Nüket Örnek Büken

Violence Against Women in Turkey and the Role of Women Physicians

Violence against women is a serious problem in Turkey. The Women and Ethics Commission of the Turkish Physicians’ Association (Ankara Physicians’ Chamber) has undertaken significant work to counteract this. This article gives some indications of the sources of violence and discusses its social and health care implications. The Commission is pivotal in the education of women physicians and in heightening awareness of the situation. An outline is given of this work and recommendations are made on how violence against women can be tackled and eliminated.

Emerging Health Sector Problems Affecting Patient Rights in Turkey

It is accepted throughout the world today that a new approach is needed to health care, one that brings to the forefront the role of economic development. This situation has also increased the importance of the health care sector and health data have begun to take a significant place in countries’ development indicators. Health care services as a basic indicator of social and economic development in Turkey, as in the rest of the world, continue to gain in importance. However, there is a significant difference between health indicators for Turkey, which is a candidate for full membership of the European Union, and European Union countries.

End-of-life care in Turkey.

Most physicians confront the moral and technical challenges of treating persons who are coming to the natural end of their lives. At the level of the health system, this issue becomes a more pressing area for reform as premature death decreases and more people live a full life span. Well-developed countries and international organizations such as the World Health Organization (WHO) and the Organisation of Economic Cooperation and Development (OECD) have made recommendations for improving healthcare problems in aging societies. Turkey belongs to the WHO and the OECD. This article describes end-of-life healthcare in Turkey, the design of the healthcare system to meet this need, challenges that should be addressed, and solutions that would be appropriate to Turkish culture and resources.

Turkey's Position Regarding Clinical Drug Trials

AbstractIn clinical drug trials it is essential in terms of Medical ethics to study on patients and subjects rights, to discuss on physician-investigator/patient-subject relations, and to evaluate the dynamics inherited within these relations. In order to have internationally acceptable trials, besides the existence of methodological and semantical harmony, it is also necessary to standardize ethical principles, as well. For different societies in which production of scientific knowledge take place, it is possible to speak about the existence of different cultural factors. On the other hand, free from the fact that to what extent they differ from each other regarding the level of economical and sociological development, there should be some “universal ethical principles” binding scientists from different geographies of the world. In Medical researches the term “universality” has started to be cited more, and it has been obvious that a common consideration on basic values that direct these researches is ...Abstract In clinical drug trials it is essential in terms of Medical ethics to study on patients and subjects rights, to discuss on physician-investigator/patient-subject relations, and to evaluate the dynamics inherited within these relations. In order to have internationally acceptable trials, besides the existence of methodological and semantical harmony, it is also necessary to standardize ethical principles, as well. For different societies in which production of scientific knowledge take place, it is possible to speak about the existence of different cultural factors. On the other hand, free from the fact that to what extent they differ from each other regarding the level of economical and sociological development, there should be some “universal ethical principles” binding scientists from different geographies of the world. In Medical researches the term “universality” has started to be cited more, and it has been obvious that a common consideration on basic values that direct these researches is needed. Only when these are taken into account, the researches that are conducted in different countries may have the same level of scientific and ethical standards. Since, the patient-physician relations in Turkish society and its reflections on clinical drug trials, and regulations about clinical drug trials in Turkey should be evaluated.

Physician-Industry Relationships and Promotion Ethics in Turkey

Abstract In recent years, physician-industry relationships and ethical problems within these relationships have been one of the most discussed topics both in medical society and in the general public in our country. Unethical, and sometimes illegal, relations between the physician and the industry destroy patient rights and security as well as the health care sector and health care institutions as a whole. Although written documents on legislative procedures about promotion ethics are available, these cannot be observed in practice. To what extent is the impact of the promotional activities targeting the physicians have an impact on the criteria considered by the physicians when diagnosing and providing therapy? How can the medical doctors make rational decisions when they are surrounded by the industry? Does the situation (details will be discussed in this manuscript), which exist in our country leave the physicians to make a choice between their conscience and wallet? In this manuscript it is aimed to find answers to these questions. Also the topic will be evaluated from the perspectives of physician-industry relations, education of the physician, factors influencing prescribing, promotion ethics, and ethical-legal procedures.

Statutory Disclosure in Article 280 of the Turkish Penal Code

A new Turkish Penal Code came into effect on 1 June 2005. Article 280 concerns health care workers’ failure to report a crime. This article removes the responsibility from health care workers to maintain confidentiality, but also removes patients’ right to confidentiality. It provides for up to one year of imprisonment for a health care worker who, while on duty, finds an indication that a crime might have been committed by a patient and who does not inform the responsible authorities about it. This forces the health care worker to divulge the patient’s confidential information. A patient who thinks he or she may be accused of a crime may therefore not seek medical help, which is the universal right of every person. The article is therefore contrary to medical ethics, oaths taken by physicians and nurses, and the understanding of patient confidentiality.

Bioethical Challenges of the Ebola Outbreak

This year marks the tenth anniversary of the publication of the Universal Declaration on Bioethics and Human Rights adopted in October 2005 by the 33rd session of the General Assembly of the United Nations Educational, Scientific and Cultural Organization (UNESCO). The aims of the Declaration are specified in Article 2 under BGeneral Provisions^—Brespect for human dignity^ and protection of human rights, promotion of Bequitable access to medical, scientific and technological developments,^ Brapid sharing of knowledge^ and benefits from such developments, and special Battention to the needs of developing countries^—all of which are deemed important transversal aspects of the Declaration. In this paper we intend to draw attention to and reflect on the bioethical challenges of the current Ebola outbreak in West Africa in the context of global health and justice. To this end, we take up several articles of the Declaration and discuss some gaps in the unfolding crisis. This unfortunate situation may serve as a learning platform for all stakeholders toward the development of more effective strategies of coordination and global solidarity. Article 8 of the Declaration, BRespect for Human Vulnerability and Personal Integrity,^ states:

Opinions about the future of Clinical Trial in Turkey

Even though all the rights and obligations of all parties of clinical trial – the researching physician, the volunteering patient, the industry, research institutions- have been assured with ethico-legal regulations, there still exist many problems in the world of clinical research, and suggestions of solutions to the said problems. As a medical ethicist who has been a permanent member of the Hacettepe University Ethical Committee since 2000, I have decided to write a short report that is a general look at the world of clinical research in Turkey. I wanted this report to be one that talks about some of the issues I believe are important about this subject, which include expectations and predictions on it. All of the headlines in this report are without doubt, issues that can be researched and written about widely and with much more details. Especially the process of adjustment to the new regulation of the EU (No 536/2014 of The European Parliament), the condition of non-medicational/non interventional clinical research, transparency in clinical research and budget issues are to me controversial subjects that should be especially and primarily discussed.

Çığlık (Çocuk İstismarı Araştırmalarından Elde Edilen Verilerin Bildirimi Zorunlu mu, Neden?)

ÖZET Türk Ceza Kanunu’na göre; sağlık mesleği mensupları görevlerini yaptıkları sırada suç belirtisi ile karşılaştıklarında durumu adli makamlara bildirmek zorundadırlar. Çocuk istismarı araştırmaları, suç niteliğinde bir eylemi konu alır. Klinik ortamda yapılan araştırmalarda, istismar bulgusuna rastlanmışsa bildirimin zorunlu olduğuna şüphe yoktur. Ancak, anketlerde de bildirim gerekli midir? Çocukların kendi kendine cevapladığı anketlerin çocuk istismarı araştırmalarında, en geçerli/güvenilir yöntemlerden biri olduğu bildirilmektedir. Anketlerde, kimliğin gizleneceği garantisi verilmesi katılımı ve yanıtlanma oranını arttırmaktadır. Bu çalışmada amaç, yoğun cinsel istismara maruz kaldığını bildirerek yardım talep eden olgu özelinde; “çocuk istismarı anketlerinde suç ile ilişkilendirilebilecek veriler elde edilmişse bunların bildirimi gerekli midir?” sorusuna yanıt aramaktır. “Bildirim denek hakları açısından sorun teşkil eder mi? ‘Sır saklama prensibi’nin ihlali midir, bildirimin sınırları ne olmalıdır? Bilgilendirme nasıl yapılmalıdır? Rıza alırken çocuklara kimliklerini açıklamamaları söylenmeli, kimliklerinin açıklanmayacağı garantisi verilmeli midir? Bu garantinin sınırları ne olmalıdır? Bildirim, araştırmanın geçerliliğini, güvenirliliğini etkiler mi?” sorularına yanıt aranmaktadır.

Gender, Infertility, Motherhood, and Assisted Reproductive Technology (ART) in Turkey

Abstract In Turkey, as in many other countries, infertility is generally regarded as a negative phenomenon in a womans life and is associated with a lot of stigma by society. In other words, female infertility and having a baby using Assisted Reproductive Technologies (ART) have to be taken into consideration with respect to gender, motherhood, social factors, religion and law. Yet if a woman chooses to use ART she has to deal with the consequences of her decision, such as being ostracized by society. Other types of procedures in this area, such as sperm and ova donation or surrogate motherhood, are not permitted in law. However, both before and after the development of this techonology, society has been finding its own solutions which are rarely questioned and are still performed. This article will discuss what these practices are and try to reach some pragmatic conclusions concerning female infertility, the concept of motherhood and some traditional practices in Turkey.