Постановление Европейского суда по правам человека от 30.09.2010 «Дело Пахомов (Pakhomov) против России» [англ.]

the Court has examined whether or not the applicant received adequate medical assistance in prison. The Court reiterates in this respect that even if Article 3 does not entitle a detainee to be released "on compassionate grounds", it has always interpreted the requirement to secure the health and well-being of detainees, among other things, as an obligation on the part of the State to provide detainees with the requisite medical assistance (see {Kudla}, cited above, § 94; Kalashnikov v. Russia, No. 47095/99, §§ 95 and 100, ECHR 2002-VI; and Khudobin v. Russia, No. 59696/00, § 96, ECHR 2006-XII (extracts)).
62. The "adequacy" of medical assistance remains the most difficult element to determine. The CPT proclaimed the principle of the equivalence of health care in prison with that in the outside community (see paragraph 43 above). However, the Court does not always adhere to this standard, at least when it comes to medical assistance for convicted prisoners (as opposed to those in pre-trial detention). While acknowledging that authorities must ensure that the diagnosis and care are prompt and accurate (see Hummatov v. Azerbaijan, Nos. 9852/03 and 13413/04, § 115, 29 November 2007; Melnik, cited above, §§ 104 - 106; and, mutatis mutandis, Holomiov v. Moldova, No. 30649/05, § 121, 7 November 2006), and that where necessitated by the nature of a medical condition supervision is regular and systematic and involves a comprehensive therapeutic strategy aimed at curing the detainee's health problems or preventing their aggravation (see Hummatov, cited above, §§ 109, 114; Sarban v. Moldova, No. 3456/05, § 79, 4 October 2005; and Popov v. Russia, cited above, § 211), the Court has also held that Article 3 of the Convention cannot be interpreted as securing for every detained person medical assistance at the same level as "in the best civilian clinics" (see Mirilashivili v. Russia (dec.), No. 6293/04, 10 July 2007). In another case the Court went further, holding that it was "prepared to accept that in principle the resources of medical facilities within the penitentiary system are limited compared to those of civil[ian] clinics" (see Grishin v. Russia, No. 30983/02, § 76, 15 November 2007).
63. On the whole, the Court reserves sufficient flexibility in defining the required standard of health care, deciding it on a case-by-case basis. That standard should be "compatible with the human dignity" of a detainee, but should also take into account "the practical demands of imprisonment" (see Aleksanyan v. Russia, No. 46468/06, § 140, 22 December 2008).
(b) Application of the above principles to the present case
64. The Court reiterates that it was not in dispute between the parties that the applicant had contracted tuberculosis in 2003, long before his arrest and placement in detention facility No. IZ-25/1 in April 2007. According to the applicant, when he learned about the infection he underwent treatment in a tuberculosis hospital in his home town. Although the Government did not comment on the outcome of the treatment, they did not dispute the applicant's assertion that the treatment had been a success, resulting in his recovery from active tuberculosis. In any event, medical records produced by the Government confirm that no signs of reactivation of the illness were recorded on the applicant's admission to facility IZ-25/1. In this respect, the Court would like to stress already at this juncture that the medical assessment of the applicant conducted during his first days in the detention facility appear to comply fully with international standards of tuberculosis control policy in prisons, a recognised setting for transmission of tuberculosis (see paragraphs 43 - 45 above). In particular, the Court notes that the applicant was seen without delay by an attending prison doctor, who studied his medical history, recorded complaints, organised a meeting with a tuberculosis specialist and

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