Medical Ethics

ISSN Print 2713-0894 ISSN Online 2713-0908

BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

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Issue 1, 2025

Topic Amendments and additions to the Helsinki Declaration of the World Medical Association "Ethical principles for medical research involving human subjects"

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Issue 4, 2023

Topic Medical ethics as an applied theory of development

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Issue 1, 2024

Topic Development of neurotechnologies. Ethical issues and public discussions

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Issue 2, 2024

Topic Ethical aspects of creating clinical guidelines for practitioners

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Issue 3, 2024

Topic Application of artificial intelligence in healthcare: ethical conclusion

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Issue 4, 2024

Topic Implementation of neurotechnologies. Development of ethical guidelines

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New articles

The study covers the problem of insufficient regulation of pediatric deep brain stimulation (DBS) in Russia, which causes neuroethical dilemmas and risk of unjustified expansion of indications. The study is relevant because of growing use of DBS in children with severe neurological disorders and lack of adapted standards. The aim of the study is to identify gaps in regulatory system and develop recommendations for ethical and clinical regulation of DBS in children. The current clinical recommendations of the Ministry of Health of the Russian Federation, international consensuses and protocols of leading Russian centers were used as a basis for the research. The main methods included analysis of regulatory documents, comparative and critical analysis of existing standards and ethical approaches. The results show that Russian practice lacks age-specific standards and assessment algorithms despite the regulations. The risks of expanded indications and pressure on patients and their families, which may lead to unregulated experimentation, have been identified. As a conclusion, the need to develop specialized recommendations and strengthen ethical standards to ensure safety and effectiveness of DBS use in children is proposed.

Received: 2025-06-06

Published online: 2025-07-03

DOI: 10.24075/medet.2025.010

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Kostrov SA, Potapov MP

The article analyzes the latest ethical challenges associated with introduction of large language models (LLMs) in medicine and healthcare. Various LLM architectures, stages of their training (pretraining, pretuning, reinforcement learning from human feedback) and criteria for quality of training data are reviewed. The emphasis is on a range of ethical issues such as copyright for AI-generated content; systematic bias in algorithms and risk of generating false information; a need to ensure transparency and explainability of AI (XAI); issues of confidentiality and protection of personal medical data, including difficulties with anonymization and obtaining informed consent. Aspects of legal responsibility for using LLMs in clinical practice are also analyzed and technological solutions (federated learning, homomorphic encryption) to minimize risks are discussed. The need for an integrated approach combining technological improvement, development of ethical standards, adaptation of legislation and critical supervision of the medical community is emphasized to ensure safe and effective integration of LLMs into clinical practice.

Received: 2025-05-06

Published online: 2025-06-29

DOI: 10.24075/medet.2025.008

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VIEWS 44

Khokholov AL, Pavlov AV, Kotlovsky MYu, Potapov MP, Gabidullina LF

Today, quantum computing is one of the most promising areas of modern science that can solve the problems which are too hard to handle for classical computers. However, a huge potential accompanied by a rapid progress in this area creates significant ethical risks, including threat of hacking existing cryptographic systems and the problem of non-transparent decisions made using quantum computing. The article highlights the need for timely ethical analysis, development of a regulatory framework, and interdisciplinary collaboration to ensure sustainable and socially acceptable technology development. Main ethical, bioethical challenges, in particular, that arise against the background of quantum computing, and identification of possible ways to regulate them captivate special attention.

Received: 2025-05-05

Published online: 2025-06-23

DOI: 10.24075/medet.2025.007

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VIEWS 76

Begishev IR, Shutova AA

The article reviews the concept of predictable harm as a methodological tool for a comprehensive risk assessment while developing and implementing AI-powered medical devices. The study is relevant due to exponential growth of using AI-powered technologies in healthcare and lack of unified approaches to prediction of potential negative consequences of their usage. Existing regulatory approaches to risk assessment, including Russian regulatory documents and international standards, have been analyzed. A multidimensional classification of types of predictable harm is proposed considering the entire life cycle of medical AI systems. Special attention is given to ethical aspects of using artificial intelligence in medicine, including the principles of patient autonomy, equity, non-harm and transparency of algorithms. An expanded matrix for assessing predictable harm has been developed. It integrated technological, clinical and ethical parameters for each stage of development and implementation of AI systems in medical practice. The results of the study can be used as a methodological framework for developers of medical AI systems, regulatory authorities and medical organizations in assessing safety and effectiveness of introducing intelligent technologies into clinical practice.

Received: 2025-05-03

Published online: 2025-06-15

DOI: 10.24075/medet.2025.006

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VIEWS 116

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Popular articles

Medvedeva EA, Marin GG, Chernogorova MV, Bakhareva IR

One of the important factors of medical deontology is the focus of a healthcare professional on the health of patients and colleagues in case of increased infectious morbidity within the framework of limiting transmission of an infectious agent. The aim of the study was to assess the true frequency of regulated use of PPE, including in the provision of medical care to patients with COVID-19, and compliance with the isolation regimen in case of respiratory illness among health workers. The study was conducted using the Internet (the questionnaire is posted on ancetolog.ru) from January to March 2022 (ongoing COVID-19 pandemic). Survey data of 3,570 respondents was analyzed in accordance with the quality criteria for filling out the questionnaires. The overwhelming majority of the respondents were women, 63.6% (2,269 people) and 36.4% (1,299 people) were men, the average age of the respondents was 38.9 ± 14.22 years. Non-compliance with the rules of wearing PPE was detected for every fourth respondent (24.9%), 4.1% refused to wear PPE, and 7% complied with the rules of wearing PPE in the workplace only when their non-compliance could be noticed. The data we have obtained indicates that a quarter of health workers do not follow professional ethics in the framework of preventive measures to reduce infectious diseases, threatening the health of colleagues and patients by their behavior in the workplace.

Received: 2024-12-20

Published online: 2025-03-05

DOI: 10.24075/medet.2025.001

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VIEWS 357

Yunusov AS, Molodtsova EV, Maletina DV, Belavina PI

A patient-physician relationship is regulated by the principles of medical ethics and the Law on Healthcare of the Russian Federation. In pediatric practice, ethical issues are even more important. Pediatric otorhinolaryngology is one of the most popular branches of medicine that diagnoses, treats and prevents diseases of the ear, throat and nose (ENT) in children. ENT diseases are most common in childhood. Pathology of the upper respiratory tract and diseases of the ear and mastoid process account for about 20% of all cases. The prevalence of pediatric otorhinolaryngologic diseases currently accounts for 184 per 1,000 children; however, as they age, the chronic pathology of the ear, throat and nose is increasing. This field has its own unique ethical and legal aspects that require special attention of medical professionals, parents, and legislators. In Russia, ethical and legal issues of pediatric otorhinolaryngology have not been addressed for a long period of time, although it has its own peculiarities due to anatomical and physiological features of a child’s ENT organs. The article provides detailed description of ethical and legal problems in the practice of an otorhinolaryngologist and describes how to solve them. Compliance with the rules will improve quality of medical aid among children.

Received: 2025-03-02

Published online: 2025-03-30

DOI: 10.24075/medet.2025.035

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VIEWS 354