Vol 17, No 1 (2024)

The III All-Russian Congress of Young Scientists was held in Sirius in the autumn of 2023. The program of the Congress included the section «Scientific search and ethical and legal issues of research activities», which gathered a large number of participants. Interestingly, Vladimir Mikhailovich Filippov, Chairman of the Higher Attestation Commission of the Ministry of Education and Science of the Russian Federation, Academician of the Russian Academy of Sciences, Valery Nikolaevich Falkov, Minister of Science and Higher Education of the Russian Federation, Mikhail Albertovich Murashko, Minister of Health of the Russian Federation, Alexander Leonidovich Khokhdov, Academician of the Russian Academy of Sciences, Chairman of the Council on Ethics of Clinical Research of the Ministry of Health of the Russian Federation, took part in the work of the section. and others. It should be noted that academician A.L. Khokhlov in November 2023 He presented the position of the Russian scientific community on bioethics at the 42nd session of the UNESCO General Conference in Paris, thanks to which Russia resumed its membership in the Intergovernmental Committee on Bioethics of UNESCO. The moderator of the section was Maria Vladimirovna Vorontsova, a pediatric endocrinologist, Candidate of Medical Sciences, Deputy Dean of the Faculty of Fundamental Medicine of Moscow State University, member of the Academic Council of Moscow State University.

The moderator outlined the problem that the section was devoted to. It can be summarized as follows:

1. All scientific research is governed by law and morality. The law acts unambiguously, and the need for an ethical assessment is always presented, especially in the scientific field, which has not yet received legal support
2. An important issue, therefore, is the question of the ethical examination of scientific research. There are different types of research in modern biomedicine and, of course, modification of ethical examination procedures is necessary.

Here we will focus on the most important issues discussed at the section meeting.

Social medicine focuses on the social and economic aspects of health and related inequalities. It recognizes the importance of considering the sociobiological context of the patient when prescribing and providing health care.

In this understanding, a person in social medicine is considered as an individual who is in interaction with the environment, social living conditions, cultural factors, access to medical services, economic and political realities. It also includes understanding the patient's needs, expectations and preferences and how these may influence treatment decisions and subsequent recovery.This article discusses the topic of an individual and personalized approach in bioethics. The basic principles underlying an individual and personalized approach in bioethics include taking into account individual values and preferences of patients, ensuring their autonomy, attention to potential risks and affirming equity in access to personalized medicine. The authors identify the main principles and offer recommendations on the use of an individual and personalized approach in bioethics. An individual approach to planning and treatment includes taking into account the physiological, psychological, social and spiritual characteristics of the patient. It aims to create a treatment plan that, based on scientific evidence, best suits each patient's individual needs and goals. Ethical resolution of dilemmas and conflicts is an integral part of the individual approach. An open dialogue between the patient and members of the medical community, as well as adherence to the principles of justice, allows us to reach agreement and constructive solutions in difficult ethical situations.

Overall, an individualized and personalized approach to bioethics helps improve the quality of medical practice and meet the unique needs of each patient. It embraces and respects the identity and diversity of individual values and beliefs, helping to create a more equitable and humane health care system.

Background: The general trend towards the moralization of society, associated both with attempts to overcome the state of social and political crises, and determined by the general tendency to accept the Other, determines the need to address issues of moral improvement of moral agents. At first glance, biological improvement seems more reliable, because in the future it is more stable and predictable. In this regard, it seems extremely important to turn to the tradition of eugenic discussions.

Aim: To analyze approaches to improving a moral agent using biological methods in domestic and world science.

Materials and methods: To achieve the goal of the work, materials from the Galton School of Eugenics, policy articles of the Russian Eugenics Society by N.K. were analyzed. Koltsov and the modern discourse of liberal eugenics.

Results: On the one hand, the biological improvement of a moral agent seems to be more predictable (in the case of relevant research) and more sustainable. On the other hand, history shows us the risks of this approach. The failure of classical eugenics, which degenerated in Europe into Nazi practices, and political decisions close to them in the USA seems obvious. Modern «liberal eugenics», in attempts to solve these problems, runs into the risks of discrimination.

Conclusion: For more than a century, moral bioenhancement scholars have failed to offer specific criteria for a moral agent. Based on the analysis of eugenic discourse, the article raises ethical questions, the answers to which must be given to the scientific community before conducting practical experiments.

Background: The inclusion of neural networks in the work of healthcare institutions and medical education is an urgent problem in bioethics – a discipline that develops issues of personal choice between benefit and harm, between good and evil, between the volume and quality of information processing. The introduction of neural networks into the practice of healing is inevitable and is "the most commonly used analytical tool". The pros and cons of digitalization of medicine are described in detail in the literature, such as acquiring a digital assistant for diagnosis, determining optimal treatment plans and monitoring the health status of patients.

Aim: to consider the possibility of improving clinical thinking in partnership with neural networks using the example of analyzing clinical situations.

Materials and methods: An analytical review of the literature on the problem of integrating artificial intelligence into medical practice was carried out. The empirical base is represented by materials from qualitative sociological research (case study method).

Results: Based on the analysis of cases, it is shown that the guidelines for writing out recipes for correcting errors are spelled out abstractly (the neural network is irresponsible, human intelligence must exceed the intelligence of the machine) and concretely (the initial answer of the neural network to the question posed is superficial and requires clarification using questions unexpected for the neural network specific configuration of terms not recognized by artificial intelligence as keywords). The risks of introducing artificial intelligence into the work of medical institutions have been identified: on the one hand, with a high degree of compliance of doctors to the recommendations of neural networks, the doctor is responsible for their errors, and the patient suffers, on the other hand, with a high degree of compliance of AI to user requests, training neural networks in dialogues is dangerous multiplication of dubious recommendations from undifferentiated/incompetent users. The doctor’s competence in dialogues training the neural network is invisible, unverified, and essentially virtual.

Conclusion: Based on the conducted research, the possibility of improving neural networks through their adaptation to regional paradigms of healing, to value systems that are based on the archetypes of domestic healthcare is shown.

A modern university is a place where meanings are created. These meanings are transmitted primarily through the university's website, through social networks, where the university is represented. To put it in marketing terms, it is through digital resources that the university is looking for clients-students. And this is where educational, scientific, and commercial interests intersect, which makes it fundamentally important to universalize ethical requirements for all participants in this process. At the same time, digital transformation is becoming an objective necessity for the development of education and the formation of a client base for the future, as well as for maintaining contacts with students' parents and graduates. And it is those universities that get involved in this process faster and better that will benefit. The university's website is the main resource where its meanings are broadcast and moral stories are objectified. Aim: to clarify the concept of digitalization of medical education as an international phenomenon regulated by general ethical and social requirements. To date, there is no universally accepted definition of such a concept as digitalization of medical education, since this term is a rather complex multifaceted phenomenon.

We are considering medical education, the possibility of obtaining it using digital technologies, analyzing the volume of built-in digital education, its feasibility and relevance. The website is the main resource of the university in terms of marketing, information, education and regulatory regulation of the entire learning process. Special requirements are imposed on its form and content in the situation of teaching medical students in a foreign language environment.

Background: At all times, moral principles and ethical standards have been the main instrument for regulating both the behavior of an individual and social consciousness as a whole. However, in modern society, the spread of cruelty and crime is becoming the norm. In such a situation, the moral qualities of the doctor become important, who must make decisions in conditions bordering between life and death.

Aim: to study social assessments of open bioethical problems of modern transplantology by future specialists.

Materials and methods: The cities of Arkhangelsk and Cherepovets served as the basis for the study. The collection of material was carried out in February-March 2023. The sample is complete (n = 436). The main group consisted of students of the Northern State Medical University (Arkhangelsk) (n = 103). The comparison group consisted of: 1) students of Cherepovets State University (n = 211): humanitarian (n = 102), technical (n = 109) areas and 2) secondary vocational education (n = 122): medical (n = 86) and pedagogical (n = 36) college.

Results: Half (43.6 %) of students, regardless of the direction of preparation for organ transplantation, have a positive attitude, perceiving this technology as “a step forward in medicine” (59.6; 95 % CI 55.0–64.1). Every third (37.8 %) is neutral, believing that organ transplantation is permissible only as a last resort (26.8 %; 95 % CI 22.9–31.2). Only 3.7 % have a negative attitude, considering organ transplantation to be unnatural to human nature (1.8 %; 95 % CI), leading to human trafficking (3.2 %; 95 % CI 1.9–5.3). Students of a medical college (90,8 %) are ten times more likely than students of a pedagogical college (9.2 %) to evaluate transplantation more loyally. They are less likely to choose neutral (40.5 % vs. 59.5 %, respectively) and negative (40 % vs. 60 %, respectively) assessments. At the same time, medical college students are twice as likely (66.7 % versus 33.3 %, respectively) to have no opinion on this issue at all.

Conclusion: Possible factors in the formation of bioethical ideas are shown based on an analysis of the personal characteristics of future specialists: demographic, social, psychological, spiritual.

Background: The search for the meaning of war, the justification of violence, the acceptance of guilt and other moral problems worried Russian thinkers of the 19th century. Russian religious philosophy considers morally justified only war in defense of the highest spiritual shrines, which I.A. Ilyin, N.A. Berdyaev, L.P. Karsavin, A.A. Kersnovsky and others call the defense of the homeland, life and peace.

Aim: To assess research interest in the problems of ethics of war, ethics of military medicine, biomedical ethics in the intellectual field of open databases of scientific publications and offer a predictive plot of this scientific direction.

Materials and methods: A comparative analysis of open databases of scientific publications RSCI, NEB, CyberLeninka was carried out. The study of literature sources in the problem field under consideration made it possible to determine the directions of the research search using vectors – keywords "ethics", "war", "military medicine". Publications from the open CyberLeninka database were used and analyzed as a model scientific network database. Quantitative (number of publications) and qualitative (annotations) indicators were studied. To identify attitudes towards the ethical problems of war, a sociological survey of medical university students was conducted, N = 154, average age of respondents (19.2 ± 1.9) years. Standards of confidentiality and autonomy were respected for respondents.

Results: An analysis of the distribution of scientific publications by area of the international OECD classifier demonstrates the interest of researchers in the problem field of "Philosophy, ethics, religious studies" in 2020–2024. In all search options (using the keywords "War and Ethics", "War and Medicine", "Military Medicine") there are a larger number of publications in this area than in other social or sociological sciences. In the search query "war and ethics", there were 2 times more such publications than others. A pilot survey of future doctors confirms the interdisciplinary connection between the ethics of war and medicine.

Conclusion: The study demonstrates modern scientific interest in the ethics of war when studying problems related to war and military medicine. It would be of interest to conduct a more detailed study of the relationship between the ethics of war and medical ethics (bioethics) as an element of the ethical training of future doctors for professional activities in extreme conditions of peace and war.