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)

INTRODUCTION[|]The practice of medicine has evolved from old approach, in which all decisions for the patient are taken by physician, to a new approach, which includes patients to the medical decision-making process and endorses informed consent of the patients. In addition to healthcare professionals and patients, parents or legal representatives are stakeholders in the informed consent process of children. The knowledge and attitudes of physicians and medical school students about the informed consent period in children are important for the effectiveness (...) of the medical intervention and the biopsychosocial development of children. In this study, it was aimed to understand involvement of medical students and physicians in the informed consent process of children and their level of knowledge on children's rights and their attitudes in daily clinical practice.[¤]METHODS[|]The study is a descriptive study and n = 150 participants, who were randomly selected from senior medical school students working in medical school campus or university hospital and physicians serving pediatric patients, were included to this study. Questionnaires were applied for the measurement of participants' socio-demographic characteristics, education on pediatric patient rights, and legal provisions. The data were evaluated using SPSS 20.00 software.[¤]RESULTS[|]Of participants, 62% (n = 93) were phase 6 medical students, while 29.33% (n = 44) were resident physicians and the rest were faculty members (8.67%; n = 13). The proportion of physicians, who didn't received training on child rights, was 80.7% (n = 46) and statistically significantly higher than medical students (49.45%; n = 45) (p <0.001). However, participants who were not educated about the children's rights stated with higher ratio (44.83%; n=65), that informed consent should be obtained before medical intervention from individuals under 18 years of age, when they are compared to the the participants who received education (20.69%; n=30) (p = 0,019). The majority of participants (59.5%; n = 88) find the intervention in individuals under the age of 18 years in emergencies without consent of legal representatives ethically and legally appropriate (p <0.001). The participants believe that it is ethically and legally appropriate to conduct an intervention on an individual under the age of 18 years without the legal representative (36. 7%; n=54) (p <0.001).[¤]DISCUSSION AND CONCLUSION[|]This study compared the levels of knowledge and attitudes of participants, who were previously trained in or didn't received any training about children's rights and informed consent of children. However, the quality of the training of the participants on children's rights, was not questioned. This study showed that education on children's rights does not significantly increase the level of legal knowledge on children's rights. Having well-designed a subject focused on this theme in medical deontology and ethics education can increase the knowledge levels and improve the attitudes of medical students. This study sheds light on the issues that need to be focused in the medical faculties and the trainings of physicians and showed lack of information and need for development of attitudes regarding children's rights and informed consent in children.[¤]. (shrink)

Mandatory reporting of infectious diseases (MRID) is an essential practice to prevent disease outbreaks. Disease notification is a mandatory procedure for most infectious diseases, even during non-pandemic periods in healthcare. The main rationale behind MRID is the protection of public health. The information and data provided by infectious disease reports are used for many purposes, such as preventing the spread and potential negative impact of infectious diseases, assessing the national and global situation regarding reported diseases, conducting scientific research and planning (...) health policy. In this context, the relevant information benefits public health, health systems and scientific work. Additionally, the follow up and treatment of individuals with infectious diseases is a necessity in certain cases to protect those who cohabit with them. However, these benefits cannot be accepted as unrestricted justifications for MRID, since it is evident that reporting should be conducted within ethical and legal boundaries. MRID should only be devised and implemented with due regard to balancing potential benefits between all individuals, as well as between the individual and the rest of society. Disease notification systems that are not designed with a balancing and harm-reductionist approach may lead to stigmatisation and discrimination. This study aims to investigate the legal framework and ethical issues regarding the reporting of individuals diagnosed with COVID-19 in Turkey—which is a primary example of a developing country. (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)

The International Covenant on Economic, Social and Cultural Rights was signed by Turkey in 2000 and has been in force since September 23rd, 2003. For this reason, the Covenant is considered as act of parliament in our domestic law, and unlike the general procedure of application of the law, it can not be alleged to contradict the Constitution (According to Article 90 of the Turkish Constitution). The article 12 of the Covenant defines the right to health and its content. In (...) the article 12 of the Covenant, in its General Comment No. 14 published in 2000, the right to the highest attainable standard of health was interpreted and commented upon. This document contains a detailed description of the right to health, its content, and its obligations to State parties. Although this Comment of the Covenant is not binding, it is a document to which the State parties refer when taking measures related to health services. Every publication and comment on the right to health was based on the General Comment 14 of the Covenant. The Article 12 was reinterpreted by the Covenant on May 2nd, 2016 in the context of rights to sexual and reproductive health. İit has been emphasized that legal, procedural, practical and social barriers limit the access of individuals to full range sexual and reproductive health services. It has also been pointed out that accessibility of sexual and reproductive health services is a distant target for women and girls. Moreover, it has been stated that discrimination that increases exclusion in legislation and practice limits lesbian, gay, bisexual, transgender and intersex (LGBTI) individuals and disabled people'senjoyment of sexual and reproductive health rights. For this reason, it is stated that although commenting on the rights of sexual health and reproductive health is included in 14 comments, it is important to make an interpretation about them. This comment is an interpretation of a binding Convention. Therefore; It is a document that will provide guidance on measures to be taken by States Parties in respect of their rights to sexual health and reproductive health. At the same time, obstacles to discrimination in medical practice bring important approaches in terms of respect for autonomy and respect for private life. In our article, information about the content of the ESKHK's interpretation and possible reflections of this content in the field of medical law and ethics will be given. (shrink)

In this article, it was aimed to determine the knowledge status of physicians about the forms used in obtaining informed consent and according to these determinations; It is aimed to provide information and suggestions to physicians that will contribute to obtaining consent in accordance with medical law and ethics. Material and Method: A questionnaire was created to determine the knowledge status of the physicians about the titles that should be included in the informed consent form (such as the diagnosis of (...) the patient, the harms, risks, benefits of the intervention, healing process, probability of success), and who should receive informed consent. This questionnaire was delivered to physicians online. The data obtained through the questionnaire were analyzed using the SPSS program. Descriptive statistical analyzes were used in the evaluation of personal information. In the evaluation of the data, frequencies and percentage distributions were taken. The analyzed data were evaluated in terms of compliance with legal regulations and medical ethics. Results: 139 physicians working in a private hospital participated in the survey voluntarily. Approximately 90% of the participants think that the complications that occur as a result of the diagnosis and intervention, approximately 85% of the benefits of the intervention and the problems of the recovery period, about 75% of the consequences of not performing the intervention, about 55% of the probability of success should be included in the form of informed consent.. More than 85% of the participating physicians expressed their opinion to agree with the article about the necessity of obtaining consent by the physician. Discussion and Conclusion: It can be accepted as a positive situation that physicians express their opinions in accordance with medical law about the information that should be included in the informed consent form. However, considering the legal values protected by informed consent, it was suggested to take measures to reduce the rates of disagreement and indecision by emphasizing the views of physicians on disagreement and indecision. (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)

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)

Türkiye hosts approximately 3.6 million Syrian refugees, which accounts for roughly 4.5% of Türkiye's population. This places undeniable pressure on public institutions, particularly on healthcare services. The objective of this study is to document the healthcare structure for Syrian refugees and various challenges faced by Syrians when seeking healthcare and to highlight the ethical concerns emerging from those challenges. To achieve this, we conducted a comprehensive review of several qualitative studies and reports conducted by various organizations and institutions, specifically focusing (...) on health or including a dedicated chapter on health issues, published between 2011 and 2023. Following an extensive analysis of the secondary literature, we classified the challenges into three categories: procedural, cultural, and psychosocial. We argue that each of these challenges is linked to overarching medical ethics concerns. Finally, we propose three possible means to mitigate the challenges Syrians experience in accessing and uptake of healthcare services in Türkiye. (shrink)

The objective of this study was to explore certain managerial work values in Turkey. A total of 1023 managers from six Turkey regions participated in the study and filled out the questionnaires. Findings were analyzed using regression and ANOVA analyses. A total of three managerial work value factors emerged, which was supported by the current value literature. It was found that there was a relationship between work values and organizational size. The lower the organizational size, the higher the proper values (...) are held. However, organizational tenure, the number of subordinates a manager is responsible, and the educational level of a manager had no significant effect on holding work values. The proper values outnumbered the improper values significantly. The three most held work values were integrity, doing work with care and discipline, and achievement. The three least held values were cliquishness, laziness, and hypocrisy. (shrink)

In today’s marketing conditions, it becomes really vital for companies to establish an appropriate relationship with suppliers and salesperson based on ethical values in order to survive. Besides, ensuring an effective relationship between the parties would contribute to increase buyer satisfaction along with economic and social satisfaction. In this study, the direct effects of suppliers’ and salespersons’ unethical behaviors on buyer satisfaction, and the moderator effect of communication between buyer–supplier relationships are examined. The results of the study have revealed that (...) unethical behaviors of suppliers and salesperson affect buyer satisfaction negatively and the communication variable has moderately affected. The results are providing important advantages for buyers who want to improve the relationships between the suppliers and their salesperson for pharmaceutical enterprises. (shrink)

1. L'histoire de l'humain comme catastrophe écologique -- La catastrophe néolithique -- L'homme contre la Nature -- L'humanisme contre l'animal -- Une haine savante contre la Nature -- 2. Substituer des machines aux êtres vivants -- L'élimination de l'animalité -- Des technologies autistes, schizophréniques et paranoïaques -- 3. Machiner l'humain -- La préférence de l'homme pour des hommes artificiels : la parabole de James -- 4. Le post-humain comme point final du désastre humaniste -- La honte prométhéenne de Ginther Anders (...) -- Détruire non seulement la Nature mais aussi le souvenir qu'on pourrait en avoir -- 5. A quoi sert donc l'humain ? -- Remettre l'homme à sa place -- Décaper la morale -- La ressource animiste -- Perspectivisme et multinaturalisme -- Immersion de l'humain dans un monde tragique. (shrink)

Les pouvoirs de la littérature sont en déshérence. Enseignante et écrivaine, l'auteure ne se résigne pas à entériner cet échec. L'enseignement des lettres doit servir à former des hommes libres, des citoyens capables d'un jugement autonome. Ce livre est aussi une réflexion sur la figure du narrateur et sur la liberté du lecteur qui retraverse des situations où se trouve engagé son imaginaire.

Mon objectif dans cet article est de mieux cerner les contours d’une conception institutionnelle de la corruption. Je tenterai de contribuer à ce programme de recherches sur la corruption institutionnelle d’une double façon. Premièrement, j’essaierai de clarifier le concept de « corruption institutionnelle » en mettant en lumière quatre de ses principales caractéristiques et certains de ses avantages. Deuxièmement, je tenterai d’exposer trois problèmes auxquels sont confrontés ses partisans : les problèmes de la portée, du faux-diagnostic et de l’essentialisme. Malgré (...) la sympathie que j’ai pour cette approche, j’espère montrer qu’elle recèle certains points problématiques. Je tenterai essentiellement de montrer que les « institutionnalistes » risquent de faire de la corruption un concept normativement surchargé. (shrink)

Quel est le type de rationalité que peut revendiquer la théologie dans le champ des savoirs ? Pas seulement d’épistémologie, la question prend aujourd’hui une tournure nettement plus utilitaire : qu’est-ce qui justifie le fait que des institutions prestigieuses comme les universités entretiennent encore à grand frais des Facultés dont l’objet même est devenu culturellement marginal ? Craintes illusoires ? Les gestionnaires des universités d’inspiration chrétienne, comme il en existe dans mon pays, vous diront qu’elles ne sont pas dépourvues de (...) fondement. Les urgences en termes humains : là est l’enjeu. Nos sociétés se trouvent face à des défis inédits. La prise de conscience la plus récente est la catastrophe écologique qui nous menace. Et l’écologie n’est pas le seul défi. Nous vivons dans un monde d’inégalités terrifiantes, où sévissent de nombreux espaces de famine, où la violence semble incontrôlable, où les idéologies religieuses qu’on croyait mortes exercent encore des ravages. L’enjeu, ce n’est donc pas la survie d’institutions vénérables, ni même la qualification culturelle de notre digne corporation, mais l’avenir de la planète et de cette espèce de vivants très particulière, les humains. A moins d’être inconscient, le théologien qui essaie de faire son métier dans ce contexte ne peut que s’interroger sur la pertinence de son travail et sur la responsabilité qui est la sienne.What kind of rationality can theology claim in the field of knowledge? No longer solely epistemological, this question today takes on a decidedly more utilitarian turn: what might justify the fact that prestigious institutions such as universities still maintain at great cost departments the only object of which has become culturally marginal? Illusory fears? The administrators of universities of Christian inspiration, as we have in my country, will tell you that these questions are well founded. What is paramount is the urgency of the issues human being must face. Our societies have to cope with previously unheard of challenges, the most recent of which is the realization that we are facing the threat of an ecological catastrophe, and this is not the only one. We live in a world of terrifying inequalities, where many areas are plagued by famine, violence appears uncontrollable, and religious ideologies we thought long past still wreak havoc. What is at stake is thus not the survival of venerable institutions, nor even the cultural qualification of our worthy community of scholars, but the future of the planet and of this very particular species – human beings. Unless they insist on being oblivious to the situation, theologians trying to do their job in this context cannot help but question what the pertinence of their work might be and what their responsibility is. (shrink)

L’héritage dont on a coutume de créditer Marcel Duchamp nous place face à des ambiguïtés que son seul nom ne suffit pas à dissiper. L’artiste le plus cérébral de son temps est aussi celui qui se prête le moins aux « théories » ou aux semblants de définition qu’il a inspirés. La question que pose Duchamp est moins celle de la marque qu’il a durablement imprimée à notre art, que celle de savoir par quelle ironie et à la faveur de (...) quel malentendu on a pu voir en lui l’artisan décisif d’une révolution dont nous serions les héritiers. Duchamp ne parlait pas « au nom de l’art ». On ne peut rien inférer de son « indifférence », sinon les réserves que le mot « art » devrait nous inspirer. (shrink)

Mon objectif est d’examiner les raisons qui ont poussé Rickert à affirmer la nécessité d’une analyse logique des sciences historiques en dépit du reproche de « formalisme » qui lui a été adressé. Revenant sur le débat qui l’oppose aux partisans d’une articulation purement ontologique ou « matérielle » des sciences empiriques, jesouligne que l’adoption d’un point de vue logique et « formel » a simplement chez lui la signification d’un procédé méthodique provisoire dont le but n’est pas de supprimer (...) toutes considérations ontologiques sur les objets historiques, mais plutôt de fournir un soubassement critique pour de telles considérations à l’aide de la « disjonction logique » entre « sciences généralisantes » et « sciences individualisantes ». Ce procédé doit permettre, in fine, d’indiquer de façon formelle et suffisamment englobante ce qu’est un objet historique quelconque, donc de fonder, pour ainsi dire, une ontologie formelle de l’historique.The goal of this article is to clarify the reasons why Rickert maintains the necessity to perform a logical analysis of historical sciences despite of the objection of « formalism » one has raised against him. Taking into account his opposition to the representatives of a merely ontological or « material » articulation of empirical sciences, I suggest that Rickert’s defence of a logical and « formal » approach simply means a provisional method whose purpose is not to eliminate all ontological considerations about historical objects, but rather to provide a critical grounding for such considerations by means of the « logical disjunction » between « generalizing sciences » and « individualizing sciences ». This method must finally indicate what is any historical object in the formal broadest sense of the term. It has therefore to ground, so to speak, a formal ontology of historical object. (shrink)

English summary: Now that it has managed to become a science, history must remain the symposium theatre which allows us to converse with the dead. Our "connected" world delivers us up, defenceless, to the tyranny of every instant. History could be the antidote, inasmuch as it is a depository of people's collective experience. It lifts shadows up from the depth of the ages to make us share what we have learned from being who we are. We have undertaken a boundless (...) dialogue with the living. This book proposes to restore the dialogue with the dead by revisiting, through a succession of brief texts in the form of short essays and short stories, a number of episodes of universal history in an attempt to cull some lessons from it. At a time when history's progress has led to an excessive specialisation which has caused many scholars to withdraw into their ivory towers to enjoy, among experts, the fruit of their research, Michel De Jaeghere wants us to resume meditating on examples that have nourished human thought since ancient times. French description: Ils ont ete pharaons, empereurs romains, rois de France, croises, missionnaires, conquerants, batisseurs de palais et de cathedrales, decouvreurs de mondes nouveaux. Ils ont connu l'ivresse de la gloire, l'amertume de la defaite, ils ont peine dans les travaux. Ils ont incarne l'aventure de l'Occident jusqu'aux extremites de la terre, ils ont du faire face a la barbarie, a la guerre, a la terreur et a la tyrannie totalitaires. De la profondeur de l'Egypte ancienne aux conflits qui ont ouvert le XXIe siecle, ils offrent la plus etonnante des galeries de portraits. Marc Aurele y croise Christophe Colomb, Louis XVI, Honore d'Estienne d'Orves ou Helie de Saint Marc. Ils forment la compagnie des ombres, surgie du passe pour nous offrir un tete a tete. Un dialogue singulier avec les morts.L'histoire est trop souvent traitee comme un cadavre par des medecins legistes si attentifs aux organes qu'ils prelevent sur le corps dont ils font l'autopsie que leur echappe son mystere, ce qui lui donnait sa vie meme. Elle est, ailleurs, consideree comme le divertissement d'un jour, l'occasion d'une promenade sans enjeu. Les textes reunis ici comme en un recueil de nouvelles voudraient s'inscrire dans une autre tradition, celle d'une histoire meditative: une histoire tournee vers la recherche de ce qu'elle a a nous dire d'essentiel, de vital sur nous-meme. Ils se proposent de convoquer les ombres du passe pour nous donner a contempler ce qui n'est pas mort avec elles. Nous doutons aujourd'hui que l'histoire puisse etre maitresse de vie: magistra vitae, disait Ciceron. Nous voulons croire que nous n'avons plus rien a apprendre d'elle. Il nous manque d'avoir les yeux ouverts sur ce qui fait echapper ses protagonistes a leur condition mortelle; ce qui leur donne leur part d'eternite. (shrink)

"Spinoza", à quoi ça sert? Et comment s'en servir? En particulier, comment penser la mise à l'épreuve du rationalisme spécifique dont il est le nom? L'objectif de ce travail est de contribuer à une réévaluation non seulement du rôle de la pratique dans la pensée de Spinoza, mais encore du système lui-même, de sa capacité à s'adapter et à communiquer avec des domaines tels que les sciences expérimentales, l'histoire, la politique ou la médecine. A travers les concepts et problèmes, (...) tels qu'ils sont formulés dans ses textes, mais également leur utilisation contemporaine, il s'agit ici d'analyser l'articulation de la philosophie de Spinoza au champ de l'action humaine, dans ses dimensions éthique, sociale, cognitive et affective - et d'apprécier la puissance de la rationalité qui en est le fondement. Les auteurs viennent d'horizons différents : professeurs, docteurs, doctorants, étudiants ou érudits originaires de divers pays, ils proposent dans les articles ici présentés des approches variées et originales des problèmes qu'ils traitent, offrant ainsi au lecteur un aperçu de la vitalité des réflexions que suscite aujourd'hui l'oeuvre de Spinoza. (shrink)