Medical Ethics

ISSN Print 2713-0894 ISSN Online 2713-0908

BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

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Tereshkova VV, Tereshkova EA, Firsov DE

In the 21st century, the rapid advance of space programs raises ethical concerns about the consequences of exploring and exploiting space resources. The concept note of the World Commission on the Ethics of Scientific Knowledge and Technology (COMEST) on the ethical considerations on space exploration and exploitation adopted in August 2024 states that “the international community is now in need of developing ethical principles for space exploration and exploitation that complement currently existing outer space treaties”. Key areas for future ethical regulation of space projects include prospects for commercial developments, space tourism programs, mining, and deep space exploration to study exoplanet atmospheres and search for terrestrial planets. Space exploration provides important knowledge that improves the quality of life and has a technological and innovative impact on society. The “inspiring factor” of space research is crucial for motivating future generations of scientists to develop science. However, it must be borne in mind that human activities pose significant risks to both near-Earth space and Earth’s ecosystems. The scale of space ethics proposed by COMEST will help systematize information about ethical uncertainty factors, risks and consequences of risks associated with initiatives in space exploration and exploitation.

Received: 2025-09-24

Published online: 2025-12-06

DOI: 10.24075/medet.2025.024

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VIEWS 651

Lileeva EG, Fomina IA, Galeeva EV, Chekanova YV, Bocharova IV

This review summarizes and analyses methods for controlling ethylene glycol (EG) and diethylene glycol (DEG) impurities in pharmaceutical products. Contamination of medicinal products with these substances threatens the safety of patients, which is confirmed by numerous mass poisoning incidents throughout history and in modern times. The main reason is using toxic glycols instead of safe fillers such as propylene glycol and glycerol. The article presents systematic review of modern EG and DEG determining methods that range from standard pharmacopoeia methods to perspective screening tools. Particular attention is given to the relevance of development and implementation of prompt, precise and affordable screening solutions to be used at all stages of the pharmaceutical supply chain. The World Health Organization (WHO) Initiatives, including the target product profile (TPP), which aims to enforce these solutions, have been reviewed. It is emphasized that shifting from traditional centralized laboratory testing to decentralized methods is essential to prevent falsification and ensure safety of patients.

Received: 2025-11-10

Published online: 2025-12-03

DOI: 10.24075/medet.2025.023

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VIEWS 686

Ziganshina LE, Yudina EV, Ziganshin AU

This article is one in a sequence of publications in the Journal of Medical Ethics focused on the integrity of healthcare research. Our first article in the series on integrity in modern biomedical science briefly reviewed the main stages of the global think tank development calling to attention of a wide range of specialists from local ethical committees, editorial boards of biomedical journals, and experts of scientific funds who determine the research priorities and fund studies. In this article, we concentrated on the specific contribution and pioneering function of the Cochrane collaboration in developing scientific research integrity principles.

Received: 2025-09-24

Published online: 2025-11-27

DOI: 10.24075/medet.2025.022

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VIEWS 644

Yeregin SY, Klyuyeva PA

The article reviews the bioethical concern in providing lipid-lowering therapy to children with hereditary dyslipidemia. The concern is associated with the gap between clinical recommendations and official prescribing information. The purpose of the research was to perform a comparative analysis of regulatory documents, clinical recommendations and prescribing information of 11 medicinal preparations including statins, cholesterol absorption inhibitors, fibrates, omega-3 polyunsaturated fatty acids and PCSK9 inhibitors. The analysis has shown the lack of pediatric-specific data regarding effectiveness and safety of 45% prescribed medications. It imposes direct age restrictions and prevents their use in patients under 18. At the same time, clinical guidelines advocate for early initiation of therapy to reduce the lifetime risk of cardiovascular complications in children with familial hypercholesterolemia. The discovered regulatory inconsistency creates a legal barrier and makes physicians encounter ethical difficulties. The results emphasize the need to update regulatory documents and conduct additional clinical studies to ensure a safe use of lipid-lowering drugs in pediatric practice.

Received: 2025-09-22

Published online: 2025-11-21

DOI: 10.24075/medet.2025.021

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VIEWS 609

Yaichkov II, Volkhin NN, Petukhov SS, Lasaryanz OE

4-(5-methyl-1,3,4-oxadiazole-2-yl)-benzenesulfonamide (ODASA), which is a novel selective type II carbonic anhydrase inhibitor for treating open-angle glaucoma, is undergoing preclinical testing. Pharmacokinetics of the substance have only been studied in rats. Prior to clinical studies, it is necessary to assess the systemic exposure of ODASA in non-rodents. ODASA was administered to Soviet Chinchilla rabbits at a dose of 0.28 mg/kg. About 40 µl of ocular suspension of ODASA was instilled into each eye of animals from the first group, whereas the second group received intraperitoneal injections of the investigational drug. Each group consisted of 6 male rabbits. Samples were obtained prior to administration of ODASA and during 288 hours following the administration at 16 time points. A 10% ascorbic acid solution was added to plasma before freezing. The samples were analyzed using HPLC-MS/MS. Following eyedrop instillation, relative bioavailability for ODASA was 31% as compared to IP administration. Thus, as ODASA was well absorbed into the systemic circulation of rabbits following topical eyedrop instillation, testing its pharmacokinetics in healthy volunteers will be obligatory if the preparation proceeds to phase 1 of clinical studies.

Received: 2025-07-23

Published online: 2025-11-09

DOI: 10.24075/medet.2025.020

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VIEWS 653

Kostrov SA, Potapov MP

The article presents a review on the potential of the distributed ledger technology (DLT), particularly federated blockchain, that can be used to create a secure, transparent and patient-managed ecosystem of medical data. The hybrid architecture reviewed uses the blockchain to store immutable metadata and hashes, and manage large amounts of data (for example, diagnostic images) on external cloud storage, which ensures the integrity of data without network overloading. The key aspect of the research is to analyze long-term threats posed by quantum computing that makes current cryptographic standards vulnerable. It is stressed that adoption of post-quantum cryptography (PQC) is required to ensure future security of medical data. An analysis was carried out to compare the leading global (CRYSTALS-Dilithium, Falcon) and Russian (Hypericum, Shipovnik) post-quantum cryptography algorithms.

Received: 2025-08-13

Published online: 2025-11-03

DOI: 10.24075/medet.2025.019

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VIEWS 740

Chelnokova OG, Khokholov AL, Mozzhukhina LI, Salova AL

In latent tuberculosis infection (LTBI), there are no clinical or radiographic symptoms of active tuberculosis (TB), although immunological tests are positive. Meanwhile, the risk of progression from LTBI to active TB remains high, especially in children. It is estimated that a quarter of the world’s population has LTBI. Identifying LTBI as a predictor of active TB represents a major public health achievement, as preventive activities can help stop the spread of TB in many cases. Phthisiologists specialize in the diagnosis, monitoring, and treatment of children with LTBI. Because the process is prolonged, pediatricians actively monitor and care for somatic issues in children with LTBI. During examination and treatment, both doctors and patients — together with their parents — may encounter numerous ethically challenging situations that significantly affect the quality of medical care and treatment outcomes for children with LTBI.

Received: 2025-06-10

Published online: 2025-10-08

DOI: 10.24075/medet.2025.018

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VIEWS 676

Sokolova OV, Smirnova AV, Isaeva IYu, Alekseeva KS

In this article, the issues of digital literacy that arise during communication of medical and pharmaceutical workers have been reviewed. The right for digital literacy, access to education that improves comprehension and develops digital skills while using medical information systems relates to one of the issues. The goal of the research is to assess digital literacy of healthcare professionals, which is essential for professional interaction during clinical research. Applicable laws and scientific publications regulating healthcare digitalization were used as instructional material. Circulation of medicinal preparations used in clinical research was examined through summary reports of medical companies in 2022–2024. Data from registered databases served as a basis for sociological research to determine digital literacy of professionals. According to the survey results, over 90.0% of respondents have computer-assisted workplaces, about 50.0% of them assessed their level of digital competence as average, and 67.4% need to improve their digital literacy. Optimal organizational solutions allow to improve digital literacy of all healthcare professionals producing a positive effect on ethics of professional interaction.

Received: 2025-09-09

Published online: 2025-09-29

DOI: 10.24075/medet.2025.017

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VIEWS 877