Sergeev V V, Shmelev I A
The Federal State Budget Educational Institution of Higher Education "The Samara State Medical University" of Minzdrav of Russia.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 Jan 15;31(1):88-92. doi: 10.32687/0869-866X-2023-31-1-88-92.
The article considers proposals developed according results of the study and targeted on improving social regulation of medical activities on basis of complex institutional approach. The complexity of approach lies in the fact that in regulation of public relations in health care opposition between norms of law and norms of morality is not allowed because in medicine they inter-condition and inter-complement each other. The institutional aspect of approach is reflected in tight interaction of moral and legal foundations, as well as in mechanisms of implementation of social standardization of specific sphere of medical activity. The formalized model of integrated institutional approach is presented. The importance of bioethics, in which principle of inter-complementarity of morality and law is realized to its maximum extent is emphasized. The significance of structural principles of bioethics that characterize totality of stable relationships of subjects of medical intervention is highlighted. The emphasis is made on interrelation between principles of bioethics and medical ethics, on norms of medical ethics, that largely determine content of professional duty of physician. The norms of medical ethics are grouped into three systems: "doctor-patient", "doctor-colleague" and "doctor-society" that are contained in international ethical documents and "The Code of Professional Ethics for Physicians" of the Russian Federation. The importance of internal and external mechanisms of implementation of complex social regulation of medical activity is marked.
本文探讨了根据研究结果制定的、旨在基于复杂制度方法改善医疗活动社会监管的建议。该方法的复杂性在于,在医疗保健领域的公共关系监管中,法律规范与道德规范之间不存在对立,因为在医学中它们相互制约且相互补充。该方法的制度层面体现在道德与法律基础的紧密互动中,以及医疗活动特定领域社会标准化的实施机制中。文中给出了综合制度方法的形式化模型。强调了生物伦理学的重要性,在生物伦理学中,道德与法律的相互补充原则得到了最大程度的体现。突出了生物伦理学结构原则的重要性,这些原则表征了医疗干预主体稳定关系的总体情况。重点阐述了生物伦理学原则与医学伦理学之间的相互关系,以及医学伦理学规范,这些规范在很大程度上决定了医生职业责任的内容。医学伦理学规范分为三个体系:“医患”“医际”和“医社”,它们包含在国际伦理文件以及俄罗斯联邦的《医师职业道德法典》中。文中指出了医疗活动复杂社会监管实施的内部和外部机制的重要性。