Vol 16, No 1 (2023)

The current situation in higher medical education is characterized by a high degree of uncertainty. This is expressed in the trend of permanent revision of the educational load. So, in the late 90s, the subordination was abolished, most recently the higher medical school lost its internship, and now all the subjects studied are divided into core and non-core, and the latter are undergoing constant reductions in teaching hours. The humanities are especially affected, including the basis of the foundations of medical activity – bioethics. It seems that students are given professional knowledge, but they are not shown how to apply it, guided by the principles of humanism. In this regard, it is necessary to turn to the latest state documents that determine the direction of the moral training of young professionals and, above all, future doctors. Their analysis shows that the state is interested not only in training top-notch specialists, but in professionals morally oriented towards kindness, compassion and understanding.

Therapy of existential distress of incurable patients is no less important task of palliative medicine than, in fact, relief of physical pain. At the same time, the unreliability of the means used in this field, noted by experts, forces us to pay attention to their alternative in the form of psychedelics-entheogens, whose therapeutic potential, judging by the content of world mythology, was well known to our distant ancestors. The research of this storehouse of information about the historical experience of mankind could explain a lot about the "historical amnesia" of society in relation to these substances, and perhaps change something in the current campaign for the benefit of the dying.

Aim: to investigate the reason for the prohibition of the archaic practice of using entheogens and to find out the source of modern thanatophobia on the model of the first high civilization of Sumer and Akkad in human history.

Methods: Analysis of literary sources, the historical method, a systematic approach.

Results: The role of the use of entheogens in the therapy of thanatophobia is determined. The destructive influence on the production sphere of the archaic tradition of free access to these substances within the cult, which threatened the very existence of civilization, is proved.

Conclusion: The proposed brief analysis of the well-known plot of Mesopotamian mythology "The Flight of Etana" allows us to see in it literary and artistic evidence of the effectiveness of the archaic tradition of using entheogens as a means of thanatophobia therapy. At the same time, the contradictory nature of the influence of this practice on the spiritual, psychological and socio-economic foundations of the Sumerian-Akkadian civilization is revealed, the reason for the objective-historical ban on the use of entheogens is explained, with an illustration of the existential consequences of this event for the population of the Mesopotamia.

The article tells instructive stories that might be useful for discussing the optimal moral choice for both future doctors and their patients. The author consider morality through a system of values that reminds that a part cannot be larger than the whole, respectively, a person as part of a social organism finds a harmonious existence with the whole through moral reflection, personally choosing between benefit and harm, between good and evil.

Background: 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.

Materials and methods: 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.

Results: 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.

Conclusion: 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.

N.N. Sedova's textbook "Philosophy of Medicine", intended for specialty students, as well as for graduate students of medical universities, students of DO, DPO and NMFO, is a relevant original and timely work on the analysis of medical activity from the point of view of the humanitarian context of modern scientific knowledge. Along with successes and achievements, today medical knowledge is unsystematized and fragmented, the main focus is not on the ways and methods of managing the internal reserves of a person, but on the creation of more and more new technological prospects and medicines. In medicine, there is no philosophical basis, the presence of which would be able to represent both the general direction of the development of medical theory and practice, and the interpretation of the innovations achieved, their conceptualization.