Original research Educating relatives of ICU patients for better compliance: our experience
Saetgaraev AK, Maximov IL, Guryleva ME, Grigoreva IA
To reduce the risk of postoperative complications among elderly and senile patients, intensive care units can engage patients’ family members in delivering bedside care and assisting in their rehabilitation after completing a nurse skills training course. The aim of this study was to analyze the legal and ethical framework pertaining to ICU organizational practices, survey the family members of ICU patients and develop a nurse skills training course for family members at the Clinic for Anesthesiology and Intensive Care of Tatarstan Clinical Cancer Center. We analyzed ICU regulations and surveyed 35 family members of ICU patients using a specially designed questionnaire. In 2017-2019, 185 individuals took the proposed training course; 32 ICU patients received additional care from their trained relatives. The mental state of the patients was assessed on the Mini Mental State scale; their physical condition was also assessed (the presence of bedsores, enteral nutrition). Results: 71% of the respondents accept the restrictive policies of ICU, 97% believe they are ready to take care of their family member in ICU, 66% do not have the necessary experience. A 3-h long interactive training course was designed to teach family members nursing skills. A total of 185 volunteers completed the training course, and 32 ICU patients received additional care from their trained relatives. As a result, the quality of their enteral nutrition, skin condition and mental state improved. Engagement of trained family members in the care and rehabilitation of ICU patients creates a friendly atmosphere and promotes positive changes to the patient’s condition, their emotional and cognitive state.
Received: 2021-03-15
Published online: 2021-03-31
DOI: 10.24075/medet.2021.003
Comments 0
VIEWS 1047
Original research Ethical aspects of the informed consent during COVID-19 vaccination
Zorin KV, Gurevich KG
The main tactics used for COVID-19 prevention should be both quarantine measures and the large-scale vaccination of the population. This does raise many ethical issues related to obtaining informed consent in biomedical research and clinical practice. The full and adequate ethical review of vaccination against the novel coronavirus infection can be provided only subject to ethical aspects of voluntary informed consent. Without that, it would be impossible to control the quality, efficiency and safety of the vaccine, and, consequently, the patients’ vaccination and its results.
Received: 2021-03-01
Published online: 2021-03-31
DOI: 10.24075/medet.2021.009
Comments 0
VIEWS 962
Original research On the 75th Anniversary of the Beginning of the Nuremberg Trials and the Creation of the Nuremberg Code: Global Relevance and Enduring Lessons
Chuchalin AG, Sayamov YN
The article reveals the significance of the Nuremberg Trials for rethinking the moral foundations of medicine, investigates the role of the Nuremberg Code in the establishment of voluntary informed consent as a mandatory component of clinical trials and procedures and assesses the impact thereof on the international legal regulation of healthcare. The authors emphasize the importance of the Nuremberg lessons for understanding the ethical challenges that came into foreground in the 21st century due to the development of artificial intelligence, human genome editing technologies and the emergence of the new forms of parenting largely backed by the new reproductive technologies.
Received: 2021-02-12
Published online: 2021-03-31
DOI: 10.24075/medet.2021.002
Comments 0
VIEWS 1129
Original research Informed consent: from historic roots towards the red line of modern crises in infectious diseases
Kubar OI, Bichurina MA, Romanenkova NI
Stages of the informed consent (IC) process, being the instrument for protecting the rights and dignity of the research subjects, ideology and essence development during the crises in medicine have been studied on the example of the infectious diseases. Special emphasis has been placed on the 100-year national history of the informed consent ethical and legal principles development. The review of information process content and logistic improvement (individual, public, delayed and broad IC) during vaccine testing and vaccination in emergency settings has been provided. Implementation of the WHO programmes aimed at eradication of preventable infections (polio, measles) illustrates the coherence of adherence to awareness-raising ethical standards with the success of epidemic control. The development of preventive vaccination ethical algorithm and the practice of its use during the epidemic crises have a significant predictive value for organization and control of using the vaccines during the pandemic.
Received: 2021-02-18
Published online: 2021-03-31
DOI: 10.24075/medet.2021.010
Comments 0
VIEWS 895
Original research Awareness as a criterion of the legality of obtaining the patient's consent to medical intervention
Pishchita AN, Alekseev VA, Borisov KN
The doctrine of patient consent to medical intervention, as a compulsory procedure, emerged in the forties of the twentieth century. However, up until the present the problem of obtaining patient consent cannot be considered conclusively resolved. One of the intervention legality criteria is the patient's complete (sufficient) awareness of the proposed medical intervention.
Received: 2021-02-26
Published online: 2021-03-30
DOI: 10.24075/medet.2021.006
Comments 0
VIEWS 891
Original research Respecting patient autonomy: voluntary informed consent in modern medicine
Grebenshchikova EG, Chuchalin AG
The article discusses voluntary informed consent as a manifestation of respect for patient's autonomy, which is determined by both legal regulations and sociocultural factors. This approach is considered to be the most influential in current bioethics. The authors review the main elements of informed consent, its specificsin clinical trials and the autonomous choice criteria.
Received: 2021-02-12
Published online: 2021-03-30
DOI: 10.24075/medet.2021.001
Comments 0
VIEWS 974
Original research The inherent right to make a mistake (on informed consent)
Zorin NA
The Informed Consent (IC) procedure is considered as a legal construct, a product of liberal economics. As such, IC is a tool for shifting responsibility for the choice of intervention from the seller of health care services to the consumer and is a binding contract to avoid legal liability and all sorts of losses on both sides. The set of problems surrounding the IC can be explained by the significant difference between an experimental procedure (for which it was originally created) and everyday clinical practice. The application of the IC law has no mechanisms for its individual application because it fails to take into account the psychology of decision-making.
Received: 2021-03-16
Published online: 2021-03-29
DOI: 10.24075/medet.2021.004
Comments 0
VIEWS 904