Physicians Professional Immunity in the COVID-19 Pandemic. Problems and Solutions

In this article, by professional immunity we refer to limitation of liability to the specific pandemic context, respectively to the concrete possibilities of diagnosis, treatment, care and too few degrees of professional freedom still available. The relevance of one or another of the limitation measures of professional liability depends on the specific legal context of each community. Our thesis is that, regardless of the form of transposition into practice, a form of health professionals protection, such as professional immunity is necessary. From the multitude of possible protection measures, each state can select the appropriate ones. The need for specific measures for professional immunity is not identical in each state, depending on the specifics of the legal system, social values, measures characteristics taken to combat the pandemic, the degree of transparency of each healthcare system, the level of bioethical principles influence. However, this need doesn`t start from "no measure", the appropriate minimum level of protection seemingly to constitute a patient compensation no-fault model, plus the characteristics of the professional immunity, designed to adapt liability to specific conditions. The main problem in the absence of professional immunity is the risk of transferring the cost of ignorance, visible, in the inadequate expectations of medical science, on healthcare professionals, the limits of scientific knowledge risking to be reinterpreted as medical fault. The COVID-19 pandemic has somehow forced an additional step towards broadening discussions on universal human rights, being forced to consider ways of putting them into practice in the context of limited resources. Assuming that the increase in social complexity increases the risks of such events, we approach these problems from the perspective of creating rapid mechanisms to adapt to such changes, the lessons learned now being applied in the future to other similar cases.

Yakov Stechkin: Portrait of a Provincial Surgeon in the Realities of the 1920s

The article provides an analysis of professional formation and conditions of development of practical medicine in a provincial city of central Russia in the 1920s. For the first time, the authors introduce materials from the personal archive of surgeon Yakov Sergeyevich Stechkin, the brother and father of famous constructors Boris and Igor Stechkin. Yakov Stechkin practiced in Aleksin in 1922–1935. Based on statistical reports from his personal archive, the article reveals the peculiarities of provincial surgery. It analyzes such features as the range of operations performed, the use of anesthesia, and the level of lethality. Main attention is paid to the analysis of the mutual interweaving and transformation of various professional and cultural components in the activity of an ordinary physician: the traditions of zemstvo medicine, military surgery, and Soviet medicine of the 1920s. Each of these components made a contribution to behavioral models of the provincial doctor. Traditions of medicine with its principles of accessibility and free service correlated with the declared norms of Soviet health care system, versatility of military surgeon was more than necessary in terms of personnel lack, while material devastation was offset by broad professional freedom, permeated with the atmosphere of research and experimentation. Based on the memoir sources, the authors show the specific ways of communication between a doctor and his patients, typical of a small provincial town. The authors of put particular emphasis on the fact that an ordinary provincial surgeon resorted to trends of the time, such as experiments in eugenics, endocrinology, and rejuvenation. The article highlights factors that led the Russian physician, who treated the power of the Bolsheviks without reverence, to be integrated into the Soviet health care system.

Values and Regulations of Journalism as Viewed by Crimean Media Workers

Crimean journalists’ professional community has been working in a specific context during the recent six years. The journalists have had to adapt to the new political, legal and socio-cultural realia. Besides, they have had to work under the international sanctions imposed on the Crimea. Due to the increased attention of Russian society to the region, the community of Crimean journalists has successfully assimilated into Russian media landscape. However, its problems and characteristics, particularly, their vision of professional values and legal regulations, still remain unstudied. The purpose of the article is to study Crimean media workers’ perception of social functions of journalism, its ethical norms and legal regulations, and freedom as a basic category and value. The study required conducting a survey that involved 95 journalists from 56 editorial offices in 20 locations in the Crimea. The respondents demonstrate a clear understanding of values and regulations of their profession and view informing the public about the events in the Crimean region as the key journalists’ role. They are convinced, in this relation, that the most important ethical principle is their audience’s right for true information. The respondents also consider Russian legal regulations a key pre-requisite for their professional freedom – free search for and distribution of information. The author infers that Crimean journalists have enough freedom to perform their professional functions.

In Praise of Idleness?

This chapter turns to the university, deepening the critical-historical focus on the institutional settings within which cynicism (for all its anti-institutionalism) resides as a modern critical practice. The primary concern here is with the university as a forum in which debate about the importance of, and the constraints on, free speech has in recent years generated unhappy and (in the USA) occasionally violent levels of conflict. Attending closely to advocacy for professional freedom of expression in the work of Bertrand Russell, John Dewey, and Laura Kipnis (the latter operating in the context of Title IX legal disputes and the #MeToo movement), the chapter examines the ways in which each of them has deployed cynicism in the course of advocacy for an ideal of the university as a place of free expression, while also anticipating and controlling charges of ‘mere’ cynicism.

3. Medical Negligence

This chapter examines the legal and ethical aspects of medical negligence. It begins with an overview of the law and medical malpractice. It then discusses the law of negligence; the law of contract; medical malpractice litigation in practice; legal costs; the perception that medical negligence litigation is unsatisfactory; the NHS Redress Act 2006; the ‘no fault’ scheme; and the law governing medicines. The law in this area seeks to strike a balance between ensuring patients receive compensation if they have been harmed as a result of bad treatment, and allowing doctors professional freedom to determine which treatment is most appropriate for a particular condition.

INDEPENDENCE OF DOCTORS IN PROVIDING MEDICAL ASSISTANCE TO PERSONS DEPRIVED FROM LIBERTY

Building an effective healthcare system and providing quality patient care is a main priority for the international community and European countries. Achieving this priority requires active behavior on the part of all actors in the health care system - state and municipal authorities, health care providers, medical professionals, and taking adequate and appropriate measures. Part of these measures should be aimed at improving access to medical care for all citizens, overcoming health inequalities between social groups, and ensuring an appropriate environment in which doctors can effectively exercise their professional rights. In this sense, guaranteeing the right to independence of doctors and their right to personal freedom in providing medical assistance and medical care to patients is an extremely important obligation for any rule of law and democracy governed countries. This situation is conditioned by the fact that the full realization of the professional rights of doctors is one of the basic prerequisites for the delivery of quality medical care and for the protection of patients' health rights. The exceptional importance of the right to the independence of doctors and their right to personal professional freedom has been recognized in a number of international universal and regional instruments and in the domestic law of European countries. When providing health care under normal conditions, healthcare professionals do not have the serious difficulty of being independent and to make their own decisions regarding the diagnosis and treatment of patients. However, this is not the case in prisons and arrest, where the activities of doctors, their independence and professional freedom are in practice limited by the adopted structural models and the normatively established organizational rules. Admitting this trend is unacceptable. It has a negative impact, on the one hand, on the ability of doctors to pursue their profession, guided solely by their conscience and the rules of medical ethics, and, on the other, on the effective exercise of the right to health and the related health rights of persons deprived from liberty. Last but not least, limiting the independence of physicians in the provision of medical care to persons deprived from liberty has implications for the physician-patient relationship that should be built on the basis of mutual trust, respect and cooperation. This article will look at international standards that guarantee the right to independence of doctors, their manifestation in the practice of medical care in prisons and in arrest, and the factors that lead to the limitation of that right.

Self-Perceptions of Teacher Autonomy Within a Standardised English Language Program at a Japanese University

Teacher autonomy relates to the teacher’s capacity, freedom and responsibility to self-direct and self-reflect on choices that affect their role as a teacher. This study takes a two-fold approach in examining (1) the degree to which English language teachers in a university in Japan felt autonomous whilst adhering to a standardized curriculum, and (2) how teachers that self-identified as having a significantly higher degree of autonomy than their colleagues continued to find ways to exercise it in this context. The first stage utilized the Teacher Autonomy Scale (TAS). Then in stage two interviews were conducted with teachers who had reported the greatest level of autonomy on the TAS. The findings from the research suggest that teachers are still able to create spaces to express their autonomy within a standardised curriculum through processes of supplementation or modification, which may be motivated by either feeling a responsibility to offer their students more, or a desire for professional freedom and confidence in using their own discretion.

THEORETICAL AND PRACTICAL ASPECTS OF MEASUREMENT AND EVALUATIONOF INTEGRATED CHARACTERISTICS OF PROFESSIONAL COMPETENCY OF THE PEDAGOGUE

The article highlights the actual aspects of the interpretation of the notion of computation, competence, their use and priority directions of diagnostics of the components of professional competence of the teacher. The analysis of modern works on the competencies and competence as a multidirectional and variety of their characteristics is proved, which testifies to the very large complexity of their measurement and evaluation; an attempt was made to find ways to solve this urgent problem, which is connected with the improvement of the quality of education in the general context of its humanization. The aim is to highlight the individual professional qualities of the teacher: the general orientation of the motivational sphere, the degree of manifestation of a personal sense of professional freedom and abilities. these problems are coverage from the position of J. Raven and his emphasis on motivation and values of the individual. The role of the acmeological orientation of the individual is emphasized as an important factor in achieving pedagogical success. The acmeological orientation acts as a personal potential, which is a component of the individual psychological characteristics of the individual. The concept of personal potential has been developed in his works by D.O. Leontev and is interpreted as the ability of the individual to maintain the stability of activity under the influence of external conditions. An attempt has been made to gauge their specificity more deeply with the help of the Rorschach method. The general tendency is highlighted concerning the peculiarities of the study of the general orientation of the motivational sphere, the degree of manifestation of the personal feeling of professional freedom and abilities, which, in our opinion, is that it is relatively autonomous and its meaning lies in the field of determining the state and trends of the functioning of professional freedom, in general. Further searches are seen in solving the problem of developing effective methods for the professional diagnosis of the competence of educators in education and the creation of a continuous experimental system, which learns on the basis of own samples and errors, corrects its actions and initiates the forms of activity.

Blood and the law of the marketplace

This chapter discusses the application of the values of the marketplace to human blood. American and British economists are making an economic case against a monopoly of altruism in blood and other human tissues. They wish to set people free from the conscience of obligation. Although their arguments are couched in the language of price elasticity and profit-maximisation, they have far-reaching implications for human values and all ‘social service’ institutions. However, the moral issues that are raised extend far beyond theories of pricing and the operations of the marketplace. They involve the foundations of professional freedom in medical care and other service relationships with people; the concept of the hospital and the university as non-profit-making institutions; and the legal doctrine in the United States of charitable immunity.