BceMHpHlUI opraHHJaUHJI J,npaaooxpaHeHIDI -~ EaponeucKoe pernoHanbH0e 6iopo ~ i KoneHrareH ~ EP6: Or11erb1 H Hccne,noBaHIDI 73 ME,IU1UHHCKI1E 11 COUl1AJibHhIE IIPOEJIEMhl Jll1U C OfPAHl111EHl1.HMH IIPI1Bhllffi0~ llE.HTEJibHOCTl1 l1JII1 CHIDKEHHEM TPYllOCIIOCOEHOCTH B. KannHo BceMHpHa.a opraHH3aUIDI 3,a;paeooxpaHeHHH -✓- ~ EeponeHcKoe pernottanbttoe 610po ~ I KonettrareH ~ ~ EP.6: OTt1eTbI u uccne,a;oBaHHH 73 ME,IU11.111HCKHE H COUHAJibHhIE IlPOEJIEMhl JIHU C OfPAHHlffiHH.HMH IlPHBhllffiOH ,IIE.HTEJlbHOCTH HJIH CHIDKEHHEM TPY,IIOCilOCOEHOCTH B. Kannuo l!HpeKTOp HccnenoaaTeJlbCKHA ueHTp no npo6neMaM pea6HJ1HT3UHH HHCTHTYTa COUHam,Horo CTp3XOBa.HHJI TypKy' <l>HHJlJIHP,HJI OneT cocrneneH no MaTepuanaM Te Ma THt1ecKHX .a;HcKyccuii, C0CTOHBllIHXCH e xo,a;e 31-H ceccHH EeponeHCKOro perH0HanbH0ro K0MHTeTa C BceMHPHaR opraHH3auHR 3,llpaBOOxpaHeHHR, 1984 Ha nyOmn<aUHH BceMHPHOH opraHH3aUHH 3.npaBooxpaHeHHR pacnpoc-rpaH.RJOTCR nono)leHHR npoTOKOna ~ 2 BceMHPHOH KOHBeHUHH oO oxpaHe aBTopcKHX npaB. 3aRBneHHR Ha nepe- neqaTl(Y HnH nepeoon nyOmn<aID!H EBponeHcKoro pernOHaJlbHOro OKJPO 803 qaCTHtrno HnH in toto cne.IIYeT HanpaBn.RTb B 9TY OpraHH3a.J..(HI() no a,llpecy: Regional Office for Europe, Scherfigsvej 8, DK-2100 Copenhagen 0, Denmark. PernoHaJlbHoe Olopo OXOTHO YDOBneTBQPReT TaKHe npocr,0!,1. 00o3HaqeHHR, HCTTOJlb3YeMbte B HaCTORllleM H3DaHHH, H npHBO,IIHMbte B HeM McnepHa11,1 HH B KoeM cnyqae He 1:1,1paJ1aIOT MHeHHR CeKpeTapHaTa BceMHPHOH opraHH3aI.MH 3npaBOOxpaHeHHR 0 IOPHD~eCKOM CTaTYCe KaKOH-nHOO CTpaHbl, TeppHTopHH, ropo.na HJIH pa:HoHa, HX opratte BnaCTH HnH oO HX rocynaPCT- BeHHbIX rpaH1,max. YnOMJ.fHaHHe HeKOTopbIX KOMnaHHH HnH nPQllYKI..IHH OTDeJlbHblX H3rOTOBHTeneH He 03HaqaeT, ~o BceMHPHaR opraHH3al.IHR 3,llpaBOOxpaHeHHR OT]laeT HM npe.nnoqTeHHe no cpaBHeHHIO C npyrnMH, He ynOMR:HyTb!MH B TeKCTe, HnH peKOMeH.IIYeT HX K HcnOJlb30BaHHIO. KaK npaBHno, naTeHTOBaHHb!e HaHMeHOBaHHR BblDeJlRIOTCR HaqaJlbHblMH nponHCHblMH OyKBa.MH. 9Ta nyOnHKal.IHR O~eT B3r.11R,Ilbl yqaCTHHKOB naHHOH PaOoqeH rpynrn,I H Heo0R3aTeJlbHO npencTaBnReT peuieHHR HnH O(j)HUHaJlbHYJO nOJlHTHKY BceMHPHOH opraHH3aUHH 3,llpaBOOxpaHeHHR. H3,llAHO B JlAHlili ISBN 978 92 890 7336 3 ISSN 0250-8729 Bae.aeHHe • . . . . . . . KoHUenIJHH H onpe.aeneHHR CO,llEPitAHHE npouecc, npHBO.[lRIJlliA K Orpa.HJNeHHIO npHBbl'UiOH .ae.RTem,HocTH HJIH CHHJtemm TPY .aocnocoOHOCTH • • • • • • • npe,aynpe-..'lE!HHe cnyqaeB orpaHH'leHH.R npHl!ld'DiOH .aeRTeJ!!,HOCTH HJ1H CHHlleHH.R TPY .aocnocoOHOCTH • • • • • • • • • PeaOHJJHTa.llH.R Me.IIHUHHCKHe H COUHaJ!!,HWe npoO.neNl,I JIHU C Orpa.HINeHHSJMH npHllliNHOO .ae.RTeJl!,HOCTH H1lH CHHJteHHeM TPY .nocnocoOHOCTH • • • • • • • ,IlaHHl,le O pacnpe.oe,neHHH 9THX COCTO.RHHH B HaceneHHH JlHua C Orpa.HJNeHH.RNH npHB>NHOO ,De.RTeJl!,HOCTH H.1IH CHHxeHHeM TPY .aocnocoOHOCTH B OOlllecTBe npe,aynpeJUleHHe cnyqaeB or,:>aHHtleHHR npHB!il'UiOO .ae.RTeJ!!,HOCTH H.1IH CHHlleHH.R V 1 1 3 5 6 6 12 TPY .aocnocoOHOCTH . • • • • • • • • 1 5 PeaOHJlHTa.llH.R J1HU C orpaHH'leHH.RMH npHBY'DiOH ,IIe.RTem,HOCTH HJ1H CHH&eHHeM TPY .ll0Cfloco0HOCTH . • . . . . 1 9 BcnOMOraTem,HJ,le cpe]X:TBa, npHcnocoOneHHR H oOopy .IIOBaHH.R • • • . . . 2 6 TlmeJlble cnytrali COUHaJlbHOH He,oOCTaTOtfiiOCTH B pe3y.11bT3Te OrpaHH'leHWI npHBbl'IHOH .oewre.llbHOCTH H.rIH CHHlleHHR TPY.OOCOOC:o0HOCTH • • • • • • • • 27 nepa(X)qepe,llHLle HanpaaneHHR Hccne.ooaaHHH 29 Cneum>J.NecKHe .l]J1R Eaponei71C1Coro pernoHa npoOneMLI, Kaca1<111HecR OrpaHH'leHHR TTPHBbltfiiOH .oewre.llbHOCTH li.J1H CHJ-uteHHR -rpy,oocnocoOHOCTH, a TaKlKe peaOH.J1HTaUHH . . . . • • • . . . . . . . 29 OCHOBHble BOilpoa,i OOBeCTKH .DHR .OByX KOKl>epeHUHH OpraHH3auHH 00'.be,mrneHHblX HaUHH, npoXO.DH13111HX B Eapone B paMKax MeJIUlYHapo,IIHoro ro.oa HHBaJlH,llOB 32 CHMl103HYM EaponeHClCOH 3KOHOMHqecJ<OH KOMHCCHH OOH . . . . . . . . . . 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A 9TO 03Ha'laeT, 'ITO HeoOXO.llHMO HaMeTHTb Howe npHQPHTeTJ,1, B tfHC- ne KOTQPl,IX Ha nepwH nnaH Bl,IJlBHraeTCR 3HatlHTeJlbHoe Yl(pen- neHHe cnygO nepBwn-!OH Me,IJHKO-Ca.HHTapHOH noMOIJlH (IIMCn), ,lleACTBYJ(lltHX Ha oaae oO!llHH. CHCTeMa nMCn npe.JlYCMaTPHBaeT MepanpHRTHR no Yl(penneHHJO 3.nopom,R, npol>HJtaKTHKe Oone3HeA H npe.oynpe:s,aeHHJO cnyqaeB orpaHHtleHHH npHW'DiOH ,lleRTe.rn.Hoc- TH HnH CHHlleHWI TPYJlocnOCoOHOCTH, a TaKlle no peaOHnHTauHH mru C TaKHMH OrpaHH'leHHJ'DOf, npoBe,lleHHe KOTq:>!,IX RBHTCR ,lleH- CTBeHHhlN cnocoOoN BblilOJtHeHHR c-rpaTenrn JlOCTHlleHHR 3JlOPQBl,R Jl1lR BCex K 2000 r., no.llBePI"'HYTOH BCeC'I'opoHHeMY oOcyl!JleHHJO B xo.ne 30-H ceccHH PerHOHaJlbHOro KOMHTeTa B 1980 r. H o.r:t00peHHOH ee yqaCTHHKaMH. Ha npor~eHHH nocneJlHero .llecRTHneTHR reHepaJlbHM Ac- caNOneR OpraHH3auHH 00'.I:,e,llHHeHHhlX HauHH npHnarana 9HeprH'I- Hhle YCHnHR K TOMY, 'IToCl.i pe!IIHTb IlPOOneMY OrpaHH'leHHH npH- Bbl'IHOI )le.FrreJlbHOCTH HnH CHHieHHR TPY JlocnOCoOHOCTH. B 1971 r. OHa npoB03rnaCHna ,UeKnapaUHJO npaB YMCTBeHHO orcTa- JlhlX nHU, a B 1975 r. - ,UeKnapal.l}Ul npaB HHBanH,llOB. B 1976 r. reHepa.JlbttaR AccaMOneR OOH oOl>RBHna 1981 r. Mext.JlY- HapoJlHl>IM ro)lOM HHBanH.llOB C ue.rn,10 npHBne'lb BHHMaHHe Mell,lly- Hapo.[IHOH oO!lecTBeHHOCTH K TOMY HeBblHOCHMOMY nonol!eHHIO, B KOTopoM HaxO,llRTCR 450 M1tH. mru c Or"paHH'{eHHRMH npHBbl'IHOH .neRTeJlbHOCTY. HnH CHHlleHHeM TPY .nocnocoOHOCTH, npolltHBaIOIIHX B pa3HhlX CTPaHax MHPa- COOTBeTCTBYIOIIM pe30Jll01..IH.F{ 34/154, npHHRTM reHepa.JlbHOH AccaMOneeA OOH B 1979 r., rnacHT: "Me11,eyHapo~ ro)l HHBanHJlOB JlOJUteH co.neACTBOBaTb QCy111e- CTB11eHHIO npa.Ba HHBanHJlOB Ha nonttoe yqaCTHe B oOilecTBeH- HOH JIK3HH H pa3BHTHH oOJlecTB, B KOTQPhlX OHH IlPollHBalOT, H Ha oOecnet1eHHe HX ycnOBHRMH l!H3HH HapaBHe C .llPYnfMH rpag- ,naHaMH 11 • IlpH no.nroTOBKe MepQnpHRTHH B paMKax MeXUlYHapo.n- HOro ro.oa HHBanH.llOB ocoOoe 3Ha'leHHe npH,llaBaJIOCb BOnpocaM npe.oynpell,lleHHR cnyqaeB orpaHH'leHHR npHBbl'IHOH .neRTeJlbHOCTH HnH cHHieHHR TPY.llOCTIOCo0HOCTH, KOTClPblM JlO TOH nQPl,I Y.llenRJn.f He,llOCTaTO'IHOH BHHMaHHe. V TipoOneMH peaOHJlHTaUHH H npe,eynpe)!UleHHR cnyqaeB OrpaH}NeHHR TIPHBbl'-IHOH .rteRTeJlbHOCTH HJlH CHHJ!eHHR TPY.ItOCnocoOHocTH ~JlH BKJll()qeHbJ B nOBecTKH .IIHR 3ace.rtaHHH 803, npQBO.ItHBIIIHXCR B b!Ta0-KBapTHJ)e H Ha pernoHaJlbHOM ypoBHe. B 1976 r. BceMHPHaR acca.MOneR 3,llpaBOOxpaHeHHR paCCMaTPHBa.TJa 3TOT BOnpoc B CBeTe .ItOKyMeHTa A25/1976 ''npe,IlYTlPel!.JleHHe HHBaJIH.ItHOCTH H peaOHJ1HTaUHR 11 • B COOTBeTCTBHH c HOBblM HanpaBneHHeM nOJlHTHKH 803, npmurn1M Ha XX ceccHH BceMHPHOH acca.MOneH 3.JJPaBOOxpatteHHR, B 1979 r. ~no no.aro-roaneHo PYKOBO.IICTBO no no.rtrOTOBKe nHU c OrpaH}NeHHRMH TIPHBbl'-IHOH .rteRTeJlbHOCTH HJ1H CHHJ!eHHeM TPY.ItOCnoco0HOCTH K HOPMaJlbHOH i'IH3HH B o0blecTBe, a B 1980 r. OHO no,ItBeprJlOCb nepecMOTPY (1). XOTR PYKOBO.ItCTBO H opHeHTHPOBaHO rnaBHblM o0pa3OM Ha pa3BHBalOIIIHecR CTpaHbl, OT.rteJlbHble ero rnaBbl MOryT OKa3aTbCR none3Hb[MH .Il1lfl paOOI'l-lHKOB 3,llpaBOOxpaHeHHR B crpa.Hax EBpoTlbl, Cne,eyia:aHM Bamih!M blaroM, ITpe.lll1PHH.flThlM 803, RBHJlaCb nO.ItroTOBKa "Mell.JlYHapo.ItHOH Knaccl-fl>HKaUHH HapY1J1eHHfl ¢H3H'4:ecKOI'O HJ1H nCHJCH'4:ecKOI'O xapaKTepa, OrpaH}NeHHH npHBbl'-IHOH .rteRTeJlbHOCTH HJ1H CHHl!eHHR TPY.nocnOCoOHOCTH H COUHaJlbHOH He.rtOCTaTO'-IHOC- TH 11 , nepBOe H3,IlaHHe KOTopoH, npe.JlHa3Ha'4:el-Dioe .Il1lfl anpoOa- UHH, BbllllJlO B 1980 r. ( 2 ) . H, HaKOHeu, BOnp<X:hl ITpe,IlYTlPel!- .rteHHR cnyqaeB OrpaH}NeHHR TIPHBbl'-IHOH .rteRTeJlbHOCTH HJ1H CHHl!eHHR TPY.rtocnocoOHOCTH H peaOHJlHTaUHH, a Ta.Kl!e nyTH pe!lleHHR 3THX npoOneM Hab!JlH OTpal!eHHe B He,IlaBHO onyO- JlHKOBaHHOM OT'4:eTe KOMHTeTa 3KCnePTOB 803 ( 3 ) . Ha pernOHaJlbHOM ypoBHe y"!le np0BO.IIHJ1HCb meUHaJlbHble TeMaTH'4:ecKHe .IIHCKYCCHH B XO.rte cecCHH PernoHaJlbHOro KOMHTeTa, COCTORB!lleHCR Ha MaJlbTe B 1971 r., H ObiJlH BblHeceHbl peKOMeH.ItaUHH B a;:ipec npaBHTeJlbCTB, HOBble nporpaMMI,I no m,oi>HnaKTHKe Hec'laCTHblX cnyqaeB H oxpaHe 3.JlopoBbR npecTapeJlblX ( Hap.fl.ItY C TIPHHRThlMH paHee nporpaMMaMH OxpaHl,I 3.JlopoBbR .rteTeH H OopbObl C cep.rte'4:HCreocy.ItHCTbIMH 3aOoneBaHHRMH, a Ta.K"lle paCIIIHpeHHOH nporpaMMOli nCHXHa'l'- PH'4:ecKOH nOMOIIIH) n03BOnHJ1H PernOHaJlbHOMy OIOPO no.apo0Hee O3HaKOMHTbCR C 3THMH BOnpocaMH, O.ItHaKO .IIO CHX nop He Clblno CBR3H Mel!.IIY BblIJOJlHReMbIMH B c-rpaHax COUHaJlbHblMH nporpaMMaMH H aHaJJOrH'IHblMH nporpaMMaMH, OCYIJleCTB11ReMblMH pa3.1llNHblMH yqpel!.JleHHRMH CHCTeMbl OOH. IlonyqHBblaR o.noOpeHHe perHOHaJlb- HaR nporpaMMa Ha 1984-1989 rr. 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B ueJlffX npe.llYnpe)f;JleHHR c.nyqaea orpaHH'leHHR npHBbl'-IHOH ,lle.RTeJlbHOCTH HJIH CHH;!;eHHff TPY JlOCnOCoOHOCTH He.11b3ff ,IlOBOJlbCTBOBaTbCff MepaMH, npoBOJlHMl,IMH J1Hlllb B ceKTope 4 3.llPaBOOXpaHeHHR. ,UJIR BblllOJU-leHH.R 3TOH 3a,Ila'-rn HeoOXO.llHMO TaK!te npHH.RTb COUHa.TlbHble MePbl, Mepbl oOyqeHH.R H npol>ecCHOHaJibHOH nO,llf"OTOBKH, 3aKOHO,llaTe.1lbHble Mepbl H T-D· HaHJTY'-IIIIHX pe3y.1lbTaTOB MO!tHO ~HTbC.R .1lHIIIb npH KOMnneKCHOM npoBeDeHHH scex 3THX MeponpH.R"I"HH. PeaOHJ1l.fTaUH.R OnpeDeneHHe noH.RTH.R ''peaOHJ'GiTa.uH.R 11 Heo.llHOKPaTHo MeHJUIOCb, Q'I'Pallta.R npe;ttDe BCero Te H3MeHeHH.R, KOTOPble npeTepneBa.11O caMO noH.RTHe "or-paHH'leHH.R npHBbl'IHOH De.RTe.TlbHOCTH HnH CHHlleHHe TPYDocnocoOHOCTH", H, B qaCTHOCTH, H3MeHeHHe 3a,naq peaOHnHTa.I..IHH. 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CaMH nHua C Of"PaHH'{eHH.RMH npHBbl'IHOH De.RTe.TlbHOCTH HJ1l,f CHmteHHeM TPYJJOC1loco0HOCTH H C COUHaJibHOH HeDOCTaTO'IHOCTblO, a TaKllte 'VteHbl HX ceMeH H OOIIHH, B KOTopblX OHH !tHBYT, DOJllKHbl npHHHMaTb yqaCTHe B nna.HHPQBaHHH cnylltO peaOHmfTauHH H B HX paOOTe. 5 ME.IlfilUlliCKJ,iE H COWiAnI:iHblE fIPOBJIEM!x JlliI.l C OI'PAHH4EHM500i rIPHBl:M-IOH JlE5fI'EJlbHOCI'rl IUlli CIDlmillEM TPY .nocnOCOBHOCTH ,IlaHHble O pacnpocTPaHeHHH 3THX COCTORHHH B HaceneHHH Pacnpoc-rpa.HeHHOCTb H qaCTO'ra HOBblX cnyqaeB HaPY111el-niH cj)H3~eci<oro HJ1H nc~ecKoro xapaKTepa, o~eHHH npHBW-U-IOH .oeR'l'eJlbHOCTH HJ1H CHl•UKeHWI TPY.IlOCTTOCo0HOCTH, C:OUHaJlbHOH He.IlOCTaTO\ffiOCTH, a TaKJKe Bbl3b1BaKXUHe HX np~Hbl BaPbHPYIOTCR B 3aBHCHMOCTH O'r B03paCTHOH rpymlhl, KaqeCT:ea CJIYlll.0 3.opaBOOxpaHeHlffl, ypoBHR npc4>HJiaK~ecKOH paOon! H pa3JlH'IHblX COUHaJlbHblX H 3KOHOMH'leCl<HX cj)a.KTOPQB. HHJKe npHBO,IlR'l'CR TTOCTymlBDIHe H3 PFl.lla eBPOTTeHCKHX CTpaH ,llaHHble, KO'ropt,le KaCaJOTCR OCHOBHblX np~, Bb13b1BalOlllHX orpa~eHHR npHBbl\ffiOH .oeRTeJlbHOCTH W1H CHHJKeHHe -rpy,aocnocoOHOCTH B -rpex B03pacnn,oc rpynnax - cpe,IlH ,IleTeH H nO.opocTKOB, cpe,IlH B3PQCJJ,1X H cpe.[lH JlliU nollHJIOro B03paCTa. H3-3a orcyTCTBHR CTa.H,IlaPTl-13O:eaHHOH CHCTeMbl cOopa IDfl>opMaUHH, OTHOCRllleHCR K npoOneMe o~eHHR npHBblqHOH .oeRTeJlbHOCTH HJ1H CHHJKeHHR TPY.OOCTioco0HOCTH, He Oblno npe.onpHHRTO TTOmlTOK npQBeCTH cpaBHHTeJlbHblH aHaJll,f3 ,llaHHblX, TTOCTYTTHBDIHX li3 pa3HblX CTpaH. no ,llaHHblM CTaTHCTHKH, 3a nepHO.Il c 1965 no 1980 r. 'fliCJIO .oeTeH H TTO,[!pOCTKOB B MHPe B03pocnO Ha 30% ( 4), ~o oOycnoBJieHO PQCTOM 'fliCJieHHOCTH HaceneHHR 9TOH B03paCTHOH rpyrntbl B Pa3BHBaiallHXCR CTpaHaX. 8 CTpaHax EBpollbl 'fliCJIO ,IleTeH H no,apocTKOB B B03paCTe 5-18 JieT B 1965 r. COCTaBJUUlO 109,5 MJIH., H, cornaCHO pacqeTHblM ,llaHHblM, K 1980 r. 9TO'r noKa3aTeJlb ,llOJllll.eH Obm cocTaBHTb 118, 6 MJIH., ~ COOTBeTCTBOBanO Obi yBemNeHHIO Ha 8,3%. Pacnpoc-rpa.HeHHOCTb H qaCTO'ra HOBblX cnyqaeB orpa~eHHR npHBbl\ffiOH .oeRTeJlbHOCTH HJ1H CHHlll.eHWI TPY.OOCTiocoOHOCTH. CornacHO ,llaHHblM, nonyqeHHblM B xo.oe He,llaBHO npQBe,IleHHoro cj)HHCKHMH yqeHblMH Hccne.oo:eaHHR, oObtee 'fliCJlO ,IleTeH B B0'3paCTe 0-15 JleT, CTpa,llalOJJlHX xpo~eCKHMH 3aOoneBaHW1MH, cOCTaBHJIO 5,3% (T. Pel tonen H coaBT., JIHq}ioe cooODteHHe, 1978). HaHOonee pacnpoCTpaHeHHblMH Ob1JIH Bpolll..IleHHble 3aOoneBaHHR H nopoKH pa3BHTHR, 3aTeM cne.oo:eaJIH annepn-NecKHe 3aOoneBaHHR H Oone3HH opraHOB qyBCTB. 6 XpoHH'-leC1<He 3aOonesaHW1 t.raCTO rIPHBO.llRT K ttapymeHHRM 4>H3H'lecKOro HJ1H ncHXH'leCKOro xapaKTepa, KOTOpble MOryT rIPHBeCTH K Orpa.HH"leHH.RM npHBbltn-lOH .lle.RTeJlbHOCTH H.1lH CHH;'!eHHIO TPY .llOCTIOCOOHOCTH H ( HJIH) K COUHaJlbHOH He.llOCTaTO<oiOCTH. O.llHaKO cneJIYeT OTMeTHTb, 'ITO, XOT.R aJUJePn-NeCKHe 3aOoneBa.HH.R, ocoOeHHO 0poHXHaJlbHa.R acrMa, .llOBOJlbHO DIHJX)KO pacnpoC'rpa.HeHbl cpe,llH .lleTeH, OHH Bbl3blBalOT nOCTO.RHHYJO COUHaJlbHYJ(l He.llOCTaTO'iHOCTb {HanpHMep, HecnOCoOHOCTb BblTIO.rni.RTb paOoTy) .1lHlllb y 2-3% ITO.JlPOCTKOB. C .llPYroA CTOPQHbl, BPQ;'l,IleHHble nopoKH pa3BHTH.R H TP3BMbl, nonyqeHHble B pe3ym,TaTe HeeqacTHblx cnyqaea, qacro .RBJI.RlOTC.R np!-NHHOH ITOCTO.RHHOH COUHaJlbHOO He.IIOCTaTO'iHOCTH B nocneJIYKll!eH l!Gf3HH. MHOl"'He COCTO.RHH.R, cny1ta111He rlPH'IBHOH COUHaJlbHOH He.llOCTaTO'iHOCTH B .lleTCKOM aoopacre, pa3BHBalOTC.R y;,a:e K MOMeHTY po;'l.lleHH.R H TOI",lla lie HX MOJKHO BblRBH'I'b. 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IlOKa3aTe.11H qacrOTbl HeocJJOJKHeHHOH 3rTHJ!encHH .llOCTHI"aJIH 6,4 Ha 1000, Bpo;'l.lleHHblX nopoKOB cep.IIUa - 5,0 Ha 1000, uepeOpa.rtbHOI"O na~a - 4,6 Ha 1000. no .QaHHbIM QTqeTa PaOoqeH rpynm,i I30'3 ( 6), OT 4 .IlO 7% »!Bopo;'I.JleHHblX .lleTeH CTpa.Jl3IOT O,[ll-lHM HJIH HeCKO.rtbKHMH He.llOCTaTKaMH pa3JIH'iHOH creneHH T.R;'lecTH, KOTC>pble MOJKHO BblRBH'I'b npH po;'l.lleHHH H11H a paHHeM .lleTCKOM BOOpacre; 0,5% acex HOBOpo;'I.JleHHblX CTpa.llalOT xpoMOCOMHblMH HapymeHHRMH, a y 0,3-0,5% HOBOPO;'I.JleHHblX OTMeqalOTCR Oone3HH oOMeHa I"eHeTH'lecKOH 3THOnOrHH. l-i3BeCTHO, 'ITO npHO.11H3HTe.rtbHO 3% .lleTeH c-rpa,llalOT HapymeHHRMH co CTopoHhl ueHTl)aJlbHOH HepBHOH CHCTeMLI, TaKHMH, KaK 3rTHJ!eITCH.R, uepe0pam,Hb1'1 napaJ!Hq, l"'HJlPOUe<l>aJIHR, YMCTBeHHaR OTCTa.JIOCTb H He3Ha~e.rtbHble noape;'l.lleHHR M03I"a. 7 B3poc.1lble Pacnpoc-rpa.HeHHOCTb H '-laCTora HOBblX cnyqaeB OrpaHH'-leIDffl npHBbl'-IHOH .neR"reJlbHOCTH HJlH CHHlleIDffl TPY.llOCTIOCo0HOCTH. Pe3YJlbTaTbl oOcne.noBaIDffl ceMeH, ITPOBe.lleHHoro B BeJJHKo0pHTaHHH, nOKa3aJIH, '-ITO OCHOBHblMH npH'-IHHaMH HapYJlleHHH (!)H3H'-lecKoro xapaKTepa y B3POCJlblX C:l,1.11H Oone3HH KOCTHO-Mblllle'-IHOH CHCTell!l,I, 3aTeM co 3Ha'-IHTeJlbHblM pa3pblBOM cne.noBa.11H Oone3HH KPQBeHOCHOH CHCTeMbI, Oone3HH ueHT!)a.JlbHOi HepBHOH CHCTeMhl (HHcyJlbT, napKHHCOHH3M), Oone3HH opraHOB .IJ,lxaHHR H Oone3HH opraHOB qyBCTB (7). HeKorop1,1e )laHHble, B t.1aCTHOCTH ,llaHHble o ,mcne TTOJJy'-laIOblHX nocoOHR HHBaJlH.llOB B crpattax EBpollbl, CBH,lleTeJlbCTBYIOT, 'ITO OCHOBHblMH npHt.lHHaMH COUHaJlbHOH He.nOCTaTO'-IHOCTH C orpaHH'-leHHeM npHBbl'-IHOH .neR'reJn,HOCTH RBJUIIOTCJI TTCHXH'-lecKHe pacc-rpoHCTBa, cep.ne'-IHO-cocy,IlHCTble 3aOoneeaHHR H 0oJJe3HH opraHOB .llBHlleIDffl. no CTaTHCTH'-lecKMM ,llaHHLIM, npe.llC'raBJJeHHblM ¢>HHCKHM HHCTHTYTOM COUHaJlbHOro CTpaXOBaHHR, .I]OJJR 11HU, nOJJy'-laIOJ11HX neHCHIO no HHBa.11H,IIHOCTH, B rpynne HaceneHHR TPY.nocnocoOttoro B03paCTa B 1979 r. COCTaB.1VU"0 7,9%, a B 1980 r. - 7,7%. OCHOBHblMH npH'-IHHaMH BbmJJaTbl nocoOHH no HHBaJIHJlHOCTH B 1980 r. Obu1H TTCHXH'-leCl<He pacc-rpoHCTBa (29,8%), 3aTeM cne.[lOBaJJH Oone3HH KOCTHO-MWde'-IHOH CHCTeMW (23,9%) H cep.ne'-IHO-cocy,IlHCTble 3aOoneBa.HWl (22,3%). B TaOn. 2 npe.llC'raBJJeHbl CBe.lleHHR O npouei-rre JlHU, Koropt,le, KaK C'l.lno ycrattoBneHO B xo.ne nocne,IIHero oOcne.noBaHHR HaCeJJeHHR ¢,HHJlRH,[tHH, TTOJlHOCTblO YT!)a.THJlH TPYJlOCl1oco0HOCTb (HHCTHTYT COUHaJlbHOro crpaXOBaHHR, HeonyOJtHKOBaHHLie J]aHHble). CTocrynHJ10 coo(SmeHHe, '-ITO B lllBeUHH, HaceJJeHHe KorOpoH COCTaBJ111eT 8,3 MJJH. qeno:eeK, OKOJ10 500 000 qeJJOBeK B B03paCTe or 16 .no 64 neT CTpa.ilalOT (!)yHKUHOHaJlbHblMH ttapymeHHJ'IMH, npH'-leM npH0JJH3HTeJlbHO 100 000 H3 HHX HCilhlTblBaJOT 3aTPy,IIHeHHR npH BblTTOJlHeHHH TTOBCe.IIHeBHblX o0R3aHHOCTeH ( 9) . Ellef'O,IIHO or 135 000 .no 140 000 qeJJOBeK TTOJJy'-lalOT T!)a.BMl,l tta nPQH3BO.IlCTBe. OKOJJO 3000 H3 HHX HaBcer.na TepRJOT TPY.llocrtOCoOHOCTb, a TRlleJlble ¢>QPMbl COUHaJlbHOH tte.nOCTaTOq- HOCTH Pa3BHBalOTCR npHOJ1H3HTeJlbHO B 200 cnyqaruc (9). 8 01<0110 16 000 '-leJlOBeK e;,r;ero,IIHO nona,na.lOT B 0o.1IbHHUbl C 'fPaBMaMH B pe3y.1IbTaTe ,aopo;nio--rpaHcnopTHblX npoHC!llecTBHH, npH'-leM notrrH 50% H3 HHX na;,;e qepe3 5 neT nocne TPaBMhl BCe eine C'l'Pa,IlalOT OT ee nocne.acraHH ( 9 ) • My)K\{Wil,[ )f;eHIJlHHbl TaOn. 2. TipoueHT nHU, nOJIHOCTblO yTpaTHBIIHX TPY.IlOCI10Co0HOCTb 30-39 2,1 1,8 Bo3paCTHaR rpynna ( B ro.aax) 40-49 7,4 3,2 50-59 21,2 11, 1 nHUa noJnUioro 003pacra 60-64 37,8 15,7 H3MeHetnffl B BQ3paCTHOH CTPYKTYpe HaceneHHR K 2000 ro.ay. COI"JJaCHO ,llaHHl,IM OpI"aHH3aUHH OO'be,IlHHeHHhlX HauHH 0 nepcneKTHBHOM HC'-IHCJleHHH HaceneHHR, B OnHllaJilJ!He JIBa ,IleCRTHneTHR B 0o.1IblJIHHCTBe eBponeHCKHX CTpaH B03paCTeT .aonR nHU B B03paCTe 60 neT H CTaPIJle. KaK ~no 00,IlC'll-!TaHO, }( 2000 ro.ay ,nOJIR nHU 3Toro B03pacra cpe,llH HaceneHHR B uenoM B cpe,IIHeM COCTaBHT 18,2% - K011e0MCb OT 7,8% (B TypUHH) .llO 22,6% (B ~e.aepaTHBHOH PecnyOmu<e repMaHHH). COOTBeTCTBYJ(r IJIHH noKa3aTe.1Ib .Il1lR MYJl:l.lHH COCTaBHT 16,1% - OT 7,4% (B TypUHH) .no 20,6% (B nlOKceMOypre), a cpe.IlHJ,I.H nOKa3aTe.1Ib JlJlR J.eHlllHH, COI"JlaCHO nporn03aM, Oy,aeT paaeH 20,4% - OT 8, 2% (B TypUHH) .ao 25,6% (B ~e.aepaTHBHOH PecnyOJIHKe repMaHHH). B OT.Ile.Tibl-lblX CTpaHax '-IHCJlO nHU B B03pacre crapme 60 neT y .IlBOHTCR (AnOal-GiR, Hc.naH.llHR, TypUHR) , B TO BpeMR Kai< B .apyrnx CTpaHax HHKa1<oro yBenH'-leHHR He npe.anonaraeTCR (ABCTPHR, ~e.aepaTHBHaR PecnyOJlHKa repMaHHH, ll!BeUHR). HaHOonee EblCOKHe TeMllbl pocTa OllGf,llalOTCR B B03paCTHOH rpynne 85-90 neT. 9 Pacnpocrpa.HeHHOCTb H qacrOTa HOBl>IX CJTY',laeB Orpalfif'leHHR npHBbl'lHOH ,lleRTe.JlbHOCTH HJ1H CHHlleHHR TPY.IlOCTTOCo0HOCTH. 8 COOTBeTCTBHH C noKa3aTe.11RMH, pacc'llITaHHhIMH Ha OCHOBaJ-IHH ,naHHblx, nonytieHHblX B xo.ne MaCCOBOro oOcne.noBaHHR ceMeA B Coe,IIHHeHHOM KoponeBCTBe (7), pacnpoc-rpaHeHHOCTb onpe.neneHHhIX COCTORHHA, Bbl3b1BaKXIIHX OrpaHH'leHHe flPHBbl'lHOH .neRTe.JlbHOCTH HJlH CHHlleHHe TPY.IIOalOCoOHOCTH, cpe,IIH JlHU, flPOllGIBaKXIIHX .l]OMa, Bb!PallanaCb B cne.nyKXl!HX m,i>pax (Ha 10 000 HaceneHHR): HHcy.JlbT cnenOTa <1acnNHaR noTepR 3peHHR rnyxOTa <IaCTH'niaR nOTepR cnyxa COUHa.JlbHaR He,IIOCTaTO'IHOCTb MHOllecTBeHHOro xapaKTepa (.rnrua B B03paCTe 75 neT H craP111e) 25 20 40 5 70 200 BO.JlblllHHCTBO naUHeHTOB, nepeHE!CIJIHX HHcy.JlbT, a Tai<Jle .nHLta, <IaCTH'lHO y-rpaTHB111He 3peHHe H.11H cnyx, - JllO.IIH no;ninoro B03paCTa. CornacHo .l]aHHl>IM Toro lie Hccne.noBaHHR, no'ITH 2/3 H3 234 .11HU c TRllenhl.NH 4)opMaMH COUHa.JlbHOH He,IIOCTaTO'lHOCTH npH cf>H3H'lecKHX H ceHCopHblX Orpalfif'leHHRX, auraneHHhlX B cpe,IIHeM Ha 10 000 HaceneHHR, cOCTaBJlRIOT nHua B Boopacre CTa\Jllle 65 ne-r. qHCJD 11HU C pa3JIH'-D-lhlMH BH.naMH He,IlOCTaTO'lHOCTH BCJle,IlCTBHe Oone3HH Oblcrpo B03paCTaeT no Mepe YBeJIH'leHHR B03paCTa, H npH0.11H3HTe.JlbHO 1/3 .11HU B BQ3pacre 75 neT H crap111e, flPOllHBaJOlltHX .IIOMa, CTpa,llalOT KaKHM-nHOo HapymeHHeM, npHtieM )lOC'l'aTO'lHO cePl,e3HblM, tIToC'l.i coo011lHTb O HeM. TIOCK01tbKY 3.IleCb npocneJIHBaeTCR <IeTKaR KoppeJtRUHR C B03paCTOM, a Tai<lle B CBR3H C TeM, 'ITC noKa3aTe1IH OllGl,naeMOH npo,IIOJDnfTe.JlbHOCTH npe,IlCTORllleA JIH3HH ,IlnR lleHIJlH)-I Bblllle, He W3b!BaeT Y.IIHBJieHHR TOT <i>aKT, 'ITO TTO'ITH 2/3 cpe,IIH nHU C COUHaJlbHOH He,IIOCTaTO'lHOCTblO COCTaBJlRIOT lleHblHHbl, npHtieM MHOrHe H3 HHX B.IlOBbl HJlH O,IlHHOKHe. He,naBHO flPOBe,IleHHOO oOcne.noBaHHe penpe3eHTaTHBHOH Bbl- 0opKH HaceneHHR <i>HHJlRHJlHH (HHCTHTYT COUHaJlbHOro crpaxo- BaHHR, HeonyO.JlHl(oBaHHhle ,llaHlil,le) nOKa3aJ'IO, 'ITC no'ITH 1/3 MYllNHH H 1/5 lleHlllHH B BQ3pacre 65 neT C'IHTaJOT ceOR aOco- nJOTHO HecnocoCiHbl.NH K BblTTOnHeHHIO KaKOH C'I,( TO HH Oblno (f>H3H- 'lecKOH paOoTbl. 10 npHO.11H3HTem,HO 1/4 M,'ir;t.lHH H 1/3 llteHlllHJ-1 CooOinHJlH, \ITO npeo.noneHHe HecJ<OJU,KHX necTHJ,NHJ,IX MaPllleH RBJlReTCR .llJ1R HHX O'-lel-lb T.flltenoo Harpy3KOH, a xo.m,Oa Ha paCCTORHHe 500 M Bbl3WBa.1la onpe.neneHHWe 3aTPy.llHeHHR npHOnJ.i3HTem,Ho y 2/5 MYgqJ,f}i Hy eme Oo.rn,mero '-!Mena i,;:eHlJlHH. rettepam,Ha.11 yOopKa Y ceOR .llOMa OKa3aJiaCb O'-lel-lb TPY .llHOH HJlH .aai,;:e HenOCHJU,HOH 3a,lla'-leH npH0.11H3HTem,HO .llJ1R 2/5 M,';f;'&IH H nonOBHHbl JKeHlJlHH. 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O~He noKa3aTenH CMepTHOCTH B Te'-leHHe 1 ro.na nocne nepetteceHHoro HKi>apKTa (c Y'-leTOM nHU, CKOH'-laBIIIHXCR .ao npH~THR B Oom,HHUY) 00.11H BLICOKHMH - 77% .llJ1R MYJJ'-IHH H 76% .llJ1R ;ir;:eHlJlHH. 9TH lfflPLI MOr"YT ~Tb 3Ha'IHTeJU,HO l:l,llde, '-leM B .llPYrHX eaponeHCKHX CTpaHax. Y mru, BbllltHBIIIHX nocne nepetteceHHoro Hl-fi>apKTa MHOKap.na, '-!aCTO pa3BHBalOTCR OrpaHH'-leHHR npHBLl'IHOH .neRTeJU,HOCTH HJ1H CHHJKeHHe TPY.llOCnOCoOHOCTH, a TaJ<.llte COUHaJlbHaR He,llOCTaTO'-IHOCTb B pe3ym,TaTe OrpaHH'-leHHR Mo0Hm,HOCTH, o0yCJJOBneHHoro OoJtRMH B r'PY.llH HJlH OJ]bll!IKOH, TeM He MeHee MHOrHe H3 HHX coxpaHRJOT cnocoOHOCTb BecTH OTHOCHTem,HO He3aBHCHMYIO lltH3Hb. CornacHo oueHKaM, ro.noBOH noKa3aTem, t.1aCTOTbl HOBl>IX CJJY'-laeB HHcynbTa Ha 1000 '-leJlOBeK HaceneHHR B B03paCTHOH rpyrme 65-74 ro.na COC"raBJllleT 9, a B B03paCTHOH rpynne 75-84 ro.aa - 20, a B aoopaCTHoH rpynne 85 ne-r H craP111e 40 ( 11). Cpe,llHee BpeMR BbllltHBaHHR COCTaBnRnO 3-4 ro.na. nOCKom,Ky OonbHWe, nepeHecmHe HHcym,T, t.1acro crpa,naJOT conyTCTBYKIIIHMH HapY111eHH.RMH, TaJ<HMH, KaJ< ceHCopHble 11 paccrpci;{crBa, cep,ne'ffian He.nocraTOttHOCTb H ocreoap-rpo3, COUHa.JlbHaR He.nocraTOttHOCTb y 1-IIDC ttaCTO ,IIOCTHraeT TRllenoA CTeneHH, ec11H CBOE!BpeMeHHO He npoBO,IlRTCR HeoOXO,IlHMLle MeponpHRTHR no peaOH.11HTaumi. flHua C On,aHHtteHHRMH npHB&I'IHOH .neRTeJlbHOCTH HJlH CHHlleHHeM TPY.IlOCOOCOOHOCTH B oC'ilnecTBe IlpoOneMLI nHU C orpaHJ.NeHHRMH npHBblttHOH .neRTeJlbHOCTH HJlH CHHlleHHeM TPY.IlocnOCOOHOCTH, C 0,I]HOH CTOpoHbl, CBR3aHhl C xapaKTepoM H cTeneHbJO <?>YHKUHOHa.JlbHblX orpaHJ.NeHHH, ooycnoBJJeHHblX TeMH HJ1H HHblMH HapymeHHJDUi, a c .npyroH - c CCUHa.JlbHblMH OTHCIJleHHRMH H opraHH3aUHOHHOH CTPYl<TYPC>H OO!necTBa. cl>YHJ<UHOHaJlbHble orpaHHtteHHR npoRBJUDOTCR B OCHOBHOM npH CHHlleHHH noJ<OMOTopHhIX, ceHCOPHblX H YMCTBeHHhlX cnocoOHocreA, l<OTOpoe Hepe.IIJ(O ocnOlKHReTCR JlPYrHMH HapymeHHRMH, ttTO npHBO,llHT I< otteHb ce!)be3HblM OrpaHHqeHHRM npHBblttHOH .neRTeJlbHOCTH HJlH CHH)l(eHHJO TPY.IlOCT1oco0HOCTH, a Ta1<lle I< COUHaJlbHOH He.nocraTO'IHOCTH, oOycnoBneHHhIM ue.llb!M l<OMnne1<COM npw.nrn. 0.IIHaKO ttaCTO npoOneMbl, c l<OTopt,IMH CTaJil<HBalOTCR .rnrua c orpaHHtteHHRMH npHBbl'IHOH .neRTeJlbHOCTH HJlH CHHlleHHeM TPY.IlOCOOCOOHOCTH, B r'OPa3.IlO OoJlbDJeH creneHH Bbl3BaHbl rnyOo1<0 YJ<opeHHBIIIHMCR HeraTHBHblM OTHOllleHHeM oC'llneCTBa, BCne.nCTBHe ttero TaKHX n10.neA Hepe.IIJ(O OTCTpaH.RIOT OT OOJlHOUeHHoro yqaCTHR B JIH3HH oC'ilnecTBa, .11HlllaR HX npaB, l<OTOPblMH OOJta,llaJOT 3,IlopoBbie nJO,IlH. 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B TOM cnyqae, ec1lH ttenOBeK C orpaHHtteHHR:MH npHBblttHOH .neRTeJlbHOCTH HJlH CHHlleHHeM TPY.IlOCOOCOOHOCTH oOna,llaeT cnocoOHOCTblO I< BOCCTaHOBJleHHIO <f>yHJ<UHH, OH ttaCTO B 12 COCTORHHH npeo,nonen, HJIH no KpaaHeH Mepe CHH3HTb B03,neHCTBHe <l>aKTopoB, npHBOJlFlblHX K no,noOHblM HapYllleHHffM. nonOl!CHTeJlbHOO HJIH OTPHUaTeJlbHOO pe111eHHe 3TOro aonpoca 3aBHCHT OT uenoro pR,lla ycnOBHH, TaKHX, KaK (6): HaJlH'llie H npHeMneMOCTb a.llbTepHaTHBHblX MO,neneH noBe.neHHR cnocoOHOCTH H HaBblKH JIHU C Or,:>aHH'{eHHRMH npHBbltffiOH .neRTeJlbHOCTH HJIH CHHllteHHeM TPY.nocnocoOHOCTH, HeoOXO.ItHMble HM .nnn Toro, ~ wpaOO'raTb a.llbTepHaTHBHLle MO,neJIH noBe.neHHR nCHXonorn'lea<an npHcnocoOnneMOCTb JIHU c OrpaHH'{eHHRMH npHBbl"-OiOH .neRTeJlbHOCTH HJIH CHHllteHHeM TPY.nocnocoOHOCTH .MRn<oe, COCTpa,!laTe.llbHOO OTHOllleHHe 'VleHOB oOnecTBa, B KOTopoM lltHBYT .TIMua C OrpaHH'{eHHRMH npHBbltffiOH .neRTeJlbHOCTH HJIM CHHllteHHeM TPY .oocnocoOHOCTH. Het<OTQpl,le npoOneMbl JlHU C OrpaHH'{eHHRMH npHWtffiOH .neRTeJlbHOCTH HJIH CHHllteHHeM Tpy,nocnocoOHOCTH CBR3a.Hbl C B03paCTOM, n03TOMY HHJle Mbl oOcy,ItHM OT,neJibHLle cne~H'ieCKHe npoOneMd .neTeA H JIHU nolGfnoro 003pacra. HeKoropwe npoOneMbl Henocpe,ncTBeHHo CBR3aHbl c Or,:>aHH'{eHHRMH, KOTopwe He n03BOJlRIOT peOeHKY no.n.neplltHBaTb H~MaJibHLle OTHOllleHHR C .llPYrHMH ,nen,MH, a TaKllte npHHHMaTb Y'{aCTHe B COUHaJlbHOH lltH3HH H B npouecce oOyqeHHR B oObi'iHOM .ll11R .neTeH ,IJa.HHOro B03paCTa oO'.beMe. OTHOllleHHe po,ItHTeneH K ,neTRM C OrpaHH'{eHHRMH npHBbltffiOH .neRTeJlbHOCTH HJIH CliHllteHHeM TPY.nocnocoOHOCTH .RBJlReTCR O,nHHM H3 Ha.J-!Oonee BalltHLIX <!)al<TopoB, onpe,neJlRJ<XllHX Bnocne.l]CTBHH npHcnocoOnReMOCTb pe0eHKa K lltH3HH oOnlecrBa. 9To OTHOIIJeHHe <l>OPMHPYeTCR no.n B03,neHCTBHeM MHOI"HX ¢>aKTOpQB, TaKHX, KaK JlH'.IHOCTb po,ItHTeneH, HX npe,nw.IlYJllHH OTTWT, KaCalOIIIHHCR OrpaHH'{eHHH npHBbi'IHOH .neRTeJlbHOCTH HJIH CHHllteHHR TPY .nocnocoOHOCTH, creneHb orpaHJ.NeHHH npHBbl"-OiOH .neRTe.TlbHOCTH HJIH CHHllteHHR TPY.nocnocoOHOCTH. Hea,neKBaTHoe HJIH HenpaBHJlbHoe OTHOllleHHe MOllteT BLlpa3HTbCR B qp€3MepHOH oneKe pe0eHKa H nopo,ItHTb npoOneMil 3MOUHOHa.llbHOro xapaJ<Tepa, HanpHMep, pa3BHTb Y 13 peOeHJ<a tzyBCTBO 3aBHCHMOCnl H cnocoOcTBOBaTb ero He3penocTH. Co BpeMeHeM nocne,llCTBHFi TaKOI'"O OTHOllleHHR OyJJYT ycyryOmrrbcR, ec.11H He npHHRTb Mepbl, HanpaBneHHble Ha HX yc-i,:,atteHHe. Pai-n,me peOeHJ<y C OI"paHH'{eHHRMH npHBbltniOH ,lleRTeJll:,HOCTH H.1lH CHHlleHHeM TPY.llocnOCOOHOCTH qac-ro He Pa3penta.11H nocemaTb DlKOny ( H.11H lie OH CaM Obin He B COCTORHHH nocemaTb ee) , ~o npHBO,llHJlO K HeOnaronpHRTHblM ,llnFi Hero nocne,llC'rBH.RM HK COUHaJll:,HOH He,llOCTaTOtniOCTH B BH,lle orpaHH'{eHHR BblC'>opa 3aHRTHFi B nocne,llylalleH l!Gf3HH. Yqeoa B 111Kone RBnReTCR .IPMHHHPYIOMHM (l)a.KTOpoM B nepHO.ll .lleTCTBa, nOOTOMy nocemeHHe DlKOJlbl (no B03MO.llHOCTH OOiltniOH) cne,llyeT CtnITaTb O,llHHM H3 OCHOBHblX npaB )le'TeH C orpaHHqeHHRMH npHBbltniOH ,lleRTeJll:,HOCTH H.11H CHHlleHHeM TPY.llOCllOCo0HOCTH. JIHUa nolltHnoro Boopac-ra JIHua nolltHnoro B03pac-ra qacTo BOCnpHHHMalOT MHorne H3 B03HHKaIOblHX y HHX OrpaHH'{eHHH npHBbltniOH ,lleRTeJll:,HOCTH HJlH CHIDiteHHe 'IPY.llOCnocoOHOCTH KaK ecTecTBeHHble CJle.llCTBHFi npouecca c-rapeHHR. 0,llHal(O .llnR HHX xapaJ<TepHbl tzyBC'rBO HeyBepeHHOCTH H ,llenpeCCHR, ~o qacTO Cl,iBaeT oOycnoBneHO OrpaHH'{eHHRMH npHBbNHOH ,lleRTeJll:,HOCTH, CBR.3aHHblMH co CHHlleHHeM cnocoOHOCTH KOMMyHHKaUHH H nOKOMOTQPHOH cnocoOHOCTH, KOTOPble npHBO,JlRT K COUHaJll:,HOH H30IUfilHH. CTapOCTH, a e111e Oonee OrpaHH'{eHHRM npHBbltniOH ,lleRTeJIJ:,HOCTH H.11H CHHlleHHlO TPY.llocnocoOHOCTH H COUHaJIE,HOH He,llOCTaTOtniOCTH, pa.3BHBal<l!1HMCFi y .1lHU nOl!GfnOro B03pacTa, qac-ro CO[l)"rC'rBYIOT COUHaJIE,Hble e-i,:>ecCbl, B03HHKaIOIJIHe acne.llC'rBHe H3MeHeHHR .llOXO,llOB H ~ecTBeHHOro c-raTYca, npoOneMbl B3aHMOOTH<:meHHA MelKJlY .11HuaMH nollHJloro Boopac-ra H tUJeHaMH HX ceMeH, a TaKlle npoOneMbl npeo,llOneHHR npenRTC'rBHH ,llnFi nepe,ItBHlleHHR B noMemeHHRX H Ha OTKPblTOM B03JlYXe. C'Il)eCC MOJ!YT ycyryOHTb nocne,llCTBHFi HaPYllleHHH cf)H3HqecKoro H.1lH nOf}CH'qecKOro xapaJ<Tepa H OrpaHH'ieHHH npHBbNHOH ,lleRTeJll:,HOCTH H.1lH CHHlleHHR 'IPY.llOCnocoOHOCTH, B qac-rHOCTH, ycyryOHTb npoOneMbl nCHXl,f'qecJ<Oro 3.llOPQBbR. 14 npeJlYYlPeJK.l]eHHe CJJY'<aeB orpamNeHHl':i npHBbltniOl':i ,IleRTeJibHOCTH HJ1H CHHJKeHWI TPY .l]OCnocoOHOCTH nepBb!l':i ypoBeHb npQi>HJlaKTHl<H npoi>HJ1aKTHJ<e nepooro ypoBHR cne.eyeT Y.Ile.nRTb nepBOOqepe.IIHoe BHHMaHHe BO Bex B03pacTHblx rpynnax. 3To HaHOoJiee .IJel':iCTBeHHaR c-rpa.TernR, n03B0.1lffiallaR CHH3HTb HeOnaronpwrrHble nocne,IlCTBHR OrpaHH'iemil':i ITPHBbl'-lHOH ,IleRTeJibHOCTH HJlH CHHJKeHHR TPY .l]OCTIOCo0HOCTH. ,llM ,IlOCTHJleHHR 3TOl':i ueJIH, KOHe'-lHO, BalKHbl BCe MeponpHRTHR, npoBO,IlHMble B ceKTope oO!aecTBeHHOI"O 3,Ilpa.BOO:xpaHeHHR C ueJibIO yKpenJieHHR 3,IlQpOB!,R B ueJIOM, O,IlHaKO B Oy.JlYllleM HeoOXO,IlHMO pa3paOoraTh H ocyll!ecTBJlRTb H HeKOTOPble cne~HtiecKHe MeponpWITHR, TaKHe, Kai<: npo!)HJiaKTHJ<a ri.iTOBLIX TPa,BM, HectiaCTHl,IX CJiytiaeB Ha ,Iloporax H Ha npoH3 BO,IlCTBe CHHllteHHe HeOnaronpHRTHOro B03,Ilel':iCTBHR ¢1aKTOpoB OKpygannel':i cpe.m,i cmmeHHR ,IleHCTBHR nCHXOCOUHaJlbHhlX CTpeCCOB H .IJPYn-OC <?>al<TopoB, npe,!]CTaB1lR!Oll1HX yrpo3y .l]JlR nCHXH'ieCJ<Or'O 3.00PQB!>R npo!)HJlaKTHKa xpoHHtiecJ<HX 0oJle3Hel':i, TaKHX, Kai< H111eM1-NecKaR Oone3Hb cep,IIUa, HapymeHHR M03 roooro KpoB000paineHHR H nmepTeH3HR; - a.l]eKBaTHoe JietieHHe xpQHH'leCJ<HX 0oJie3HeH B ueJIRX npo!)HJiaKTHKH pa3BHTHR HapymeHHl':i <l>H3HtiecJ<Oro HJlH nCHXH'ieCJ<Oro xapaJ<Tepa HJ1H CHHllteHHR tiHCJia HX CJJY'<aeB. nOCKOJlbKY npoXO,IlHT HeCJ<OJlbKO ,IlecRTHJieTHl':i, npelK,Ile tieM xpoHHtieCKHe 3aOoneBaHHR pa30Bf>IOTCR HaCTOJibKO, tiTO nPQRBRTCR BCe CBOl':iCTBeHHble HM KJIHHH'iecKHe ITPH3HaKH, T.e. ,llOCTHrayT TOH CTa.,IU,fH, npH KOTopOH OHH HeH30e»JO npHBO,IlRT K HapymeHHRM <l>H3HtiecJ<Oro HJlH nCHXH'ieCJ<Oro xapaJ<Tepa, K OI"paHH'leHHRM ITPHBLl'-lHOO ,IleRTeJlbHOCTH HJlH CHHJKeHHIO TPY.IlOCnocoOHOCTH, a TaKJKe K COUHaJlbHOH He.l]OCTaTO'-lHOCTH, HX npo!)HJiaKTHKY cne.eyeT HatiHHaTh B paHHeM .l]eTCTBe, cnocoOcTBYR TOMy, tiT<nl peOeHOK BeJl 3,IlOp()Bbll':i oOpa3 JKH3HH. 15 JleTH. B EBponeACKoM pernoHe Ta1rne HaHOo.nee BalKHl,Ie .Il.l1R pa3BHBaia!IHXCR C-rpa}i np!NHHhl Orpa.Hl-NeHHH npHBbl'-OiOH .neRTe.1lbHOCTH HJlH CHHllteHHR TPY .nocnocoOHOCTH, KaJ< He.nOCTa- TO'-OiOCTb rnITaHHR, HKf>eKUHOHHhle Oone3HH H Hey,ooBneTBOPH- Te.1lbHaR Me.llHl.niHCKaR nOMOll[b xteHlllHHaM B nepHHaTaJlbHb!H ne- PHO.n pe.nKO cnylltaT npH'UiHOH B03HHKHOBeHHR nOCTORHHLIX Orpa.HHqeHHH npHBbl'-OiOO .neRTeJlbHOCTH HJlH CHHllteHHR -rpy.nocnocoOHOCTH. 0.nHaKO B c-rpa.Hax 3TOro PeI"'HOHa cytllecTBylOT .llPYI"'He <l)a.KTOpt,l, KOTOPl>le HeoOXO,llHMO TIJlaTeJlbHO paccMOTpeTb B ueruuc npe.nynpe,t;,neHHR cnyqaea orpa.Hl-NeHHR npHBbl'-OiOO .neRTeJlbHOCTH HJ1H CHHllteHHR TPY .nocnocoOHOCTH B ,neTCKOM B03paCTe. Cel)be3Hoe BHHMaHHe n03TOMY HYltHO y,nemn'b Ta.KHN BOnpocaM, KaK: npoBe.neHHe KOHcyJlbTaI.IHH no reHeTINeCKHM npoOneMaM BaKUHHauHR npOTHB KpaCHYXH BCeX HeHMMyHH3HPOBaJ-IHb!X .neBOqeK nO,llpOCTKOBOro B03paCTa YJ(penneHHe ceMbH, 3ail1HTa .neTeH H OKa3aHHe HM no.nepxtKH Ha ypoBHe oO!nHHl,i ~HJJaKTHJ<a HecqaCTHhlX cnyqaeB .noMa, B mKone H Ha .noporax, BKJl}()qa.R npocBeTHTeJlbHytO paOoTy ~HJJaKTHJ<a HaPKOMaHHH H 3noyno-rpeOneHHR anKoroneM 3'W>eKTHBHoe neqeHHe OCTpt,IX HKf>eKUHOHHblX 3aOoneBa.HHH B ueJV'[){ npe.nynpe,t;,neHHR HX xpoH!NeCKHX npo,oonxteHHH HMMyHH3aUHR, 83poc.Jible. TIOMHMO npe.nynpe,t;,neHHR B03.neHCTBHR Bpe,IIl-lblX <l>aJ<TOPOB ITPOH3BO,IlCTBeHHOO cpe,llbl, Heo0XO,llHMO pa3paOoTaTb H CTaH,[lapn130BaTb MeTO,llbl ENRBneHHR BCex BH.nOB <l>aKTOpQB OKPYJKaI<llteH cpe.ll,I H oueHKH HX B03,neHCTBHR Ha OnarocOCTORHHe paOoTaJOIIIHX, A.neKBaTHble H :eceoO'.oeMJU0111He cnylltObi rnrneHbl TPY.llci .nonJIHbl cne.mrn, 3a YCJlOBHRMH Ha BCeX paOotrnX MeCTax. 9TOT :eonpoc He.aaBHO oOcyllt,nana PaOoqa.R rpynna 803 (12). Jim.a nolltHnoro B03paCTa, HacTYnJieHHe CTapoCTH npe,OOTBpaTHTb HeB03MOltHO, O.nHaKO cne,eyeT Ha.HTH cnocoObi 16 npe,IlYnpe!UleHH.R npoOneM nommoro B03paCTa, KaK coUHaJibHhlX, TaK H Me,llHUHHCKHX, HnH cnocoClil CHH;iKeHH.R HX OCTPOTl,I. Ha nepBblH nnaH C1Ie,IlYeT B,I,UBHHYTh npcx::aenrreJibttylO paOoTy, B xo.ne KOTOP<JH HaceneHHIO Oy,IlYT oOnRCH.RTb, KaKHM o0pa30M nyqme BCero CllpaBH'l'bC.R C B03HHKalOl!lHMH C B03paCTOM npoOneMaMH, HeoOxo,nHMo wpaOaran, y mo.neA nono;iKHTeJibHoe OTHOl!leHHe 1< nocne.nHHM ro,naM ffl3HH H .aoOH'l'bc.R Toro, trroClil OHH COxpaHHnH Mal<CHMaJlbHO B03MOmiYJO CTeneHb He3aBHCHMOCTH (13). npo0ne.M1>1 ncHXH'-lea<oro 3,nopom,.R, KOTO(Jlde, KaK OTMe<1anOCb pa.Hee, qacro B03HHKaIOT BCJie,UCTBHe COUHaJibHhlX CTpeCCOB, B03,UeHCTBYIOIIIHX Ha nHU nOlPJ.iJ!Oro B03paCTa, <laCTO MOlKHO pe!IIHTh nyTeM npoae,neHH.R COOTBeTCTBYIOIIIHX MeponpHffTHH, HanpaBneHHblx Ha yMeHbmeHHe CTeneHH COUHaJU,HOH H30J1.Rl.lHH npecrape.11,1x H yCTpaHeHHe ,npyrHX HeOnaronpH.RTHblX <J>aKTopoB, CBR3aHHhlx CO crapocn,10. B 9TOM OTHOl!eHHH none3HOH OKa3aJlaCb paOara cneUHa.TlbHblX ,ntteBHblX ueHTPQB, npe.nocTaBJ1RIOIUHX JIHI.JaM no;iKHnoro B03paCTa B03MO;iKHOCTh 3aHHMaTbC.R .moOHMblN .nenoM, noce111an, Pa3nH<1Hble Kypcb[, nonyqan, ct,H3HOTepaneBTJNecKoe ne<1eHHe, tnITaTh JJHTepaTYPY H T,,n, O.ntto H3 TaKHX yqpeJt,DeHHH - UeHTP Sonja Renie-Onstad B Hopaen01 - npe,nCTaBJI.ReT coOoA npHJOT .nn.R J1Hll no;iKHnoro BCY3paCTa, B KOTQPOM oOcny;iKHBalOT He TOJibKO ero oOHTaTeneH, HOH npecrape.111,1x, npomBaXXIIHX no0nH30CTH, Ha.nnellalllee BHHMaHHe cne,IlYeT y,nenHTh TaK;iii:e npe,nynpe;iii:.neHHIO Hec<1aCTHblX cnyqaes cpe.JlH J1Hll nolPJ.iJ!oro BCY3paCTa, qacro HCilblTb!BaJOll1HX npHCTyTlbl I"OOOBOKpy;iii:eHH.R H nOTepH paBHOBeCH.R H n09TOMY no.naep;,ii:eHHl,[X pa3Jll,NHh[M TpaBMaM, B TOM t{HC]Ie nepenoMy meHKH Oe,npa, <ITO npHBO,llHT !( orpaHH<leHH.RM npHBbl<IHOH .ne.RTeJibHOCTH HnH CHH;iKeHHIO -rpy,nocnocoOHOCTH, a TaK)l(e !( COUHaJibHOH He.nocraTO<IHOCTH, BTQPOfl ypo:eeHb f1J)CA>HJJaKTHKH HeoOxo,llHMO pacnooHasan, HapymeHHR ¢H3J.Nec1<oro HnH TTCHXHtlecKOro xapaKTepa KaK MOllHO paHbme, t{TQCl,i OHH He npHBenH !( o~eHHRM npHBbl<IHOA ,ne.RTeJibHOCTH HnH CHH)l(eIDOO -rpy,nocnocoOHOCTH, KOTQPble noMemaIOT HH.llHBH.!lYYMY .IleHCTBOBa.Th TaKHM oOpa30M H B TaKHX paMKax, l<OTOP,Ie C<IHTaIOTC.R ,nn.R Hero HopMaJibHblMH, Me-ro.m,i paHHero Bbl.RBneHH.R COUHaJibHOfl He,nocTaTO<IHOCTH y .ne-refl OblnH no,npo0HO o0cy)l(,lleHbl B He.naBHO 17 onyOmu<OBaJiHOM OT'leTe PaOot.leH rpyrnn,1 !303 ( 6). MHorne H3 H3nOl!eHHNx TaM npHHUHTTOB npHMeHHMbl TaKJ!e K B3pocJlbIM H K .m-iuaM nollHJlOro B03pacra. IlporpaMMbl BblRBneHHR HaPY111eHHH $H3H'-leCKoro HJIH OCH~eci<oro xapai<Tepa .llOJU!Oibl orpaHJ.f'-lHBaThCR BblRMeHHeM qeTl(O oxapaKTepH30BaHHhlX COCTORHH11, JlJ1R KOTOPhlX HMeIOTCR COOTBeTCTJ3Yl(XllHe MeTO,IJ,1 ne'-leHHR, KJ)OMe roro, OHH .00.1DIOihl ~Th MaKCHMaJlbHO npocTblMH H ra~HMH. nporpaMMbl CKPHHHHra He cne.oyeT BHe.opRTh Oe3 yqeTa OCHXOnOn-NeCKHX nocne.ocraHA. Cne.oyeT noanpRTb ai<THBHhlH no.oxo.o cnyl!O nepBINHOH Me,llHKCrcaHHTapHOH OOMallH K pa3paOoTl<e COOTBeTCTBYiallHX MeT0.00B BblRBJieH}ffl HaPYllleHHH <l>H3H'-leCKOro HJIH OCHXH'-lecKOro xapaKTepa, npe.oycMaTPHBaIOlllHX TaKl!e yqaCTHe po.mrreneA H .opyrnx t.lneHOB ceMbH. TpeTHH ypoBeHb npol>HJJaKTHKH OcHOBHaR 3a.oaqa npol>mlal<TH'-lecKOH paOon,t Ha -rpen,eM ypoaHe 3aJ<,moqaeTCR B TOM, '-l'!oC'l.i npe.oynpe,IlHTh nepexo.o orpaHH'-leHHH npHBbl'-lHOH .oeRTeJlbHOCTH HJIH CHHl!eHHR -rpy.nocnocoOHocTH B COUHaJlbHYJ() He.OOCTaTO'-lHOCTb, T.e. H30el!a.Tb nocne.ocTBHH, KOTop1,1e noMemaIOT HH.IlHBHJlYYMy BblOOJIHRTb B oOuiecr:ee HCIPMaJlbHYIO Jl]1R Hero poJlb. HeoOXO.l]HMhle Jl]1R 9TOI'O Mepl,I oC'l.i'-lHO COBna.naIOT C MepaMH, npHMeHReMhlMH Jl]1R peaOHJIHTauHH .m-iu C OrpaHH'-leHHRMH npHBbl'-lHOH ,lleRTeJlbHOCTH HJIH CHHl!eHHeM TPY.OocnOCoOHOCTH. 0.JJHaKO cne.oyeT no,oqepKHYTh npol>Hnai<nNecKHH acneKT 9TOH .neRTeJlbHOCTH, nOCKOJlbKY OH HaKJTa.ID,IBaeT Ha ace npoBO,IlHMble MeponpHIITW'I onpe.oeneHHhlH OTTlet.laTOK, B '-laCTHOCTH, npHMepOM MOl!eT cnymn, coopyl!eHHe HOBblX oCS!necTBeHHblX 3,llaHHH H llGUlblX .OOMOB C npHMeHeHHeM Tai< Ha3hlBaeMoro Oecnperpa,llHoro npHHmma, '-lTO 003B011ReT MHOOiM m-iuaM CO CHHJ!eHHOH nOKOMOTopHGI cnocoOHOCTblO H30e;ilan, COUHaJlbHOH He.OOCTaTO'IHOCTH Ha not.lBe orpaHH'-leHHR MoOHJlbHOCTH. OcoOoe BHHMa.HHe cne.oyeT Tai<l!e y,oe.m-tTh aonpocy yCTpaHeHHR yl!e cyntecTBYlOlllHX nperpa.o JlJ1R nepe.oaH;-,;eHHR, oOycnoaneHHhlX apXHTeKTYPHhlMH ocoOeHHOCTRMH 3,naHHH. B03MOmiO, notta.ooOHTcR COOT:eeTCTBYIO!Jlee 3aKOHO,llaTeJlbCTBO B no.o.oepl!Ky Oecnperpa.JJHoro npHHmma CTPOHTeJlbCTBa 3.naHHH. Eme O.llHH cnocoO npe.oynpe)!.lleHHR cnyqaea COUHaJlbHOH He.oOCTaTO'-lHOCTH HJIH cHHl!eHHR ee creneHH - H3MeHeHHe 18 HeranraHoro OTHCtlleHHR oOtaecTBa K mma.M C OrpaHJ-NeHHRMH npHBbl'lHOH .neRTe.TlbHOCTH HJlH CHHllteHHeM TPY.Ilcx:::nOCOOHOCTH. TTpe.nynpeg,naTb noMe111eHHe JIHU C TeMH HJIH HHblMH HaPY!lleHHRMH a cneUHaJIH3HPQBaHHhle yqpeg,neHHR Ha .nonn-iH cpoK ( T • e. He .I]OnyCKaTb HX H3O11RUHH err oCilnecrBa ) - BallHaR 3a,aaqa, Kcrropy~ cne.nyeT pe111aTb C nOMOIIIb~ cocrrBeTCTBYIOlllKX MeP, no.noOHblX MepaM, omicaHHblM B He,IIaBHO BblilYllleHHOH nyOmu<auHH 803 ( 14). 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OCHOBHaR 3a;::iaqa peaOH.miTaUHH - B03BPaJlleHHe K HOPMaJlbHOH llH3HH B oObtecTBe, .UM JIHU TPY.IIOCTToco0HOr'O BQ3pacra O,IlHOH H3 r'JJaBHblX ueneH MOllHO cqHTaTb yqacTHe B TPY.OOBOH .oeRTeJlbHOCTH, 8 KatlecTBe nepeooqepe,IlHOH 3a.natfli cne.oyeT K3MeTHTb npol>eccHOHanbHYJO peaOHnHTaJ.ll,flO H Tpy.ooycrpoACTBO, O,llHaKO Heo0XO.IlHMO cpa:3y tfeTKO Or'OBOPHTb, ~o HeJlb3R nepeoueHHBaTb 3HatfeHHe paOon,i KaJ< TaJ<OBOH B KatlecTBe KOHe'-OiOH uenH ycnemHOH peaOHJlHTaUHH, HyllHO no.oqepKHYTb, ~o BallHOH 3a,naqeH peaOlinHTaUHH B TeX cnyqa,oc:, Kor.ra nHua C orpam,iqeHHRMH npHBbltniOH .oeRTeJlbHOCTH HnH CHHlleHHeM TPY.aocnOCoOHOCTH He B COCTORHHH BePHYTbCR K paOO're, RBnReTCR ynyq111eHHe Kat1ecrsa llH3HH, 4acro MR roro, tfToObi peanoHo onpe.IIenHTb npHro.IlHOCTb nauHeHTa K TPY.OOBOH .oeRTeJlbHOCTH, -rpe0yeTCR TlllaTeJlbHoe oOcne.oosaHHe, npoBO,IlHMoe 0pHr'a.IIOH, B COCTaB KOTopoH BXO.I]HT Bpatf, paOO'rHHK COUHaJlbHOH nOMOIIIH Ii nCHXOJDr', npH no.II.IIeplltKe OT.IIeneHHR no oueHKe xapaKTepa paOon.I. 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XOTR B OyJlY!lleM nQTPeOHOCTb B TaKHX yqpe;!t.!leHHRX coxpamrrcR (a HHX OyJJYT OKa3blBaTb nOMOl!ll, JlHLtaM C HaHOonee CePbe3HblMH OrpaIDNeHHRMH), HenpaBHJlbHoe HX HCTTOJlb30BaHHe CTaBHT no.n yrpo3y .llOCTH)!eHHe COUHa.TibHOH HHTerpauHH, nOCKOJlbKY npHBO,IIHT K OTqy;!t.!leHHIO JlHU C orpaHJNeHH.RMH npHBblqHQH ,lleRTe.TibHOCTH HJlH CHH!teHHeM TPY.!locnocoCiHOCTH OT HX eC'reC'I'BeHHOro OKPY!teHHR, OT .!lOMa. EcJlH neqeHHe B cneUHanH3HPC)saHHOM yqpel!UleHHH HJlH B 0o.TibHHUe Heo0XO,llHMO, OHO .IlOJlllHO npoBO,llHTbCR B .MaKCHMa.TibHO CJlaTl,le cpoKH, trroCl.i y na.t.IHeHTa He ycneno ol>opMHposan,cR qyBCTBO 3aBHCHMOCTH. nHeBHble KJlHHHKH .!lnR JlHU nollCHJIOro B03paCTa HrpalOT BaJIHYIO pom, BO MHOr'HX esponeHCKHX CTpaHax. 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O.llHaKO Heo0XO,IlHMO ffCHO C03HaBaTb, 'ITO He3aBHCHMO OT Toro, cyJllecTBYIOT cny;,g('.";w peaOHJIHTaUHH H1IH HeT, orpaHH'leHHe llPHBbl'ffiOO .aeRTe.ltbHOCTH HJlH CHHl!eHHe TPY.IlOCTTOCo0HOCTH OT.IIe.ltbHblX 'IJleHOB oO!necTBa noXHTCff Ha Hero TfflleJlblM 0peMeHeM KaK B MaTepHaJibHOM, TaK H B COUHa.ltbHOM nnaHe, llPH'leM pacXO,ll,I, KOTQpl,le llPHXO,IlHTCff HecTH oOmecTBY, MOllHO 3HatrnTe.ltbHO COKpaTHTb C nOMOlltblO MeponpHRTHA no peaOHJIHTaUHH H nporpaMM no.Il,Ileplll<H ( 18) . npe,aynpellt,IleHHe cny'laeB Orpa.HH1.leHHH llPHBbl'llHOH ,IleffTe.ltbHOCTH HJ1H CHHlleHHff TPY .aocnocoOHOCTH Ha acex ypoaHffX, a TaKl!e paHHee BblffBneHHe H ne'leHHe HaPY!lleHHA, B03HHKIIIHX Bcne.IICTBHe 0one3HeH, HMeeT aa;nioe 3Ha'leHHe He TO.ltbKO H3 tniCTO ryMaHHblX cooOpalleHHH, HOH nOTOMy, 'ITO nOOBOJIReT CHH3HTb CTOHMOC'I'b 9TOH nOMOIIH. nocne,llHee ocoOeHHO BallHO B OTHOllleHHH mru MOJlO,IlOro BQ3pacra, HaXO.IlRIJlHXCff no.a yrpo300 pa3BHTiffl KaKOro-JlHOo xpoHH'lecKOro COCTORHHR, KOTopoe MOlleT C:l.!Tb COBMecTHMblM C )l11HTe.ltbHblM cpoKOM XH3HH. 25 PeaOH.JJHTal..lHR JJHU C orpamNeHHRMH npHBbNHOH .neRTe1IbHOCTH H.J1H CHHl!eHHeM TPY .nocnocoOHOCTH npeHMYJllecTBeHHO Ha ypoaHe oOl!!HHhl, a He B cneUHaJIH3HPOBaHHblX yqpei,;,neHH.RX, a TaKl!e HCTI01Ib30BaIDfe c.nylltO nepBH'DiOH Me,llHKO-CamITapHOH OOMODIH - ,neHCTBeHHble cnoc~I CHHl!eHH.R pacxo.noa, KOTOpble TTPHXO,llHTC.R HecTH o0ntecTBY B CBR3H C OrpaHH"ieHHeM npHBbltniOH .neRTe1IbHOCTH HJIH CHHl!eHHeM TPY.llOCllOCoOHOCTH ero tUieHOB, oco0eHHO y,.u.rrb!Ba.R B0'3paCTaianee trnCJlO J1HU OOllHJIOf'O B0'3paCTa, MHorne Hccne.noaaTeJJH .nena.11H nOl1blTKH npoaHa.11H3HPOBaTb COOTHOl!eHHe 3aTpaTbl-Bblf'O,I!,I npHMeHHTe1IbHO K MeponpH.RTHRM no peaOHJIHTaUHH, Hanpa.aneHHblM Ha BOCCTaHOBJleHHe TPY.llOBOH ,lle.RTeJibHOCTH .11HU C orpaffiNeHH.FlMH npHBbltniOH .neRTe1IbHOCTH H.J1H CHHXeHHeM TPYllOCnOCoOHOCTH, ,IlaHHble nocne,IlHHX Hccne,aoBaliHH n03BOJ1.RIOT npe.nnonol!HTb, qTQ oueHHBaTb 3TOT noKa3aTe1Ib TOJibKO C TO'll<H 3peHH.R 3KOHOMHKH TPY.llHO, B03MOl!HO, oOJJaCTblO, r.ne Hfil!OOJlee .RPKO npo.RBJl.ReTC.R npo.JlYKTHBHOCTb peaOHJlHTaUHOHHblX Mep, .RBJl.ReTC.R ,n0Ma111Hee OKPYl!eHHe, a He npOH3 BO,llCTBeHHa.R cpe.na ( 19 ) . 3TO BOBCe He 0'3Ha'-laeT, '-ITC He cne,nyeT 11blTBTbC.R ocyuieCTBJl.RTb ~ecCHOHaJibHYIO peaOHJJHTamno B TeX CJlyqa.RX, KOr.na OHa nOKa3aHa, TipocTO nOCKOJlbKY pecypa,i, Bbl,lleJ1.ReMb1e Ha MeponpH.RTH.R no peaOH.JJHTaI.lIDi, orpaffiNeHbl, Bepo.RTHO, cne,nyeT O'-leHb BHHMaTe1IbHO no.nxO.IIHTb I( HX pacnpe.neneHHIO, c-rpeM.RCb K TOMy, '-lToCl.i OKa3aTb nOMOl!lb !(al( MOXHO OOJlbllleMY '-lHCJlY .11HU C orpaffiNeHH.RMH npHBbl'lliOH ,ne.RTe1IbHOCTH H.1lH CHHl!eHHeM TPY.ll0Cl10Co0HOCTH, BcnoMoraTe1IhHbie cpe,ncraa, npHcnocoOneHH.R H oOopy,aoBaHHe B ueruuc oOecneqeHH.R .11HuaM c orpaHH'-leHH.RMH npHBbl'lliOH .neRTe1IbHOCTH H.J1H CHH~HHeM TPY.llOCllOCoOHOCTH !(al( MOJ!HO 001IbllleH caMOCTO.RTeJlbHOCTH cne,nyeT HCTIOJlb30BaTb pa3JllNHble cpe,ncTBa H npHcnocoOneHH.R .ll1IR JlH'-lHOro yxo.na, nepe.nBHXeHH.R, Be,nel-lWI ,n0Ma111Hero xooRHCTBa, oOrneHH.R H npoBe,neHH.R .nocyra (20). B HaCTO.Rlllee BpeM.R cymecreyeT MHOl!ecTBO TeXHH'-lecKHX cpe,ncrB - OT npocroro npHcnocoOneHHR .ll1IR XO.llbCJ.I .no CJlOl!HOro KOMrlJleKCHOro oOopy,nOBaHH.R. 0,llHaKO cne,nye-r no.INePKHYTb, qTQ npei,;,ne qeM npHMeH.RTb TO H.JJH ,npyroe yCTpoHCTBO, Heo0XO,llHMO npoBeCTH T!llaTe1IbHoe oOcne,noBaHHe 26 OoJlbHOro H 113y,.nrn, ero narpe0HOCTH. Ha peKOMeH.OaUHH MOl!eT OKa3aTb BJ1HRHHe JlH'lliOCTb HH,llHBH.IIYYMa, ero noOylK,JleHHJ'I H creneH:c HHTeJlJleKTYaJlbHOro pa3BHTH.R. TTauHeHTa HeoOXO,llHMO OOY'{HTb (ecJ1H B03MOJKHO, B .IIOMalllHHX YCJIOBHJIX) npaBHJlbHO noJlb30BaTbC.R np1-1cnocoOneHH.RMH. ECJIH y.uaeTC.R C,IIenaTb ycrpoHCTBa H npHcnocoOneHH.R, KO'rOpt,Ie Cb!J1H Obi ManO 0pocaJOIIIHMHC.R B r-na3a H npQCTblMH, TeM ~e, nOCKOJlbKY nHua C or-paHHqeHH.RMH npHBbNHOH ,IIe.RTeJlbHOCTH HJ1H CHHl!eHHeM TPY.IIocnocoOHOCTH H HX pQ.JJCTBeHHHKH, oqeBH.IIHO, OyJJ;yT cqffTaTb, qTQ OHH oOneMalO'l' l!H3Hb, a Ha.Illa 3a,naqa - C,IIenaTb HX l!H3Hb KaK MOl!HO Oonee oObl'lliOH. 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Bo ocex CJIYt{aRX, KOI"',lla 3TO BO3MOJPJiO, pea6HnHTaUHJO cne,nye-r npoBO,IIHTI,, HCTIOJlb3YR nO,IIXO.II C n03HUHH nepBHt{HOH Me,IIHKCr-CaHHTapHOH nOMOIIIH H o6ecne'-rnBa1l OXBaT ocero HaceneHHR. Cnylt~ peaOHJYHTaUHH HYllGiO C03,llaBaTb Ha Cia3e oO!nHH, npe,ItYCMaTPHBaR COOTBeTCTBYIOl!IHe CHCTeMhl KOHTPOM H KOHcyJlbTaTHBHOH nOMOIIIH H HCnOJlb3YR MHOI"'onpol>HJlbHblH no,IIXO.II, CTOJlb BalKHbl.H ,IIn1l npose,IIeHHR BCecTopoHHeH H BCeo0'.beM.TIIOllleH peaOHJYHTaUHH. Cne,IIyeT noanpRTb pemeHHe a,IIMHHHCTpaTHBHblX H opraHH3aUHOHHblX BOnpQCOB, CBR3aHHblX C npe.oynpellUleHHeM cnyqaeB Orpa.HHt{eHHH npHBbl'-OiOH ,IIeRTeJlbHOCTH H.1tH CHHlteHHR TPY.IIOCllOCo0HOCTH H peaOHJJHTaUHeH Jll,fU C TaJ<HMH o:rpaIDNeHHRMH, C 3TOH ueJlbJO CJle,ItYeT ocoOeHHO nOOlllPRTb Hccne,IIOBaHHR B oOJYaCTH cnyi,;O peaOHJJHTaUHH B CHCTeMe 3,llpaBOOxpaHeHHR. Hy;nJO npHHRTb BCe HeoOXO,llHMble Mepbl, t{T~ .ooOHTbCR nonHOUeHHoro yqaCTHJ'I JJHU C orpaIDNeHHRMH npHBbl'lliOH ,IIeRTeJlbHOCTH HnH CHHJteHHeM TPY .IIOCTIOCo0HOCTH B l!H3 HH oO!necTBa Ha paBHonpaBHOH OCHOBe. Bo BCeX CTPaHaX CJle,IIyeT npoBOJ]J,fTb nOnHTHKY, cnocoOcTsyJOmyJO COUHaJlbHOH HHTerpaUHH 42 Jil-!U C COUHa.JlbHOH He,.llOCTaTO'-iHOCTblO. Co6mo..lleHHe npHHUHTia ypaBHHBaHHR B npa:sax, npe,.ll[lonaral<lilero yc-rpaHeHHe npertRTCTBlffl K nom-ioueHHOMY y-qacTHJO Jil-!U C orpaHH'-ieHHRMH npHBbl'-iHOH ,.lleRTeJif>HOCTH HJlH CHH!CeHHeM TPY ,.llocnOCoOHOCTH B l!J.13HH oCmecT:sa, oOecne'-iHT HM Ta.Koe ;,;e Ka'-iecTBO JIIH3HH, KaJ< H BCeM ..llPYr'HM qneHaM oOIIlecTBa. Bann.1H HTOr' Mel!llYHapo,.llHOr'O r'O,.lla HHBaJil-1,.llOB 3aJ<Jil(JqaeTCR B TOM, '-iTO Heo,.llHOKPaTHO Cibma no.INePKHYTa Heo0XO,.llHMOCTb yBa!taTb npa:sa Jil-!U C orpaHH'-ieHHRMH npHBbl'-iHOH ,.lleRTeJif>HOCTH HJII-! CHH!CeHHeM TPY..llocnOCoOHOCTH. B pe3ym,TaTe TeMaTH'-iecKHX .IIHCKYCClffl ObJJil-1 nO,.llHRTbl BOnp()Cbl, KaCa.JOIJIHecR POnH PYKOBO,.llRlllHX opraHOB 3,.llpaBOOxpaHetruR B crpaHax EBPQilbl H, B qaCTHOCTH, PQJII-! 803, a TaJ<~e pecypcoB, KOTOPMMH pacnonarae-r OpraHH3aUHR ..ll1lR Bblnom-ieHHR CTORIIIHX nepe,.ll HeH 3a,JJaq. OTBeThl Ha HeKOTOPble H3 3THX BonpocOB ~ ,.llaHhl B npHHRTOH PernoHaJif>HhlM KOMHTeTOM pe3QJllOUHH FUR/JC31/Rl3. 43 JIHTEPATYPA 1. Helander, E. et al . Training the disabled in the community. Geneva , World Health Organization, 1980. 2. International classification of impainnents, disabilities and handicaps. Geneva, World Health Organization, 1980. 3. WHO Technical Report Series, No. 668, 1981 (Disability prevention and rehabilitation: report of the WHO Expert Committee on Disability Prevention and Rehabilitation). 4 . Holt, K.S. The handicapped child. In: Mattingly, S., ed. Rehabilitation today. London, Update Books, 1977, pp . 89-97 . 5 . 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Proceedin11s ofa Seminar on Rehabili- tation of the Disabled. London, Macmillan Press . 1979 . 18. Hammerman, S. & Mai.kowski , S., ed . The economics of disability- inter- national perspectives. New York, Rehabilitation International , 1981 . 19. Taylor, D.G. The economics of rehabilitation. In : Kenedi , R.M. et al ., ed . Disability. Proceedings of a Seminar on Rehabilitation of the Dis- abled. London, Macmillan Press , 1979, pp . 87 - 100. 20 . Nichols, P J .R. & Williams , E. Aids and appliances . In : Mattingly, S., ed. Rehabilitation today. London, Update Books , 1977. 45 IlpHJJOlleHl-le 1 !'JlOCCAPHH TEPMHHOB, HMEDIJU{X OI'HOIIIEHHE K BOJ1E3H5!M H HX TTOCJIE,llCTBH5JMa TepMHHononffl, KaCa.KlllaRCR or-paIDNeHHH npHW'lliOH ,lleRTeJlbHOCTH H.JlH CHHllteHHR TPY ,llocnOCoOHOCTH H .IIPYI"'HX nOCJ1e.I1CTBHH Oone3HeH, Ol.1J1a KpaHHe 3anyTa.HHOH. IlpH'lliHa 3TOMy - OTcyTCTBHe COOTBeTCTBYIOll!eH OOn-NecKOH cxeMhl H.J1H KOHUerrryaJlbHOH MO.lle.JJH, a Ta.J<;tte TO oOCToRTeJlbCTBO, '-ITO cneUHanHCThl, 3aHRTble 3TOH npoOneMOH, He BblpaOoTa.JlH TO'llihIX onpe,lleneHHH COOTBeTCTBYIOll1HX noHRTHH. HcnpaBHTb nono&eHHe noMor.JJH .IIBa Bal!aiblX mara, npe.JlnPHHRTLIX no HHHUHaTHBe 803. 0.IIHH H3 HHX - npHHI..IHnHaJlbHoe O.llo0peHHe KOHuenTYa1lbHOH MO,llenH nocne,llCTBHH Oone3HeH, KOTopaR 3aTeM Obina npe,llCTaBneHa B Mell,llyHapO,llHOH KJ1acci-,t,HKamtH HapymeHHH 4>H3H'leci<oro H nCHXH'lecKoro xapaKTel)a, Orpa.H}NeHHH npHBhl'lliOO .lleRTeJlbHOCTH H.J1H CHH;tteHl-!R TPY .llOCTTOCo0HOCTH H COUHaJlbHOH He,llOCTaTO'lliOCTH ("International classification of impairments, disabilities and handicaps" - ICIDH (l); B YITPOll!eHHOM BH,lle 3Ta MO.lle1lb Ol.lna npe,llCTaBneHa H B .IIPYI"'HX H3,lli3.HHJDC (2,3). 8TOpOH 111ar - corJ'lallleHHe no nOBO.JlY ynorpeOneHHR HaHOonee Bal!aiblX TepMHHOB, BblpaOoTaHHoe PR.IIOM Me;t(,llyHapO.JlHblX y"{Pe;tt.JleHHH, TaJ<HX, Ka.J< Mell,llyHapo,llHaR opraHH3aUHR TPYJli3. H Mell,llyHapo,llHaR accoUHaI.IHR COUHaJlbHOro CTpaXOBaHHR. HH;tte npHBe,lleHbl a,pe;::ieneHHR 3THX peKOMeH,llyeMi>IX TepMHHOB B TOM BH.lle, Ka.J< OHH npe,llCTaBneHbl B ICIDH. rnoccapHH, npe,nnaraeMblH B 3TOM H3,lli3.HHH, nepBOHat.1a1lbHO Obin TTO,llI"'OTOBneH B KatlecTBe npHnO;tteHHR K ICIDH. PeKOMeH,llyeM1>1e TePMHHhl IlpHBO,llRTCR no ICIDH. a A..aanTHPoBaHHblH BapHaHT paOon,t Wood, p. H. N, , onyOmil<oBaHHOH B "International rehabilitation medicine", 2:86-92 (1980); npHBO.JlHTCR c .rno0e3Horo pa3pemeHHR EULAR Publishers, Ba3e1lb. 46 Or,::>aIDNeHH.R ITPHBbl'iHOH .ne.RTeJlbHOCTII l-i1lli CHHlleHHe TPY .nocnOCOOHOCTII nJOOoe Or,::>aIDNeHHe HJIH arcyTCTBHe (BCJleJlCTBHe HaPY!lleHH.R) cnocoOHOCTII .neflCTBOBaTb TaKHM oOpasoM H B Tex paMKax, KOTopble C'IHTaIOTC.R HQPMaJ!bHblMH ,ll1l.R qeJlOBeKa. TipHMe\iaHHe: i) Or,::>aIDNeHH.R ITPHBbl'iHOH .ne.RTeJlbHOCTH l-i1lli CHJ.illteHHe TPYJlOClloco0HOCTII MOryT CI.ITb BpeMeHHblMH HJlH nOCTO.RHHblMH, o0paTI!MblMH HJIH HeClOpaTHMblMH, nporpecCHPYIOb!HMH HJIH pefl)ecCHPYICIIIHMH; ii) Ofl)filiH'ieHH.R flPHBbl'iHOH .oe.RTeJlbHOCTH HJlH CHHlleHHe TPYJlOCnocoOHOCTH MOryT nepepacTII (Ho HeClO.R3aTeJlbHO) B COUHam.HYIO He.nOCTaTO'iHOCTb. HeJlQCTaTO'iHOCTb KaK nocne,llCTBHe 0oJle3HH (Hecxi>HUHaJlbHoe onpe.neneHHe} CoOHP<1Tem.Hoe onpe.neneHHe, OTHOC.Rllleec.R K .IIIOOoMY COCTO.RHHIO, ouemrnaeMOMy KaK HapymeHHe, Ofl)aHH'ieHHe flPHBbl'IHOO .ne.RTeJlbHOCTII HJlH CHHlleHHe TPYJlOCl10C00HOCTH, COUHaJn,Ha.R He.nOCTaTO'iHOCTb. (CTPOro I"OBOP.R, TePMHH ''HenOJlHOUeHHOCTb" ynorpe0Jl.ReTC.R ,ll1l.R Offi!CaHHFI COCTOJ'IHH.R qeJlOBeKa npH Orpa.HHt{eHH.RX flPHBbNHOH ,ne.RTeJlbHOCTII HJ'IH CHHlle~ TPY.IIOCnOCo0HOCTII (TaKHM o0pa3OM nblTaIOTC.R npoBecTI! pa.3.IUNHe MellJIY CaMHM COCTO.RHHeM H nonolleHHeM HH.llHBHJlYYMa, HaXOJl.R!Jleroc.R B 3TOM COCTO.RHHH); XOT.R CXOJlCTBO MellJIY 3THMH TepNmiaMH HHO[")la MOlleT BBecTH B 3aOJly)IJleHHe, nOKa He Y.DaJlOCb paspaOOTaTb aJlbTepHaTHBHOro onpe.neneHH.R). CoUHam.Ha.R HeJl()CTaTO'iHOCTb YmepO, HaHOCHMb!H HHJlHBHJlYYMY BCJle,llCTBHe HapymeHHH <!)H3HtiecKOI"O HJlH nCHJONecKOI"O xapaKTepa, Orpa.HHt{eHHH ITPHBbl'iHOH .ne.RTeJlbHOCTII l-i1lli CHHlleHH.R TPYJlOCl10Co0HOCTII, Karopble MetdaIOT eMY BbITTOJlH.RTb HQPMaJlbHYIO ,ll1l.R Hero pom, (c yqeTOM ero B03paCTa, nona, COUHaJlbHblX H KYJlbTYPHblX 4>aJ(TopoB ) . TipHMe\iaHHe: Pa3HHlJY B 3Ha'ieHH.RX TepMHHOB "HapymeHHe ~H3H'iea<oro HJ'IH ncHXJNea<oro xapaKTepa", "orpaHHqeHHe ITPHBbl'iHOH .ne.RTeJlbHOCTH HJlH CHHlleHHe TPY JlQCflOCOOHOCTII" H "coUHaJlbHa.R He.nOCTaTOtiHocrb" MOlltHO nO.RCHHTb Ha c11e,eyIC111eM npHMepe. norep.R HOITeBOH (j)anaHrH Ha cpeJlHeM nam,ue neBoii PYKH - 3TO HapymeHHe cl>H3H'iecKOI"O xapaKTepa. 3TO HapymeHHe MOlleT noMemaTb BbITTOJlHeHHIO KaKHX-JlHOo .neflCTBHH, Karopble C'iHTaIOTC.R HQPMaJ!bHblMH ,ll1l.R ,!lcl.HHOr'O qeJlOBeKa, B TaKOM c.nyqae ero cne,eyeT pacueHHBaTb KaK Orpa.HHt{eHHe flPHBbl'iHOH ,De.RTeJlbHOCTH HJlH CHHlleHHe TPYJlOCllOCOOHOCTII. BOJlbMHHCTBY JllOJleA TaKoe HapymeHHe He HaHeceT ymepOa, OJlHaKO OHO, 0e3YCJlOBHO, HaHeceT ceP!,e3HhlH ymepO npo:t>eccHOHaJlbHOMY 47 CKPH!'latzy, H B 3TOM CJlY'lae Ta.Koe HapyroeHHe CJie,IIyeT pacueHHBaTb y'll.e Ka.K COUHaJlbHYIO He,.QOCTaTO'IHOCTb. (TepMHH 11 COUHa.11bHaR He.oOCTaTO'lliOCTb 11 npe,.aCTaB./UleT coOoH COUHaJIH3auHIO HapyroeHHH ¢H31-NeCKOro HJlH nCHXl-NecKoro xapaKTepa, OrpaHH"-leHHH ITPHBbNHOH .oe.FITeJlbHOCTH HJlH TPY .oocnocoOHOCTH, T. e. CTOKa3blBaeT, KaKOBbl HX nocne,.QCTBH.FI .ll11R HH.JlHBH.JlYYMa B KY.11bTYPHOM, COUHaJlbHOM H 3KOHOMH'leCKOM nnaHe H BO B3aHMO,.QeHCTBHH C OKPY!talOllleH cpe.ooH! .ll11R COUHaJibHOH He.oOCTaTO'lliOCTH xapaKTepHa HeB03MO'll.HOCTb .ll11R HHJJHBH.JlYYMa B CBOeH ,.ae.FITeJ1bHOCTH COOTBeTCTBOBaTb CBOHM co0cTBeHHblM QllG{,IJaHHJ'IM HnH QllG{,.aaHH.FIM OKPY!talODIHX ero nIO.[leH). HapymeHH.FI (3.0QpOBb.FI), T. e. HapyroeHH.FI ¢H3H"-leCKOro H ncIDGNeocoro xapaKTepa JlioOoe B1ma..aeHHe HJ1H HeHOPMaJlbHOCTb nCHXH"-leCKOH, <l>H3HOJ10n-NecKOH HJlH aHaTOMH"-lecKOH CTPyK-ryµ,I HnH ¢yHKUHH. npHMe"-laHHe: i) 3TOT TepMHH IIIHPe, qeM TepMHH "paccrpoHCTB0 11 ' nOCKOJ1bKY OH BKnIO"-laeT BC.FIKOro po,na nOTepH; HanpHMep, n0Tep10 Horn CJie.IIYeT pacueHHBaTb Ka.K HapYllleHHe, a He Ka.K pacCTP()HCTBo! ii) HapymeHHe MOJKeT e..iTb BpeMeHHblM HJ1H nOCTO.RHHl>IM. TepMHHbl, KOTOpt,lM OT,IJaeTC.R npe.zmo"-ITeHHe 9-rn TepMHHbl B3.FITbl H3 nepooro aapHaHTa rnoccaph.R 803, O,JlHaKO 3TO HH B KoeM C]ly'-lae He 03Ha"-laeT, "-ITC OHH o.ooOpeHbl 80'3. npH HX npe,.QCTaBneHHH CJie.OOBanH TeM JKe rtpaBHJlaM, "-ITO H npH npe,llCTaBneHHH peKOMeHJlYeMblX TepMHHOB. npe,IIynpelK,JleHHe cnyqaeB OrpaHH"-leHHH ITPHBbNHOH .oe.FITeJ1bHOCTH HnH CHHlKeHH.R TPY.OOCCToco0HOCTH n~H.TiaKTI-Nea<oe HanpaBneHHe Me.oHUHHbl, 3a,oaqa KOTOporo - npe,IIynpeg,naTb no.FIBneHHe cnyqaes OrpaHH"-leHHH ITPHBbl"-IHOH .oe.FITeJ1bHOCTH HJ1H CHHlKeHH.R TPY.OocnocoOHOCTH H CJlY'laeB COUHaJlbHOH He,.aOCTaTO'lliOCTH, a TaKJKe CHHJKaTb "-IHCJJO y11.e cyil!eCTBYl(IIIHX CJIY"-laeB Ta.KHX HapyroeHHft. npHMe<raHHe: npe.JlYTlpelK.IleHHe C]ly'-laeB orpaHH"-leHHH ITPHBbl"-IHOH .oe.FITe.11bHOCTH HJlH CHH71.eHH.FI TPY .oocnocoOHOCTH QCYllleCTBn.ReTC.FI Ha cne,IIyIOIJIHX ypoBH.FIX: 48 nepmn71 ypoaem, - ace Mepbl, HanpaaneHHble Ha npe.nynpelK,OeHMe no,mneHWI HOBbIX cny-qaea HapynJeHHH ( 3.00PQBbR); BTopoH ypoaem, - ace Mep&1, HanpaaneHHble Ha npe.nynpelK,OeHHe cny-qaea orpaHH-qeJiHH npHBblt{HOH .neRTem,HQCTH HJlH CHHlKeHHR TPY.llOCTTocoOHOCTH, 1<or.na HapynJeHMR (3.nopoBbR) ylKe HMelOTCR HJ1H aepoR'nil>I; TpeTHH ypoaem, - ace MePbl, HanpaaneHHble Ha yMeHb111eHHe creneHH y'JJ.e B03HHKIIIHX orpaI-ONeHHH npHBbl'll-lOH .neRTem,HocTH HJJH CHH'JJ.eHHR TPY.llOCTTOCo0HOCTH, a TaKlKe npe.nynpelK,[leHMe HX nepexo,lla B COUHam,HYJO He.nocTaTO'll-lOCTb HJJH CHH'JJ.eHHe ee CTeneHH. Bone3Hb (3aOone:eaHHe) JIIOOoH naTOnOrHt{ea<HH npouecc, OT.rnNHTem,HblM npH3Ha!<OM !<OToporo RBJlReTCR COBOl<YnHOCTb xapa!(Tepl-lblX, no.n.naIOIIIHXCR pacn03Ha.BaHHJO CHMnTOMOB. IlpHMe-qaHHe: cpaBHHTe C TepMHHaMH "paCCTPQHCTB0 11 H "ttapymeHHe" (3.nopoBbR) (npH o003Hat{el-lIDI COCTORHHR opraHH3Ma HJIH 1<a1<oro-JJHOo y-qaCTKa HJIH opratta repMHH "Oone3Hb" HMeer Oonee aOC'rpa.KTHoe 3Ha-qeHHe no cpaaHeHHJO c KOHl<peTHblMH TepMHHa.MH "npoRBneHHe II HJlH "HapymeHHe", KOTQpl,le OTpal!laJOT pe3ym,TaT 803,0eHCTBHR Oone3HH Ha opraHH3M HH,IIHBH.[lyyMa) . PaCCTPQHCTBO JIIOOoH naTonorHt{ecKHH npouecc HJJH <l)yHJ<UHOHam,Hoe OTKnOHeHHe. IlpHMe-qaHHe: 3TOT TepMHH llll-{pe nOHRTHR "Oone3Hb 11 , HO y-,,.e nOHRTHR 11 HapymeHHe 11 (3.00PQBbR) • IlCHXOCOUHam,HblH <!>aJ<Top (npHMeHHTem,Ho K 3,IlpaBOOxpa.HeHHIO) OCilltHH TepMHH, O3Hat{alallHH nlOOoe H3 orpoMHoro MHO'JJ.ecTBa ycnOBHH, BJJHR!QdHX Ha COCTORHHe 3.0OPQBbR HJlH npe.nOCTaaneHHe H nony-qeHHe Me.nHl<O-CaHHTapHOH noMOIIIH H B03HHKalOIIIHX Ka!< 49 CJle,JlCTBHe nOBe,JleHHR OT,JleJlbHOro HH,JlHBH.llYYMa HJlH rpyTlTlhl JDO.JleH, me npe.JlCTaBnel-iHH, 3HaHHH H OTHcmeHHH. PeaOHJJHTauHR KOMllJleKCHoe H CKOOP.llHHHPOBaHHoe np()Be,JleHHe MepoopHR'nlli B Me,JlHUHHCKOH, COUHaJlbHOH, oOpaso:ea.TeJlbHOH H npol>ecCHOHaJlbHOH ai,epe C uem,10 no B03MOlKHOCTH Ha.HJlY'-Ol!HM oOpasoM no,JlroTOBHTb HJlH nepeno,JlroTOBHTb HH,JlHBH.llYYMa K Bl,ITTOJlHeHHIO HQPMaJlbHOH ,JlJlR Hero poJIH. npuMetJaHHe: i) 3Ha'leHHR TepMHHOB "peaOHJ1HTauHR 11 H "npelJYnpelt,JleHHe cnyqaeB orpaHH'lel-iHH npHBbl'IHOH .lleRTeJlbHOCTH HJ1H CHHllteHHR TPY.llOCTToco0HOCTH 11 (Ha TpeTbeM ypQBHe npc¢H.1laKTHKH) BO MHOI'OM COBna,Jla.IOT; ii) MeponpHRTHR no peaOHJJHTa.I.lHH paertpOC'l'paHRIOTCR He TOJlbKO Ha JlHU C ¢H3H'lecKHMH HaPY!lleHHRMH, Bee 3a,Jla'IH BXO,JlHT pemeHHe IIIHP()KOro Kpyra npoOneM 3,llpaBOOxpaHeHHR, TaKHX, KaK nOMOlllb .raruaM C ¢YHKUHOHaJlbHblMH nCHXH'lecKHMH paCCTpoHCTBaMH H rrpoOJleMl,l, CBR3a.HHLle C JleKapcTBeHHOH 3aBHCHMOCTblO H YM::TBeHHOH OTCTaJlOCTblO; iii) peaOHJIHTaUHR MOllteT Cib!Tb pa3HOro po,lla, nOOTOMY TepMHH Hepe,JlKO noRCHRlOT COOTBeTCT'B'JIOIIIHMH npHnaraTeJlbHhlMH, HanpHMep: Me,JlHUHHCKaR peaOH.11HTaUHR, coUHaJlbHaR peaOHJIHTaUHR, npol>ecCHOHaJlbHaR peaOI-IJIHTaUHR! iv) TepMHH "peaOliJIHTaUHR" He COBna,JlaeT no 3Ha'leHJ.DO C noHRTHeM 11 OKa3aHHe nOMCllllH HHBa.11H,JlaM 11 (.JlOnI"OCpo'IHaR, KaK npaBHJlO, CTaUHOHapHaR nOMaitb Tpe0yeTCR JIHuaM, y KOTOPWC HapY111eHHR npHBbl'IHOH ,JleRTeJlbHOCTH HJ1H CHHlltetrne TPY,JlOCTTOCoOHOCTH HOCHT TRllteJlblH Heo0paTHMblH xapai<rep). COCTORHHe 3,J]opOBbR (CHHOHHM - CTaTYC 3,JlOpQBbR) OC':lnee noHRTHe, QTPaAalOblee, B KaKOH Mepe HH,JlHBH.llYYMY, rpynne JlHU HJlH HaceneHHIO B uenoM y,JlaeTCR BbITTOJlHRTb <l>YHKUHH ( KaK B <l>H3HOJlOrn'lecKOM, TaK H B HHTeJlJleteTYaJlbHOM nnaHe), C'IHTa.KlllHecR ,JlJlR HHX HQPMaJlbHblMH, C y'{eTOM npHHRTblx KpHTepHeB. ,Ilpynie peneBaHTHble TePMHHbl OTHOCHTeJlbHO HCTTOJlb3OBaHWI .JlPYrHX TepMHHOB eme He 0!.1110 npHHRTO HJ,fl(aKHX Mell.llYHapo,JlHl,IX corJlallleHHH, O,JlHaKO HX ynOTpeOJleHHR 'laCTO TPY.llHO H30ellaTb. Qnpe,J]eJleHHR, 50 npHBO.IIHMbte HHi!Ce C uem,10 YTO'IBHTb HX 3Ha'ieHHR, B OCHOBHOM npHBO.IlRTC.R no "The shorter Oxford English dictionary" (3-e H3.IIaHHe, 1944). • - --- AHOMa.TIH.R OTKJIOHeHHe OT OOLl'iHOl"O HJIH ecTecTBeHHOI"'O nop.R,IIKa BellleH, COCTO.RHH.R. (CHHOHHM TePMHHa 110TKJIOHeHHe OT HopMbl", HO ynOTpe0JI.ReTC.R rnaBHblM o0pa3OM .IIJI.R o0o3Ha'ieHH.R BpQi!C.IleHHblX HapynieHHH) • TToBe.IIeHHe MaHepa BecTH ceOR. (O.IIHH H3 BH}lOB orpaHH'ieHHH npHBbl'iHOH }le.RTeJn,HOCTH HJIH CHHi!CeHH.R TPY ,IlOCnocoOHOCTH npHMeHHTeJn,HO K nCHXOJlOI"'HH TepMHH MOi!CeT oOo3Ha'iaTb ,IleHCTBH.R HHJlHBH,eyyMa, <l>YHKUHOHaJn,Hl,JH OTBeT Ha pa3,Ilpai!CHTem, (T.e. HaPYIJ1eHHe), HOB Oonee IIIHPOKOM nCHXOJIOI"'H'iecKOM nnaHe 3TOT TepMHH xapaKTePH3YeT MaHepy BeCTH ceO.R no OTHCllleHHJO K OKPYi!CalOlllHM H no,Il'iepKHBaeT Bam-!oe 3Ha'ieHHe B3aHMO,IleHCTBH.R JIIO,IleH .IIJI.R YTBePlK.lleHH.R JIH'iHOCTH H yCTaHOBJieHH.R c61ecTBeHHoro nop.R.ID<a! 3TO nocne,IlHee 3Ha'ieHHe 6JIH3KO noH.RTHJO "orpaHH'ieHHe .I1eRTem,HocTH 11 ). Bpol!Jlel-lHblH CY1llecTeyt01llHH npH pol!JleHHH. (CaM no ceOe TepMHH He 03Ha'iaeT, 'iTO COCTO.RHHe o6yCJ1OBJieHO HacJie.IICTBeHHblMH HJIH I"eHeTH'iecKHMH npH'ruHaMH, XOT.R BPQi!C,IleHH1,te HapYllleHH.R ,IleHCTBHTeJn,HO MOI"'YT CI.ITb Bbl3Balibl O,IlHOH H3 3THX npH'ruH HJIH o0eHMH cpa3y! OTMeTHM, 'iTO COUHaJibHa.R He,IlOCTaTO'iHOCTb He MOi!CeT 6b!Tb Bpol!JleHHOH, TOJlbKO HaPYllleHHe H, B03MOm-!O, orpaHH'ieHHe npHBbl'iHOH .IIe.RTeJlbHOCTH MOi!CeT npo.RBHTbC.R B MOMeHT poi!C,IleHH.R H cpa3y nocne Hero, a Ylllep6, HaHOCHMblH .rnNHOCTH, npo.RBJI.ReTC.R nooir;e, no Mepe TOl"O, KaK HH.l]HBH.llYYM Ha'lliHaeT B3aHMO,IleHCTBOBaTb C OKPYlltal<lllHMH ero JIIO.m,MH H OKPYlltaKX!!eH cpe,IlOH). He,IlOCTaTOK COCTORHHe, npH KOTopoM OTcyTCTBYeT 'iTO-JIHOo, Heo0XO.l]HMoe .IIJI.R 3aBep111eHHOCTH. (O3Ha'iaeT OTcyTCTBHe KaKOro--JIHOo opraHa, npH'ieM oCll,t'iHO nO.IlPa3yMeBaeTC.R, 'iTO 3TO OTCYTCTBHe Bpol!JleHHoe) • 51 .Ile$0PMa.UHR ,Ilel>opMffP()BaHHaR (ypo,ll11HBaR) qacTb Tena. (9TOT TePMHH qacro Hcnom,3yeTCR KaK CHHOHHM TepMHHa "nopCl< pa3BHTHR 11 , HO .n,nme npHMeHRTb 3TO onpe,neneHHe ,nJIR o00'.3Ha'-leHHR .aei>opMaUHH yqacn<a HJJH opraHa, KOTopaR npoHSCIIIJJa y'll:e nocne HX <f>oPMHpOBaHH.R; oC"lpaTHTe BHHMaHHe, '-ITO 3TOT TepMHH Heo0R3aTe1IbHO 03HatlaeT OrpaHH'-leHHe <f>yHKUHH). Ypo,ncrBO COCTORHHe, npH KOTopoM ¢Hrypa HJ1H BHetdHOCTb HH.llHBHJlYYMa o0e3o0pa~Hl,l. (OcoC'a.lH BH.n HapYMeHHR, KOTOpoe MO'll:eT OTPHuaTeJibHO CKa3aTbCR Ha B3aHMOOTHCllleHHRX HH.llHBH.JlYYMa C OKPY'll.aDIIHMH ero JllO.llbMH, nOCKOJibKY ypo,nCTBO cnocoOHO E1,13hlBaTb y HHX OTBPataeHHe) • ci>yHKUHOHaJibHoe orpai-rnqeHHe HapYMeHHe <l>YHKUHOHHpoBaHHR CHC"reM opraHH3Ma H1lH .llBHJl:eHHH Tena. He3,nopom,e COCTO.RHHe HH.IIHBH,nyyMa, crpa,lla!Olllero KaKOH-JJHOo Oone3Hb10 HJJH paccrpoHCTBOM. (Tipe.nnoraraeT OC03HaHHe HH.llHBH.JlYYMOM ¢aKTa cBoero 3a0oJJeBaHHR H HOCHT Oonee aOc'rpaKTHhG\ xapaKrep, qeM HaJJH'Ofe COBOKynHOC'rH CHMnTOMOB, KOTOl)Oe CJJe,nyeT o0o3Hat.1aTb TePMHHOM "npoRBJleHHe 11 ; OXBa'NBaeT CTpa.[laHHff H HenpHR'nible Oll(yll1eHHR, CBR3aHHble C 0oJJe3HblO, H OCHXOJlOrH'-lecKHA OTBeT HH,JlHBH,nyyMa Ha pa3BHTHe 3aOoneBaHHR, TaK Ha3b1BaeMoe noBe,neHHe Oom,ttoro; a pa3rooopHOH pe'-IH BblpallteHHe 110H He3.IlOPQB 11 qacro HCTT01Ib3YIOT B 3HaqeHHH "oH 3aOonen" a Tex CJJY'iaRX, Korna ¢aKTH'-lecKH XOTRT CKa3aTb O Ha.TIH'-IHH 0oJJe3HH y HH,llKBH.JlYYMa) • IlopoK pa3BHTH.R OTKJ'IOHeHHe B crpoeHHH KaKOro-JJHOo opraHa HJJH TKaHH. (O,JlHH H3 BH,JlOB HapYMeHH.R; 3TOT TepMHH oClii'-IHO npe.nnonaraeT, '-ITO HaPYMeHHe MOJIHO YBH,neTb, .l]allte ecJJH ero Y.JlaeTC.R BblRBHTb JlHlllb npH XHPYPrH'-lecKOM BMell!aTe1IbCTBe HJlH Ha peHTreHOBCKOM CHHMKe) • 52 TipoRBJleHHe TipH3HaK HJlH CHMilTOM, KOTOPYH CBH,lleTeJlbCTByeT 0 HaJ1INHH 3a0oneBaHHR, (Yno-rpeOJJReTCR ,llllR oCio3Ha<1eHHR COCTORHHA, KOTopYe HeB03MOlKHO OT.[leJJHTb OT Jle~HX B HX OCHOBe npi-NHH (OnHCaHHblX B Mel!UlYHapOJJHOH KJJaccm>HKal.lliH 0oJJe3HeH), BKJ11()<{aeT TaKHe COCTORHHR, KaK He<f)ponaTHR H KaTapaKTa y OoJlbHOro JJHa0eroM H ap-rpHT y OoJlbHOI"'O no.IIarpoA). TiaTOJlOrnR (B KOHTeKCTe Me,ItHUHHCKOH M0.00.TIH 0oJJe3HH) n100ofl 0oJle3Hel:iHl,Ui npouecc, pa3BHBalOl!GiHCR B OTBeT Ha KOHKPeTHylO npfftrnHY 3THOJ10n-f<{ecKOI"O xapaKTepa. (I'JJaBHblM oCipa.3oM KacaeTCR npHPQ,lll,I 0oJJe3Hefl H H3MeHeHHfl, KOTopYe npoHCXO.IIRT B opraHH3Me B CBR3H C 3aOoJ1eBaHHRMH), QrpaHH<{eHHe ( .newreJlbHOCTH) YTpaTa HJ1H CHJ-uteHHe cnocoOHOCTH BblOOJIHRTb CJlOJIGible HHTerpHl)OBaHHble J]eJiCTBHR, C'IHTaKldHecJ'I HQPMaJlbHblMH JlJlR J.Ui,llHBHJlYYMa, KOTophle B0'3HHJ<aIOT B pe3YJlbTaTe HapynieHHR, (TepMHH OTpallaeT rnaBl-lblH OT.rnNHTeJlbl-lblfl npH3HaK nOHR'rHR ''orpaHHqeHHe npHBbl<{HQH .newreJlbHOCTH HJ1H CHHllteHHe TPY.IIOC110CoOHOCTH 11 H npemonaraeT HaPYlJleHHe cnocoOHOCTH nepeJJBHraTbCR, mmoJlHRTb rnrneHHtlecKHe npoue.IIYPY, BeCTH ceOR B COOTBeTCTBHH C npHHRnIMH HQPMaMH H BblnOJlHRTb ..apyrne .OOHCTBHR, C'-IHTaIOlllHecR HopMaJlbHblMH .[lJlR 3.llQPOBOI"O qeJJOBeKa). He.IIOMOraHHe, c.naOocn, COCTORHHe, KOTopoe pa3BHBaeTCR BCJJe.IICTBHe He3JlClPOBbR, (TepMHH OXBaThlBaeT PeaKUHIO HH,IlHBHJlYYMa Ha Te npe.IICTaBJJeHHR O HeM, KOTQPYe CKJla.Jl,IBalOTCR y OKPYlltaI<lllHX JUO.[lefl BO BpeMR ero 0oJJe3HH) , HetleTKHe H Heonpe.[leJJeHHhle TePMHHhl Yno-rpeOneHHe npHBO.ItHMYX B 9TOM Pa3.IIeJJe TepMHHOB HellteJJaTeJlbHO B XO.De ceP!,e3HOro Hay<{HOI"'O o0cyllt.[leHHR, O.IIHaKO, nOCKOJlbKY OHH qacro BCTPe<laIOTCR, Owia npeJJnpHHR'ra 00£1l,ITKa OORCHHTb HX 3HatleHHe. 53 OTKJJOHeHHe OT HopMbl COC'rOfflme, npe.ID1onaraianee OTCTyn.neHHe OT CTaH.IIaPTHblX nOKaaaTe.neH. (MeHee KOHKpeTHblH TepMHH, qeM 11 HaPY111eHHe 11 , H nOOTOMY, :eepo.RTHo, OTHOCHTCR B OCHOBHOM K pa:aroeopHOH petiH). Ka.neKa HH.llHBH.IIYYM, nO.nHOCTblO HJlH qaCTINHO J'11-1111eHHblH c:nocoOHOCTH BJJaJleTl, KOHe'-DiOC'rRMH. (TepMHH oCN'iHO npe.unonaraeT 3Ha'IHTeJ1bHoe orpa.HHt{eHHe npHBbltiHOH ,Ile.RTeJ1bHOCTH HJlH CHHlleHHe TPY.IIOCnocoOHOCTH, O,IlHaKO HMeeT HecJCOJlI:,KO yH}NHJIHTeJ1bHoe 3Ha'ieHHe). ,ll~eKT He.aocTaTOK HJlH orcyTCTBHe qero-JJHOo, Heo0XO.llHMOro ,Il.nR 3aeepaeHHOC'rH. (MeHee KOHKPeTHhIH TepMHH, 'ieM 11HaPY111eHHe 11 ; OTHOCHTCR B OCHOBHOM K pa3roeopHOH petiH), HecnocoOHOCTb HeB03MOJCHOCTb c:npaBHTbCR C KaKOH-.nHOo 3a)la'ieH, BblllOJlliHTh KaKoe-JlHOo ,IleHCTBHe. (no CYllleCTey CHHOHHM repMHHa 11Orpa.HHt{eHHe npHBbl'-DiOH ,IleRTeJ1bHOCTH HJlH CHH!teHHe TPY.IlOCllOCo0HOCTH 11 , npHtieM noc.ne.DHeMY TepMHHY H CJJe.IlYe'r OT,Qa.BaTh npe.ID10'iTeHHe; O,IlHaKO B onpe,IleJ'leHHlilX KOHTeKCTaX 9TOT TepNHH npi,ioOpeTaeT cneUHi>Htiect<HH OTTeHOK 3Ha'ieHHR: TaK, HarJPHMeP, B HeKOTopblX c-rpaHa.X nOH.RTHe 11 HeTPY.IlOCTioco0HOCTb no Oo.ne3HH 11 OTHOCHTCR K COUHaJtI:,HOlf He,IJOCTaTO'-DiOCTH npH OrpaHKt{eHHRX npol>eccHOHaJ1bHOH ,Ile.RTeJ'lbHOCTH, KOTopaR ,IlJlHTCR OTHOCHTeJ1bHO KopOTKHH cpoK (HaCTPHMep, no 6 MeCRl.lee). HeMCXllHOCTb ~H'iecJ<aR cnaOocn,, orpaHff'.leHHe npHBbl'iHOH ,Ile.RTeJ'lbHOCTH HJlH CHH!teHHe TPY.IIOCnoco0HOCTH B pe3ym,TaTe 0oJJe3HH H.11H paCCTPQHCTBa, (8 HaCTO.Rlllee epeMR ynO'l'l)eOmleTCR B OCHOBHOM ,Il.nR o0o3HatieHHR OrpaHKt{eHHH npHBbl'UiOH ,Ile.RTeJ1bHOCTH H.1IH CHH;f;eHHR TPY .IlOCTTOCo0HOCTH BCJJe.IlCTBHe npeK.nOHHOro B03PaCTa; TepMHH HMeeT HecJ<OJ1bKO yHHt{HllHTeJ1bHoe 3HatieHHe). 54 HHBa.llH,IIHOCTh COCTORHHe, .Il]lR KOToporo xapaKTepHa HecnOCOOHOCTh BblnO.JUiRTh npHBbl'lHble 3aHRTHJ'I. (TepMHH 11 HHBa.11Hll 11 HMeeT Oonee OOntee 3HaqeHHe H rrpemonaraeT, qTO HH.IlHBHllYYM He3.nopo:a H HeManeH). YMCTBeHHaR He.nocTaTO'DiOCTh He.nOCTaTO'<Oioe pa3BHTHe HHTenneKTYaJlbHblX cnocOOHOCTeH (9TOT TepMHH ynarpe0MeTCR B KaqecT:ae 3B¢eMH3Ma .Il]lR oOo3HaqeHHR YMCTBeHHOH OTCTanOCTH (CHHOHHM - YMCTBeHHafl HenonttoueHHOCTh). OnHcaTeJlbHoe npunaraTeJlbHoe 11 YMCTBeHHblH 11 C TTO.JUiblM npaBOM MOJKHO coqeTaTh JlHIIIb C TepMHHOM 11HapY111eHHe 11 ; ynQTPeOJleHHe ero B coqeTaHHH C TepMHHOM "orpattuqeHHe npHBbl'DiOH .neRTeJlbHOCTH HJlH CHH"/1:.eHHe TPYllOCTTOC00HOCTH 11 llOBOJlbHO HeTOqHo, H y"/1:. COBCeM He cne.nyeT ynQTPeOMTh ero B coqeTaHHH C TepMHHOM 11COUHaJlbHaR He.nocTaTO'DiOCTh" - cTeneHb Ylllepoa, np~eMoro HHllHBH.llYYMy C nCHXOJlO~ecKHMH HaPYllleHHRMH, M0"/1:.eT 3HaqffTeJlbHO BaPbHPOBaTh, npuqeM YlllepO He RBJJReTCR HeH30elKHblM CJle.llCTBHeM HaPYllleHHR TaKOro po,lla). <l>H3uqecKaR He.nOCTaTO'DiOCTh (4aCTO ynOTpe0MeTC1'1 B pa3r'OBOPHOH pequ .Il1lR oOo3HaqeHHR HapYllleHHH, KOTopble He 3aTparHBa!O'r KOHJ<peTHblX opra.HOB qyBCTB HJ1H YMCTBeHHblX cnocOOHOCTeH; npH ynOTpeOJleHHH 3TOro TepMHHa B03HHKa!O'r TPY.IIHOCTH, attanOrn'lHhle TeM, 0 KOTopblX ro:aopHJlOCb npHMeHHTeJlbHO K nOHRTHJO "yMCTBeHHafl He,llOCTaTO'DiOCTh"! B no.nOOHlilX cnyqaRJC M0"/1:.HO ynQTPeOMTh TepMHH "cJ)H3HqecKaR ocnaOneHHOCTb 11 ) , 55 JMI'EPATYPA I . International classification of impairments, disabilities, and handi- caps - a manual of classification relating to the consequences of dis- ease. Geneva , World Health Organization, 1980. 2. Wood, P.H.N. & Badley, E.M. Setting disablement in perspective. Inter- national rehabilitation medicine, l : 32-37 (1978). 3. Wood, P.H.N. OueHKa nocne.nCTBHH OOne3HeH: 56 Me~po,llHaR Knaco,l>HKal..lHR HapymeHHH <l>H31.fllecKOr"O HJIH nCHXJNecKOr'O xapax-repa, Or'paHl.flleHHH npH.BbNHOH .ne.flTeJlbHOCTH HJIH CHHJP;eHHR TPY .nocnocoOHOCTH H COUHaJlbHOO He,QOCTaTO'D-IOCTH. XpoHHKa 803, 1981, 35, ~ 2, c. 84 PE30JIDUH.H EUR/RC31/Rl3, flPHHffi'A.H HA TPH,llUATb fIEPBOH CF.COrn EBPOflEICKOI'O PEI'HOHAJlbHOI'O KOMlfI'ETA, BEPJIHH, 15-19 CEHl'.HBP.H 1981 PerHOHa.TlbHhlH KOMH'reT, npHHHMaR BO BHHMaHHe pe:30J1IOUHIO WHA34.30 - 0 corpy,[llil-NecTBe C yqpell,lleHHRMH CHCTeMl,I OpraHH3auHH 00'.be.llHHeHHblx Ha.J..IHH - MelK,IlyHaPQ,llHl,IH I'O.ll HHBaJIH)lOB, 1981: COBMeCTHaR )leRTeJlbHOCTl, 803 c .IIPYrHMH yqpell,lleHHRMH CHCTeMl,I OpraHH3aUHH 00'.be.IIHHeHHblx HaUHH no npe,aynpell,lleHHJO nOTepH TPY .IIOCnoco0HOCTH H peaOHJJHTa.IlHH; npHHHMa.R K CBe)leHHJO .I]OKyMeHT EUR/RC31/Tech.D i sc./l - Me.IIHUHHCKHe H COUHa.TlbHhle npoOJieMbl HHBaJIH)loB; 1. BJIAI'O,llAPln' PernOHaJlbHoro ,IlHPeKTopa 3a paOOTy no peaJIH3aJ.lHH MeponpHRTHH B paMKax Mell,llyHapo)lHoro ro.oa HHBaJIH)lOB, 1981! 2. nPOCln' KoHcyJlbTantBHy!O rpynny no pa3BHTHIO nporpaMMbt H3Y'{H'l'b B03MOJKHOCTH .llJIR Pa3BHTHff CO'I'PY.IIHH'llecTBa .C .JlPYI"HMH yqpell,lleHHRMH B ueJIRX oOecne'lleHHff a!leKBaTHOH peaJ1H3aUHH MeponpHRTHH, npe,aycMO'Il)eHHblX Ha .IIByXJiente 1982-1983 ! 3. IlPE,JlJlAI'AET rocympcTBaM-'llJleHaM npoaHaJIH3HPOBa'I'l, CYl!leC'I'BYIOlllHe B HX C-rpaHax CHCTeMbl Qpr"a.HH3aUHH peaOHJIHTaUHOHHOr"O oOcJiymBaHHff HHBaJIH.IIOB B ueJIRX coaep111eHCTBOBa.HHff 3THX CHCTeM, a TaKl!e noanp.R'I'b Hay'llHbte HCCJie)lOBaHHff B 9TOH oOJiacni, 3a)la'lla KOTQphlX - noMO'llb HHBaJIH)laM HaHTH CBOe MecTO B noace)lHeBHOH »f3HH! 4. 0.IlOBP.HEI' npe)lJlO!l:eHHe o BKJlt()qeHHH nporpaMMl,I no npol>HJiaJ<nnce HHBaJIH)lHOCTH H peaOHm!'I'aUHH B Ce.llbMYIO 00tlly10 nporpaMMY paOcm,i C yqeTOM 3aMe'lla.HHH, C)leJBHHblX BO BpeMff oOcyll,lleHHR 9TOro BOnpoca Ha HaCTOfftlleH cecCHH; 57 5 • PEKOMEH,ItYEr 803 npo.non»m:, COTPY .JlHH',lecTBO c rcx::y ,llapcTBaMH-'VleHcU4H H .IlPYrHMH opraHH3aUH.RMH B uemoc KPH'TI-NecKOI"O aHaJ1H3a HhlHe!IIHHX CHCTeM opraHH3aUHH peaOHJlHTaUHOHHOI'O oOcnym-tBaHHR HHBaJIH.llOB H oOoObteHHR pe3yJibTaTOB .neRTeJibHOCTH, npoBO,llHK)H rcx::y,napcT:eaMH-'IJieHaMH B paMKax Me.11:JlYHaPQ.llHOI'O ro.na HHBaJIH,llOB! 6. l1PE,llJlAI'AEI' PentOHaJlbHOMY ,llHpeKTopy H~QPMHPOBa'l'b PerHOHaJibHYH KOMHTeT O XO.Ile paOOT!,i B 3TOH oOnaCTH. 58
Organisation mondiale de la santé (OMS) · Publications
Медицинские и социальные проблемы лиц с ограничениями привычной деятельности или снижением трудоспособности: отчет составлен по материалам тематических дискуссий, состоявшихся в ходе 31-й сессии Европейского регионального комитета
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