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Bioethical and sociocultural aspects of diagnosis disclosure 披露诊断结果的生物伦理和社会文化问题
Pub Date : 2023-12-14 DOI: 10.19163/2070-1586-2023-16-2-32-36
V. Zhura
Aim: The aim of the article was to analyze various approaches to diagnostic disclosure considering its bioethical, sociocultural, psychoemotional and sociolinguistic implications. Results: Diagnosis disclosure is considered to be one of the major challenges of doctor – patient communication as it brings forth complex bioethical, legal, sociocultural, and psychoemotional tensions. The former non-maleficence approach to diagnosis delivery has been replaced with the one based on the bioethical principle of patient autonomy obliging physicians to reveal information truthfully and completely. The current bioethical approach has been refined to develop a number of protocols used for effective delivery of negative diagnostic information. However, alongside with the protocols building on this principle, alternative ways of diagnosis disclosure and patterns of diagnosis breaking are practised. The latter rest on culture specific norms, which are followed to balance the principles of non-maleficence and patient autonomy. Conclusion: The rationale behind the selection of the best approach to diagnostic disclosure has to rest not only on the dominant bioethical principle, but also align with the sociocultural norms as this is the way to ensure greater flexibility, variability and optionality and achieve better management outcomes.
目的:文章旨在分析诊断披露的各种方法,考虑其对生物伦理、社会文化、心理情感和社会语言的影响。 结果:诊断披露被认为是医患沟通的主要挑战之一,因为它带来了复杂的生物伦理、法律、社会文化和心理情感矛盾。以前的非恶意诊断方法已被基于患者自主的生命伦理原则的方法所取代,后者要求医生如实、完整地披露信息。现行的生物伦理方法经过改进,制定了一系列用于有效提供负面诊断信息的规程。然而,除了建立在这一原则基础上的规程外,还有其他的诊断披露方式和诊断中断模式。后者以特定文化规范为基础,在非恶意原则和患者自主权原则之间取得平衡。 结论:选择最佳诊断公开方式的依据,不仅要以生物伦理原则为主导,还要与社会文化规范相一致,因为这样才能确保更大的灵活性、可变性和可选择性,并取得更好的管理效果。
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引用次数: 0
Modern aspects of deontology in dentistry 牙科中的现代义务论
Pub Date : 2023-12-14 DOI: 10.19163/2070-1586-2023-16-2-37-40
Irina V. Muravyeva, Daniil R. Pavlov, Alyona A. Uvarova
Background: The basic norms of deontology for a dentist we can find in the Code of Ethics of the Dental Profile. The aim of the article was to review and analyze the norms of deontology set forth in the Code of Ethics of the Dental Profile. Results: The article deals with modern aspects of compliance with confidentiality standards. The paragraphs of the Code concerning the relationship between a doctor and colleagues are analyzed and the features of interaction in dentistry are shown. The issues of maintaining a balance between the principles of "do no harm" and "do good" in terms of the patient's financial costs are considered: any intervention is associated with the possibility of causing harm, while the very concept of "harm" includes both the physical side and the moral and financial side. The role of empathy in building relationships in the doctor-patient system is shown. Due to the specifics of the work of a dentist, the importance of moral support for the patient, as well as the importance of informing him about upcoming actions and manipulations, is described. Conclusion: The patient must be involved in the treatment process, be an active participant in it: it is necessary to provide him with full information to the patient about the methods of treatment, alternative options and possible risks, this ensures the observance of the principle of patient autonomy and respect for his dignity.
背景:我们可以在《牙医职业道德规范》中找到牙医的基本道德规范。 本文旨在回顾和分析《牙医职业道德规范》中规定的道义论准则。 结果:文章论述了遵守保密标准的现代方面。分析了《守则》中关于医生与同事之间关系的段落,并展示了牙科中互动的特点。文章考虑了在 "不伤害 "原则和 "做好事 "原则之间保持平衡的问题:任何干预都有可能造成伤害,而 "伤害 "的概念本身既包括身体方面的伤害,也包括道德和经济方面的伤害。移情在建立医患关系中的作用得到了体现。由于牙医工作的特殊性,描述了为病人提供精神支持的重要性,以及告知病人即将采取的行动和操作的重要性。 结论:病人必须参与治疗过程,成为治疗过程的积极参与者:有必要向病人提供有关治疗方法、替代选择和可能风险的全部信息,这样才能确保遵守病人自主和尊重病人尊严的原则。
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引用次数: 0
Problems of norm and pathology in the sociology of health 健康社会学中的规范与病理学问题
Pub Date : 2023-12-14 DOI: 10.19163/2070-1586-2023-16-2-20-25
T. Svetlichnaya, Elena A. Smirnova
Currently, the norm is usually understood as a certain average, the most common indicator in society. The concept of norm changed and as a result, different standards of health (ancient, adaptive, anthropocentric) were distinguished in different time periods. In the modern postmodern world, there is an intensive reassessment of norms, individual and social consciousness is changing, the concepts of good and evil, norms and pathology are blurring, where the old norm, which contradicts the new views on success, can be canceled and introduced into the status of pathology. The changes also affected medical practice. So, the reforms of F. Pinel (1793) imbues insanity with a certain medical meaning, the condition or behavior begins to be defined as a medical problem requiring medical intervention. Psychiatry gains professional power over the patient, and the psychiatrist gains control over the soul and body of the patient. A psychiatrist, remaining the ultimate truth, determines a person's place in the structure of society through diagnosis and stigmatization mechanisms. In addition, new risks are being created in the company. Biomedical technologies regulating the processes of birth, prolongation of human life and death are being developed.
目前,常模通常被理解为某种平均值,即社会中最常见的指标。准则的概念发生了变化,因此,不同时期有不同的健康标准(古代标准、适应性标准、人类中心标准)。在现代后现代世界,人们对规范进行了深入的重新评估,个人和社会意识正在发生变化,善与恶、规范与病理学的概念变得模糊,在这种情况下,与新的成功观相悖的旧规范可能会被取消,并被引入病理学的地位。 这些变化也影响到了医疗实践。因此,F. Pinel(1793 年)的改革为精神错乱赋予了一定的医学含义,精神错乱的状况或行为开始被定义为需要医疗干预的医学问题。精神病学获得了对病人的职业权力,精神病医生获得了对病人灵魂和身体的控制权。精神科医生仍然是终极真理,通过诊断和污名化机制来决定一个人在社会结构中的位置。此外,公司内部也出现了新的风险。调节出生、延长人的生命和死亡过程的生物医学技术正在发展。
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引用次数: 0
The Ethics of Artificial Intelligence: A Sociological Approach 人工智能的伦理:社会学方法
Pub Date : 2023-12-14 DOI: 10.19163/2070-1586-2023-16-2-26-31
Alena D. Donika
Background: to create effective mechanisms for state regulation of potential moral challenges caused by the widespread introduction of artificial intelligence technologies, it is of practical interest to study the attitude of society to this problem. The purpose of the work is a sociological analysis of the attitude of the Russian society to the introduction of artificial intelligence technologies. Materials and methods: A comprehensive analysis of data from open access databases of All-Russian Center for the Study of Public Opinion was carried out. The materials of sociological surveys for the period 2007 to 2023 were used. Data weighted by socio-demographic parameters. Results: The majority of respondents believe that AI cannot completely replace humans (78 %). The greatest fears of the population (noted by 50–65 % of respondents) are associated with the loss of personal data and violation of privacy boundaries, the loss of personal responsibility for erroneous actions. Every third noted the risks of violation of civil rights and social guarantees ("increases inequality", "violates the balance of interests of society and the individual"), potential ethical problems ("artificial intelligence has no morals and ethics" – 32 %). Conclusion: Distrust of AI technologies is associated with an understanding of the social risks of their integration and an awareness of the loss of human values of communication, creativity, and individuality. Particular risks in this context are presented for social institutions of education and healthcare, where the loss of interpersonal communication calls into question the manifestation of empathy, sympathy and compassion.
背景:为了建立有效的国家监管机制,应对人工智能技术的广泛引入所带来的潜在道德挑战,研究社会对这一问题的态度具有现实意义。本文旨在从社会学角度分析俄罗斯社会对引入人工智能技术的态度。 材料与方法对来自全俄社会舆论研究中心开放数据库的数据进行了综合分析。使用的是 2007 年至 2023 年期间的社会学调查材料。数据按社会人口参数加权。 结果显示大多数受访者认为人工智能无法完全取代人类(78%)。人们(50%-65% 的受访者)最担心的是个人数据丢失、隐私边界被侵犯、个人对错误行为失去责任。三分之一的受访者指出了侵犯公民权利和社会保障的风险("加剧不平等"、"破坏社会和个人利益的平衡"),以及潜在的道德问题("人工智能没有道德和伦理"--32%)。 结论对人工智能技术的不信任与对其融合的社会风险的理解以及对交流、创造力和个性等人类价值丧失的认识有关。在这种情况下,教育和医疗保健等社会机构面临的风险尤为突出,因为在这些机构中,人际交往的缺失会对同理心、同情心和怜悯心的体现产生质疑。
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引用次数: 0
Bioethical deconstruction of the phenomenon of evil 从生物伦理角度解构邪恶现象
Pub Date : 2023-12-14 DOI: 10.19163/2070-1586-2023-16-2-8-12
Kirill S. Smirnov, Alexander A. Ruchtin
The phenomenon of evil in modern socialcultural situation from the point of view of bioethics, interpreted as deconstruction is analyzed in the article. Evil as the striving to destruct appears in the form of the dividing of whole and extreme reductionism. In social and anthropological dimensions such reductionism is expressed in the idea of the society as original chaos (war of all against all) which is caused by “evil and vicious human nature”. However this chaos is structured by means of social contract (financial order) coming out in the form of the principle of a lesser evil. Now this structuring is the process of substitution at the new type of order: surveillance biocapitalism. This last is the real threat not only to human existence but to the whole bios. From here is the task of the developing of discourse which is able to block given destructive tendency. Such discourse is conservative bioethics as radical ethics of salvation, on the basis of which the global bioethos can be formed. Global bioethos is the topos of cooperation and solidarity (Great Harmony). In this new social topos Homo misericordis can rise: human whose main quality is misericordia. Owing to misericordia human overcomes estrangement, enters into a dialogue, and creates the premises for the meeting with Other (the whole totality of bios).
文章从生命伦理学的角度分析了现代社会文化中的 "恶 "现象,并将其解释为解构主义。恶作为一种破坏的努力,以分割整体和极端还原论的形式出现。在社会学和人类学方面,这种还原论表现为社会是由 "邪恶和恶毒的人性 "造成的原始混乱(所有人对所有人的战争)。然而,这种混乱是通过社会契约(金融秩序)以少恶原则的形式表现出来的。现在,这种结构化是新型秩序的替代过程:监控生物资本主义。这不仅是对人类生存的真正威胁,也是对整个生物界的威胁。从这里开始,我们的任务就是发展能够阻止这种破坏性趋势的话语。这种话语就是作为激进救赎伦理的保守生物伦理学,在此基础上可以形成全球生物伦理。全球生物伦理是合作与团结的主题(大和谐)。在这一新的社会理念中,Homo misericordis 得以崛起:人类的主要特质是 misericordia。由于 "恻隐之心",人类克服了隔阂,开始对话,为与他者(生物的整体)相遇创造了条件。
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引用次数: 0
BRICS Medical and Humanitarian Development Association (AMEGRA BRICS): birth and first steps 金砖国家医疗与人道主义发展协会(AMEGRA BRICS):诞生与第一步
Pub Date : 2023-12-14 DOI: 10.19163/2070-1586-2023-16-2-57-58
Vyacheslav I. Moiseev
The BRICS Medical and Humanitarian Development Association (AMEGRA BRICS) was established on January 17, 2023, receiving final registration as a legal entity on May 11, 2023. One of the central tasks of the Association is the creation of an International University of Integrative Medicine on the basis of one of the medical universities in Russia.
金砖国家医学与人道主义发展协会(AMEGRA BRICS)成立于2023年1月17日,并于2023年5月11日获得法人实体的最终注册。协会的中心任务之一是在俄罗斯一所医科大学的基础上创建一所国际中西医结合大学。
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引用次数: 0
Interdisciplinary connections in the teaching of bioethics 生物伦理教学中的跨学科联系
Pub Date : 2023-12-14 DOI: 10.19163/2070-1586-2023-16-2-3-7
Natalia N. Sedova
As you know, the moral side is in all our relationships, actions and thoughts. The procedure for evaluating on a scale of "good – bad" immediately translates judgments about reality into an ethical plane. This is most clearly seen when working with living objects, which makes bioethics a metascience. This, in turn, requires special methods, skills and ways of explication of value bases. And since the axiological portrait of reality is subjective and has a high degree of variability, the permanently ongoing dispute about the structure and content of education in the field of bioethics is unlikely to have an unambiguous solution. Therefore, the bioethical paradigm of intentionality is so important in educational practices in this field of knowledge.
众所周知,道德的一面存在于我们所有的关系、行为和思想中。以 "好-坏 "为标准进行评价的程序会立即将对现实的判断转化为道德层面。这一点在与有生命的物体打交道时体现得最为明显,这也使得生物伦理学成为一门元科学。这反过来又需要特殊的方法、技能和价值基础的阐释方式。由于对现实的公理描述是主观的,具有很大的可变性,因此关于生命伦理学教育的 结构和内容的长期争议不可能有一个明确的解决方案。因此,意向性的生命伦理学范式在这一知识领域的教育实践中是如此重要。
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引用次数: 0
Ethical and legal responsibility of medical organizations and medical workers for causing harm to the life and health of patients while carry-ing out professional activities 医疗组织和医务工作者在开展专业活动时对患者的生命和健康造成损害的道德和法律责任
Pub Date : 2023-12-14 DOI: 10.19163/2070-1586-2023-16-2-46-51
L. L. Kozhevnikov, Nikolay N. Mikhailenko
Аuthors, consider the issues of recognizing the subjects of civil liability for causing harm to life and health, patients of specific medical institutions, regardless of their form of ownership and doctors of these institutions. It also raises the issue of the recognition of private doctors who are individual entrepreneurs as the subjects of this type of liability.
А 的作者考虑了承认造成生命和健康损害的民事责任主体的问题,即特定医疗机构(无论其所有 权形式如何)的患者以及这些机构的医生。报告还提出了承认作为个体经营者的私人医生为此类责任主体的问题。
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引用次数: 0
Moral values in Ancient Greek Aesthetics 古希腊美学中的道德价值观
Pub Date : 2023-12-14 DOI: 10.19163/2070-1586-2023-16-2-13-19
G. Tabatadze, Olga V. Kostenko
Characterizing the ancient aesthetics, we adhere to the moral approach of the correlation of aesthetic and moral categories, which allows us to reveal the logic of the development of the relationship between aesthetics and morality. In our study, an attempt has been made, in general terms, to consider the development of aesthetics not as the evolution of concepts, terms, theories, but as an essential factor in the development of morality, morality, ethics, how the understanding of beauty, beauty and harmony in art determined a person's perception of himself and the essence of his actions.
对于古代美学的特点,我们坚持从美学与道德范畴相关性的道德角度进行研究,从而揭示美学与道德之间关系的发展逻辑。 在我们的研究中,我们试图从总体上考虑美学的发展,不是将其视为概念、术语、理论的演变,而是将其视为道德、道义、伦理发展中的一个重要因素,即对艺术中的美、美与和谐的理解如何决定一个人对自身及其行为本质的认识。
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引用次数: 0
Cultural and historical context of understanding health: analysis of opinions and traditions of the peoples of the world 了解健康的文化和历史背景:分析世界各国人民的观点和传统
Pub Date : 2023-12-14 DOI: 10.19163/2070-1586-2023-16-2-52-56
Anna E. Sorokoletova, Elena A. Tkachenko
This article analyzes the opinions and traditions of the peoples of the world in the context of understanding health. The authors investigate cultural and historical factors influencing the idea of health and methods of health improvement, including traditional medicine, cultural practices and beliefs. The article describes different approaches to understanding health, including Western medicine, traditional Chinese medicine, Ayurveda, and other traditions, and examines factors influencing acceptable health treatment and care practices in different cultures. The findings may help health professionals better understand the multicultural nature of understanding health and develop more effective strategies for treating and preventing disease.
本文从理解健康的角度分析了世界各民族的观点和传统。作者调查了影响健康观念和改善健康方法的文化和历史因素,包括传统医学、文化习俗和信仰。文章介绍了理解健康的不同方法,包括西医、传统中医、阿育吠陀和其他传统,并研究了影响不同文化中可接受的健康治疗和护理方法的因素。研究结果可帮助卫生专业人员更好地理解理解健康的多元文化性质,并制定更有效的治疗和预防疾病的策略。
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引用次数: 0
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Bioethics journal
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