Medical Ethics

ISSN Print 2713-0894 ISSN Online 2713-0908

BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

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The study covers the problem of insufficient regulation of pediatric deep brain stimulation (DBS) in Russia, which causes neuroethical dilemmas and risk of unjustified expansion of indications. The study is relevant because of growing use of DBS in children with severe neurological disorders and lack of adapted standards. The aim of the study is to identify gaps in regulatory system and develop recommendations for ethical and clinical regulation of DBS in children. The current clinical recommendations of the Ministry of Health of the Russian Federation, international consensuses and protocols of leading Russian centers were used as a basis for the research. The main methods included analysis of regulatory documents, comparative and critical analysis of existing standards and ethical approaches. The results show that Russian practice lacks age-specific standards and assessment algorithms despite the regulations. The risks of expanded indications and pressure on patients and their families, which may lead to unregulated experimentation, have been identified. As a conclusion, the need to develop specialized recommendations and strengthen ethical standards to ensure safety and effectiveness of DBS use in children is proposed.

Received: 2025-06-06

Published online: 2025-06-30

DOI: 10.24075/medet.2025.010

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VIEWS 343

Kostrov SA, Potapov MP

The article analyzes the latest ethical challenges associated with introduction of large language models (LLMs) in medicine and healthcare. Various LLM architectures, stages of their training (pretraining, pretuning, reinforcement learning from human feedback) and criteria for quality of training data are reviewed. The emphasis is on a range of ethical issues such as copyright for AI-generated content; systematic bias in algorithms and risk of generating false information; a need to ensure transparency and explainability of AI (XAI); issues of confidentiality and protection of personal medical data, including difficulties with anonymization and obtaining informed consent. Aspects of legal responsibility for using LLMs in clinical practice are also analyzed and technological solutions (federated learning, homomorphic encryption) to minimize risks are discussed. The need for an integrated approach combining technological improvement, development of ethical standards, adaptation of legislation and critical supervision of the medical community is emphasized to ensure safe and effective integration of LLMs into clinical practice.

Received: 2025-05-06

Published online: 2025-06-29

DOI: 10.24075/medet.2025.008

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VIEWS 597

Khokholov AL, Pavlov AV, Kotlovsky MYu, Potapov MP, Gabidullina LF

Today, quantum computing is one of the most promising areas of modern science that can solve the problems which are too hard to handle for classical computers. However, a huge potential accompanied by a rapid progress in this area creates significant ethical risks, including threat of hacking existing cryptographic systems and the problem of non-transparent decisions made using quantum computing. The article highlights the need for timely ethical analysis, development of a regulatory framework, and interdisciplinary collaboration to ensure sustainable and socially acceptable technology development. Main ethical, bioethical challenges, in particular, that arise against the background of quantum computing, and identification of possible ways to regulate them captivate special attention.

Received: 2025-05-05

Published online: 2025-06-23

DOI: 10.24075/medet.2025.007

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VIEWS 414

Begishev IR, Shutova AA

The article reviews the concept of predictable harm as a methodological tool for a comprehensive risk assessment while developing and implementing AI-powered medical devices. The study is relevant due to exponential growth of using AI-powered technologies in healthcare and lack of unified approaches to prediction of potential negative consequences of their usage. Existing regulatory approaches to risk assessment, including Russian regulatory documents and international standards, have been analyzed. A multidimensional classification of types of predictable harm is proposed considering the entire life cycle of medical AI systems. Special attention is given to ethical aspects of using artificial intelligence in medicine, including the principles of patient autonomy, equity, non-harm and transparency of algorithms. An expanded matrix for assessing predictable harm has been developed. It integrated technological, clinical and ethical parameters for each stage of development and implementation of AI systems in medical practice. The results of the study can be used as a methodological framework for developers of medical AI systems, regulatory authorities and medical organizations in assessing safety and effectiveness of introducing intelligent technologies into clinical practice.

Received: 2025-05-03

Published online: 2025-06-15

DOI: 10.24075/medet.2025.006

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VIEWS 454

Semenova NV, Martynyuk KL

The use of artificial intelligence systems (AIS) in healthcare is one of the promising solutions for improving access of citizens to modern medical technologies to prevent mental health disorders, stress-associated and psychosomatic diseases, to ensure early diagnosis and correction of mental disorders and their risk factors. However, an urgent problem is assessment of the risks of implementing AIS in the field of mental health and possibilities of managing such risks depending on various factors affecting clinical outcomes, as well as ethical aspects related to provision of this type of AIS-based medical care. The proposed risk classification system for the use of AIS in the field of mental health will expand the possibilities of introducing medical AIS into clinical practice while maintaining a high level of control over the risks of mental health disorders.

Received: 2025-04-22

Published online: 2025-06-09

DOI: 10.24075/medet.2025.005

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VIEWS 468

Pleshchev IE, Shishkin AA, Ivashkovskaya AV

The purpose of this study is to examine the existing ethical standards and guidelines to provide a comprehensive overview of ethical issues and processes related to research and publications in domestic and international medical practice. The importance of informed consent, data integrity, plagiarism, authorship disputes, and conflicts of interest are just some of the key topics briefly covered in the article. It is obvious that ethical standards and regulations in medical (clinical) research are crucial for determining how research is conducted and how scientific articles are published.

Received: 2025-04-30

Published online: 2025-05-30

DOI: 10.24075/medet.2025.004

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VIEWS 735

The field of medicine has traditionally focused on such symptoms of a disease as pain, inflammation, and tissue deformity. However, according to the modern approach, it is necessary to identify the cause of the disease, which is often hidden deep inside the body. Examining genetic polymorphism as the basis for purulent complications after treatment of the lower limb injury was one of the method that could solve the problem. Epidemiological observations confirm that purulent complications after orthopedic surgery are associated with hereditary predisposition factors. This highlights the important role of genetic changes in development and course of this pathology. However, any medical intervention is associated with potential risks, including emotional pain of the patient, violation of personal data confidentiality and misuse of the obtained information. That is why it is important to think in advance about the possible consequences of genetic tests and to find ways how to resolve ethical issues.

Received: 2025-04-30

Published online: 2025-05-25

DOI: 10.24075/medet.2025.003

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VIEWS 695

The article provides a comparative analysis of the Orthodox ethics of the Russian religious philosopher Vladimir Solovyov and the mystical ethics of the Renaissance representative Dante Alighieri. The aim of the study is to identify points of contact between the ethical concepts of these two very different philosophers. Two works were selected for comparison: “Readings on God-Manhood” by V. S. Solovyov and “The Divine Comedy” by Dante. The ethics of man’s abstraction from natural principles and the acquisition of a metaphysical existence by the individual are explored. Three stages of human ethical development are considered in the concept of V. S. Solovyov. It is shown that in the process of ethical development, the human personality perceives the Divine principle and reunites nature with it. It is noted that for Solovyov, ethical development is a positive and objective process — a divine-human process. A significant place is devoted to the symbolic-metaphysical understanding of ethics in Dante Alighieri’s Divine Comedy. It is indicated that Dante shows an inexhaustible source of possibilities for man to overcome the burden of earthly existence and turn to the true ethics of divine revelation. It is concluded that both Dante Alighieri and V. S. Soloviev came to the realization that the religious principle in man is the only real implementation of the free ethical process.

Received: 2025-02-28

Published online: 2025-04-16

DOI: 10.24075/medet.2025.037

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VIEWS 699