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ОСНОВНОЙ РАЗДЕЛ
UDK 61
Abdiyeva S.A. teacher Rahimova N.B. student
Fergana Public Health Medical Institute
Uzbekistan, Fergana
MODERN PROBLEMS OF OBSTETRICS AND GYNECOLOGY
Annotation: Scientific and technological progress, which has affected all aspects of society, has had an impact on medicine. Under her control were the processes of human reproduction (the emergence, preservation and termination ofpregnancy), the course of embryonic and fetal development.
Key words: bioethics, obstetrics and gynecology, medicine.
At the end of the XX - beginning of the XI century. there is a clear trend of absorption of the philosophy of biology and medicine by bioethics (biomedical ethics). This is quite an understandable process, since bioethics is a relatively new direction, and excessive hopes are always associated with every innovation, and only with time a more balanced attitude to the new direction is achieved, which is gradually assimilated by culture and finds its niche in it, delineating the boundaries of possibilities and limitations.
Ethics has always been ontological - in the sense that many purely ethical problems required addressing some form of ontological questions. For example, the assessment of the subject's sanity when committing a particular offense required criteria of sanity, which inevitably affected issues of biology, neurophysiology, psychology, etc., i.e. purely psychological aspects. In bioethics, especially the connection of axiological and ontological moments comes to the fore, a tradition of a kind of onto-axiology is being formed, i.e. the image of axiology, essentially rooted in various kinds of ontological - biological, medical, social - problems.
At the same time, a significant disadvantage of bioethics, as it is becoming increasingly obvious, is attempts to solve complex transdisciplinary problems without developing a new deeper ontology, but constantly limiting themselves to a conventional approach, i.e. the results of some agreement, compromise between representatives of different disciplines and strata of society. Such a line can be called the conventionalization of ontology.
As a result, an important and correct trend of movement towards ontological-axiological synthesis begins to connect more and more with the conventionalization of ontology and ultimately leads to atrophy in bioethical research of issues of ontology, epistemology and logic. A certain technology of
socio-cultural communication comes to the fore, by means of which they hope to solve all the metaphysical issues of the phenomenon of life. But it doesn't happen that way. If there is no Kant, no community of philosophy teachers and their communication will solve the problems of criticism of pure reason. In other words, it is necessary to develop the ontological and epistemological problems of philosophy, biology and medicine independently within the framework of full-fledged scientific research, and such research cannot be replaced by any communications of those subjects who are not directly engaged in these problems.
Biophilosophy can be understood not just as the philosophy of biology, but as a branch of philosophy that puts the phenomenon of life in the center of its attention, considering life as a universal ontological state that necessarily arises in being. There is a real opportunity in the treatment of male and female infertility, prenatal diagnosis of congenital malformations and hereditary diseases, saving the lives of previously doomed children.
Contrary to expectations, new technologies that have emerged on the basis of biology and genetics, biochemistry and physics are not always perceived unambiguously by society, they cause not only admiration, but also stubborn opposition, since they do not fit into traditional ideas. Nevertheless, the expediency of using new technologies can be determined by such concepts as need, efficiency, risk, cost, morality and law.
Factors of bioethics development:
1. Rapid development of fundamental sciences in the second half of the XX century. The biggest event of the late 1990s was the decoding of the structure of the human genome. There were subsidiary sciences: genomics and proteomics. Cytology has achieved great success. It is enough to mention the discovery of the receptor apparatus, the deciphering of the structure of the cytoplasmic membrane, the phenomenon, etc. In immunology, the mechanisms of cellular cooperation, the role of cytokines, the mechanism of apoptosis, etc. have been deciphered.
2. Rapid, sometimes aggressive introduction of new theoretical discoveries into medical practice. Methods of artificial fertilization, the use of so-called surrogate mothers have been created and widely spread. Particular attention was drawn to the success in cloning warm-blooded, by transferring the nucleus of a somatic cell into an egg cell devoid of a nucleus, followed by carrying a fetus by a surrogate mother.
3. Unpredictability, or uncertainty, of the consequences of the widespread use of medical achievements. Today it is difficult to foresee what social shifts tissue cloning will lead to, which in the future will probably be available only to rich people.
4. Tragedies of humanity that occurred as a result of ignoring or underestimating the principles of humanity, ethics, morality and law in medicine.
The main principles of the European Convention on Bioethics are the autonomy of the individual; the priority of the patient's interests over the interests of science and society. It is extremely important to provide all citizens with decent medical care, regardless of their property status. The problem of informed consent is considered in detail. The main ethical positions related to organ and tissue transplantation, genetics, and research on embryos are determined.
The convention omits such acute problems as abortion, human cloning, etc. due to the fact that some of them, in principle, do not have a satisfactory solution (in particular, abortions), while others, such as, for example, genetic identification of the entire population with the creation of a single data bank, require public discussion and decision-making.
Domestic and foreign practice has shown that any measures restricting the possibility of legal abortion lead to an increase in criminal abortions with all the ensuing consequences. At the same time, the practice of reasonable regulation of abortion in late terms always gives positive results.
Assisted reproductive technologies (ART) are developing so rapidly that in a little more than two decades, humanity has gone from the inevitability of the divine curse - infertility to almost completely taking over the sacrament of human conception. More than a million children conceived in vitro have already been born, in some countries three or four out of every hundred newborns were conceived as a result of the use of ART. But today ART is not only a way to overcome infertility, it is a basic technology for the prevention of hereditary and chromosomal diseases, cloning, etc. promising areas of biology and medicine.
Cloning is the transfer of embryonic and somatic cell nuclei into enucleated oocytes. The cell obtained by electrofusion was called the "reconstructed oocyte". It has been shown that the potency for the development of an oocyte formed from an embryonic donor cell is 20 times higher than that of a somatic one. It also turned out that the younger the cell, the better it is cloned, in other words, the potential for cloning decreases as the body ages: embryonic cells are best cloned, then fetal, newborn cells, and only then an adult.
Transgenesis involves transferring the DNA of one animal into the adult organism of another, resulting in animals with new properties. Already today, bioreactor pets have been obtained, the milk of which contains medical preparations. Obtaining these drugs from the milk of transgenic animals is much easier and cheaper than using synthetic, bacterial or cultural bioreactors. However, the efficiency of transgenesis is still very low today - less than 1% of animals can be made transgenic. For this reason, the subsequent cloning of such animals can be considered a way out.
Embryonic stem cells (ESCs) are another aspect of cloning. The pluripotency of embryonic cells, that is, their ability to develop into any cells of the body and replace any damaged differentiated cells, made the idea of their use
for therapeutic purposes invaluable. However, it is possible to obtain a sufficient number of ESCs only by cloning. Of practical interest is the cloning of a somatic, that is, a differentiated cell with known properties. Currently, clones have been obtained from somatic cells of sheep, calves, pigs, mice, etc.
Thus, ART has become not only a method of infertility treatment, but also a supplier of material for the implementation of truly fantastic biotechnologies, such as cloning, transgenesis or ESC therapy.
Information about artificial insemination and embryo implantation, as well as about the identity of the donor, is a medical secret. A woman has the right to information about the procedure of artificial insemination and embryo implantation, about the medical and legal aspects of its consequences, about the data of a medical and genetic examination, external data and the nationality of the donor provided by the doctor performing the medical intervention. In vitro fertilization is an expensive procedure. Most patients have to experience quite severe psychological trauma due to the lack of the desired result. Negative emotions associated with the collapse of hopes naturally generate dissatisfaction. In reproductive medicine, only the quality of the procedure itself can be discussed and guaranteed.
The considered aspects of the fruitful interaction of biophilosophy and bioethics in its various forms, indicate in our opinion that it is located in the frontier zone - the unfolding of the movement every time anew on the path of the beginning of philosophizing - every time a unique, but recognizable and desirable route for self-knowledge. "Philosophizing is the personal life basis of philosophy. It grows out of a fundamental philosophical mood." Every person feels the need for philosophizing to the extent that he is gripped by a philosophical mood of surprise, longing, horror, love, admiration, awe, doubt, despair.
References:
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4. Kurkin V.A. Modern aspects of chemical classification of biologically active connections of herbs / Pharmaciya. 2002. - №2. - P. 8-16.
