Turkiye Klinikleri Journal of Medical Ethics-Law and History

.: RESEARCH
Antidepresan Kullanım Bozukluğu Sorununa Karşı Bir Normatif Çözüm Algoritması
A Normative Algorithm of Solution for the Problem of Antidepressant Use Disorder
M. Kemal TEMELa
aİstanbul Üniversitesi İstanbul Tıp Fakültesi, Tıp Tarihi ve Etik ABD, İstanbul, TÜRKİYE
Turkiye Klinikleri J Med Ethics. 2020;28(3):421-44
doi: 10.5336/mdethic.2020-76420
Article Language: TR
Full Text
ÖZET
 'Antidepresanların bilinçsizce, gereksizce, kontrolsüzce ve/veya endikasyon haricinde kullan(dır)ılışı' olarak tanımlanabilecek olan 'antidepresan kullanım bozukluğu (AKB)', bugüne dek gerek genel medyada, gerek literatürde ruh sağlığı profesyonellerince, gerekse resmî teftiş ve tespitlerde çok kez dile getirilmiş, dikkat çekilmiş olan bir meseledir. Antidepresif ilaç kullanım oranlarında kaydedilen ve de ruhsal hastalık prevalanslarındaki ve hasta popülasyonlarındaki artışlar ile açıklanamaz görünen yükselişe dair ampirik veriler, pek çok rapor ve çalışmada ortaya konmuştur. AKB'nin ortaya çıkışı için çeşitli neden ve mekanizmalar tarif edilebilirse de, sağlık çalışanları, bilhassa ruh sağlığı çalışanları, her tür AKB karşısında doğrudan veyahut dolaylı olarak sorumludurlar. Zira mesleklerinin etik yükümlülük ve icapları doğrultusunda, kişileri AKB'den korumak ve kurtarmak için hem yapabilecekleri hem de yapmaları gerekenler vardır. Bu çalışmada, yaygın varlığı daha önceki araştırmalarda ampirik, istatistik vd. verilerle ortaya konmuş olan AKB sorununa karşı, Tom. L. Beauchamp ve James F. Childress tarafından geliştirilmiş olan biyomedikal etik prensiplerinden yine Beauchamp ve Childress'a has normatif metodoloji (ayrıntılandırma) kullanılarak üretilen bir dizi etik önermede bulunulmuştur. Zira benimsenen etik prensipler tababetin nasıl icra edileceğini, tababetin nasıl icra edildiği ise ortaya çıkacak iyi ya da (AKB gibi) kötü pratik sonuçları belirler.

Anahtar Kelimeler: Antidepresan; antidepresan kullanım bozukluğu; bağımlılık; etik; tıp etiği; meslek etiği; kullanım bozukluğu
ABSTRACT
 Antidepressant use disorder (AUD) as the uninformed, undue, uncontrolled and/or off-label use of antidepressants is an issue that has been frequently reported in the literature and mass media by diverse observers, including mental health-care professionals and official regulatory bodies. There have been many studies presenting sets of empirical data showing the increased rates of antidepressive drug use that appear to be unexplainable by a parallel increase in mental illness rates and patient populations. Although various mechanisms and causes could be suggested for AUD, health-care professionals, particularly mental health-care professionals, may be held directly or indirectly liable for all observed patterns of AUD, as they have both the potential and the duty to protect and rescue individuals from AUD, in accordance with the ethical obligations and requirements of their profession. In an effort against the problem of AUD, the prevalent presence of which has previously been shown based on empirical, statistical and other data, this study formulates a number of ethical propositions as derived from the principles of biomedical ethics developed by Tom. L. Beauchamp and James F. Childress, by using the normative method of specification, also articulated by Beauchamp and Childress. The ethical principles adopted outline how doctoring ought to be performed, and how doctoring is performed determines the positive or negative outcomes, such as AUD.

Keywords: Antidepressant; antidepressant use disorder; dependence; ethics; medical ethics; professional ethics; use disorder
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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