613
necessary639591011060113166219265312365406468
information1134591011065125165225265358412445478539599
about1763591011084145205265298
the2091591011065125178
neurosonography2299591011091144204244304350410470530591630684743805866
has3192591011091146192
already3414591011084117157211264324386
been3828591011091145198257
provided4115591011091133193253287347400460
to4605591011064124
her4759591011091145184
during4973591011091151192225285346
the5348591011064124179
informed63972901103393133193233326379439
consent1108729011065125185232285344378
process.1516729011072112172225279325373403
Mentioning19617290110106160219253286346406440500560
the2550729011045105158
lack273872901104599152211
of2979729011072113
time312272901104780174227
for3379729011052112152
further3560729011052112152184244298338
discussion,3927729011072105152205265312360393453513543
the4500729011046106159
doctor4689729011072132185218278318
leaves503772901104598151211264310
for5377729011052113153
the63986701103393147
staff81686701105993146186223
room.1069867011053113173266296
Twenty1395867011086164218277310373
minutes1810867011093126187247280333380
later,2220867011046100133186226251
the2501867011046106159
child's2690867011066126159193253275320
mother3054867011094154187247301340
posts3424867011073133180213260
a3714867011066
negative3810867011073126186239272305366419
message4272867011093146193240293352406
in4707867011047107
a4844867011066
parent4940867011073126166220279312
chat,5282867011067127181214244
prompting6391005011060100160253313347380440500
numerous11681005011084144237291331390450497
comments16951005011077136231324378437471517
from22421005011065105164257
other25291005011084118178231271
parents.28291005011084138177231291324371401
The32601005011097157210
situation35001005011070104137198251284317377437
is39671005011058104
actively41011005011078131164197257311343405
discussed45331005011084118164218278324371424484
on50471005011084144
social52211005011070130184217271304
media6391143011093147207240293
for9621143011040100140
several11311143011047100160214253307339
days.15001143011060115177220250
Explain6391281011073133194228281314374
why10521281011086146207
the12851281011042102155
doctor14711281011068128182215275315
violated18161281011069102162196249282335395
both22411281011069129162222
ethical2493128101106295155188242294327
and28501281011062122182
legal3063128101104195155208240
norms.33331281011069129169262309339
What371012810110114174227260
should40001281011056116176236269329
the43591281011042102155
doctor45441281011068128181214274314
have48881281011068122181234
done51521281011068128188243
in54241281011043103
this639141901103393127174
situation?843141901104680114174227260294354414466
Task6391700010880130176243
4.912170001086090
Discussion6391838010887120167220286333380413474540
of1210183801086099
the13391838010840107160
text.1529183801084093152192222
N.6392066010887117
N.78620660108105135
Blokhin149512066010899133193259327360427137820360744081
"A14592064011049136
conversation16172064011070130190250303344390444476510570630
with227720640110103137170230
a25372064011070
patient26372064011076130163196250309343
should30102064011063123182242275335
always33752064011071103190243304348
be37532064011077130
based39132064011077130176231290
on42332064011077137
the44002064011050110163
desire45932064011076130176209249303
to49252064011050110
best50652064011077130177210
help53052064011077130163223
them.639220201103393147240270
The9402202011073133187
degree11562202011062116176215269322
of15072202011063103
detail16402202011061115148201235268
to1939220201103595
which20672202011087147180233293
the2390220201103494148
patient25682202011062115148181235294328
should29262202011049109168228261321
be32772202011063116
informed3422220201103696136196236329382442
depends38942202011062115175228288348394
largely4318220201103689129186240273334
on46822202011060120
their4832220201103595149182222
character50842202011055115168209262314347402441
and6392340011053113173
behavior.8422340011060113173226285319379420442
Many63924780110107160220281
cancer9472478011074127186241293333
patients,13102478011079133166199253312346392422
when176224780110106166220279
they20712478011052112166228
come23262478011073132226279
to26352478011052112
the27772478011053113166
doctor,29732478011080140193226286326351
already33542478011073105145199252312374
have37562478011079132192246
an40322478011072132
idea41942478011053113166220
of44432478011079119
the45922478011057117170
nature47922478011079132165225265318
of51402478011079119
their52892478011052112166199239
disease,639261601106093140193247293346376
look10452616011046106166226
at13012616011067100
the14312616011046106159
doctor16202616011073133187219279319
with19822616011087120154214
fear22262616011053106159198
and24542616011066126186
hope,26702616011074134194247277
and29772616011066127187
are31942616011066106159
ready33822616011053106160219282
to36902616011047107
agree38272616011066127167220272
to41292616011046106
any42672616011066126187
testing44812616011047100147180213273335
and48452616011066126186
treatment5061261601104686139192225318372432466
methods6392754011093147180240300360407
proposed.10762754011066106166226286332385445475
When158727540110113174227286
meeting19092754011094147200233266327387
with23312754011087120154214
such25752754011053113166226
patients,28312754011065119152185240299333379409
the32702754011040100153
doctor34532754011066126179212272312
should37952754011052112172232266326
not41512754011066127160
exacerbate43412754011060119174226279319379432465518
their4889275401103999153186226
anxiety,51452754011059119179213267300360380
given639289201106092152205265
the9342892011041101154
severity11182892011053107166221260294327389
of15352892011067107
the16722892011040100153
disease.18552892011068102148202255301354384
It2269289201104880
is2379289201104187
better24962892011068121154187241280
to28062892011041101
instill29372892011040100147180214247281
optimism32482892011067127161194287320367461
by37392892011067128
explaining38942892011060119180214267300360394454514
that44372892011040100154187
the46542892011040100154
tumor48382892011040100193254294
may51682892011094147213
be54092892011067121
benign.6393030011060113173206266325355
However,6393168011087147233286346399439464
it1133316801106699
is12633168011065112
necessary14053168011093146199251298344398438498
to19313168011067127
firmly20883168011072105145238272333
insist24493168011065125172205253286
on27653168011093153
carrying29483168011085139178218280311371432
out34093168011092152186
all36253168011086118152
the38073168011066126179
necessary40163168011092145198252298345398438500
research45433168011073126172226279319373432
and50053168011086145205
those52403168011066126186234287
treatment639330601103373127179212306359419452
methods11213306011093147180240300360407
that1558330601103393146180
are1768330601105393147
necessary19443306011060113166220266313366406468
in2439330601103494
this2563330601103394127174
case.27673306011053106152206235
It's63934440110407295140
a8093444011063
different9023444011069102142181234273327387420
matter13623444011093147180213267307
if1698344401104383
a18113444011062
patient19033444011069123156189243302335
suffering22683444011057117157194247288321381441
from,2738344401104990150243273
for30413444011049109149
example,32203444011062122176269329363416446
stomach3696344401105689149243296349409
cancer,41353444011062115175228281320345
upon45103444011070130190250
hearing47903444011069122176216249309370
from5189344401104989153247
a54663444011063
doctor6393582011060120173206266306
that975358201103797150183
it's118835820110377193138
an13563582011057117
ulcer,1503358201106396150203242267
refuses1800358201104397137197244297343
the2173358201103797150
necessary23533582011063117169223269316369409471
surgery,28523582011050110150208262301362382
citing3264358201105790123157217278
the3571358201103797150
fact3751358201104397149182
that3963358201103797150184
gastric41773582011064118164197237271324
ulcers4531358201106396150203242289
can48503582011056110170
be50503582011063117
treated5196358201103777130183216269330
with6393720011087120153213
medical8913720011093147207240293346379
methods.13083720011094147180240300360407437
In17753720011050108
such19133720011055115168228
a21713720011061
case,22623720011062114161215245
it's253737200110417597142
essential27093720011062108155208268301335389422
to31613720011042102
discuss32933720011068102148202262308355
the36783720011042102155
possible38633720011068128175222255315349402
malignant43033720011093147180213273332386445479
transformation4812372001104181135194241281341381475528561594655716
of6393858011060100
the7693858011042102156
stomach955385801105689149242296350410
ulcer13953858011069102156210249
or16753858011069109
even18143858011064124177236
mention20903858011093146206240273333393
that25133858011043103158192
there27353858011044104157197250
are30153858011064103157
already3202385801106396136189243302364
signs3594385801105690151210256
of38803858011070111
malignancy.40303858011094147180214275334387447501561582
This46433858011083143176223
means49063858011093146200260306
doing52423858011070130163223285
everything6393996011053113166206267298358392452513
possible11813996011088148194241274335368421
to16323996011061121
ensure17833996011081140187247287340
the21533996011060120174
patient23573996011087140173206260320353
doesn't27403996011088148201247307329362
avoid31323996011081141201234294
necessary34563996011088141194247293340393433495
treatment39783996011061101154207240334388448481
and44893996011081140200
instead47193996011061121168201255308367
uses51163996011088134188234
all53803996011080113146
available6394134011053113166199232286345379432
means11014134011093147200259306
to1437413401103393
save15604134011047102161214
their1804413401103395148181221
life.2055413401103366107160189
A6394272011087
patient's7534272011060113146179233293326349394
refusal1177427201104598139199245299331
of15384272011065105
surgery16734272011051111151210262302364
based20654272011064118164217277
on23724272011064124
misinformation,25314272011094127174207267307367407500555588621681741771
ostensibly33324272011065112145198258305338401434496
for38554272011045105145
ethical4029427201105891151184239292325
reasons,4384427201104598152198258318365395
negates48094272011064118178230263317363
ethical5202427201105992152185239293326
principles,6394410011060100133193247279339373426473503
which117244100110120180213266326
always15294410011087120206260321367
place19264410011093127180233286
the22434410011066126180
patient's24534410011093147180214267327360383428
interests29114410011067127161214254307353386433
above33744410011088148208268321
all37254410011088121154
else.39094410011087120167220250
Therefore,419044100110107168221260314353413453507536
from47574410011073113173266
a50534410011088
ethical51714410011088121181214268320354
standpoint,639454801104780133193253313373407467500530
an11994548011063123
oncologist13524548011069129182242275335395428474508
shouldn't18914548011056116176236270330390412444
always2365454801106396182236297342
be27374548011069124
solely28904548011056116150203236298
concerned32154548011064124184237290330390444503
with37574548011087120154214
sparing40014548011056116169209242303363
the43934548011043103156
patient's45794548011069124157190244303336358404
psyche.50134548011069116178229290343373
In54164548011050110
some6394686011047107200253
cases,9224686011073125172225271301
if1253468601105393
the13764686011052112166
patient's15714686011079133166199253313347368414
interests20154686011052112146199239292338371418
require24634686011059113172232265305359
it,2852468601105286116
they29984686011053112165226
may325146860110113166228
even35064686011073132187246
intimidate37824686011053113146180273307367420453507
them43184686011053113166259
somewhat,46074686011066126219273359419472505535
so51724686011066126
that53284686011053113165198
refusing639482401104093132192239272332393
necessary10614824011060114166220266313366406468
treatment1557482401103374128180213306361421454
won't20414824011087147207228260
later2331482401103487120175214
be25754824011060114
on27184824011060120
the2868482401103393146
doctor's30444824011061121175207267307330375
conscience.34494824011054113173220273306360420474526556
Some6994962011067127220274
foreign10034962011042102142194227287346
clinics1379496201105689122182216269316
require1725496201104295154215249289342
patients20964962011063116149182236295329375
to2501496201103696
be26274962011063116
told2773496201103595128188
the2991496201103696148
truth3168496201103676136169229
about34274962011056116176236269
their3726496201103696149182222
illness.3978496201103668101162215261308337
This43464962011073133167213
is4589496201103683
often47024962011063103136189249
justified4981496201103595142175208248281335398
by54094962011062122
considerations6395100011053113173219253313366406459492525585645692
such13615100011047107160220
as1611510001105399
the1740510001103494148
need19185100011060113166225
for21735100011040100141
a23445100011053
terminally2427510001103386127220254314367400433495
ill2949510001103467101
patient30815100011060114146180233293326
to3437510001103494
manage35615100011093147207260320372
their3963510001103393147180220
property,42125100011060102162222275314347408429
etc.4671510001105487140170
It639523801104072
seems74152380110109162216309356
that11275238011096156209242
doctor-patient139952380110123183236269329369411470524556590643703736
relationships216552380110103156189242275309369429475536569629676
should287152380110109169229289322382
never328352380110123176236289328
be364152380110122176
formulaic,384652380110102162202295355390443476529559
and443552380110116175235
that47005238011096156209242
obligatory497252380110123183216249310362395455496557
communication6395376011053113206300360420453507560592626686746
of14155376011096136
the15815376011069129182
entire17935376011088147181214254308
truth21305376011069109169202262
about24225376011090149209269303
a27555376011089
patient's28745376011095149182214267327361382428
illness33325376011069102136196249296343
is37055376011069116
just38515376011069129175208
as40895376011090139
unjustified42575376011095155189249295329362403436489549
as48365376011089135
obligatory50015376011096156188222282334367427467529
communication6395514011053113206300360420453507560592626686746
of14155514011068108
untruths.15535514011068128162202262295356403433
The20165514011082142195
degree22405514011069122182221275328
of25985514011068109
accuracy27375514011061115168227267321375436
of32005514011070110
the33405514011041101154
communication35245514011063122216309369429463516569602635696756
should43105514011055115175235268328
be46685514011069122
determined48195514011069122155208248341374434488547
by53975514011069130
the639565201103393147
nature8165652011090144177237277330
and11755652011085144204
stage14095652011078111165226278
of17165652011091131
the18785652011064124178
illness,2086565201106497131191244291338368
the24845652011064124177
patient's26915652011091144177211264324357379424
attitude31455652011085118151185218279339392
toward35665652011065125211265304364
the39605652011064124178
proposed41685652011090130190250310357410470
examination46685652011084144198291324384438471504564624
and53225652011085144204
treatment639579001103373127179212306359419452
methods,11215790011093147180240300360407437
and15885790011053113173
the1791579001103394148
patient's19685790011060113146180233293326349395
character23935790011054113167207261313346400440
and28635790011053112172
behavior.30675790011060113172226285318378418441
There6395928011073133187226279
are9475928011072112165
known11425928011077137197284344
cases15165928011071124170224271
where181759280110104164218257310
rashly21565928011058112158218252313
informing24975928011051111151211251344377437499
a30245928011073
patient31265928011078131164198251311344
of35005928011078118
their36485928011051111164198238
cancer39155928011072124184237290330
status4276592801106598151185245291
has45975928011079132178
led48055928011051105165
to50005928011051111
suicide.51405928011064124158211244304356386
Telling6396067011073118151184218278338
a10066067011062
patient10976067011067121153187240300333
with14686067011086120153213
a17116067011062
late-stage1802606701104195128181224270303357417469
disease23016067011067101147201254300353
that26856067011040100154187
there29026067011040100154195248
is3179606701104087
no32966067011067127
way34616067011086140202
to36916067011040100
help38216067011068122155215
them40666067011040100154248
is4344606701104187
tantamount4461606701104194154188241334394454514547
to50396067011040100
a51696067011061
death52596067011067120174208268
sentence6396205011047100160193246306360412
and10816205011054113173
cannot12846205011054107166226286319
be16336205011060115
justified.1778620501103393140173207247280333394424
In639634301104098
addition,7676343011068127187221254288348408438
there12356343011047107160200253
may15306343011093147209
be17666343011075129
situations1925634301105993126187240273306366426473
where24416343011087147200239293
an27636343011067127
oncologist29206343011073133187247280340400433479513
must34766343011094154200234
offer37406343011073113150204244
a40146343011066
patient41106343011074127160194248308341
surgery,44816343011060120160218270310372392
which49166343011087147180234293
under52396343011073133193248288
these639648101103393147193247
circumstances9156481011069102142195254348394428481541594648694
is1639648101104996
highly17656481011076108168227260323
risky,2114648101105689136196258278
given,24226481011076108168221281311
for27636481011056116156
example,29496481011069129184276336370423453
advanced34326481011069128188242301354407467
age39296481011068128181
or41406481011075115
significant4285648101106295155215248288321374427487520
tumor48356481011049109203263303
spread.51686481011062122162215268328358
From6396619011067106166259
a9286619011064
deontological10236619011070124183243277337370430491524577630663
standpoint,1716661901105791144205265325385418478512542
the22886619011044104157
physician24756619011071131192236270323356411470
is2975661901104491
obligated30976619011071131164198258313345399459
to35876619011044104
discuss37216619011070104151204264311357
the41086619011044104158
degree42966619011071124185224277331
of46566619011071111
risk4797661901105184131191
of50186619011071111
surgery51596619011057117158216268308370
with6396757011087120153213
the8826757011041101154
patient,10666757011067120153187240300333363
as14596757011061107
in15966757011041101
some17276757011054114206259
cases20166757011060113159213259
the23056757011040100154
physician24896757011067127189232265320353406466
cannot29856757011060114174234294327
be33426757011067121
certain34926757011060113153186239272332
that38546757011041101154187
surgery40716757011054114154213265305367
will44736757011087120153187
result46906757011047100146206240273
in49936757011041101
a51246757011060
longer52146757011040100160220273312
life639689501103367107160
than828689501103494147207
refusing1065689501104093132192239272332393
surgery14876895011047107148206259298360
and18766895011053113173
using20796895011060106140200260
only23686895011060120153215
symptomatic26116895011047109200260293354447500534567620
treatment.3261689501103474127180212306359419452482
treatment."639703301103373127179212306359419452482531
14Nikolai639743608141827207461012078105160219247304332
Nikolaevich10797461012093121175234262319378433460511574
Blokhin16807461012081109172226288316379
(1912–1993)20877461012052113172233295355416477538598635
was274974610120102157204
a29807461012074
Russian30817461012080143190237264322385
scientist34947461012062113140200263296330377414
and39367461012073135199
surgical41617461012063126167223250301357385
oncologist.45737461012079142194255283346403431478515546
He51467461012091150
was532374610120102158204
one6397609012063126187
of8527609012064100
the9807609012040103162
founders1170760901203697160223286346388432
of16307609012063100
oncology17577609012063125177238266329386441
as22257609012057104
a23567609012058
medical24407609012096156219248298354382
specialty28497609012047109169219246304331372427
in3303760901202790
Russia.34217609012065127174221249306337