Does Acknowledgement of a Small Value Gratuity Gift for a Medic as a Bribe Not Infringe Ultima Ratio Principle?

Abstract

Lithuania is considered to be one of the most corrupted states in the sphere of health care in the European Union. Every third inhabitant of Lithuania is inclinable to pay medic off the record. Most often payments are symbolic ones (amounting to €50). Obviously, the extent of corruption in the sphere of health care is a tender question in Lithuania that is rarely investigated both in jurisprudence and in judiciary practice.

With intend to safeguard clearness and reduced corruption in the sphere of health care, the standard of Art.6.470 part 4 of the Civil Code of the Republic of Lithuania allowed medics to take symbolic gifts with value that does not exceed the sum of one minimal life level. Therefore, such symbolic gratuity was criminalised and criminal liability was determined to both a medic and a patient. In 2002 the conception of a state officer was extended. Since a medic has been equated to a state officer, the Criminal Code of the Republic of Lithuania prohibits to take any kind of presents, whereas the Civil Code of the Republic of Lithuania allow to take symbolic presents the value of which is amounting to 1 MLL (€50). According to international recommendations presented to GRECO, the standard of Art.6.470 part 4 of the Civil Code of the Republic of Lithuania was defeated in 2006. Since that moment any gift presented to a medic is considered as a criminal deed prevising criminal responsibility according to the Criminal Code of the Republic of Lithuania both to a medic (art.225 – bribery) and a patient (art.227 – bribe).

However, during a period of 12 years (since the criminalisation of bribery) there are only a few cases where medics or patients are criminated with corruption in the sphere of health care; what concerns crime doing, i.e. minor corruption – the only one case. Meanwhile, other state officers (for example, police officers) are penalized more often even though corruption is less. The question can be raised on the oneness of the relations between medics and patients. It seems that the Criminal Code is not valid for them and criminal law is not a means to solve a problem, i.e. acknowledgement of a small value gratuity gift for a medic as a bribe does not infringe ultima ratio principle? 

This article deals with legal regulations, i.e. acknowledgement of a small value gratuity gift for a medic as a bribe does not infringe ultima ratio principle (inevitability of criminal law failing alternative means of responsibility).

On purpose to answer this legal question, it is established that it is necessary to follow certain criminalized activities. It means that it is necessary to ground such deed as criminalization of cultural common gratuity to a medic with a symbolic gift (amounting to €50) according to criminal law due to its level of insecurity to main goods of the state and declare if such gratuity gift for a medic as a bribe does not infringe ultima ratio principle. It is discovered when a medic is a special subject of XXXIII chapter of the Criminal Code of the Republic of Lithuania, i.e. equated to a state officer. It is necessary to clear what a non-official gratuity to a medic is – a bribery or a gift? The dichotomy of a bribe and a gift as well as the historical development of a gift / bribery taking is disputed. It is necessary to answer the question if acknowledgement of a small value gratuity gift (amounting to €50) for a medic as a bribe does not infringe ultima ratio principle

The fulfilled analysis of scientific papers, empiric investigation, legal deeds and documents allow to state that insecurity of symbolic gratuity criminalization is not proven.  Not only criminal responsibility but also other forms of responsibility can reduce minor bribery in the sphere of health care. It can be concluded that even though symbolic non-official payment is considered to be a criminal activity; however, its implementation has to be secured by means of demerit, civil and administrative law.

In conclusion, it can be stated that alternative means are not debated, it is unclear how such criminalization influences on the reduction of corruption in the sphere of health care, how it is implemented in a criminal process, etc. The hypothesis that gratuity to a medic with a symbolic gift (amounting to €50) can not be called bribery was proved. As a result, one of the main criminalization criteria – ultima ratio principle is infringed.