Abstract The main topic of this review is invasive procedures used in the Russian healthcare without sufficient indications. This topic is interconnected with paternalism, disregard for the principles of informed consent, professional autonomy and scientific polemics. In conditions of paternalism, misinformation of patients, persuasion and compulsory treatments are regarded to be permissible. In the healthcare, partly due to low wages, various kinds of unofficial payments have become widespread. In conditions of legitimacy and high ethical standards, market economy stimulates a sound competition of constructive ideas, innovations and treatment quality. When laws, regulations and ethics are disregarded, the competition turns towards discrediting the free healthcare, manipulation to paid services, harassment of non-paying patients. Public acceptance of corruption in the healthcare is acknowledged in the most recent publications, despite generally declining transparency. Military functionaries and their relatives will become more dominant thanks to the war in Ukraine and Russia. Those participating in it, factually or on paper, are obtaining the veteran status and privileges over fellow-citizens. Some of them will occupy leading positions at universities and other institutions without adequate preparation and selection. Military and medical ethics are not the same. One of the motives to overuse invasive procedures is personnel training under the imperative of readiness for war. The low life expectancy in Russia is a strategic advantage: fewer pensions to be paid, less heathcare investments. Considering shortcomings of medical practice, research and education, governmental directives and increase in funding are unlikely to be a solution. Measures for improvement of the healthcare in Russia must include participation of authorized foreign advisors.
Sergei V. Jargin (Tue,) studied this question.