Signs of serious harm to health are: penetrating injury, disfigurement of the face, life-threatening condition. The order of the Ministry of Health No. 194n of 24. 04. 2008

Damage to health - in itself, the concept is not very pleasant; immediately an association with criminals, traffic accidents or other dangerous factors comes to mind. If it is also heavy, then some immediately imagine a wheelchair invalid or a “mummy” in a cast, for others a scratch is already hard. So what are the criteria for identifying the severity of harm to health, who determines how and how? We’ll figure it out now.

The concept

Damage to health is any violation of the integrity of the human body due to the action of factors from outside (physical, biological, chemical, etc.). In this case, the result may be not only physical physical damage, but also a malfunction in the neuropsychic processes. All existing signs are set forth in the Criminal Code of the Russian Federation: Art. 111, 112, 115.

Facial trauma

Based on the data qualifying the signs, 3 categories of severity of harm are legally distinguished:

  • easy,
  • average,
  • heavy.

It should be borne in mind that those named in Art. 111 of the Criminal Code of the Russian Federation, criminal signs of harm to health are used only in this area to correctly qualify the actions of the accused, they are not applicable to civil law relations, as well as when establishing disability.

The magnitude of the severity of harm is detected in state medical institutions by a doctor who has special knowledge in this field - a forensic expert.

Legislative consolidation

The main regulatory acts regulating the definition and signs of serious harm to health are:

  1. Criminal Code of the Russian Federation.
  2. The rules for determining the severity of harm to health, approved by the Decree of the Government of the Russian Federation in 2007 N 522.
  3. Medical criteria for identifying the severity of harm to human health, approved. By order of the Ministry of Health and Social Development in 2008 N 194.

The Criminal Code is fundamental of all these sources of law. It is in it that the main criteria are prescribed, according to which the harm can be recognized as serious.

Other named normative acts supplement and specify the provisions of the Criminal Code with the aim of the most correct and easy interpretation.

The order of the Ministry of Health 194n dated 04.24.2008 very detailed describes the list of possible damages - the grounds for determining damage to health as serious. The list is divided into categories, which we will consider later.

Distinctive criteria

So, the criminal legal signs of serious harm to health are:

  • threat to life, i.e. damage can result in death;
  • loss of ability to see, hear, speak;
  • loss of an organ (its purpose);
  • abortion;
  • crazy. disorder;
  • substance abuse or addiction;
  • fatal face ugliness;
  • persistent loss of overall performance of at least 1/3;
  • consequence in the form of a complete loss of professional ability to work (must be known to the culprit in advance).

To recognize the serious grievance, one of these criteria is sufficient.

Injury classification

Depending on the presence of the above symptoms, you can combine all the "serious" injuries into groups:

  1. Life-threatening - wounds, fractures, injuries.
    Leg wound
  2. Life-threatening conditions, in many cases a fatal outcome is likely. These include: severe shock, coma, acute failure (heart, kidney, liver, respiratory), purulent sepsis, peritonitis, large amounts of blood loss, acute poisoning by chemical or bio-substances, mechanical asphyxiation, electrical injuries.
  3. Loss of vision. This group includes diseases in which a person has complete blindness in two eyes or a visual impairment that cannot be restored with an acuity of 0.04 or less.
  4. Loss of speech - the inability to express one’s thoughts in an understandable language (constant).
  5. Loss of auditory function - a complete lack of hearing in two ears or a condition that cannot be restored, in which a person does not hear a word at a distance of 3-5 cm.
  6. Deprivation of an organ or loss of its purpose: arm, leg (hands, feet), paralysis, loss of productive and reproductive function, loss of testicle in men.
  7. Forced termination of pregnancy: miscarriage, premature birth, abortion, etc. Must be associated with causing harm, causing injury.
  8. Mental disorders.
  9. Substance Abuse and Addiction.
  10. Disfigurement of the face.
  11. Health damage + permanent disability by at least 1/3.

Next, we consider the most controversial of the categories encountered.

Injuries, injuries

This category includes serious damage to almost all organs and systems: the head, intracranial, including the facial bones, neck, thyroid, larynx, spine, chest and organs in it (heart, lungs, etc.), abdomen, organs of the abdominal cavity, pelvis and organs located therein, perineum, damage to the spinal cord, blood vessels, burns, frostbite, radiation sickness of a certain degree, etc.

Of particular danger are penetrating wounds (head, sternum, abdomen, joints). They are deep (more than 4 cm), because they are usually caused by sharp and long objects (ax, nail, knife, etc.), fragments of shells, stones, bullets, etc.

Stab wound

It is also worth noting that almost all injuries with fractures (nose, jaw, ribs, etc.) cause a lasting loss of overall performance by 30 percent or more, which immediately relates them to serious harm.


In a separate subgroup, burns can be distinguished. Like injuries, they represent a violation of the integrity of the skin through exposure to high temperatures and chemicals. Severe harm is caused not by every household burn (for example, from a pan or steam), the consequences of them should be life threatening.

Thermal burn (code according to ICD-10 T20-T32) is a skin damage that is distinguished by the international classification of diseases. The specified system has been in force from 1998 to the present.

Thermal burns according to ICD-10 (code T20-T32) are classified according to many signs (severity of injury, area of ​​damage, localization, nature). These include injuries caused by electrical appliances, current, flame, hot objects, air, gas, friction, lightning, radiation, etc.

Mental illness

Post-traumatic disorder (MFD) - this term is used to refer to a serious mental condition after a traumatic situation (physical trauma, sexual abuse, hostage taking, etc.). It can manifest itself in the form of nightmares, thoughts of suicide, characterized by the reproduction of experienced events. The risk of developing a mental illness is affected by age and gender. Children, the elderly, and women are more prone to PTR.

Mental disorder

The occurrence of mental illness, as a result of trauma, is the basis for qualifying the damage as causing serious harm.

In this case, the diagnosis of mental post-traumatic disorder, the establishment of a causal relationship with the fact of damage is the competence of a forensic psychiatrist. Assessment of the severity of the injury occurs with the participation of a forensic expert.

Disease: Addiction and Substance Abuse

The very name of this qualifying attribute shows that the severity of damage to health is assessed by its consequences. This category was introduced into the law on causing harm to health quite recently, therefore in the literature you will not find numerous descriptions of this problem precisely as a category of grievous harm. Addiction is an addiction to drugs, turned into a disease. Substance abuse differs from it only in that it is not drugs that are used, but stupefying substances.

Drug addiction

To determine the disease, it is necessary to conduct an appropriate examination: forensic-narcological or forensic-toxicological. Assessment of the severity of harm due to this disease after examination is given by a forensic expert together with a narcologist or toxicologist.

It is a persistent disease with these ailments that are classified as serious harm, and not just one-time tests. The methods of committing a crime can be different: mental impact (tales of heavenly enjoyment), physical abuse (injections). When qualifying a case of intentional grievous bodily harm on these grounds, the courts always proceed from the harm done upon the fact. For example, the decline in drug use can be attributed to actions falling under Art. 230 of the Criminal Code. This composition differs from that enshrined in Art. 111 in the form of guilt: in the latter case, there must be intent to harm.

Disfigurement of the face

One of the signs of serious harm to health is a wound to the face, which has an indelible defective character. This subgroup can include damage to a specified part of the body that does not pass on its own, i.e. a surgical operation is required. In such cases, the damage is usually caused by chemicals (acid) or sharp objects (knives).

Many experts agree that this trauma always causes serious harm to the human psyche.

It is important to distinguish between the concepts of “indelible disfigurement” and simply “disfigurement”. Only the first category is a criterion for serious harm, for determination it is necessary to have special medical knowledge.

At the same time, disfigurement is not a concept from the field of medicine, therefore, an expert cannot write this in conclusion. He only concludes that the injury is indelible. If the court finds this damage on the victim’s face disfiguring him, then, according to the corresponding criterion, the injury will be classified as grievous bodily harm (Article 111 of the Criminal Code).

In addition, some experts came to the conclusion that the legislator too narrowly approached the regulation of this feature: only the person registered as an object of encroachment. Whereas, along with this part of the body, other mutilated elements can also cause a person significant psychological discomfort and moral suffering (for example, neck, arms, legs). Therefore, it is proposed to supplement this feature with other parts of the body and separate it into a separate composition.

Loss of performance

Causing health damage is a violation of the integrity or purpose of certain organs and systems of a person. In some cases, such injuries, even after treatment, leave lasting consequences in the form of a lack of a part of the body or a dysfunction that does not disappear over time. Οʜᴎ do not give a person the opportunity to perform his job duties.


It is these consequences that are called persistent disability, which are measured in percent. In this case, it is important to take into account the overall performance of a person - the ability to work under ordinary conditions without special knowledge and skills.

The same injuries in different people can lead to different consequences, the degree of disability will also vary. In this case, the forensic assessment of the severity will be different, and the qualifications of the committed unlawful acts will also vary.

The percentage of disability is identified by special tables. When assessing the consequences of many injuries caused to one person, interest is added up, but their amount cannot be more than 100%.

If as a result of mathematical calculation it turned out 34% or more, then the damage is severe.

Putting criteria into practice

When resolving cases in courts, the main problematic issue is border situations where, for example, it is very difficult to distinguish between grave and moderate harm.

The main signs of serious harm to health are those that pose a threat to a person’s life or, in their normal course, result in death. Sometimes when providing timely medical care, these injuries can have a happy outcome - a complete recovery of the victim. Moreover, this fact does not affect the opinion of the forensic expert when giving an opinion on the severity of the injury, since it is based on a hazard to life during the period of injury.

Medical expert

In their practice, experts in the field of forensic medicine use the main list of life-threatening injuries, that is, those that are most common and for which there is already an established judicial opinion about their danger to life. For example, a penetrating wound to the head often leads to death. This list allows experts from all over the country to give an identical assessment of similar damage.

If the forensic physician suffered a “new” damage that was not included in the specified list, he analyzes and makes his own conclusion about the danger of injury at the time of the infliction, or that without timely assistance can lead to sad consequences.

In the case when a person received an injury that at first glance seems life-threatening, the expert assesses the consequences of this damage according to their degree of danger.

As can be seen from the problem considered, there are many criteria for serious harm to health, and there are even more specific injuries and injuries that are consistent with them. Therefore, it is important that only a qualified specialist evaluate the severity of damage and its consequences. The correctness of the choice of the type of punishment for the guilty, as well as the moral and material satisfaction of the victim, will depend on this.


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