ISSN Print 2713-0894    ISSN Online 2713-0908
Medical Ethics

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Biography of Sergey Spasokukotsky, the outstanding Russian surgeon, is closely related to the Yaroslavl Territory. He spent his childhood in the Danilovsky region, coming from a large and friendly family of a zemstvo doctor. In 1880–1888, he studied at the Men’s Gymnasium after his family had moved to Yaroslavl. The building now belongs to the Yaroslavl State Medical University where a representative of his scientific school, Professor Busalov AA, worked decades later. Life and activity of Sergey Spasokukotsky represent a bright example of unselfish service to medicine. Being a graduate of the Emperor’s Moscow University, he had a chance to continue his medical career in Moscow but went to the province where he worked as a zemstvo doctor for many years, actively implementing advance achievements of medicine into abdominal surgery, neurosurgery, pulmonary surgery, creating novel and modifying available surgeries. S. Spasokukotsky and his student developed an affordable and effective method of preparing a surgeon’s hands for a surgery with 0.5% ammonia solution (method by Spasokukotsky and Kochergyn). The scientific and practical activities of Sergey Spasokukotsky resulted in the development of a large scientific school with an ultimate scientific social responsibility, originality, great depth and boldness while solving the issues of surgical pathology.
The article explains what an antibacterial reserve preparation means. It has been shown that the drug belonging to the group is determined by its pharmacological properties only such as a clinically significant (sufficient for empirical application) activity in relation to Pseudomonas aeruginosa or nosocomial (methicillin-resistant) strains of Staphylococcus aureus. It allows to differentiate between two categories of reserve antibiotics, which exert an anti-Gram-negative and anti-Gram-positive activity. There is an exhaustive list of preparations included into each group and available in the Russian market. Meanwhile, no drugs that correspond to inclusion requirements for both groups are available. Possible conflicts that occur during clinical application of antibacterial reserve drugs are comprehensively analyzed. It is based on divergence of interests of a patient and the patient’s representatives, treating physician, management of the clinic, hospital epidemiologists and manufacturers of reserve generics. Economic and general biological (selection of drug-resistant strains in extensively wide application) arguments commonly contradict the legal (compliance with clinical recommendations), moral and ethical (independence of aid quality from the patient’s prognosis) standards. The Legislator’s position in relation to the issue has been reviewed. Imperfect regularity framework and insufficient legal safety of a doctor make it possible to resolve conflicts through concessions and agreements including reserve antibiotics prescribed as per conditionally social indications.

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The article provides answers to immediate questions associated with the state regulation of confidentiality of information and exchange of data in the era of digital healthcare. The institute of medical confidentiality which originated in the ancient world is still evolving throughout the development of medical law. In the current era of global digitalization, however, the issues related to data confidentiality have become more relevant than ever. With all the modern technologies and digital health care platforms on the rise, new challenges associated with protection of these patients are emerging. To ensure the reliable protection of patient’s personal and medical information, doctors and medical institutions have to meet data security standards. It becomes vital to develop effective strategies and mechanisms to prevent unauthorized access and data leakage due to a larger volume of electronic medical records and digital data exchange. Strict rules and standards regulating collection, storage and transfer of medical data belong to a key aspect in this area. The Russian Federation is making great efforts to create the legislation which could protect the rights of patients and made medical establishments to follow the high standards of confidentiality, and to develop technical aids that provide data encryption and protection against hacker attacks.