What is medical medical ethics?
Skilful doctors were always appreciated worth its weight in gold. At Homer in “Illiada“ we read: “There is many people one Aesculapian skillful. It will cut out both an arrow and a wound will powder with medicine...“
Respectively, to inept unsuccessful doctors were threatened by all troubles. B.C. under laws of Hammurapi the doctor who as a result of a surgery caused death to the free person was punished for one thousand years by cutting off of fingers; and if he was guilty of death of the slave, then was obliged to give the slave for the slave.
In sovetsko - Stalin time customs became even more rigid. It is possible to remember the consequences which came for doctor Kazakov who did not succeed in treatment of Kuibyshev, or destiny of doctor Levin, the personal doctor of the chairman of OGPU Menzhinsky. After death of the high-ranking patients both physicians were executed in 1938; naturally, for “wrecking“. One of resolutions of the Politburo of the Central Committee and was called “About wrecking in medical business“. But it was already later, at the beginning of 50 - x. Then there was “a business of doctors“ - these murderers in white dressing gowns which rascally destroyed eminent Soviet persons and military leaders in the most devil way: by the wrong treatment. Fortunately, the academician V. N. Vinogradov and his colleagues were not managed to be killed, companion Stalin died.
It is necessary to recognize, as doctors not always were warm and fuzzy. In the report of the Extraordinary commission for Auschwitz which was submitted to the International military court in Nuremberg it appears: “In camp special hospitals, surgical blocks, histologic laboratory and other institutions were created... The German professors and doctors conducted in them mass experiments on sterilization of women, castrations of men, experiments on children, arranged artificial general infection of people with cancer, typhus, malaria and watched results“.
Nuremberg military court which pronounced on August 20, 1947 a sentence to 23 nazi criminals who were accused of commission of inadmissible experiences in public formulated ten principles - conditions of carrying out medical experiment on the person. Later they received the name of the Nuremberg code.
The Nuremberg code became the base of medical medical ethics. Then there were Helsinki (1964), Tokyo (1975) and Venetian (1983) declarations adopted by World Health Organization. In them the question of carrying out medical researches and experiments is in detail settled.
The term “medical ethics“ (science about due) was entered by Bentam in a century before last for designation of the theory of morality in general. The term “medical medical ethics“ appeared in Russian-language publications in the middle of 1940 - x years, and its introduction is attributed to the famous surgeon - the oncologist N. N. Petrov.
Now the medical medical ethics is a doctrine about duties and rules of conduct of health workers in relation to the patient. However the former sheaf “the doctor - the patient“ is inevitably replaced with new “the doctor - the medical equipment - the patient“. In fact, the medical medical ethics is the modern embodiment of the known principle of Hippocrates of “primum non nocere“ . At the same time new methods of treatment have to be that that the risk of possible harm is no more, than risk from treatment in the standard way. At the same time the principle of “primum non nocere“ cannot have an absolute priority, it is always necessary to consider a ratio “risk - advantage“ for the specific patient.
With medical medical ethics it is closely connected by of a yatrogeniye when the disease state of the patient is caused by the wrong actions of medical personnel. Carelessly thrown remark of the doctor easily will lead to the fact that the hypochondriac patient will find at himself symptoms of the most different diseases. Then it will be very difficult to dissuade such person from his thought-up diseases. It is necessary to carry to yatrogenny diseases also AIDS if it resulted from transfusion of the infected blood, and also various internal injuries at band operations (for example, injury of a spleen at a stomach resection).
Happens and so that complaints of patients remain out of sight of the attending physician. Often presence of the doctor at office of a hospital acts on patients soothingly, and complaints and deterioration in a state arise when there is no doctor in office, that is in the second half of day and in the evening. This private question also lies in the sphere of medical ethics.
One of the most complex problems in medical medical ethics - relationship of the doctor with relatives. If treatment goes successfully, then full frankness will be reasonable option of behavior of the doctor. However it is hardly worth telling the husband that operation for extra-uterine pregnancy of his wife is performed, and the patient in couple of days will be as a cucumber. Especially if the husband the last half a year was in business trip.
In the presence serious complications during an illness correct conversation with the immediate family of the patient is necessary; the medical secret does not extend to them, the doctor is obliged to tell them the true diagnosis.
It is obvious that the concept “medical medical ethics“ is multiple-valued. It and the relations with the patient providing obligatory feedback; it and contacts between the doctor and the patient`s family, his acquaintances and colleagues. For all that it is worth remembering that the doctor possesses the enormous power over the sick person who entrusted him the life. And this power predetermines responsibility of the doctor.