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May 24, 1995

Guarding the Integrity of Medical EthicsSome Lessons From Soviet Russia

Author Affiliations

From the Center for Clinical Bioethics and the Departments of Medicine and Medical Ethics, Georgetown University Medical Center, Washington, DC.

JAMA. 1995;273(20):1622-1623. doi:10.1001/jama.1995.03520440076042

Now that the Soviet regime is defunct, the record of the depredation it visited on its own people is becoming better known. A plethora of evidence now documents the devastations of the public's health and environment, which Russians inherited from their many years of communist rule.1,2 The Letter From Saratov in this issue of JAMA3 not only confirms that devastation, but also points to something equally disturbing—the consequences of the subversion of medical ethics to the ideology of the Marxist-Stalinist state.

See also p 1569.

Two important lessons can be learned from this depressing story. First, corruption inevitably afflicts any health care system not designed with care of the patient as its primary driving force. Second, medical ethics must maintain independence from political exigency. These lessons are closely linked; indeed, a morally responsive profession might have prevented or ameliorated some of the disastrous consequences of the ideologically and

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