Vol 11, No 1 (2018)

Articles
The fate of bioethics in medical education of contemporary Russia is under threat
Sedova N.N.
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.
Bioethics. 2018;11(1):6-7
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Transformation of ethical norms in society in the era of implementation of the latest technologies
Mailenova F.G.
Abstract
The development of modern medicine today directly depends on biomedical technology. Human life begins to depend more and more not only on the physician's personality (his knowledge and experience), but also on the level of technology development, availability of access to them. In this regard, the entire picture of the interaction between the doctor and the patient is gradually changing, ethical norms regulating these relationships are being transformed. Mostly clear and impressive these changes can be observed in the field of transplantology and organ donation. Dependence of the development of organ donation on the human factor, namely the presence / lack of donor organs, sets a special ethical tension. Hopes and fears associated with the implementation of the latest technologies, reflected in the cinema and literature, including science fiction. How will the future medicine deal with ethical issues related to organ donation, will an alternative be found - a question that excites not only physicians, but also philosophers and ethics.
Bioethics. 2018;11(1):8-12
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About contradictory connection of bioethics and event (of medicalization of society and socialization of medicine)
Prjamitsin V.N., Smirnov K.S., Reymer M.V.
Abstract
The article demonstrates that there is contradictory connection of bioethics and event. This principle is conditioned by the event of the medicalization of society on the one hand and socialization of medicine on the other hand. The conceptual elaboration of the problem of the connection of event and bioethics, of the definition of hermeneutics of this connection from the point of view of existentially-ontological phenomenology is supposed. The connection of bioethics and event is revealed with the aid of intuition, which is discovered phenomenologically. Their connection appears as contradictory unity of two sides. Their contradiction is existential-and-dialectical. It means, that essentially-ontological pattern of their connection is existential. Event and bioethics appear as existentials. But their existential qualities must not be generalized, for quite often the essentially-existential disintegration of the connection takes place. The event is the cause of disintegration and divergence, what supposes human participation. Bioethics and event are anthropologoessential existentials. They are connected between each other by essential connection. And here the traditional question about essence of anthropologoessential arises. The latter is guaranteed by the experience of its existential basis. This leads to the original essence of the event and bioethics. The existence manifests itself here. It is the basis for the possibility of the essential connection of bioethics and event. The essence of their connection is defined by existential essence of anthropologoessential. It is interpreted as dependent on existence of anthropologoessential, on its existential behavior. Anthropologoessential is the ontological totality of the existential acts-behavior of each human and all humankind. At the same time bioethics is the existentially-ontological phenomena intrinsic in living world of anthropologoessential. The conclusion is that contradictory and united continuum of event-bioethics exists existentially. Bioethics and event take place in each other. And their relations are asymmetrical and accompanied by tension, which initiates their interaction.
Bioethics. 2018;11(1):13-16
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Principle “ethical equals precise” as basis for ethos of biomedicine
Tiras K.P.
Abstract
The principle of "ethical - means precise" suggests that only if ethically correct approaches to a living object are observed, it is possible to obtain accurate information about it. Previously, the problem of following ethical norms in biology has traditionally been examined in the context of the requirements of ethical committees on observance of certain formal rules for working with animals. In the present work, an attempt is made to justify the necessity of observing ethically adequate approaches to biological experiment as a necessary condition for obtaining accurate scientific information about a living object. Ethical approaches are considered ethical, which considers an animal in natural, natural conditions. This approach goes back to the ethics of naturalism, which means the return of remote monitoring of a living object as the basis for obtaining precise information about its structure and function.
Bioethics. 2018;11(1):17-22
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Medical law, bioethics and multiculturalism: points for close cooperation of UNESCO and WAML
Mammadova V.Y., Mammadov V.G.
Abstract
Medical Law and Bioethics are new scientific disciplines appeared in the end of the last century as response to the challenges and technological innovations coming to the human activities related with health and biology. To respond these challenges on the global level scientists and experts come together within different organizations on international level in attempt to find out possible suggestions and solutions, appropriate in the different parts of the world. World becomes smaller nowadays and international cooperation starts to play crucial role for future success. This increases role and importance of Multiculturalsim as approach based on general and global human values with respect to the diverse cultural needs and particularities. World Association of Medical Law (WAML) was created in 1967 in Gent, Belgium with purpose to focus on multicultural issues in the filed of Medical Law. UNESCO as one of the largest UN organizations is a key international organization in the field of science, education and culture, which declared Bioethics and Multiculturalsim as own priorities. The first session of the General Conference of UNESCO took place in Paris in 1946. Despite WAML has indirect associate membership at UNESCO as non-governmental non-profit professional organization, in recent years cooperation of these two influential organizations has not been strongly seen. The 23rd WAML Congress in Baku, Azerbaijan in July 2017 was named “Medical Law, Bioethics and Multiculturalism” and brought together these international organizations.
Bioethics. 2018;11(1):23-27
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Ethical problems when conducting hygiene studies in modern Russia
Latishevskaya N.I., Guerusova G.P., Guba T.I., Kovaleva M.D.
Abstract
Ethical problems arising from hygiene research in modern Russia are considered in the article. Changes in socioeconomic conditions in the country (emergence of enterprises of various forms of ownership, employer‘s disinterest in assessing working conditions and, in fact, development of measures for prevention of diseases, primacy of the concepts of «human rights» and «voluntary consent» in organization of hygienic research; sometimes the lack of interest of administrative structures in obtaining real indicators of the health status of those surveyed, which often entails the need to develop in accordance with the laws of the country and the introduction of activities that require organizational and additional material costs) was the reason for the formation of new approaches and new conditions for solving scientific problems in the system hygienist (researcher) - the tested (healthy person). The authors determine ethical problems that arise from conduct of sanitary-hygienic, physiological, sociological and mathematical methods in the real conditions of production and human activity. It is the lack of interest of the subject in the research and the possibility of effective belief in the necessity of the research because of insufficient level of education and motivation. And it is the reluctance of the employer to show the real situation due to the negative results of hygienic studies in the dynamics of health status and the identification of risk factors for health at work, educational establishment etc. The solution to these problems is based on informal communication with the subjects, its encouragement in the form of various bonuses and in the absence of official permissive document. The relevance of the discussion about the ethical principles of research in preventive medicine is argued in the article.
Bioethics. 2018;11(1):28-31
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Leadership in medicine: risks of ethical conflicts
Donika A.D., Chernyshkova E.V., Andriyanova E.A., Volchanskiy M.E.
Abstract
The article deals with the problem of ethical conflicts in medicine. The growth of legal conflicts in medical practice is largely conditioned by increase of ethical conflicts. As the leader of a medical staff is the central figure, we’ve conducted the research of his/her personal features with the aim to reveal risk factors of ethical conflicts. The carried out literature review of the mentioned problem defined that leadership in medicine has its own peculiarities, connected with specificity of activity, gender asymmetry of a professional sphere. The research of role-playing features of a head in the medical staff was conducted on the example of physicians who performed leading duties with work experience in a senior post of 7±1,3 years. The research was carried out in the categorical field of sociology of medicine using methods of content-analysis, participant observation, sociological inquiry and interviewing, and psycho-diagnostic techniques (by Sinyavsky V.V. and Fedorishina B.A., Raygorodsky D.Y., Shubert, Boiko B.B., Snider M. etc.). The research results made it possible to determine ethical risk factors in 20-25% of leaders. It was concluded that there is a need to institute a bioethical methodical block to the system of continuing professional education of medical specialists, which can make it possible to form leader’s necessary ethical values and attitudes in conditions of educational sphere.
Bioethics. 2018;11(1):32-35
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The debriefing as psycho-technology assistance to victims of war, terrorism and disasters: Bioethical aspects
Arpentieva M.R.
Abstract
The article is devoted to psychological support and rehabilitation of military personnel and victims of war. The possibilities and limitation of debriefing as a form of psychological support and prevention last heavy military stress, post-traumatic stress disorder and other disorders. Examines the main mechanisms of debriefing and its functions. Particular attention is drawn to the problem of social exchange of experiences, its role in overcoming the negative effects of war trauma, and the role and functions of social exchange of experiences in the reconstruction of the events of wars, disasters, and terrorist attacks. Describes the conditions of the effectiveness of psychological debriefing and its problems. The experience of trans-ordinal events, including a long stay in them, can be very valuable for the individual and the community, requires research, reflection, not only leads to nonhealing wounds and psychosomatic disorders and mental type, but with proper work with him, identifies new opportunities of moral and psychological development of man as the Creator of the surrounding reality. We analyzed the results of studies of social exchange (separation) of experiences in debriefing and other studies of socio-psychological counseling. In the considered works he acts as a process of social exchange or "division" by the subjects of the meanings of his life activity, experiences and perceptions about it. The success of such an exchange, its effectiveness and productivity is associated with the formation and development of partnerships and mutual support. Very important are the conditions for achieving psychological security and the focus on the development of subjects of dialogue. The central bioethical aspect of assistance to the victims of wars, terrorist acts, disasters and other psychotrauma events is the consideration of the interests of the victims themselves and the protection of the interests of the society, the preservation and development of social relations.
Bioethics. 2018;11(1):36-43
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Religiousness as a factor for forming the bioethics ideology of patients
Svetlichnaya T.G., Menshikova L.I., Kharkova O.A., Shchekin G.Y.
Abstract
The aim of the study was to explore the moral and ethical and bioethical representations of believers and nonbelievers among patients in order to assess the influence of religiosity on the formation of a bioethical ideology and morally responsible attitude to the use of medical services. Study participants were divided into two groups in accordance with religious belief - believers (53,0%) and non-believers (47,0%). We found that there is a difference in all variables related to moral and ethical state of the patients between believers and non-believers. Moreover, we observe differences in the attitude of patients to all 7 analyzed biomedical technologies: in vitro fertilization, surrogate motherhood, human cloning, organ transplantation, fetal cell therapy, abortion and euthanasia. The attitude to the biomedical technologies of religious patients is bioethically responsible and is built on moral grounds, has a moral value and is filled with moral meaning. Religiousness promotes a deeper understanding by patients of the meaning of bioethical dilemmas and morally responsible attitude to medical interventions in the life and death of a person. The results obtained make it possible to assert that religiosity, acting as a factor in the formation of the bioethical ideology of patients, is an ethical regulator of the practice of using biomedical technologies.
Bioethics. 2018;11(1):44-50
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Acquisition of deontological principles through game technologies
Starikova I.V., Piterskaya N.V., Radyshevskaya T.N., Alyoshina N.F.
Abstract
The actual task of professional education of students is the development of independent evaluation and selection of information received. In pedagogical practice, active and interactive teaching methods are used. The influence of the role play on the formation and assimilation of deontological principles among the students of a medical college was studied. The initial level of knowledge on the principles of deontology revealed 48% of correct answers. After the role play and discussion of the basic deontological principles of the relationship between the doctor -patient, the doctor - the nurse, the degree of mastering the material was estimated at 79% of the correct answers. It is established that the use of role games consolidates professional skills, reveals the creative abilities of students and the ability to find solutions in various clinical situations. Mastering students with deontological principles of behavior makes it possible to avoid conflict situations in further independent work. The results of the conducted research showed high efficiency of the use of gaming technologies in the educational process.
Bioethics. 2018;11(1):51-53
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About the importance of monitoring non-medical expectations of surgical patients
Karsanov A.M., Maskin S.S., Remizov O.V., Kozhevnikov L.L.
Abstract
The article presents the results of a questionnaire survey of 197 patients who received inpatient treatment at the Vladikavkaz Junction Station Hospital of Russian Railways JSC. The questionnaire included 26 questions structured according to the levels of work and reflecting the parameters of non-medical expectations of patients. 85 patients of the surgical profile were included in the group I, and 112 patients of the therapeutic profile were included in the group II. The result: the group I demonstrated significantly lower rates of patient satisfaction with the level of social and living conditions when receiving medical care and regarding the compliance with the patients' rights. The average satisfaction rates of patients in the groups were 0.92±0.02 and 0.98±0.02, which generally characterizes the level of social efficiency of the hospital as high. The measures of an educational, economic, disciplinary and scientific-public nature were introduced at the hospital to improve the level of responsiveness of the health system. A structured approach to the organization of population studies among individual groups of patients allows identifying hidden defects in the system of ensuring non-medical expectations of the population and organizing their targeted elimination.
Bioethics. 2018;11(1):54-59
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PUBLICATION ETHICS OF THE JOURNAL
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Bioethics. 2018;11(1):60-60
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PAPER SUBMISSION GUIDELINES
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Bioethics. 2018;11(1):61-63
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