Medical Ethics

ISSN Print 2713-0894 ISSN Online 2713-0908

BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

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In this article, the evolution of ethics in traumatology and orthopedics is explored. Timeline history of medical ethics, from ancient postulates to modern professional codes, is discussed. The fundamental principles of modern bioethics are delved into. These include respect for patient autonomy, informed consent, confidentiality and professional responsibility in treating patients with injuries. Particular attention is paid to communication, practical application of ethics in the clinical examination, and continuity of care. The final section highlights the emerging ethical challenges of the 21st century associated with the technological progress, allocation of resources and palliative care in traumatology. The article demonstrates that the doctor–patient relationship has moved from a paternalism-based model to one with active involvement of a patient in the process of treatment.

Received: 2025-07-24

Published online: 2025-08-23

DOI: 10.24075/medet.2025.012

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VIEWS 46

Along with well-known scientists who dealt with the issues of medical ethics, writers, some of whom were also medical doctors, made a significant contribution to the development of the field under study as well. The surviving pieces of writing are highly valuable not only for Russian culture but also for sciences, especially for biomedical, social and humanitarian sciences. The stories of Anton Chekhov, a doctor, a writer and a public figure of the second half of the 19th century, made a significant contribution to Russian and global culture. Chekhov’s correspondence with his family members and notable figures of that time is an independent layer for researchers. To date, they have been important sources for historians, cultural scientists, health care organizers, lawyers, and specialists in ethics.

Received: 2025-06-02

Published online: 2025-08-23

DOI: 10.24075/medet.2025.011

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VIEWS 62

The article examines the relationship between religious values and rational principles of science. The purpose of the study is to identify common grounds of religion and scientific rationality to determine the foundations of medical ethics. The article examines the concept by Kavelin KD in relation to opinions of modern philosophers. Religion educates a moral person and provides guidelines for medical ethics, medicine and scientific knowledge, while science, rational knowledge, clarifies the general conditions of actual existence and provides a tool for arranging a human life. It is concluded that both religion and science display interest in the same task but in a different way. Thus, religion looks at the mental, subjective, and moral side, whereas science is interested in something external and objective.

Received: 2025-05-16

Published online: 2025-06-30

DOI: 10.24075/medet.2025.009

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VIEWS 157

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: 2025-06-30

DOI: 10.24075/medet.2025.010

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VIEWS 147

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 258

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 201

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 240

Semenova NV, Martynyuk KL

The use of artificial intelligence systems (AIS) in healthcare is one of the promising solutions for improving access of citizens to modern medical technologies to prevent mental health disorders, stress-associated and psychosomatic diseases, to ensure early diagnosis and correction of mental disorders and their risk factors. However, an urgent problem is assessment of the risks of implementing AIS in the field of mental health and possibilities of managing such risks depending on various factors affecting clinical outcomes, as well as ethical aspects related to provision of this type of AIS-based medical care. The proposed risk classification system for the use of AIS in the field of mental health will expand the possibilities of introducing medical AIS into clinical practice while maintaining a high level of control over the risks of mental health disorders.

Received: 2025-04-22

Published online: 2025-06-09

DOI: 10.24075/medet.2025.005

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VIEWS 227