Этическая экспертиза в медицине: от гуманизма к формализму

Abstract

Background: Everyone knows what ethical expertise is in medicine, but most often they understand it as an axiological component of clinical research, which is incorrect [1]. Firstly, the subject of expertise is not research, but testing. Secondly, not only clinical trials, but also the entire medical practice are subject to expert evaluation. Aim: Understanding of the described situation allows us to formulate topical questions about the further development of the insti-tute of ethical expertise and to propose for discussion options for this development in new medical and social conditions. Methods: Statistical analysis of the data of examinations conducted by ethical committees (councils, commissions) shows a ten-dency to limit the subject of examination, the lack of connection between different types of examinations. Results: Modern medicine requires new forms of control over ongoing research and testing in connection with new risks both in the individual human body and in the social organism as a whole. Ethical expertise responds to the challenges associated with these risks by specifying and multiplying its norms and rules, which leads to excessive formalization that does not correspond to the princi-ples of the axiology of scientific knowledge and practice in medicine. Conclusion: The transition from ethical to fully humanitarian expertise will reduce the level of formalization, which deprives the ethical approach of its essential intentions. The allocation of deontology as the basis of ethical assessments is illegitimate, axiological components are ignored. Humanitarian expertise makes it possible to restore the parity of norms and assessments as a criterion of ex-pertise in medicine