Ethics and factors of humanization of modern neurosurgery
Keywords:
Medical ethics, deontology, neurosurgery, humanism, a conflict of interestAbstract
This study offers a concise exploration of the history of ethics and morality in neurosurgery, focusing on the current contradictory situation characterized by a technological boom in diagnostic and treatment methods for nervous system diseases, alongside a crisis in medical ethics. Key factors contributing to the humanization of neurosurgery are identified, including the development of criteria for ideal diagnostic methods, treatment of previously inoperable lesions, the implementation of minimally invasive procedures, the shift from neurodestruction to neurostimulation and neuromodulation, advancements in reconstructive surgeries, adequate anesthesia, intraoperative neuromonitoring, and the capability for prolonged monitoring of vital functions.
The study also emphasizes the main challenges contributing to the dehumanization of neurosurgery, such as the distancing of doctors from patients, the potential for adverse psychological changes following neurosurgical interventions, the rise in iatrogenic neurosurgical pathology, and the escalating costs of neurosurgical evaluation and treatment.
The authors highlight the contradictions present in modern neurosurgery, with particular attention to conflicts of interest and obligations related to the commercialization of the field and the issues arising from unnecessary surgeries. They argue that prioritizing human values at all stages of neurosurgical education, training, and practice is essential to preventing the dehumanization of neurosurgery in this era of advanced technology. The study concludes that for the humanization of neurosurgery to succeed, neurosurgeons must not only be "homo sapiens" but also "homo moralis."
Downloads
References
Filocofskiy entsiklopedicheskiy slovar’ (Philosophic
Encyclopedic Dictionary). Moscow: Sovetskaya
entsiklopediya, 1983: 808–811. [in Russian]
Petrov N.N. Voprosy khirurgicheskoy deontologii.
(Questions of surgical deontology). Leningrad, 1945.
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.
Bol’shaya meditsinskaya entsiklopediya. 3-e izd.
[Great Medical Encyclopedia. 3d ed.] Vol. 7. Moscow:
Sovetskaya entsiklopediya, 1977: 109–115. [in
Russian]
Babchin I.S. Problemy meditsinskoy etiki i deontologii v
neyrokhirurgii [Problems of medical ethics and deontology
in neurosurgery]. Voprosy neyrokhirurgii [Issues in
Neurosurgery]. 1970; 6: 3–11. [in Russian]
Fraerman A.P., Troshin V.D., Nazarov V.M. Voprosy
etiki v neyrokhirurgii [Ethical issues in neurosurgery].
Voprosy neyrokhirurgii. 2002; 4: 40–42. [in Russian]
Troshin V.D., Kovaleva T.S. Kodeks neyroetiki
[Neuroethics Code]. Zhurnal nevrologii i psikhiatrii
[Journal of neurology and psychiatry]. 2001; 10: 65–68.
[in Russian]
Umansky F., Black P.L., Di Rocco C. et al. Statement
of ethics in neurosurgery of the World Federation of
Neurosurgical Societies. World Neurosurg. 2011; 76 (3-4):
–247.
Likhterman L.B., Kravchuk A.D., Okhlopkov V.A. et al.
Klinicheskoe myshlenie neyrokhirurga [Clinical thinking in neurosurgery]. Voprosy neyrokhirurgii. 2014; 6: 68–78.
[in Russian]
Beauchamp T.L., Childress J.F. Principles of Biomedical
Ethics. 7th ed. N.Y.-L.: Oxford University Press, 2012; 480 p.
Bioetika: printsipy, pravila, problemy. Pod red. B.G.Yudina
(Bioethics: guidelines, rules, and problems. Ed. B.G. Yudin).
Moscow: “Editorial URSS”, 1998; 470 p. [in Russian]
Likhterman L.B. Cherepno-mozgovaya travma: diagnostika
i lechenie (Traumatic brain injury: diagnosis and treatment).
Moscow: “Geotar-Media”, 2014: 473–481. [in Russian]
Balalykin D.A. Galen i galenizm v istorii meditsiny.
V kn.: Galen. Sochineniya. T. 1. Balalykin D.A. (red.)
[Galen and galenizm in the history of medicine. In: Galen.
Works. Balalykin D.A. (ed.)]. Vol. 1. M.: Vest’, 2014. [in
Russian]
Eticheskiy kodeks rossiyskogo vracha (Ethical code for
the Russian doctor): http://www.med-pravo.ru/Ethics/
EthCodRF.htm last access date – 09.07.2015)
Kodeks professional’noy etiki vracha Rossiyskoy Federatsii (Code of professional ethics for doctors of the Russian
Federation) http:// minzdrav.rkomi.ru/.../Кодекс%20
профессиональной%20этики%20вра... (last access
date – 09.07.2015)
Rolston J.D., Bernstein M. Errors in Neurosurgery. Neurosurgery clinics of North America. 2015; 26: 149–155.
Zotov Yu.V., Kasumov R.D., Taufik I. Ochagi
razmozzheniya golovnogo mozga (The damage site of
the compression injury of the brain). SPb., 1996; 254 p.
[in Russian]
Lebedev V.V., Bykovnikov L.D. Rukovodstvo po neotlozhnoy
neyrokhirurgii (Guidelines for emergency neurosurgery).
Moscow: Meditsina, 1987; 336 p. [in Russian]
Bryukhovetsky A.S. Travma spinnogo mozga: kletochnye
tekhnologii v lechenii i reabilitatsii (Spinal cord injury: cell
technologies in treatment and rehabilitation). Moscow:
Prakticheskaya meditsina, 2010; 341 p. [in Russian]
Downloads
Published
Issue
Section
License
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
