Medical Ethics

ISSN Print 2713-0894 ISSN Online 2713-0908

BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

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Filkin AN, Kudrina SA

Religion, ethics and medicine are recognized to be related since antiquity. This article discusses the ethical aspect of medicine and focuses on the moral qualities of a doctor in the face of modern challenges. The main focus is on returning to traditional values based on Christian morality. The Bible changed the relationship between humanity and the Divine, when a man is viewed as an image of the Creator and the need for divine intervention in healing is emphasized. Unlike ancient rationalism, Christian faith is aware of the cognition limits and understands the importance of the spiritual aspect of health. The article analyzes how the Hippocratic oath has changed under the influence of Christian values. The importance of cooperation between doctors and priests who healed patients is considered, and the need for compassion in medical practice is emphasized. The synthesis of faith and medical science makes us understand that healing involves achieving both physical and mental, as well as spiritual well-being.

Received: 2024-10-28

Published online: 2024-12-31

DOI: 10.24075/medet.2024.026

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VIEWS 268

Lobanova IV, Sataev AE, Manaeva TA

This article highlights the ethical aspects that arise when the attending psychiatrist communicates with patients and their family members on the issues of planning a pregnancy. While counseling people with mental disorders about their reproductive plans, it is difficult from an ethical point of view to discuss some issues such as the risks of pathology in an unborn child and a possibility of reducing the risks, in particular the probability of genetic inheritance of a mental disorder; the expediency of discontinuing psychotropic drugs used by the expectant mother and/or father to treat or prevent a mental disorder exacerbations, given that drugs can affect the quality of reproductive biological material, whereas cancellation of therapy is associated with risks to the mental health of expectant parents; the need to inform the patient’s family members about his/her mental disorder, the treatment used and all available personal risks to offspring. Different literature sources, including domestic and foreign ones, were reviewed. The keywords used in literature were “genetics”, “psychiatry”, “ethical aspects of genetic counseling”, “psychopharmacotherapy during pregnancy”, “the effect of psychotropic drugs on spermatogenesis” with filtering by language (Russian and English) and document type. Two own clinical observations are presented. The purpose of the article is a comprehensive analysis of ethical aspects of counseling people with mental disorders on pregnancy planning by a psychiatrist.

Received: 2024-11-13

Published online: 2024-12-24

DOI: 10.24075/medet.2024.025

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VIEWS 318

Firsov DE, Ivashkovskaya AV

Discussion of the draft of the Recommendations on the Ethics of Neurotechnology proposed by UNESCO reveals the need to develop domestic regulations in this area, taking into account modern challenges of technological development. The purpose of the recommendations in the field of neuroethics is to ensure the human right to protect health, well-being and dignity associated with the risks of technological interference in the brain and mental processes, as well as threats associated with the social and humanitarian consequences of scientific and technological progress in the field of neuroscience and neurotechnology. The draft of domestic recommendations should establish obligations related to the ethical aspects of creation, implementation and use of neurotechnologies, which are currently not regulated by the legislation of the Russian Federation and acts of technical regulation. The objectives of the recommendations are to specify the terminological apparatus in accordance with the current regulatory legal acts, targeted separation of neurotechnologies for medical and non-medical purposes, ensuring safety for the health and well-being of vulnerable persons and social groups. In the socioeconomic aspect, development of domestic recommendations on the use of neurotechnologies shows the relevance of stimulating development of domestic production and socioeconomic growth in accordance with the national development goals of the Russian Federation until 2030.

Received: 2024-11-02

Published online: 2024-12-21

DOI: 10.24075/medet.2024.024

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VIEWS 299

Mylnikova IS, Mylnikova MA, Shkolnikova EA

Patient-centredness is a relatively new proof-of-concept setting associated with the concept of quality of medical care, which gradually becomes a new moral standard of medical practice. We conducted a study of the attitude of the younger generation of doctors (graduate students and residents of the Pirogov Russian National Research Medical University and RUDN, 2024) towards patient-centredness. They were offered a questionnaire consisting of 21 questions on different aspects of patient-centred communication. 155 completed questionnaires were received. The answers indicated that many young doctors are familiar with the concept of patient-centred approach and practice patient-centred communication skills. At the same time, many people feel a lack of training in this area and realize their vulnerability in communicating with the patient. At the same time, the survey revealed paternalistic attitudes in more than half of the respondents. It can be concluded that young doctors need not only mastering the skills of patient-centred communication, but also a deeper study of the moral foundations of patient-centredness, which can be implemented within the training courses in bioethics, as well as while teaching clinical disciplines.

Received: 2024-10-22

Published online: 2024-12-17

DOI: 10.24075/medet.2024.023

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VIEWS 334

Fedorov VN, Korsakov MK, Shetnev AA, Grechischeva OV, Vdovichenko VP, Volkhin NN, Smirnov NA, Khokhlova AA, Arshinov AV

Treatment of rheumatoid arthritis is a complex and time-consuming process that does not always lead to significant results both due to poor effectiveness of drugs and drug toxicity. It means we need to search for new pharmacological targets to influence the pathological process, one of which is inhibition of proteinase-activated receptors 2 (PAR2 receptors) activity. In 2016–2019, synthesis of low-molecular-weight antagonists of PAR2 receptors belonging to 4,5-dihydroisoxazole-5-carboxamide derivatives was carried out, and in 2023 their anti-inflammatory efficacy was examined using the formaldehyde edema model. The most effective laboratory R004 compound was tested on a model of autoimmune pristane-induced inflammation in rats. During treatment of chronic inflammation in rats, R004 inhibited significant development of edema of feet, damage to small joints, and specific changes in the formula of white blood, and according to biochemical blood test led to normalization of liver and kidney functions and energy metabolism. R004 turned out to be more effective and safer than the comparator drugs such as diclofenac sodium and dexamethasone.

Received: 2024-10-29

Published online: 2024-12-13

DOI: 10.24075/medet.2024.022

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VIEWS 370

Kovaleva TV, Pariyskaya EN, Kovaleva-Kircicek VA

The purpose of this article is to determine the objectivity of culture from the perspective of the neuroscience`s research interests of and to identify neuroethical problems that arise in the process of using neurotechnologies and applying research results. The following aspects were set: to provide a clear understanding of the reasons behind neuroscience’s growing interest in culture; to identify new scientific and neurobiological directions studying the relationship between a culture and humans; to substantiate the importance of the emergence of cultural neuroscience, to identify some ethical categories revealed through analysis of research results; to highlight ethical problems that arise or may arise near future during the application of neurotechnologies and the use of research results in this field. The main conclusion of this article is that the development and application of neurotechnologies will be the main priority for many countries, especially taking into account the interest in understanding the cultural characteristics of all people living in the same territories. On the one hand, the knowledge can help to prevent cross-cultural conflicts and improve the effectiveness of management systems in the social sphere. On the other hand, it may lead to bioethical problems due to possible manipulations in various fields as business and politics.

Received: 2024-07-14

Published online: 2024-09-25

DOI: 10.24075/medet.2024.021

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VIEWS 453

Toichuev RM, Abylaeva BA, Zhilova LV, Toichueva AU

This article examines the Kyrgyz tradition of bioethics and the conditions of its use in higher educational institutions of Kyrgyzstan. The article analyzes formation of bioethics as a science closely related to medicine, veterinary medicine and biology, which studies the relationship between men, animals and other creatures. The bioethical aspects of conducting an experimental and preclinical testing of medicinal herbs and other products that have been used in folk medicine for centuries, as well as their application in practical medicine, are presented. The bioethical aspects of brain transplantation, artificial intelligence (AI) and the use of AI robotics to perform medical manipulations, surgical interventions, as well as tactical mistakes made by them (robots) when performing diagnostic manipulations, operations and when new infections and diseases occur, are considered. The issues of obtaining permits to prepare vaccines and drugs and the issues of studying the “non-natural” human nature are highlighted. In this regard, bioethical science will face many complex tasks that require solutions in the future. The laws of the Kyrgyz Republic related to bioethics and teaching of this discipline in universities of the Kyrgyz Republic, adopted in the period from 1992 to the present (August 2024), are presented.

Received: 2024-07-24

Published online: 2024-09-24

DOI: 10.24075/medet.2024.020

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VIEWS 456

The article is devoted to the issues of clinical research: their ethical and legal regulation at the present time, the history of ethical expertise in the Russian Federation and at Kazan State Medical University. The role of ethical committees as a structure responsible for quality of scientific research and a guarantor of compliance with the principles of ethics, protection of the rights, safety and well-being of research participants is considered. The article presents the working experience of the local ethics committee of Kazan State Medical University on ethical examination of research projects with human participation and analysis of the most common mistakes in preparation of research documentation made by young scientists of clinical departments. The digital information showing typical errors and inaccuracies in the formation of a package of documents for ethical examination, based on the analysis of 284 initiative papers of PhD candidates from clinical departments: every fifth protocol required revision in accordance with the ethical and legal framework adopted in the Russian Federation, in 1.5% of cases the documentation was submitted for already conducted studies (i.e. ost factum), when no changes to its design are possible anymore. Typical mistakes were the following: inability to form research and control groups, calculate a representative number of participants, write an information sheet for a participant in a clinical trial and a sheet of informed consent, going beyond the specialty, desire to prescribe drugs beyond the scope of registered indications, etc. The ways of increasing both the awareness of young researchers and quality of ethical expertise by specialists of the ethics committee are proposed.

Received: 2024-08-27

Published online: 2024-09-19

DOI: 10.24075/medet.2024.019

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VIEWS 392