Medical Ethics

ISSN Print 2713-0894 ISSN Online 2713-0908

BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

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Dvornikov AS, Minkina OV, Grebenshchikova EG, Vvedenskaya EV, Mylnikova IS

The article deals with ethical aspects of physician-patient relationship in dermatology, and demonstrates their influence on success of diagnostic and treatment activities and level of satisfaction with quality of medical services. Special attention is paid to the specific nature of bioethical issues in dermatology, associated with visuality and peculiarities of the course of disease, emotional and physiological background and coexisting disorders. Special priority is given to effective strategies of physician-patient communication, respect for patient autonomy and protection of confidentiality both in clinical practice, and on the Internet. It is shown that linking personal and strategic social media accounts raises a number of ethical and legal issues, associated with obtaining voluntary informed consent, compliance with standards of corporate ethics, and perception of medical information by non-professional audience. In conclusion, compliance with principles and rules of biomedical ethics is important to set constructive relations in clinical dermatological practice, ensure social trust in medicine and prepare future specialists. It is also important to discuss ethical issues in a professional community, slowly forming an interdisciplinary space of communication between physicians, health officials, specialists in bioethics, medical law, psychology and sociology of medicine.

Received: 2022-01-19

Published online: 2022-03-30

DOI: 10.24075/medet.2022.037

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VIEWS 2342

Fedorov VN, Petrovskii AK, Vdovichenko VP, Zakharova MN, Arshinov AV

In developed countries, mortality from cerebrovascular diseases (CVD) is about 12%, which is second only to mortality from cardiovascular diseases. In order to make treatment of CVD successful, a complex approach to the problem is required with compensation for cardiovascular diseases (atherosclerosis, arterial hypertension, rheological properties of blood, etc.), elimination of neurological and psychopathological syndromes, improvement of cerebral circulation and use of neurotropic agents. The use of neurotropic agents by a practicing physician is complicated due to the lack of a clear classification reflecting their position and significance in CVD treatment. It is suggested that taking into account the predominant mechanism of action targeting for a pathological process, neurotropic agents should be divided into 4 groups such as neuroprotectors, neurometabolics, nootropics and neurotrophic agents (direct activators of neutrophin synthesis in the brain). The last group is related to analogues of regulatory peptides and shares positive properties with medicinal agents from other groups: they have the properties of primary and secondary neuroprotectors, neurometabolics, and produce a positive effect on cognitive functions of a healthy and sick person. Heptapeptide Semax is a typical agent belonging to this group.

Received: 2022-01-20

Published online: 2022-03-30

DOI: 10.24075/medet.2022.036

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VIEWS 2082

Gayduk AYa, Vlasov YaV, Churakov MV, Polyarnaya NG, Sineok EV

The article discusses the most unfavorable course of multiple sclerosis — the secondary progressive form. In the course of the study, conducted by a questionnaire survey of patients with secondary progressive multiple sclerosis and specialists from multiple sclerosis centers from 15 regions of Russia, medical, labor and other characteristics of patients, their problems and needs, subjective attitude to the effectiveness of therapy and rehabilitation were clarified. The main, according to doctors, defects in the organization of medical care for patients with secondary progressive multiple sclerosis have been identified. In conclusion, it was concluded that there is a significant variability in the social status and living conditions of patients with secondary progressive multiple sclerosis. The authors consider the registration in the Russian Federation of highly effective drugs for the treatment of patients with secondary progressive multiple sclerosis to be one of the most important measures.

Received: 2021-10-07

Published online: 2021-12-30

DOI: 10.24075/medet.2021.031

Comments 0

VIEWS 1492

The article deals with the problem of ethical ambiguity of VR Potter’s approaches to the tasks of the civilization development associated with “dangerous knowledge”, primarily to demographic issues. The purpose of the study is to identify the methodological basis for a number of discussion theses in the program book by VR Potter “Bioethics: Bridge to the Futur”. Material of the work is presented by VR Potter’s “Bioethics: Bridge to the Future”. The research was performed using the comparative- historical and cause-and-effect analysis. The paper analyzes the significance of the “dangerous knowledge” considered by VR Potter as part of the humanistic content of bioethics. The author comes to the conclusion that the discussion theses of VR Potter’s bioethical concept are based on the methodological ‘realism’ of an expert who considered the current problems of society in the context of the rationalism of civilization.

Received: 2021-10-03

Published online: 2021-12-30

DOI: 10.24075/medet.2021.030

Comments 0

VIEWS 1383

Shereshneva MV, Ilyin MV

Coronary heart disease (CHD), being one of the most common cardiovascular diseases, has a negative impact on patients’ quality of life. The purpose of the work was to study the dynamics of quality of life indicators in patients with CHD during surgical revascularization of myocardium depending on the presence or absence of old myocardial infarction. 68 patients with CHD were examined, including 57 (83.8%) patients with old myocardial infarction (old MI) and 11 (16.2%) patients in the absence of old MI. There was a statistically significant improvement in quality of life, both in the physical and psychoemotional spheres, in patients with stable coronary heart disease including those with a history of myocardial infarction. No effect of old MI on quality of life in patients after myocardial revascularization surgery was observed.

Received: 2021-10-09

Published online: 2021-12-30

DOI: 10.24075/medet.2021.033

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VIEWS 1419

The author considers the phenomenon of vaccine diplomacy throughout history. The purpose of the study is to trace the history and modernity of medical cooperation in the field of combating infectious diseases, the role and place of “vaccine diplomacy” in international relations, and its development in the context of global health diplomacy. Historical- chronological and comparative methods were used in the work. It is stated in the article that a vaccine is the most powerful and effective medical intervention in the human body that enables to preserve its life and health. It is asserted that Russian vaccine diplomacy, continuing the traditions of the Russian civilizational code based on humanism and compassion, acts as an effective “soft power” that influences the minds and wins supporters with its attractiveness. It is concluded that for Russia, vaccine diplomacy, based on the remarkable success of domestic science, which has managed to develop and offer the world a highly effective vaccine against COVID-19, opens up new opportunities for many partnerships along the path of broader pharmaceutical diplomacy. * The article was published in the materials of the III International Conference “The Life Path of Medicines: Simple and Complex Tasks”, Yaroslavl, October 21–22, 2021, https://clinpharmbook.ru/event/15

Received: 2021-10-10

Published online: 2021-12-30

DOI: 10.24075/medet.2021.028

Comments 0

VIEWS 2060

Kudlay DA, Vdovin VV, Shiller EE, Khokholov AL, Davydkin IL, Borozinets AYu

The proportion of drugs for use in juvenile patients is much less than for the adult population. This is due both to the lack of specific drugs for a number of childhood diseases, and the need to conduct special clinical studies in different age groups to assess safety and efficacy parameters. When developing a program for clinical trials of an orphan drug, ethical aspects of the participation of underage patients are considered, taking into account the current international and Russian legislation. Obtaining the informed consent of a minor patient from one of the parents requires detailed prior information and the establishment of a trusting relationship before the participation of a minor patient in a clinical trial. The results of clinical and observational studies of orphan drugs on the example of moroctocog alfa in previously treated pediatric patients with hemophilia A in different age groups contribute to an increase in the arsenal of drugs for the treatment of orphan diseases in the pediatric population and determine the optimal conditions for the use of moroctocog alfa in different age groups.

Received: 2021-10-08

Published online: 2021-12-30

DOI: 10.24075/medet.2021.032

Comments 0

VIEWS 1453

Kozlova OV, Khristenko DN

At present, the most important problems of medical ethics related to the issues of fair access to medicine and health care as the main human benefits are of particular importance. In this regard, the study of biological and social foundations seems to be especially relevant, allowing us to consider a person not only as a user of medical services, but also as a sense-m aking center, influenced by the value-driven norms and societal ideas. The aim of the study is to consider the following two aspects of conceptualizing a person in medical ethics: his/her biological and social status. Dialectical method, system analysis, cultural and phenomenological approaches constitute the article’s methodological basis. Based on the discussion undertaken in modern scientific literature, these allow us to come to an understanding of a person in the system of medical ethics. It is noted that consideration of a person in the context of issues of medical ethics goes, first of all, in two main directions: first, the role of a person is revitalized in the process of choosing treatment methods and understanding the degree of risk associated with the treatment and prevention of his person as a biological being; the second is the immersion of a person, engaged in decision-m aking, into the system of values and traditions of society. It is shown that the second aspect is connected with the understanding of a citizen as a social being. Comprehension of a person should be undertaken through the study of his moral, spiritual, emotional, physical and biological foundations of being; at the same time, biological and social approaches should not act separately, but in unity, and lead to a holistic concept of man.

Received: 2021-10-07

Published online: 2021-12-30

DOI: 10.24075/medet.2021.029

Comments 0

VIEWS 1447