The fate of bioethics in medical education of contemporary Russia is under threat

Abstract


Teaching bioethics in medical universities in Russia is currently artificially restricted. This is due to the financial problems of universities. But solving them we provoke the appearance of distant negative consequences. They will be expressed in the ethical incompetence of future doctors to which patients are already complaining. In connection with the introduction of new biotechnologies into medical practice the role of the ethical expertise of their application sharply increases. The lack of bioethical training among university graduates will not allow to carry out this expertise qualitatively. This entails risks for both individual patients and the health care system as a whole. It is necessary to raise the status of bioethics as a compulsory discipline in the training of future doctors, create scientific and methodical support for the training courses in this discipline that is adequate to modern requirements, agree on model programs and organize the training of qualified teachers. The author proposes to hold a meeting of the heads of social and humanitarian disciplines of medical universities to discuss these and other similar problems of the humanitarian training of future doctors.

Full Text

Recently a strange process has been observed in Russian medical universities. This process cannot be called any otherwise than dehumanization of medical education. This is reflected in the reduction of teaching hours, literally, for all humanitarian disciplines, not excluding the compulsory in uniting humanitarian subjects and departments, the arbitrary placement of these disciplines in curricula on the "residual principle", thus violating the logic of the humanitarian education The reason for this attitude to the humanities disciplines in medical universities is obvious: the increase in the salaries of university teachers to 200% of the average for the region, which provided by the May Presidential Decrees, is realized in organizations due to the reduction in the number of jobs. In the universities it is also expected to reduce the number of entrants (a generation will come from the "demographic pit"). One of the directions to cut jobs is an attack on "non-core" disciplines in medical universities. This is, above all, a socio-humanitarian block. The socio-humanitarian block includes compulsory disciplines (modules): Foreign language, History, Philosophy, Life safety and Physical training. The total number of credit units for these disciplines (except for physical education) is not defined by standards. But the basic educational program for each discipline indicates their recommended number. Practice shows that at the level of the university this number is accepted as compulsory. Three credit units are defined for Physical training individually. The remaining disciplines of the block receive hours by the decision of each particular higher educational establishment. Of course, they need to coordinate their actions and preferably receive recommendations. From whom? There are no working groups on humanitarian disciplines in five "medical" Federal educational and methodical associations, it is not known whether exemplary educational programs are being developed and by whom. Some universities initiate the teaching of bioethics in the form of an elective, although the hours for electives are not included for specialist degree [1]. Exemplary basic educational programs are formed in accordance with professional standards, in all of them there are indications of the mandatory assimilation of ethical competencies and skills [2]. But! Who develops POPs for humanitarian disciplines for medical schools? Now - no one. (see http://reestr.fgosvo.ru/ugs/3/2). 6 Currently the section of the website of the Ministry of Education and Science "Actual exemplary curricula of disciplines" contains only 1 curriculum for pedagogy for bachelors (http://fgosvo.ru/ppd711/11). The administration of the site reports that "The resource is at the stage of formation, and as it develops we will inform the academic community" (http://reestr.fgosvo.ru//). A particular danger of reducing the humanitarian training of future doctors is the ignoring of such an important course as Bioethics. The result of any reduction of this course will be the ethical illiteracy of graduates of medical schools, which is unacceptable at present due to existing social risks, to which we refer the following • Dissatisfaction of patients with the attitude of medical workers to them when providing medical care; • Violation of the rights of subjects in clinical trials; • Violation of ethical standards in pre-clinical studies; • Inability to assess the ethical and social consequences of the introduction of new biotechnologies (ART, exocortex, gene therapy, personalized medicine, regenerative medicine, nanomedicine, neurotechnologies, electronic implants, etc.). The lack of knowledge and skills in the field of biomedical ethics will not allow the graduates of medical universities to fulfill those ethical duties that are entrusted to them by the Federal laws of the Russian Federation and other legal documents: Federal Law of the Russian Federation of 12 April 2010, Federal Law No. 61 - "On the circulation of pharmaceutical products" Federal Law of the Russian Federation of November 21, 2011, Federal law No. 323 - "On the fundamentals of protecting the health of citizens in the Russian Federation" Federal Law of the Russian Federation of November 29, 2010, Federal Law No. 326 - «On compulsory medical insurance in the Russian Federation" Federal Law of the Russian Federation of June 23, 2016, Federal Law No. 180 - "On biomedical cell products" The order of the Ministry of Health of the Russian Federation No.200n dated 01/04/2016 "On approval of the rules of good clinical practice", etc. The editorial staff of the journal “Bioethics” is ready to provide a venue for the All-Russian meeting of heads of the departments of socio-humanitarian disciplines of medical universities, and to participate in the organization of working groups on humanitarian education in all medical Federal educational and methodical associations. Support us, colleagues! Together we will save national bioethics and will not allow violating the principles of the "Universal Declaration on Bioethics and Human Rights" (UN on education, science and culture, 2006), which relates the education in the field of bioethics to the tasks of each state's policy.

About the authors

N. N. Sedova

"Bioethics "

Email: nnsl8@yandex.ru

Deputy editor-in-Chief of "Bioethics ", Honored scientist of the Russian Federation, doctor of philosophy, doctor of law, Professor

References

  1. Федеральный государственный образовательный стандарт высшего образования - специалитет по специальности 33.05.01 Фармация, п.2.8// http://fgosvo.ru/ksumo/view/edufieldid/3/id/36#viewdocs. Доступ 09.03.2018
  2. Приказ Министерства труда и социальной защиты РФ от 7 ноября 2017 г. N 768н "Об утверждении профессионального стандарта "Специалист в области организации здравоохранения и общественного здоровья" Указана этическая проблематика в разделе 3.1. http://fgosvo.ru/uploadfiles/profstandart/02.022.pdf
  3. Петров В.И., Седова Н.Н. О чем забыли сказать в новом законе // Биоэтика. - 2011. № 2(8). С.28-29.
  4. Sedova N.N., Donika A.D. Methodology connection between bioethics & law. В книге: 23rd Annual Congress of World Association for Medical Law Book of Abstracts. 2017. С. 99.

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