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Medical ethics in relationship with moribund patient

https://doi.org/10.20340/vmi-rvz.2021.5.EDT.1

Abstract

The continuous changes in the basic values of modern society are based on transformations in the field of intellectual communication, an avalanche-like increase in the volume of new knowledge, the emergence of new medical technology, and a sharp increase in attention to human rights. These processes exacerbate deontological problems, which are most difficult to manifest when a doctor comes into contact with a dying patient. Purpose of the study. To improve the quality of medical care for a patient in a terminal state. Research results. For most people, death is associated with severe physical and spiritual suffering. The doctor can alleviate this suffering only with a deep understanding of the phenomenon of death, both from scientific and religious positions. The article analyzes the philosophical foundations of medical ethics, knowledge of which is necessary for a doctor when communicating with a dying patient. The modern understanding of death as a natural event necessary to support the development of living nature is given. It is shown that our society has not yet developed the principles of the culture of death. In connection with the development of modern medical technologies, it became necessary to search for new criteria for death. The modern legal and moral interpretation of the human right to death with dignity is considered. The difficulty of communicating information about a fatal diagnosis to a patient is noted: when a bitter truth is possible, and when a “holy” lie is needed. The proposition is put forward that the complexity and contradictory nature of the problem of euthanasia is solved by providing the terminal patient with high-quality palliative care. Conclusion. Despite all the wonderful judgments about the necessity and importance of death in the development of mankind, the tragedy of personal death cannot be removed even by the most optimistic philosophy. However, a doctor, armed with modern knowledge, possessing modern deontological methods, endowed with high moral qualities, can significantly reduce the level of feeling of this tragedy. Death is an important stage in a person's life, the confidence of all living people that their terminal period will be provided with proper care and attention, will greatly improve the quality and the entire period of a person's life.

About the Authors

V. N. Shabalin
Medical University "Reaviz"; Scientific Research Institute of General Pathology and Pathophysiology
Russian Federation

Samara, Moscow 



S. N. Shatokhina
Scientific Research Institute of General Pathology and Pathophysiology; Moscow Regional Research Institute (MONIKI)

Moscow 



References

1. Gurevich P.S. Chelovek: Mysliteli proshlogo i nastoyashchego o ego zhizni, smerti i bessmertii. Moscow: Politizdat, 1991. 463 s. (In Russ).

2. Tishchenko P.D. Na granyakh zhizni i smerti: filosofskie issledovaniya osnovaniy bioetiki. St. Petersburg: Mir, 2011. 328 s. (In Russ).

3. Lissabonskaya deklaratsiya o pravakh patsienta (Prinyata 34-y Vsemirnoy Meditsinskoy Assambleey. Lissabon, Portugaliya, sentyabr'–oktyabr' 1981 goda. https://e-stomatology.ru/star/info/2010/lissabon_declaration.htm

4. Gnezdilov A. V. Psikhologiya i psikhoterapiya poter'. Posobie po palliativ¬noy meditsine dlya vrachey, psikhologov i vsekh interesuyushchikhsya problemoy. St. Petersburg: Rech, 2002. 162 s. (In Russ).

5. Zabolotnaya S.G. Tsennostnoe samoopredelenie budushchego vracha v meditsinskoy professii. Sovremennye problemy nauki i obrazovaniya: elektronnyy zhurnal. 2016;4. URL: https://www.scicnce- cducation.ru/ru/article/view?id=24971 (In Russ).

6. Veresaev V.V. O roli nravstvennogo sostoyaniya lichnosti vracha. Sovremennye issledovaniya sotsial'nykh problem. 2017;8(7). http://ej.soc-journal.ru (In Russ).

7. Pronitsina O.S. Analiz opyta eticheskikh i deontologicheskikh problem vrachey pri informirovanii bol'nogo o smertel'nom zabolevanii v otechestvennoy i zarubezhnoy praktike. Tverskoy meditsinskiy zhurnal. 2018;4:5- 10. (In Russ).

8. Federal'nyy zakon ot 21.11.2011 N 323- FZ (red. ot 03.07.2016) "Ob osnovakh okhrany zdorov'ya grazhdan v Rossiyskoy Federatsii" (s izm. i dop., vstup. v silu s 01.01.2017) https://www.medcentr-tula.ru

9. Vasserman L.I., Iovlev B.V., Karpova E.B., Vuk A.Ya. Psikhologicheskaya diagnostika otnosheniya k bolezni. Posobie dlya vrachey. St. Petersburg, 2005. 30 s. (In Russ).

10. Siluyanova I.V. Bioetika v Rossii: tsennosti i zakony. Moscow: RNIMU im. N.I. Pirogova, 2014. 192 s. (In Russ).

11. Letov O.V. Bioetika i sovremennaya meditsina. Moscow, 2009. 226 s. (In Russ).

12. Baskakov V.Yu. Tanatoterapiya. Teoreticheskie osnovy i prakticheskoe primenenie. Moscow, 2007. 184 s. (In Russ).

13. Bakanova A.A. Tanatopsikhologiya: sovremennoe sostoyanie i osnovnye napravleniya issledovaniy v Rossii. Meditsinskaya psikhologiya v Rossii: elektron. nauch. zhurn. 2014;6(29). URL: http://mprj.ru (In Russ).

14. Mechnikov I.I. Etyud o estestvennoy smerti. Moscow, 1917. S. 92-130. URI:http://dspace.univer.kharkov.ua/handle/123456789/4558. (In Russ).

15. Instruktsiya po opredeleniyu kriteriev i poryadka opredeleniya momenta smerti cheloveka, prekrashcheniya reanimatsionnykh meropriyatiy (utv. prikazom Minzdrava RF ot 4 marta 2003 g. N 73) https://base.garant.ru/4179063/53f89421bbdaf741eb2d1ecc4ddb4c33 (In Russ).

16. Deklaratsiya 1987g. Vsemirnoy meditsinskoy assotsiatsii i problema evtanazii. https://vuzlit.ru/1447998/deklaratsiya_1987g/ (In Russ).

17. Evtanaziya: istoricheskiy i teoreticheskiy aspekty problem. https://revolution.allbest.ru/medicine/00556392_1.html/ (In Russ).


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For citations:


Shabalin V.N., Shatokhina S.N. Medical ethics in relationship with moribund patient. Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH). 2021;11(5):5-13. (In Russ.) https://doi.org/10.20340/vmi-rvz.2021.5.EDT.1

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