Modern neurosurgery and neuroethics
Abstract
Objective. To enlight the features of neuroethics and new hallenges arising in modern neurosurgery because of its intimate connection with technology.
Material and methods. We analyzed the literature concerning neuroethics as well as our long-term experience and some groups of neurosurgical patients (78 patients with acute traumatic intracranial hematomas and brain contusions treated conservatively; 490 patients with chronic subdural hematomas) with their neurovisualization and catamnesis follow-up.
Results. The factors for neurosurgery humanization were ystemized. The new challenges arising because of wide use of neurovisualization methods are discovered: фетишизация of visual data and ignoring of clinical signs and patient himself; professional duties of physician and mercantile temptations; holiness of life and quality of life and some others. It was demonstrated how ethic problems are raised which may lead to atrophy of clinical thinking, hyposkillia and increase of distance between physician and patient.
Conclusion. The solve of challenges in modern neurosurgery requires taking into account both interests of patient and society that means combination of high professionalism of neurosurgeon with priority of ethics and humanity values during all time of his education.
About the Authors
L. B. Likhterman
Национальный научно-практический центр нейрохирургии им. Н.Н. Бурденко
Russian Federation
Russian Federation
B. L. Likhterman
Первый Московский государственный медицинский университет им. И.М. Сеченова
Russian Federation
Russian Federation
References
1. Tatagiba M., Ugarte O.N., Acioly M.A. Ethics in Neurosurgery. In: Clausen J, Levy N (Eds): Handbook of Neuroethics. — Dordrecht: Springer, 2015 : 931-936
2. Freeman J.M. To treat or not to treat: ethical dilemmas of treating the infant with a myelomeningocele. In: Clinical Neurosurgery. Vol.20 — Baltimore: Williams and Wilkins, 1973: 134 — 146.
3. Лихтерман Л.Б., Лонг Д., Лихтерман Б.Л. Клиническая философия нейрохирургии. Москва, Геотар Медиа, 2016, 264 с.
4. Ammar A., Bernstein M. (eds). Neurosurgical Ethics in Practice: Value-based Medicine. — Berlin Heidelberg: Springer, 2014, 286 p.
5. Beauchamp T.L., Childress J.F. Principles of Biomedical Ethics, 7th ed. N.Y.-L.: Oxford University Press, 2012; 480 p.
6. Биоэтика: принципы, правила, проблемы. Под ред. Б.Г.Юдина. М., «Эдиториал УРСС», 1998; 470 с.
7. Gavrus D. Informed Consent and the History of Modern Neurosurgery. In: Clausen J, Levy N (Eds): Handbook of Neuroethics. — Dordrecht: Springer, 2015 : 505-518.
8. Loew F. Ethic in Neurosurgery. Acta Neurochir (Wien); 1999, 116:187-189.
9. Van Alpen H.F. (ed.). Introduction in: Neurosurgery and Medical Ethics. Acta Neurochir (1999) [Suppl] 74. s.15-16.
10. Umansky F., Black P.L., Di Rocco C. et al. Statement of ethic in neurosurgery of the World Federation of Neurosurgical Societies. World Neurosur. 2011; 76 (3-4): 239-247.
11. Лихтерман Л.Б., Кравчук А.Д., Охлопков В.А. и др. Клиническое мышление нейрохирурга. Вопросы нейрохирургии. 2014; 6: 68-78.
12. Лихтерман Л.Б., Лихтерман Б.Л. Этика и факторы гуманизации современной нейрохирургии. История медицины. 2015. Т.2. № 3: 416-425.
13. Лихтерман Л.Б. Черепно-мозговая травма: диагностика и лечение. Москва, Гэотар-Медиа, 2014, 481 с.
14. Потапов А.А., Лихтерман Л.Б., Кравчук А.Д. Хронические субдуральные гематомы. М., Антидор, 1997, 231 с.
15. Коновалов А.Н., Потапов А.А., Лихтерман Л.Б. и др. Хирургия последствий черепно- мозговой травмы. М., 2006, 352 с.
16. Potapov A., Kravchuk A., Likhterman L. etc. Sequele des trauma cranio-encefalici. Classificazione clinica e chirurgia riconstruttiva e mini-invasiva. Modena (Italia), Athena srl, 2016, 319 s.
17. Лихтерман Л.Б. Высокие технологии и клиническое мышление в нейрохирургии и неврологии. Нейрохирургия, 2012, № 1, с.9-17.
18. Lichterman B. Medical Ethics and Communism in the Soviet Union. In: Baker R, McCullough L. (Eds). The Cambridge World History of Medical Ethics. N.Y.: Cambridge University Press, 2009: 609-616.
Review
For citations:
Likhterman L.B., Likhterman B.L. Modern neurosurgery and neuroethics. Russian journal of neurosurgery. 2017;(3):3-10. (In Russ.)
Views:
816
Email this article 