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1 | The article reviews the results of research. It is exposed that shift of interest to narrative in bioethics and creation of narrative ethics are natural consequences of realizing the necessity of “turning” to a patient, necessity of protection of his individuality. The role and objects of narrative in medical practice are defined and it is exposed that one of physician’s criterion of professionalism is taking into account patient’s narrative. Keywords: narrative medicine, narrative ethics, individuality, physician-patient relationship, narrative competence | 990 | ||||
2 | The article reveals characteristics of modern scientific development and necessity of taking into consideration an ethical component of science related to it. According to it author specifies the role of religious reasoning in bioethical area, in particular, position of Russian Orthodox Church in regard of scientific research conducted at biomedicine. Keywords: bioethics, science and morals, religion | 1019 | ||||
3 | During the last decades relationships between a doctor and a patient changed considerably due to a number of reasons including technicalization of medicine. In the article philosophical and methodological aspects of those changes are examined. Critical analysis of autonomy concepts implemented in modern medical practice is given and in the ways of its management. The problem of setting patient’s autonomy borders is raised. The paper presents some results of the project RFBR № 10-06-00313 “Attractive Management: Methodological Principles of Managing Complex Systems’ Dynamics” and grounded in the draft statement of the problem RFH № 12-03-00198 “Bioethics as a form of Self-consciousness of Modern Culture”. Keywords: bioethics, patient autonomy, technical model, information model, paternalism | 976 | ||||
4 | In the article the results of sociological research conducted by the authors are discussed and theoretical summarizing of the research results acquired with the support of RFH (project No. 12-03-00198 “Bioethics as a Form of Self-consciousness of Modern Culture”) based on the use of semiotic diagnostics methodological procedure developed by I.V.Melik-Gaykazyan. The dynamics of value and outlook of medical students observed and its cultural determination are explored. The given research was conducted as a part of solving one of the project’s tasks: definition of bioethics symbolization’s direction in philosophic-anthropologic dimensions of modern culture. Keywords: bioethics, sociology, information-synergetic approach, medical education, semiotic diagnostics, models of healing | 1005 | ||||
5 | In the article results of research of different kinds of patient's autonomy in regard of definite cultures are reflected. Research have been conducted under support of RFH (project № 12-03-00198 “Bioethics as a Phenomenon of Selfconsciousness of Modern Culture”). Keywords: bioethics, autonomy of the patient, Confucian ethics, paternalism | 955 | ||||
6 | In the article specifics of medical knowledge are clarified and logical-methodological foundations of individuality problematics in bioethics are proved. The article represents the results of conducting RFH project № 15–03–00598 and RFBR project № 14–06–00440. In the article the problem of logic-methodological foundations of bioethics definition is posed. To solve it the author clarifies specifics of medicinal knowledge. First of all, medicine can be treated both as an art and as a science. The second, medicine has some specific features as any other science. Historian of culture Carlo Ginzburg ranks medicine among the so called “clue” disciplines. Such disciplines address individual cases that may be reconstructured via traces and symptoms only. Thus allows to fulfill integral attitude to patient but do not add to medicine scientific character. The situation changes while bioethical model is strengthening in Western medicine deepening the gap between exclusively individual experience of disease and impersonal-anonymous medical theory. Specifics of medicinal knowledge are based on David Greaves conception. At first, medicinal knowledge contains considerable part of uncertainty elements (diagnostic hypothesis and prognosis are of plausible nature), secondly, medicinal knowledge does not belong to closed restricted circle of professionals, finally, that knowledge is a combination of technological (or objective) and humanitarian (or subjective) components. It is bioethics that pose a problem of dualistic interpretation of “all-purpose” and “existential” medicinal knowledge today as well as issue the challenge to overcome a gap between “two cultures” (medicine as an art and medicine as a science). That will allow to “turn” medicine to a patient as a personality and individuality. It is mentioned that conception of “medicinal cosmology” (D. Greaves) allows to include morality and cultural questions in medicinal area together with technological which make possible to increase taking individual into consideration in modern medicinal theory and practice. In conclusion author summarizes epistemological features of medicine caused by gap between “two cultures” in medicine and dual nature of medicinal knowledge (as nomothetic and ideographic science) and actualizes patients' individuality (in its different manifestations) in bioethics. Keywords: bioethics, clue paradigm, biomedicine, medical cosmology, individuality | 733 |