DOI: 10.17916/p64s3r
title: MEDICAL ASSISTANCE AND ORTHODOX TRADITIONS IN RUSSIA

description: The article examines the participation and assistance of the Orthodox
 Church in solving problems that allowed to give a scientific justification
 for the cooperation of health care and Orthodox religious institutions, to
 determine their role in the historical context and structure of modern
 healthcare in Russia. The article presents an algorithm for organizing
 sisters of mercy, their system of upbringing. Particular attention is
 given to the possibility of teaching the course "Foundations of
 Orthodox Culture" in secular educational institutions. Research
 materials can serve as a basis for the formation of morally sound
 positions of medical workers and the population on the main problems of
 medical activity. Based on the study, the authors published a series of
 articles in which the experience of the work of the Orthodox Church in the
 charitable sphere has been summarized. This experience can be used to
 create new charitable institutions, including those who provided medical
 assistance. In preparing the article, the authors used concrete
 historical, civilizational, formational and social methods of research
 that allowed us to uncover facts, phenomena and processes in the
 interconnection and unity of the past, present and future.  
description: The study was conducted in
 the methodological field of the sociology of medicine. The research
 program was of a multistage nature and provided for the use of a
 methodology based on traditional methods of socio-hygienic,
 medical-organizational and historical-analytical nature, adapted to the
 specifics of the purposes followed by statistical processing and data
 analysis. In the work to achieve the goal and implement research tasks, a
 number of methods of concrete sociology are offered: a survey, in-depth
 interviews, expert interviews, content analysis, a biographical
 method3.<br> The organizational chart of the interaction of Orthodox
 organizations and bodies of practical health, developed in this article,
 is based on historical traditions of the charitable activities of the
 Russian Orthodox Church. This scheme takes into account modern
 socio-economic realities. This scheme proved to be effective in the
 organization of medical care and can serve as a basic model for the
 development of cooperation between the Church and medical institutions.
 Given the deep historical evidence of the important role of Orthodox
 Christianity in preserving health and creating a healthy lifestyle for the
 population, it should be recognized that the development of special
 programs for cooperation between medical organizations and the Church is
 justified in modern conditions.
description:   <strong>I.
 INTRODUCTION</strong><br>  <br> State-church relations
 as a combination of historically emerging and changing forms of relations
 between state institutions and religious organizations are one of the main
 parts of the domestic and foreign policies of any state. Russia has always
 been a multi-confessional country, here all major religious confessions
 coexist: Christianity, Buddhism, Islam, Judaism. At the same time, in the
 modern Russian consciousness there is a close connection between Orthodoxy
 and national identity.  <br> 80-82% of the population of Russia
 consider themselves Orthodox. The role of the Russian Orthodox Church in
 the economic and social life of the country was significant throughout the
 history of the country until October 1917. Even in the Old Russian period,
 the spiritual foundations of charity were formed under the influence of
 selfconsciousness. Since the late 1980's. in our country, the gradual
 return of the Church to the sphere of charity and medical and social
 services began, the process of uniting the interests of the Church and the
 state in the field of protecting human health was intensified.  
 The main legal documents
 in this area were the "Fundamentals of Legislation on the Protection
 of Health of Citizens in the Russian Federation" of 1993 and the
 "Agreement on Cooperation between the Ministry of Health of the
 Russian Federation and the Russian Orthodox Church." The importance
 of the church mission in the health sector was expressed in the creation
 of hospital temples, church hospitals and an almshouse. The number of
 monasteries engaged in social activities is increasing, fraternities are
 being organized. At the same time, the catastrophic situation in the field
 of public health in Russia is growing. The state public health system is
 developing mainly around the world, the volume of medical care often
 increases without regard for quality.  <br> Many researchers believe
 that the public health system can not function effectively under the
 current conditions. In this connection, studies that reflect the
 relationship between the Church and medical institutions in modern Russia
 are of great importance.<br>   <strong>II.
 RESULTS</strong><br>  <br> The article shows the
 results, which testify that medical and social assistance to the
 population of Russia is mainly under the aegis of monasteries. The nature
 and scope of this assistance in different periods were not the same and
 depended on the policy of state power towards the Church. If at the
 initial stages of the country's development there were no other
 shelters for the sick and disabled, with the exception of monasteries. By
 the beginning of the 20th century, shelters occupied a leading position in
 state, public and charitable organizations. They created a unique system
 of medical and social assistance to the population. The church has been
 active in this area since the late 1980s, and both traditional and new
 forms and methods of medico-social and charitable work were
 realized.<br> The cooperation of the Church and the state in the
 field of health and social services, the legal basis of which is in the
 process of formation, testifies to the recognition of the Church in the
 life of Russian society, contributes to the expansion of social health and
 the participation of a wide range of people to solve health problems and
 revive the spiritual traditions of medicine. The Orthodox Church provides
 medical and social assistance to the following groups of people: terminal,
 somatic, mental, HIVinfected, drug addicts, patients with toxic and
 alcoholic diseases. The expediency of creating hospitals for religious
 confessions as a whole was recognized by 41.7% of doctors and 46.1% of
 patients.<br> In addition, it can be noted that the main types of
 institutions that are actively engaged in medical and social activities
 are: a) medical institutions of a stationary type, incl. hospitals
 operating under the Moscow Patriarchate, diocesan hospitals, monastery
 hospitals, hospitals in theological schools; (b) outpatient medical
 facilities, including first aid centers for religious schools, monastic
 medical posts; (c) Medical and social institutions. For example, the
 diocesan hospital of Saint Blessed Xenia helps orphans and elderly people.
 The average length of stay in the hospital is 31 days. Among the patients,
 pensioners were 95.4%, disabled people - 71.3%, lonely - 30.4%. The
 hospital staff was selected from among Orthodox believers. The
 satisfaction of patients with treatment is high (98.4%) and the ratio of
 medical personnel (100.0%).<br> A special form of medical and social
 activities of the Church are care centers (in 2016 in the Russian
 Federation, 14), designed for outpatient rehabilitation of mentally ill,
 alcoholics and drug addicts affected by totalitarian sects, psychics. The
 task of Orthodox priests and doctors is to closely cooperate in these
 centers. The course of rehabilitation takes an average of 1-2 years. In
 addition to institutions, the Church creates medical organizations that
 carry out their ministry in public medical and social institutions: for
 example, the society of Orthodox doctors; sisterhood of mercy, brotherhood
 of mercy, parish communities of hospital temples. The Society of Orthodox
 Physicians is a new form of association of medical workers for Russia on
 the basis of a religious community. Their goal is to provide medical and
 spiritual assistance to sick poor people, coordinate the activities of
 charitable brotherhoods and sisterhoods, organize a system of qualified
 diagnostic, therapeutic and preventive care for churchmen, discuss current
 medical problems in accordance with the canons of the Orthodox Church. For
 example, the society in Moscow consists of medical , scientific and
 educational and training departments. For the years 2000-2016. The number
 of people seeking help was about 25,000 people. Training courses for
 Orthodox doctors and psychologists have been organized.<br> Today,
 the centers of the sisters of mercy, organized in Russia in the XIX
 century, demonstrated their effectiveness. Based on the analysis of the
 development of nursing, five main stages (periods) of the movement of
 nurses in Russia were identified. The distinctive features of this
 movement were medical and social assistance, strict morality, love and
 charity toward one's neighbor, diligence and dedication, discipline.
 In 2016, there are about 40 communities and groups of sisters of mercy in
 Russia. An algorithm for creating a community of sisters of mercy is
 developed and conceptual principles of its organization are formulated.
  <br> The main thing is to find a job for a sister, where she can
 perform church obedience in addition to medical, within the framework of
 jointly developed contract documents regulating the status and order of
 service in the conditions of a particular institution. Clearly organized
 sisterhoods, consisting of religious, morally educated and at the same
 time professionally trained sisters, can undoubtedly provide more
 effective assistance to public health institutions and social workers,
 since there is a shortage of medical specialists of junior and middle
 level.<br> The activities of nurses, based on Christian charity,
 combine medical care with spiritual care for the patient. The main goal of
 the sisterhood was to strengthen the moral and spiritual foundations of
 society.<br> As a result, today the revival of the brotherly and
 sister movement is an objective process of returning to traditional forms
 of religious life in Russia. At the same time, the current socio-economic
 situation in the country does not allow many Orthodox movements and
 organizations to revive the church and social life and fully understand
 the tasks of social services.<br> Despite the positive results in
 the social and philanthropic activities of individual brotherhoods and
 sisterhoods, the author believes that the revival of the sister movement
 is associated with the same problems that led to the suspension of the
 work of Orthodox brotherhoods. Today, 150 brotherhoods and sisterhoods
 registered with the Ministry of Justice of the Russian Federation operate
 independently and in isolation, without information and
 coordination.<br> However, despite the artificial suppression of the
 fraternal movement, the Unions of Orthodox brotherhoods should be
 attributed to institutions that seek to mobilize community and church
 organizations to jointly solve social, spiritual and ethical problems. In
 these unions, new technologies are being developed in various fields of
 medicine.<br> Thus, history shows that such forms of Orthodox life
 as brotherhood and sisterhood, unlike secular and some church
 institutions, can not be created or canceled only "from above".
 They are based on believers and want to fulfill one or another church
 ministry together.   <strong>III.  DISCUSSION</strong><br>
        <br> Some aspects of the participation of the Russian
 Orthodox Church in protecting public health were examined in the works of
 Mirsky MB, Pospelovsky D., Siluyanova IV, Filimonova SV, Cherkasova AE.
 and other domestic scientists. However, few works are devoted to a
 comprehensive study of the interaction of the Russian Orthodox Church with
 medical personnel. Almost in the scientific literature, there was no
 analysis of the participation of the Russian Orthodox Church in protecting
 the health of the population of the Voronezh Region.       <br> The
 author of this article proposes to classify various aspects of the
 historiography of this problem by periods. The first historiographical
 period - from the beginning of the XIX century to the 70-ies. At that
 time, a complex historical work was carried out to collect and publish
 materials that had the character of historical data, reference data, the
 Charter of various institutions of public charity and education. Studies
 were often onesided and subjective, devoid of profound scientific medical
 analysis.       <br> The second historiographical period from the
 70s. XIX century until 1917. During this period, a great leap was made in
 historical science for the collection, processing and publication of
 official documents and extensive factual materials, as well as
 bibliographic indexes. In the works of EE Golubinsky, AP Dobrolonsky, SG
 Runkevich, Runovsky, Znamensky, Klyuchevsky, Barsov, FV Blagovidov, B.
 Titlipov, B.II. Kudryavtseva, Papkova, Prugavina, Makariya (Bulgakova),
 Berdyaeva, various aspects of the development of medical charity were
 systematized. Scientists also considered the medical and social role of
 church parishes in the development of assistance to the needy.      
  <br> There was a significant amount of biographical work, about the
 most vivid representatives of the parish clergy and their ministry.
 Statistical information on the total number of medical societies and
 fraternities in the Russian Empire is also found in the encyclopedia
 "Russia", published in 1898.<br> A valuable group are
 modern published reports and surveys that contain data on the history of
 the church and statistical work. Therefore, the relevance of studying the
 problems associated with the embodiment of Christian ideals in medical
 practice, both public and secular authors, is topical.<br> Thus, in
 this article, all of the above indicates the necessity and importance of
 scientific research, conducted in terms of a systematic approach, in-depth
 analysis, justification and implementation of results in educational and
 medical institutions.<br>   <strong>IV.  CONCLUSION</strong><br>
  <br> Currently, the medical and social charitable activities of the
 Russian Orthodox Church are actively developing. The cooperation of
 Orthodox organizations with medical institutions can give such positive
 results as: the revival of the spiritual traditions of medicine; awareness
 of the interdependence of man's spiritual and physical health;
 attraction of additional financial, organizational and especially human
 resources for medical care; formation of morally grounded positions of
 medical workers and the population on the main problems of medical ethics
 (bioethics); formation of a healthy lifestyle of the population and
 combating the spread of bad habits; expansion of the base of social health
 and involvement of the general public in solving health
 problems.<br> The views of doctors and patients on the problems of
 clinical ethics (the relationship between a doctor and a patient,
 including the ethics of informing, obtaining informed consent for
 treatment, confidence indicators, medical secrets, etc.) are not very
 dependent on their attitude to the Orthodox faith. In the performance of
 their duties, most doctors prefer professional views on
 medicine.<br> The opinions of many doctors and patients about modern
 medical technologies are not yet formed, they have no solid moral
 justification. There are significant differences in the assessment of
 modern biotechnology of doctors and patients, depending on their religious
 affiliations, and the views of church members are more in line with the
 norms of religious morality and medical ethics.<br> The
 organizational chart of the interaction of Orthodox organizations and
 bodies of practical health, developed in this article, is based on
 historical traditions of the charitable activities of the Russian Orthodox
 Church19. This scheme takes into account modern socio-economic realities,
 has proved effective in the organization of medical services and can
 become a basic model for the development of cooperation between the Church
 and medical institutions.<br>   <strong>REFERENCE
 LIST</strong><br>  <br> American Medical Association,
 Council on Ethical and Judicial Affairs, Ethical considerations in the
 allocation of organs and other scarce medical resources for patients.
 Archives of Internal Medicine. (1995)  № 155.  Pp. 29-40.<br>
 Benrubi, G. I., (1992) Euthanasia - the Need for Procedural Safeguards. 
 New England Journal of Medicine. № 326/3. 198 p.<br> Cyril,
 Metropolitan. (2000) On the «Fundamentals of the Social Concept of the
 Russian Orthodox Church» The Anniversary Bishops' Council of the
 Russian Orthodox Church. Collection of reports and documents. Pp.
 133-149.<br> Dmitrieva, (1998) T.B. On urgent measures to implement
 the Concept of the Development of Health Care and Medical Science in the
 Russian Federation.  Problems of Social Hygiene and the History of
 Medicine.  № 1. Pp. 25-28<br> Glushkova, V.A. (1985) Medical error
 and accident in medical practice.  Clinical surgery. № 1.  Pp. 63
 64.<br> Gromov, A.P. (1988) Medical duty, medical responsibility,
 medical secret Deontology in medicine. Pp. 73-122.<br> International
 Commission on Occupational Health (ICOH). International Code of Ethics for
 Occupational Health Professionals (1992)  Bull. Med. № 82. Pp.
 9-11.<br> Ivanov, A.E. (1993) Mental Health of the Population:
 Demographic Aspect.  Health Protection of the Russian Federation. № 12.
 Pp. 7-11.<br> Karpov, A.S. (2002) On the interaction of state
 bodies, health services and the Moscow Patriarchate of the Russian
 Orthodox Church.  Health. № 12. Pp. 12-16.<br> Kondratiev,  F.V.
 (2001)  Orthodox-ethical aspects of euthanasia.  Orthodoxy and problems of
 bioethics. 98 p.<br> Largey G., (1978) Reproductive technologies:
 sex selection  Reich W. T. (ed.). Encyclopedia of bioethics.-The Free
 Press, New York. Pp. 1439-1443.<br> Matveev, G.N. (2001) The modern
 hospital and the rights of the believer.  Sisterhood. № 2. Pp.
 38-39.<br> Miller, F. G., (1994) Regulating Physician Assisted
 Death, New England. Journal of Medicine. № 14. 120 p.<br> Health
 Reforms: Problems and Prospects (2001)  Orthodoxy and Bioethics. Pp.
 91-95.<br> Shchepin, О.P. (2001) Problems of health of the
 population of the Russian Federation and its forecast for the period up to
 2005.  Problems of social medicine, public health services and history of
 medicine.  № 3. Pp.  3-10.<br> Shevchenko, Y.L. (2000) Priority
 tasks of the Russian public health services for 2000. Bulletin of
 compulsory medical insurance. № 1. Pp.  4-6.<br> Siluyanova, I.V.
 (1998) Modern Medicine and Orthodoxy. Moscow: Publishing House of Holy
 Trinity Sergius Lavra. 296 p.<br> Sorokina, Т.S. (1994) Russian
 Sisters of Mercy in the Crimean campaign of 1854-1856. Problems of social
 hygiene and history of medicine. № 6.  Pp. 51-53.<br> Vasileva, O.Y.
 (1993)  Russian Orthodox Church and Soviet Power in 1917-1927. Voprosy
 istorii. № 8. Pp. 40-54.<br> Vlasov,  P.V. (1987) History of the
 formation of nurses in Russia. Med. sister. № 3. Pp. 248-249.