Access to surgical care in outpatient clinics and hospitals where I work is guaranteed. Every Bulgarian and foreign citizen is entitled to it, both for elective and emergency surgical care.
However, I reserve the right to decline in cases where the patient has unreasonable, inappropriate, or unethical goals related to the outcomes of physical well-being achieved through surgery.
Surgical treatment is carried out in accordance with the fundamental principles of medicine and consensus on best surgical practices in Bulgaria, Europe, and worldwide to the extent possible.
Application of surgical treatment begins only after it is determined that the treatment will help to improve the quality of life of the patient, following the primary principle of medicine, “Primum non nocere,” Latin for “First, do no harm.”
Surgery is performed after the patient has expressly agreed to it. Nothing related to health or patient care is done by force or without consent. In cases where the patient's life is in imminent danger and he does not realize the seriousness of the situation, the responsibility for his life and health remains in the hands of the surgeon.
The surgeon has the right to assess whether the malady/condition of the patient requires elective or urgent surgical treatment. When a condition is assessed as being in need of urgent treatment by the surgeon, and the patient refuses treatment, then the patient remains responsible and is required declare this in writing. When a particular malady/condition is assessed as “uncritical” by the surgeon, but as "urgent" by the patient, the surgeon is not obliged to comply with the wishes of the patient.
The provision of surgical care is guaranteed, but there is no guarantee that it will be free. Due to legal and administrative gaps and complexity at the state level, payment or partial payment for services rendered may be required.
Many methods of payment are possible: National Health Fund, additional mandatory and voluntary health insurance, European Union health insurance, other insurance, or cash.
Because the question of access to medical care is to a large extent an ethical question, I would like to share with you the moral values and principles I follow in my life and my profession. It is not necessary to state them as they were stated 2500 years ago by Hippocrates in the 4th century BC.
I swear by Apollo the physician, and Aesculapius the surgeon, likewise Hygeia and Panacea, and call all the gods and goddesses to witness, that I will observe and keep this underwritten oath, to the utmost of my power and judgment.
I will reverence my master who taught me the art. Equally with my parents, will I allow him things necessary for his support, and will consider his sons as brothers. I will teach them my art without reward or agreement; and I will impart all my acquirement, instructions, and whatever I know, to my master's children, as to my own; and likewise to all my pupils, who shall bind and tie themselves by a professional oath, but to none else.
With regard to healing the sick, I will devise and order for them the best diet, according to my judgment and means; and I will take care that they suffer no hurt or damage.
Nor shall any man's entreaty prevail upon me to administer poison to anyone; neither will I counsel any man to do so. Moreover, I will give no sort of medicine to any pregnant woman, with a view to destroy the child.
Further, I will comport myself and use my knowledge in a godly manner.
I will not cut for the stone, but will commit that affair entirely to the surgeons.
Whatsoever house I may enter, my visit shall be for the convenience and advantage of the patient; and I will willingly refrain from doing any injury or wrong from falsehood, and (in an especial manner) from acts of an amorous nature, whatever may be the rank of those who it may be my duty to cure, whether mistress or servant, bond or free.
Whatever, in the course of my practice, I may see or hear (even when not invited), whatever I may happen to obtain knowledge of, if it be not proper to repeat it, I will keep sacred and secret within my own breast.
If I faithfully observe this oath, may I thrive and prosper in my fortune and profession, and live in the estimation of posterity; or on breach thereof, may the reverse be my fate!