Medical Ethics

ISSN Print 2713-0894 ISSN Online 2713-0908

BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

Log In Registration RU

This article addresses problems stemming from the implementation and development of digital health in general and telehealth in particular. It focuses on ethical and legal issues associated with the progress of new information technologies and other technologies used in health care. The aim of the article was to define the role of ethical and legal norms in the implementation and development of telehealth. The analysis of the currently effective legislation, its application and lacunae in the regulation of new forms of social relations suggests the need to expedite development of legal and ethical guidelines for the implementation of new technologies in health care. Higher standards of data security for vulnerable groups of patients should be established in the legislation and ethical guidelines.

Received: 2021-08-02

Published online: 2021-09-30

DOI: 10.24075/medet.2021.025

Comments 0

VIEWS 722

Podurueva-Miloevich VYu, Krivosheeva NI, Martinson ZhS

The article deals with ethical aspects of psychological and pedagogical approach of teaching international medical students in the process of educational computerization at modern universities. Particular attention is paid to studying the basics of psychology and pedagogy and mechanisms of distance learning, taking into account cognitive and personal traits of students to develop their professional knowledge, skills and competencies.

Received: 2021-08-07

Published online: 2021-09-30

DOI: 10.24075/medet.2021.022

Comments 0

VIEWS 775

Digital technologies are currently entering a human life and changing it drastically. Education, economy and healthcare go hand in hand with digitalization. The author of the article stresses that digital technologies spawn fear and mistrust in many people. This applies especially to digitalization of the healthcare system. To overcome the mixed feelings arising in people, we need to understand what digitalization is and review its perspectives and threats. Thus, the purpose of this paper is to consider perspective trends of digitalization of the Russian healthcare system and reveal the existing risks. The author of the article analyzes the normative legal base devoted to the development of healthcare system in Russia, examines the available articles of scientists on the subject, and analyzes the interviews undertaken by IT company representatives, which assess the use of digital technologies in medicine. Based on the performed analysis, the author underlines the following upcoming trends in healthcare digitalization: rapid data generation and processing, remote medical aid, remote enrollment in a medical institution, and easy access to an electronic medical record. The author mentions the following risks: a set of personal data, which could be stolen from digital media, mistakes existing when telehealth technologies are used, and impossibility to get access to a high-speed Internet connection in some Russian regions. According to the author, coordinated work of all actors of healthcare digitalization will allow to keep to a minimum or completely avoid the mentioned risks.

Received: 2021-08-02

Published online: 2021-09-30

DOI: 10.24075/medet.2021.021

Comments 0

VIEWS 755

Zhukova OV, Khokholov AL

The features of evaluating data from real clinical practice are discussed. Approaches to material processing for decision support in medicine and health care are also given. The development of standardized methods of analysis with the possibility of obtaining a unified indicator for assessing data from routine clinical practice, combined with the development of information technology is the direction of development of the concept of result-oriented health care. The classification of information technologies used in medicine and public health is presented. The main characteristics and functioning features of the developed software modules for automated data evaluation of real clinical practice are presented: a program for the distribution of drugs on the levels of clinical efficacy, a program to assess the effectiveness of therapy for the specified period; a program to determine the interval of clinical efficacy of drugs.

Received: 2021-08-06

Published online: 2021-09-30

DOI: 10.24075/medet.2021.020

Comments 0

VIEWS 826

In this article, the author examines the philosophical issues associated with the introduction of artificial intelligence (AI) systems in medicine. Currently, the use of AI technologies in the field of medical sciences is one of the most important trends in the world of health. ‘Smart’ AI systems are able to learn from their own experience, adapt in the environment and, according to the parameters of the assigned tasks, can make decisions that in the past belonged only to humans. These AI technologies provide an opportunity to take diagnostics, treatment and disease prevention to a higher level. Particular attention is paid to the ethics and moral obligations of AI developers and healthcare professionals in the transition to such digital medicine.

Received: 2021-08-01

Published online: 2021-09-30

DOI: 10.24075/medet.2021.019

Comments 0

VIEWS 885

Chudova NV, Tsyzman LG

The article analyzes how well members of research ethics committees (RECs) know the operational and organizational procedures of REC and provides the assessment of standard operational procedures for professional training of REC members.

Received: 2021-03-20

Published online: 2021-03-31

DOI: 10.24075/medet.2021.008

Comments 0

VIEWS 859

Even T. Beauchamp and J. Childress, the founders of ethical principlism, noted that in practice the principles of bioethics, which they might have formulated, may conflict, and adherence to one principle may violate the other. To date, the conflict between the principle of autonomy and the doctrine of informed consent, and the principle of vulnerability formulated ten years later (one of the principles introduced by P. Kemp) and the necessity to take care of the patient is one of the major irreconcilable conflicts. This conflict is especially severe in Russia, where the informed consent was immediately enshrined as a statutory provision without prior discussion with the medical and non-medical communities, which gave rise to numerous opportunities for misuse and abuse, and stepped up the bureaucratic pressure both on patients, who became more vulnerable, and the physicians, who started using the informed consent to their advantage, sometimes being openly market-oriented. The growth of mutual mistrust, sometimes reaching the level of aggression, forces one to find a remedy for this situation. In the author's view, this requires revision of the patient’s autonomy concept and the concept of informed consent considering the acceptance of the patient’s intense vulnerability and the patient’s need for the healthcare specialists’ (physicians and nurses) personal involvement and care. It may be helpful to consult the writings of the ethics of care, feminist ethics and other ethical trends representation, as well as the results of field research aimed to combine principles of freedom and patient care in a given situation.

Received: 2021-03-12

Published online: 2021-03-31

DOI: 10.24075/medet.2021.007

Comments 0

VIEWS 908

Vvedenskaya EV, Lepkova NV, Egorova AV

The article talks about the ethical dilemmas of diagnostic and prognostic disclosure in oncology. Below, we discuss the principles of diagnostic and prognostic disclosure to curable and terminally ill patients proposed by Soviet medical deontology. Despite its evolution, the principle of benevolent deception applied to incurable patients in the USSR still persists into the present. The article discusses the cons and pros of withholding the diagnosis from terminally ill patients and the Russian legislation on the patient’s rights. The article places a special focus on the strategy of disclosing an unfavorable diagnosis to a cancer patient adopted in Russian oncology.

Received: 2021-02-12

Published online: 2021-03-31

DOI: 10.24075/medet.2021.005

Comments 0

VIEWS 931