There is no single universally accepted definition of clinical ethics.Among many a definition has been proposed by La Puma as follows: "Clinical ethics is the process of identifying, analyzing and resolving moral problems of a particular patient's care. The primary goal of clinical ethics is to improve patient care with bedside assistance. Clinical ethics seeks to improve the relationship between the patient and the clinician and the relationships among patient, family and hospital."This definition has much in common with our approach (...) for the real case we wish to present. We will try to analyze and resolve this case brought by the gynecologist to us, from the point of view of medicine, ethics, and law; while considering socio-economic elements. (shrink)

Neural tube defects (NTDs) are very serious malformations for the fetus, causing either low life expectancy or a chance of survival only with costly and difficult surgical interventions. In western countries the average prevalence is 1/1000-2000 and in Turkey it is 4/1000. The aim of the study was to characterize ethical approaches at institutional level to the fetus with an NTD and the mother, and the role of health care professionals in four major centers in Turkey. The authors chose perinatology (...) units of four university hospitals and prepared questionnaires for the responsible professionals concerning their own and their institution’s ethical approaches to the fetus with an NTD and the mother. The investigation revealed that there were no institutional ethical frameworks or ethics committees available to professional teams in the units. The roles of the health care professionals and their individual decisions and approaches based on ethical principles are described. The ethical decision-making process concerning fetuses with NTDs, examples of institutional approaches to the topic and institutional frameworks, and the role of nurses and other health care professionals are all discussed, based on a literature review. The authors suggest that institutional ethical frameworks, ethics committees, professionals’ ethics education and multidisciplinary teamwork should be established for critical situations such as fetuses with an NTD. (shrink)

Elderly people are a particularly vulnerable group in society and have special health problems. The world population of older people is increasing. People who are 65 years or older constitute 6% of the Turkish population, 90% of whom have chronic health problems. In Turkey, there is a high possibility that elderly people’s requirements are not met by today’s health care system in the way they would wish. They prefer not to be hospitalized when they have health problems. From a wider (...) perspective, various countries are still seeking how to provide the best care for elderly people. Our goal was to characterize home-based care for elderly people using an ethical approach as an area of interest for nurses and other health care professionals now and in the future, both for Turkey specifically and from a global perspective. We studied four case histories and then prepared a composite scenario and a short questionnaire for elderly people living in a specific district of Istanbul to evaluate their expectations from the health care system. We compared our findings with situations in other countries and have proposed some practical solutions. The results showed that these older people preferred to receive nursing care at home instead of in hospital in Turkey, and also in many other countries. In this article we discuss our findings, comparing them with those in the literature, and suggest that there should be nursing care at home with insurance coverage while using a proper ethical approach. (shrink)

New applications in medicine, science and technology are changing our lives. The delicate border between clinical trials and conventional diagnostic / treatment methods is becoming more evident. At this border new questions arise that need both rational and humanistic answers and that affect humankind‘s understanding of self: What are our responsibilities towards human subjects in clinical trials? What are our responsibilities towards patients and decisionally impaired psychiatry patients? What are rules about the routine techniques on decisionally incompetent psychiatry patients? What (...) are the economic parameters‘ affecting decisions?Many current research projects are concerned with the ethical problems of clinical trials of newly used medication, clinical trials of newly used measurement techniques, clinical trials proposed as conventional treatment methods, new measuring methods or conventional measuring methods on irrelevant patient groups; all being concerned with clinical trials of EEG and neuroscience. In 2009, the Ministry of Health of Turkey implemented new legislation on ―clinical trials and newly established independent ethics committees ‖. These independent and multidisiplinary IRBs analyze research projects and make recommendations about them. What should be the rationale about psychiatric patients in Turkey in a global setting? (shrink)

Many Turkish people migrated to Germany between 1955 and 1975. This study was carried out in Göttingen, Germany. Fifty Turkish people (described as patients) were asked about the care they had received from German health care personnel, and 50 German nurses and 50 German physiotherapists were questioned about care they had given to Turkish patients. Significant findings were the needs of the Turkish patients for good communication, physical contact and understanding of their culture-based expressions of illness. The German nurses and (...) physiotherapists expressed the need for language barriers to be minimized and for education in the specific culture of Turkish patients. Our findings are discussed from an ethical viewpoint. The International Council of Nurses’ code of ethics is used to guide the ethical debate about the findings within the context of transcultural and multicultural care. Suggestions for better transcultural health care paradigms are made for relating to patients from different cultures when patients and care providers have little understanding of each other’s needs and expectations. (shrink)

This article describes stigmatization and its impact on the mentally ill and on the advancement of psychiatry. The article highlights an ethical review of stigmatization establishing a link between the psychosocial factors, culture and moral development. This paper offers an examination of studies conducted in Turkey and the Western world, and socio-cultural frameworks for dealing with ethical values and psychosocial development. The paper then argues for the need to discuss moral, psychosocial and cultural meanings embedded in various ethical issues in (...) arriving at conclusions and suggestions to prevent stigmatization.The paper concludes by emphasizing the importance of ethical training, cultural diversity and moral development giving reasons and examples why these are important against stigmatization and suggesting ways of handling mentally ill. (shrink)

Since the beginning of the late modern era, modern constitutions have been trying to keep both group rights as minority rights and individual rights. But, in some cases, it is still ambiguous if an action or a phenomenon must refer to individual rights or group rights. Abortion discussions, with regard to political rights, are one example of these ambiguous cases. In this context, whereas Liberal view tends to regard abortion as individual rights of a woman, Communitarian view can be against (...) it by pointing out the right to life and this case may lead to a kind of liberal constitutional crises. This article gains importance as such constitutional crises still emerge even nowadays. John Rawls’s theory of overlapping consensus in Political Liberalism tries to solve these political conflicts that emerged in liberal constitutions by prioritizing public reason. This article conceptionally aims to examine Rawls’s theory in terms of prioritization and value relativity in abortion discussions. The method of article is hermeneutics. In order to extend the universe of the discussion, some important thinkers such as Immanuel Kant, Isaiah Berlin and John Gray, who have related studies on the topic, were included. In conclusion, it is asserted that Rawl’s theory is weak both practically and theoretically as to the principle of utilitarianism violates the rights of communitarians. (shrink)

A petition signed by Turkish and Kurdish intellectuals denouncing the attacks in South East of Turkey and demanding a return to peace opens up to question how this intellectual movement can be evaluated as a political action and/or a form of resistance. Here I will try to analyze it from two different aspects: 1) the role of intellectuals leading social change; 2) the form of this movement. The first aspect is associated with the relation of theory to praxis that matters (...) most. The questions are: Is the role of intellectuals in society only educative or pedagogical? Or can they also play the role of directors, organizers, and illuminators of larger groups? Regarding the second aspect, we should ask whether or not the movement led by this petition is spontaneous or organizational, which addresses us to the form of resistance. For this purpose, firstly, I will use Antonio Gramsci's theory of intellectuals. In the Prison Notebooks, Gramsci considers the problem not only as a cultural problem but as a problem directly linked to the concept of hegemony, praxis, and ideology. I will concentrate on some paragraphs in his fourth, twelfth, and eleventh Notebooks. Secondly, I will try to analyze this movement through Luxemburg’s concept of spontaneity and her understanding of consciousness especially by use of Mass Strike and Stagnation and Progress of Marxism. (shrink)

Sadece tarihi ilgilendiriyor gibi görünen felsefenin başlangıcı problemi, şüphesiz tarihsel bir meseledir, ama aynı zamanda felsefenin kendisine de ait bir konudur, çünkü bu probleme ilişkin değerlendirmeler zorunlu olarak felsefenin doğasını açığa vurmaktadır. Felsefeyi Miletli Thales’in başlattığına ve ilk filozof olduğuna dair yerleşik bir gelenek söz konusudur; bununla birlikte, felsefe kendine özgü belirlenimler kazanıp kendini belirlemesini sağlayan belli bir gelişme sürecinin ürünüdür ve bu bakımdan birçok filozofun emeğine gerek duymuştur. Felsefe tarihinin ilk döneminde Grek filozoflar yeni başlangıçlar yapmışlar ve böylelikle felsefenin (...) yeni yönlerinin açığa çıkmasına hizmet etmişlerdir. Bu çalışmada, felsefenin sadece bir kurucusu değil kurucuları olduğunu vurgulamak üzere Thales’ten Aristoteles’e dek Grek filozofların felsefenin oluşumuna sağladıkları katkı irdelenecektir. (shrink)

Many studies have been conducted on the effect of item order in self-report questionnaires on mean scores. This research aims to study the effect of item order on measurement invariance in addition to mean scores. To this end, two groups randomly obtained from the same sample were presented a fixed order form in which all items belonging to the same dimension were adjacent to each other, and a random order form in which the items were randomly sequenced respectively. The results (...) obtained revealed a statistically significant difference between the mean scores of the two forms. In the next stage of the study, the fit indices obtained from the confirmatory factor analysis applied to the two separate forms and the modification indices suggested by the software were compared. Both forms returned high modification suggestions for adjacent items or items presented near each other. Additionally, it was found that high χ2 reductions suggested by the MIs in one form resulted in low χ2 reductions in the other. Lastly, multiple group CFA was conducted to determine whether or not measurement invariance was achieved through different item order presentations of the scale. The findings indicate that measurement invariance could not be achieved even at the first stage of analysis. It may specifically be stated that presenting respondents items under the same dimension together ensures empirical findings congruent with theoretical structure. (shrink)

BackgroundThe intensive care unit entails working as a team in rescuing patients from life-threatening conditions. The care being given by the team could also be done by nurses and other health professionals through the coordinated use of all medical practices.ObjectiveTo determine the opinion of nurses on the ethical problems they experienced while working as a team in the intensive care units of a university hospital.MethodThe descriptive research was conducted on nurses working in intensive care units. A 56-item data collection form (...) consisting of two parts developed by the researchers was used. Frequency and median were evaluated, and statistical calculations were used for group comparisons.ResultsOut of the 82 nurses who participated in the study, 65 were university graduates. About 52 of the participants were female with a mean age of 28.12 ± 5.84; 26 had intensive care certification, and 54 had ethical training. The internal intensive care unit nurses were less satisfied with their jobs, able to use tools, said that they had the right to refuse the patient compared to the surgical intensive care unit nurses. Discussion and conclusions: It is a positive situation for the participants to score low with ethical problems based on suggestion as the probability of meeting with their teammates. However, it is important that the problems that affect the motivation of the nurses are different according to the intensive care unit and the employees. (shrink)

It is thought that determining which methods and techniques are used by teachers to teach concepts, which is one of the important dimensions of religious teaching, will contribute to the science of religious education and practice of religious teaching. In this context, the problematic of the study is based on the question of the methods preferred by the Religious Culture and Moral Knowledge teachers in their concept teaching activities. Therefore, the aim of the study is to try to reveal the (...) qualities of the methods preferred by the Religious Culture and Moral Knowledge teachers in the concept teaching process with a descriptive perspective. To serve this purpose, a case study was preferred as one of the qualitative research methods in the methodology of the study, and 20 Religious Culture and Moral Knowledge teachers were selected in the study group with maximum variation sampling, which is one of the purposeful sampling methods. Since the study focused on teachers' opinions, a semi-structured interview technique is used as a data collection tool, and descriptive analysis method, envisaging coding of the data according to the pre-determined themes and titles in the context of the problematic of the study, has been preferred. As a result of the study, it has been observed that teachers preferred that supporting teaching methods such as story and game, induction in line with the approach of reaching definition with students, deducting from the definition. In addition, despite the teachers' attempts to enrich the concept teaching process and increase the quality of the process, it has been found that their knowledge and skills regarding concept teaching methods and techniques were not sufficient. (shrink)

Although nature of science and nature of scientific inquiry are related to each other, they are differentiated as NOS is being more related to the product of scientific inquiry which is scientific knowledge whereas NOSI is more related to the process of SI. Lederman et al. determined eight NOSI aspects for K-16 context. In this study, a science camp was conducted to teach scientific inquiry and NOSI to 24 6th and 7th graders. The core of the program was guided inquiry (...) in nature. The children working in small groups under guidance of science advisors conducted four guided-inquiries in the nature in morning sessions on nearby plants, animals, water, and soil. NOSI aspects were made explicit during and at the end of each inquiry session. Views about scientific inquiry questionnaire was applied as pre- and post-test. The results of the study showed that children developed in all eight NOSI aspects, but higher developments were observed in “scientific investigations all begin with a question” and “there is no single scientific method,” and “explanations are developed from data and what is already known” aspects. It was concluded that the science camp program was effective in teaching NOSI. (shrink)

Organizations differ tremendously in the extent to which they engage in socially responsible behavior and the extent to which this behavior is evaluated by stakeholders. This research examines the complex role of organization size as a driver of perceptions of an organization’s socially responsible behavior and its social performance. Using a unique data set of 302 organizations in the higher education industry, we find that the strength of the organization size–organizational social performance relationship is contingent on whether the organization is (...) autonomous from community stakeholders and resource pressures. Our results show that the organization size–OSP relationship is stronger when stakeholders in the organization’s community are more involved in the organization itself and decision-making processes, and that this relationship is weaker when greater financial and human resources are available to the organization. (shrink)

Due to its structure, language is open to change with the differentiation of time and events. The importance of language, which has a great importance in interpersonal communication, is much more privileged for Muslims who shape their civilizations according to the Qur’ān. Because the language in question in this medium is not only an element that completes human relations, but also the language of religion with divine characteristics, which communicates with people through revelation and belongs to the supreme creator. It (...) is normal for a language, which is considered to be a social phenomenon, to be constantly open to change due to meaning expansion, meaning narrowing or meaning distortions. It is possible to change the language in proportion to the development of the human mind. However, if the “language of religion” is in question, it is extremely important in terms of the universal messages it carries that the concepts it contains should not be expanded or distorted in order to preserve the purity of that religion. It is certain that the change that will occur in the words of the Qur’ān will affect its interpretation and thus religious life. In a realm where revelation is fixed and unchangeable, time and understanding are variable, what matters to us is how much we are in harmony with the first and essential meaning given to the concepts in our effort to understand the Qur’ān. In this article, with the revelation of the revelation, the expansion of the concept of mustad‘af to gain new political meanings, a case which almost all commentators have agreed on until today, has been analyzed, especially in the last century. The concept of mustad‘af, which is mentioned in four verses in the Qur’ān and is rarely included in the hadiths, basically represents the people who have not had the opportunity to migrate to live their faith, who were persecuted by deniers and oppressors and whose right to worship was taken away. The concept of mustad‘af, which basically means “weak, belittled and oppressed”, gained a religious content with Islam and preserved it. While the concept has been used in a narrow sense in the Sunni world until today and did not develop any meaning, it found a wide place in the Shiite world and underwent new meaning expansions. After the period of Hulefa-i Raşidîn, the Shiites accepted themselves as victims of the treatment they received by the political powers and named themselves as mustad‘af, and they produced a literature of victimization from there. This concept, which is used by Shiite scholars for people who sometimes do not fall into blasphemy and shirk, and sometimes believe in Allah and His Messenger, although they are not subject to the sect of shia, has been made available for new meanings with the change of world politics after the modern period. In the 19th century, the “social justice” and “equality” discourses of communism affected the Islamic world as well as the whole world. In addition to the establishment of many “left”-centered political parties in the Islamic world, contemporary Muslim thinkers were also influenced by this, and after a while many Islamic values started to be considered as left-wing. Especially before the Iranian Islamic Revolution in 1979, the proletariat and bourgeois conflict was evaluated as an affiliate and mustad‘af, and it was hoped that the neglected masses would be converted to Islam with this new discourse. Those who have an imperialist and capitalist character, covet the wealth of third world countries and do all kinds of evil against them. Those who were left weak, exploited and stripped of their resources were regarded as mustad‘af. Again, the dictators who came to power against the will of the Muslims were evaluated as mustaqbir and the masses of the people as mustad‘af. It is possible to read a historical or religious text through any ideology. However, the fact that should not be ignored here is that if every word and concept in the Qur’ān loses its meaning in the medium and culture in which it descended, the language of religion and therefore all values belonging to religion will evaporate over time. (shrink)

Fate has always existed in life both as a faith issue appearing in most of the religions and as a vital phenomenon. The unknown sides of fate and the uncertainties related to fate have been a factor that always keeps a human’s sense of curiosity alive. The fate perceptions’ potential of affecting life is high. As an individual’s fate perception is one of the factors determining his attitude to life, and it also affects his behaviours. The fate perceptions’ power of (...) influencing human behaviours was effective in specifying the research topic. The subject of the research was determined as “fate perception”, and university students were selected as the sample group. The research was carried out through metaphor analysis technique based on the phenomenological method. The reason for referring this method rather than directly asking questions related to fate is to reach the real thoughts in the depths of youths’ minds. A total of 211 students participated in the study performed with undergraduate students from different departments of different universities, and the analysis was continued with 163 data sets since the inappropriate data were sorted out. First of all, groups that included the same theme according to the meanings attributed to the fate in the metaphors were formed, and rather than the metaphor, the “because…” part that described it was based on in the grouping. The categories and the metaphors collected in the themes under them were again reviewed relationally, and then the research was analysed by two specialists to ensure the validity and reliability. As a result of the research, it was determined that some of the participants tried to clarify equivalents of the problems related to fate in their minds and to conceptually define the fate while producing metaphors. It was seen that some of the participants associated the fate with religious beliefs in forming metaphors while some of them dealt with it separately from the religion. The most frequently repeated metaphor is the "path" metaphor in the study, in which university students were found to have produced 106 metaphors related to the concept of "fate". This is followed by the metaphors "book" and "wheel". "Scenario, pen, map, crossroads, bunker, line, ship" metaphors are among the top ten most preferred metaphors. After the explanations of the metaphors produced in the scope of the research were examined, they were grouped in terms of their common features, themes were formed, and categories were formed by grouping the themes among themselves. Accordingly, the first category was identified as “fate in the context of characteristic” and its sub-themes were “fate as a(n) unchanging/determined phenomenon, fate as a divertible/preferable phenomenon, fate as an unknown/uncontrollable phenomenon, fate as both determined and divertible phenomenon and fate as a defence mechanism”. The second category was “fate in the context of faith/freedom”. The sub-themes of this category were determined as “the phenomenon of fatalist-inclined fate, the phenomenon of pure faith-based fate, the phenomenon of faith-based voluntaristic fate, the phenomenon of faith-based Cebrî fate, the phenomenon of not faith-based voluntaristic fate, fate contrast”. (shrink)

Rawls's view that the right is prior to the good has been criticized by various scholars from divergent points of view. Some contend that Rawls's teleological/deontological distinction based on the priority of the right is misleading while others claim that no plausible ethical theory can determine what is right prior to the good. There is no consensus on how to interpret the priority of right to the good; nor is there an agreement on the criteria of teleological/deontological distinction. In this (...) article, I argue that the critics' interpretations of the principle of the priority of right to the good as well as their conceptions of the teleological/deontological distinction have serious shortcomings to the extent that they ignore rich theoretical resources we find in Kant's moral and political philosophy. Kant's conception of human dignity and his division of the doctrine of virtue and the doctrine of right supply powerful arguments to clarify and sustain the idea of the priority of right to the good and the teleological/deontological division. (shrink)

BackgroundThe Covid-19 pandemic has impacted compassion fatigue and the mental health of health care providers, particularly midwives and nurses. Although there are studies involving health workers...