The Interaction of Healthcare and the Russian Orthodox Church in the Formation of Individual and Public Health: History, Opportunities, Development Paths, and Prospects

The dissertation is devoted to the study of the interaction between the healthcare system and the Russian Orthodox Church in the context of the formation of individual and public health. The work examines the historical prerequisites for cooperation between medicine and the Orthodox religion—from biblical concepts of health and healing to the role of monasteries, communities of mercy sisters, and the participation of the ROC in medical education. It analyzes the organizational forms and types of social and medical assistance provided by the Church, as well as public opinion on the issue of interaction between the two institutions.

The research is aimed at identifying low-cost reserves for influencing the health status of the population and developing practical recommendations for healthcare management bodies and physicians. The work examines the regulatory and legal framework for cooperation, the relationship between spiritual and physical health, and develops a draft standard agreement between a medical and preventive institution and a parish of the ROC. The practical significance of the work lies in the implementation of methodological recommendations that have undergone expert review and pilot testing.

Relevance

The organization of medical care in our country, as in the world at large, is a priority task of the healthcare authorities and the state, since the health of the population is the most important condition and goal of the socio-economic development of a country, its prosperity, and political stability. At the same time, the therapeutic and diagnostic process represents an extremely complex system encompassing various factors, conditions, and technologies. Conditionally, the factors influencing health can be divided into medical and paramedical ones; however, it is important to note that both groups of factors are closely interrelated and constitute a complex, indivisible whole. In the context of large-scale social, economic, and political reforms of contemporary society, the connections between individual factors and processes are constantly changing, which gives rise to the problem of determining the priority links in this system at each time period, since the need for such determination is driven by the aspiration to optimize and improve the quality of medical care in order to ensure patient satisfaction.

In our view, one of the important paramedical factors is the spiritual assistance provided to patients. In this context, human health is viewed from the perspectives of morality and faith. The most qualified, accessible, and adequately perceived spiritual assistance can be provided by representatives of religious denominations.

History attests to the role of the Russian Orthodox Church in the creation and development of medicine, whose traditional heritage calls upon physicians of all specialties to pay careful attention not only to questions of the physical health of their patients but also to the spiritual dimension of existing problems. At present, the Russian Orthodox Church occupies a worthy place in Russian public life and has the capacity to contribute to the provision of both social-psychological and medical assistance.

The relevance of the issue is confirmed by the existing agreement on cooperation between the Ministry of Health and Social Development of the Russian Federation and the Moscow Patriarchate of the Russian Orthodox Church, the purpose of which is to ensure an inseparable connection between the physical and spiritual health of the population, the formation of a healthy lifestyle, and the preservation of the national gene pool. The existing positive experience of such interaction, developed over the past several years, serves as the foundation for this cooperation and for the intensification of joint efforts not only in the provision of medical care and the prevention of various diseases, but also in the revival of the spiritual traditions of Russian medicine and public life as a whole.

A number of scientific works have been devoted to the study of the features of cooperation between healthcare and the ROC, in which the relevance and significance of the topic have been demonstrated and certain aspects of interaction have been examined [T.I. Tyul'kova, 2004; S.V. Filimonov, 2004; A.E. Cherkasova, 2005]; however, the development of modern healthcare and society as a whole sets the task and dictates the necessity for an in-depth study and the development of time-appropriate recommendations for healthcare authorities and the ROC regarding cooperation.

As a development of the scientific direction devoted to the study of cooperation between healthcare and the Russian Orthodox Church, the present dissertation work differs from previously completed works by the first-time comprehensive study of the attitudes of patients, physicians, and heads of medical and preventive institutions toward the need, expediency, necessity, and practical feasibility of such interaction.

Goal of the Research:

To identify underutilized low-cost reserves for influencing the state of individual and public health and to develop recommendations for the interaction of healthcare management bodies and physicians with the Russian Orthodox Church.

To achieve the stated goal, the following research tasks were defined:

1. To study the history of the interaction between healthcare and physicians with the Russian Orthodox Church, and to identify promising directions for joint activity of healthcare, physicians, and the ROC in meeting the population's need for a healthy lifestyle and disease prevention.

2. To conduct research on the organizational aspects of interaction and to identify the population's need for the participation of the ROC in the organization of medical care, as well as to determine the readiness of the healthcare system and the ROC for cooperation.

3. To conduct a study of the relationship between spiritual and physical health of the population in the conditions of social and economic reforms.

4. To study the regulatory and legal framework for cooperation between healthcare authorities and physicians and the ROC.

5. To develop a draft standard agreement on cooperation between a medical and preventive institution and a parish of the ROC.

6. To develop and implement methodological recommendations for physicians and healthcare management bodies on interaction with the Russian Orthodox Church in matters of strengthening individual and public health.

Scientific Novelty

The scientific novelty lies in the comprehensive study of the history of the interaction of medicine and the ROC, on the basis of which an analysis has been performed of the organizational questions of the ROC's participation in healthcare and the forms of its cooperation with healthcare.

For the first time, on the basis of the conducted research, patterns have been identified in the population's need for the participation of the Russian Orthodox Church in the organization of medical care, the patients in need of such participation, as well as the readiness of physicians and representatives of the Orthodox Church for such interaction and the prospects for its development.

On the basis of an analysis of the existing regulatory and legal framework, the most promising forms of cooperation have been determined.

Practical Significance

For the first time, on the basis of a scientific analysis of existing legislative and legal acts that facilitate or impede the interaction of medicine and the Orthodox Church, a draft standard document "Agreement on Cooperation between a Medical and Preventive Institution and a Parish of the ROC" and the latest methodological recommendations have been developed. Their implementation is carried out in three stages: (a) expert review by leading scientists in the field of public health and healthcare, heads of healthcare management bodies, and the largest medical and preventive institutions in the country; (b) a pilot implementation project in model regions (territories) with an assessment of effectiveness; (c) submission of the final version (taking into account expert conclusions and monitoring results) for approval to the Ministry of Health and Social Development of the Russian Federation and for coordination to the Synodal Department for Social Service and Charity of the Russian Orthodox Church.

Implementation in Practice

The scientific provisions and recommendations have been introduced into the educational process for students, as well as in the course of continuous professional development training at the Department of Public Health and Healthcare of the State Educational Institution of Higher Professional Education "Moscow State Medical and Dental University" of Roszdrav; the results of the research, conclusions, and practical recommendations have been reported at a meeting of the commission on the implementation of the Agreement on Cooperation between the Moscow Diocese of the Russian Orthodox Church and the Ministry of Health of the Moscow Region Government, 2007; a draft of methodological recommendations has been prepared and submitted in accordance with the implementation plan for expanded expert review to leading scientific and clinical centers, departments of public health and healthcare, and hierarchs of the Russian Orthodox Church.

Publications on the Dissertation Topic

Four scientific works have been published on the dissertation topic, including one in a publication included in the VAK list. The materials of the dissertation have been reported at the All-Russian Scientific Conference "Youth Health and the Future of Russia," 2006, Tver.

Scope and Structure of the Dissertation

The dissertation is presented in 147 pages of typescript and consists of an introduction, a literature review, a description of materials and methods, results of original research, discussion of obtained data, conclusions, practical recommendations, a literature review, and appendices. The bibliography contains 165 sources, including 163 domestic and 2 foreign authors. The dissertation is illustrated with 16 tables, 6 figures, and has 6 appendices.