In Kaliningrad, a high-profile case surrounding the death of a premature newborn has moved through the Russian judiciary, drawing intense debate within the medical community. Two physicians, Elina Sushkevich and Elena Belaya, were sentenced to nine years and nine years plus six months respectively in a penal colony, with a ban on practicing medicine for three years after release. The court also limited their ability to work in their profession following the sentence. The prosecution had sought a longer term, proposing thirteen years in prison for each defendant with a three-year ban on employment after release.
Earlier, the jury found the doctors guilty and determined that they did not deserve leniency. The defense announced plans to appeal, arguing that the judge favored the prosecution and that jurors were improperly influenced by outside pressure.
A question of guilt
Over recent years, this case has become one of Russia’s most prominent medical-criminal disputes. The central issue under discussion among medical professionals is whether proxy officers bore responsibility for the infant’s death. The case involves the chief physician of a maternity hospital and an anesthesiologist-resuscitator connected to the regional perinatal center, who faced questions about the circumstances surrounding a 700-gram newborn’s death.
According to investigators, the defense contends there was no malicious intent. The prosecution maintains that the mother was admitted to maternity hospital No. 4 in Kaliningrad in late November 2018, at about 23–24 weeks of pregnancy, and later gave birth to a baby boy weighing roughly 700 grams in the final week of gestation. The prosecution asserts that the chief physician and the resuscitation team made decisions that contributed to the baby’s death, including the administration of magnesium sulfate, which allegedly led to fatal outcomes.
Officials claim that Belaya ordered actions to kill the newborn due to serious health issues and fears of deterioration in clinical performance, while Sushkevich administered the drug as part of the resuscitation effort. Investigators allege that incorrect information about the birth date was entered in the medical records to obscure fetal death.
The defense argues that the administration of the drug has not been proven and that the jury initially acquitted the doctors in December 2020. They also noted that the mother had taken magnesium-containing medication during pregnancy, which could have affected the infant.
To go forward
After the initial acquittal, representations from the injured party and the Attorney General’s Office contended that the jury faced public and media pressure. The Prosecutor’s Office appealed the decision, and in May 2021 the Supreme Court, at the request of the country’s leading prosecutor, transferred the hearings from Kaliningrad to Moscow District Court for review.
The reversal of the acquittal sparked strong reaction within the professional community. Figures such as Leonid Roshal, who heads a national medical association, publicly urged that the doctors be released from custody, even offering to take their place in pretrial detention to demonstrate concern for due process. During the investigation, the physicians were under house arrest in Kaliningrad. Following the trial, Sushkevich returned to work at the regional perinatal center, while Belaya served as deputy chief of maternity hospital No. 4. In November 2021, the Moscow court began hearings, and both doctors were remanded again, with unresolved questions about residency in the Moscow region and related administrative matters.
“The child would never die”
One key witness was a nurse from maternity hospital No. 4 who was on duty the night the infant died. The defense pressed to record her testimony, which had been given earlier during preliminary inquiries, but the nurse did not attend three scheduled sessions, and the court did not accept her subsequent testimony. The doctors’ attorney criticized the proceedings as biased and pointed to missing expert input that could clarify aspects like drug concentrations in the infant’s blood. The attorney emphasized that independent neonatology and toxicology review had not been sufficiently considered, and questioned the reliability of certain forensic conclusions.
Family representatives expressed confidence that the doctors acted within professional standards and that the child’s death could not be equated with outright malice. They noted that the legal framework distinguishes between an alive birth and stillbirth, and argued that the infant’s brief life should have been treated with every possible effort to save it. Some witnesses suggested that the child may have survived under different circumstances, and they called for careful examination of all medical data to determine what happened in the early hours after birth.
Debates around the case extended into the medical community as well. Some neonatologists and professional associations defended the doctors, while others called for a rigorous review of the medical evidence. Public discussions intensified around whether the case reflected a broader ethical dilemma in neonatal care or an isolated misjudgment in a high-stakes clinical setting. Advocates highlighted the complexity of neonatal resuscitation decisions, particularly when faced with extreme prematurity and challenging clinical trajectories. Critics pressed for transparent, evidence-based conclusions supported by robust expert testimony. Legal and medical leaders urged balancing accountability with the understanding that perinatal care often presents nuanced, time-sensitive decisions.
Professionals’ doubts
Within the medical community, prominent associations and leaders expressed mixed views about the defendants. Campaigns and petitions supporting the neonatologists circulated on social media, reflecting solidarity among many colleagues who questioned the prosecution’s narrative and the handling of the case. Some doctors described the trial as highly political, arguing that the broader ethical and medical questions were overshadowed by procedural disputes. Several medical professionals contended that expert assessments presented in court were insufficient or incomplete, calling for additional independent review to establish clearer facts about the infant’s condition, the drug dosages used, and the timing of critical interventions.
Experts and advocates emphasized that medical decisions in neonatal care hinge on accurate interpretation of laboratory results, blood tests, and pharmacology. They argued that misinterpretations could lead to erroneous conclusions about responsibility. Despite disagreements, many in the field stressed the importance of safeguarding patient safety and maintaining public trust in medical institutions while ensuring due process for healthcare providers facing criminal allegations. The case continued to evoke passionate discussions about the balance between accountability and the realities of life-and-death clinical choices in neonatal wards. Experts pointed to the need for ongoing education and robust peer review in neonatology to prevent similar disputes in the future. The broader takeaway, they argued, was not to dismiss the complexities of neonatal resuscitation but to strengthen systems that support rapid, evidence-based decision-making under pressure. [Citation: Investigative records and professional statements from major medical associations]