“Philosophy of Medicine” - course 25,000 rubles. from MSU, training 4 weeks. (1 month), Date: December 5, 2023.

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Section 1. Philosophical agenda of modern medicine (8 ocloc'k) 

Topic 1.1 Philosophy and medicine: “and indeed there is little difference between wisdom and medicine..” (2 hours) 

The lecture will present the author's vision of the relationship between philosophy and medicine as branches of knowledge and spiritual activity, united by the subject of study - man. The tasks of philosophical education in a medical university will be presented as a contribution to the formation of a specialist, armed with the art of rational holistic and conceptual thinking, without which genuine clinical thinking.

Topic 1.2 Key trends in the development of modern science. Conceptual understanding of the future of medicine (2 hours) 

The lecture will reveal key trends in the development of medicine in the digital era in the context of the transformation of human nature under the influence of the development of science and technology. The lecture will describe the conceptual foundations of the 4P medicine concept as a social project and the strategy for the development of medicine as a science and healthcare system.

Topic 1.3. Humanitarian dimension of medicine of the 21st century (2 hours) 

The lecture, from the perspective of a practicing physician and healthcare organizer, will outline the author’s vision of the tasks of creating a humanitarian culture within the framework of medical education. The importance of humanitarian communication skills in the culture of healing will be revealed.

Topic 1.4. The meaning of the concept of medicalization of life in socio-humanitarian knowledge (2 hours) 

The lecture will identify the reasons for the emergence and deepening of the process of medicalization of life. Using examples from different fields of knowledge, the need to apply medical knowledge in socio-humanitarian research will be shown, and the role of an interdisciplinary approach will be emphasized. The role of geneticization in the transformation of ideas about a person and his construction of his future will be examined separately.

Section 2 Philosophy of Medicine (10 hours) 

Topic 2.1 Methodology of human sciences in the light of problems of medicine of the 21st century (2 hours) 

Methodology of science as knowledge about the creation of knowledge. Human sciences: characteristics, features, foundations of research methods. Foundations of medicine as a science about man in a biologically oriented discourse: problems of finding a path to knowledge about man. Clinic as a positive time of knowledge. Forms of medical rationality. Invariant of medical knowledge at the patient's bedside. The problem of a double transition from monitoring the individual course of the disease to generalizations and identifying patterns and back to a specific person.

Topic 2.2. Object language of philosophy of medicine (2 hours) 

Microcosm and macrocosm in medical and anatomical discourse. The contrast between the hidden and the visible. Clinical experience as the discovery of the individual in the language of rationality. A grammar of signs instead of a botany of symptoms. Matrix language of medicine. Seeing and naming a disease does not mean understanding it. Medicine “before and after” autopsy. Object and subject of medical discourse: discrepancies and distortions. Difference between disease and illness. “Bracketing” the patient.

Topic 1.3 Medicine ontologies emerging in the history of medicine, in laboratories and in the clinic (2 hours) 

Philosophical ideas of ancient medicine as knowledge about man. Teorica as a historical technical way of talking about humors in medicine. Medicine in the higher faculties of early modern universities. “Balanced nature” in the teachings of Avicenna. “The completion of the biological old order in the 18th century” by F. Braudel. The origins of modern problems in the philosophy of medicine.

The space of experience and the space of theory in medicine. Man as a whole. The problem of “observing” a person as a whole in the laboratory. The problem of “translation” and “breaks”. STS and field studies in medical laboratories. The problem of coordination of practices. From perspectivism to the disease itself. Symptom or reality. Variants of criticism of the “strong program” of STS.

Topic 2.4. The problem of pathology and norms in medicine (2 hours) 

The problem of historically changing medical standards that regulate the living conditions of society. The non-cumulative nature of scientific knowledge in relation to the development of medicine. Ethics as a way of constituting oneself as a moral subject of one’s medically regulated sexual behavior. The search for a “panacea” as a historical problem. The clinic as a non-free area of ​​liberation from illness. History of science, medicine and ideology (P. Dear). Medical deontology: unanswered questions?

Topic 2.5. Personalized medicine of the 21st century (2 hours) 

Medicine as a part of culture and society. What is evidence-based medicine? The use of artificial intelligence algorithms in analyzing databases and making diagnoses and the development of pharmacology: boundaries and prospects. Medicine as a science about man vs. Big Data: the main philosophical problems of the discrepancy between the discourses of the humanitarian approach and AI in the topos of the clinic. Ambivalence of norms in medicine of the 21st century: problems and solutions.

Section 3 Paradigmatic history of medical knowledge and practices (8 ocloc'k) 

Topic 3.1. Introduction. History of medicine as a science (2 hours) 

Main features and general characteristics. Connections with other disciplines. Humanitarian and natural science components. Conceptual approach in the history of medicine. The works of Professor L.Z. Morokhovets. Options for constructing a system of medical knowledge: descriptive-biographical, chronological, cultural and textual.

Topic 3.2. Chronological approach to the history of medicine (2 hours) 

Works of Professor TS. Sorokina. Problems of constructing a medical chronology. The connection between the development of medical knowledge and the history of the Christian church. Christianity and Hermeticism. The main advantages and disadvantages of the chronological approach.

Topic 3.3. Cultural approach to the history of medicine (2 hours) 

The emergence of medicine. The connection between medicine and culture. The roles of individuals in the formation of medical schools and directions. Stages of development of medical knowledge. Works by J. Vico. Vico's “Snail” as applied to the history of medicine. Models of modern medicine.

Topic 3.4. Textual approach to the history of medicine (2 hours) 

Literary basis of medical knowledge. Doctors-writers and doctors-non-writers. The role of language in the history of medicine. Medical terminology. Case history as a detailed narrative. Narrative practice in teaching the history of medicine. Narrative features of medicine according to the works of R. Sharon. The phenomenon of disease simulation. Examples of mutual influence of literary texts and medical practices. Some features of conducting seminars on the history of medicine.

Section 4 Bioethics as a science and social institution: theoretical and applied aspects (24 hours) 

Topic 4. 1 Specifics of modern bioethics as a post-non-classical science and a new type of social institution (2 hours) 

Historical models of traditional professional medical ethics. Factors shaping modern biomedical ethics. Features of biomedical ethics as professional ethics. The essence and interdisciplinary nature of modern biomedical ethics. Basic models of relationships between doctors and patients. Current state and prospects for the development of bioethics as a scientific direction, academic discipline and social institution. The role of bioethical education in the training of specialists in the field of biomedicine.

Topic 4.2 Main directions of bioethical discussions. Principles of modern bioethics (2 hours) 

Refusal of the universality of the principles of “do good!” and “do no harm!” in modern biomedicine. The principle of respect for personal autonomy (personal autonomy and autonomy of action; autonomy as freedom of choice and freedom of action, rationality of action and autonomy). Medical confidentiality (principle of confidentiality). Ethical aspects of the problem of confidentiality in modern medicine. "Natural", "promised" and "professional" secret. The principle of truthfulness. The right, duty, opportunity and expediency to always be truthful in relations between doctors and patients. The patient's right to receive truthful information.

Topic 4.3. Bioethical problems of the beginning of human life (4 hours) 

Reproductive health. Reproductive choice. Reproductive rights. Moral status of pre-embryos, embryos and fetuses. Abortion and its types. Liberal, conservative and moderate approaches to the issue of abortion. Moral and ethical problems of contraception.

New technologies of human reproduction. Heterologous and homologous insemination. Technology of in vitro fertilization with subsequent embryo transfer (IVF and ET) and ethical problems of medicine. Ethical problems of donating sexual material. "Surrogacy". Moral and ethical problems of prenatal diagnosis. The problem of reasonable risk when choosing a diagnostic procedure. Directive and non-directive model of medical consultation based on the results of prenatal diagnosis.

Ethical problems of neonatology. Moral problems of establishing a newborn criterion.

Topic 4.4. Bioethics about death and dying: transformation of the boundaries of existence in modern science and social practices (4 hours) 

The story of a doctor's relationship with a dying patient. The problem of criteria and definition of death. Brain death: medical, philosophical, moral, ethical, social and legal problems. Medical and bioethical prerequisites for modern palliative medicine. Hospice organizational principles and goals. Problems and difficulties in the development of palliative medicine services in Russia. The concept of “quality of life of a dying person”. Overcoming the fear of death as a moral and psychotherapeutic task. Ethical considerations in the treatment of chronic pain.

The concept of "right to die". History of the problem of euthanasia. Euthanasia: active and passive, direct and indirect (indirect), voluntary and involuntary, forced. The trend is to abandon the term “passive euthanasia”. Active voluntary euthanasia: arguments for and against.

Topic 4.5 Ethics of interventions in the physical and mental integrity of a person (regulation experimentation and high-tech interventions) Moral problems of medical experimentation (6 hours) 

Specifics of experiment as a scientific method. Epistemological features and structure of experiment in medicine. History of medical experimentation. The Nuremberg Code is the first international “Code of Rules for Conducting Experiments on Humans.” European documents guaranteeing the protection of the rights and dignity of a person who finds himself in the role of a test subject. Russian national legislation governing biomedical research. Typology of experimentation in medicine: self-experimentation, experimental therapy, non-therapeutic experiment, experiment on a healthy person. Specificity of experiments involving certain categories of people (children, the elderly, people with mental defects). Conflict between freedom of scientific research and personal privacy 

Moral problems of organ and tissue transplantation. The problem of moral justification for the development of transplantology. Trends in the commercialization of transplantation. Moral and legal prohibitions on the trade in organs and tissues for transplants. Major moral dilemmas associated with organ transplantation from living donors. Donation as an altruistic, conscious, voluntary sacrifice to one’s neighbor. Problems of incompetent donors (children, mentally ill people), donors with a sharp restriction of freedom of choice (prisoners sentenced to death). Moral problems of transplanting organs and tissues from corpses. Transplantology and the problem of defining death. Types of organ harvesting from corpses and associated moral issues (routine collection, presumption of consent, presumption of disagreement or voluntary informed consent). The problem of fairness in the distribution of donor organ resources.

Moral problems of fetal organ and tissue transplantation.

Moral problems of xenotransplantology. The problem of assessing the risk of xenotransplantations.

Topic 4.6. Moral issues of biomedical experimentation with animals: theoretical and applied aspects (2 hours) 

Historical aspects of the regulation of experimentation with animals for research purposes. Key regulatory documents regulating experiments with animals. Specifics of ethical and legal regulation of experiments with animals. The main goals of experimentation with animals. Bioethical principle 3R-history of formation and problems of application. The main arguments of opponents and supporters of experimentation with animals: a conceptual analysis. Activities of international and Russian organizations of specialists in working with laboratory animals. The role of bioethical committees in regulating experimental activities.

Topic 4.7 Individual and collective good in biomedicine: the problem of correlation (2 hours) 

Model of universal, free healthcare: pros and cons. Health and market relations. Doctor as a civil servant. The patient as a passive “recipient” of distributed medical care in a hierarchical health care system. Moral problems of fair distribution. Medical assistance and medical service. Patient as client. The doctor as a “seller” of medical services. Commercialization of medical practice and its impact on the moral climate in medicine. Conflict between the good of the patient and financial gain. Moral foundations of medical business. The priority of moral values ​​over economic interests.

Specificity of moral problems of medical genetics. The problem of the relationship between genetic and social in the history of culture. Psychogenetics about the factors in the formation of individuality. Methods of psychogenetics: main results and conclusions. The problem of improving human nature. Eugenics: Historical forms of eugenics as a science and social movement for the betterment of human nature. F. Galton and his eugenics project. Positive and negative eugenics. Neo-eugenics: specifics of modern formulation of problems. Social, philosophical and ethical problems of human cloning projects.

The problem of confidentiality and voluntary informed consent in medical genetics. Coding, anonymization and non-identification of medical genetic information. Ethical problems in the application of methods used by medicine for the diagnosis and correction of genetic disorders (genetic screening and testing, genealogical method, prenatal diagnosis and etc.).

Genetic information as property. Moral problems of implementing the international project "Human Genome". Problems of gene patenting.

Topic 4.8 Projects for “improving human nature”: philosophical contexts and analysis of practices (2 hours) 

The concept of “improvement” as applied to a person. The relationship between traditional ideas about improvement as perfection and new scientific and technological possibilities for intervention in human nature. Eugenics as a scientific form of knowledge and social movement. Positive and negative eugenics. Modern philosophical, ideological, moral and ethical problems of human improvement projects. Legal, socio-political problems of application of medical and biological knowledge. Problems of bioidentification: arguments for and against.

Section 5. Modern educational technologies in teaching philosophical courses to students in medical and biological areas of training (10 hours).

Topic 5.1 Teacher as director of a social and humanitarian course: general development methodology (2 hours) 

Educational course as a social and humanitarian project. Roles in the new “educational architecture”: producer (director), account manager, methodologist, graphic designer, quality control specialist, expert. Goals and stages of development of a social and humanitarian educational course (concept, scenario, visualization model, knowledge management model, control tools, etc.), types of courses. Course development methods and fundamental theoretical and methodological premises. Education 2.0, education 3.0, heutagogy: fact or fiction? Case analysis.

Topic 5.2 Challenges and risks for the teacher as a subject of activity in the space of social network culture (2 hours) 

Modern realities, dictated by the pandemic, have brought teachers and students together in the same virtual space. In this new world, it became necessary to create a new digital code of relationships, maneuvering between the Scylla of virtual freedom of action and the Charybdis of the commandments of the university.

Competent relationships between a teacher and a student in distance learning are built on clear rules of digital communication that must be followed by both parties. Students, as natives of the virtual environment, should not transfer the usual interpersonal nature of communication into Internet for a lecture, and teachers, being digital immigrants, must adapt to the new environment. The lecture will discuss the principles of managing networked public communication.

Topic 5.3 The role of the medical and biological case in the teaching of social and humanitarian disciplines. (2 hours) 

Based on the experience of conducting classes at the philosophical, legal and sociological faculties of Moscow State University. M.V. Lomonosov will demonstrate the role of cases, and also propose a methodology for their use within the framework of teaching social and humanitarian disciplines. Particular attention will be paid to the inclusion in teaching of cases related to the development of medical genetics (in particular, using the example of studies of hereditary cardiomyopathy).

Topic 5.4 The “copy-paste” problem in education: technologies and typical errors when checking the amount of borrowing (2 hours) 

The active development and spread of digital technologies has greatly simplified the search and receipt of information. Meanwhile, the problem of copyright on the Internet has become one of the key ones and has had a huge impact on the field of education. For a student, the method of preparing written work using “copy-paste” turns out to be much more simple and natural from the point of view of an Internet user than writing it yourself text. The lecture will examine the basic technologies for checking texts by teachers for the amount of borrowing, typical errors when assessment of the test results, as well as possible methods of explanatory and educational work with students on the problem "copy-paste".

Topic 5.5 Ethics of communication in a virtual educational environment (2 hours) 

The emergence of virtual spaces and virtual communication practices has become a new challenge for ethics as a research discipline. Initially, ethical reflection revolved around the question: “Are virtual spaces a natural continuation of the everyday environment, or are they a special reality, where can a different, not entirely familiar morality operate?” Simultaneously with the development of new technologies, this dilemma has largely lost its categorical nature, but gradual the transition of secondary and higher education to a virtual environment partially recalled long-standing discussions, and also updated debate about goals, values ​​and priorities education. The expansion of the electronic environment undoubtedly carries ethical risks associated, for example, with additional formalization, anonymity and destruction of educational distance but, on the other hand, new opportunities have opened up for building effective intellectual communications.

Section 6 Text in teaching philosophical disciplines to students in medical and biological areas of training (10 hours).

Topic 6.1. Discourse analysis of the nature of the “clinic” in philosophical texts. Or what is a “clinic”? (2 hours) 

“Essay on Method” in medical discourse in the ideas of M. Foucault. Analysis and criticism of European culture as a study of the evolution of technology, medical and hygienic practices in the Annales school (F. Braudel and Le Goff). “Anthropological circle” of clinical experience in “The History of Madness in the Classical Age” by M. Foucault. Anthropological foundations of the sociocultural crisis in modern clinics.

Topic 6.2. Discursive analysis of the phenomenon of the “laboratory” as the birthplace of “objective knowledge” about a person in philosophical texts. Or what is a medical laboratory? (2 hours) 

Ontology in medical practice by A. Mol. Ontological choreography. Carrying out diagnosis in a doctor's practice. Displacement as translation. The invisible modification of invisible microbes becomes visible (B. Latour). The destabilizing role of the laboratory. The laboratory turned the world upside down. From the birth of the laboratory (R. Boyle) towards dawn (L. Pasteur) and further. "Adequatio rei et intellectus." The task in studying is not “how”, but “what” of knowledge.

Topic 6.3. Discourse analysis of the concept of “knowledge” in texts on the philosophy of medicine. Or what is medical Knowledge? (2 hours) 

Name vs. understand in romantic science O. Sachs. “Internal picture of the disease” and early diagnosis of R.A. Luria. The main ideas of the “little book about big memory” by A.R. Luria. “Self-care” as part of Greek paideia. Medical understanding of Aristotelian catharsis by J. Lacan. Medicine as a science and as knowledge about man.

Topic 6.4. Methodology of expert analysis of text (MEAT) in the educational process: features of analytics of philosophical and humanitarian texts. (2 hours) 

The lecture will present the main ideas of the Methodology of Expert Text Analysis. MEAT is based on systematic work with texts presented in both oral and written implementation, including digital implementation of texts. It will be shown that text analytics turns out to be a tool for the development of both science and education in the processes of their mutual influence on each other.

Topic 6.5 Texts of popular culture as an educational tool in social and humanitarian courses (cases of bioethics in cinema) (2 hours) 

 The lecture will analyze the possibilities of using cinematic works of mass culture in the educational process using the example of the discipline "Bioethics". The specificity of bioethics, on the one hand, allows us to consider solutions to basic problems and answers to fundamental bioethical questions presented in a specific language of cinema, and on the other hand, mass culture, being a reflection of social reality, independently problematizes certain bioethical situations.

final examination is carried out in the form of an interview on questions relevant to the content of the program.