Turkiye Klinikleri Journal of Medical Ethics-Law and History

.: RESEARCH
Göçmenlik Kapsamında, Doğum Eyleminde Dil Engeli: Sistematik Derleme
Language Barrier in the Act of Birth in the Scope of Immigration: Systematic Review
Selda YILDIZa, Hülya ÖZTÜRKa, Elif TERZİb
aEskişehir Osmangazi Üniversitesi Tıp Fakültesi, Tıp Tarihi ve Etik ABD, Eskişehir, TÜRKİYE
bLokman Hekim Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum ABD, Ankara, TÜRKİYE
Turkiye Klinikleri J Med Ethics. 2021;29(3):421-8
doi: 10.5336/mdethic.2021-83044
Article Language: TR
ÖZET
Yüzyılımızda savaşlar, yoksulluk, işsizlik, eğitim ve siyasi nedenler gibi pek çok nedenden hızla artan göç olgusu, büyük sorunları da beraberinde getirmiştir. Göç eden insanlar, göç ettiği ülkeye entegre olamama, barınma, dil sorununun doğurduğu kendisini yeterince ifade edememe, işsizlik, kültürel farklılıklara bağlı engeller gibi sağlık ve sosyal alanda ciddi problemler yaşamaktadırlar. Bu bakımdan göçmenler, sosyal bakımdan ve sağlık hizmeti açısından savunmasız/örselenebilir grupta yer almaktadırlar. Göç olgusundan en çok olumsuz etkilenenler kadınlar ve çocuklar olarak kabul edilmektedir. Kadınlar ve çocukların içinde daha hassas ve kırılgan olan grup şüphesiz ki hamileler ve yenidoğanlardır. Çalışmamızda göçmen hamile bir kadının dil sorunu nedeniyle hastanede sağlık çalışanlarıyla yaşadığı iletişim sorununu içeren olgu kapsamında; 33 yaşında, 7 çocuklu, 8. gebeliği olan bir kadının, özel bir hastanenin kadın hastalıkları ve doğum polikliniğine başvurmuştur. Gebelik takiplerinin Somali'de gerçekleştirildiğini belirtmiştir. Son adet tarihini bilmeyen kadının tam olarak gebeliğinin kaçıncı haftasında olduğu anlaşılamamıştır. Yapılan ultrasonografi (USG) verilerine göre fetüsün ağırlığı 4.000 gr civarında bulunmuştur. USG ölçümlerine göre gebelik haftası yaklaşık 40 hafta ile uyumlu gözlemlenen hastaya kontrol amacıyla yapılan nonstress testte, fetüsün kalp atışlarının fetal sıkıntıyı düşündürmesi nedeniyle hasta yatırılarak takibe alınmıştır. Doğum sonrası yenidoğanın kaybedilmesiyle ortaya çıkan durum doğrultusunda olgu etik olarak gözden geçirilmiştir. Vaka doğrultusunda, göç olgusuyla birlikte insan onuru, yaşam hakkı, sağlık hakkı, tıp etiği ilkeleriyle değerlendirilmiş, göç olgusunda kültür dil bariyerinin sağlık uygulayıcıları ve sağlık hizmeti alıcıları üzerindeki olumsuz etkileri değerlendirilerek tartışılmaya çalışılmıştır.

Anahtar Kelimeler: Tıp etiği; savunmasız gruplar; göç ve doğum; göç ve dil; göç ve kültür
ABSTRACT
In our century, the phenomenon of immigration, which has rapidly increased due to many reasons such as wars, poverty, unemployment, education and politics, has brought great problems with it. The most negatively affected by the phenomenon of migration are primarily women and children, and among them, pregnant women and newborns. In this respect, immigrants are in the vulnerable group in terms of social and health care. In our study, within the scope of the case involving the communication problem of a pregnant immigrant woman with healthcare workers in hospital due to language problem; a 33-year-old woman with 7 children and 8th pregnancy applied to the gynecology and obstetrics outpatient clinic of a private hospital. He stated that pregnancy follow-ups were carried out in Somalia. The exact week of pregnancy for the woman who does not know the date of her last menstrual period is not understood. According to the ultrasonography data, the weight of the fetus was found to be around 4,000 gr. According to the ultrasonographic measurements, the patient, whose gestational week was observed to be compatible with about 40 weeks, was hospitalized and followed up because of the fetal distress in the nonstress test performed for control purposes. The case has been reviewed ethically in line with the situation caused by the loss of the newborn after birth. In line with the case, the phenomenon of migration and human dignity, the right to life, the right to health, and the principles of medical ethics were evaluated, and the negative effects of the cultural language barrier on health practitioners and health service recipients in the phenomenon of immigration were discussed.

Keywords: Medical ethics; vulnerable groups; migration and birth; immigration and language; immigration and culture
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