This study aimed to examine the thoughts and expectations of patients receiving healthcare from their physicians and evaluate the ethical aspects of these thoughts and expectations. To determine the ethical aspects of the thoughts and expectations of patients, an open-ended question was asked on the web page of the Turkish Armed Forces (TAF) Health Care Command, which is accessible to the users of the TAF intranet system (the internet system used within TAF institutions). The participants were asked to express their (...) thoughts in their own words. A total of 804 participants answered the question by providing their input. The statements of the participants were classified separately by two public health specialists. The classification was made in accordance with the basic principles of patient rights, and they were collected under various headings including expectations about respect and care, good communication, informed consent, and fair and non-privileged distribution of healthcare services. The results show that patients tend to consider the physicians they see as solely responsible for all the negative issues that they encounter during their healthcare. This indicates that there is a need for extensive research on the underlying factors involved in the negative thoughts and feelings toward healthcare professionals in both TAF and Turkey in general. (shrink)

This article aims to examine critically the ‘cultural incompatibility’ argument, which asserts that disclosure of cancer-related information to patients is incompatible with Turkey’s cultural context. For this purpose, a brief overview of the approach to truth-telling in Turkey will first be provided, followed by the claims of two different Turkish authors on the issue and a critical analysis of their approach. It will be contended that this argument has actually been formulated with paternalistic concerns and it may be playing an (...) important role in shaping the approach of Turkish health care professionals to the issue. The article will then examine, in the light of study findings and case reports from Turkey, the concept of patient autonomy as it applies to truth-telling issues. It will be concluded that truth-telling can be compatible with Turkey’s cultural context, provided that health care professionals place more emphasis on good communication with their patients. (shrink)

This paper examines the ethico-legal problems regarding the right to refuse treatment in Turkey's healthcare system. We discuss these problems in the light of a recent case that was directly reported to us. We first summarise the experience of a chronically dependent patient (as recounted by her daughter) and her family during their efforts to refuse treatment and receive palliative care only. This is followed by a summary of the legal framework governing the limits of the right to refuse treatment (...) in Turkey. With the help of this background information on the legal framework, we re-examine the ethico-legal aspects of the case and explain the underlying reasons for the problems the family and the patient experienced. Finally, we conclude that Turkey's legal framework relating to the right to refuse treatment needs to be clarified and amended in accordance with international conventions and fundamental human rights. (shrink)

Advance directives are not a part of the healthcare service in Turkey. This may be related with the fact that paternalism is common among the healthcare professionals in the country, and patients are not yet integrated in the decision-making process adequately. However, starting from the enactment of the Regulation of Patient Rights in 1998, this situation started to change. While the paternalist tradition still appears to be strong in Turkey, the Ministry of Health has been taking concrete measures in the (...) recent years to ensure that patient rights are implemented in healthcare practice. Therefore, Turkey now seems to be in a transitional period where a move towards a more patient-autonomy centred approach is being supported by the regulatory authorities, as well as the academic circles and the public at large. In the light of this background, this paper aims to examine the potential benefits of advance directives, particularly with regard to their possible effect in the clinical decision-making process of Turkey's context. It will be argued that advance directives, if correctly understood and implemented in the right settings, may be beneficial, particularly for improving communication between patients and healthcare professionals and for implementing of the right to refuse treatment. (shrink)

Understanding dental ethics as a field separate from its much better known counterpart, medical ethics, is a relatively new, but necessary approach in bioethics. This need is particularly felt in dental education and establishing a curriculum specifically for dental ethics is a challenging task. Although certain topics such as informed consent and patient rights can be considered to be of equal importance in both fields, a number of ethical issues in dental practice are only remotely—if at all—relevant for medical practice. (...) Therefore, any sound approach to education in dental ethics has to recognise the unique aspects of dental practice in order to meet the needs of dental students and prepare them for the ethical challenges they may face during their professional practice. With this goal in mind, this paper examines the approach of the authors to dental ethics education and proposes a system to organise the topics of biomedical ethics for dental education. While the authors' perspective is based on their experience in Turkey, the proposed system of classification is not a rigid one; it is open to interpretation in other contexts with different social, cultural and professional expectations. Therefore, the paper also aims to inspire discussion on the development of an ideal dental ethics curriculum at an international level. (shrink)

INTRODUCTION[|]This paper has been planned as a critical response to Murat Civaner's article entitled 'Medical Ethics arguments should be concordant with scientific knowledge and certain values', published in the Autumn 2015 issue of Turkish Journal of Bioethics. It also aims to provide an evaluation of the way the authoritarian discourse manifests itself in ethical arguments.[¤]METHODS[|]For this purpose, the paper first presents the views of Orhan Hançerlioğlu on Karl Marx and Karl Popper and treats these views as a written example of (...) such authoritarian discourse, which is essentially a problematic attitude that results from an inability to acknowledge the value-laden aspects of a given perspective. [¤]RESULTS[|]In order to show that problems in Hançerlioğlu's approach is also present in Civaner's arguments, several examples where the author did not recognize the value-laden aspects and the subjective nature of information are provided. The paper then examines the recent claim by Celal Şengör, who asserted that force feeding of feces to individuals do not qualify as torture. Based on the presentation and the justification of this reductionist claim, it is emphasized that the relationship between information and values is much more complicated than those presented by Civaner. Civaner's claim, which asserts that the concept of conscience should have no place in medical ethics arguments, is also evaluated on this basis and the dangers of excluding the moral agent in ethical evaluation are underlined. In addition, the relationship of the paternalist tradition with the perspective which I refer to as the 'macro axis' is examined. Last but not least, the paper deals with the concept of 'ethics of ethics' by using examples from national and international ethics literature and emphasizes the reason why it is important for the ethicist to become aware of her own scheme of values. [¤]DISCUSSION AND CONCLUSION[|]The paper concludes that contrary to what Civaner has asserted, it is not possible to exclude subjective aspects from ethical argumentation and that such an appraoch will inevitably have an authoritarian quality. For this reason, the need for other approaches for revealing, rather than repressing or ignoring, the subjective aspects of ethical inquiry is underlined.[¤]. (shrink)