Turkiye Klinikleri Journal of Medical Ethics-Law and History

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Palyatif Bakımda Etik Sorunlar: Bir Sistematik Derleme
Ethical Problems in Palliative Care: A Systematic Review
Esra AKIN KORHANa, Merve KIRŞANb, Duygu YILDIRIMb, Servet KIRAYb, Meltem UYARc
aHemşirelik Bölümü, Hemşirelik Esasları AD, İzmir Kâtip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi,
bHemşirelik Bölümü, Hemşirelik Esasları AD, İzmir Kâtip Çelebi Üniversitesi, Sağlık Bilimleri Enstitüsü,
cAnesteziyoloji ve Reanimasyon AD, Ege Üniversitesi Tıp Fakültesi, İzmir, TÜRKİYE
Turkiye Klinikleri J Med Ethics. 2019;27(2):116-27
doi: 10.5336/mdethic.2019-65994
Article Language: TR
Full Text
ÖZET
 Amaç: Palyatif bakımda yaşanan etik sorunlara odaklanan mevcut literatürün gözden geçirilmesi ve çalışmalardan elde edilen verilerin sistematik biçimde incelenmesidir. Gereç ve Yöntemler: Çalışmanın evrenini, 1 Ocak 2008-1 Temmuz 2018 tarihleri arasında "Google Scholar", "Pubmed", "Science Direct", "Proquest", "Cochrane", "EBSCOhost", "Ovid", "Web of Science", "Clinical Key", "Google Akademik" ulusal ve uluslararası veri tabanları taranarak ulaşılan makaleler oluşturmuştur. İncelemede "etik sorunlar", "etik ikilemler", "etik çatışmalar", "etik problemler", "palyatif bakım", "palyatif bakım ünitesi", Türkçe ve İngilizce anahtar kelimeleriyle palyatif bakımda karşılaşılan etik sorunlara ilişkin verileri içeren, yayın dili Türkçe ve İngilizce olan, son 10 yılda yayımlanmış ve tam metnine ulaşılabilen makaleler seçilmiştir. Bulgular: Bu makalelerden araştırma kriterlerini karşılayan toplam 31 çalışma incelemenin örneklemini oluşturmuştur. Taramalardan elde edilen sonuçlar doğrultusunda; kaynak eksikliği, ilaç yönetimi, iletişim, hasta-hasta yakını-sağlık profesyoneli arasındaki ilişkiler, sedasyon yönetimi gibi çeşitli başlıklarda etik sorunlar yaşandığı görülmüştür. Sonuç: Bu sistematik çalışma sonucunda; palyatif bakımda çeşitli boyutlarda etik sorunların yaşandığı, bu etik sorunlardan en çok etik ikilemlerin meydana geldiği, etik ilke ve değer ihlallerinin olduğu, etik ikilemlerin genellikle tedavi sürecine ilişkin olduğu, sıklıkla da kaynak eksikliği nedeni ile etik çatışmaların yaşandığı ve özerklik ilkesinin sıklıkla ihlal edildiği görülmüştür.

Anahtar Kelimeler: Palyatif bakım; etik sorunlar; sistematik derleme
ABSTRACT
 Objective: The purpose of this study was to review the present literature focusing on ethical problems in palliative care and to examine the data obtained from the studies systematically. Material and Methods: The universe of the study consisted of articles published between 1 January 2008-1 July 2018, that were accessed by screening national and international databases that were "Google Scholar", "Pubmed", "Science Direct", "Proquest", "Cochrane", "EBSCOhost", "Ovid", "Web of Science", "Clinical Key". Articles that were reached by using the keywords "ethical issues", "ethical dilemmas", "ethical conflicts", "ethical problems", " palliative care", "palliative care unit" that included data related to the reports on newborns and medication errors in newborns, that were published in English and Turkish in the last decade and that could be found in the form of full text were included in the study. Results: A total of 31 studies that met the research criteria from these articles constituted the sample of the study. According to the results obtained from the scans; it has been seen that ethical problems are experienced in various topics such as lack of resources, drug management, communication, patient-patient relatives-health professionals and sedation management. Conclusion: As a result of this systematic review; in the palliative care, it is seen that ethical problems are experienced in various dimensions, ethical issues are the most common ethical dilemmas, there are ethical principles and values violations, ethical dilemmas are generally related to the treatment process, there are often ethical conflicts due to lack of resources and the principle of autonomy is frequently violated.

Keywords: Palliative care; ethical issues; systematic review
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