卷 11, 编号 2 (2018)
- 年: 2018
- 文章: 18
- URL: https://journal-vniispk.ru/2070-1586/issue/view/3217
完整期次
Articles
10 years of the Bioethics journal
Bioethics. 2018;11(2):5-5
5-5
Tibetan medicine: features of bioethical and ethical concepts
摘要
The article presents Tibetan views on the key problems of medical ethics, based on the materials of Tibetan sources, mainly on the 31st chapter of the second volume of rGyud bzhi (the 12 century). The aim of the study is an attempt to review medieval Tibetan medical ethics in the context of ethical models of modern medicine. It is shown that the ethical norms of the Tibetan physician's activities, unlike the often transformed European ethical principles, have remained absolutely unchanged for several centuries, and are still practiced. Particular attention is paid to six types of relationship between the Tibetan physician and the patient; although, they bear significant similarities to European models, specific approaches to solving some problems differ. The attitude of Tibetans to euthanasia and abortion that was seriously influenced by the Buddhist teachings on karma, reincarnation, is analyzed in detail. It is concluded that despite the corporate, paternalistic nature of the ancient medical ethics of Tibet in general, there is an obligatory true informing of the patient about the diagnosis and prognosis of the disease that recalls one of the basic principles of modern bioethics.
Bioethics. 2018;11(2):6-9
6-9
Religious determination of bioethical beliefs of health workers
摘要
The article presents the results are set forth regarding the research of moral-ethical and bioethical representations of the believers and non-believers among the health workers to assess the influence of the religiosity factor upon the formation of bioethical type of worldview. The conducted comparative analysis of moral-ethical characteristics of health workers with religious (43.3%) and non-religious (56.7%) type of worldview revealed the statistically significant divergence in 13-15 variables reflecting the moral-ethical personal states of the health workers. The results of the analysis allowed to identify differences in the attitude of the believers and non-believers to all seven analysed biomedical technologies: in vitro fertilization, surrogate maternity, human cloning, organs transplant, foetal stem cell transplantation, artificial termination of pregnancy and euthanasia. The attitude to the biomedical technologies on part of the religious health workers is based on the moral grounds, is filled with the moral sense and relates to the moral obligations. The phenomenon of religiosity contributes to a deeper understanding by the health workers of the meaning conveyed by the bioethical dilemmas and bioethically responsible attitude towards medical interventions into the life and death of a human being. The received results allow to ascertain that religiosity, by facilitating the establishment of the bioethical worldviews of the health workers and formation on its basis of the ethical competency, appears to be an important factor of the ethical regulation of the practice related to application of biomedical technologies under the conditions of a new model of moral relations in medicine.
Bioethics. 2018;11(2):10-15
10-15
Analysis of embryos’ cryopreservation in in vitro fertilization from orthodox point of view
摘要
In Vitro Fertilization (IVF) is the most effective and wide-spread means to overcome the infertility. Many contemporary types of IVF are accompanied with ovary hyperstimulation and so result in an excessive embryos appearance. But only one or two of them are transferred into a uterus. Others are being cryopreserved and kept in liquid nitrogen for future possible use. Even though the rate of pregnancy after cryopreservation is higher than in fresh cycles of IVF, there occurs a damage of embryos during freezing procedures. So Orthodox bioethics regards cryopreservation as a homicide. Moreover, the fact that not all embryos are going to be thawed and transferred into uterus to succeed a pregnancy leads to an increase of the number of embryos being frozen. The Article provides the arguments for cryopreservation to be ethically unacceptable, but also reveals some possible cases when cryopreservation (but only in vitrification form) could be justified.
Bioethics. 2018;11(2):16-19
16-19
Ethical dilemmas of modern nursing practice
摘要
The issues of the day of the ethic adjusting of modern sisterly practice are examined in the article, in particular, steady tendency, sent to confrontation and disconnect of medical workers and patients, and also reasons of this phenomenon. Legal and ethic unpreparedness of sisterly personnel results in ignoring of organization of professional care of seriously sick and immobile patients. Nurses, trusting a sisterly care to the casual people, dramatically worsen the prognosis for patients at high risk, demonstrating a lack of understanding of the essence of their profession, as well as violation of a number of legal and ethical documents. In Russian nursing there is a situation of terminological confusion of two completely different concepts: "professional" and "home" care. Independence and autonomy of profession of nurse must show up, foremost, in organization of the care of patients, based on scientific proofs. The professional caring must answer necessary requirements, such as scientific character, system, individual approach and documentation. Authors discuss the value of block of socially-humanitarian disciplines in education of medical sister. His tasks include teaching business etiquette, shaping the ethical thinking of the nurse and her ability to empathize (understanding and sharing the feelings of the other). Education of skills of ethic behavior of medical worker requires the observance of two obligatory conditions. The first condition is a sufficient volume of humanities in programs of all levels of preparation of sisterly personnel. The second condition of overcoming of break of theory of educating and practice of direct work is maintenance of the mode of "psychical asepsis" in medical establishments. In particular, on the base of hospitals the constantly operating joint medical-sisterly ethic training is needed.
Bioethics. 2018;11(2):20-25
20-25
Authoritative participation of the russian medical centres in UNESCO’S programs for education, training and information in the field of bioethics
摘要
In the article, the stages of long-term cooperation of the leading Russian educational chairs in bioethics with the responsible for ethics of science and technologies bodies in UNESCO are presented. The analysis of the main activities on creation and development of educational, information and debatable resources concerning the universal ethical principles proclaimed in the Universal declaration UNESCO (2005) “On bioethics and human rights” is given. The value of the process related with an extensive discussion the questions for realization of ethical principles at the specialized conferences organized by UNESCO Chair in Bioethics is comprehensively consecrated. The special part is assigned to thematic and system publications on a problem of bioethics and representation of priorities of ethical thinking on various administrative platforms for the purpose of formation of humanitarian influence and construction of the harmonized space for application of ethical principles in all areas of biology and medicine. Value of the magazine “BIOETHICA”, as innovative platform on creation of broad access to fundamental knowledge and initiative projects in the field of bioethics for representatives of medical audience and adjacent professions is shown.
Bioethics. 2018;11(2):26-30
26-30
Ethical education in the medical university: european practice
摘要
The article discusses the problem of bioethical education in medical universities. The urgency of the topic is conditioned by the society's need to balance the benefits and risks of applying modern biological or medical technologies, which requires a broader implementation of the principles of bioethics in modern medical practice. Awareness of future medical specialists about the problems and risks in the field under consideration will reduce the possibility of abuse of these technologies. As the review of domestic and foreign literature has shown, the goals of bioethical education are characterized by a wide range, the main ones of which are contained in the domestic bioethics curricula for medical universities and contain such elements as the development of medical knowledge in an interdisciplinary context; inculcating the skills of analyzing the risk / benefit ratio, as well as critical thinking and decision making, reflexive processes; personal moral development. In European practice, various teaching methods for different target groups are used, such as lectures, seminars, narratives, role plays, presentations and analysis, writing essays, small group discussions, online discussion forums, newsletters, discussions, etc. that play an important role in achieving the above goals. At the same time, each country has its own cultural and mental values that determine its tendencies and key moments in the development of pedagogical technologies of bioethical education. The analysis of the moral games used in the bioethical education of medical specialists under the UNESCO program allowed them to give a general description, in the form of a scheme proposed in the article, containing elements such as the name of the game, its purpose, requirements for conducting, description, recommendations. The characterization of several "moral games" presented in the article demonstrates their purposeful certainty and, at the same time, the simplicity and availability of the application in pedagogical practice of teaching bioethics. This allows them to be recommended for inclusion in national practice, subject to further analysis and adaptation
Bioethics. 2018;11(2):31-34
31-34
On the importance of control of the level of interference communications in improving safety of treatment of surgical patients
摘要
The safety of the treatment of surgical patients (SSP) is considered by the authors in the form of a complex concept combining progressive educational, clinical and management technologies aimed at preventing the negative consequences of surgical treatment based on their internal connections and overall development prospects. The latter can be traced when structuring the SSP system into five components. Significant difficulties with the organization of quality and safe surgical care are due in large part to the shortcomings in medical communications between medical law subjects and the low level of teamwork of employees. The article substantiates that in the overall concept of increasing SSP, the measures to improve the bioethical and communication component of the treatment process take an equal place. In addition to the traditional forms of internal quality control of medical care, the authors implemented their principles of monitoring the information and legal component of SSP, which are based on an assessment of the degree of "communication satisfaction" of all participants in the treatment process. Such a scientific and practical approach made it possible to assess the adequacy of measures to implement an integrated approach to SSP.
Bioethics. 2018;11(2):35-39
35-39
Tattoo: ethics of performance and classification of complications
摘要
Fashion tattoo extremely developing intensively lately. The socio-cultural causes of this phenomenon are now better understood than the consequences of these procedures. At the same time, tattooing procedures can provoke clinical risks, the actualization of which requires the intervention of dermatologists, and other specialists in some cases. This article contains the results of the study of such risks, the aim of the authors is to develop a classification of tattooing complications and proposals for their prevention. The analysis was carried out by the method of content analysis of literature sources and by the method of case study, special methods of clinical and laboratory diagnostics were used. There are situations in which the actualization of the potential risks of tattooing occur as a result of lack of the client’s awareness and non-compliance with other norms of bioethics. Recommendations for the prevention of the risks of tattooing for health were given. It is proposed to legally fix the status of tattooing as a medical service, which will allow stricter control over the performance of health-saving functions in tattoo parlors and conduct effective prevention of the described risks.
Bioethics. 2018;11(2):40-45
40-45
In vitro fertilization norm-setting
摘要
The article presents the pedagogical technology of the master class for post-graduate students on the problem of in vitro fertilization norm-setting by means of modeling on the practical lesson of complex sociological research, which includes a survey, case study, focus groups, content analysis and interviewing.
Bioethics. 2018;11(2):46-48
46-48
Bioethical aspects of providing equivalent medical treatment for prisoners
摘要
The article discusses the bioethical foundations and problems of ensuring the practical implementation of the principle of equivalence of medical care for prisoners. The urgency of the problem in question is conditioned by the need to improve the quality of medical care in prisons. Among the key problems can be identified socio-demographic characteristics of prisoners: a large proportion of representatives of the marginalized population, low level of medical literacy, risky behavior, gender specific structure of the prison population. These features determine a significant difference in the structure of morbidity, characterized by a wider prevalence of chronic and socially significant diseases and a higher need for prisoners in medical care. Another aspect under consideration is the prison conditions themselves, in which the implementation of the principle of equivalence is difficult due to the specifics of their activities, dictating the need for strict adherence to regime and restrictive measures, which manifests itself in a significant restriction on the free choice of a doctor or medical institution, the need to disclose the diagnosis of the prison administration and other. An important factor is the negative social factor deprivation of prisoners, which not only hinders the effective rehabilitation of patients suffering from mental illnesses, but also is the cause of their occurrence.Finally, the role of a doctor in the penitentiary health system plays a crucial role in ensuring the equivalence principle. On the one hand, this relationship is a doctor-administration, on the other hand it is a doctor-patient relationship. A departure from the principle of equivalence in these relationships can lead to the phenomenon of "double loyalty" and mutual distrust.
Bioethics. 2018;11(2):49-51
49-51
Quests as an innovative pedagogical technology for assessing the quality of students’ training in hygienic education: ethical aspects and problems
摘要
The urgent task of vocational training for a medical student is the introduction of innovative educational technologies that increase the interest of students and "include" them in a joint production with the teacher of knowledge and their active use. The article discusses some ethical aspects and problems that arose during the quest for the discipline "Hygiene" as an innovative technology. The authors noted that the nature of the relationship between students and teachers is changing (the teacher at the time of the quest turns into a group member moderator who has special rights and who ensures that other participants comply with the rules of the game). Secondly, the problem arises of combining the collective (group) activity of students and individual interest in the results of work. Thirdly, inertia and reluctance to depart from the traditional mass practices of assessing the quality of knowledge by older faculty, "the gap in the generational values of the educational process". Thus, the quest raises the level of students' interest in the subject, allows them to be active participants in the actions, stimulates the development of such professional skills of the doctor as teamwork, the ability to make quick decisions, and act in conditions of uncertainty. In the face of increasing demands on the quality of vocational education, it is necessary to popularize the quest and other innovative educational technologies among university professors.
Bioethics. 2018;11(2):52-54
52-54
The ethical problems of supervision training
摘要
Ethical problems of a new psychological discipline -Supervision, are considered in this article. Two new approaches to its implementation in the process of pre-diploma training are presented, i.e. educational and personal. Such ethical issues as what student groups should - academic or therapeutic ones, the content of these classes from the point of view of ethics, etc. are in the focus. All the questions mentioned are suggested to be discussed in the All-Russian conference
Bioethics. 2018;11(2):55-57
55-57
The theory of medical tourism and the practice of health care tourism
摘要
May 2018, the next (now the 4th!) All-Russian Scientific and Practical Conference with international participation “Modern tourism in medical and health care activities” took place in Pyatigorsk. The conference was organized by the Volgograd State Medical University and its branch - the Pyatigorsk Medical and Pharmaceutical Institute, as well as the Volgograd Medical Research Center and the Russian branch of the UNESCO Network of Bioethics International Network. This time the guests from Great Britain, Italy, Turkey, Armenia, Belarus, as well as representatives from different regions of the Russian Federation took part in the conference. The conference discussed the development of medical and medical tourism in Russia and other countries of the world. Much attention was paid to the problems of the sanatorium-resort complex. Here Russia has gained a lot of experience shared by the participants of the conference. The problems of medical tourism were discussed mainly in theoretical aspects, since its system in our country has not yet developed. The participants adopted a number of practical recommendations that were sent to interested authorities.
Bioethics. 2018;11(2):58-58
58-58
Ethics and law in medical tourism
摘要
The Health Committee of the Volgograd region held a Round table devoted to the development of medical tourism in the region on June 29, 2018, on the basis of the Volgograd state medical University. The Round table was attended not only by employees of the health Committee, but also by chief physicians of public and private medical institutions of Volgograd, medical workers involved in the implementation of medical tourism programs, representatives of travel agencies, experts in the field of clinical psychology, medical law, sociology of medicine and bioethics from different regions of Russia. The results of the discussion revealed three approaches to the problems of medical tourism development: medical workers and health care organizers were interested in the forms of attracting patients from other countries and regions for treatment in medical organizations of Volgograd, tour operators focused on the ratio of price and quality of medical care, without which tourist activities lose their meaning. Experts focused on the culture of consumption and provision of medical tourism services, their ethical arrangement. The discussion resulted in the adoption of practical recommendations.
Bioethics. 2018;11(2):59-60
59-60
Safety of medical care
摘要
A Round table "Safety of medical care" was held by Committee of health of the Volgograd region and the Department of ethical, legal and sociological expertise of the VMSC together with the Department of philosophy, bioethics and law with the course of sociology of medicine and the Department of public health and health of the Volgograd state medical University on July 5, 2018 on the basis of the state medical institution "Volgograd medical research center". The Round table was attended by practitioners, heads of medical organizations of the Volgograd region, experts in the field of medical law, medical psychology and sociology of medicine. All participants agreed with the view that the problem of ensuring the safety of health care needs a detailed analysis and does not have a common solution. A conclusion was reached on discussions on specific issues involving health workers and patients in all major health organizations in the region.
Bioethics. 2018;11(2):61-62
61-62
PUBLICATION ETHICS OF THE JOURNAL
Bioethics. 2018;11(2):63-63
63-63
PAPER SUBMISSION GUIDELINES
Bioethics. 2018;11(2):63-64
63-64