Perihan Elif Ekmekci

Health and Roma People in Turkey.

BACKGROUND The research and published literature on Roma health in Turkey is much more limited than in other European countries. Among these, there are hardly any published literature focusing on the health status, health indicators and health behaviors. AIMS The aim of this research is to describe the perceptions of health-related concepts and access and the use of health services and social determinants of the health of Roma people in Turkey. STUDY DESIGN Descriptive qualitative survey. METHODS The participants were chosen by random sampling. The semi-structured interview topic guide was developed from sources such as advice from the Romani community leaders, published evidence and personal experience from previous work with Roma communities. Non-directive open-ended questions allowed the exploration of their health status, how they conceptualize health and disease, their level of awareness on the impact of social determinants of health, on their health status and the access and use of health services. The data analysis was based on grounded theory. Analysis proceeded in four steps: 1. Reading and examining the transcripts separately using open coding, 2. Extracting the key words and codes from the transcripts and sorting them into categories, 3. Re-reading the transcripts by using selective coding, and 4. Examining the categories derived from the open coding systematically and determining the concepts summarizing the material. RESULTS The survey results are compatible with the existing literature on Roma health and reveal that 1) there is a tight link between the lack of social determinants of health and the poor health status of Roma people 2) socioeconomic factors and cultural norms of the ethnic minority are suspicious factors 3) comparative and systematic research is needed to illuminate the actual health gaps and causal factors for them. CONCLUSION The research proves that the need for comparative and systematic research in Turkey to determine the actual health status of Roma people and develop policies to combat the health disparities is profound.

Evaluation of the informed consent procedure for total knee arthroplasty patients in Turkey.

Objective The purpose of this research is to evaluate the ethical aspects of informed consent process of total knee arthroplasty (TKA) patients in Turkey. Methods The study included 50 patients undergoing TKA in Gazi Mustafa Kemal State Hospital Orthopedics Clinic. A face to face survey was conducted to determine the ethical appropriateness of the main components of informed consent process such as; disclosure of material information about the disease and alternative treatment options, understanding the disclosed information, comprehending the written consent form and voluntariness in deciding. Results The survey revealed that all TKA patients signed informed consent form, 80% of the participants received material information about their disease, 62% were disclosed information about TKA operation, 56% read (in personal or with the assistance of a relative) the written informed consent form, 28% received information regarding possible complications of TKA and 85% were not given any information about the alternative treatments. Conclusions Informed consent process in TKA patients have flourished compared to previous years, but still there are some aspects in need of improvement. Using short and understandable language, developing multi-media sources and involving patients to informed consent form development process would contribute to the process.

Standardizing Decision-Making Processes in Institutional Review Boards in Accordance with International Guidelines and Turkish Regulations

6 he first Turkish regulation on conducting clinical research on human subjects was released in 1993. The number and scope of clinical trials have been growing steadily in Turkey which led the country to review its legislation and align it with international guidelines and codes. In this regard, Turkish regulations were harmonized by the International ConStandardizing Decision-Making Processes in Institutional Review Boards in Accordance with International Guidelines and Turkish Regulations

Mejora de la teoría de justicia de John Rawls para abordar temas de salud y los determinantes sociales de la salud

The vast improvements in medical technology reviled the crucial role of social determinants of health for the etiology, prevalence and prognosis of diseases. This changed the content of the right to health concept from a demand of health services, to a claim of having access to all social determinants of health. Thus, the just allocation of scarce resources of health and social determinants of health became an issue of ethical theories. John Rawls developed a theory of justice. His theory suggests that the principles of justice should be determined by individuals in a hypothetic initial position. In the initial position, individuals agree on principles of justice. Rawls puts forth that the institutions of the society should be structured in compliance with these principles to reach a fair social system. Although Rawls did not justify right to health in his theory, the efforts to enlarge the theory to cover right to health flourished quite fast. In this paper first the basic components of Rawls theory is explained. Then the most outstanding approaches to enlarge his theory to cover right to health is introduced and discussed within the discourse of Rawls theory of justice.

Enfatizando a teoria da justiça de John Rawls para envolver a saúde e as determinantes sociais da saúde

The vast improvements in medical technology reviled the crucial role of social determinants of health for the etiology, prevalence and prognosis of diseases. This changed the content of the right to health concept from a demand of health services, to a claim of having access to all social determinants of health. Thus, the just allocation of scarce resources of health and social determinants of health became an issue of ethical theories. John Rawls developed a theory of justice. His theory suggests that the principles of justice should be determined by individuals in a hypothetic initial position. In the initial position, individuals agree on principles of justice. Rawls puts forth that the institutions of the society should be structured in compliance with these principles to reach a fair social system. Although Rawls did not justify right to health in his theory, the efforts to enlarge the theory to cover right to health flourished quite fast. In this paper first the basic components of Rawls theory is explained. Then the most outstanding approaches to enlarge his theory to cover right to health is introduced and discussed within the discourse of Rawls theory of justice.