Turkiye Klinikleri Journal of Medical Ethics-Law and History

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Tıp Etiği Açısından Amputasyon Kararları: Olgu Sunumu ve Literatürün Gözden Geçirilmesi
Amputation Decisions in Terms of Medical Ethics: Case Report and Review of Literature
Ramazan İlter ÖZTÜRKa, Gülhan KÜÇÜK ÖZTÜRKb
aErciyes Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji ABD, Kayseri, TÜRKİYE
bNevşehir Hacı Bektaş Veli Üniversitesi Semra ve Vefa Küçük Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, Ruh Sağlığı ve Psikiyatri Hemşireliği ABD, Nevşehir, TÜRKİYE
Turkiye Klinikleri J Med Ethics. 2020;28(3):492-8
doi: 10.5336/mdethic.2020-75744
Article Language: TR
Full Text
ÖZET
 Sağlık ve teknoloji alanında, hızla ilerlemenin olması nedeni ile sağlık profesyonelleri etik sorunlarla daha fazla karşılaşır hâle gelmiştir. Ortopedi ve travmatoloji alanında, genellikle aydınlatılmış onam, vücut bütünlüğüyle ilgili operasyon kararları, sağlık profesyoneli ile hasta ilişkileri konularında etik sorunlar yaşanmaktadır. Bu çalışmada, bir amputasyon olgu sunumu ile tıp etiği açısından amputasyon kararları değerlendirilmiştir. Hastanın ileri yaşı, kronik hastalıklarını, ailesinin bakımına ihtiyacının olması ve tedaviyi reddetmesi etik sorun oluşturmuştur. Amputasyon olgusunda özerkliğe saygı, aydınlatılmış onam ve yarar sağlama ilkesiyle hastanın tedavi süreci ile ailenin bu sürece katılımı ele alınmıştır. İnsanlık tarihinin en eski ameliyatlarından olan amputasyon, sadece fiziksel bir yaralanma değil, aynı zamanda uzun süren, şiddetli bir stres olup yıkıcı ve travmatik bir deneyimdir. Hastanın vücut bütünlüğünü ve yaşamını etkileyecek olan amputasyon kararının, cerrahın, sağlık ekibinin ve hastanın fikir birliğiyle alınması gerekir. Etiğin temel ilkesi, hastaların tedavi kararlarına katılmasıdır. Amputasyon kararı alınırken hastaya detaylı bilgi verilmesi, hasta ve ailesi ile açık iletişim kurulması oldukça önemlidir. Sağlık profesyonelleri, karşılaştıkları etik sorunlara evrensel etik ilkeler rehberliğinde çözüm getirmelidir. Ayrıca ortopedi ve travmatoloji uygulamalarında karşılaşılan etik sorunların azaltılabilmesi veya çözümler geliştirilmesi için düzenli tıp etiği eğitimlerine yer verilmelidir.

Anahtar Kelimeler: Etik; tıp etiği; amputasyon; ortopedi ve travmatoloji
ABSTRACT
 Due to the rapid progress in the field of health and technology, healthcare professionals have become more confronted with ethical problems. In the field of orthopedics and traumatology, there are generally ethical problems regarding informed consent, operational decisions regarding body integrity, and healthcare professional-patient relations. In this study, amputation decisions were evaluated in terms of medical ethics with an amputation case report. The patient's elderly, chronic illnesses, need for family care and refusal of treatment have created an ethical problem. In the case of amputation, the treatment process of the patient and the participation of the family in this process were discussed with the principle of respect for autonomy, informed consent and providing benefit. Amputation, one of the oldest surgeries in human history, is not only a physical injury but also a long lasting, severe stress and a destructive and traumatic experience. The amputation decision, which will affect the patient's body integrity and life, should be made in consensus with the surgeon, the medical team and the patient. The basic principle of ethics is that patients participate in treatment decisions. It is very important to give detailed information to the patient and to establish open communication with the patient-family while making the amputation decision. Healthcare professionals should find solutions to the ethical problems they face under the guidance of universal ethical principles. Additionally, regular medical ethics training should be provided to reduce ethical problems or develop solutions in orthopedics and traumatology practices.

Keywords: Ethics; medical ethics; amputation; orthopedics and traumatology
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