Bioethics journalBioethics journal2070-15862782-6589Volgograd State Medical University46281010.19163/2070-1586-2023-16-1-39-43Review ArticleRehabilitation of сombatants: еhical and мedical аpproachesVorobievAlexander A.<p>Doctor of Medical Sciences, Professor, Head of the Department of Operative Surgery and Topographic Anatomy, Deputy Director for Research of the Federal Center for Support of the Development and Production of Exoprostheses of the Volgograd State Medical University, Head of the Laboratory of Innovative Methods of Rehabilitation and Habilitation of the Volgograd Medical Research Center</p>cos@volgmed.ruhttps://orcid.org/0000-0001-8378-0505DonikaAlena D.<p>Doctor of Science (Sociology), Professor, Senior Researcher of Ethical, judicial and sociological expertise in medicine Department of the Volgograd Medical Research Center, Head of the Department of Philosophy, Bioethics and Law with the Course of Sociology of Medicine at the Institute of Public Health of the Volgograd State Medical University</p>addonika@yandex.ruhttps://orcid.org/0000-0002-8203-6634GorelikIlya M.<p>Specialist of the Federal Center for Support of the Development and Production of Exoprostheses of the Volgograd State Medical University, Junior Researcher of the Laboratory of Innovative Methods of Rehabilitation and Habilitation of the Volgograd Medical Research Center</p>gorelik1969@gmail.comAndryushchenkoFedor A.<p>Candidate of Medical Sciences, Senior Researcher, Laboratory of Innovative Methods of Rehabilitation and Habilitation of the Volgograd Medical Research Center</p>andrewshenko@mail.ruVolgograd State Medical UniversityVolgograd Medical Research CenterFederal Center for Support of the Development and Production of Exoprostheses2905202316139432905202329052023Copyright © 2023, Vorobiev A.A., Donika A.D., Gorelik I.M., Andryushchenko F.A.2023<p><strong><em>Background</em>:</strong> The need for early and effective medical rehabilitation of combatants is determined by a number of social, ethical and demographic factors. The ethical context of the rehabilitation of combatants is associated with the mental reflection of participants in local wars, considered on the model of the Afghan and Chechen wars. At the same time, the researchers note that the phenomenon is most fully represented in American and European literature on the example of Vietnam War veterans, known in publications as "trauma and memory studies" and requires the development of similar research practices in domestic science. The purpose of the work is to show the possibilities of medical rehabilitation of NWO combatants using exoprostheses in the context of the ethics of care.</p>
<p><strong><em>Materials and methods</em></strong><strong>:</strong> To demonstrate the medical and social prospects for the rehabilitation of pathology and injuries of the upper limbs, a review of domestic and foreign sources of open databases was carried out. The calculation of the needs for orthotics of the upper limbs was carried out on the model of Tatarstan and the Volgograd region. The research materials of the Federal Center for Support of the Development and Production of Exoprostheses of the Federal State Budgetary Educational Institution of Higher Education VolgGMU of the Ministry of Health of Russia were used in the work.</p>
<p><strong><em>Results:</em></strong> Specialists of the Center for Exoprosthetics of the Volg State Medical University developed a passive exoskeleton of the upper limb "EKZAR-34" for habilitation and rehabilitation of patients with symptoms of upper flaccid paresis. The advantages of the development are complemented by affordability, technical feasibility and wide application possibilities. Currently, on the basis of the Center for Exoprostheses of the VolgGMU, participants in combat operations and non-combatants of the Northern Military District are undergoing rehabilitation using the EXAR-34. The need for orthotics, calculated on the model of Tatarstan and the Volgograd region, demonstrates the continuity of rehabilitation of wartime and peacetime, as a general trend in personalized medicine aimed at the needs of a particular patient.</p>
<p><strong><em>Conclusion:</em></strong> Attention to the problem of rehabilitation should be permanent, reflecting the position of society towards vulnerable groups, based on the ethics of respect and care.</p>rehabilitationcombatantsexoprosthesisethics of careреабилитациякомбатантыэкзопротезэтика заботы[Karayani A.G. Psychological rehabilitation of combatants. Monograph. 2003. 82 (in Rus.).][Burlak A.M., Yudin V.E., Lyamin M.V., Dybov M.D. Philosophical aspects of adaptation of those rehabilitated in the process of medical and psychological rehabilitation. Filosofiya i obshchestvo = Philosophy and society. 2004;1:138–154. (in Rus.).][Nikolai F., Kobylin I. American trauma studies and the limits of their transitivity in Russia Kitchen conversations with veterans of local conflicts. LOGOS. 2017;27(5):115–136. (in Rus.).][Burlak A.M. Features of the psychological status of the wounded with dorsopathies with combat trauma of the upper limbs. Vestnik vosstanovitel'noi meditsiny = Bulletin of Rehabilitation Medicine. 2012;1:7–11. (in Rus.).][Burlak A.M., Belyakin S.A. Organizational and methodological approaches to the medical rehabilitation of the wounded with the consequences of a combat injury of the upper limbs in a rehabilitation center. Voenno-meditsinskii zhurnal = Military Medical Journal. 2012;8:48–53. (in Rus.).][Starostin O. A., Solovyov A. G., Barachevsky Yu. E. Correction of disorders of psychophysiological functions in specialists of "dangerous" professions by the combined use of physical factors. Ekologiya cheloveka = Human Ecology. 2012;5:36–40. (in Rus.).][Vorobyov A.A., Petrukhin A.V., Zasypkina O.A. Exoskeleton as a new tool in the habilitation and rehabilitation of the disabled (review). Sovremennye tekhnologii v meditsine = Modern technologies in medicine. 2015;7(2):185–197. (in Rus.).]