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. 1996 Feb;22(1):33–40. doi: 10.1136/jme.22.1.33

The ethics of Soviet medical practice: behaviours and attitudes of physicians in Soviet Estonia.

D A Barr 1
PMCID: PMC1376857  PMID: 8932723

Abstract

OBJECTIVES: To study and report the attitudes and practices of physicians in a former Soviet republic regarding issues pertaining to patients' rights, physician negligence and the acceptance of gratuities from patients. DESIGN: Survey questionnaire administered to physicians in 1991 at the time of the Soviet breakup. SETTING: Estonia, formerly a Soviet republic, now an independent state. SURVEY SAMPLE: A stratified, random sample of 1,000 physicians, representing approximately 20 per cent of practicing physicians under the age of 65. RESULTS: Most physicians shared information with patients about treatment risks and alternatives, with the exception of cancer patients: only a third of physicians tell the patient when cancer is suspected. Current practice at the time of the survey left patients few options when physician negligence occurred; most physicians feel that under a reformed system physician negligence should be handled within the local facility rather than by the government. It was common practice for physicians to receive gifts, tips, or preferential access to scarce consumer goods from their patients. Responses varied somewhat by facility and physician nationality. CONCLUSION: The ethics of Soviet medical practice were different in a number of ways from generally accepted norms in Western countries. Physicians' attitudes about the need for ethical reform suggest that there will be movement in Estonia towards a system of medical ethics that more closely approximates those in the West.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adam G. Gratuity for doctors and medical ethics. J Med Philos. 1989 Jun;14(3):315–322. doi: 10.1093/jmp/14.3.315. [DOI] [PubMed] [Google Scholar]
  2. Barr D. A. The professional structure of Soviet medical care: the relationship between personal characteristics, medical education, and occupational setting for Estonian physicians. Am J Public Health. 1995 Mar;85(3):373–378. doi: 10.2105/ajph.85.3.373. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Blasszauer B. Medical ethics committees in Hungary. HEC Forum. 1991;3(5):277–283. doi: 10.1007/BF00168525. [DOI] [PubMed] [Google Scholar]
  4. Cassileth B. R., Vlassov V. V., Chapman C. C. Health care, medical practice, and medical ethics in Russia today. JAMA. 1995 May 24;273(20):1569–1573. [PubMed] [Google Scholar]
  5. Chodoff P. Ethical conflicts in psychiatry: the Soviet Union vs. the U.S. Hosp Community Psychiatry. 1985 Sep;36(9):925–928. doi: 10.1176/ps.36.9.925. [DOI] [PubMed] [Google Scholar]
  6. Field M. G. The position of the Soviet physician: the bureaucratic professional. Milbank Q. 1988;66 (Suppl 2):182–201. [PubMed] [Google Scholar]
  7. Korotkikh R. V. The social and ethical implications of universal access to health care in Russia. Kennedy Inst Ethics J. 1993 Dec;3(4):411–418. doi: 10.1353/ken.0.0020. [DOI] [PubMed] [Google Scholar]
  8. Paton C. Present dangers and future threats: some perverse incentives in the NHS reforms. BMJ. 1995 May 13;310(6989):1245–1248. doi: 10.1136/bmj.310.6989.1245. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Persaud R. D. What future for ethical medical practice in the new National Health Service? J Med Ethics. 1991 Mar;17(1):10–18. doi: 10.1136/jme.17.1.10. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Ryan M. Remuneration of Soviet medical personnel. Br Med J (Clin Res Ed) 1987 May 23;294(6583):1340–1341. doi: 10.1136/bmj.294.6583.1340. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Schultz D. S., Rafferty M. P. Soviet health care and perestroika. Am J Public Health. 1990 Feb;80(2):193–197. doi: 10.2105/ajph.80.2.193. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Smirnov I. Human health: from theory to practice. J Med Philos. 1989 Jun;14(3):251–259. doi: 10.1093/jmp/14.3.251. [DOI] [PubMed] [Google Scholar]
  13. Tsaregorodtsev G. I., Ivanyushkin AYa Trends in the development of medical ethics in the USSR. J Med Philos. 1989 Jun;14(3):301–314. doi: 10.1093/jmp/14.3.301. [DOI] [PubMed] [Google Scholar]
  14. Veatch R. M. Medical ethics in the Soviet Union. Hastings Cent Rep. 1989 Mar-Apr;19(2):11–14. [PubMed] [Google Scholar]
  15. White C. The debasing of medicine in the Soviet Union. Br Med J (Clin Res Ed) 1986 Dec 13;293(6561):1524–1524. doi: 10.1136/bmj.293.6561.1524. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Whitehead M. Who cares about equity in the NHS? BMJ. 1994 May 14;308(6939):1284–1287. doi: 10.1136/bmj.308.6939.1284. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Wilkinson G. Political dissent and "sluggish" schizophrenia in the Soviet Union. Br Med J (Clin Res Ed) 1986 Sep 13;293(6548):641–642. doi: 10.1136/bmj.293.6548.641. [DOI] [PMC free article] [PubMed] [Google Scholar]

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