Annotation. The relevance of this study lies in the fact that Russian legislation currently lacks a legal definition of aesthetic medicine, which creates significant difficulties in law enforcement when protecting the rights of citizens affected by poor-quality services. Judicial practice has yet to determine the distribution of the burden of proof in cases involving the protection of patients’ rights. Furthermore, an acceptable standard for proving causation in medical disputes has not been established, which hinders the use of a proportionate approach (the doctrine of loss of opportunity) in situations where causation is extremely difficult to establish. The aim of this study is a comparative legal analysis of the experience of prosecution under Russian and foreign law for the provision of poor-quality aesthetic medicine services in order to identify the optimal approach to resolving emerging problems. The study was conducted using the dialectical method as a general scientific method of inquiry, as well as specific scientific methods: formal legal, comparative legal, and legal modeling. The study reveals the lack of a uniform approach to proving causation, which is a key obstacle to the effective protection of patients’ rights. It substantiates the need to define the limits of evidentiary presumptions when resolving disputes over the protection of patients’ rights, particularly regarding the presumption of causation in cases of gross medical errors, distortion of medical records, or concealment of information about a patient’s health. The need to pilot the transition to mandatory liability insurance for medical and medical-aesthetic professionals is emphasized.
