Healing is an active merci and the foundation of solidarity. Discussion about the past and future of bioethics dedicated to the 75th anniversary of Pavel Dmitrievich Tishchenko

Abstract

Pavel Dmitrievich Tishchenko, one of the founders of Russian bioethics, turned 75 on January 10, 2022. Joining the numerous congratulations, journal Bioethics publishes the text of the discussion dedicated to this event. The discussion was initiated by the question of the history of Russian bioethics formation in the perspective of its simultaneous emergence in Moscow, Volgograd, St. Petersburg, Kazan. The participants exchanged opinions on the significance of I.T. Frolov's ideas for the formation of the Moscow School of Bioethics. The influence of the concept of "frontier" proposed by Tristram Engelhardt Jr. on the formation of distinctive features of Russian bioethics was revealed during the discussion. It is emphasized that at the early stages of its formation Russian bioethics was more concerned with the problems of clinical trials than with the moral dilemmas arising from medical practice. An important stage for self-understanding of bioethics was the events of the Afghan company, which exposed the imperfection of the healthcare system in the USSR. The discussion touches a critical examination of the traditional principles of bioethics. The conversation of the philosophical foundations of modern bioethics allowed to formulate two theoretical opinions. The firs assertion determines that philosophical theories delay with revolutionary changes in the field of medical and scientific practice. The second one determines the need for the formation of stable teacher-student relations sufficient for enculturation with the tradition of thinking. The participants noted the undoubted humanizing influence of these principles on clinical practice and scientific research. At the same time the risks associated with an attempt to transfer the principles that was established in the Western tradition into the practices of Russian medicine and science were identified. Speakers claimed the idea of harmonization the principles to the traditions of Russian philosophy and ethics. Thus, the medical art should be conceived as an active mercy, and many bioethical problems as social challenges that require solidarity. It was noted, that bioethics is transforming from type of value-based communication of specialists to a formalized procedure.