the recipient, and both cases involve criminal liability:

• for giving a bribe - under Art. 291 of the Criminal Code of the Russian Federation;
• for receiving - under Art. 290 of the Criminal Code of the Russian Federation.

But not always both parties are equally inclined to commit an offense. For example, an official does not want to take a bribe, but he is persistently tempted by the value or, conversely, the official extorts a reward and the other party simply has no other choice. That is why each incident involving bribery must be considered individually and with the utmost care.

Swindlers from medicine and law

According to statistics, the number of draft dodgers has decreased by almost a third in 2021. This data was provided by the chief military prosecutor Valery Petrov.

“I would like to note certain positive results of our work in this area. This year, the number of crimes against military service has decreased by more than 18%, and the number of evasions from military service has decreased by a third,” Petrov said at a meeting of the coordination council for combating crime in the Armed Forces.

Corruption in the conscription system has existed for decades, but in recent years they have begun to fight it more effectively, says Anton Tsvetkov, member of the Public Council under the Ministry of Defense of the Russian Federation, chairman of the All-Russian movement “Strong Russia”.

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Photo: IZVESTIA/Pavel Bednyakov

Limitedly unfit: The Ministry of Defense is ready to tighten the rules of conscription

Exemptions from military service due to health reasons will be rechecked every spring and autumn

— The leadership of the Ministry of Defense is really, not in words, but in deeds, strengthening control over military registration and enlistment offices and all processes related to conscription. Members of the Public Council and relevant public organizations are actively involved in ensuring the transparency of the process and legal information to citizens, the conscripts themselves and their parents. Special attention, the professional approach of the leadership of the Ministry of Defense, transparency and public control always lead to improvement,” Tsvetkov explained in an interview with Izvestia.

In addition to doctors extorting money from conscripts for deferment and release from the army, there is a huge layer of lawyers who offer illegal services and promise to negotiate with medical commissions, Tsvetkov added. Services originally created to combat rights violations are now working to look for diseases where there were none in the first place. The prices for the services of such lawyers do not differ much from the average amount of bribes, and the revenue of lawyers specializing in exemption from conscription amounts to hundreds of millions of rubles.

— There is a whole layer of swindlers who mislead children and impose their pseudo-legal services. Fraudsters simply deceive conscripts, intimidate them with the conditions of service, sell them “fraudulent” military tickets and promise to reach an agreement with medical commissions. But in most cases, these are just scammers who have no connections in military registration and enlistment offices, selling fake certificates or simply scamming guys out of money,” added a member of the Public Council under the Ministry of Defense.

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Photo: IZVESTIA/Pavel Bednyakov

The prestige of the army has grown noticeably in recent years, and the opposite trend is observed: young people unfit for service are trying to hide their diagnoses in order to join the Armed Forces. This situation is especially typical for economically depressed areas of the country. In the summer of 2021, an investigation began into the case of a conscript from Severodvinsk, who gave a bribe to a doctor in the amount of 55 thousand rubles in order to be recognized as fit. The 27-year-old suspect explained that he did this in order to find a well-paid job in the future. He was declared unfit back in 2011, but on the eve of his 28th birthday, the young man decided to take a desperate step.

A hundred grand before the order: how they do business with army dodgers

Since the beginning of conscription, scammers have become more active, offering conscripts to avoid military service.

“Those who are not eligible for service due to medical reasons hide their illnesses and try to pass a medical examination. There is no need for forced recruitment now; there are enough volunteers. Plus, the number of contract workers is constantly increasing. But there is another problem. The state of health and physical fitness of the younger generation leaves much to be desired,” summarized the chairman of Strong Russia.

If the crime is unfinished, then what happens?

There are often cases when something did not work out for a citizen who tried to give a bribe, and for reasons beyond his control it was not possible to transfer the bribe to an official. For example:

• the moment of transfer of money was stopped by representatives of law enforcement agencies;
• the official refused the illegal action under the influence of external factors (presence of witnesses, video recording).

In this case, the crime is considered unfinished and there is no evidence, but this does not negate the fact of preparation for committing illegal acts. Especially for these situations, an incrimination of attempted bribery to an official is provided.

How is the fact of a bribe proven?

Any crime must be proven; this is done using the materials of the criminal case. If you are wondering how to prove a bribe, the information below will be useful.

First of all, the investigation must provide official evidence that the accused is an official according to legal norms. In order to determine the scope of his rights and obligations, a request is sent to his place of work. In response, the representative of law enforcement agencies must be provided with all the necessary documentation defining the powers of the subject. It is taken into account that they must be relevant at the time the response to the request is generated. Otherwise, the fact of illegal acquisition of property assets will not be proven.

As for the direct receipt of a bribe, materials that were obtained during operational search work can be used as evidence, namely:

• results of operational experiments;
• wiretapping data;
• video recordings.

Subject to legal compliance when received, all materials are considered valid. It is worth noting that wiretapping a citizen without the permission of the prosecutor is prohibited by law.

When the evidence base has been collected, the investigation moves on to “consolidate” the result, this is done through a personal search of the accused, his detention, as well as an inspection of the place where the crime was committed. The protocol must reflect information about the presence of material assets during the search, which became the subject of the bribe.

Assigning liability for attempted bribery to an official

Preparation and attempt to commit a crime is subject to consideration under Articles 29 and 30 of the Criminal Code of the Russian Federation. These acts in the case of giving a bribe intended for an official include collecting money or valuables (for bribery), searching for a method of transfer and persons providing assistance, scheduling a meeting - in general, all deliberate actions that ensured the commission of the illegal act in full .

It should be noted that Art. 29 provides for the application of criminal liability to a person as for a crime committed under Art. 291, but with reference to Article 30 of the Criminal Code, which, in turn, notes the possibility of such punishment only for preparation for a serious and especially serious crime. In other cases, sanctions against the accused person are not applied in full, but provide for partial application of the responsibility provided for the crime committed.

Important! Liability depends on how the bribe is recognized (in a significant amount, large and especially large), as well as on whether the crime was committed by a group (which is an aggravating circumstance) or concerned one person.

Bribes to a psychiatrist

A special crime is giving a bribe to a psychiatrist, the purpose of this offense may be:

• declaring the bribe-giver insane in order to avoid criminal punishment;
• recognition of a conscript as limitedly fit for military service;
• issuing prescriptions for psychotropic or narcotic drugs.

Many criminals who have committed serious crimes are sent for examination by a commission of psychiatrists - if the criminal is found insane, then a long prison sentence can be replaced by 1-2 years of compulsory treatment in a psychiatric hospital.

Mental illness is one of the most common grounds for declaring conscripts unfit for military service in peacetime , and to make fictitious diagnoses, bribes are given to psychiatrists participating in the commission who make decisions about assigning a conscript a category of fitness for military service.

In large cities, the purpose of giving a bribe to a psychiatrist may be to falsely recognize an individual as mentally ill and forcibly detain him in the hospital - here the bribe givers are the victim’s relatives, intending to appropriate her living space.

What is the punishment for giving a bribe to an official?

The measure of responsibility for a completed crime can be assigned in the form of:

• fine;
• correctional labor (most often with a ban on holding certain positions for a designated time);
• imprisonment (from one year to 15 years, depending on the size of the bribe and the presence of aggravating circumstances).

Important! If a person accused of attempted bribery actively cooperated with the investigation, helped in uncovering the criminal activities of other citizens, or was a victim of extortion, then he will be released from criminal liability.

Prohibited methods for detecting criminal activity

There was a time when law enforcement agencies practiced such operational experiments as staging a bribe to a suspect. But! This is against the law. This is because the experiment does not allow stopping the crime, but, on the contrary, provokes the official to break the law again, which will further aggravate the situation. Such actions on the part of law enforcement officers contradict the principles of legality and justice.

Another important point is that it is necessary to prove the malicious intent of the person accused of corruption, namely, that he took the money of his own free will. As practice shows, this is the most difficult thing to do, because no one wants to testify against themselves. But there is another way to prove the consciousness of the crime. For these purposes, the following facts may be used, which must be obtained legally. To be more precise, this is:

1. results of operational search activities;
2. testimony of victims, witnesses in the case;
3. audio recordings from auditions;
4. recordings of investigative dramatizations.

If you or someone you know is faced with a similar situation, you should definitely contact a lawyer. With its help, it will be possible to collect the maximum amount of evidence. The defense lawyer will prepare you for the court hearing and tell you what to say. Even if you are in isolation, he will still visit you frequently.

Detained for a bribe - evidence of guilt or innocence

Important: For this purpose, the debtor began to receive instructions and means of covert audio and video surveillance to record his conversations. All this was done informally, i.e. illegal. Secondly, in order to repay the loan issued, the creditor is forced to communicate with the debtor and must accept the debt from him. In conversations, the debtor, being an agent, began to incite the creditor to receive a bribe for resolving an issue not related to debt obligations in favor of a third party. Thus, the situation turned out to be ambiguous. It is not clear from the content of the conversations what the money was transferred for: partial repayment of a debt or as a bribe? In the example considered, the provocation of a bribe was carried out by an agent in the form of incitement. Attention: The falsification of the results of the operational investigation resulted in the fact that the return of part of the debt, the existence of which the operational workers knew, was documented by them as a bribe.

And the expert did not examine the recording of the agent provocateur persuading the official to accept a bribe (it would be a great success for the defense if such an audio recording ended up in the case). These manipulations are aimed at giving legality to bringing an official to criminal liability and at concealing evidence of provocation of a bribe committed against him and falsification of the results of operational-search activities. 8. Recordings of conversations within the framework of computer technical forensics should be examined for the presence or absence of signs of editing.

The expert’s conclusion about the absence of signs of installation must be categorical.

Otherwise, the doubts that arise must be interpreted in favor of the accused. 9. No less important is the answer to the question of what technical means were used to record the negotiations on which the charges were based.

What needs to be proven

In order for a corrupt official to receive a deserved punishment, the court must make an appropriate decision. But in his actions, the judge will be guided by what evidence is presented, how convincing it is, and whether it confirms the fact of bribery. Otherwise, the court may conclude that there is no corpus delicti.

It is up to the person filing the claim to prove it. It is this person who will have to collect the necessary information. Often it is difficult to do this on your own and a person is forced to contact law enforcement agencies.

The following facts must be proven:

1. The subject accused of a crime truly belongs to the category of official persons.
2. The bribe was indeed received by this person.
3. A person, using his official position, provided or was going to provide a certain service to the bribe-giver for a fee.

Proving the second point is the most difficult stage.

To confirm the fact that the subject belongs to the category of officials, a request is sent to his place of work, which contains a request to indicate:

• what position does the subject hold;
• what powers the subject is endowed with;
• what are his job responsibilities?

A request from law enforcement authorities is subject to mandatory consideration, the answer to it is given taking into account the relevance of the requested information.

Proving the third point, as a rule, is also not too difficult; it is enough to provide documentary evidence of the action taken.

This can be a variety of evidence:

• photos;
• video recordings;
• extracts and so on.

Moreover, it must be remembered that for a judge it is not always important that the corrupt official’s response was carried out; what is more important is the fact that the bribe was received, and not that its conditions were met.

Why should you contact a lawyer for additional help?

Cooperation with representatives of government agencies is, of course, good, but there is no need to rush to give evidence to them. First you need to find a good lawyer who specializes in resolving such issues and describe the situation in detail. He definitely knows more about how best to act. Even if the situation at first glance seems hopeless, a competent approach to solving it will definitely give a positive result.

The main thing in this matter is not to panic. If you are charged with bribery, this does not mean that the court will immediately agree with the charges. A certain list of operational-search activities is mandatory. But! To ensure that no violations occur during this period, you need to enlist the support of a qualified specialist who will monitor everything.

A lawyer who has extensive positive experience in such cases, after conducting an in-depth analysis, studying all available evidence, will have the opportunity to begin his active investigation. This will help him prove his client's innocence, thus winning the trial. Practice shows that it is quite possible to achieve a positive result; this can be achieved already at the stage of preliminary investigation. A perfect knowledge of the laws of the Russian Federation, regulations, as well as extensive experience in handling similar cases by a lawyer will have a positive effect on the development of events.

As for the cost of the services of a forensic specialist, it is calculated taking into account the nature of the crime and its severity. No less significant factors are:

• professional experience;
• the level of education;
• lawyer's qualifications;
• client location;
• complexity of the case;
• time that will be spent on investigation.

You need to choose a lawyer based on his professional status, education, reputation, practice, and manners. It would be a good idea to clarify where your potential defender studied, as well as where he did his internship. The fact that he is included in the Bar Association and has the status of a lawyer will add advantages to the specialist. There will be no problems finding this information; it is freely available on the Internet. To defend yourself, you need to hire a lawyer who has experience and, as a result, has a reputation. You should not 100% trust advertisements in newspapers or the Internet. It is better to seek useful information from people involved in criminal proceedings. And lastly, if you are dealing with a professional, then note such qualities as the ability to persuade, honesty, self-confidence, and charm.

If someone is faced with the question of how to prove the receipt of a bribe by an official, then he should be well aware that in order to answer it, it is necessary to clearly understand what a bribe is and what it can be expressed in. Not every cash injection is considered a bribe. Another important point is that there is a certain circle of people who can be accused of bribery. Not every person can receive such an accusation, but only one who holds a position and has the opportunity to influence the resolution of a certain issue in someone else’s favor, thanks to his position.