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The doctor-patient relationship, regulated by a number of principles derived from general human ethics and medical ethics, has undergone transformations over the centuries and a lot has changed since Hippocrates described in his work “Epidemiae librum I” three simple components of this relationship. Since the 70s of the last century, after the concept of patient's autonomy has become a permanent fixture in medicine, we can talk about a partnership with the patient's active role in making diagnostic and therapeutic decisions. In the decision-making process, knowledge, skills and experience are essential. The doctor is obliged to have current medical knowledge and in the case of pain medicine, this obligation becomes particularly important due to the fact that every patient has the right to pain treatment. Therefore, the question arises, what kind of education and what level of knowledge about pain treatment should be provided to every physician, regardless of specialty? We also need to look at the other side of the relationship. Does the patient have any responsibilities or ethical obligations related to education? A relatively new, interdisciplinary field of health literacy and health education is gaining in importance when making diagnostic and therapeutic decisions regarding patients with various chronic pain syndromes. These are special health situations that require good communication with the patient, defining his expectations and analyzing various aspects of treatment. The study attempts to find answers to the questions, after analyzing historical and current records in the field of medical ethics and selected legal provisions.

Telemedycyna stanowi stosunkowo nowe zjawisko w ochronie zdrowia, a jej wdrażanie generuje wiele pytań, na które eksperci reprezentujący różne dziedziny próbują znaleźć odpowiedź. Brakuje interdyscyplinarnych opracowań naukowych dotyczących oceny tej nowej możliwości w kontekście szeroko rozumianego dobra pacjenta. W artykule przedstawiono wybrane zagadnienia związane z telemedycyną poddawane pod dyskusję w literaturze przedmiotu. Autorka, będąc praktykującym lekarzem, zwraca również uwagę na pewne aspekty praktyczne z punktu widzenia pracownika ochrony zdrowia.

A reflection on progress in medicine – bioethics appeared in the 1970s. „Principless of biomedical ethics” – the monograph by Tom Beachamp and James Childress – was to change the concept of ethical evaluation of new possibilities of diagnostic and therapy and making decisions in medicine. In the 70’s there was also the development of chronic pain management. A pioneering concept of multidisciplinary management of a patient suffering from chronic pain by John Bonica is a part of the process of implementing four bioethical principles. The idea of integrative medicine – combining the methods resulting from the scientific and technical progress of Western medicine with the methods of traditional Eastern medicine has enabled the implementation of beneficience, nonmaleficence, autonomy, and justice. This article will present facts related to the Bonica’s concept in the first chronic pain clinic created in Poland in the 1970s.

Background Conflicts occur in intensive care units (ICUs), and an international multicentre study conducted in 2008, including 323 ICUs from 24 European countries, confirmed the occurrence of this phenomenon. There are no data in Poland. The aim of the study was to analyse the frequency of the occurrence of conflicts in ICUs in Polish hospitals, and their most frequent sources. Methods The study was based on an original questionnaire performed in 12 ICUs in the Pomeranian Voivodship. The respondents were asked questions regarding the frequency, type, and lines of conflicts between employees, as well as potential causes of conflicts. Results Completed surveys were received from 232 employees, including 79 doctors and 153 nurses. The phenomenon of occurrence of conflicts was confirmed by about 30% of the staff, providing answer that conflicts occur "often". About 43% of staff estimated that conflicts "sometimes" occur and 25% chose the answer "rarely". Analysis of the answers made it possible to identify the most common potential causes of conflict. Conclusions The main sources of conflicts in ICUs appear to be external factors such a financial issues and physical overload. The hospital policy and the health policy of the state are also important. The perceived conflicts require careful and constant monitoring. The frequency of hidden conflicts requires thorough assessment of their impact on the quality of work.

In every country, the burden of fighting the pandemic lies on the shoulders of healthcare professionals...

The article describes biographical details of Aleksander Lewiński - one of the pioneers of Polish anaesthesiology and pioneering research of chronic pain. Also described are important scientific events related to the issue of chronic pain in Poland, whose inspirer was Aleksander Lewiński: the development of Section of Pain Researches and Treatment of Society of Polish Anaesthesiologists in 1976 and organisation of the first international symposium: „Pain and its treatment”, which was held in Gdańsk in 1978.

Bioethics was created in the 70s of the last century. From this period come works written by Van Resselaer Potter and André Hellegers, in which the authors raised the issue of the need to discuss the progress and to define a new reflection, they used for the first time in the scientific literature the term bioethics. In the United States of America, as well as in European countries, institutions began to emerge in which scientific bioethical reflection was realized. In Poland in the 1970s, the socio-political situation was not conducive to the integration of scientific circles or the freedom of exchange of views. Significant progress in the field of medicine, emerging new treatment options, posed questions that had to be answered. The questions were formulated in different environments, including by doctors who themselves participated in the progress of medical sciences, introducing, for example, new increasingly aggressive treatments, or saw new challenges emerging in the medical profession, which were not regulated by the hitherto applied principles of classical medical ethics. The article describes the achievements of prof. Jan Nielubowicz, prof. Józef Bogusz and prof. Tadeusz Kielanowski in the creation of Polish bioethical regulations in the field of experimental research in humans, the activity of prof. Kornel Gibińki in the formation of Bioethics Commisions, contribution of prof. Stefan Raszeja and prof. Marek Sych in bioethical education of the society and the role of prof. Krzysztof Szczygieł in the creation of the first Polish scientific bioethical unit.

The first open-heart surgery in Gdansk took place in 1975. It was possible thanks to the gift of a Pemco extracorporeal circulation machine from the Netherlands to the Surgery Institute of the Medical Academy of Gdansk. The article presents additional, unpublished informations which enable a new interpretation of the previously known facts.W 1975 r. odbyła się w Gdańsku pierwsza operacja na otwartym sercu. Stało się to możliwe dzięki temu, że Instytut Chirurgii Akademii Medycznej w Gdańsku otrzymał w darze z Holandii aparat do krążenia pozaustrojowego Pemco. W artykule opisano niepublikowane dotychczas informacje, dzięki którym możliwa staje się nowa interpretacja znanych faktów.

Significant recovery of discussion about the need for the formulation of criteria of death was provoked due to the progress of medicine. Development of anaesthesiology and intensive therapy, introduction of new resuscitation techniques and devices, which are increasingly better able to maintain and sometimes even replace functions of the respiratory or cardiovascular system, which are essential for the survival meant that existing for centuries, socially accepted classical criteria of death, based on cessation of breath and circulation, are no longer sufficient. The criteria of brain death developed by the Ad Hoc Committee - 12-experts commission at Harvard University, published in Journal of American Medical Association in August 1968 and were the breaking point. The concept has been adopted and accepted by society in many countries soon, while in Poland the process of formulating and introduction of criteria for brain death took much more time. Based on the available literature and preserved archival materials, this article describing the process of development of new death criteria, acceptance by the National Team of Specialists and publication in 1984 the announcement by the Minister of Health and Social Welfare about the criteria of brain death.

First codes of medical ethics appeared between 18th and 19th century. Their formation was inspired by changes that happened in medicine, positive in general but with some negative setbacks. Those negative consequences revealed the need to codify all those ethical duties, which were formerly passed from generation to generation by the word of mouth and individual example by master physicians. 210 years has passed since the publication of "Medical Ethics" by Thomas Percival, yet essential ethical guidelines remain the same. Similarly, ethical codes published in Poland in 19 century can still be an inspiration to modem physicians.

The critical steps of modern cardiopulmonary resuscitation had arrived in the middle of our 20th century. Mouth-to-mouth ventilation was rediscovered and proven more effective than the manual methods and was combined with external chest compression into what we know today as cardiopulmonary resuscitation.