Medical Ethics

ISSN Print 2713-0894 ISSN Online 2713-0908

BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

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Kulikova OA, Sokolova OV, Alekseeva KS

Professional activity in the sphere of pharmacological support means compliance with moral and ethical standards while fulfillment of labor functions by pharmaceutical professionals. The study purpose was to examine requirements for compliance with ethics and deontology placed on pharmaceutical professionals who carry out their professional activity. Study methods: content analysis, sociological survey, comparative analysis, mathematical and statistical methods, and ranking. Study materials: federal laws, orders of the Ministry of Health of the Russian Federation, occupational standards of pharmaceutical professionals, data from questionnaires of 95 pharmaceutical professionals. The performed analysis of regulatory documentation that regulates compliance with ethics and deontology by pharmaceutical professionals, examination of opinions of pharmaceutical professionals about the functions performed by them, identification of knowledge of those interviewed about constituents of ethics and deontology along with labor functions, fulfillment of which requires compliance with moral and ethical standards, displayed the necessity to improve knowledge and skills in the field of ethics and deontology at all educational levels.

Received: 2022-10-20

Published online: 2023-01-09

DOI: 10.24075/medet.2022.059

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VIEWS 1294

Zhilina AN, Melnikova JuE, Voronina MM, Martyshova AV

In spite of all existing achievements, modern endocrinology comes across a rather complex issue such as treatment of patients with catecholamine secreting tumors. True prevalence of pheochromocytoma is not known, as data obtained during the research depend on criteria of patients’ selection and can vary significantly. The tumors have numerous pathophysiological mechanisms of disease development due to a wide variability of symptoms and complex diagnostics. Meanwhile, timely diagnosis produces a direct effect on prognosis and quality of life. Catecholamine secreting tumors are commonly not detected. In such cases, there is a high risk of severe cardiovascular complications up to a lethal outcome. Complex diagnostics of this pathology also means that the tumors can have adrenal and extraadrenal localization and that the disease is hereditary. This makes diagnostics and treatment of pheochromocytoma even more complex. Timely detection of concomitant tumor and hormonal manifestations belongs to an important factor of management of patients with genetically determined pheochromocytomas. Thus, examination of pheochromocytoma is a pressing issue of modern endocrinology.

Received: 2022-07-25

Published online: 2022-12-15

DOI: 10.24075/medet.2022.058

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VIEWS 1298

Volkova AS, Ilyin MV, Kagramanyan IN, Khokholov AL

The concept of quality of life is an integral characteristic of human physical, psychological, emotional, and social functioning. The disorders associated with atherosclerosis reduce the patients’ quality of life. Surgical treatment improves physical health of patients with atherosclerosis affecting primarily precranial arteries. The decrease in the indicators of physical functioning, role-playing, and bodily pain in patients with atherosclerosis mostly affecting the arteries of lower extremities persists in the late postoperative period. Comprehensive analysis of the broad spectrum of factors, such as clinical and demographic, anatomic, laboratory and instrumental, medical and social, and psychological factors, is the key to successful revascularization associated with the lowest risk of possible adverse events that makes it possible to implement the personalized approach to treatment and rehabilitation of patients. Ethical regulation of the quality of life assessment by the patient, his/her relatives and medical professionals is required. Reconciling the positions of the parties on the issue requires bioethical expertise in studying indicators of the quality of life.

Received: 2022-07-18

Published online: 2022-12-12

DOI: 10.24075/medet.2022.057

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VIEWS 1348

Orlova NV, Suvorov GN, Gorbunov KS

Use of information technologies in medicine resulted in formation of large databases. Analysis of large databases allows to reveal the patterns between the environmental conditions, a way of life and morbidity, that promote a progressive study of pathogenesis, clinical course, disease prognosis, and accelerate clinical trials of novel treatment options. Large databases are most in demand in bioinformatics and biomedicine. The issues of using large databases are associated with a number of ethical issues such as confidentiality, informed consent, and privacy. Ethical issues of using personal medical data were reflected in international documents. The use of large databases is associated with a dilemma of legislative protection of patients’ rights, on the one hand, and a decrease in analytical capabilities of using the data, on the other hand. Several methods of medical data safety are suggested to prevent identification of patients. Depersonilized data belong to one way of solving the issues. The options of studying secondary medical data are being discussed.

Received: 2022-07-26

Published online: 2022-12-05

DOI: 10.24075/medet.2022.056

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VIEWS 2196

Borisova EO, Eremina OE, Gulbekova OV

In this article, various designs of clinical trials used to obtain new scientific knowledge in the field of clinical medicine are considered from the position of their evidential value in studying the cause‑and‑effect relationship between the influencing factor and result of its potential effect on human health. Basic differences between observational and experimental trials, their limitations due to peculiarities of design of clinical trials are being discussed. A conclusion is made that validity of results of clinical trials should be assessed taking into account the limitations that are typical of various designs. Accuracy of clinical trials depends on many factors that can distort the obtained results as compared with true values. It is noted that observational trials are subject to systematic and accidental errors to a greater extent than experimental ones. It occurs because design characteristics do not allow observational trials to control the mistakes associated with possible incompatibility of comparison groups. They can detect a statistical relation between the phenomena, but only randomized clinical trials can prove that there is a causal relationship. Accuracy of a randomized clinical trial can be increased using systematic reviews and meta‑analysis.

Received: 2022-07-23

Published online: 2022-11-30

DOI: 10.24075/medet.2022.054

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VIEWS 1457

Severova YaG, Teplova NV

The article discusses the issues related to the ethical aspects of the off-label use of medications for treatment of coronavirus infection, including in terms of conducting clinical trials of these medications. Furthermore, the article raises the issue of using drugs for treatment of coronavirus infection at the moment and discusses the related ethical principles. The major issue of this review is the ethical aspect of the search for benefits of using drugs not according to instructions in patients with emergencies and life-threatening conditions, such as COVID-19. The ethical role of the informed consent in both clinical trials and off-label prescription of drugs in general is also clarified. Several options provided in this review are proposed to address this issue.

Received: 2022-07-25

Published online: 2022-11-29

DOI: 10.24075/medet.2022.055

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VIEWS 1294

Zabolotneva YA, Gurevich KG

According to European authors, patients with multiple myeloma (MM) and high cytogenetic risk have shorter values of progression free survival (PFS) and overall survival (OS) as compared with standard hazard. More frequent hospitalizations mean potentially high expenses associated with management of patients with unfavorable cytogenetic risk. Cost and availability of treatment of oncological patients relate to one of pressing ethical issues. Another important aspect of this issue consists in an effective use of available approved modes of therapy in patients with various survival prognosis, which is especially critical for early lines of therapy. It has been proven that early administration of more effective modes based on individual characteristics both of a patient, and a disease will improve the total survival of patients. This will result in reduction of economic resources spent on selecting new modes of treatment in patients with a disease recurrence and correction of possible adverse effects and hospitalization.

Received: 2022-07-19

Published online: 2022-11-29

DOI: 10.24075/medet.2022.053

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VIEWS 1334

Sokolchik VN, Klimovich АI

The burnout syndrome is a disease of modern societies. The acquired data prove that health professionals are more prone to the disease than others. Global programs supporting health professionals with this syndrome are lacking. In most severe cases, this can result in a loss of a professional. The purpose of this study was to detect socioexistential, ethical and communication conditions for emotional burnout among healthcare professionals to develop recommendations that prevent the examined syndrome. The authors consider a health worker as a significant and continuously renewable health resource (from Public Health perspective) and as a compassionate person without professional patterns of empathy. The basic study material includes data obtained during interviewing and questioning of medical workers at the Belarusian State Medical University and Belarusian Medical Academy of Postgraduate Education and content analysis of international interviews, medical chats and social networks. The principal methods include questioning, interviewing and content analysis.

Received: 2022-07-21

Published online: 2022-11-28

DOI: 10.24075/medet.2022.052

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VIEWS 1436