Medical Ethics

ISSN Print 2713-0894 ISSN Online 2713-0908

BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

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Khokholov AL, Zhbannikov PS, Zarov AYu, Firsov DE, Shkurankov AV, Makarov SV

In the modern world, traditions of social work are highly demanded both by the professional medical corporation and entire society. The experience of hospital volunteering is particularly relevant in relation to palliative patients. Volunteers involved in practical healthcare should have the corresponding level of qualification. The issue is solved by training and retraining of hospital volunteers and specialists of various levels at medical educational institutions. Junior medical nurses (sisters of mercy) have been trained at the Yaroslavl State Medical University since 2023. The specialized department of palliative medicine on the basis of Clinical Central Hospital of St. Alexy Metropolitan of Moscow of the Moscow Patriarchate of the Russian Orthodox Church was created at the Yaroslavl State Medical University. It is the interaction with state, social and confessional structures that allows to solve issues of practical implementation of the skills obtained by volunteers considering a wide range of community demands.

Received: 2023-10-06

Published online: 2023-11-20

DOI: 10.24075/medet.2023.027

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VIEWS 1683

Lutsevich KA, Ryzhenkova IG, Reshetko OV

The article deals with the need of compulsory participation of pregnant women in clinical research of drugs. By the beginning of the 90‑s of the last century, the majority of drugs prescribed to women was characterized by unsubstantial evidence of effectiveness and safety for women. Moreover, pregnant women almost did not participate in clinical research. Though pregnancy is a dynamic condition that can be compared with itself only. Then supervisory bodies created some documents regulating compulsory participation of the population in the research of drugs. However, until now, women are not sufficiently involved in the research of new original drugs, and pregnant women do the same very rarely. Possible scenarios of participation of pregnant women in clinical research have been reviewed. In particular, research of drugs used in therapy of abnormal conditions associated with pregnancy; drugs to treat chronic and acute pathological processes not related to pregnancy, and when a woman gets pregnant during the research have been distinguished. The importance of inclusion of pregnant women into the trials of effectiveness and safety of drugs in the presence of socially significant diseases, including the ones found during COVID‑19 pandemics, is postulated.

Received: 2023-06-21

Published online: 2023-10-10

DOI: 10.24075/medet.2023.025

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VIEWS 1777

Oleskin AV

The term ‘bioethics’ (in the narrow sense) or ‘biomedical ethics’ denotes medical ethics at the modern stage of development. Bioethics is currently institutionalized and falls under the responsibility of specialized organizational structures (bioethics commissions, ‘divine committees’, etc.). The article expounds the prospects of applying network structures to institutions and organizations dealing with bioethical issues and tasks (ethical aspects of reproductive technologies, biomedical experiments, organ transplantation, and bioethical education). With the principles of decentralization (‘multiple authority’) and ecology (an integrative approach to issues under study and integrity of a bioethical expert team), network structures promote creative and effective functioning of bioethical organizations. Nonetheless, the centralized hierarchies of traditional educational and research institutions are also expected to perform essential functions. A reasonable combination of network structures and hierarchies provides the latter with a new role: the hierarchies assess the activity of emergent network structures using competent experts and provide selective support (including financing) to the most effective among them.

Received: 2023-08-06

Published online: 2023-10-04

DOI: 10.24075/medet.2023.024

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VIEWS 1823

Moiseev VI

A new approach to medical ethics when it is interpreted as an applied theory of development has been investigated in this article. Relying on the ideas of German classical philosophy and Russian philosophy of unitotality, the development is defined based on the idea of any system as a set of basic polarities (thesis and antithesis). Their composition expresses deep polar definitions of the system and its polar portrait. A simulation model of this methodology is suggested using vector spaces with a scalar product. The development measure is introduced using the basis, the development law is defined, polar portraits of health and diseases are determined, the highest moral law is formulated as the law of development in the ethical sphere. To display medical ethics as an applied theory of development, three standards of classical medical ethics such as standards of mercy, ‘no harm’ and medical secrecy are analyzed, their polar interpretation is performed taking into account the suggested models. It is also displayed that all these standards express specific cases of the development law. Hypothesis of medical ethics as an applied section of development theory is supported, and a new research program of similar reinterpretation of other standards of medical ethics is suggested.

Received: 2023-08-10

Published online: 2023-09-25

DOI: 10.24075/medet.2023.023

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VIEWS 1859

Mikhel DV, Mikhel IV

Bioethics, which addresses the pressing humanitarian issues, is an essential element of modern medical education. Transplant tourism is definitely one of these issues. Going abroad to resolve health problems, receive organs and have surgeries might be a growing trend for some Russians. The objective preconditions include deficiency of donor organs and inability of the healthcare system to satisfy the requirements of all those in need. Asia (India and China) has been the major destination of transplant tourism lately. However, things are changing, as Asian authorities attempt to eliminate the unwelcome trend. Russian citizens who go abroad as transplant tourists come across various risks including medical and ethical aspects.

Received: 2023-08-15

Published online: 2023-09-22

DOI: 10.24075/medet.2023.022

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VIEWS 1925

Firsova AO

The article analyzes the ethical problems that arise in the process of discourse on voluntary departure from life, examines the ethical aspects of existing views on euthanasia. It is noted that adherence to the principles and rules of biomedical ethics is of particular importance when making decisions regarding the end of life. The paper presents the relationship between the characteristics of modern society and hedonistic tendencies, determined when choosing the value orientations of young people who have chosen medicine as their future profession. In this regard, it is necessary to discuss issues related to the ethical aspects of euthanasia at interdisciplinary platforms in the professional community of representatives of medicine, philosophy, law and religious organizations. The author comes to the conclusion that following the norms of morality in the activities of a doctor, determined by the centuries-old achievements of philosophical thought, predetermines the trajectory of his professional activity in terms of the duty he performs.

Received: 2023-07-05

Published online: 2023-09-18

DOI: 10.24075/medet.2023.021

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VIEWS 1828

Borisova AO, Nesterov RS

Preconception genetic testing for carrier diseases (PGT(C)) became a noticeable sociocultural phenomenon that raised various ethical issues with the individual and society. The issue of informing patients about the risks of giving birth to children with genetic abnormalities includes a range of questions about the probabilistic nature of genetic data, determinism, and cost and quality of medical and genetic counseling. Preventive tasks of genetics inevitably raise a question about the borders of a patient’s autonomy and mutual responsibility of the individual and society. In this article, ethical and philosophical analysis of sociocultural aspects of PGT(C) has been presented, including neoeugenic prevention traits, hubris and genetic fatalism.

Received: 2023-05-21

Published online: 2023-09-14

DOI: 10.24075/medet.2023.020

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VIEWS 2119

Firsov DE

In this article, ‘Sovereign Decision’ has been analyzed in the discourse of medical ethics (authors: Mihailo Lukovich, Katarina Meistorovich, Dunja Knezhevich). The interdisciplinary approach to the issue of axiological dissonance has been justified. It arises at the demarcation line of scientific private interests and society expectations and concerns implementation of research outcomes into the social practice. According to the authors, the ‘sovereign decision’, the key notion of the research, is a social phenomenon. In it, the legal sense of exclusive authorities becomes the imperative of an informed (ethical) choice in boundary situations of the subject’s legal elimination in relation to whom the ‘nominal’ or ‘exclusive’ medical decision is taken. By analyzing the issue of the ‘sovereign decision’ using the examples of vaccine prevention and euthanasia, the authors reveal the dialectic nature of the responsible choice. The issues that go beyond the subject of research seem perspective as well.

Received: 2023-08-16

Published online: 2023-09-12

DOI: 10.24075/medet.2023.019

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VIEWS 1645