Turkiye Klinikleri Journal of Medical Ethics-Law and History

.: REVIEW
Ölümün Eşiğindeki İkilemler: Ötanazi, Yardımlı İntihar ve Psikiyatri: Geleneksel Derleme
Dilemmas at the Edge of Death: Euthanasia, Assisted Suicide and Psychiatry: Traditional Review
Burak OKUMUŞa
aUşak Eğitim ve Araştırma Hastanesi, Psikiyatri Kliniği, Uşak, Türkiye
Turkiye Klinikleri J Med Ethics. 2024;32(2):123-37
doi: 10.5336/mdethic.2023-99654
Article Language: TR
Full Text
ÖZET
 Günümüzde ölümler tipik olarak kademeli fiziksel ve işlevsel bir düşüş döneminden sonra ileri bir yaşta meydana gelmektedir. Bu durum yaşamın son aşamasındaki hastalara yönelik yüksek kaliteli bakımı, XXI. yüzyılın sağlık hizmetlerinin temel zorluklarından birisi hâline getirmektedir. Biyomedikal araştırmalardaki ilerlemeler ve biyoetikte yeni disiplinlerin kurulması yaşam sonu bakımı, ötanazi ve hekim yardımlı intihar konusunda güncel tartışmaları beraberinde getirmektedir. Geçmişten günümüze gelen tartışmalar hâlâ güncelliğini korurken, ötanazi ve hekim yardımlı intihar dünya çapında giderek daha fazla yasallaşmaktadır. Bu tür düzenlemelerin temel amaçları; uygulamaları netliğe kavuşturmak, hekimlere yasal zemini açık bir şekilde sunmak ve hastaları korumaktır. Buna rağmen ölümde tıbbi yardım konusu, paradoksik unsurlar içeren çok boyutlu ciddi tartışmaları gündeme getirerek kamunun dikkatini çekmektedir. Bu uygulamaların evrimi ile ilgili tarihsel yönlerin ve ilgili literatürün araştırılması geçmişten günümüze gelen tartışmaları aydınlatabilir. Bu terimlerin evrimi ve olgularla biçimlenen yasal düzenlemeler, multidisipliner bir yaklaşımın gerekliliğini vurgulamaktadır. Metinde uygulamaların lehindeki ve aleyhindeki yaygın argümanlar literatür verileri ışığında sunulmaktadır. Ayrıca ölümde tıbbi yardım konusunu adli boyutları ve uygulanma biçimleriyle karşılaştırmak klinisyenlere farklı görüşler sunabilir. Derleme ötanazi ve hekim yardımlı intihar uygulamaları sürecinde yer alan ve genellikle ihmal edilen hekimin profesyonel yükümlülükleriyle çelişen gerilimini ortaya koymaktadır. Gözden geçirme, ötanazi ve hekim yardımlı intihar talebinde bulunan hastaların değerlendirilmesinde rol alan psikiyatristlerin ikilem içeren görüşlerinin tartışılmasıyla sona ermektedir.

Anahtar Kelimeler: Ötanazi; yardımlı intihar; psikiyatri; ikilem
ABSTRACT
 Death today usually occurs at an advanced age after a gradual physical and functional decline. As a result, the provision of high quality care to patients in the final stages of life is one of the major challenges facing healthcare in the 21st century. Advances in biomedical research and the emergence of new bioethical disciplines have fuelled ongoing debates about end-of-life care, euthanasia and assisted suicide. While the debates of the past remain relevant, euthanasia and assisted suicide are increasingly being legalised around the world. The main aims of such legislation are to clarify practice, to provide clear legal bases for doctors and to protect patients. However, medical assistance in dying attracts public attention by raising serious multidimensional discussions with paradoxical elements. A study of the historical aspects of these practices and the relevant literature can shed light on the debates from the past to the present. The evolution of these notions and the legal regulations shaped by the evidence emphasise the need for a multidisciplinary approach. The text presents common arguments for and against the practices in the context of the literature. In addition, a comparison of the issue of medical assistance in dying with its legal dimensions and application can provide different perspectives for health professionals. The review highlights the often overlooked conflict that physicians face regarding their professional obligations when involved in practices such as euthanasia and assisted suicide. The review concludes with a discussion of the uncertain position of psychiatrists responsible for assessing patients who request euthanasia and assisted suicide.

Keywords: Euthanasia; assisted suicide; psychiatry; dilemma
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4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com