Turkiye Klinikleri Journal of Medical Ethics-Law and History

.: REVIEW
Klinik Etik ve Adli Danışmanlık Hizmetinin Mahiyeti ve Birlikte Sunumu Üzerine-Kanada ile Türkiye'de: Geleneksel Derleme
On the Essence and Collaboration of Clinical Ethics and Forensic Consultation Services-in Canada and Turkey: Traditional Review
Gamze NESİPOĞLUa, Gökhan ORALb, Nil SARIc
aİstanbul Üniversitesi-Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Tıp Tarihi ve Etik ABD, İstanbul, TÜRKİYE
bİstanbul Üniversitesi-Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Adli Tıp ABD, İstanbul, TÜRKİYE
cBiruni Üniversitesi Tıp Fakültesi, Tıp Tarihi ve Etik ABD, İstanbul, TÜRKİYE
Turkiye Klinikleri J Med Ethics. 2022;30(1):105-16
doi: 10.5336/mdethic.2021-86221
Article Language: TR
Full Text
ÖZET
 'Klinik etik danışmanlık/konsültasyon'; klinik uygulamalarda ortaya çıkan etik ikilem/sorunları tanımlayıp, analiz ederek ilgili tarafların etik açıdan haklı çıkarılabilir kararlar vermesine yardımcı olmaktadır. Bu hizmetin Kanada'da sağlık sisteminin önemli bir bileşeni olarak yer edinmiş olmasına karşın, Türkiye'de henüz özerk bir mesleki faaliyet alanı niteliği kazanmadığı görülmektedir. Öte yandan klinik uygulamalarda çeşitli tıbbiadli (mediko-legal) sorunlarla da karşılaşılabilmektedir. Gerek tıbbi-adli vakalarda gerekse tıbbi-adli boyutta inceleme veya görüş gerektiren davalarda hayatta olan mağdura/mağdur olduğu iddia edilen kişiye, hekime, sağlık kuruluşuna ve mahkemeye tıbbi-adli değerlendirme ve kanıtlarla yardımcı olunabilmektedir. 'Klinik adli danışmanlık' olarak adlandırılan bu hizmetin ise Kanada ve Türkiye'de az sayıda uzman tarafından sunulduğu, bu nedenle de hâlihazırda her iki ülkede kurumsal ve özerk bir meslek olarak faaliyet alanı edinmediği görülmektedir. Klinik etik ve adli danışmanlığın etik ihlal ve tıbbi uygulama hatasıyla ilgili şikâyet/davaların azaltılması, hasta mağduriyetinin hafifletilmesi, hekim veya sağlık kurumuna tıbbi-adli ve etik konularda yardımcı olunması ve nihai olarak sağlık hizmetinde kalitenin artırılması gibi ortak amaç ve hedefleri bulunmaktadır. Ortak amaç ve hedeflere ise klinik etik ve adli danışmanlık hizmetinin aynı çatı altında kurumsal, sistematik ve sürdürülebilir nitelikte ve birlikte sunulmasıyla ulaşılabileceğini varsaymaktayız. Bu çalışmada, her iki danışmanlık hizmetinin birlikteliğine duyulan gereksinime ilişkin savımızın tanıtlanması yönünde tarafımızdan yürütülen ileri araştırmaların kuramsal temeli atılmaya çalışılmaktadır. Bu doğrultuda klinik etik ve adli danışmanlığın mahiyeti, tarihsel süreci ve mesleki yetkinlik kuralları literatür incelemesi ışığında Kanada ve Türkiye düzleminde karşılaştırmalı olarak irdelenmektedir.

Anahtar Kelimeler: Etik sorun; klinik adli danışmanlık; klinik etik danışmanlık; tıbbi-adli sorun; tıbbi uygulama hatası
ABSTRACT
 'Clinical ethics consultation' helps the related stakeholders to make ethically justified decisions by identifying and analyzing ethical dilemma/issues arising from clinical practices. It seems that this service is taken hold as an important component of the healthcare system in Canada, but hasn't been an autonomous area of professional activity in Turkey, yet. On the other hand, various medico-legal issues would be confronted in clinical practices, too. Both in medico-legal issues and litigations necessitating medico-legal examinations/opinions, relevant living person/ victim alleged, physician, healthcare institution and court can get medico-legal assessment and guidance as an aid. The service, called 'clinical forensic consultation', is provided by a couple of experts in Canada and Turkey, thus hasn't yet acquired an institutional and autonomous area of professional activity in both countries. Clinical ethics and forensic consultation has common goals and objectives such as reducing the complaints/litigations related to ethical violations and medical malpractice, easing patient suffering, assisting physicians/healthcare institutions about medico-legal and ethical issues, and ultimately improving quality of healthcare. We consider that these common goals and objectives can be achieved by establishing and providing clinical ethics and forensic consultation service together as a corporate, systematic and sustainable structure in the same organization. In this study, we attempt to lay a theoretical foundation for further researches that are carried out by us to prove our argument about requirement for collaboration of both consultation services. Therefore, the essence, historical process and code of professional competence for both subfields are comparatively questioned at the boundaries of Canada and Turkey by reviewing the related literature.

Keywords: Ethical issue; clinical forensic consultation; clinical ethics consultation; medico-legal issue; medical malpractice
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