ISSN Print 2713-0894    ISSN Online 2713-0908
Medical Ethics
BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

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The article contains the results obtained during an empirical study of health care practices among people of a large Russian city implemented in a combined strategy in 2020–2021. Our focus remains on the reference of citizens to the procedure of DNA diagnostics as a novel instrument of health-saving behavior and attitude to genetic knowledge in general. The obtained data allow concluding that genetic testing is not widely popular among population today, as only 9,5% of those interviewed have ever done it. DNA diagnostics is more frequently used by young women and men with high income and don’t trusting modern medicine, which probably reflects the actual condition of the market of genetic services in our country. Apart from financial possibilities, involvement into consumer genomics is influenced by insufficient trust in DNA information, and suspecting that players on the market of genetic services obtain economic profit. However, the most important argument against it consists in the discovered discrepancy between perception of genetic data as something inevitable and currently popular ideology of healthy lifestyle, meaning that a person can influence the outcome of the efforts made. As a result, research participants are not willing to become the everlasting ‘patients-in-waiting’ even in case of existing symptoms, but implement their ‘right not to know’. Under these conditions, an important task includes organization of active promoting awareness that unlocks potential, capabilities and limitations of genetic diagnostics.
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Although legal regulation of genetic research has been steadily improved, it is still lagging behind promotion of genetic research, especially in the field of development and use of its achievement-based technologies. A distinct feature of this legal area is currently a higher dependence on ethics. This resulted in establishment of a special institution, an ethics committee, that unites the possibilities of ethical and legal expertise giving birth to numerous organizational and substantive issues. Some of them are reflected in discussions about the relationship between moral reflection and legislative processes, epidemiological status of bioethics, etc. For instance, in Russian literature there is a thesis that organization and conduction of ethical expertise is regulated much better than those of legal one and can be implemented within the current legal and regulatory framework. Meanwhile, a need for legal expertise in genomic research and genetic technologies is not inferior but even superior. This is confirmed by deficient legal support of many important decisions taken by the authorities and actions accomplished by research groups. The article reviews opinions of Russian and foreign scientists who provide different assessment of the role of ethics committees and their possible falling within law or ethics. The role and place of ethics committees in the system of rule-making harmonization and law enforcement are specified.
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In developed countries, mortality from cerebrovascular diseases (CVD) is about 12%, which is second only to mortality from cardiovascular diseases. In order to make treatment of CVD successful, a complex approach to the problem is required with compensation for cardiovascular diseases (atherosclerosis, arterial hypertension, rheological properties of blood, etc.), elimination of neurological and psychopathological syndromes, improvement of cerebral circulation and use of neurotropic agents. The use of neurotropic agents by a practicing physician is complicated due to the lack of a clear classification reflecting their position and significance in CVD treatment. It is suggested that taking into account the predominant mechanism of action targeting for a pathological process, neurotropic agents should be divided into 4 groups such as neuroprotectors, neurometabolics, nootropics and neurotrophic agents (direct activators of neutrophin synthesis in the brain). The last group is related to analogues of regulatory peptides and shares positive properties with medicinal agents from other groups: they have the properties of primary and secondary neuroprotectors, neurometabolics, and produce a positive effect on cognitive functions of a healthy and sick person. Heptapeptide Semax is a typical agent belonging to this group.
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