Health Minister Kiril Ananiev revokes earlier order mandating hospitalization for particular groups COVID-19 patients

In his first set of orders issued on May 14, following the end of the state of emergency, Health Minister Kiril Ananiev included an article mandating hospitalization for people with confirmed coronavirus infection over 60, people with underlying conditions, patients with a serious clinical condition and people who cannot isolate by their own means. In the latter three cases the original order stated these groups will be admitted involuntarily for hospital treatment ‘regardless of the way the clinical representation of the disease’.

The article was challenged yesterday by a group of lawyers, Maria Sharkova, Emilia Nedeva, Snezhana Stefanova and Teodor Stoev. The procedure calls for a challenge to first be admitted to the Ministry of Health, and then it must be sent to the Supreme Administrative Court for judgement. The lawyers have cited among other things a ruling by the European Court for Human Rights, which states that hospitalization without the patient’s consent is equal to incarceration and violates the right of liberty and security.

The order is questionable even only given the Bulgarian legal system itself and the fact that patient informed consent and right to refuse treatment is well defined and part of normal practice. Under Bulgarian law, before undergoing any treatment or hospitalization, a patient must give consent beforehand. The constitution also prohibits involuntary treatment of patients, except is special cases, as defined in the law.

In their stipulation the lawyers argue the minister had no right issuing the order and that it grossly violated the constitution, the Health Act and the Convention for Human Rights.

Not only did the order mandate treatment and hospitalization for particular groups in the population (people 60 and over; having any underlying conditions; serious clinical presentation; impossibility to self-isolate), it applied to any confirmed positive coronavirus infection, including asymptomatic patients.

A day after the stipulation by the lawyers was received in the Ministry of Health, the minister issued a new order, revising the critical points. The new order now allows consent by giving the option of ‘mandatory hospitalization and/or self-isolation’. If a patient refuses treatment in a hospital he or she must subject to mandatory self-quarantine for a period of 28 days starting from the date the lab results confirming the infection have returned.