The study of professional ethics has a long tradition in the Soviet Union; medical ethics is a code of conduct as well as an academic discipline. The paper discusses the ethical issues in intensive care, the definition of death, abortion, euthanasia, and the moral aspects of medical mistakes.
Thanks to the work of the great doctor, scientist and teacher Nikolay Pirogov, Russian science reached the forefront in the field of biomedicine in the XIX century. The article presents a scientific review of the life, medical and scientific activities of Nikolai Pirogov, it presents an analysis of the emergence of the Russian health care system in the XVIII century as part of the social and political reforms of Peter the Great. Since this period, the most important feature of the health care system in Russia is the dominance of statism. The project of Peter I to introduce into Russian society the achievements of scientific medicine in Western Europe contained a contradiction, which can be described as a “conflict of civilizations”. The main sources for this scientific review were Pirogov’s “The Old Physician’s Diary” and the work of his pre-revolutionary biographer Julius Malis. Patriarchal family traditions and the Orthodox religion had an important influence on the upbringing of Nikolay Pirogov in childhood and adolescence. During the years of study of Nikolay Pirogov (1824-1828), the education system at the medical faculty of the Imperial Moscow University was still at the stage when there was an opposition between two parties of professors (“Germans” and “non-Germans” - Aleksandr Gertsen). The historical mission of Nikolai Pirogov is that he plays a leading role to resolve the “conflict of civilizations” in Russian medicine. The period of the Patriotic War of 1812 was notable in Russia for the extraordinary rise of patriotism, which played a major role in shaping the civic worldview of Nikolai Pirogov. But Nikolai Pirogov’s worldview rules out nationalist bias and one-sidedness.
The stages of the legitimization of the new criterion of death («brain death») in domestic medicine are presented. The semantic value of legitimizing the criterion for death is considered as recognition and confirmation of the legitimacy of the new criterion of death «brain death», based on values accepted in society. The problem of a new definition of brain death in a child patient is analyzed. The problems of philosophical and sociocultural perception of the diagnosis of brain death, organ donation, national features of the formation of the criteria for brain death, ethico-legal mechanisms for the regulation of the diagnosis of brain death are considered. Some moral and ethical problems of the development of transplantology in modern pediatrics are highlighted.
Review of actual historical medical questions of the formation of clinical transplantology in general and transplantology in pediatrics in particular. A comparative analysis of the development of transplantology in Russia and other countries is given. The ethical dilemmas of organ transplantation (ex vivo and ex mortuo) in pediatrics are discussed. The authors believe decisions about the admissibility of the definitions and criteria of these burning problems to have to be sanctioned beyond the limits of not only medicine, but the whole body of sciences, in the transdisciplinary space in which we all inhabit.
The article deals with bioethics’ problems in medical students’ training through the prism of the philosophy of education, which was formed in the middle of the XX century when the humanitarian-anthropological turn in philosophy was formed. The term “bioethics “was first used in 1970 by W.R. Potter, who proposed the concept of “bioethics” to refer to a complex interdisciplinary knowledge, the goal of which is the survival of humankind. As an independent discipline, bioethics is taught in the first years of the medical university. It is this course of bioethics in medical universities that can be called “propaedeutics of bioethics.” This is due to the fact theoretical bioethics to be studied in the context of philosophy, when the student is given the opportunity to adequately interpret philosophical abstractions in bioethics, and applied, often very acute and complex problems of bioethics are studied in the senior courses of the university and in the system of postgraduate education, when future doctors master medical bioethics in the courses of resuscitation, transplantology, medical genetics, psychiatry, etc. The professional knowledge and culture of the doctor were shown to be not identical to his humanism. In this regard, the need for the integration of humanitarian and clinical disciplines in Russian higher medical schools is emphasized. At the same time, numerous concepts and principles of bioethics serve as universal mechanisms for “fitting” modern man and his life world into the totality of life, which allows us to speak of bioethics as universal ethics.
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