Turkiye Klinikleri Journal of Medical Ethics-Law and History

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Ortaya Çıkışından 50 Yıl Sonra Beyin Ölümü Kavramı ve Süren Tartışmalar: Geleneksel Derleme
The Concept of Brain Death and Continuing Discussions 50 Years After its Emergence: Traditional Review
Mine HANOĞLUa , Lütfü HANOĞLUb , Mahmut TOKAÇc
aİstanbul Medipol Üniversitesi Sağlık Bilimleri Enstitüsü, Tıp Tarihi ve Etik Doktora Programı, İstanbul, Türkiye
bİstanbul Medipol Üniversitesi Tıp Fakültesi, Nöroloji ABD, İstanbul, Türkiye
cİstanbul Medipol Üniversitesi Tıp Fakültesi, Tıp Tarihi ve Etik ABD, İstanbul, Türkiye
Turkiye Klinikleri J Med Ethics. 2023;31(3):246-54
doi: 10.5336/mdethic.2023-96850
Article Language: TR
Full Text
ÖZET
Ölüm anının kesin olarak belirlenmesi pek çok nedenden dolayı bir zorunluluktur. Bugün beyin ölümü [brain death (BD)] ile belirlenen ölüm, nerdeyse dünyanın her yerinde olduğu gibi ülkemizde de ölüm için kabul edilen yasal bir durumdur. Oysa biyolojik bilimlerdeki gelişmeler insanın ölüm anının zamansal olarak belirlenmesini netleştirmekten ziyade daha bulanık ve karmaşık bir hâle getirmiştir. Diğer yandan BD'nin biyolojik ölümle aynı olmadığı iddiası bu tartışmaların başlangıcından beri var olmuştur. Buradan hareketle bazı yaklaşımlar BD'nin biyolojik değil de insanlığın doğasına ait felsefi kavramlar veya sosyal politikalar hakkında bir tartışma olduğunu ileri sürmektedir. Türkiye'de aradan geçen zaman boyunca BD kavramı ve etrafındaki tartışmalar yeni olmaktan çıkıp oldukça bilinir bir hâle gelmiştir. Ancak tanımlanmasından bu yana geçen yaklaşık 50 yılın ardından BD'nin özellikle Batı literatüründe yeniden tartışmalara konu olduğu, hem akademide hem de kamusal alanda artan bir yeniden gözden geçirmeye tabi tutulduğu izlenmektedir. Bir İslam ülkesi olan ülkemizde, Batı ülkelerine paralel yasal durum ve dinî otoritenin ciddi desteği söz konusudur. Buna rağmen BD kavramına yakından bağlı olan kadavradan organ nakli oranları hâlâ çok düşüktür ve bu konuda yeterli tartışma zemini oluşmuş değildir. Bu yazının amacı, konuyla ilgili klinik ve etik perspektifler çerçevesinde BD hakkında dünyada son dönemdeki etik tartışmaları ülkemiz perspektifinden gözden geçirmektir.

Anahtar Kelimeler: Beyin ölümü; organ nakli; etik
ABSTRACT
The precise determination of the moment of death is necessary for many reasons. Today, death determined by brain death (BD) is a legal condition accepted for death in our country as it is almost everywhere. However, developments in biological sciences have made the temporal determination of human death more blurry and complex rather than clarification. On the other hand, the claim that BD is not the same as biological death has existed since the beginning of these discussions. From this point of view, some approaches argue that BD is not biological but a discussion about the philosophical concepts of the nature of humanity or social policies. During the intervening time in Türkiye, the concept of BD and the debates around it have ceased to be new and have become quite well-known. However, after nearly 50 years since its definition, it is observed that BD has been the subject of debate, especially in Western literature. It has been subject to increasing reconsideration in academia and the public sphere. In our country, which is an Islamic country, there is a parallel legal situation with Western countries and severe support of the religious authority. Despite this, the rates of organ transplantation from cadavers, closely related to the concept of BD, are still meager, and there is not enough discussion on this issue. This article aims to review the recent ethical debates in the world about BD from the perspective of our country within the framework of clinical and ethical perspectives on the subject.

Keywords: Brain death; organ transplant; ethic
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