Medical Ethics

ISSN Print 2713-0894 ISSN Online 2713-0908

BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

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The article defines the term ‘bioethics’ taking into account the common regulatory act, shows the interrelation between bioethical and legal regulations, and defines the mechanisms that enhance and improve effectiveness of ethical standards by turning them into legal regulations. Basic regulatory legal acts such as laws and subordinate acts in health regulation are reviewed and analyzed for the presence of an ethical constituent. Critical areas in the regulatory acts are specified; certain ways of their ethical transformation are mentioned. Insufficient ethical substantiation of regulatory provisions in the body of legislation and lack of universal declarative regulations are found. The role of a new subject of bioethics and law (future generations), which significantly expands the area of ethical issues, including applied medical sciences, has been denoted. The conflict between modern ethics and interests of future generations can be a complex issue and should be solved immediately on a constant basis. Ethical and legal principles of future generations — precaution and non-regression — were introduced. It is indicated that the standards of ethical and legal regulation of interests of future generations should be developed.

Received: 2024-01-29

Published online: 2024-03-14

DOI: 10.24075/medet.2024.002

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VIEWS 244

Samarina EI, Lileeva EG, Rybachkova JV

Bioethical approach to determine the feasibility of using medicines involves systemic analysis of pharmacoepidemiological and pharmacoeconomic aspects of treatment, especially while treating the most common and chronic diseases. Psoriasis is the most common disease of the skin and subcutaneous tissue, accounting for 15% of cases. The rate of psoriatic complications constitutes 6–42%. Skin lesions, psoriatic arthritis, cardiovascular diseases, metabolic syndrome, inflammatory intestinal diseases, mental disorders and malignant lesions produce a great effect on health, duration and quality of life, and result in early loss of labor capacity and disability of patients. So, it is important to study effectiveness and safety of systemic medicines in patients with severe and moderate-to-severe disease and perform subsequent analysis of possible use and comparison of the effectiveness of various combinations. Most affordable but ineffective medicines commonly cause real growth of further expenses on treatment, and postpone administration of more effective, though much more expensive medicines. Economic aspects of rational use of healthcare resources are becoming increasingly important whereas pharmacoeconomic values are crucial while selecting a treatment strategy.

Received: 2024-01-24

Published online: 2024-03-11

DOI: 10.24075/medet.2024.001

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VIEWS 234

Intensive development of modern science expands the scope of bioethical issues. Debates on ethical aspects of bioinformatics, neurotechnology, genetics, bioeconomics, ethics of preclinical and clinical trials are actively developing. Axiology of bioethics is of particular relevance. It is the structure of valuable categories that determines the priorities of ‘human science’ development taking into account the historical experience of interaction between a person and community, and criteria of civilized changes in the actual and perspective (prognostic) sense. Development of bioethical axiology is influenced by the challenges of technological development of the current decade, the issues that objectively demand a reaction on the part of the state and society. One of the main tasks of modern bioethics is to develop bioethical thinking, and grounds for using bioethical axiology in the scientific process. Health axiology, which represents a fixed conscious attitude to the issues of health developed during the academic process to be subsequently used during a labor process, is practical expression of bioethical thinking. Bioethical dialogue is essential as it urges young perspective specialists to examine novel bioethical scientific issues and achieve technological country-specific goals. Focus on young scientist’s potential totally corresponds to the cross-cutting goal of axiological, prognostic and educational tasks of bioethics. Bioethical thinking is developed based on the experience of the school of ethics of scientific research, which is an educational project intended for young Russian researchers.

Received: 2024-02-05

Published online: 2024-03-04

DOI: 10.24075/medet.2023.035

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VIEWS 304

Shereshneva MV, Ilyin MV

In cardiac surgery, patient’s awareness and consent to surgery are problematic as due to the lack of previous medical background a patient can’t understand the processes occurring in the body and effects of exposure on them. Thus, provision of sufficient information by a doctor is a part of safe surgical strategy. An open randomized prospective trial involving 89 patients with stable coronary artery disease (CAD) was conducted. High rate of blood oxidation is believed to be an independent predictor of cognitive dysfunction development during the early postoperative period of coronary artery bypass grafting (CABG). Determination of blood oxidation rate is a tool of risk management during cardiac surgery starting from the stage of preoperative preparation, which is optimal to implement a safe strategy, including psychological and drug-induced support of the patient aimed at prevention of cognitive disturbances.

Received: 2023-11-26

Published online: 2024-02-28

DOI: 10.24075/medet.2023.034

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VIEWS 283

Shereshneva MV, Ilyin MV

Exposure on key modified risk factors, mainly hypercholesterolemia, arterial hypertension and diabetes mellitus, is an essential component of successful management of patients with coronary artery disease (CAD). As far as the concept of cardiovascular continuum goes, the predisposing behavioral factors that contribute to the development of these abnormal conditions include smoking, hypodynamia and obesity. Oxidative stress is closely associated with atherogenesis at every stage of progression. An open non-randomized prospective study is conducted. An observational group includes 89 patients with stable CAD. Key risk factors of cardiovascular diseases and their correlation with the values of induced blood oxidation were analyzed. Statistically significant (p < 0.05) positive correlation between hypercholesteremia and coefficient of oxidative activity (r = 0.22), smoking and initial rate of blood oxidation (r = 0.24), maximum rate of blood oxidation (r = 0.25), coefficient of oxidative activity (r = 0.24), diabetes mellitus and time of the initiation period (r = 0.25); negative correlation between smoking and time of the initiation period (r = –0.4) were detected. The results obtained show there is a correlation between a lifestyle and oxidative status of patients with stable CAD. Thus, influence on behavioral risk factors is the most important task of management of patients with cardiovascular pathology.

Received: 2023-11-26

Published online: 2023-12-29

DOI: 10.24075/medet.2023.033

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VIEWS 354

Lileeva EG, Speshilova SA, Zinoveva MA

Alcohol currently contributes to 5% of the overall global burden of diseases and injuries. Alcohol consumption results in death and disability at young age. Medicinal products approved for treatment of alcohol dependence syndrome include disulfiram, Naltrexone, Cyanamid and nalmefene. Variability of a patient-to-patient pharmacotherapy therapeutic effect can also be associated with genetic causes. Examination of the system of pharmacogenetic markers in narcology will be used to provide for preliminary prognosis of effectiveness and tolerance of medicinal products during personalized anti-relapse (supporting) therapy to support and prolong remission in patients with alcohol dependence.

Received: 2023-10-13

Published online: 2023-12-21

DOI: 10.24075/medet.2023.032

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VIEWS 315

Borzova MA, Kalinichenko VV, Kolbin AS

The real-world data (RWD) constitute a modern trend in the healthcare system and in the structure of taking decisions. The trend is being actively developed in the Russian Federation. Ethical aspects of these trials and legal regulation of RWD are, however, still unresolved. In this paper, development of the legal field and national regulation of RWD in Russia is discussed during registration, assessment of healthcare technologies, management of patient registries, and development of clinical recommendations. It is shown that the acting regulatory field of the Russian Federation contains no bans on the use of RWD to support regulatory decisions. Nevertheless, the existing legal laws set limited opportunities for practical application and accounting of RWD by the competent authority. In conclusion, recommendations on further development of RWD legal field in Russia are provided.

Received: 2023-10-14

Published online: 2023-12-10

DOI: 10.24075/medet.2023.031

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VIEWS 414

The article provides answers to immediate questions associated with the state regulation of confidentiality of information and exchange of data in the era of digital healthcare. The institute of medical confidentiality which originated in the ancient world is still evolving throughout the development of medical law. In the current era of global digitalization, however, the issues related to data confidentiality have become more relevant than ever. With all the modern technologies and digital health care platforms on the rise, new challenges associated with protection of these patients are emerging. To ensure the reliable protection of patient’s personal and medical information, doctors and medical institutions have to meet data security standards. It becomes vital to develop effective strategies and mechanisms to prevent unauthorized access and data leakage due to a larger volume of electronic medical records and digital data exchange. Strict rules and standards regulating collection, storage and transfer of medical data belong to a key aspect in this area. The Russian Federation is making great efforts to create the legislation which could protect the rights of patients and made medical establishments to follow the high standards of confidentiality, and to develop technical aids that provide data encryption and protection against hacker attacks.

Received: 2023-10-14

Published online: 2023-12-06

DOI: 10.24075/medet.2023.030

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VIEWS 388