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Vol 8, No 1 (2015)

Articles
On the 70 th anniversary of Victory (greetings)
Petrov V.I.
Abstract
Bioethics. 2015;8(1):4-5
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On the possibility of definition of bioethics and biopolitics in the observation philosophy
Petrov K.A., Pilipenko V.A.
Abstract
At the turn of the century, problems of bioethics and biopolitics attract attention of many researchers. However, there is no precise definition of these phenomenons in the science. For the solution of this task we use the methodology of the observation philosophy, which was developed by A.M. Piatigorsky. Thereby, this investigation presupposes exposing of basic categories of bioethics / biopolitics. In this article we establish that the notion of «homo sacer» is the «shifters», that mean conversion from bioethical to biopolitical point of view. It is realized that the biopolitics has a futuristic character, refers to the notion of benefit as the highest good, when we applied the notion of homo sacer to the problem of IVF. In addition, bioethics is directed to the preserve the life.
Bioethics. 2015;8(1):6-10
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Ethical attitude to the live in chinese cultural tradition
Avkhodeeva E.A.
Abstract
One of the key tasks of bioethics is not only the solving of the practical problems, determined by the development of the biomedical technologies and connected with ethical aspects of the doctor-patient relations, but also to discover cultural and historical foundations of the relationship to the life. These studying is actualized by modern environmental situation and urgent necessity of forming environmental consciousness as an important mechanism in the regulation process of the relations in «Nature - Man» system. This article describes two contradictory models of man-and-nature relations: the western and eastern ones. Eastern culture, in contrast to western, was formed under the influence of ethical thinking (Taoism, Zen Buddhism), which denied the exclusion of the Man out of environment and his superiority over the Nature. Fundamental concepts of holistic ecosystem and the «middle way» allowed the traditional culture of China to form, consolidate and pass on cultural code that protects not only the nature, but also the cultural actor. The links between Chinese philosophical tradition and general approach in tradition medicine, based on the idea of energy balance and connection of human body and Nature is represent. The Eastern ethical studies created the bases of the universal ethics of relation to the live proclaimed the need for the high degree of the psychological inclusion of the Man into the Universe.
Bioethics. 2015;8(1):10-13
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Bioethics and medical law
Davtyan S.A., Ghazaryan K.T., Khachatryan M.A.
Abstract
There is a close correlation between bioethics and law. The extension of the scope of the relationship regulating by law depends on social developments. However, there are various contradictions between law and morality in societies. In the present article attempts to articulate the problems of modern bioethics and law, namely the law enforcement practice in the field of human rights and the development of human rights approaches in the health system. Of course, it would be a profound mistake to reduce all the problems in the relationship between the doctor, patient and society to the code of laws. However, to downplay the role of law as a social regulator.
Bioethics. 2015;8(1):14-17
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Extent of implementation of the international bioethical standards on protection of the patients’ rights in the national legislation of Azerbaijan
Mammadov V.G., Qalandarli N.G.
Abstract
Regulation of the patients’ rights in the legislation of Azerbaijan Republic is analyzed in the article. The patients’ rights issue is not only of interstate character, they are reflected in numerous international documents. Nowadays the universal bioethical principles developed on international level, which found reflection in the Universal Declaration on Bioethics and Human Rights, became one of sources for improvement of the modern legislation in the field of medicine. The author specifies relevant laws and articles concerning the patients’ rights. Articles of medical laws and the provision of the main law - Constitution in the field are compared to the international standards. On the basis of the carried-out analysis the conclusion about extent of implementation of bioethical standards in the national legislation is drawn.
Bioethics. 2015;8(1):18-22
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Ethical attitudes of modern public health in Russia
Potapova O.N.
Abstract
Priority public policy in modern Russia is the realization of citizens’ rights to health care and medical care. Increased funding for health care and new social programs stabilized the situation, but the health of Russians didn’t improve radically. There is an increase in incidence, morbidity and mortality among the population. The mortality rate by reason of incurable diseases remains high, especially among children and youth. Medical institutions now are sufficiently staffed by expensive diagnostic equipment, but it is used inefficiently. In many cases this is due to the lack of doctors’ competence that is the reason of certain ethical attitudes and diagnostic errors. Proof of this is given in the article as extracts from the case history of patients with different disease profile. There are considering the cases of oncology, gynecology, therapeutics, pediatrics and dentistry. In connection with the situation there is the new tendency among the population - desperate to get qualified assistance in Russia and financial support from the state, terminally ill people are trying to be treated abroad, gaining cash through the media and charitable organizations. But foreign clinics in most cases provide quality medical care, and the diseases become «quite curable». Despite the high level of Russian doctors’ professionalism, they are not adequately focused on the treatment of serious diseases. Unnormalized workloads of doctors and low wages have led to reducing the effectiveness of the treatment process, empathy reduction, stress reduction, professional burnout among doctors. Now many of the «curable» diseases have a tendency to atypical progressing course and the occurrence of complications, it is necessary to conduct new clinical trials to develop effective approaches to treatment. Upper respiratory tract infection has a particularly aggressive form, leading to death. This phenomenon requires a more careful study and development of a new generation of antiviral drugs. To improve the situation Russian government should provide special funds for the purchase of diagnostic and therapeutic equipment with focused on the Russian medical technology and increase its quality to international standards, extension of modern medical technology, training doctors and traineeship in foreign clinics.
Bioethics. 2015;8(1):23-26
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Morality and rationality in health and social behaviour of the indigenous population of Siberia at the population level
Kozhevnikov A.A.
Abstract
The article describes the medico-social behaviour in the context of morality and rationality, as some of the qualitative features of the organization of the health system at the population level. The author comes to the conclusion that the prevalence among the population of non-communicable diseases, and infectious, depends on the degree of development of not only the social environment, but also a system of social relations regulated by the authorities and administration in the sphere of life and livelihood of people. Developed in the population type of behavior is not always positive from the point of view of social norms, morality, law and security, as much depends on the quality of the socio-cultural environment, as well as from the existing laws related to the fact that in responding to the needs in a particular situation, people tend to create the same situation, and repeated for a long period of committing such actions, they become habits and influencing behavior, behavioral become a stereotype.
Bioethics. 2015;8(1):26-30
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Psychodynamic approach to teaching medical students about the bioethics
Bermant-Polyakova O.V.
Abstract
Psychodynamic methods are well-known as an effective tool in increasing students’ self-mindedness, setting up reflection thinking strategies and improving their communication skills. The article represents an evaluation and review of the latest foreign studies on moral decision-making. The author introduces the number of recent Russian psycho-diagnostics development through and by which a comprehensive understanding of the emotional and the ethical processes have been achieved. The paper proposes the original method to deal with ethical reasoning. Using it as a tool enables a teacher to diagnose the ethical attitudes of students and the level of their inadequacy if exists. Moreover, the decision-making algorithms in case of ethical dilemmas may be worked through and reorganized in the teaching process applying this method.
Bioethics. 2015;8(1):30-34
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Physician’s rights in the troubled field of bioethics (the case of the european practice)
Ayvazyan S.H., Donika A.D., Elansky Y.G.
Abstract
The article presents the particular case materials from European practice of conflict resolution in medicine, which shows the need for a universal approach to the realization of human rights. The physician’s rights are examined not only in the context of them professional activity, but also in the social content of individual autonomy. These comments of Russian colleagues and experts from UNESCO demonstrate common approaches to resolving conflicts in medicine in Russia and abroad. Universal mechanism is the application of absolute and inalienable human rights as a patient and the doctor. The article discusses the significance of the pre-trial settlement of conflicts between doctors and patients through the activities of ethics committees, and the introduction of standardized informed consent form.
Bioethics. 2015;8(1):35-37
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The dichotomy between clinical and ethical decisions in medicine
Shipunov D.A., Maltseva N.L., Shestakov A.A.
Abstract
The article describes clinical case of intensive care and nursing of premature babies suffering from several serious diseases. The authors show the arguments of doctors, the mother of the child, give them legal and ethical evaluation. The main conclusion of the article is the statement of the absolute values of life compared to other human values. The question is, is it moral to preserve life, prolonging suffering? The authors pay attention to role of ethical committees in resolving conflicts between doctor and patient or his representative. The authors note the difference in the capabilities of the treatment and nursing of a child in full-time and part family, recognize the need to attract doctors - obstetrician-gynecologists to solving complex issues in neonatology.
Bioethics. 2015;8(1):38-39
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About the problem of ethical rules for medical-social work with adolescent mothers
Reymer E.A., Kantemirova G.A.
Abstract
The article grounds the relevance of establishing ethical rules for medical-social work with adolescent mothers on the base of bioethical principles. The article considers the particular case in the medical practice which proves the necessity of constructing the strategy of «doctor - patient - social worker» relationship.
Bioethics. 2015;8(1):40-43
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Social aspects of doctor -patient relationship in choosing the innovative technology in treatment of dental caries
Kazantseva I.A., Kazantseva N.N., Lukyanenko A.A.
Abstract
Dental caries is the most common dental disease. The paper presents a clinical case of the doctor-patient relationship in choosing the method of treatment of initial caries. Innovative technologies of treatment are offered: the infiltration method (ICON) when the esthetic effect of treatment depends on intensity of pigmentation of spot lesions; method of minimal intervention tooth preparation and sealing with flowable composite (achievement of excellent esthetic result). The authors have identified the importance of social factors - individual doctor - patient relationship as motivation in choice between the aesthetic and the invasive component of treatment.
Bioethics. 2015;8(1):43-45
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Bioethical principles in the orthodontia
Gazizullina O.R., Danilova M.A., Serova I.A.
Abstract
An attempt to analyse influence of the principles of bioethics on planning and conducting of orthodontic treatment is presented in article. An explication of the principle «don’t do harm» it is presented in classification of types of harm in orthodontia.
Bioethics. 2015;8(1):46-49
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Moral and ethical aspects of cancer patients narcotic anesthesia
Kaminskaya I.A., Veshneva S.A., Scripchenko L.G.
Abstract
Pain, going along the disease, often appears to be the cause of patient suffering. Opioid analgesics are the most effective drugs in the treatment of acute and chronic pain. However, not always patients can get the necessary preparations for the relief of pain. Terms of activities related to legal turnover of controlled substances are strictly regulated by state. The article deals with some problems with prescribing narcotic drugs and psychotropic substances for pain relief to cancer patients in the clinics.
Bioethics. 2015;8(1):50-52
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About the need for ethical reflection on sociological research in medicine
Petrov A.V., Avanesyan R.A.
Abstract
The article is a review of the book by N.N. Sedova and G.Y. Shchekin «Medical tourism: history, theory, practice». This review states the relevance and timeliness of the appeal to the issues of medical tourism in the monograph by N.N. Sedova and G.Y. Shchekin. As the positive aspects is the following: the definition of «medical tourism», the difference between health and medical tourism, the reasons for the predominance of outbound medical tourism on inbound tourism in Russia, the role of social actors - the organizers of medical tourism. Reviewers come to the conclusion about the need to develop ethical and legal foundations of medical-tourism activities, as in the monograph raised, but not resolved the ethical and legal problems. Preventing ethical risks in the development of medical tourism is an actual task of bioethics.
Bioethics. 2015;8(1):53-55
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Ethnic bioethics in education
Sedova N.N.
Abstract
Self-protective behavior ethnos is a natural process. Ethnic extinction feels some discomfort in different areas, taken private measures to eliminate it. And there are already modifications ethical standards and legislative change. Liberal-moral issues of cloning, euthanasia, surrogate motherhood / fatherhood, homosexuality, etc. are signs of such self-preservation behavior. Therefore, assessment and standards in modern bioethics cannot be exactly the same for all countries and peoples; they must correspond to ethnic age of this particular ethnic group.
Bioethics. 2015;8(1):56-57
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The problem of the formation of the ethical regulators of the physician professional activities
Donika A.D.
Abstract
We conducted a study on the value orientations of doctors on the undergraduate stage to assess the formation of ethical regulators of the professional activities of doctors. Conducted a comparative analysis of value motivations of doctors and medical students revealed underdevelopment moral qualities of empathy considered undergraduate professional group on stage. According to our data, only 46,3 % of the surveyed medical students have expressed an altruistic orientation and 37,3 % of the study - the selfish orientation (p > 0,05). At the same time, similar studies on model groups of doctors have shown that the majority of physicians (69,2 % of physicians and 83,3 % of surgeons) has altruistic orientation (p < 0,05). Orientation selfishness marked by no more than 15,7 % of physicians. The obtained results reflect the overall negative trend in the orientation of the youth society and can be predictive of future decline in the importance of ethical principles of medical practice.
Bioethics. 2015;8(1):58-60
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Dermatological ethical problems of personalized medicine
Krainova I.Y.
Abstract
The special nature of genetic information produces another ethical dilemma: the conflict between principle of respect for autonomy and principle of «do no harm». It’s important to develop the procedure of ethical review cases when it is necessary to violate the privacy of a patient without his consent to the notification of his family members are potentially exposed to the risk of disease.
Bioethics. 2015;8(1):60-61
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