Specialised medical care

Rare diseases
 

In the European Union, a rare disease is any disease affecting fewer than five people in 10,000. Although rare diseases are characterised by their low incidence, there are many different types of rare diseases. It is estimated that there are about 5,000–8,000 different rare diseases which affect 6–8% of the population throughout their lives.

Additional information: Rare diseases in the EU

 

Psychiatric care
 

The Mental Health Act regulates the provision of psychiatric care. Psychiatric care as well as other health services are provided to a patient only with their consent. A person close to the patient or their family member or legal representative cannot give consent for the provision of psychiatric care to the patient on their behalf. Psychiatric care can be provided to a patient regardless of their consent only if all of the following circumstances exist:

the patient has a severe mental disorder which restricts their ability to understand or control their behaviour;

Without in-patient treatment, the person endangers the life, health or safety of themselves or others due to a mental disorder;

other psychiatric care is not sufficient.

Involuntary psychiatric treatment may be applied only on the basis of a court ruling. Involuntary psychiatric treatment may be also applied without a court ruling if it is inevitable for the protection of the person or the public and if a court ruling cannot be received as quickly as necessary.

The court examines the justification of involuntary psychiatric treatment.

Coercive psychiatric treatment is assigned by the court on the basis of the Penal Code. The court has jurisdiction to examine the justification of the assigned psychiatric coercive treatment. Supervision over the provision of coercive psychiatric treatment as a health service is exercised by the Health Board.

Establishments providing involuntary psychiatric treatment and psychiatric coercive treatment are also examined by the Chancellor of Justice as a maltreatment prevention authority to prevent ill-treatment.

 

Infertility treatment

 

The Artificial Insemination and Embryo Protection Act regulates activities related to infertility treatment.

Only adult women of up to 50 years of age who have active legal capacity are, at their own request, permitted to undergo artificial insemination. Artificial insemination is permitted if it is justified by medical indications and it is prohibited if the pregnancy or the delivery is dangerous to the life or health of the woman or the baby or if other medical contraindications exist. A decision on whether contraindications to the pregnancy of the patient exist are made by a doctor on the basis of the rules of medical science.

The right to apply for the compensation for medical expenses related to artificial insemination applies to females up to and including 40 years of age who have health insurance who meet the following conditions:

  • they have medical indications for in vitro fertilisation and/or embryo transfer;
  • they have undergone the procedure;
  • they have purchased medications included in the list of medications of the Estonian Health Insurance Fund which are necessary for the procedure from pharmacies within 90 days before the date of performance of the procedure.
 

Donation

 

Specific principles have been developed for countries to follow in the field of procurement, handling and transplantation of cells, tissues, and organs.

These include:

  • the donation of cells, tissues and organs must be strictly voluntary and the provision of remuneration for this must be prohibited;
  • comprehensive protection of donors and recipients.

Anyone who of their own volition wishes to donate their cells, tissues or organs during their life or after their death may become a donor of cells, tissues, and organs. A donor may also be a person who is dead but who during their life had expressed the wish to donate their cells, tissues, and organs after their death or if there is no evidence that they would have been opposed to it. It is possible to express a wish to become a donor after death in the Patient Portal.

 

Blood donation
 

In Estonia, blood donation is an uncompensated and voluntary system whereby a donor gives blood to unknown people in need as a gift. As blood is a body fluid that may transfer pathogens and contain antibodies that may cause reactions in the people in need, strict requirements have been established with the Blood Act for the functioning of the blood service (including blood donation).

The Ministry of Social Affairs is responsible for providing the reference service for immunohematological testing in blood donation. The Ministry of Social Affairs also supports the promotion of donation and the organisation of blood donor days every year.

Estonian blood service consists of four blood centres located in private hospitals and 24 hospital blood banks operating in private hospitals. Blood centres are responsible for the collection of donor blood and the manufacture, testing, storage, and sale of blood components.

On the basis of the Blood Act, a donor has the right to ask for time off from their employer for the donation of blood. A donor should keep in mind that as blood centres are responsible for the quality of blood components, they have the right to set even stricter requirements to donation than those established with the Blood Act.

The Agency of Medicines exercises supervision over the handling of blood in blood centres and the Health Board exercises supervision over the handling of blood in hospital blood banks.

Last updated: 13 July 2017