Bioethical Problems Research Articles

PERSONAL SELF-DEVELOPMENT IN THE CONTEXT OF GLOBAL EDUCATION: THE TRANSFORMATION OF VALUES AND IDENTITY

The article discusses the issues of pedagogical support for personal self-development and the problems of human self-development, acting as one of the leading trends in improving education and training in thecontext of globalization of the modern world and modern education. It considers the limitations and opportunities(pedagogical resources) of additional and global education in the field of personal self-development and theimplementation of pedagogical ideas of Russian and foreign scientists. Global education is a complex idea that helpsa person better understand the world. Thanks to global education, a person can comprehend the problems of relationsbetween peoples and other social groups, the problems of war and migration, the problems of corruption and socialjustice, the problems of poverty and homelessness, the bioethical and biotechnological problems of mankind, theproblems of ecology and culture, science and art, the problems of gender relations and generations, career and professional issues, science and education, other global aspects. He can comprehend them in the context of internationalrepresentations. In addition, he can touch the “timeless” Vedic knowledge of his ancestors about the unity of theuniverse, its laws, etc. This can be done both through contact with the Vedic sources and texts proper, and in thecontext of understanding the ideas of modern cosmic scientists. Global (as Vedic) education is able to transform theway people understand themselves and the world, it helps them (trans) to shape themselves and the world in the mostharmonious, authentic and congruent way. This will naturally manifest itself in the transformation of values andidentities of pupils and students facilitate the proactive participation of people and their mutual learning andupbringing in the process of solving significant problems for their community and the context of the evolution ofhumankind, preventing and blocking involutionary processes.

Семиотический подход в биоэтике: от морального кодекса читателя к этике чистого листа

<p>Целью статьи является исследование возможностей использования эвристических ресурсов семиотики в современном биоэтическом дискурсе. Опираясь на идеи классиков семиотики Ч. С. Пирса, В. леди Уэлби, У. Эко автор обращает внимание на концепт знака как этически релевантного объекта. В процессе исследования демонстрируется необходимость поиска «семантических универсалий» (понятие У. Эко), которые должны были бы обеспечить универсальные соматические (телесные) права человека. По мнению автора, данные универсалии являются фундирующими для биоэтического дискурса и, в целом, являются необходимыми для перевода динамики науки «в интеллектуальное и моральное русло» (В. Уэлби).</p><p>На основе использования результатов исследований отечественных философов (Б. Г. Юдина, П. Д. Тищенко, И. В. Мелик-Гайказян и др.) артикулирован ряд проблем биоэтики, позволяющих оценить релевантность семантического подхода для формирования биоэтического знания. Показано, что языковые игры с именованием и манипулированием знаками, представляющие реализацию лингвистического модуса конструирования человека, зачастую направлены на осуществление тех или иных прагматических биомедицинских целей, которые соответствуют познавательным интенциям ученого, например, связанным с проведением успешного биомедицинского эксперимента. При переходе в рассуждениях о человеке от персонально ориентированного дискурса к дискурсам о «вещах», «артефактах», «объектах опыта» и т. д. дискурсивное пространство может использоваться как инструмент легитимации каких-либо действий по отношению к человеческому существу.</p><p>Сделан вывод о том, что среди существующих стратегий толкования человеческого существования (в контексте распространяющихся тенденций генетического и нейронаучного редукционизма) необходимо отстаивать нередукционистскую герменевтику человека и сопряженную с нею «этику чистого листа» (понятие О. В. Поповой).</p>

Bioethics in Physiotherapy and Nursing Schools’ Programs

Abstract The interest in ethical and bioethical topics in society is always present. However, the question arises as to how are ethical and bioethical problems of broad spectrum presented to the public, starting from issues related to health, medicine, technology, genetics, to issues about economy and politics. If ethical-bioethical issues will be addressed in different fields of social life without systematic methodological preparation, we could easily be trapped in ethics and bioethics speeches, which would be presented in a way that suits somebody at a certain point. When talking about educational institutions like College or Polytechnic with medical and health-related study programs, it would certainly be useful to make an analysis about the ethical-bioethical topics and subjects they are offering to students. Recently, there is a high interest of high school graduates in enrolling to professional study programs like Physiotherapy and Nursing. Bioethics is an obligatory subject within the framework of those study programs. However, lecturers of different profiles are chair professors of Bioethics at the aforementioned institutions, starting from physicians, through philosophers, theologians, sociologists, and lawyers. Of course, that is possible because a scientist can deal with various scientific challenges through his career, but it would certainly be important to at least equate syllabi, as well as plans and programs of Bioethics in Physiotherapy and Nursing study program. It is important to note that in Physiotherapy programs, besides subjects from the field of biomedicine, a significant part of the program is based on the science of movement and especially therapeutic exercises, which point out the need to include the field of kinesiology into the Bioethics plan and program.

Anatomical Education Using Marine Products for Elementary School Students

Anatomical education is very important in understanding the internal structure of the body and the mechanism of life, especially for the medical profession, including nursing. However, in Japan, students have a few opportunities of getting anatomical education using animals before they enter university. The different step-by-step anatomical curriculum needs to be created for elementary school, junior high school, high school, and university students. However, it is difficult to perform anatomical education widely, particularly with bioethics problems and students who often have an aversion to dissected animals. Therefore, it is considered very useful to introduce anatomical education using marine products, which are more familiar. In particular, fish have the same basic structure as vertebrates, so they are useful for understanding the bodies of vertebrate animals, including the human body. Also, the use of marine products other than fish can deepen students’ understanding of the structure of organisms of various systems. Therefore, in this study, we conducted anatomical lectures from functional morphology and ecological point of view, using marine products as teaching materials for elementary school children. To prevent students’ aversion, the marine products were wrapped, which also reduced the smell. Students actively learned the internal structure of fishes, cephalopods, and shellfish, without aversion. According to our questionnaire survey, most participants reported that their impression and comprehension of the course was excellent or good. The use of “seafood” as teaching material for young learners was found to be very useful for anatomical education.

Legal Issues of Creation and Use of Bioprinted Human Organs

Transplantation of human organs and (or) tissues is an effective means of saving lives and restoring health of citizens. The achievements of modern medical science contribute to a significant reduction in the potential adverse effects of such operations, which largely determines their prevalence and effectiveness. At the same time, the availability of such high-tech medical care raises certain concerns due to the insufficiency of human organs and (or) tissues suitable for transplantation. In this regard, the most promising is the introduction of modern additive technologies (3D bioprinting) into medical practice. However, the rapid development of new medical methods determines the need to address the most complex bioethical and legal problems associated with the need to ensure respect for human dignity and prevent violations of the integrity of the individual. As a result, the legal principles of creation and use of bioprinted human organs in this paper are the following: the principle of inadmissibility of obtaining donor cell material to create a bioprinted human organ in the absence of explicit and specific consent, the principle of permissible use of the resulting cell material. The principles of exclusivity and noncommercialization of the human body should retain limited effect: the first principle — in terms of allowing the production of cellular material to create a bioprinted human organ to be transplanted, only for the treatment of the recipient, and the second — in terms of determining the legal regime of cellular material and bioprinted human organs. The paper emphasizes the importance of extending the principle of priority of human interests over the interests of society and science to the analyzed sphere. In turn, models of legal regulation of social relations arising from the removal and transplantation of human organs and tissues, on the one hand, and about the creation and use of bioprinted human organs, on the other hand, should be based on the principles of unity and differentiation.

Gene Therapy Legal Framework: In Search of Balance of Interests

The paper deals with the problem of finding a balance of interests in the light of the use of gene therapy. The rapid development of new medical technologies determines the need to solve bioethical problems related to ensuring respect for human dignity. Gene therapy refers to specialized, including high-tech, medical care and is a set of genetic engineering (biotechnological) and medical methods aimed at making changes in the genetic apparatus of human somatic cells for the treatment of diseases. At the same time, the main directions of modern gene therapy can be attributed not only to untraceable genome modifications, namely genome editing in situ (in vivo) and genome editing of somatic cells in vitro with subsequent transplantation, but also inherited genome modifications, i.e. editing of the embryo genome.Editing of the embryo genome gives rise to a serious discussion, due to the legislative ban on interference in the human embryonic line. Despite this ban, the use of CRISPR/Cas9 has contributed to the creation of the world’s first people with artificially altered genes, resulting in the scientific community called for a moratorium on the editing of the human genome in clinical practice. The current situation is due to the need to find a fair balance of private and public interests in the field of gene therapy. According to the author, in the context of the embryo genome editing public interest is manifested in the development of scientific research. This allows the state not only to create the conditions for ensuring the protection of the population health, improve the level of their life, but also to establish control over the person, to obtain certain advantages in international relations with other sovereign states. In view of this, ensuring a fair balance between private and public interests in the application of gene therapy should be based on the principle of priority protection of the rights and interests of the individual.

Evolution of perception of “living” in religious and philosophical discourse

Modern scientific discourse, basing on the postnonclassical scientific world picture and on the permanent-transitive fluctuations of the postmodern period, still includes such eternal questions as the problem of a man, human life and health, the fundamental factors of the world and human being in the world. Life is the only biologically possible way of human being in the world. Its value lies not only in the specificities of existing biological forms and various manifestations, which are nevertheless a unique phenomenon of being in their totality, but also in the possibility of self-reflection, conscious experience of the phenomenon itself and the ability to form symbolic pictures of the existential world on this basis. The purpose of the article is to examine the transformation of scientific discourse on the concept of “living” within the framework of the formation and development of religious and ethical studies. To achieve this purpose, the author analyzes the categorical framework of the concept of “living”. Analyzing classical philosophical and modern scientific approaches to the definition of the concept of “living”, the author distinguishes two main approaches to the definition of life: substrate and functional. In the article the main attention is focused on the analysis of religious and bioethical discourses in the study of “living”. Bioethical discourse proceeds from the need for identifying moral norms and imperatives that can answer the question of the limits of the existence of “living” and determine the moral possibilities of impact (expansion or narrowing) on these limits. One of the fundamental problems of bioethics is the problem of life as a value. In modern bioethical discourse there are two main points of view in this regard. The first may be named the ethics of the sacrality of life or life as the highest value (sanctity of life), the second – the ethics of the quality life (quality of life). The sacrality of life implies an attitude to the phenomenon of “living” as to the object of exceptional weight, of the most important value, and on this basis requires a reverent attitude to it. This approach has the most clear and full representation by modern religious discourse. The religious content of the bioethical discourse on “living” is manifested, firstly, in approval of the objective ontological status of the human personality by the Christian personalism; secondly, in the teachings of Christian theologians who claim the beauty and righteousness of life created by God, where nature and human are understood as something sacral, and therefore the actions against them are sinful and unacceptable; thirdly, the basis of human life is rooted in the spiritual world of human himself related to the divine transcendence. In is concluded that modern religious and ethical discourse forms a system of categories and concepts that describe applied ethical conceptual constructs in order to form a person’s moral attitude to all living. The proposed author’s approach allowed establishing the essence of modern bioethical discourse in the study of “living”.

Islam, ethics and bioethics

The article discusses the influence of Sharia, as mandatory rules of behavior of Muslims, on ethical and bioethical norms of life. Based on the sources of Islam, the Koran and the Sunnah, rather than their various interpretations, the article deals with a number of problems of medical bioethics. It is noted that, despite the influence of modern biomedical technologies on modern world cultures, their moral and ethical comprehension is the least in Islam. All of these issues are considered solely on the basis of the provisions of the Koran and the Sunnah. From the various ethical positions that contain the Qur'an and the Sunnah, it can be concluded that the physician, as a true Muslim, must demonstrate the qualities prescribed by Islam to the individual. It is shown that discussions in Islamic countries in a number of areas of modern bioethics do not conflict with the sources of Islam. It is concluded that in the Islamic world the norms of medical bioethics are determined by religious beliefs, which are the dominant of all social life.

INTERNATIONAL LEGAL STANDARDS FOR CONDUCTING BIOMEDICAL EXPERIMENTS ON ANIMALS: STATUS AND PROSPECTS OF DEVELOPMENT

The article highlights the basic principles of the use of animals in biomedical research raised the main problems of vivisection. It also suggests specific steps to enhance the humanization of this process. The conclusions are the following: it is very important to prevent cruelty to animals in the context of resolving bioethical and legal problems associated with the implementation of the principle of humanism and the protection of animal rights. Modern science and the practice of preclinical and clinical tests should be involved into serious challenge in order to improve and universalize the process of medical and biological research technology in vitro. The purpose of the article is to study the main international legal principles of using animals in biomedical experiments, as well as to determine the main problems on this issue and to outline the ways to resolve them. The research material is a modern international regulatory framework that establishes the basic principles for the animals treatment. The methods of information retrieval, analysis, systematization, and generalization were used in this article. As it is well-known, human treatment of people begins with a human attitude towards animals. Nowadays the international community has adopted enough legal acts regulating the proper behavior with animals, including those specially cultivated for such studies (laboratory) when conducting biomedical experiments. Recently, both, in the national legislation of European countries and international legislation, there have been trends in the protection of both the general rights of animals as well as intensification of their protection in the field of biomedical research. It is imperative, both at the international and national levels, to adopt programs for development and support of scientific study of the in vitro biosystems introduction into the practice of toxicological studies. At the national level, it is necessary to criminalize the violation of international standards for conducting biomedical research using animals, strengthen other types of responsibility, and create a special system of state bodies responsible for the policy of using animals for biomedical purposes and exercising control in this area. Both, international and national legislation should impose a direct ban on the use of in vivo technologies in case of the possibility of using in vitro technologies.

Bioethical problems of rendering medical aid to patients with dementia

Bioethical problems of rendering medical aid to patients with dementia

ЧИ МАЄ БУТИ ЕВТАНАЗІЯ РОЗВ’ЯЗАННЯМ ПРОБЛЕМИ "ГІДНОЇ"СМЕРТІ? (НА ПРИКЛАДІ СПРАВИ LAMBERT AND OTHERS V. FRANCE)

The legal and bioethical problem of legalizing involuntary passive euthanasia as a practice of ending a person’s life, which in particular is in a minimal conscious state and with disabilities, on the example of the case Lambert and Others v. France of the European Court of Human Rights, is explored in this article. Due to the differences between the national legislation of the states on the regulation of euthanasia and given the lack of the international consensus on this issue, as well as the unified position of the judges on the legality of its application in the context of protecting the right to life on the basis of Art. 2 and 3 of the Convention for the Protection of Human Rights and Fundamental Freedoms of 1950, the need to ensure adequate medical care and treatment guaranteed by the state in order to maintain/prolong a person’s life (first of all, artificial hydration and nutrition, mechanical ventilation, cardiopulmonary resuscitation, blood transfusions, dialysis, etc.), and subsequent rehabilitation, as well as palliative care as an alternative to euthanasia, is emphasized. Mandatory compliance with the principle of prohibition of discrimination against person based on health status is stressed. The consequences of using involuntary passive euthanasia, including the need to bring to legal liability, are analyzed.

Bioética e condição humana: contribuições para pensar o nascimento

Resumo A bioética recorre à filosofia ao examinar conceitos e valores, problemas e ferramentas metodológicas e ao tratar de problemas específicos da vida humana no mundo moderno. Contudo, tanto na bioética quanto na filosofia, a compreensão existencial do que significa nascer é poucas vezes articulada, enquanto a dimensão existencial da morte e do morrer tem recebido mais atenção. Neste artigo, propomos reconsiderar a condição humana como pano de fundo de uma ética para a vida em seus múltiplos extratos e modulações, e a partir da qual se pode elaborar perspectiva filosófica que pense o nascimento como horizonte mais amplo para tratar problemas bioéticos específicos. Destacamos, neste artigo, algumas contribuições de Hannah Arendt e María Zambrano, duas pensadoras que se ocuparam da condição humana, entre o nascimento e a morte.

Lessons of Reproductive Ethics for Principlism

This article brings together two debates in bioethics more substantively than has been the case until now. One is the methodological debate over "principlism," i.e., the theoretical framework for analyzing and solving (bio)ethical problems proposed by Beauchamp and Childress in Principles of Biomedical Ethics (PBE). The other is the normative debate about reproductive ethics, i.e., procreative rights and obligations in a time of pervasive opportunities for making detailed choices about the properties and capacities of future people. The obvious point of bringing the debates together is to show how they can illuminate each other in fruitful ways consistent with the method of reflective equilibrium endorsed in PBE. Furthermore, discussions of reproductive ethics is almost absent in PBE, making it an interesting "test case" on how principlist theory can have an impact on and be affected by confrontations with new practices and considerations in biomedicine. Reproductive ethics is especially interesting due to the so-called non-identity considerations, which pose a challenge to common morality views on harm to and respect for persons. My focus is mainly on some methodological points about the import of concrete normative discussions for formulating basic normative principles. However, I unfold a number of substantial points in order to demonstrate this. It is my impression that most writers on principlism underestimate the effect of engaging with concrete problems. Specifically, I conclude that reflecting on procreative obligations provides strong reasons for specifying the basic principles in ways that uncover new dimensions of them and not just new applications.
 Key words: principlism, reproductive ethics, non-identity problem, nonmaleficence, respect for persons

Revisiting Death: Implicit Bias and the Case of Jahi McMath.

For nearly five years, bioethicists and neurologists debated whether Jahi McMath, an African American teenager, was alive or dead. While Jahi's condition provides a compelling study for analyzing brain death, circumscribing her life status to a question of brain death fails to acknowledge and respond to a chronic, if uncomfortable, bioethics problem in American health care-namely, racial bias and unequal treatment, both real and perceived. Bioethicists should examine the underlying, arguably broader social implications of what Jahi's medical treatment and experience represented. On any given day, disparities in the quality of health care and health outcomes for people of color in comparison to whites are evidenced in American hospitals and clinics. These disparities are not entirely explained by differences in patient education, insurance status, employment, income, expressed preference for treatments, and severity of disease. Instead, research indicates that, even for African Americans able to gain access to health care services and navigate institutional nuances, disparities persist across a broad range of services, including diagnostic screening and general medical care, mental health diagnosis and treatment, pain management, HIV-related care, and treatments for cancer, heart disease, diabetes, and kidney disease.

Das provokative Essay: Justifizierung ethisch-moralischer Maßstäbe der Gesellschaft im bio- und medizinethischen Kontext? Zur Frage des normativen Einflusses juristischer Grundsatzurteile im Rahmen der ethischen Bewertung weitreichender medizin- und bioethischer Problemstellungen

Bio- and life sciences raise ethical-moral problems due to technological advances and far-reaching decisions at the beginning and the end of life. For example, ethical considerations are important not only with regard to pre-natal genetics, stem-cell research and gene therapy, but also in the fields of neonatology, when problems occur after birth, and when discussing medically assisted suicide at the end of life. Against the background of social developments, in particular in the context of postmodernism, and the high level of complexity of bioethical and medical ethical problems, it seems that social conventions and ethical-moral standards diffuses more and more. In consideration of observed eroding social and ethical agreements and only sporadic political debates, the thesis is discussed that finally in the question and decision of far-reaching medical and bioethical problems, some basic legal decisions often take a key role. Fundamental aspects of Niklas Luhmann’s Theory of Autopoietic Legal Systems, Philosophy of Law and Sociology of Law are involved in the discussion.

The "Use" of Sex Robots: A Bioethical Issue.

The manufacture of humanoid robots with embedded artificial intelligence and for sexual purposeshas generated some debates within bioethics, in which diverse competing views have been presented. Themes such as sexuality and its deviations, the objectification of women, the relational problems of contemporary life, loneliness, and even the reproductive future of the species constitute the arguments which have emerged in relation to this subject. Based on these themes, this article presents the current state of the use of female sex robots, the bioethical problems that arise, and how bioethics could serve as a medium for both thinking about and resolving some of these challenges.

Kościół katolicki wobec niepłodności

Teza. Kościół katolicki, jako instytucja żywo zaangażowana w dyskusje na tematy bioetyczne, włącza się w publiczny dyskurs dotyczący niepłodności i metod jej leczenia. Stanowisko Kościoła w tych kwestiach jest znacznie bliższe etyce chrześcijańskiej niż etyce naturalnej (tj. wiążącej się z biomedycyną).
 Omówione koncepcje. Kościół prezentuje swoje stanowisko wobec omawianej problematyki w oficjalnych dokumentach instytucji, np. w encyklikach, listach apostolskich, dokumentach Kongregacji Nauki Wiary czy Konferencji Episkopatu Polski. Odnaleźć je można również w dokumentach nieoficjalnych, jak chociażby kazaniach. Autorka przyjęła metodę omawiania nie tyle poszczególnych koncepcji, co ujęła temat problemowo, dzieląc strukturę wywodu na stanowisko Kościoła wobec metody zapłodnienia pozaustrojowego i wobec badań prenatalnych.
 Wyniki i wnioski. Podsumowując przedstawione stanowisko Kościoła katolickiego wobec problematyki in vitro i badań prenatalnych, należy skonstatować bardzo sceptyczne i krytyczne podejście do ww. kwestii. Dyskurs hierarchów Kościoła dąży do zachęcenia par niemogących posiadać potomstwa, do korzystania z innych metod radzenia sobie z niepłodnością, takich jak chociażby naprotechnologia czy adopcja dzieci. Kościół katolicki prezentuje podejście bardzo restrykcyjne i konserwatywne względem współczesnych problemów bioetycznych.
 Oryginalność/wartość poznawcza podejścia. Celem artykułu było usystematyzowanie oraz przybliżenie czytelnikowi argumentów Kościoła katolickiego w kwestii leczenia niepłodności metodą in vitro oraz badaniami prenatalnymi. Niezwykle szybki postęp technologiczny umożliwiający leczenie wielu chorób, w tym m.in. niepłodności wiąże się bowiem z etycznymi dylematami w związku z korzystaniem z procedury in vitro, zamrażania zarodków czy wykonywaniem badań prenatalnych oraz preimplantacyjnych. Artykuł ma za zadanie w syntetyczny sposób przedstawić stanowisko Kościoła katolickiego, który jest uczestnikiem publicznej debaty na tematy bioetyczne, sięgając bezpośrednio do oficjalnych dokumentów kościelnych.

Eutanasia y justicia distributiva sanitaria: aportes a la discusión moral sobre el derecho a la buena muerte

En este artículo se analizan algunos de los argumentos morales relacionados con la justa distribución de recursos sanitarios escasos que permiten discutir los problemas asociados a las demandas por la disponibilidad de la propia vida y al proyecto de ley que pretende despenalizar la eutanasia y el auxilio al suicidio en Chile.

Cryptococcus neoformans can form titan-like cells in vitro in response to multiple signals.

Cryptococcus neoformans is an encapsulated pathogenic yeast that can change the size of the cells during infection. In particular, this process can occur by enlarging the size of the capsule without modifying the size of the cell body, or by increasing the diameter of the cell body, which is normally accompanied by an increase of the capsule too. This last process leads to the formation of cells of an abnormal enlarged size denominated titan cells. Previous works characterized titan cell formation during pulmonary infection but research on this topic has been hampered due to the difficulty to obtain them in vitro. In this work, we describe in vitro conditions (low nutrient, serum supplemented medium at neutral pH) that promote the transition from regular to titan-like cells. Moreover, addition of azide and static incubation of the cultures in a CO2 enriched atmosphere favored cellular enlargement. This transition occurred at low cell densities, suggesting that the process was regulated by quorum sensing molecules and it was independent of the cryptococcal serotype/species. Transition to titan-like cell was impaired by pharmacological inhibition of PKC signaling pathway. Analysis of the gene expression profile during the transition to titan-like cells showed overexpression of enzymes involved in carbohydrate metabolism, as well as proteins from the coatomer complex, and related to iron metabolism. Indeed, we observed that iron limitation also induced the formation of titan cells. Our gene expression analysis also revealed other elements involved in titan cell formation, such as calnexin, whose absence resulted in appearance of abnormal large cells even in regular rich media. In summary, our work provides a new alternative method to investigate titan cell formation devoid the bioethical problems that involve animal experimentation.

DEONTOLOGY IN PREVENTIVE MEDICINE: SCIENTIFIC AND HISTORICAL BASES, CHALLENGES OF THE PRESENT AND SOLUTIONS

The article presents the peculiarities of medical deontology in preventive medicine. The differences between deontological problems in the activity of a Clinician and a Physician in the specialty of medical and preventive medicine are considered. The historical stages of the formation and development of ideas of deontology and medical ethics in Russia are shown. The comparative plan presents an analysis of the main legislative acts in the field of bioethics and deontology of medical and preventive medicine. The world community was noted to show a great interest in topical problems of bioethics: several World Congresses and European Conferences were held, in most countries of Europe and America national bioethics committees were established (in the USA and France they were organized under the Presidents of these States). The main goal of the doctor’s professional activity is to preserve human life, prevent diseases and restore health, as well as reduce suffering from incurable diseases. Much attention is paid to this problem in the Federal law of November 21, 2011. (N 323-FZ) about bases of the protection of the health of citizens in the Russian Federation “which is fundamental in the field of healthcare”. It establishes the obligation of medical and pharmaceutical workers to carry out their activities in accordance with the legislation of the Russian Federation, guided by the principles. The aim of this study was to develop and substantiate the main differences between deontological problems in the activities of clinicians and physicians in the specialty medical and preventive care in the historical aspect. An invaluable role in the development of the principles of deontology was played by outstanding doctors of the past: Hippocrates, Abu-l-Faraj, as well as Russian and Soviet scientists and doctors M.Ya. Mudrov, 8N.I. Pirogov, V.A. Manassein, V.I. Davydovsky, N.Kh. Petrov, B.V. Petrovsky. Separately, it is noted that the role of medicine can be radically changed, if not exclude the importance of the preventive direction, but, on the contrary, through it to strengthen the ideological and controlling.