Basic problems of medical ethics in Russia in a historical context.

The paper provides a short overview of key problems of medical ethics in the Russian and Soviet contexts--confidentiality, informed consent, human experimentation, abortion, euthanasia, organ and tissue transplantation, abuse of psychiatry. In Soviet ideology common interests were declared superior to private ones. Hence, medical confidentiality was viewed as a bourgeois survival. On the other hand, diagnosis was normally not disclosed to a patient in the case of an incurable disease (especially cancer). Due to the strong paternalistic traditions of Russian medicine the idea of informed consent is still disputed by many physicians. Abortions were first legalized in Soviet Russia in 1920. A brief history of this landmark event is provided. However, abortions were forbidden in 1936 and legalized again only in 1955. Active euthanasia was legalized in Soviet Russia in 1922 but for a short period. Federal law regulating human transplantation was adopted only in 1992 and based on the presumed consent model. Until then forensic autopsy and procurement of cadaver organs were viewed as equal procedures. In 1960s-1980s there was a practice of declaring political dissidents insane in their involuntary treatment.