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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">bekhterev</journal-id><journal-title-group><journal-title xml:lang="ru">Обозрение психиатрии и медицинской психологии имени В.М.Бехтерева</journal-title><trans-title-group xml:lang="en"><trans-title>V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2313-7053</issn><issn pub-type="epub">2713-055X</issn><publisher><publisher-name>V. M. BEKHTEREV  NATIONAL  RESEARCH  MEDICAL  CENTER  FOR  PSYCHIATRY  AND  NEUROLOGY                           OF    THE  RUSSIAN  FEDERATION   MINISTRY  OF  HEALTH</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.31363/2313-7053-2018-4-108-116</article-id><article-id custom-type="elpub" pub-id-type="custom">bekhterev-222</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>В ПОМОЩЬ ПРАКТИКУЮЩЕМУ ВРАЧУ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>GUIDELINES FOR THE PRACTITIONER</subject></subj-group></article-categories><title-group><article-title>Этические проблемы информированного добровольного согласия у больных шизофренией в связи с особенностями их когнитивного функционирования</article-title><trans-title-group xml:lang="en"><trans-title>Ethical issues of the informed consent procedure in schizophrenia patients in view of cognitive dysfunction</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Семенова</surname><given-names>Наталия Владимировна</given-names></name><name name-style="western" xml:lang="en"><surname>Semenova</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"/><email xlink:type="simple">nvs@bekhterev.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Янушко</surname><given-names>Мария Григорьевна</given-names></name><name name-style="western" xml:lang="en"><surname>Yanushko</surname><given-names>M. G.</given-names></name></name-alternatives><bio xml:lang="ru"/><email xlink:type="simple">yanushko@list.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Яковлева</surname><given-names>Юлия Александровна</given-names></name><name name-style="western" xml:lang="en"><surname>Iakovleva</surname><given-names>A. Iu.</given-names></name></name-alternatives><bio xml:lang="ru"/><email xlink:type="simple">yya.08@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр психиатрии и неврологии имени В.М. Бехтерева, Санкт-Петербург</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.M.Bekhterev National Research Medical Centre for Psychiatry and Neurology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>24</day><month>02</month><year>2019</year></pub-date><volume>0</volume><issue>4</issue><fpage>108</fpage><lpage>116</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Семенова Н.В., Янушко М.Г., Яковлева Ю.А., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Семенова Н.В., Янушко М.Г., Яковлева Ю.А.</copyright-holder><copyright-holder xml:lang="en">Semenova N.V., Yanushko M.G., Iakovleva A.I.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.bekhterevreview.com/jour/article/view/222">https://www.bekhterevreview.com/jour/article/view/222</self-uri><abstract><p>Получение информированного согласия является ключевым компонентом биомедицинских исследований. Психиатрические пациенты относятся к уязвимой категории, у них часто имеет место конфликт между необходимостью соблюдения автономии и ограничениями данной автономии вследствие заболевания. Для пациентов, страдающих шизофренией, характерно снижение параметров когнитивного функционирования, связанных со способностью к восприятию информации и принятию решений. С другой стороны, оспаривание правомерности получения согласия у лиц, страдающих тяжёлыми психическими расстройствами (например, шизофренией) и, тем самым, отлучение их от участия в исследованиях, может расцениваться как дискриминация, несправедливое ограничение для них доступа к достижениям научно-технического прогресса в области медицины. Потенциальные сложности в проведении процедуры получения информированного согласия у пациентов, страдающих шизофренией, можно разделить на три основные категории: 1) факторы, связанные с пациентом; 2) факторы, связанные с протоколом 3) факторы, связанные с врачом\исследователем. Как исследователи, так и клиницисты должны быть в курсе этических проблем, связанных с принятием решений пациентами, страдающими шизофренией, заболеванием, которое потенциально способно снизить уровень автономии, влияя непосредственным образом на когнитивные функции, отвечающие за принятие решений.</p></abstract><trans-abstract xml:lang="en"><p>Te procedure of obtaining the informed consent plays the crucial role in biomedical studies. Psychiatric patients refer to the vulnerable category of subjects, as there is an obvious conﬂict exists between the necessity of compliance to the subject’s autonomy rules and the restrictions of this autonomy caused by the illness. Schizophrenia patients suﬀer from cognitive dysfunction in diﬀerent domains, which inﬂuence their ability to comprehend the information and to make decisions. From the other hand, arguing the appropriateness of informed consent obtaining in patients with severe mental disorders (e.g. with schizophrenia) and, thus, limitation of their ability to participate in clinical trials, can be considered as an equitable limitation of their access to the latest achievements of medical science. Potential difculties in obtaining informed consent in schizophrenia subjects can be divided into three categories: 1) subject related; 2) protocol related; 3) investigator/physician related; Both the investigators and the physicians must be acquainted with the potential ethical issues that can inﬂuence the decision making ability in schizophrenia subjects due cognitive dysfunction and the decline in subject’s autonomy level.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>этика</kwd><kwd>информированное согласие</kwd><kwd>уязвимые пациенты</kwd><kwd>шизофрения</kwd><kwd>когнитивное функционирование.</kwd></kwd-group><kwd-group xml:lang="en"><kwd>ethics</kwd><kwd>informed consent</kwd><kwd>vulnerable subjects</kwd><kwd>schizophrenia</kwd><kwd>cognitive functioning</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Иванюшкин А.Я., Тихоненко В.А. 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