On the history of medical risk

Authors

  • Nikolay A. Kuznetsov FSAEI HE I.M. Sechenov First MSMU MOH Russia (Sechenov University) 8 Trubetskaya St., building 2, Moscow 119991, Russia Author

Keywords:

history of medicine, history of surgery, operational risk, quantitative risk assessment in routine surgery, interdisciplinary ap-proach, prognosis

Abstract

This article reviews the main approaches to the interpretation of the term “risk”, which has acquired the status of a general scientific and widely interpreted concept. The unresolved issues of surgical risk terminology make it extremely difficult to solve the problem of perioperative prognosis at the narrow professional (medical) level. The author considers the problem of objectifying operational risk at an interdisciplinary level. In his opinion, understanding risk as a specific form of the subject’s active relation to the surrounding reality is the most justified at the present time. The essential particular features of such activities are the lack of confidence and the subject’s uncertainty in achieving the stated goal since a doctor’s professional activity takes place under conditions of risk, uncertainty and in contradictory situations.
 The author of the article suggests using the definition of “risk” proposed by A.P. Algin, according to which risk should be un-derstood “as an activity connected with overcoming uncertainty and the situation of inevitable choice, in the process of which it is possible to quantitatively and qualitatively assess the probability of achieving the expected result, failure and deviation from the goal.” This definition prevents the use of antiscientific and scholastic views of this phenomenon. With reference to medical science (in particular, to surgery), this approach to risk allowed the author to formulate an individual quantitative prognosis and to distinguish five types of perioperative prognosis.

Downloads

Download data is not yet available.

References

Algin AP (1989) Risk i ego rol’ v obshchestvennoj zhizni [Risk and its

role in public life]. Moscow: Mysl. 187 p. (In Russ.)

Balagin VM, Doleckij AS, Soboleva NS et al. (1987) Opredelenie stepeni operatsionno-anesteziologicheskogo riska u detej [Determination of the degree of operational and anesthetic risk for children]. Anesteziologiya i reanimatologiya [Anaesthesiology and Reanimatology] 4: 70–74. (In Russ.)

Bek U (2000) Obshchestvo riska. Na puti k drugomu modernu [Risk Society. On the way to another modernity]. Moscow: Progress-Tradiciya. 384 p. (In Russ.)

Belov YuV, Isaev RM (2014) Stratifikatsiya riska v serdechnososudistoj

hirurgii [Risk stratification in cardiovascular surgery]. Hirurgiya.

Zhurnal im N.I. Pirogova [Surgery. The Journal named after N.I. Pirogov] 7: 78–82. (In Russ.)

Bisenkov LN (2004) Torakal’naya hirurgiya. Rukovodstvo dlya vrachej

[Thoracic surgery. A guide for physicians]. Saint Petersburg: Gippokrat. 1142 p. (In Russ.)

Bokeriya LA (2007) Prognozirovanie operatsionnogo riska v hirurgii

[Prediction of operational risk in surgery]. Annaly hirurgii [Annals

of Surgery] 5: 5–10. (In Russ.)

Chadaev AP, Domnin MS, Dobaev VA, Kozlov VF (1988) Primenenie

matematicheskih metodov klassifikatsij dlya otsenki riska operatsij

i vybora hirurgicheskih vmeshatel’stv u geriatricheskih bol’nyh [The

application of mathematical methods of classifications to assess the

risk of surgery and the selection of surgical interventions in geriatric

patients]. Respublikanskij sbornik nauchnyh trudov [Republican collection of scientific works]. Moscow. P. 14–21. (In Russ.)

Doleckij SYa (1992) Risk v hirurgicheskom i obshchem plane (lekciya)

[Risk in the surgical and general plan (lecture)]. Hirurgiya. Zhurnal

im. N.I. Pirogova [Surgery. The Journal named after N.I. Pirogov] 2:

–11. (In Russ.)

Dyachenko PK, Galkin VV (1975) Metod opredeleniya i klassifikatsiya

hirurgicheskogo riska [The method of definition and classification of

surgical risk]. Vestnik hirurgii [Surgery Bulletin] 7: 75–79. (In Russ.)

Glushkov VA (1988) O vrachebnom riske i krajnej neobhodimosti

[About medical risk and extreme necessity]. Klinicheskaya hirurgiya

[Clinical Surgery] 5: 48–50. (In Russ.)

Hayat H, Gojdman L (1994) Sdelaem meditsinu bole nauchnoj [We

will make medicine more scientific]. Nature 371 (8): 1–3. (In

Russ.)

Komorovskiy JuT (1980) Sravnitel’naya otsenka metodov opredeleniya

riska operatsii v vozrastnom aspekte [Comparative evaluation of

methods of determining the risk of surger in the age aspect]. Vestnik

hirurgii [Surgery Bulletin] 125(11): 9–16. (In Russ.)

Kuznetsov NA (2009) Osnovy klinicheskoj hirurgii: prakticheskoe rukovodstvo [Basics of clinical surgery: a practical guide]. Moscow:

GEOTAR-Media. 671 p. (In Russ.)

Malinovskij NN, Leontieva NS, Meshalkin IN, Ovchininskij NN (1973)

Stepen operacionnogo riska (metodika klinicheskogo opredeleniya

i prakticheskoe znachenie) [Degree of operational risk (method of

clinical definition and practical significance)]. Hirurgiya. Zhurnal

im. N.I. Pirogova [Surgery. The Journal named after N.I. Pirogov]

: 32–36. (In Russ.)

Melnychuk AS (2017) Chelovek. Risk. Tsennosti. Risk v sisteme tsennostej i smyslov kadrov upravleniya [Human. Risk. Values. Risk in the

system of values and meanings of management personnel]. Moscow:

Narodnoe obrazovanie. 236 p. (In Russ.)

Mincer OP, Kanevskij VA, Spitkovskij AI (1988) Risk prinyatiya

nepravil’nogo resheniya kak kriterij tsennosti diagnosticheskoj informatsii [The risk of making an incorrect decision as a criterion

for the value of diagnostic information]. Vestnik AMN SSSR [Bulletin of the Academy of Medical Sciences of the USSR] 9: 74–81.

(In Russ.)

Quantitative Risk Assessment. Biomedical Ethics Reviews (1986) New

Jersey: Humana Press. P. 225–237.

Ruzavin GI (2001) Epistemologicheskie problemy prinyatiya resheniya v

sotsial’no-ehkonomicheskoj deyatel’nosti [Epistemological problems

of decision-making in socio-economic activities]. Voprosy filosofii

[Question of philosophy] 13: 81–100. (In Russ.)

Sigaev AA, Shvalb PG, Shitov II (1966) Prognozirovanie posleoperatsionnyh oslozhnenij v angiohirurgii [Predicting postoperative complications in angiosurgery]. Angiologiya i sosudistaya hirurgiya [Angiology and Vascular Surgery] 1: 113–118. (In Russ.)

Downloads

Published

2018-06-30

Issue

Section

Articles

How to Cite