Medical Ethics

ISSN Print 2713-0894 ISSN Online 2713-0908

BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

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Abramova AV, Abramova VO

Further development of genetic engineering improved the chances to defeat deadly disorders due to discovery of innovative methods of treatment of various diseases, including oncological ones. In doing so, the methods have to go through clinical trials; they are not safe today. In fact, a paradox emerges: the trials are necessary, but they can’t be approved in accordance with regulatory requirements, as the risk for the subjects is higher than the benefit. For oncological patients, clinical trials, however, are the last chance for salvation. This requires an additional ethical discussion regarding approval of ethical expertise by the corresponding authorities in these exceptional cases. In this regard, the author of the article provides an ethical assessment of human genome editing applications from the point of view of risk and benefit for a subject and community of subjects, taking into account such ethical principles as ‘human priority’, ‘precautionary principle’ and ‘principle of responsibility to future generations’.

Received: 2022-04-24

Published online: 2022-06-30

DOI: 10.24075/medet.2022.049

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VIEWS 1469

Continuous development of social relations implies the need in constant improvement of primarily legislative regulation so that it could adapt to the current realities in the society and country. This assumption is true both with regard to the legal regulation of the status given to participants of genomic research, as this relatively new area of social relations embraces both public, and private interests. In this respect, legal regulation should consider certain principles such as the balance of public and private interests, protection of human rights and freedoms, protection of sensitive data by the law, protection of the national interests, etc. Nevertheless, normative legal regulation of the status of genomic research participants in the Russian Federation is not complex in nature yet. Thus, it fails to result in development of this area of social relations and ensuring the rights, freedoms and legitimate interests of the mentioned persons. It is necessary to settle the issue about the boundaries of the allowed behavior, rights, obligations, guarantees and liability of genetic research participants. It seems to be appropriate to develop a complex federal law about the legal status of genetic research participants in the Russian Federation. A general approach to arranging complex legal regulation in this field consists in systematization of the existing legal regulation considering legislative regulatory activity of the discovered issues in the field of using genetic technologies and conducting genome research. During the regulatory control, it is necessary to reflect common moral and ethical principles and standards of medical and genetic research.

Received: 2022-04-22

Published online: 2022-06-30

DOI: 10.24075/medet.2022.046

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VIEWS 1448

Sinitsina II, Nenascheva NM, Peredelskaya MYu, Sosin DN

While obtaining voluntary informed consent from patients with chronic obstructive pulmonary disease (COPD), bronchial asthma and patients presenting with psychiatric symptomology who participate in clinical trials, it is necessary to remember not only about the rights and ethical standards, but also about an extremely vulnerable position of the participants due to their disease specificity. Changes in the mental status of the patients and principal problems of every patient need to be considered. In this article, the aspects of obtaining informed consent from patients with respiratory diseases such as bronchial asthma and COPD and those under psychiatric supervision are reviewed. Apart from general recommendations, every category of patients has its own specific features. Being aware of them will improve doctor-patient communication.

Received: 2022-01-22

Published online: 2022-03-30

DOI: 10.24075/medet.2022.042

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VIEWS 1429

Oxyethylammonium methylphenoxyacetate is an adaptogenic immunomodulator with a complex mechanism of action. It can be successfully used for treatment, prevention and restoration in case of flu and cold, and to improve working capacity in asthenia, including conditions developed following COVID‑19. Clinical investigation of the effect produced by oxyethylammonium methylphenoxyacetate demonstrates its effectiveness under extreme climate and geographic conditions, during physical and mental overload, exercise, viral infections, severe infectious pathology, and all diseases associated with a weakened immune system. Based on conducted clinical trials of oxyethylammonium methylphenoxyacetate, no adverse effects were found and good tolerability was observed. Due to good compatibility of oxyethylammonium methylphenoxyacetate with other agents, it can be included into complex rehabilitation programs as an independent or/and complementary agent. This increases effectiveness of the conducted treatment and improves the diagnosis.

Received: 2022-01-23

Published online: 2022-03-30

DOI: 10.24075/medet.2022.041

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VIEWS 2019

Khokholov AL, Belousov DYu

Scientific development of 3D bioprinting is rapidly advancing. Bioprinting is expected to be actively implemented within the healthcare industry producing a revolutionary impact on transplantation. However, the innovative biotechnology involves numerous ethical and regulatory issues. Special attention is given to ethical issues associated with the use of embryonic cells, storage of personal data, obtaining informed consent, and peculiarities of clinical trials. The issues of safety and quality are reviewed. Equal access to technologies and use of biotechnologies to ‘enhance a human being’ are addressed. The issues of culture and religion are separately discussed within the context of this technology. It is stressed that as far as the issue of ethical estimation and legal regulation goes, 3D bioprinting can’t be completely assessed with the help of regular clinical trials or acting regulatory requirements. In particular, no suitable regulatory system or special documents regulating 3D bioprinting of tissues and organs and their subsequent transplantation are currently available in Russia or globally. Thus, it’s necessary to develop requirements to safety, quality and effectiveness of technological processes and end products obtained with the help of 3D bioprinting with the best interests of generally acknowledged human rights.

Received: 2022-01-20

Published online: 2022-03-30

DOI: 10.24075/medet.2022.040

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VIEWS 1751

Firsov DE, Miroshnikov AE, Pozdnyakov NO

The article reviews the edition known as ‘Ethical Examination in Biomedical Research: Practical Considerations’ (third edition, revised and enlarged) under the general editorship of Professor Khokhlov AL, a corresponding member of the Russian Academy of Sciences. Due to a constantly growing number of clinical trials of medicinal products and improved level and quality of medical technologies, the role of an ethical examination aimed at compliance with ethical rights of trial participants and consumers, and safety aspects is increased. The article sums up what was described in the published edition.

Received: 2022-01-20

Published online: 2022-03-30

DOI: 10.24075/medet.2022.038

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VIEWS 1428

Guryleva ME, Nezhmetdinova FT

New forms of medical aid have been widely used in the presence of global digital transformation of medicine. This concerns not only medical equipment and ensuring access to health services, but also the entire healthcare system and doctor‑patient relationship. It’s impossible to imagine modern medicine without digital decisions. Digitalization of the available information and making it available for all participants of the doctor‑p atient system form the basis of subsequent development of clinical practice, breakthrough in scientific research, improved patient‑ centered healthcare, and comfort of system operation for people. This requires a general culture of values and ethical standards that should correspond to digital decisions. The article deals with the reasons for actualization of remote forms of doctor‑p atient communication during the COVID‑19 pandemic illustrated by telemedicine. Principle forms of telemedicine under modern conditions caused not only by the pandemic but also by digital transformation of medicine have been reviewed. Special attention is given to possibilities of telemedicine from the point of view of benefit, as well as to legal and ethical aspects from the point of view of risks.

Received: 2022-01-23

Published online: 2022-03-30

DOI: 10.24075/medet.2022.039

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VIEWS 2671

Kozlova OV, Khristenko DN

In the modern world, a human being comes across the double absolute priority given to the values of medical ethics. On the one hand, moral ideals are metaphysical by nature. On the other hand, a human being treats ethical standards of medical ethics pragmatically. In this aspect, the key players of the ancient world who developed the metaphysical basics of medical ethics were especially important. The study is aimed at determining the contribution of ancient thinkers into development of fundamental basics of medical ethics. The works of ancient thinkers were taken as materials for the study. The study methods are represented by system analysis, dialectic method, phenomenological and hermeneutical approaches that enable to interpret the ideas of thinkers in relation to creating the basics of medical ethics. It has been established during the study that thinking based on the integration of rational, empirical and metaphysical principles has been developed in the ancient world. Metaphysical provisions of Plato and Aristotle manifested through the works of Galen make it is possible to conclude on eclectic philosophical views of Claudius Galen. Eclecticism is not just about plain borrowing of ideas, but about new fusion of physics, logics, and metaphysics in relation to understanding human health and disease. It can be stated that the first stage of nature cognition (natural philosophy) is the most important stage of developing sense-making basics of medical ethics. This period turns into a starting point for the emerging basics of fused humanitarian and natural science- based knowledge and formation of medical ethics principles.

Received: 2022-01-17

Published online: 2022-03-30

DOI: 10.24075/medet.2022.035

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VIEWS 1482