Tbilisi, 2012 weli

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paliatiuri mzrunvelobis arsi 5

ra aris paliatiuri mzrunveloba? 5

ratom aris mniSvnelovani paliatiuri mzrunvelobis arsis codna? 7

romelia paliatiur mzrunvelobasTan dakavSirebuli uflebebi? 7

pacientis uflebebi da paliatiuri mzrunveloba 9

paliatiuri mzrunvelobis xelmisawvdomoba 9

tanjvis da tkivilis arideba, rogorc paliatiuri mzrunvelobis Semadgeneli 10

informaciis miRebis ufleba da paliatiuri mzrunveloba 12

gadawyvetilebis miReba paliatiuri mzrunvelobis Sesaxeb 14

informaciis konfidencialuroba da informaciis miwodeba pacientis axloblebisTvis paliatiuri mzrunvelobis dros

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axloblebis gverdze yolis ufleba 18

paliatiur mzrunvelobasTan dakavSirebuli ZiriTadi terminebi 20

ufaso iuridiuli konsultacia 29

paliatiuri mzrunvelobis gamwevi organizaciebi 31

uflebebis dacvisa da mxardaWeris sxva resursebi saqarTveloSi 35

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ra aris paliatiuri mzrunveloba?

paliatiuri mzrunveloba da adamianis uflebebi

`Sen mniSvnelovani unda iyo, radgan Sen xar Sen, da Sen mniSvnelovani xar sicocxlis bolo wuTamde. Cven yvelafers gavakeTebT SesaZleblobebis farglebSi, raTa dagexmaroT am qveynidan ara mxolod mSvidad wasvlaSi, ar­amed wasvlamde sicocxleSi.»

deim siseli sondersi, Tanamedrove `hospisis» moZraobis damfuZnebeli

paliatiuri mzrunveloba aris sxvadasxva specialobis adamianebis, agreTve araprofesionalebis, maT Soris, pacien­tis ojaxis wevrebisa da sxva axloblebis erToblivi zrunva im adamianebis mdgomareobis Semsubuqebasa da keTldReobaze, romelTac mZime daavadeba aqvT (igulisxmeba iseTi daavade­bebi, romelTa gankurneba SeuZlebelia da, romlebic iwveven tkivils da sxva Zlier Semawuxebel simptomebs).

paliatiuri mzrunveloba mniSvnelovnad ver gaaxan­grZlivebs sicocxles, magram is sruliad cvlis pacientis md­gomareobas – aseTi daavadebis mqone pacienti aRar itanjeba tkiviliT da iseTi Semawuxebeli simtpomebiT, rogorebi caa gulisreva, Rebineba, slokini, nawolebiT gamowveuli tanjva da sxva.

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paliatiuri mzrunvelobis mniSvnelovani maxasiaTebelia pacientis fsiqologiuri mxardaWera. is moicavs mZime daa­vadebis mqone pacientisaTvis saTanado ganmartebebis, rCev­ebis miwodebas, maT fsiqologiur mdgomareobaze zrunvas diagnozis gagebis wudidan daavadebis mimidnareobis mTel periodSi.

paliatiuri mzrunveloba gulisxmobs ara mxolod uSua­lod pacientze zrunvas, aramed mis ojaxis wevrebzec, vi­naidan axloblis mZime daavadeba gavlenas axdens ojaxis yvela wevrsa da maTs cxovrebaze. ojaxis wevrebs bevris ga­keTeba SeuZliaT pacientisTvis. aucilebelia, rom profe­sionalebTan erTad isinic CaerTon, rogorc pacientis mov­laSi, ise maT fsiqologiur mxardaWeraSi.

paliatiuri mzrunveloba saqarTvelos kanonmde­blobiT aRiarebulia, rogorc samedicino momsaxurebis sistemis ganuyofeli nawili.

paliatiuri mzrunveloba: · uzrunvelyofs tkivilisa da tanjvis sxva simptomebis

Semsu buqebas; · ganamtkicebs sicocxlis SegrZnebas;

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· miznad ar isaxavs sikvdilis arc daCqarebas da arc gadavadebas;

· axdens pacientis movlis fsiqologiuri da sulieri aspeqtebis integracias;

· uzrunvelyofs mxardaWeris sistemas, romelic paci­entebs exma reba, icxovron rac SeiZleba aqtiurad gardacvalebamde;

· uzrunvelyofs mxardaWeris sistemas, romelic exmareba ojaxs gadaitanos pacientis avadmyofobisa da Semdgomi mZime danaklisis periodi;

· es aris multidisciplinaruli gunduri midgoma, ro­melic aumjo besebs cxovrebis xarisxs da agreTve SesaZloa pozitiuri gavlena iqonios daavadebis mimdinareobazec.

ratom aris mniSvnelovani paliatiuri mzrunvelobis arsis codna?

mniSvnelovania, rom moqalaqeebma icodnen paliatiuri mzrun velobis arsi, agreTve is, Tu rogor SeiZleba aseTi momsaxurebis miReba da ra uflebebia dakavSirebuli paliti­uri mzrunvelobis saWiroebis mqone pirebis movlasTan.

codnis nakleboba paliatiuri mzrunvelobis arsis Ses­axeb, misi SesaZleblobisa da mniSvnelobis, agreTve, Cvens qyveyanaSi arsebuli resursebis Taobaze, mizezia imisa, rom kvlav bevri adamiani itanjeba mZime simptomebiTa da uimedo­biT.

amitom aseTi codna saSualebas miscems adamianebs, moiZion maT Tvis saWiro daxmareba an daexmaron sxvebs, isargeblon paliatiuri mzrunvelobiT.

romelia paliatiur mzrunvelobasTan dakavS­irebuli uflebebi?

paliatiuri mzrunveloba moicavs adamianis uflebebs, romelebic ukve aRiarebulia erovnuli kanonmdeblobebis, adamianis uflebaTa dacvis saerTaSoriso dokumentebisa da sxva gancxadebebis safuZvelze.

paliatiur mzrunvelobasTan dakavSirebuli uflebebi moicavs uflebas:

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· tkivilis Semsubuqebaze; · fizikuri da fsiqologiuri simptomebis simptomatur

kontrolze; · paliatiuri mzrunvelobisaTvis aucilebel medika­

mentebze; · mZime danaklisis periodSi sulier mzrunvelobaze; · ojaxze orientirebul mzrunvelobaze; · paliatiuri mzrunvelobis sferoSi momzadebuli pro­

fesionalebis mier pacientis movlaze; · movlis saxlSi miRebaze da survilis SemTxvevaSi saxlSi

gardacvalebaze; · daavadebis mkurnalobaze da mkurnalobis SeCerebaze an

Sewyvetaze; · diagnozis, prognozisa da paliatiuri mzrunvelobis

momsaxurebaTa Sesaxeb informaciis miRebaze; · gadawyvetilebaTa miRebis mizniT jandacvis sferoSi

rwmunebulis dasaxelebaze; · mkurnalobis uzrunvelyofisas asakis, sqesis, erovnuli

kuTvnilebis an infeqciis safuZvelze diskriminaciis dauSveblobaze.

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paliatiuri mzrunvelobis xelmisawvdomobasaqarTvelos kanonmdebloba paliatiur mzrunvelobas

samedicino saqmianobis da, mTlianad, jandacvis sistemis Semadenel komponentad moiazrebs (kanoni `janmrTelobis dacvis Sesaxeb~, muxlebi 3, 8, 10, 53, 147–149).

saxelmwifo paliatiur mzrunvelobas afinansebs janmr­Telobis dacvis saxelmwifo programis `inkurabelur pacientTa paliatiuri mzrunveloba~ safuZvelze.

prorgama iTvaliswinebs ganukurnebeli daavadebis mqone pacientebis paliatiuri mzrunvelobis dafinansebas:

· stacionarSi (saavadmyofoSi), da

· binaze.

paliatiuri mzrunveloba stacionarSi (saavadmyofoSi):

zemoxsenebuli programis farglebSi stacionarSi pali atiuri mzrunveloba daufinansdeba:

· mZime formis (ganukurnebeli) onkologiuri daava­debis da aiv/Sidsis mqone pirebs;

· 18 wlamde asakis mZime (ganukurnebeli) daavadebis mqone pirebs, miuxedavad daavadebis tipisa.

amasTan, zemoaRniSnuli kategoriis pirTaTvis sta­

cionarSi paliatiuri mzrunvelobis anazRaurebis pirobebi gansxva vebulia:

· mZime formis (ganukurnebeli) onkologiuri daava­debis mqone pirebis stacionarSi momsaxurebis faq­tobrivi xarjebis 70% anazRaurdeba programiT, xolo 30%–s gadaixdis pacienti (erTi sawoldRis maqsimaluri jamuri Rirebulebaa 75 lari, saidanac 22.5 lars ixdis pacienti, xolo 52.5 lari ifareba programidan);

· mZie formis (ganukurnebeli) aiv/Sidsis mqone pirebis stacionarSi momsaxurebis faqtobrivi xarjebi (erTi sawoldRis maqsimaluri jamuri Rirebulebaa 75 lari) srulad anazRaurdeba programiT da pacienti arafers ixdis;

· 18 wlamde asakis mZime (ganukurnebeli) daavadebis

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mqone pirebis momsaxurebis faqtobrivi xarjebis 80% anazRaurdeba programiT, xolo 20%–s gadaixdis pacienti (erTi sawoldRis maqsimaluri jamuri Rirebulebaa 60 lari, saidanac 12 lars ixdis pacienti, xolo 48 lari ifareba programidan);

stacionarSi paliatiuri mzrunvelobis safasurs, garkveuli gamonaklisis garda, anazRaurebs sadazRvevo kompaniebic. msgavsad sxva momsaxurebis safasuris moTxovnisa, am SemTxvevaSic gasaTvaliswinebelia polisSi (dazRvevis xel SekrulebaSi) miTiTebuli pirobebi.

siRaribis zRvars qvemoT myofi mosaxleobisTvis paliatiuri mzrunveloba Sesabamis klinikebSi ufasoa. mom saxurebis safasurs faravs is sadazRvevo kompania, romlis polissac flobs dazRveuli.

paliatiuri mzrunveloba binaze:

binaze paliatiur mzrunveloba daufinansdeba mxolod q. Tbilisis, q. quTaisis, q. Telavisa da q. zugdidis muni cipalitetebSi registrirebul saqarTvelos moqalaqeebs, romlebsac mZime (ganaukurnebeli) daavadeba aqvT. amasTan, anazRaurebis piroba aseTia – programa anazRaurebs calkeul vizitis Rirebulebis 100%–s; erTi vizitis anazRaureba programis farglebSi Seadgens 11 lars.

tanjvis da tkivilis arideba, rogorc paliatiuri mzrunvelobis Semadgeneli

paliatiuri mzrunvelobis ganuyofeli nawili da misi umniSvnelovanesi Semadgenelia tkivilis adekvaturi marTva. garkveul etapze is moicavs narkotikuli saSualebebis gamoyenebasac.

Sromis janmrTelobisa da socialuri dacvis ministris 2008 wlis 10 ivlisis #157/n brZanebiT, paliatiuri mzrunvelobis instruqciasTan erTad, damtkicda narkotikuli saSualebis gamowerisa da gacemis wesi.

aRniSnuli wesis mixedviT SesaZlebelia, eqimma tki­vilis gasayuCeblad receptiT gamoweros 7 (Svidi) dRis samyofi narkotikuli saSualeba.

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amasTan, Tu paliatiuri mzrunvelobis gawevis pro­cesSi pacientis mdgomareoba Seicvala da saWiro gaxda narkotikuli saSualebis dozis gazrda an wamlis formis Secvla, eqimma unda gasces axali recepti.

eqimis mier gamowerili receptis safuZvelze nar­kotikuli saSualeba unda gaices 5 samuSao dRis ganmavlobaSi. xuTi samuSao dRis Semdeg farmacevts aRar aqvs ufleba gasces medikamenti. saWiroebis SemTxvevaSi eqimma unda gasces axali recepti.

eqims SeuZlia erTi receptis blankze gamoweros sxvadasxva dasaxelebisa da formis

narkotikuli saSualeba (saqarTvelos janmrTelobis da socialuri dacvis minis tris da saqarTvelos Sinagan saqmeTa ministris 2010 wlis 28 ianvaris erToblivi brZaneba N 18/n ­ N 96).

sofelSi momuSave pirveladi jandacvis eqims, romelic axorcielebs soflis mosaxleobisaTvis ambula­toriuli momsaxurebis miwodebas, erTpirovnulad SeuZlia receptze gamoweros narkotikuli saSualeba (saqarTvelos Sromis, janmrTelobisa da socialuri dacvis ministris 2010 wlis 26 Tebervlis N 55/n brZaneba).

xSirad narkotikuli tkivilgamayuCebeli saSualebebis maRali dozebiT gamoyenebis winaaRmdegi pacientis axlo­blebi arian. aseT SemTxvevebSi maT rCevebi unda miiRon paliatiuri mzrunvelobisa da tkivilis medicinis specialistebisgan. saqme is aris, rom narkotikuli tkivilgamayuCebeli saSualebebis racionaluri gamoye­neba, Tu eqimi kargad flobs tkivilis marTvis unar­Cvevebs, usafrTxo da efeqturia.

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informaciis miRebis ufleba da paliatiuri mzrunveloba

kanonmdeblobiT dadgenilia, rom pacients ufleba aqvs TviTon miiRos informacia sakuTari janmrTelobis Sesaxeb yovelgvari SezRudvis gareSe (kanoni `pacientis uflebebis Sesaxeb~, muxli 7). es informacia unda moicavdes, rogorc diagnozs, ise detalur monacmebs SeTavazebuli samedicino momsaxurebisa da misi mosalodneli Sedegebis Taobaze.

informacia pacients gasagebi eniT unda miewodos; kerZod, `pacientis uflebebis Sesaxeb~ saqarTvelos kanonis me–19 muxlis mixedviT, pacientebs (garkveul SemTxvevebSi, maT naTesavebs) informacia unda miewodoT maTi aRqmis unaris gaTvaliswinebiT. amasTan, ~ganmartebebis micemisas specialuri terminebi minimalurad unda iqnes gamoyenebuli”.

zemoaRniSnulTan erTad gasaTvaliswinebelia isic, rom `pacientis uflebebis Sesaxeb~ kanonis me­17 muxlis Tanaxmad, pacients, xolo misi Tanxmobis an qmeduunarobis SemTxvevaSi, naTesavs an kanonier wamomadgenels, ufleba aqvT gaecnon samedicino Canawerebs da moiTxovon samedicino Canawerebis nebismieri nawilis asli.

roca eqimi Tavs ikavebs pacientisaTvis sruli informaciis miwodebisagan

aris SemTxvevebi, roca informaciis miwodebam SeiZleba arasasurveli reaqcia gamoiwvios pacientSi, rac sabolood uaryofiTad aisaxeba pacientis janmrTelobaze. meore mxriv, eqimis upirvelesi movaleoba swored pacientis janmrTelobaze zrunvaa. aRniSnulidan gamomdinare eqimi mZime arCevanis winaSe dgeba. man ori gzidan mxolod erTi unda airCios:

· gaufrTxildes pacientis janmrTelobas da daumalos mas simarTle; an

· pativi sces mis uflebebs da simarTle uTxras da amiT `safrTxe~ Seuqmnas mis janmrTelobas.

zemoT moxseniebuli ZiriTadad mZime daavadebebs exeba; magram mxolod mZime daavadebis arsebobis faqti ar unda gaxdes informaciis damalvis safuZveli.

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aviRoT `kibos~ magaliTi. dRes kibo momakvdinebeli daavadeba aRar aris. adreul stadiaze misi diagnostireba sruli gajansaRebis saSualebas iZleva. am dros pacientma, Tu ar icis ra daavadeba aqvs, SeiZleba Tavi aaridos mkurnalobas, romelic misTvis sasicocxlo mniSvnelobis aris.

gasaTvaliswinebelia is garemoebac, rom pacientebi xSirad TviTon moiTxoven srul informacias sakuTari janmrTelobis Sesa xeb da SeswevT unari realurad Seafason sakuTari janm rTelobis mdgomareoba. aseT SemTxvevebSi simarTlis damalva dauSvebelia da es kanoniTac ikrZaleba.

miuxedavad zemoxsenebulisa, mainc aris SemTxvevebi, roca mZime daavadebis arsebobis Sesaxeb informaciis miwodebam SeiZleba ziani moutanos pacients. aseTi SemTxvevebi xSiri ar aris. Tumca, radgan arsebobs zianis miyenebis Tundac mci re albaToba, eqims unda hqondes SesaZlebloba, dauSvas gamonaklisi da ar uTxras simarTle pacients. cxadia, es gamo naklisi wesad ar unda iqces.

kanoni zemoxsenebul problemas Semdegi principebis mixedviT awesrigebs (kanoni `pacientis uflebebis Sesaxeb~, muxli 18):

· pacients aqvs ufleba miiRos srulyofili informacia sakuTari janmrTelobis Sesaxeb;

· eqims eZleva ufleba, gamonaklis SemTxvevebSi, ar miawodos pacients informacia, Tu Zalian didi albaTobaa imisa, rom pacients ziani miadgeba;

· eqimi valdebulia sTxovos samedicino eTikis komisias an meore eqimis dasturi informaciis `damalvis~ Sesaxeb gadawyvetilebaze;

· Tu pacienti daJinebiT iTxovs informacias, eqimi, yovelgvari gamonaklisis gareSe, valdebulia miawodos pacients kanoniT gaTvaliswinebuli informacia.

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gadawyvetilebis miReba paliatiuri mzrunvelobis Sesaxeb

eqimi valdebulia nebismieri samedicino Carevis win, maT Soris paliatiuri mzrunvelobiT gaTvaliswinebuli Carevebis win, pacientisagan miiRos informriebuli Tanxmoba (kanoni `pacientis uflebebis Sesaxeb~, muxli 22).

eqimma mxolod mas Semdeg unda miiRos Tanxmoba, roca darwmundeba, rom pacientma kargad gaiazra, razea saubari, ratom unda Catardes samedicino Careva, ra mizani aqvs mas, axlavs Tu ar tkivili da diskomforti, ra garTulebebi SeiZleba mohyves da ra alternatiuli meTodebi arsebobs.

amasTan, pacients SeuZlia nebismier SemTxvevaSi uari Tqvas samedicino Carevaze an airCios ramdenime alternatiuli variantidan erT­erTi an moiZios meore azri, anu mimarTos sxva eqims da gaigos am eqimis azric misi diagnozisa da/an mkurnalobis Sesaxeb (kanoni `pacientis uflebebis Sesaxeb~, muxli 7).

eqimi movalea, CarTos pacienti gadawyvetilebis miRebis procesSi, ganumartos mas samedicino momsaxu­rebasTan daka vSirebuli pacientisaTvis saintereso yve­la sakiTxi da miiRos misi Tanxmoba ama Tu im samedicino Carevis win.

uari samedicino momsaxurebaze

Tu pacienti winaaRmdegia samedicino momsaxurebis gawe visa, eqimi unda darwmundes, rom pacientma kargad gaiazra yovelive da Seswevs gadawyvetilebis miRebis unari. aseT SemTxvevaSi eqimi movalea daeTanxmos mis azrs da ar mimarTos aRniSnul samedicino Carevas (kanoni `pacientis uflebebis Sesaxeb~, muxli 23, punqti 2). amasTan, eqimi da sxva samedicino personali gaagrZelebs pacientze zrunvas da SesTavazeben pacients samedicino daxmarebis alternatiul, misTvis misaReb formebs.

cxadia, samedicino momsaxurebaze uaris Tqmis ufleba mZime, (ganukurnebeli) daavadebis mqone pacientebsac aqvT es mkafiod aris naTqvami `janmrTelobis dacvis Sesaxeb» saqarTvelos kanonis 148–e muxlSi, romlis mixedviTac, `ter minalur stadiaSi myof qmedunarian,

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gacnobierebuli gadawyvetilebis miRebis unaris mqone avadmyofs ufleba aqvs uari ganacxados sareanimacio, sicocxlis SemanarCunebel an paliatiur mkurnalobaze an/da paliatiur mzrunvelobaze.»

pacientis winaswar gacxadebuli neba

dRes moqmedi kanonmdeblobis mixedviT, mZime pa­ci en tisaTvis samedicino momsaxurebis Sesaxeb gada­wyvetilebis miRebisas, roca pacients ukve aRar aqvs gacnobierebuli gadawyvetilebis miRebis unari (magaliTad, roca pacienti komur mdgomareobaSia), samedicino personali unda iTvaliswinebdes pacientis winaswar gacxadebul nebas (kanoni «janmrTelobis dacvis Sesaxeb», muxli 11).

winaswar gacxadebuli neba SeiZleba exebodes sa­re animacio, sicocxlis SemanarCunebeli, agreTve, paliatiuri mkurnalobis an mzrunvelobis Catarebas (kanoni`pacientis uflebebis Sesaxeb»).

amasTan, uari zemoaRniSnul Carevebis ganxor­cielebaze, SeiZleba dakavSirebuli iyos mxolod im SemTxvevebTan, roca pacientis ugono mdgomareoba an

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gadawyvetilebis miRebis unaris SezRudva gamowveulia an ganukurnebeli daavadebis terminaluri stadiiT an daavadebiT, romelic aucileblad gamoiwvevs mZime invalidobas (kanoni`pacientis uflebebis Sesaxeb»,muxli 24, puqnti 1).

moqalaqeebs SeuZliaT winaswar daasaxelon piri, romelic miiRebs gadawyvetilebas maTi mkurnalobis Sesaxeb, Tu dadgeba zemoT moxseniebuli garemoebebi – terminaluri mdgomareoba, mZime invalidobis ganviTareba (kanoni`pacientis uflebebis Sesaxeb»,muxli 24, puqnti 2).

informaciis konfidencialuroba da informaciis miwodeba pacientis axloblebisTvis paliatiuri mzrunvelobis dros

kanoni samedicino personals avalebs saidumlod daicvas pacientis Sesaxeb mis xelT arsebuli informacia (kanoni ̀ pacientis uflebebis Sesaxeb~, muxli 27). aRniSnuli srulad exeba ganukurnebeli daavadebiT Sepyrobili pacientisaTvis samedicino momsaxurebis gawevas.

Tumca, aRniSnuli eTikuri da samarTlebrivi moTxovna xSirad irRveva. magaliTad, informacia pacientis Sesaxeb pacieentis Tanxmobis gareSe miewodeba mis naTesavebs, agreTve, samedicino personals, romelic ar aris CarTuli mocemuli pacientisaTvis samedicino momsaxurebis gawevaSi, Jurnalistebsa da sxv.

sayuradReboa, rom kanonmdeblobis Sesabamisad, pacients Tavad SeuZlia gadawyvitos, vis da ra informacia unda miewodos. kerZod, `pacientis uflebebis Sesaxeb~ kanonis 21­e muxlis mixedviT `qmedunarian pacients ufleba aqvs gadawyvitos, miiRos Tu ara vinmem informacia misi janmrTelobis mdgomareobis Sesaxeb.~

Tu pacienti gadawyvets, rom informacia sxvasac SeiZleba gauziaron, `manve unda daasaxelos is piri, romelsac es informacia unda miewodos. gadawyvetileba da piris vinaoba fiqsirdeba samedicino dokumentaciaSi~ (kanoni `pacientis uflebebis Sesaxeb~, muxli 21).

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amrigad, pacientis Tanxmobis gareSe samedicino personals ara aqvs ufleba vinmes gaumJRavnos informacia pacientis janmrTelobis mdgomareobis Sesaxeb.

mxolod im SemTxvevaSi, Tu pacienti qmeduunaroa an moklebulia gacnobierebuli gadawyvetilebis miRebis unars, samedicino momsaxurebis gamwevs aqvs ufleba informacia miawodos pacientis naTesavs an kanonier wamomadgenels.

amasTan, informaciis gamJRavnebis uflebas kanoni iZleva im SemTxvevaSic, Tu gaumJRavnebloba safrTxes uqmnis xva piris sicocxles an/da janmrTelobas (mag., sicocxlisaTvis saSiSi infeqciuri daavadeba) an roca es kanonmdeblobiT aris savaldebulo (mag., kriminaluri SemTxevebi).

SemTxvevebi, roca pacientis axloblebis mier miRebuli gadawyvetileba ar Seesabameba pacientis interesebs

mZime pacientis samedicino momsaxurebis Sesaxeb gadawyvetilebis miReba Zalian xSirad naTesavebs uxdebaT. miT umetes, rom saqarTveloSi jer ar aris damkvidrebuli tradicia, rom pacientma winaswar mkafiod werilobiT an Tundac zepirad ganacxados, ra saxis samedicino momsaxurebas isurvebda mZime mdgomareobaSi aRmoCenisas. Tumca, rogorc ukve aRiniSna, saqarTvelos kanonmdebloba ukve iZleva mkurnalobis Sesaxeb nebis winaswar gacxadebis SesaZleblobas.

kanondmeblobis mixedviT, momakvdavi pacientis axloblebs aqvT ufleba, uari ganacxadon pacientisaTvis samedicino daxmarebis gawevaze, Tuki maTi uaris safuZveli pacientis Rirsebis dacvaa.

kidev erTi mniSvnelovani piroba imisa, rom axloblebma uari ganacxadon momakvadvi pacientis mkurnalobaze, aris pacientis Sexedulebebis (winaswar gacxadebuli nebis) gaTvaliswineba.

zemoaRniSnulTan erTad, ar aris gamoricxuli, rom pacientebis naTesavebis mier miRebuli gadawyvetileba ewinaaRmdegebodes pacientis interesebs.

saqarTvelos kanonmdebloba eqims uflebas, aZlevs ar daeTanxmos gacnobierebuli gadawyvetilebis miRebis

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unars moklebuli pacientis naTesavis gadawyvetilebas, Tu is fiqrobs, rom gadawyvetileba ewinaaRmdegeba pacientis janmrTelobis interesebs.

erTi mxriv, eqims SeuZlia mimarTos sasamarTlos, Tu pacientis mdgomareoba amis saSualebas iZleva (kanoni «pacientis uflebebis Sesaxeb», muxli 25.1).

sxva SemTvevaSi, Tu qmeduunaro an gacnobierebuli gadawyvetilebis miRebis unars moklebuli pacienti gadaudeblad saWiroebs samedicino momsaxurebas, romlis gawevis gareSe garduvalia pacientis sikvdili, xolo misi naTesavi an kanonieri warmomadgeneli samedicino momsaxurebis winaaRmdegia, kanoni eqims aZlevs uflebas, imoqmedos pacientis janmrTelobis interesebis Sesabamisad (kanoni «pacientis uflebebis Sesaxeb», muxli 25.2).

axloblebis gverdze yolis uflebamZime daavadebis mqone pacientisaTvis, gansakuTrebiT

paliatiuri mzrunvelobisas, Zalze mniSvnelovania, rom maT gverdze iyvnen maTi axloblebi, ojaxis wevrebi. paliatiur mzrunvelobaSi, rogorc wesi, ojaxis wevrebic arian CarTuli.

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saqarTvelos kanonmdeblobaSi pacientTan misi axloblebis yofnis ufleba mkafiod gacxadebuli ar aris. amasTan, axloblebis pacientis gverdze yolis moTxovnis ufleba gamomdinareobs `pacientis uflebebis Sesaxeb~ kanonis 30­e muxlidan, romlis mizani pacientis piradi cxovrebis dacvaa.

zemoxsenebuli muxlis mixedviT, pacientisaTvis samedicino momsaxurebis gawevisas dasaSvebia mxolod im pirTa daswreba, romlebic monawileoben samedicino momsaxurebis gawevaSi, `garda im SemTxvevebisa, roca pacienti Tanaxmaa an moiTxovs sxva pirTa daswrebas~.

amrigad, kanonmdebloba iTvaliswinebs samedicino momsaxurebis gawevisas pacientis gverdiT sxva pirTa (pirebi, romlebic ar arian CarTulis samedicino momsaxurebaSi), maT Soris, cxadia, ojaxis wevrTa yofnis SesaZleblobas, Tuki pacienti amas moiTxovs.

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specialur terminTa leqsikoni

adamianis uflebebi (Human rights)uflebebi, Tavisuflebebi da privilegiebi, romelebic yvela adamians ekuTvnis, miuxedavad iurisdiqciisa an sxva faqtorebisa, rogorebicaa warmomavloba, erovnuloba, religia Tu sqesi.

anderZi (Will)iuridiuli dokumenti, romelic pirovnebas SesaZle­blobas aZlevs sakuTari qonebis nebismieri nawili dauto­vos nebismier sxva pirovnebas an organizacias.

ganmarteba: fizikur pirs SeuZlia sikvdilis SemTxvevi­saTvis Tavisi qoneba an misi nawili anderZiT dautovos erT an ramdenime pirs, rogorc memkvidreTa wridan, ise gareSe pirebsac.

ar gamacocxloT brZanebebi (Do-Not-Resuscitate (DNR) orders)

DNR warmoadgens samedicino direqtivas, romlidanac gamomdinareobs pacientis, misi advokatis an eqimis Tanx­moba, rom pacients ar umkurnalon gulis an sunTqvis

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SeCerebis SemTxvevaSi. es direqtiva gamoiyeneba, rode­sac pacientis mkurnaloba pacientis sicocxlis gaxan­grZlivebisTvis sasurvel Sedegs an warmatebas ver moi­tans. rogorc wesi, es mZime da ganukurnebel daavadebebsa da xandazmulTa SemTxvevebs exeba. es direqtivebi ar gu­lisxmobs, rom maameblur zomebze uari iqneba gacxadebu­li.

aucilebeli medikamentebi (Essential medicines)medikamentebi, romelebic akmayofilebs mosaxleobis janmrTelobis dacvis prioritetul moTxovnilebebs. aucilebeli medikamentebi nebismier dros adekvaturi ra­odenobiT, saTanado dozirebuli formiT, garantirebuli xarisxiTa da individualuri pirovnebebisa da sazogadoe­bisaTvis misaReb fasad unda iyos xelmisawvdomi.

binaze mzrunveloba (Home based care)socialuri muSakebis, eqTnebis, momvlelebis.mowyalebis debis an moxaliseebis mier pirovnebisaTvis sacxovreb­elSi aRmoCenili samedicino, paliatiuri da socialuri mzrunveloba.

hospisi (Hospice)dawesebuleba, sadac ukurnebeli/qronikuli seniT daa­vadebul pirebze da maTi ojaxis wevrebze xorcieldeba fizikuri, fsiqologiuri, socialuri da sulieri zrunva; hospisuri mzrunveloba xorcieldeba rogorc hospisSi, aseve binazec.

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hospisuri mzrunveloba (Hospice care)mzrunveloba, romlis mizanicaa ganukurnebeli daa­vadebis bolo fazaSi myofi adamianebis mxardaWera, maTT­vis komfortis Seqmna da sicocxlis xarisxis gaumjobese­ba. aseve mizania is, rom pacientebma komfortulad da tki­vilisgan ganTavisuflebulad igrZnon Tavi da TiToeuli dRe maqsimalurad gaataron. hospisuri mzrunvelobis SemTxvevaSi tkivilis gakontrolebis agresiuli meTo­debis gamoyenebac ki dasaSvebia.

gardacvaleba (Death)sicocxlis dasasruli – adamianis Tavis tvinis funq­cionirebis Sewyveta.

grZelvadiani mindobiloba (Durable power of attorney)gardacvalebis piras myof adamians SeuZlia daniSnos nebi­smieri warmomadgeneli, romelic mis finansebs marTavs da misi saxeliT miiRebs gadawyvetilebebs. aseT adamians moixsenieben, rogorc `agents”, “ndobiT arWurvil pirs”.

damatebiTi Terapiebi (Complementary therapies)midgomebi, romlebic ar jdeba ZiriTad samedicino praq­tikaSi. tkivilis sawinaaRmdegod an simSvidis mosagvre­lad gamoyenebuli damatebiTi Terapiis mkurnalobis kursebi moicavs: nemsiT Terapias, dabali donis lazerul

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Terapias, meditacias, aromatuli Terapias, Cinur medici­nas, cekvis Terapias, musikis Terapias, masaJs, samkurnalo mcenareebis medicinas, Terapevtul Sexebas, iogas, os­teopaTias, qiropraqtikul mkurnalobas, naturopaTiasa da homeopaTias.

damokidebuleba (Addiction)farTod gamoyenebuli termini, romelic aRniSnavs medi­kamentebis gamoyenebis iseT formas, rom aSkaraa fizikuri an fsiqikuri damokidebuleba. es ar aris diagnostikuri termini da amitom mas jandacvis msoflio organizacia aRar iyenebs.

eTika (Ethics)moraluri principebisa da wesebis sistema, romelic pro­fesiuli qcevis standartebad gamoiyeneba. mraval saavad­myofosa da jandacvis sxva dawesebulebaSi funqcioni­rebs eTikis komitetebi/komisiebi, romelebic exmareba eqimebs, jandacvis sferos sxva muSakebs, pacientebsa da ojaxis wevrebs mkurnalobasTan dakavSirebuli rTuli gadawyvetilebebis miRebaSi. aseTi daxmareba, sasuliero da kulturuli aspeqtebis gaTvaliswinebiT, SeiZleba gan­sxvavebulic iyos.

informirebuli Tanxmoba (Informed consent)samedicino daxmarebis Sesaxeb gadawyvetilebaTa miRebis procesi, romelic efuZneba faqtobriv, Ria da gulwrfel komunikacias jandacvis sferos muSaksa da pacientsa an/da pacientis ojaxis wevrebs Soris. informirebuli Tanxmo­bad CaiTvleba, rodesac samedicino momsaxurebis gamwevi pacients/mis ojaxis wevrs/meurves an mzrunvels deta­lurad da gasageb enaze miawodebs amomwurav informacias mkurnalobis meTodebis, alternatiuli saSualebebis, mosalodneli Sedegebis Sesaxeb, xolo amis Semdeg miiRebs pacientisgan uars an Tanxmobas.

mzrunvelobis Sewyveta (Withdrawing care)pacientTan mimarTebiT ukve dawyebuli mkurnalobis pro­cesis Sewyveta.

mkurnalobaze uaris Tqma (Treatment withholding)rodesac iTvleba, rom mkurnaloba araefeqturi, arapro­porciuli da pacientis sicocxlis xarisxisaTvis aravi­Tari Rirebulebis matarebeli aRar aris, is SeiZleba Se­Cerdes an dasruldes.

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mkurnalobis Sewyveta (Treatment withdrawal)iseTi mkurnalobis Sewyveta, romelic avadmyofobis gankurnebis an masze SesaZlo kontrolis damyarebis kuTx­iTa da samedicino TvalsazrisiT sruliad amaoa.

momvleli (Caregiver)nebismieri pirovneba, romelic iCens mzrunvelobas paci­entis, ojaxis wevris an megobris fizikuri, emociuri an sulieri moTxovnilebebis dasakmayofileblad.

mravalfunqciuri/multidisciplinaruli gundi (Multidisciplinary team)

sxvadasxva profesiis adamianebisgan Semdgari jgufi, ro­melic pacientsa da mis ojaxze mzrunvelobis mizniT er­Tad moqmedebs.

mwvave tkivili (Acute pain)tkivili, romlis mizezi cnobilia da romelic SezRudu­li drois ganmavlobaSi Cndeba. rogorc wesi, is reagirebs tkivilgamayuCebel medikamentebsa da tkivilis gamomwvevi mizezis mkurnalobaze.

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mwuxareba (Grief)danakargze reagirebis procesi. danakargi SeiZleba iyos fizikuri (gardacvaleba), socialuri (gaSoreba) an pro­fesiuli (samuSao adgili). mwuxarebis mier gamowveuli emociuri reaqcia SeiZleba gamoixatos braziT, braleu­lobiT, aRelvebiT, dardianobiTa da sasowarkveTilebiT. mwuxarebis fizikuri reaqcia SesaZloa gamoixatos uZi­lobaSi, uWmelobaSi, fizikur problemebSi an daavadebaSi.

opioidi (Opioid)opiumTan dakavSirebuli narkotikuli medikamentis saxe­oba. opioidebi warmoadgens Zlier tkivilgamayuCebel sa­Sualebas, romelsac mwvave da qronikuli tkivilebis dros iyeneben. opioidebi moicavs morfs, kodeins da sinTeturi (adamianis mier gamogonili) narkotikuli saSualebebis did raodenobas, rogoricaa metadoni da fentanili.

Zlieri opioidebi: ­ morfinis swrafi moqmedebis da gaxan­grZlivebuli moqmedebis tabletebi, saineqcio morfini, morfinis suspenzia, fentalini.

susti opioidebi: ­ kodeini, tramadoli, promedolidamxmare (adiuvaturi) tkivilgamayuCebeli saSualebe­bi: karbamazepini, amitriptilini, deqsametazoni, gabapen­tini da sxv

piradi mzrunvelobis uflebamosileba (Power of attorney for personal care)

iuridiuli dokumenti, romelic asaxelebs erT an met pirovnebas, romelTac pacienti aniWebs uflebamosilebas, miiRon misi saxeliT gadawyvetilebebi, Tu pacienti amis unars iqneba moklebuli.

reabilitacia (Rehabilitation)nawilobrivi an sruli funqciis aRdgenis mizniT Wrilo­bis, daavadebis an tkivilis mkurnaloba.

sazogadoebriv doneze mzrunveloba (Community based care)

moxalise wevrebis mier gaweuli samedicino da socialuri momsaxureba.

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samedicino mindobiloba (Medical power of attorney)dokumenti, romlis safuZvelze nebismier adamians Seu­Zlia daniSnos sxva pirovneba sakuTar agentad da mianiWos mas gadawyvetilebebis miRebis ufleba im SemTxvevaSi, Tu TviTon mas gadawyvetilebebis miRebis unari aRar eqneba.

siTxis miReba intravenurad/siTxeebis gadasxma (Nutrition hydration)

intravenurad Sesayvani siTxe/kvebis danamatebi eZlevaT pacientebs, romlebsac ar SeuZliaT dalion siTxe an mi­iRon sakvebi, an ganicdian gauwyalovnebas.

simptomebis marTva (Symptom management)im pacientTa sicocxlis xarisxis gaumjobesebis mizniT gaweuli mzrunveloba, romelTac mZime an sicocxlisaT­vis safrTxis Semcveli daavadeba awuxebT. simptomebis marTvis mizania daavadebis simptomTa, mkurnalobis Sede­gad gamowveuli gverdiTi efeqtebisa da daavadebasTan dakavSirebuli fsiqologiuri, socialuri da sulieri problemebis rac SeiZleba adreul stadiaze prevencia an mkurnaloba. terminis sinonimebia paliatiuri mzrun­veloba, komfortuli mzrunveloba, SemcvelobiTi Tera­pia.

sicocxlis dasasruls/terminalur stadiaze mzrun­veloba (End-of-life care)

samedicino personalis, mzrunvelebis da socialuri mu­Sakebis mier gaweuli mzrunveloba im pacientebisaTvis, romelTa sicocxlec dasasruls uaxlovdeba (arian ter­minalur stadiaze).

socialuri samuSao (Social work)profesional muSakTa mier Catarebuli samuSao, romelic exeba socialur problemebs, maT mizezebs, gadawyvetis gzebsa da adamianebze maT gavlenas. socialuri muSakebi muSaoben individualur pirebTan, ojaxebTan, jgufebTan, organizaciebTan da sazogadoebebTan, rogorc im profe­siis warmomadgenlebi, romlis mizania socialuri samar­Tlianoba da adamianis uflebebis dacva.

terminaluri (Terminal)progresirebadi daavadebis bolo stadia, romelsac gar­dacvaleba mohyveba.

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tkivilgamayuCebeli medikamentebi (Analgesic medications)

medikamentebi, romelic gamoiy­eneba tkivilis prevenciis an sam­kurnalod.

tkivili (Pain)

arasasiamovno SegrZneba, romelic SesaZloa ukavSirdebodes an ar ukavSirdebodes Wrilobas, daa­vadebas an sxeulis sxva travmas. tkivili kompleqsuri movlenaa da gansxvavdeba sxvadasxva pirovne­baTaTvis, rac damokidebulia TiToeuli adamianis tkivilis zR­varze. tkivilis gakontrolebisas miRweul unda iqnas TiToeuli in­dividisaTvis misaRebi (an sasurve­li) dadebiTi Sedegi.

fsiqosocialuri mzrunveloba (Psychosocial care)mzrunveloba, romlis mizania socialuri, fsiqikuri da emociuri moTxovnilebebis erTianobis dakmayofileba.

qronikuli tkivili (Chronic pain)tkivili, romelic erT Tveze met xans grZeldeba an Tvee­bis gasvlis Semdeg periodulad iCens Tavs.

winaswari samedicino direqtivebi (Advance medical directives)

gamoiyeneba, raTa sxva adamianebs, maT Soris jandacvis sferoSi momsaxurebis mimwodeblebs gadascen informa­cia pacientis survilis Sesaxeb samedicino daxmarebasTan dakavSirebiT. winaswari direqtivebi Zalze mniSvnelova­nia im SemTxvevaSi, Tu pacientebs fizikuri an fsiqikuri SezRudvebis gamo ar SeuZliaT TviTon metyveleba da sa­kuTari survilebis gadmocema. winaswari direqtivebis yvelaze farTod gavrcelebuli formaa anderZi sicocx­lis Sesaxeb da grZelvadiani mindobiloba jandacvis

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sferoSi. `ar gamacocxloT” aseve winaswari samedicino direqtivis erT­erTi formaa.

jandacvis sferoSi rwmunebuli (Health care proxy)werilobiTi dokumenti, romlis meSveobiTac piri kanoni­erad axdens sxva pirovnebaze uflebamosilebis delegire­bas, miiRos maTi saxeliT janmrTelobasTan dakavSirebu­li garkveuli gadawyvetilebebi.

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2010 wlidan fondi `Ria sazogadoeba saqarTvelos~ mx­ardaWeriT xorcieldeba proeqti `ufaso iuridiuli dax­mareba paliatiuri mzrunvelobis pacientebs~.proeqtis farglebSi ufaso iuridiuli daxmareba/konsul­tacia gaeweva yvela paliatiuri mzrunvelobis pacients da maT ojaxis wevrebs. survilis SemTxvevaSi pacientebs/ojaxis wevrebs daxmarebi­sTvis SeuZliaT mimarTon qvemoT mocemul iuridiul kom­paniebs:

Sps `asaTiani da advokatebi~ misamarTi: iuridiuli: Tbilisi, WonqZis 7; faqtobrivi: Tbilisi, SaniZis 8.telefoni: 2–91–27–53sakontaqto piri: giorgi qaTamaZe 57776155

iuridiuli kompania ̀ asaTiani da advokatebi~ aris advokatTa gundi, romelis profesiuli codna da miRebuli gamocdile­ba problemis swrafad mogvarebis saSualebas iZleva.kompania aris profesionalebis gundi, romelic orientire­bulia Sedegze da maRal eTikur Rire bulebebze; kompaniis advokatebi arian licenzirebuli trenerebi advo­katTa unar­Cvevebsa da eTikaSi.

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~korZaZis saadvokato biuro”ks «korZaZis saadvokato biuro» daarsebis dRidan klientebs sTavazobs momsaxurebis srul speqtrs, romelic moicavs zepir da werilobiT konsultaciebs, dokumentebis damuSavebas, rekomendaciebisa da samarTlebrivi daskvnebis momzadebas, warmomadgenlobas sasamarTloSi, arbitraJSi, saxelmwifo organoebisa da mesame pirTa winaSe. Cven Segvi­Zlia warmovadginoT klientis interesi samarTlis Semdeg dargebSi:misamarTi: Tbilisi, 0186 qavTaraZis q. 21, sadarbazo I, bloki «A», I-II sarTuli;telefoni: 2–38–03–22 / 2–38–03–32; faqsi: 2–37–02–58 veb–gverdi: http://www.kordzadzelawoffice.ge ელ-ფოსტა: lp@kordzadzelawoffice.gesakontaqto piri: Salva nadiraZe.

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`onkoprevenciis centri~

misamarTi: Tbilisi, 0177, lisis tba, onkologiis nacionaluri centris mimdebare teritoria (onkologiis centris ukan orsarTuliani Senoba baneriT – `onkoprevenciis centris paliatiuri mzrunvelobis klinika – hospisi~)

telefoni: 2–36–91–12, mob.: 599–587–377,

el–fosta: rema_cpc@yahoo.com

veb–gverdi: www.cancer.org.ge ; www.hospice.med.ge

ra momsaxurebas sTavazobs pacientebs: paliatiuri mzrun-veloba (stacionaruli da ambulatoriuli), qimioTerapi-uli momsaxureba, Sinmovla.

mimarTva: pacients SeuZlia mimarTos, rogorc TviT dine biT ambulatoriuli momsaxureobisTvis, aseve winaswari SeTanx-mebis safuZvelzec, zemoT miTiTebuli sakontaqto tele-foniT. SesaZlebelia binaze an sxva klinikaSi konsultaciac.

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momsaxurebis anazRaureba: klinika CarTulia saxelmwifo prog ramaSi `inkurabelur pacientTa paliatiuri mzrun-veloba~.

~onkologiis nacionaluri centris paliatiuri mzrunv­elobis samsaxuri”

misamarTi: Tbilisi, 0177, lisis tba; telefoni: 2 – 2 3 – 8 5 –41; faqsi: 2–39–77–16

el–fosta: onc.palliativecare@gmail.com

ra momsaxurebas sTavazobs pacientebs: paliatiuri mzrun-veloba (stacionaruli da ambulatoriuli).

resursebi: paliatiuri mzrunvelobis stacionarebi Tbilissa dazugdidSi.

binaze paliatiuri mzrunveloba xorcieldeba TbilisSi, TelavSi, quTaissa da zugdidSi.

mimarTva: pacients SeuZlia mimarTos rogorc TviTdi ne biT ambulatoriuli momsaxurebisTvis, aseve winaswari SeTanx-mebis safuZvelzec, zemoT miTiTebuli sakontaqto tele-foniT.

momsaxurebis anazRaureba: klinika CarTulia saxelmwifo programaSi `inkurabelur pacientTa paliatiuri mzrunv-eloba~.

feriscvalebis dedaTa monasterTan arsebuli mowyalebis centris sasneulo saxli da binaze movlis samsaxuri

misamarTi: Tbilisi, urbnisis q. #7., darejan is sasaxlis teritoria (misvla SeiZleba metexis aRmarTidan an avlabris moednidan).

telefoni: 2–74–70–23,

el–fosta: peritsvalebismonasteri@gmail.com

veb–gverdi: www.mercycenter.ge

SeTavazebuli daxmareba/momsaxureba: ukurnebeli da sx-vadasxva qronikuli daavadebis mqone pacientebis movla-mz-runveloba, maTi ZiriTadi Civilebis Semsubuqeba da sulieri da moraluri mxardaWera.

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mimarTva: aucilebelia winaswar dakavSireba zemoxsenebuli sakontaqto informaciis gamoyenebiT.

momsaxurebis anazRaureba: sasneulo saxli da binaze movlis samsaxuri ar finansdeba romelime saxelmwifo programiT. dafinansebis wyaroa Semowirulobebi. pacients momsaxurebi-sTvis safasuris gadaxdas ar Txoven. Tumca, Semowirulobis saxiT pacients an mis ojaxs SeuZlia garkveuli Tanxis gadax-da.

`baTumis onkologiuri centris paliatiuri mzrun velo­bis samsaxuri~

misamarTi: baTumi, puSkinis q. #118 (puSkinisa da 26 maisis quCebis gadakveTaze).

telefoni: 27–67–52, 22–29–52;

el–fosta: adjonkcenter@mail.ru

ra momsaxurebs sTavazobs pacientebs: onkologiuri pacien-tebis paliatiuri mzrunveloba, tkivilis marTva, dezinto-qsikaciuri RonisZiebebi, hemotransfuzia, mcire qirurgi-uli operaciebi, paliatiuri qimioTerapia.

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`koalicia Sinmovla saqarTveloSi~

misamarTi: Tbilisi, 0186, nucubiZis q. #187a (`nucubiZis platos~ me–2/4 m/r–is asaxvevTan);

telefoni/faqsi: 231-62-02, 231-41-58, 232-27-60, 253-74 48/49;

veb­gverdi: www.homecare.ge

ra momsaxurebas sTavazobs pacientebs: Sinmovla, rac gu lisxmobs pacientis samedicino, socialur da sayofa-cxovrebo momsaxurebas mis sacxovrebel garemoSi; aRniS-nulis Semadgeneli, garkveulwilad, paliatiuri mzrunv-elobac aris.

mimarTva: zemoT miTiTebul misamarTze an sakontaqto tele-foniT.

momsaxurebis anazRaureba: socialurad daucveli mosax-leobis nawili iRebs ufaso momsaxurebas, rac dafinansebu-lia donorebis mier, xolo sxva kategoriis pacientTaTvis momsaxureba fasiania.

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saqarTvelos saxalxo damcveli:

misamarTi: Tbilisi 0179, nino ramiSvilisq. #6.telefoni: 2234499 / 2913814 / 2913815 / 2913841 / 2913842 / 2913843 / 2913875 / 2913876 / 2913877el–fosta: info@ombudsman.ge ; veb–gverdi: www.ombudsman.ge

janmrTelobis dazRvevis mediaciis samsaxuri:

misamarTi: Tbilisi 0119, akaki wereTlis gamziri #144.telefoni: 2–555–115; el–fosta: info@him.ge; veb–gverdi: www.him.ge

saqarTvelos sadazRvevo asociaciis ̀ sadazRevo gzamkvlevi~:

veb–gverdi: www.insurance.org.ge mimarTvisaTvis saWiroa veb–gverdze www.insurance.org.ge

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mimarTvis formis CamotvirTva, Sevseba da el–fostis Semdeg misamarTze gagzavna gzamkvlevi@insurance.org.ge

C da B hepatitis pacientTa gaerTianeba

misamarTi: Tbilisi, Ciqovanis #24 telefoni: 571 071710el–fosta: n.iovashvili@gmail.comveb–gverdi: www.tkivilisgareshe.ge

koalicia `adamianis uflebebi janmrTelobis dacvis sferoSi~:

telefoni: 8790-954-954; el–fosta: coalition.hrh@hrh.ge, gjavashvili@hotmail.com veb–gverdi: www.hrh.ge