Ethical dilemmas of modern neurosurgery

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Abstract

The purpose of the work is to reveal the features of neuroethics and new contradictions that have arisen in modern neurosurgery in close connection with its technology. Material and methods. The literature on neuroethics, the 20-year experience of the authors and individual samples of neurosurgical patients with acute traumatic injuries (in particular, 170 patients with intracerebral hematomas and focal brain injuries) and chronic subdural hematomas (400 patients) were analyzed to identify ethical problems and their pathways solutions. Results. Systematized factors of humanization and dehumanization of neurosurgery. New contradictions have arisen due to the widespread use in neurosurgery of methods of neuroimaging: fetishization of visual data and ignoring the patient's clinic and personality; The abundance of sophisticated technologies and the lack of generalized concepts; The professional duty of the doctor and commercial temptations; The sanctity of life and the quality of life, and a number of others. It shows how dilemmas arise that are fraught with threats of atrophy of clinical thinking, hypokylia, and distancing the doctor from the patient. Conclusion. Resolution of contradictions in modern neurosurgery must be based on the interests of both the patient and society. This requires a combination of a highly professional neurosurgeon with a priority of ethical and humanitarian values at all stages of his training and activities.

About the authors

B. L Likhterman

I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation

Email: Likhterman@nsi.ru
д-р мед. наук, проф. каф. истории медицины, истории Отечества и культурологии ФГАОУ ВО «Первый МГМУ им. И.М.Сеченова» 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2

L. B Likhterman

N.N.Burdenko National Scientific and Practical Center for Neurosurgery of the Ministry of Health of the Russian Federation

д-р мед. наук, проф., глав. науч. сотр. ФГАУ «ННПЦН им. акад. Н.Н.Бурденко» 125047, Russian Federation, Moscow, 4-ia Tverskaia-Iamskaia ul., d. 16

V. V Mogila

S.I.Georgievsky Medical Academy of the V.I.Vernadsky Crimean Federal University

д-р мед. наук, проф. каф. неврологии и нейрохирургии МА им. С.И.Георгиевского ФГАОУ «ВО КФУ им. В.И.Вернадского» 295006, Russian Federation, Simferopol, b-r Lenina, d. 5/7

M. A Spiru

N.N.Burdenko National Scientific and Practical Center for Neurosurgery of the Ministry of Health of the Russian Federation

канд. мед. наук, Лимасол, Республика Кипр, докторант, ФГАУ «Национальный научно-практический центр нейрохирургии им. акад. Н.Н.Бурденко» Минздрава России 125047, Russian Federation, Moscow, 4-ia Tverskaia-Iamskaia ul., d. 16

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