DOCTOR-SURGEON AUTONOMY. RELEVANCE, SPECIFICITY, PROBLEM. LITERATURE REVIEW
Introduction: Currently, many scientific and popular scientific works are devoted to the relationship between patients and doctors, which substantiate the principle of personal autonomy, while only the patient's autonomy is taken as a basis. The autonomy of the doctor himself is unfairly ignored, which in the eyes of the public and the medical community itself creates a picture of the lack of rights of the medical worker, significantly reduces his self-esteem and, finally, affects his status in society. Knowledge, understanding and respect for the boundaries of the doctor's autonomy contributes to the increase and awareness of the importance of the special role of the medical worker in society, which will certainly motivate the provision of high-quality medical care. Objective: To study the relevance and identify the specifics of the problem of the autonomy of the surgeon. Search strategy: A retrospective analysis of the literature was performed. For use by: Pubmed, Google Academy, elibrary.ru. Search strategy for the question: «Тhe relevance and problems of the autonomy of the surgeon». The following keywords were used: doctor, personal autonomy, surgeon's autonomy, patient, conflict of interest, medical-clinical thinking (MeSH Terms: doctor, surgeon autonomy, patient, conflict of interest, medical-clinical thinking). The search depth was not limited. Criteria for inclusion of publications for information: publications that are available in full-text, in Russian and English, and that carry statistically verified conclusions. Exclusion criteria: summary of reports, newspaper publications, personal messages. Results: Personal autonomy - the basis of the principle of personal autonomy is the recognition of its independence and the right to self-determination. The main postulate in the Declaration on the Independence and Professional Freedom of the Doctor, adopted in 1986 at the World Medical Assembly in California, USA, is the principle of the doctor's freedom from outside interference in the course of medical activities. «The independence of the professional medical and ethical decisions of the doctor in the treatment and care of the patient should always and everywhere be protected and protected» and develop medical and clinical thinking. Medical and clinical thinking is a medical view of the disease, a set of practical skills that guide the doctor and a creative thought process that constantly solves problems. It should be noted that the reforms in healthcare have changed the social status of medical workers. When it is changed, a conflict is inevitably formed, for the prevention of which a legislative framework is necessary. Conclusions: The main goal of the professional autonomy of a surgeon is freedom in making decisions in order to provide high-quality medical care. The expansion of the types of control and the rights of patients to the detriment of the rights and professional autonomy of the doctor leads to a deterioration in the quality of surgical care.