Vol 15, No 2 (2022)


Bioethics and network education in medical universities

Petrov V.I.


The issues of teaching bioethics are widely discussed all over the world nowadays. On the pages of our magazine, much attention was also paid to this problem [1, 2, 3, 4, 5, 6, 7]. But life does not stand still, and new teaching methods require a careful approach to their implementation in the practice of higher education. In this regard, the practical component is very important for teaching bioethics students – trainings, role-playing games, any interactive forms of classes. These are well-known distinctive features of this training course. But, as it seems to us, until now our universities do not pay due attention to such a form as network education in the field of bioethics. And it is here that it can play an important role.

Bioethics. 2022;15(2):3-5
pages 3-5 views

Theoretical bioethics

Ethical expertise in medicine: from humanism to formalism

Sedova N.N.


Background: Everyone knows what ethical expertise is in medicine, but most often they understand it as an axiological component of clinical research, which is incorrect [1]. Firstly, the subject of expertise is not research, but testing. Secondly, not only clinical trials, but also the entire medical practice are subject to expert evaluation.

Aim: Understanding of the described situation allows us to formulate topical questions about the further development of the institute of ethical expertise and to propose for discussion options for this development in new medical and social conditions.

Methods: Statistical analysis of the data of examinations conducted by ethical committees (councils, commissions) shows a tendency to limit the subject of examination, the lack of connection between different types of examinations.

Results: Modern medicine requires new forms of control over ongoing research and testing in connection with new risks both in the individual human body and in the social organism as a whole. Ethical expertise responds to the challenges associated with these risks by specifying and multiplying its norms and rules, which leads to excessive formalization that does not correspond to the principles of the axiology of scientific knowledge and practice in medicine.

Conclusion: The transition from ethical to fully humanitarian expertise will reduce the level of formalization, which deprives the ethical approach of its essential intentions. The allocation of deontology as the basis of ethical assessments is illegitimate, axiological components are ignored. Humanitarian expertise makes it possible to restore the parity of norms and assessments as a criterion of expertise in medicine.

Bioethics. 2022;15(2):6-11
pages 6-11 views

Autonomy and care in the logic of competing and solidarity relations in medicine

Sidorova T.A.


The interactions of the subjects of medicine are considered in the projection of two logics: solidary and competing relations. This approach develops the critique of the dominance of the concept of patient autonomy that comes with the bioethics represented in the ethics of care by K. Dörner, A. Moll and others. The conceptual forms of competition and solidarity are identified as oppositions to power and equality, autonomy and care, individualism and interdependence of subjects of medicine, anti-paternalism and paternalism, neglect and attentiveness, the legal and ethical meaning of informed consent, control and compliance, medical services and medical care.

In medicine, from point of view of bioethics, the solidary relations could be expressed in a paternalistic model. It is based on ethical connotations such as doctor's responsibility and mutual trust. Autonomy has a legal and economic predication. The ethics of care, traditional for the Russian cultural model, implies not so much the doctor's authorities over the patient, recognizing him as unequal in medical decisions, but in modern healthcare it can be combined with a voluntary expression of consent to medical interventions with the properly provided information.

Bioethics. 2022;15(2):12-17
pages 12-17 views

Practical bioethics

Case study of bioethics: a case of improper treatment of bladder exstrophy

Tarabrin R.E., Zolotukhina A.S., Afanasyeva A.V., Kikhasurova P.M.


Background: The principles of bioethics proposed by Beechamp and Childress are difficult to apply to the specific ethical dilemmas that arise in clinical practice. The scientific literature has suggested other ways of analyzing them.

Methods: We use the Moscop's case study method to analyze a case of inappropriate treatment of bladder exstrophy, a rare congenital condition associated with a high chance of medical error during treatment.

Results: The analysis of the present case of a medical mistake considers ethical aspects such as the doctor-patient relationship, the reaction of physician-colleagues and the patient to the medical mistake, and the disclosure of the medical mistake. As a result of the bioethical analysis of the case, the following recommendations have been formed: 1) Despite the objective difficulties of treatment in a low-profile regional center and bureaucratic mechanisms of referral of the patient to another institution, the doctor should respect the autonomy of the patient and his relatives, for which full information about possible risks and treatment alternatives should be provided; 2) Disclosure of the true causes of medical error and apology can help to build trusting relationships with the patient and reduce subsequent conflicts. Short-term psychological discomfort of disclosure will be compensated by long-term positive results of interaction with patients; 3) Criticism of previous treatment should take into account possible difficulties of diagnostics at regional level and lack of experience in treatment of rare pathologies. Achieving an advantage over one's colleagues through pointing out their medical error without knowing the real reasons for the prior treatment is ethically unjustified.

Conclusion: An important function of disclosing medical errors is to warn colleagues against such errors. Most authors are of the opinion that it is the professional duty of a doctor who witnesses an adverse event to assist in the disclosure of an error and help in minimizing its consequences, however, in a medical environment with strong corporate ties and cultivating a spirit of solidarity, this principle has not become widespread in practice.

Bioethics. 2022;15(2):18-26
pages 18-26 views

Medico-sociological assessment of surgeons' activities during the COVID-19 pandemic

Us O.A., Chepurina N.G., Panin S.I.


Background: The article considers the results of a survey of surgeons of non-infectious multidisciplinary hospitals in Volgograd, carrying out their activities during the COVID-19 pandemic.

Aim: Тo study the opinion of surgeons of surgical departments of non-infectious multidisciplinary hospitals, about satisfaction with their work, conditions of medical activity, about security, availability of planned surgical care during the COVID-19 pandemic and the main factors affecting them.

Methods: Тhe study was conducted using a questionnaire method with the participation of 47 surgeons of surgical departments of non-infectious multidisciplinary hospitals in Volgograd, working during the COVID-19 pandemic 2020-2022. Statistical (Microsoft Excel 365) and graphoanalytic methods were used.

Results: When analyzing the questionnaires, it was found that only 32.6 % of surgeons were satisfied with their work, 47.8 % were partially satisfied, and 19.6 % were not satisfied. In turn, 69.6 % of surgeons consider the operating units of the departments to be not fully provided with all the necessary equipment, 15.9 % consider the provision to be complete, 15.9 % refrain from answering.

Conclusion: During the discussion, proposals were made to increase the satisfaction of surgeons with their professional activities, to improve the efficiency, quality and safety of planned surgical services.

Bioethics. 2022;15(2):27-32
pages 27-32 views

Ethical aspects of the anatomical museum in the development of a future doctor

Perepelkin A.I., Komissarova E.V., Vlasova E.V.


The article reveals the tasks of the anatomical museum, which is not only one of the most important conditions for teaching students, but also a moral educational institution. In the process of training medical university students at the Department of Anatomy, its museum is of great importance, as it performs a social function of transferring the accumulated knowledge, experience, material and spiritual wealth to subsequent generations. The formation of the personality of a doctor follows certain directions, including the expansion of professional horizons, the professionalization of mental processes, the formation of a sense of duty and an increase in the level of claims within the chosen profession.

Bioethics. 2022;15(2):33-36
pages 33-36 views

Higher education for foreign students in Medical Academies during COVID-19 pandemic

Alshuk N.A., Al-Atoum H.


Background: The pandemic of the new coronavirus COVID-19 has affected all aspects of modern society. The higher medical education is no exception here. The borders closure by many countries has created a situation where the education in another country became possible only in a virtual format. The way the quality of education was affected will become clear later. But the effectiveness of work in this area mainly depends on the acceptance or rejection of the new forms of education by students. A study conducted by the International Relations Office of Volgograd State Medical University in February-April 2021 was dedicated to the study of this issue.

Aim: Тo determine the projections the application of a blended format of teaching to medical students in the post-Covid period in order to optimize the development of educational programs and improve international cooperation in this area.

Methods: The field of study included a questionnaire developed in Google forms. The Processing of questionnaires is automated. Editing and coding of information, statistical analysis, comparative analysis, combinatorial analysis using the SPSS program have been carried out. The study was conducted at medical universities in 8 countries in different regions of the world. The article discusses research results in Russia. General population – 1835 international students for March, 1, 2021. N = 320. Confidence – 97 %.

Research hypothesis: The transition to online education during a pandemic allows students continue medical education with minimum interruption. In general, they adapt well in the digital environment, however, they consider its disadvantages as: the lack of direct guidance from teachers in the development of practical skills and the absence of personal contacts. In the future, the online training format can be considered as supplementary, but not the main one in the process of training of doctors.

Results: Practical recommendations have been developed for the development of international relations in higher medical education using blended teaching methods, both in regular and in emergency situations.

Conclusion: Comparing these data, we can conclude that studying in a foreign medical university is assessed by students higher than education in their own country, they value the acquired knowledge more and choose those forms of training that are most advantageous for their professional development.

Bioethics. 2022;15(2):37-42
pages 37-42 views

Applied Bioethics

Problems of ethics in medical tourism

Shchekin G.Y., Troneva V.E.


The article deals with the following issues: globalization and integration of the economic, political and information space, which have led to changes in the tourism industry; medical tourism as a promising area of ​​modern health care, which requires theoretical understanding; implementation of the federal project "Development of the export of medical services", part of the national project "Healthcare"; medical tourism as an object of research activities: goals, objectives, results of ongoing research; publication activity of medical tourism researchers; the role of ongoing scientific and practical conferences in promoting scientific knowledge about medical tourism; problems of professional competence of specialists in the field of medical tourism; scientific contribution to the optimization of modern administration of the medical services market.

Bioethics. 2022;15(2):43-48
pages 43-48 views

Ethical and linguistic features of the interaction between the patient and the medical community

Fomina T.K., Fateeva Y.G., Ignatenko O.P., Altukhova O.N.


Background: The activity of a doctor, among other things, includes the need to communicate with the patient, so the presence of communication skills is a mandatory feature of this profession.

The object of the study is informed voluntary consent from the point of view of the main component of the communicative act.

Aim: Тo analyze the linguistic and ethical features of this document.

Methods: Linguistic.

Results: Тhe lexical and grammatical composition of the title of the document includes the distribution of communicative roles: the doctor is an active communicator, the patient is a passive one; The semantic analysis of the text gives grounds to assert that this document in most cases cannot be independently understood by the patient, the participation of the doctor is necessary as part of the explanation of the content of the consent.

Conclusion: The conducted analysis gives grounds to assert that if the work with informed voluntary consent is not carried out correctly, communicative problems may arise and, as a result, communicative failures.

Bioethics. 2022;15(2):49-54
pages 49-54 views

Problems of training students with mental disabilities in a medical university

Zholudova A.N., Os´kin D.N., Polyakova O.V., Vershinin E.G.


The article presents the results of a study of personal and emotional states of teachers of the Ryazan State Medical University named after Academician I.P. Pavlov, working with students with mental disabilities. As practice shows, training is associated with a number of problems associated with psychological barriers, both among students with disabilities or disabilities themselves, and psychological and pedagogical ones among university teachers who do not have special training for working in inclusive groups. To identify and analyze these problems in the educational process, as well as the emotional state of teachers, a survey and testing of the teaching staff of the university was conducted. Teachers believe that students with mental disabilities need special teaching aids and methodological developments, video materials and other technical means. It is also important to provide additional psychological and pedagogical training for teachers on the organization of the educational process with persons with disabilities or disabilities in order to adapt and improve the quality of educational work.

Bioethics. 2022;15(2):55-58
pages 55-58 views

Modified pre-abortion counseling section

Tkachenko L.V., Gritsenko I.A., Tikhaeva K.Y., Gavrilova I.S., Dolgova V.A.


The problem of pregnancy termination is multifaceted. According to the current legislation, women who come to a healthcare facility for an induced termination of pregnancy undergo pre-abortion counseling. During the consultation, the specialist has several tasks: to compare the arguments for pregnancy termination or preservation; to help competently assess the current life situation; to consider ways to solve problems; to provide information about federal and regional support measures for pregnant women and families with children; to inform about possible negative consequences of an artificial termination of pregnancy. The authors believe that in addition to psychological assistance to women in the situation of choice, it is of great importance to provide detailed information about the negative reproductive consequences of abortion, including the problem of premature ovarian insufficiency. Due to the high prevalence of premature ovarian insufficiency among female population, it seems necessary to supplement the existing pre-abortion counseling procedure with a section devoted to the problem of physiological and pathological loss of ovarian reserve and the impact of pregnancy termination on this process. To inform a woman about her risk of premature ovarian insufficiency and about her presence of this condition in general would allow a woman to consciously avoid additional negative influences (smoking, alcohol, stress), make an informed decision about her reproductive plans and their timing, and possibly resort to oocyte cryopreservation methods in cases where the risks of premature ovarian insufficiency are extremely high. When premature ovarian insufficiency is already diagnosed, the only way to have a baby is to use assisted reproductive technology, but with the use of donor eggs.

Bioethics. 2022;15(2):59-65
pages 59-65 views


Bioethics today

Ivanov K.V.


Five years have passed since the death of the great scientist, the "father" of Russian bioethics Boris Grigoryevich Yudin. A round table held at the Institute of Philosophy of the Russian Academy of Sciences was dedicated to his memory. Memories of B.G.Yudin and the reinterpretation of his ideas in the modern era have become the subject of discussion by leading bioethicists. Science itself has undergone major changes over the years. It is all the more important to "read" the works of Boris Grigorievich in a new way, who not only reflected on contemporary bioethics, but also formulated the main ideas of its future development.

Bioethics. 2022;15(2):66-67
pages 66-67 views

Book review

Bioethics for nurses

Vlasova V.N.


The first bioethics textbook for nurses in our country has been published in the leading domestic publishing house of educational literature KNORUS [1]. This, without a doubt, can be called a long-awaited event. The fact is that until now, despite the importance of ethical problems in the work of nurses, there was little relevant educational material, it was not systematized, moreover, in some medical colleges there was no such subject as bioethics in the curriculum at all. Some issues of professional ethics were considered in courses of other academic disciplines, but no holistic teaching concept was developed. The new textbook, the authors of which are Professors N.N. Sedova, A.D. Donika and associate Professor O.V. Kostenko, allows us to overcome the existing fragmentation in the ethical training of nurses.

Bioethics. 2022;15(2):68-69
pages 68-69 views

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