Vol 9, No 2 (2016)

This article makes explicit the discrepancy between the original term "human enhancement” and its Russian translation. "Enhancement” is interpreted as improvement and not perfection. At the same time, the operational content of the term "perfection " makes it possible to overcome the numerous ethical issues of the use of “human enhancement" technologies highlighted in the scientific literature. Apparent relativism of the term "improvement" hinders the generation of quantitative and qualitative evidence of perfection. "Human enhancement" technologies regarded as human perfection technologies result _ from the evolution of all the previous and current anthropic technologies, but there is an extent to which they can be applied after which a person can acquire a new quality. The moral status of the "Homo Perfectos" is very important for bioethics. Obviously, having more features of a technogenic species than those of a biospecies, it will create and share a new system of moral values, in which the technical "life support system" would represent the major value, and the preservation of natural features will be of applied value. This can be interpreted as the improvement from the viewpoint of Homo Perfectus, and as degradation from the standpoint of modern bioethics. The alternative may be seen as bioimprovement, i.e. the implementation of the natural program of self-development of the living. But mankind does not yet have sufficient knowledge, while commercial interests demand accelerated advancement of technology, rather than fundamental science.

В статье анализируется связь трех принципов: морального принципа благодеяния(Beneficence), юридической нормы приоритета человека над интересами общества и науки, принципом Гиппократа о приоритете пациента во взаимоотношениях врач/пациент. Автор выявляет единство мировоззренческих оснований этих принципов на примере подвига доктора Е. С. Боткина, канонизированного РПЦ в 2016 году.

In the second half of the twentieth century many anthropologists shared a view that biological evolution of a modern human had completed, since biology adaptogenesis had been replaced with social adaptogenesis. The up-to-date data, obtained in genetics and a number of other specilaities, require such views should be revised and updated. From the evolutionary standpoint, some human behavior strategies, which originally used to be adaptive and contributed to human survival in the conditions of contemporary global civilization, are getting less adaptive or maladaptive. To successfully address the problems facing mankind it is necessary to consider them from the standpoint of bioethics.

The article discussed the problem of establishing a partnership between the physician and the patient with a chronic disease as an optimal model of their interaction. The urgency of the problem stems from the need to improve the quality of care, particularly for patients with a chronic pathology, making up the majority of the patient groups. The article drew upon the author's medical and sociological research of interaction between professional physicians and patients with bronchial asthma. The selection of the nosology group was due to the chronic course of the disease, as well as significant stratification of the patients’ sampling which made it possible to use a multifactor approach to its assessment (age, sex, social status, etc.). As a tool for establishing a partnership between doctors and patients with asthma we planned to use the basic principles of bioethics set forth in the Universal Declaration on Bioethics and Human Rights (UNESCO. 2005). The article showed the features of the physician-patient interaction taking into account their age, cultural values, religious affiliation. The author showed the role of ethics committees for the prevention and resolution of conflicts between doctors and patients with a chronic pathology beyond the scope of the legal field.

The article reviews ethical behavior of retired athletes in post-sports life. We analyzed the predictors of social maladjustment in elite athletes in post-sports period and identified ethical aspects of their negative behaviour. We studied the likelihood of unethical behavior which include irresponsibility, ignoring and breaking social norms, rules and responsibilities, having difficulty maintaining stable relationships, aggression and violent behavior, lacking any true sense of guilt, inability to learn lessons through failure, and a tendency to blame others or to offer plausible rationalizations for the behavior bringing them into conflict with society. We conclude that a post-sports adjustment program must consider the ethical issues of a new daily routine for retired athletes.

In many cases, people do not disclose their HIV-positive status because of fear of being rejected by society. This can have both positive and negative effects. Between 2012-2014 we performed an anonymous survey of 187 HIV-positive patients and individual interviews of 52 HIV-positive patients in the Volgograd regional center for prevention and treatment of AIDS and infectious diseases and the Volgograd regional clinical hospital for infectious diseases №1 to evaluate and describe the influence of disclosing HIV-positive status on the doctor-patient relationship and interactions of patients and their families. We analyzed the frequencies of responses to the questions posed in the questionnaire (expressed as a percentage) and for interview questions to conclude that the doctor-patient relationship and interactions of patients and their families correlate with decision-making about disclosure of HIV-positive status. Disclosure of HIV infection to the family members was associated with high levels of interaction; however, disclosure of HIV infection to health professionals was associated with low levels of interaction (unfriendly attitudes, lack of confidentiality). The article describes the motives which guide decision-making about disclosure of HIV-positive status in HIV-positive patients.

The number of clinical psychologists working in medical settings in Russia is very small although most medical settings must have at least one psychologist on staff. This situation needs to be changed because a clinical psychologist is trained not only to provide psychological support for patients during the treatment process, but also to help create a favorable psychological environment in the medical setting. To seek out the opinions of patients and the experts about the practice of clinical psychology in Russia, a focus group was organized and held by the Volgograd Medical Research Centre. All experts showed positive attitudes towards: a) employing clinical psychologists by medical settings, b) getting patients to adhere to their treatments and ensuring a trusting relationship between doctor and patient, c) improving the efficiency of the medical staff through promoting positive medical practice environment by clinical psychologists.