Medical Ethics

ISSN Print 2713-0894 ISSN Online 2713-0908

BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

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Demarina SM, Usolkin AA, Balashova YD, Tikhomirova SV

This review examines the ethical and legal implications of creating pharmacogenetic passports during the preconception (prior to conception) and prenatal (intrauterine) periods. The work is based on a methodological differentiation between the stages of genetic testing.. Preconception screening aims to assess carrier status in prospective parents and ensure their reproductive freedom, while prenatal testing provides fetus-related data, raising bioethical issues regarding the protection of interests and self-determination of the future child. The technologies of non-invasive prenatal testing (NIPT), preimplantation genetic testing (PGT), and prospects for intrauterine pharmacotherapy in severe congenital abnormalities are discussed. Special attention is given to ethical conflicts such as a conflict between the right to health and the right not to know, limits of parental proxy, and risk of genetic stigmatization. Normative approaches are suggested to address the identified ethical tensions (minimum intervention, clinical benefit, and deferred choice). The analysis of the Russian legislation and international instruments (Oviedo Convention, the GINA Act, the GDPR) yields recommendations for the healthcare system and legal regulation.

Received: 2026-03-19

Published online: 2026-05-23

DOI: 10.24075/medet.2026.012

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Gidirim UO, Beliaeva AM

The article presents an ethical analysis of randomized placebo-controlled trials (PCTs) conducted in developing countries in situations where effective treatment already exists elsewhere in the world. The authors examine a fundamental contradiction: the use of a placebo often becomes feasible only because of global inequality in access to healthcare, whereby the actual standard of care for the local population is the complete absence of treatment. Through two case studies: trials of drugs for HIV prevention and for the treatment of infant respiratory distress syndrome (IRDS) — the ambiguity of ethical evaluation is demonstrated. The key criterion for the acceptability of a PCT is identified as the degree of potential harm: while in the case of HIV the risk to participants was high but not fatal, in the case of IRDS the use of a placebo directly endangered the lives of infants. To provide a philosophical foundation for the problem, the authors employ John Rawls’ thought experiment of the “veil of ignorance” and Gerald Cohen’s test of interpersonal justifiability. From Rawls’ perspective, PCTs perpetuate injustice, because the standard of care cannot depend on a patient’s place of residence, and no one would agree to risk their life due to the contingency of being born in a poor country. Cohen’s test reveals the moral deficiency in the pharmaceutical companies’ reasoning: they themselves contribute to the inaccessibility of medicines and then use this as a justification for placebo controls. The conclusions argue for the necessity of a differentiated approach: prohibition of PCTs when lethal risks are involved, and permissibility only under the condition that the research is aimed at developing accessible treatment for the same vulnerable population.

Received: 2026-03-13

Published online: 2026-05-21

DOI: 10.24075/medet.2026.011

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Rutkovskaya LM

The article analyzes the image of healthcare professionals shown in Russian poetry of the XX century through the lens of a duty. The topic declared as the subject of a special comprehensive survey has not been brought up in the Russian scientific field. The notion of ‘a duty’ is defined, a summary of research literature related to this issue is provided. The author mentions that the category of a doctor’s professional duty, which appeared in Russian poetry in the beginning of the XX century only, is firmly fixed and reflected herein during the entire investigated period. Meanwhile, poetry provides examples both for children and adults. In this paper, pieces of poetry by Mayakovsky VV, Chukovsky KI, Drunina YV, Zabolotsky NA and Rutkovsky MA have been analyzed. It is indicated that poetry produces a specific effect on the reader. The author concludes that the images of devoted doctors and nurses that have been created by Russian poets can play a significant methodological and educational role in developing the professional identity and personality of future healthcare professionals.

Received: 2026-04-02

Published online: 2026-05-10

DOI: 10.24075/medet.2026.010

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Sokolova OV, Zheltkevich OV, Kalabekova SV

The paper analyzes information security issues in Russian healthcare in the context of digital transformation. Digitalization of the healthcare sector, including integration of information systems of medical and pharmaceutical organizations with the Uniform State Health Information System (EGISZ), improves the quality of medicines and healthcare provided to the population. Meanwhile, the risk of patient personal data leakage and computer attacks on healthcare organizational information systems is increasing. The purpose of the study is to develop an integrated approach to information security in medical and pharmaceutical organizations. The research uses content analysis, logical and structural analysis of scientific papers and regulatory legal acts in the field of information technology in healthcare. The authors identify the stages of information security regulation from protecting medical secrets to categorizing critical information infrastructure and using domestic software. The classification of security threats to digital systems is provided based on the location of the threat source depending on whether they originate outside or inside the organization’s network perimeter. The directions and evaluation criteria for improving information security are provided based on modern methods and technologies of information protection, including technical means of protection, legal mechanisms, as well as organizational and managerial methods.

Received: 2026-04-10

Published online: 2026-04-27

DOI: 10.24075/medet.2026.009

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Bozhkova AG, Melkumyan AR, Spivak MV

Biobanking of patient- isolated microbial strains is a critically important tool for modern biomedical research, though it is associated with a complex of unresolved ethical and legal issues. The goal of this paper is to analyze the issues based on biobanking case studies at the National Medical Research Center of Coloproctology named after Ryzhykh AN. The focus is on the contradictions between the need for scientific progress and respect for the rights of donors, including obtaining informed consent and ensuring data confidentiality. The study material included legal documents and internal regulations describing how to work with microbial collections. During the analysis, isolated Russian legislation, lack of a clear legal status for biological samples and dependence of ethical aspects of work on local protocols and internal policy of the institution have been found out. The key conclusion is the urgent need to develop a specialized regulatory system that harmonizes the principles of bioethics with the practical tasks of biobanking, establishing clear rules for handling a patient’s microbiota and consent management mechanisms.

Received: 2026-02-28

Published online: 2026-03-31

DOI: 10.24075/medet.2026.008

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Eregina NT, Yeregin SY

The article analyzes the historical and medical literature devoted to the life and work of Matvey Yakovlevich Mudrov (1776–1831). The first stage in the historiography of this issue was the pre-revolutionary interpretation of Mudrov’s personality and his contribution to the development of clinical medicine. The main attention was paid to biographical facts, assessments of Mudrov’s professional activity by the medical community, and a general description of his role in Russian medicine. In the middle of the 20th century, a canon emerged that consistently described the main milestones of his biography. This narrative formed the basis of educational, reference, and popular science publications. Since the mid-1990s, the interest of practitioners in Mudrov’s legacy has come to the fore launching reassessment of his personality. In recent decades, the research has shifted to examining his impact as a reformer of medical education, organizer of clinical teaching, and creator of ethical medical standards. The implementation of research tasks contributed to the introduction of new archival data into scientific circulation, clarifying previously existing estimates and conclusions. The conducted historiographical review comprehensively covers the multifaceted activities of Mudrov MY and outlines possible prospects for further study.

Received: 2026-02-23

Published online: 2026-03-30

DOI: 10.24075/medet.2026.007

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VIEWS 230

Filatova YS

The professional activity of a doctor focuses on the intersection of clinical knowledge and ethical principles. Meanwhile, medical ethics establishes the value and ideological foundations of the profession, whereas deontology serves as a tool that implements the principles within particular standards and rules of behavior. The contradiction between the importance of ethical and deontological regulators and the lack of empirical data on their relationship to the psychological characteristics of the doctor’s personality makes the study relevant. The aim of the paper is to study the relationship between deontological competence of a doctor and communicative competence, metacognitive characteristics and socio-psychological attitudes. 72 internists participated in the study (the average age was 48.5 years; the average proven record was 21.6 years). The methods of diagnosis of communicative competence, metacognitive knowledge and activity, social and psychological attitudes, as well as the author’s methodology for assessing deontological competence were used. Statistical processing included correlation analysis using the r-Spearman coefficient. Significant positive links of deontological competence with communicative ideals, metacognitive knowledge, metacognitive activity, concentration, choice of main ideas, time management, focus on altruism, as well as negative links with focus on selfishness and material values have been established. Deontological competence is an integrative education that combines value-semantic, reflexive-regulatory and motivational components, which allows it to be considered as a key mechanism for the implementation of ethical principles in clinical practice.

Received: 2026-02-18

Published online: 2026-03-29

DOI: 10.24075/medet.2026.006

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VIEWS 233

Startseva ON

The article shows how gerontological ageism can be prevented by embedding professional ethics in training of social workers. The ageism is often manifested through emotional alienation of young people and discriminatory practices towards the elderly. Survey data on social work students from the Yaroslavl State Medical University (YSMU) confirm the need for the training. During the survey, the KPAINS Freedom from Age questionnaire, which is a widespread gerontology tool, was used for early assessment of attitudes to aging. Young people’s psychological trends have confirmed that deeper ethical study is essential for those professionals who work with older adults. Students learn to apply the basic ethical principles of autonomy, dignity and justice while exercising complex interaction with older adults through analysis of practical cases. It confirms that training competent social professionals is ethically relevant.

Received: 2026-01-28

Published online: 2026-03-26

DOI: 10.24075/medet.2026.005

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VIEWS 263