Turkiye Klinikleri Journal of Medical Ethics-Law and History

.: RESEARCH
Dünyanın Genomu Düzenlenmiş İlk Bebekleri Vakasına Yapılan Etik Değerlendirmeler Üzerine Bir İnceleme
Investigation of ethical evaluations of the World's First Genome-Edited Babies Case
Bengisu Kevser BULDUKa, Serap ŞAHİNOĞLUb
aAnkara Üniversitesi Kök Hücre Enstitüsü, Ankara, TÜRKİYE
bAnkara Üniversitesi Tıp Fakültesi, Tıp Tarihi ve Etik ABD, Ankara, TÜRKİYE
Turkiye Klinikleri J Med Ethics. 2021;29(1):38-47
doi: 10.5336/mdethic.2020-74194
Article Language: TR
Full Text
ÖZET
 He Jiankui isimli Çinli araştırmacı, 26 Kasım 2018 tarihinde bir sosyal paylaşım platformunda paylaştığı video ile CRISPR-Cas9 teknolojisini insan embriyosunda kullandığını iddia ederek, insanlık tarihinin ilk genetik tasarımlı bebeklerinin dünyaya gelmesine katkıda bulunduğunu duyurmuştur. Kısa bir süre sonra yetkili makamlarca da doğrulanan bu deney, yaşadığımız yüzyılın bilim dünyasında sarsıcı etkiler bırakan her yönüyle etik ihlallerine tanık olduğumuz bir deneydir. Bu çalışmada, Dr. He Jiankui'nin CRISPR-Cas9'u insan embriyosu üzerinde kullanma gerekçelerini YouTube'da paylaştığı videolar ve 2. Uluslararası İnsan Genomu Düzenleme Zirvesi'nde sunduğu veriler ışığında ele alıyor, bilim dünyasından gelen tepkiler ile yarattığı etik tartışmaları alanyazındaki ilgili kaynakları derleyerek inceliyoruz. Çalışmamızda, oldukça dinamik ve etik açıdan pek çok ikilemi bulunan, insan embriyoları üzerinde yapılmış bu deneye yönelik bilimsel ve etik değerlendirmelerin Türkçe alanyazına kazandırılmasını amaçlıyor, etik ihlaller ile oldukça olumsuz bir örnek teşkil eden bu çalışmayı görünür kılarak, her bilim insanının çalışmalarını sürdürürken bazı etik kurallar çerçevesinde hareket etmesi gerekliliğinin altını çiziyoruz.

Anahtar Kelimeler: Tıp etiği; embriyo düzenleme; CRISPR-Cas9; üreme hakkı; onam formları; gönüllülük; etik kurul
ABSTRACT
 On 26 November 2018, Chinese scientist He Jiankui posted a video on a social media platform in which he announced the creation of the world's first genetically edited babies with CRISPRCas9 technology. This experiment, which was soon confirmed by the competent authorities, is an experiment that has a staggering impact on our century while it holds ethical violations excessively in all aspects. In this study, the ethical debates that his study caused and the reactions from the scientific environments were evaluated by addressing the reasons behind his use of CRISPR-Cas9 on the human embryo in the light of the videos on the social media platform which belongs to him and the outputs of his study shared at the 2nd International Human Genome Editing Summit. Moreover, we investigate the reactions from the scientific world and the ethical discussions it has created by compiling within the relevant literature. In this study, it is aimed to contribute to the Turkish literature by evaluating He Jianku's experiment from the ethical perspectives and presenting the criticisms of his study. We aim to this experiment, which constitutes a very negative example with ethical violations, makes it more visible to underline the necessity of every scientist to act within the framework of ethical rules while continuing their studies.

Keywords: Medical ethics; embryo editing; CRISPR-Cas9; reproduction rights; consent forms; volunteerism; ethics committee
REFERENCES:
  1. The He Lab YouTube Channel. About Lulu and Nana: Twin Girls Born Healthy After Gene Surgery As Single-Cell Embryos, in Lulu and Nana Born in China After CCR5 Gene Surgery, T.H. Lab, November 25, 2018, YouTube (Date of access: January 5, 2019, from)[Link] 
  2. Cohn SK Jr, Weaver LT. The black death and AIDS: CCR5-Delta32 in genetics and history. QJM. 2006;99(8):497-503.[Crossref] [PubMed] 
  3. Haworth KG, Peterson CW, Kiem HP. CCR5-edited gene therapies for HIV cure: closing the door to viral entry. Cytotherapy. 2017;19(11):1325-38.[Crossref] [PubMed] 
  4. National Academies of Sciences, Engineering, and Medicine; Policy and Global Affairs. Second International Summit on Human Genome Editing: Continuing the Global Discussion: Proceedings of a Workshop-in Brief. Washington (DC): National Academies Press; 2019 Jan 10.[PubMed] 
  5. The He Lab YouTube Channel. Why We Chose HIV and CCR5 First, in Lulu and Nana Born in China After CCR5 Gene Surgery, T.H. Lab, November 25, 2018, YouTube (Date of access: January 5, 2019, from) [Link] 
  6. The National Academies of Sciences, Engineering, and Medicine Webpage. Second International Summit on Human Gene Editing Day Videos. Day 2 Session III (1:18:10). (Date of Access: May 1, 2019) from [Link] 
  7. Cyranoski D, Ledford H. Genome-edited baby claim provokes international outcry. Nature. 2018;563(7733):607-8.[Crossref] [PubMed] 
  8. Doudna J. He Jiankui, in TIME 2019.[Link] 
  9. Zhang P. 'China's Dr Frankestein' will be punished, in Inkstone. 2018, South China Morning Post Publishers Ltd.: Online (Date of Access: May 1, 2019) from [Link] 
  10. Ramzy A, Wee SL. Scientist Who Edited Babies' Genes Is Likely to Face Charges in China, in The New York Times, New York: A.G Sulzberger; 2019. p.8. (Date of Access: March 3, 2019) from [Link] 
  11. Barrangou R, Marraffini LA. CRISPR-Cas systems: prokaryotes upgrade to adaptive immunity. Mol Cell. 2014;54(2):234-44.[Crossref] [PubMed] [PMC] 
  12. Doudna JA, Charpentier E. Genome editing. The new frontier of genome engineering with CRISPR-Cas9. Science. 2014;346(6213):1258096.[Crossref] [PubMed] 
  13. Akcay D, Kocaefe Ç. The past, present and future of gene correction therapy. Acta Medica. 2014;45(1):51-4.[Link] 
  14. Gümüş N, Kaymaz Tezcanlı B. [CRISPR/Cas9 age in genome editing and leukemia applications]. Kafkas J Med Sci. 2018;8(3):232-48.[Crossref] 
  15. Ledford H. CRISPR babies: when will the world be ready? Nature. 2019;570(7761):293-6.[Crossref] [PubMed] 
  16. Rath D, Amlinger L, Rath A, Lundgren M. The CRISPR-Cas immune system: biology, mechanisms and applications. Biochimie. 2015;117:119-28.[Crossref] [PubMed] 
  17. Take stock of research ethics in human genome editing. Nature. 2017;549(7672):307.[Crossref] [PubMed] 
  18. Liang P, Xu Y, Zhang X, Ding C, Huang R, Zhang Z, et al. /Cas9-mediated gene editing in human tripronuclear zygotes. Protein Cell. 2015;6(5):363-72.[Crossref] [PubMed] [PMC] 
  19. Fogarty NME, McCarthy A, Snijders KE, Powell BE, Kubikova N, Blakeley P, et al. Genome editing reveals a role for OCT4 in human embryogenesis. Nature. 2017;550(7674):67-73. Erratum in: Nature. 2017 Oct 04.[Crossref] [PubMed] [PMC] 
  20. Ma H, Marti-Gutierrez N, Park SW, Wu J, Lee Y, Suzuki K, et al. Correction of a pathogenic gene mutation in human embryos. Nature. 2017;548(7668):413-9.[Crossref] [PubMed] 
  21. National Academies of Sciences, Engineering, and Medicine; National Academy of Medicine; National Academy of Sciences; Committee on Human Gene Editing: Scientific, Medical, and Ethical Considerations. Human Genome Editing: Science, Ethics, and Governance. Washington (DC): National Academies Press; 2017.[PubMed] 
  22. Araki M, Ishii T. International regulatory landscape and integration of corrective genome editing into in vitro fertilization. Reprod Biol Endocrinol. 2014;24;12:108.[Crossref] [PubMed] [PMC] 
  23. Collins FS. Statement on NIH funding of research using gene-editing technologies in human embryosi in National Institutes of Health. 2015.[Link] 
  24. Collins FS. Statement on Claim of First Gene-Edited Babies by Chinese Researcher, in National Institutes of Health. 2018.[Link] 
  25. Callaway E. UK scientists gain licence to edit genes in human embryos. Nature. 2016;530(7588):18.[Crossref] [PubMed] 
  26. Resmî Gazete (09.12.2003/25311), 5013 sayılı Biyoloji ve Tıbbın Uygulanması Bakımından İnsan Hakları ve İnsan Haysiyetinin Korunması Sözleşmesi: İnsan Hakları ve Biyotıp Sözleşmesinin Onaylanmasının Uygun Bulunduğuna Dair Kanun; 2003.[Link] 
  27. Resmî Gazete (30.9.2014, Sayı: 29135) sayılı Üremeye Yardımcı Tedavi Uygulamaları ve Üremeye Yardımcı Tedavi Merkezleri Hakkında Yönetmelik; 2014.[Link] 
  28. Marmor M, Hertzmark K, Thomas SM, Halkitis PN, Vogler M. Resistance to HIV infection. J Urban Health. 2006;83(1):5-17.[Crossref] [PubMed] [PMC] 
  29. Novembre J, Galvani AP, Slatkin M. The geographic spread of the CCR5 Delta32 HIV-resistance allele. PLoS Biol. 2005;3(11):e339.[Crossref] [PubMed] [PMC] 
  30. Shaw D. The consent form in the Chinese CRISPR Study: in Search of Ethical Gene Editing. J Bioeth Inq. 2020;17(1):5-10.[Crossref] [PubMed] [PMC] 
  31. Sciences N.A.o. On Human Gene Editing: International Summit Statement. 2015. Date of access: 1 May 2019.[Link] 
  32. Ryder SP. #CRISPRbabies: notes on a Scandal. CRISPR J. 2018;1(6):355-7. Erratum in: CRISPR J. 2019;2:64.[Crossref] [PubMed] [PMC] 
  33. Zimmer K. CRISPR Scientists Slam Methods Used on Gene-Edited Babies, in The Scientist. US: LabX Media Group; 2018.[Link] 
  34. Cyranoski D. First CRISPR babies: six questions that remain. Nature. 2018.[Crossref] 
  35. Berry J. HIV & AIDS glossary. Posit Aware. 2004;15(6):35-6.[PubMed] 
  36. Krimsky S. Ten ways in which He Jiankui violated ethics. Nat Biotechnol. 2019;3;37(1):19-20.[Crossref] [PubMed] 
  37. Krimsky S. Breaking the germline barrier in a moral vacuum. Account Res. 2019;26(6):351-68.[Crossref] [PubMed] 
  38. Zhang L. On Gene Edited Babies: What Chinese Law Says. Date of access: 26 December 2018.[Link] 
  39. Semprini AE, Fiore S, Pardi G. Reproductive counselling for HIV-discordant couples. Lancet. 1997;349(9062):1401-2.[Crossref] [PubMed] 
  40. Semprini AE, Levi-Setti P, Bozzo M, Ravizza M, Taglioretti A, Sulpizio P, et al. Insemination of HIV-negative women with processed semen of HIV-positive partners. Lancet. 1992;340(8831):1317-9.[Crossref] [PubMed] 
  41. Zafer M, Horvath H, Mmeje O, van der Poel S, Semprini AE, Rutherford G, Brown J, et al. Effectiveness of semen washing to prevent human immunodeficiency virus (HIV) transmission and assist pregnancy in HIV-discordant couples: a systematic review and meta-analysis. Fertil Steril. 2016;105(3):645-55.e2.[Crossref] [PubMed] [PMC] 
  42. Coleman Z. The businesses behind the doctor who manipulated baby DNA, in Nikkei Asian Review. Nikkei Inc. 2018.[Link] 
  43. Cyranoski D. What CRISPR-baby prison sentences mean for research. Nature. 2020;577(7789):154-5.[Crossref] [PubMed] 

.: Up To Date

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

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