Outstanding Doctors Research Articles

СОГЛАСИЕ ПАЦИЕНТА В ЭТИКО-ПРАВОВОМ ДИСКУРСЕ НАЧАЛА XX ВЕКА В РОССИИ

Цель. Сквозь ретроспективную призму дискуссий, развернувшихся в начале XX столетия в среде врачей и правоведов относительно оценки врачебной деятельности, автор ставит целью проследить истоки формирования практики информированного согласия, выявить возможные причины актуальных для современной системы здравоохранения проблем правомерности действий врача при взаимодействии с пациентами, врачебной этико-правовой ответственности за последствия медицинских манипуляций, защиты интересов, как врачей, так и пациентов.Метод и методология. Исследование основано на сравнительно-историческом методе с привлечением общенаучных методов анализа и синтеза.Результаты. В ходе проведенного анализа различных точек зрения выдающихся врачей и правоведов начала XX века установлено, что первые попытки обоснования необходимости согласия пациента при оказании медицинской помощи предпринимались врачами исключительно в контексте врачебной этики. В юридическом же сообществе в связи с резким ростом судебных разбирательств по делам врачей возникла необходимость в правовой оценке медицинской деятельности, но отсутствие достаточного опыта не позволяло ее корректно квалифицировать. Автор полагает, что преодоление сложившихся препятствий к конструктивному обсуждению дилемм вокруг согласия пациента восходит к началу установления этико-правового диалога.Область применения результатов. Полученные результаты могут найти применение в решении современных вопросов этико-правового регулирования практики информированного добровольного согласия пациента на медицинское вмешательство, а также в курсах биоэтики и правоведения.

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.

On the occasion of the 200th birthday anniversary of D.E. Min

This article is dedicated to the memory of the outstanding Russian forensic doctor and literary figure professor D.E. Min on the occasion of his 200th birthday anniversary. The assignment of D.E. Min to the position of the head of Department of the State Medical Practice at the Emperor's Moscow University coincided with the large-scale judiciary reform carried out in the country at that time which envisaged, among other innovations, the practice of questioning of an expert in the court room. The new developments in the practical expert activities required the revision of the former approaches to the education and training of forensic medical experts. D.E. Min was the first to introduce the practice of public defense of expert judgements by the students of the Department as an indispensable component of their routine learning activities. He founded the museum of forensic medicine and pioneered the method for teaching the intravital forensic examination. D.E. Min initiated and supervised original research on mechanical asphyxia, forensic-medical toxicology, and traumatology. D.E. Min and his co-workers were frequently engaged by the agencies in charge of preliminary investigation to participate in forensic medical expertise associated with the inquiries into the most lurid criminal cases of those times. The scientist made the essential contribution to the development of forensic medicine in this country and the modernization of the academic process at the Department of the State Medical Practice that greatly promoted satisfaction of the basic requirements of practical forensic medical activities.

MUKHIN EFREM OSIPOVICH (THE 250TH ANNIVERSARY)

Interesting and outstanding figure of domestic medicine on the verge of 18–19 centuries was Ephraim Iosipovich Muhin. Article describes his contributions in the formation of anatomy, physiology, traumatology, surgery, forensic medicine, hygiene, toxicology, epidemiology, etc. The scientific work of E. I. Mukhin «First Principles of bone correcting science» was the very first national guide in traumatology and orthopedics. This direction separated from the surgery. Professor is considered the founder of the national traumatology. E. I. Muhin organized work in a hospital and anyone could get help at any time for free. Professor one of the first who organized vaccination against smallpox. Many E. I. Mukhin’s students, who later became outstanding doctors, including N. I. Pirogov and I. W. Buyal'skiy, gratefully remembered his teacher. He has helped many people to get medical education, and he directed the most talented to foreign universities. In connection with the anniversary of E. I. Mukhin significant work conducted to perpetuate his memory at home, and initiated celebration «Born in the Ukraine» under the auspices of the public council of Kharkiv Regional State Administration, Ukrainian public organization named by Pirogov «Military medicine of Ukraine», Ukrainian public organization «Ukrainian Association of orthopedic trauma» and the University of Kharkiv named by V. N. Karazin.

To the memory of Andrew E. Czeizel

The article is devoted to the outstanding Hungarian doctor - Andrew Czeizel, his biography and achievements in the Enforcement Network for the improvement of the Health of Children - the future of humanity.

THOUGHTS AND THEMES FROM THE 2016 ADFM WINTER MEETING

Are we Luddites? How can we “recalibrate”? What is a more pressing need in our Departments than producing outstanding family doctors? How can we bring joy back to clinical practice? These questions are a few among many that stimulated our thinking during ADFM’s 2016 Annual Winter meeting. A

The practice and exploration of improving the teaching quality of clinical practice under the background of the outstanding doctor training

In 2012, the Ministry of Education, Ministry of Health jointly issued the notice of implementation of the outstanding doctor training plan, which stressed the need to identify the dominant position of students in learning, and strengthened the training of medical ethics and clinical practice ability of medical students. Our hospital actively explored how to improve the teaching quality of clinical practice under the culture background of excellent doctor education. We constructed undergraduate clinical practice teaching management framework of school /secondary college — educational department /teaching and research section — three disciplines / subspeciality, established clinical skills teaching and research sec-tion, cleared responsibilities of all levels, improved the clinical teaching management system, and strengthened the practice teaching and medical students' clinical skills training, and standardized teaching rounds and lectures. We also promoted the teaching and learning through clinical skills competition, and at the same time, we paid attention to the cultivation of students' medical humanities and medical science spirit, so that students could obtain better clinical practice effect, and promote the development of the reform and development of hospital education and teaching. Key words: Outstanding doctor training; Clinical practice; Teaching management; Clinical skills training; Medical humanities education

Galen and Pharmaceutical Technology

Using certain examples we have shown, that Galen took the properties of the used components and their components into consideration, offered sensible ingredients combinations and blends, and prepared a dosage form, capable of implementing its pharmacological action. The analysis of the materials gave grounds to consider Galen not only as an outstanding doctor, but one of the first manufacturing chemist.

Prof. Hong Zhao, ATM's Associate Editor-in-Chief, honored with Beijing's 10 Outstanding Young Doctors Award.

Professor Hong Zhao ( Figure 1 ), 38 years, MD, is a tutor of graduate students, an associate chief physician, and a deputy director of the Laboratory of Abdominal Surgery of Cancer Hospital, Chinese Academy of Medical Sciences.

Professor Boles aw Rutkowski's 70th birthday Laudatio

On 5 December 2014 Professor Bolesław Rutkowski, the outstanding Polish nephrologist, doctor and researcher, renowned organizer, our teacher, colleague and friend, will celebrate his 70th birthday. We would like to take this opportunity to present to you his life and his scientific achievements.

The thinking of teaching ＂basic clinical skills＂ course to order-oriented medical students

Based on the minimum basic requirements of global medical education（GMER）, and taking example of training experience of domestic and foreign medical students＇ learning clinical skills, we have made a detailed analysis of the backgrounds, necessity and feasibility of opening course clinical basic skills to the order-oriented medical students in Chongqing. We have also put forward some countermeasures and suggestions to ensure the quality of teaching, so as to promote the course smoothly. Key words: Order-oriented medical students; Basic clinical skills; Course construction; Outstanding doctor education

Progress and challenges in the cardiovascular field

Progress and challenges in the cardiovascular field

Exemplary Physicians' Strategies for Avoiding Burnout

Burnout has damaging effects on physicians. This research reveals how outstanding doctors avoid burnout. Winners of the American Medical Association Foundation's Pride in the Professions Award were interviewed to learn how they manage burnout. Information was collected through telephone interviews. The data were categorized through content analysis. The results showed that techniques for avoiding burnout varied and included setting limits, sharing issues with family and friends, physical exercise, cultivating relaxation, and humor. These doctors have become skilled at recognizing the signs of burnout and countering its effects while maintaining the highest standard of care and demonstrating leadership in their vocation.

P40 Short-CGH in a PGD for a reciprocal translocation: first clinical application

Introduction: An increase of embryonic chromosome abnormalities with maternal age contributes to low implantation rates and high miscarriage rates. PGS may reduce this trend by selecting chromosomally normal embryos for replacement, provided that the biopsy is done with minimal damage to the embryo and the analysis is accurate. Unfortunately, different studies using day-3 biopsy and FISH have used diverse methodologies yielding conflicting results. Although day 5 biopsy, CGH and vitrification combined seem to produce outstanding results, patients and doctors still prefer fresh over frozen cycles. An improvement over CGH is array CGH (aCGH), which provides complete chromosome analysis in one day. The Here we present our preliminary clinical data on the use of aCGH. Methods: aCGH was performed on 87 cycles from 19 fertility centers. Average maternal age was 37.6. The indications were advanced maternal age ( 38, n = 46), recurrent pregnancy loss (RPL, n = 28) or other (n = 13). A single cell was biopsied per embryo on day 3 of development. Normal embryos were replaced on day 5. Some abnormal embryos were fully fixed and reanalyzed by FISH to determine the error rate of the technique. Pregnancy rates and miscarriage rates from each center were compared to SART data from the same center controlling for age. Results: A total of 747 embryos were analyzed. 2.4% of cells did not show DNA amplification. Of the rest 38% were euploid and the rest abnormal. Euploidy decreased with maternal age from 45.7% in Conclusions: aCGH provides results in one day with very low no result frequency (2%) and error rate (5%). Pregnancy and miscarriage rates seem to indicate an improvement over historic controls. While comparing pregnancy rates in this manner may be subject to confounding factors, miscarriage rates are probably even higher in an ideal control that should include >25% RPL patients.

Rocke Robertson: Surgeon and Shepherd of Change (review)

Reviewed by: Rocke Robertson: Surgeon and Shepherd of Change Thomas Schlich Rocke Robertson: Surgeon and Shepherd of Change. Richard W. Pound. Montreal and Kingston: McGill-Queen’s University Press, 2008. Pp. 344, $45.00 cloth This book is a biography of Rocke Robertson (1912–98), who was principal of McGill University from 1962 to 1970. These years saw significant change in universities around the world, and McGill was no exception. During Robertson’s term in office the university underwent an enormous expansion in students, staff, and facilities. At the same time, McGill’s governance went through a redistribution of power among the board of governors, staff, students, departments, divisions, and faculties, while financially it became ever more dependent on the funding of the provincial government. Robertson participated in all these events – events that represented, in fact, parts of more general developments of the time. One of these developments was the worldwide anti-authoritarian youth rebellion of the 1960s. Another was the anticlerical movement in Quebec society known as the Quiet Revolution. A third one concerned the efforts of many people in Quebec to gain more political independence from the rest of Canada, a movement that culminated in the October crisis of 1970. The key passages of the book tell the story of these events from Robertson’s perspective. We see him struggling with the provincial government to maintain the financial viability of his university. This [End Page 814] struggle is remarkable in that it had had profound political implications for the emergent French-language universities and a climate of growing political distrust towards the old English-speaking elite. For example, it forced Robertson to deal with the idea of provincial university financing as a zero-sum game. This would have meant that if the new French-language universities got more money, McGill would get less. A related issue came from the different cultures of university funding in English- and French-speaking environments. These differences led to the demand that the grant money McGill solicited from outside should be deducted from its share of provincial funding, a demand that Robertson made great efforts to fend off. In another chapter we see Robertson dealing with political unrest among students in the 1960s student rebellion, trying to maintain his and the institution’s authority and integrity against politically motivated provocations of all sorts. Reading the story from his specific perspective is very informative and helps readers to understand the university’s position within the changing political, social, and cultural landscape of that period. The book’s author, Richard W. Pound, is the present chancellor of McGill University. By profession he is a lawyer and partner of the law firm Stikeman Elliott. He is known to the wider public as a disputatious critic of doping practices in sports and former president of the Montreal-based World Anti-Doping Agency. His book on Robertson is based on a comprehensive study of primary archival sources, originating mostly from Robertson himself, such as his diaries, speeches, and letters. As befitting a biography, the narrative starts with Robertson’s family history and childhood, and continues with his education and medical training at McGill. One chapter is devoted to Robertson’s experience as a surgeon in the Second World War. The narrative then follows his surgical career, which, in 1959, led him to the position of head of the Department of Surgery at McGill and surgeon-in-chief at the Montreal General Hospital, a position that he gave up three years later to take on the office of the principal of McGill University. Robertson’s surgical career is relatively unremarkable but is of historical interest because it represents a typical case rather than that of an outstanding doctor and scientist. Based on a wealth of documents, the book provides ample detail about Robertson’s life, such as his career decisions or his grades at university, which are supplemented by long quotations from his letters and speeches. Most of Robertson’s personal life events are explained satisfactorily. There are a few weak points, however. Most importantly, Robertson’s exact function with regard to the changes in [End Page 815] McGill’s governance could have been made clearer. In which ways...

Professor Tadeusz Orłowski: in memory of an outstanding doctor and a leading personality in the scientific life

Professor Tadeusz Orłowski: in memory of an outstanding doctor and a leading personality in the scientific life

Ethical and legislative perspectives on liver transplantation in the People's Republic of China

Ethical and legislative perspectives on liver transplantation in the People's Republic of China

Sackett [correction of Sacker], a pioneer of clinical epidemiology and evidence-based medicine

Sacker, a world famous clinical epidemiologist and pioneer of evidence-based medicine, to which he makes great contributions to its appearance and development. He is an outstanding doctor and medical researcher, director of all internal medicine, and an even more famous educationist of clinical epidemiology. He has his own living philosophy, and is indefatigable and conscientious to his profession.

—An outstanding doctor of integrative medicine on respiratory diseases

—An outstanding doctor of integrative medicine on respiratory diseases

Antoniana Margarita: Gómez Pereira, Francisco Lobato y los antecedentes del mecanicismo cerebral en el Renacimiento español

The year 2000 is the fifth century of the birth, in Medina del Campo (Vallodolid, Spain) of licenciado Perea' (Gomez Perea or Pereira). A man of the Renaissance, he was an outstanding doctor, humanist, theologist, nominalist philosopher, naturalist and practical engineer. He developed the first modern theory of behavior, based purely on mechanicistic principles, describing his ideas in a text known by the curious title of Antoniana Margarita. The objective of this paper is to pay him homage on the fifth centenary of his birth, making a historiographic study of Gomez Perea and his works, with particular emphasis on the ideological basis and its relationship with Renaissance hydraulic engineering, collaborating with his colleague Francisco Lobato, author of one of the only two pretechnological codices of sixteenth century Spain. The book Antoniana Margarita is written in Renaissance Latin and was published in Medina del Campo in 1554. It represents the first truly modern approach to brain function which excludes the providencialist concepts of Galen involving the soul and the spirit, in vogue until then, transmitted through the Arab and Scholastic tradition. Analyzing his theory of the automatism of animals' Perea made the first description ever of the reflex arc and the conditioned reflex. He also established a topographical model of the brain in which he sketched the functioning of the prefrontal cortex and neurophysiology of memory. Perea was the immediate forerunner of Neuropsychology and of the methodology and organicist thought which predominates in modern Neurobiology. He was also a visionary of the Evolution of Darwin and of modern aetiology.