Principles of Bioethics
The basic principles of bioethics are, first and foremost, respect for the autonomy of the individual (his or her right to self-determination) and the pursuit of patient welfare, based on fundamental democratic values, such as solidarity, complicity, compassion and the idea of communitarian interests (B. Jennings). Classical principles of bioethics include respect for patient autonomy, “non-maleficence”, charity (do good), justice (T. Beechamp, J. Childress); contractual basis, honesty, and the desire to avoid human death (R. Veach). The model of the doctor-patient relationship, based on these principles, is more adequate to the nature and level of bioethical problems that need to be solved. Therefore, according to the WHO recommendation, instead of the traditional paternalistic model, a new autonomous model of the doctor-patient relationship was developed and is being implemented.
(from Greek: forecasting)
This is originally - prediction of the course of the disease, based on its recognition, diagnosis; then in general any specific prediction, a judgment about the state of any phenomenon in the future (Forecast weather, the outcome of elections, etc.). In the modern sense - a scientifically validated judgment about the possible states of a phenomenon in the future and/or about alternative ways and timing of these states.
This is notion that includes knowledge of the latest achievements of medical science, knowledge of practical and social psychology, ability to think logically, presence of developed intuition and ability to analyze and synthesize the facts, possession of high technique of necessary actions execution, high moral qualities, such as humanism and fidelity to duty.
This is one of the components of doctor’s professionalism, which deals daily with specific and different in mental reactions of people, to each of which requires individual approach, taking into account their psychological features, socially and individually determined behavioral and ideological stereotypes, which requires from the doctor a deep understanding of practical and social psychology.
Resuscitation ethical problems
(from Latin reanimatio - revival)
A set of measures to revive a person in the state of clinical death. Resuscitation care measures are aimed at delaying the transition from life to death and as soon as possible to restore the vital functions of the organism. The main regulator for Resuscitation is the time factor - an interval of 5-6 minutes (sometimes less) - a quantitative measure of life remaining in the condition of clinical death. Ethical problems of Resuscitation:
- when dealing with the problem of keeping incurable patients alive - how ethical are the ideals of traditional medical ethics prescribing to fight for life “to the end” if the patient prefers “an easy death”;
- in transplantation - the opposition between the need to remove for transplantation a still “living” donor organ, for which the donor himself should already be irreversibly dead;
- when prolonging patients' life by means of the machine - which arguments will be ethically weighty when disabling the machine, i. e. What arguments will be ethically valid for disconnecting the machine, i. e., essentially “killing” the patient, etc.?
This is the necessity to make a decision and a specific responsible choice in extreme therapeutic situations. Medical risk can be
- operative - reflects incomplete knowledge of medicine or lack of experience of a doctor;
- ethical - reflects the sphere of interpersonal relations of a doctor with the patients, with their relatives, by self estimation of possibilities and abilities;
- calculated - in case when methods of diagnostic or treatment influence are carefully analyzed and a doctor chooses the method that involves less Medical risk and more efficient medical intervention. It is possible to reduce ethical Medical risk to the minimum if the patient is objectively informed about real and possible Medical risk for his life as a result of the intervention and maximal reduction of operative Medical risk The concept of Medical risk is close, but not identical with the concept “danger” that characterizes objective life situation by itself; Medical risk concept reflects the doctor’s subjective attitude towards the dangerous life situation.