Medical Ethics

ISSN Print 2713-0894 ISSN Online 2713-0908

BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

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Dreytser ED, Mudrova AV, Pavlov ChS

Clinical guidelines represent documents that contain structured information based on scientific evidence on prevention, diagnosis, treatment and rehabilitation, and regulate professional activities of the medical community. Starting from January 1, 2025, it is planned to switch to the mandatory use of clinical recommendations approved by the Ministry of Health of the Russian Federation, while the year of 2024 is an interim period for their application. However, various methodological and ethical issues arise while developing and discussing clinical recommendations. They include a conflict of interests of the authors, as well as aspects of its disclosure and settlement, accessibility of clinical recommendations for patients, as well as the discrepancy between the provisions of the recommendations and their evidence base such as results of systematic reviews and meta-analyses. Resolution of these problems will significantly improve the quality of clinical recommendations, and increase patient awareness of diseases and treatment approaches. This review analyzes a wide range of methodological problems related to the development of clinical recommendations, examines regulatory acts and ethical principles issued by government agencies, professional communities and international organizations, and makes suggestions to reduce the level of bias and, as a result, to increase the degree of evidence of clinical recommendations.

Received: 2024-05-24

Published online: 2024-06-30

DOI: 10.24075/medet.2024.013

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VIEWS 509

Currently, the prevalence of hearing loss in the population is extremely high both among elderly and younger patients due to the prolonged and intense load on the auditory analyzer. Auditory disorders are currently one of the most important geriatric and ethical problems, since it has a significant negative impact on a human’s emotional and physical condition, and is the cause of conflicts with other people. According to the research done in recent decades, there is a relationship between hearing loss and cognitive decline, which can be assessed using the MCAS (Montreal Cognitive Assessment Scale) test. This article presents a clinical case of a patient with progressive sensorineural hearing loss and, as a result, a decrease in cognitive functions, as well as the ethical aspect of the work of an ENT specialist with audiology patients.

Received: 2024-05-04

Published online: 2024-06-26

DOI: 10.24075/medet.2024.010

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VIEWS 542

At the turn of the XX–XXI centuries, Russia had to conduct active military operations twice to suppress the hotbed of separatism, crime and terrorism in the North Caucasus. Serious military medicine forces had to be involved. Meanwhile, the participation of medical professionals in two Chechen operations is still on the periphery of attention of domestic researchers. In the 1990s and early 2000s, the Russian mass media wrote that military doctors were helping wounded and sick servicemen of the federal troops directly on the front line and in rear hospitals, often informed the general public about maintaining the mental health of recent front-line soldiers, and also never ignored the assistance to the civilian population (women, the elderly, children) of the Chechen Republic. Some press publications described the most successful and complex operations performed by Russian military surgeons. In many publications of those years, you can also find reports about the doctors who distinguished themselves the most during the active hostilities and were awarded high state awards, including the Gold Star of the Hero of the Russian Federation. The practical activities of Russian doctors in the North Caucasus in the 1990s and early 2000s resulted not only in the saving of the lives of the vast majority of wounded soldiers, but also in restoration of the Chechen health system, prevention of epidemics and successful fight against numerous infectious diseases.

Received: 2024-05-24

Published online: 2024-06-20

DOI: 10.24075/medet.2024.009

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VIEWS 594

Khokholov AL, Eleskina AA, Belchik LM

The pandemic caused by the SARS-CoV-2 virus has put a huge strain on health systems around the world. Clinical trials of new drugs were also influenced by the pandemic, during which Sponsors came across a number of problems, including ensuring patient safety and maintaining the ability to obtain reliable data in the course of ongoing research. The purpose of this study was to compare the protocols of clinical trials of two Sponsors, approved by the Russian health authorities for three years, from 2017 to 2019, by their adaptability to the SARS-CoV-2 virus pandemic. 23 protocols and 51 amendments were studied in total. The amendments published in 2020 by both Sponsors underwent a comparative analysis to determine the degree of their influence by the pandemic. Statistical processing of the results was carried out using the correlation analysis. Conclusions were drawn about the Sponsors’ approach to clinical trial planning and establishing the safety margin of clinical trial protocols.

Received: 2024-04-24

Published online: 2024-06-18

DOI: 10.24075/medet.2024.008

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VIEWS 552

Kurmangaleeva AYu, Sibirskaya EV

Teen pregnancy remains one of the key social issues that deeply affects not only the life of a young mother and her child but their inner circle and society as well. In spite of multiple efforts to reduce its prevalence rate, teen pregnancy is still a pressing issue in many countries. Currently, there are several key problems that can result in an increased risk of teen pregnancy. They include an early beginning of sexual activity, history of sexual abuse, low social and economic status, lack of parental care and support, cultural and family behavioral models, use of psychoactive substances, poor academic performance and expulsion from school. In addition, the probability of a repeated teenage pregnancy is significantly increased, passing the problem on from one generation to another. This article is aimed at a comprehensive analysis of these factors and statistical data in order to better understand the problem of teenage pregnancy, assess its consequences for the health and well-being of those underaged and their children. Special attention is paid to the ethical and social aspects of teenage pregnancy.

Received: 2024-03-15

Published online: 2024-06-13

DOI: 10.24075/medet.2024.007

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VIEWS 586

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

At present, neurotechnologies are emerging rapidly. The scope of state and private investment in the trend, which is the investment priority, is growing steadily. Interstate, national initiatives and public-private alliances for their development are created. Meanwhile, a significant potential of neurotechnologies consists not only in treatment of a wide specter of diseases and disorders of the nervous system, but also in improvement of human nature. At the same time, uncontrolled use of these technologies can violate fundamental rights. This raises the questions associated with accessibility and potential use of neurotechnologies to improve the human nature. It can produce a deep effect both on certain people, and the entire society. Development of neurotechnologies requires a highly organized approach on the part of ethics and morality with subsequent fixation of these provisions in the legislative and regulatory acts. International, state and non-governmental organizations play a great role in this case.

Received: 2024-03-20

Published online: 2024-03-31

DOI: 10.24075/medet.2024.005

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VIEWS 705

Koshechkin KA, Khokholov AL

The integration of artificial intelligence (AI) in healthcare presents unprecedented opportunities for improving patient care and outcomes, yet it also brings forth a myriad of ethical dilemmas that demand careful consideration. This article examines the ethical challenges posed by AI in healthcare, ranging from concerns about algorithmic bias and patient privacy to issues of transparency, accountability, and professional autonomy. Through a comprehensive analysis of relevant literature, case studies, and regulatory considerations, the study explores the multifaceted ethical implications of AI technologies in clinical practice. Key findings underscore the importance of promoting transparency and accountability in AI algorithm development and deployment, as well as the need for robust regulatory oversight and ethical guidance to ensure patient rights and safety. Despite the complexities and challenges, AI offers immense potential to enhance patient care and healthcare efficiency when navigated responsibly and ethically. By prioritizing ethical principles and collaborative efforts, stakeholders can harness the transformative power of AI while upholding the highest standards of ethical healthcare practice.

Received: 2024-02-16

Published online: 2024-03-31

DOI: 10.24075/medet.2024.006

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VIEWS 863

Biography of Sergey Spasokukotsky, the outstanding Russian surgeon, is closely related to the Yaroslavl Territory. He spent his childhood in the Danilovsky region, coming from a large and friendly family of a zemstvo doctor. In 1880–1888, he studied at the Men’s Gymnasium after his family had moved to Yaroslavl. The building now belongs to the Yaroslavl State Medical University where a representative of his scientific school, Professor Busalov AA, worked decades later. Life and activity of Sergey Spasokukotsky represent a bright example of unselfish service to medicine. Being a graduate of the Emperor’s Moscow University, he had a chance to continue his medical career in Moscow but went to the province where he worked as a zemstvo doctor for many years, actively implementing advance achievements of medicine into abdominal surgery, neurosurgery, pulmonary surgery, creating novel and modifying available surgeries. S. Spasokukotsky and his student developed an affordable and effective method of preparing a surgeon’s hands for a surgery with 0.5% ammonia solution (method by Spasokukotsky and Kochergyn). The scientific and practical activities of Sergey Spasokukotsky resulted in the development of a large scientific school with an ultimate scientific social responsibility, originality, great depth and boldness while solving the issues of surgical pathology.

Received: 2024-03-05

Published online: 2024-03-26

DOI: 10.24075/medet.2024.004

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VIEWS 697