Medical Ethics

ISSN Print 2713-0894 ISSN Online 2713-0908

BIOMEDICAL JOURNAL OF ERMC EASTERN EUROPEAN

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The term ‘bioethics’ (in the narrow sense) or ‘biomedical ethics’ denotes medical ethics at the modern stage of development. Bioethics is currently institutionalized and falls under the responsibility of specialized organizational structures (bioethics commissions, ‘divine committees’, etc.). The article expounds the prospects of applying network structures to institutions and organizations dealing with bioethical issues and tasks (ethical aspects of reproductive technologies, biomedical experiments, organ transplantation, and bioethical education). With the principles of decentralization (‘multiple authority’) and ecology (an integrative approach to issues under study and integrity of a bioethical expert team), network structures promote creative and effective functioning of bioethical organizations. Nonetheless, the centralized hierarchies of traditional educational and research institutions are also expected to perform essential functions. A reasonable combination of network structures and hierarchies provides the latter with a new role: the hierarchies assess the activity of emergent network structures using competent experts and provide selective support (including financing) to the most effective among them.

Received: 2023-08-06

Published online: 2023-10-04

DOI: 10.24075/medet.2023.024

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VIEWS 646

A new approach to medical ethics when it is interpreted as an applied theory of development has been investigated in this article. Relying on the ideas of German classical philosophy and Russian philosophy of unitotality, the development is defined based on the idea of any system as a set of basic polarities (thesis and antithesis). Their composition expresses deep polar definitions of the system and its polar portrait. A simulation model of this methodology is suggested using vector spaces with a scalar product. The development measure is introduced using the basis, the development law is defined, polar portraits of health and diseases are determined, the highest moral law is formulated as the law of development in the ethical sphere. To display medical ethics as an applied theory of development, three standards of classical medical ethics such as standards of mercy, ‘no harm’ and medical secrecy are analyzed, their polar interpretation is performed taking into account the suggested models. It is also displayed that all these standards express specific cases of the development law. Hypothesis of medical ethics as an applied section of development theory is supported, and a new research program of similar reinterpretation of other standards of medical ethics is suggested.

Received: 2023-08-10

Published online: 2023-09-25

DOI: 10.24075/medet.2023.023

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VIEWS 642

Mikhel DV, Mikhel IV

Bioethics, which addresses the pressing humanitarian issues, is an essential element of modern medical education. Transplant tourism is definitely one of these issues. Going abroad to resolve health problems, receive organs and have surgeries might be a growing trend for some Russians. The objective preconditions include deficiency of donor organs and inability of the healthcare system to satisfy the requirements of all those in need. Asia (India and China) has been the major destination of transplant tourism lately. However, things are changing, as Asian authorities attempt to eliminate the unwelcome trend. Russian citizens who go abroad as transplant tourists come across various risks including medical and ethical aspects.

Received: 2023-08-15

Published online: 2023-09-22

DOI: 10.24075/medet.2023.022

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VIEWS 654

The article analyzes the ethical problems that arise in the process of discourse on voluntary departure from life, examines the ethical aspects of existing views on euthanasia. It is noted that adherence to the principles and rules of biomedical ethics is of particular importance when making decisions regarding the end of life. The paper presents the relationship between the characteristics of modern society and hedonistic tendencies, determined when choosing the value orientations of young people who have chosen medicine as their future profession. In this regard, it is necessary to discuss issues related to the ethical aspects of euthanasia at interdisciplinary platforms in the professional community of representatives of medicine, philosophy, law and religious organizations. The author comes to the conclusion that following the norms of morality in the activities of a doctor, determined by the centuries-old achievements of philosophical thought, predetermines the trajectory of his professional activity in terms of the duty he performs.

Received: 2023-07-05

Published online: 2023-09-18

DOI: 10.24075/medet.2023.021

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VIEWS 667

Borisova AO, Nesterov RS

Preconception genetic testing for carrier diseases (PGT(C)) became a noticeable sociocultural phenomenon that raised various ethical issues with the individual and society. The issue of informing patients about the risks of giving birth to children with genetic abnormalities includes a range of questions about the probabilistic nature of genetic data, determinism, and cost and quality of medical and genetic counseling. Preventive tasks of genetics inevitably raise a question about the borders of a patient’s autonomy and mutual responsibility of the individual and society. In this article, ethical and philosophical analysis of sociocultural aspects of PGT(C) has been presented, including neoeugenic prevention traits, hubris and genetic fatalism.

Received: 2023-05-21

Published online: 2023-09-14

DOI: 10.24075/medet.2023.020

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VIEWS 714

In this article, ‘Sovereign Decision’ has been analyzed in the discourse of medical ethics (authors: Mihailo Lukovich, Katarina Meistorovich, Dunja Knezhevich). The interdisciplinary approach to the issue of axiological dissonance has been justified. It arises at the demarcation line of scientific private interests and society expectations and concerns implementation of research outcomes into the social practice. According to the authors, the ‘sovereign decision’, the key notion of the research, is a social phenomenon. In it, the legal sense of exclusive authorities becomes the imperative of an informed (ethical) choice in boundary situations of the subject’s legal elimination in relation to whom the ‘nominal’ or ‘exclusive’ medical decision is taken. By analyzing the issue of the ‘sovereign decision’ using the examples of vaccine prevention and euthanasia, the authors reveal the dialectic nature of the responsible choice. The issues that go beyond the subject of research seem perspective as well.

Received: 2023-08-16

Published online: 2023-09-12

DOI: 10.24075/medet.2023.019

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VIEWS 545

Lukovich M, Meistorovich K, Knezhevich D

Recently, there has been tension is our society because of health-associated problems resulting from at least two factors. First, we are facing collision of neoliberal economics with the traditional ethics of our society. Simplistic understandings of social tendencies typical of our society and processes within the global community provoke a reaction in the form of various conspiracy theories supported by a dualistic ethical approach within our society. In one case, it is based on neoliberal trends and is increasingly manifested through the views of non-governmental organizations. In the other case, it is extremely conservative and tied to the traditional morality. The politics that tends to act within the bounds of the possible goes through both options, creating even more confusion. Another factor, which is no less important, includes blurred connotation and denotation of such notions as ‘freedom’, ‘sovereign’, ‘sovereign decision’, ‘human life sacredness’, resulting in various misinterpretations. The purpose of this article is to review the occurring dilemmas by disclosing the terms in the historical context. The possible conclusion is that the common global tendency of law harmonization under the influence of neoliberal economics is far from the dream about the Perpetual Peace as seen by Kant two hundred years ago. Regular standards that form the basis of the social ethics occupy less space in the legislation just like the ethics itself, even if used as a corrective measure, with economic logics taking up a larger place. There will be a ‘market price’ for everything (Kant). In the light of the above, we tried to review vaccination and euthanasia as two very specific and pressing issues.

Received: 2023-08-16

Published online: 2023-09-12

DOI: 10.24075/medet.2023.018

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VIEWS 869

The shortage of healthcare personnel is a contemporary issue of national healthcare. At the same time, admission to medical colleges and universities is always highly competitive. However, having become a doctor, many specialists either seek private medical practice or retire from medicine. It is widely thought that low earnings of healthcare professionals are the reason for that. But this is not entirely true. The article summarizes the results of a sociological trial used to conclude about the hierarchy of reasons for the reduction in the number of physicians in state medicine of modern Russia. The trial was conducted in a typical region of the Russian Federation — the Volgograd region. An expert survey of the heads of state medical organizations was used. It turned out that ethical and legal insecurity of doctors promoted retiring from medicine and seeking private medical practice. It is the profession that healthcare professionals worry about the most; they have to shun medicine due to the decline of the value of the profession in the society and inattentiveness to healthcare professionals, which is most acutely felt by young physicians. Thus, care for medical personnel, especially young specialists, is the most pressing issue. That’s why mentors of medical beginners play a specific role as they do not only educate but also raise devotion to the profession. At the same time, mentors need state support as well. The article suggests which forms of support can be provided.

Received: 2023-08-03

Published online: 2023-09-11

DOI: 10.24075/medet.2023.017

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VIEWS 561