Original research What do members of research ethics committees know about their organizational and operational aspects?
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 1282
Original research Informed consent in Russia: misuse and abuse
Mylnikova IS
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 1294
Original research Ethical issues in disclosing diagnostic and prognostic information to cancer patients
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 1353
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 1638
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 1505
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 1620
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 1320
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 1275