Aim:This study aimed to evaluate the attitudes towards and experiences of ethical dilemmas in the treatment decision-making process among medical oncologists who are the members of the Turkish Society of Medical Oncology. Materials and methods:A questionnaire was developed based on related literature.Between April 1 and May 1, 2016, questionnaires were electronically sent to 412 medical oncologists who were the members of the Turkish Society of Medical Oncology. Overall, 125 of 412 medical oncologists (30.33%) filled the questionnaire.Results: Most medical oncologists encountered dilemmas, such as a lack of comprehension among the patients and family members regarding the information provided, a lack of clarity regarding the identity and role of individuals in the decision-making process, and demands for futile treatment. The most common problem (70.4%) was the lack of available clinical ethics consultancy services to guide medical oncologists when facing an ethical dilemma. Legal concerns regarding withholding or withdrawing futile treatments were high. More than half of the medical oncologists (56.8%) reported the preservation of the quality of life as their primary professional duty. Conclusion:Our results demonstrate that medical oncologists tend to adopt an approach that respects patient autonomy and that adheres to the principle of proportionality rather than a paternalistic approach when facing ethical dilemmas. Within this context, we suggest an increased use of a multidisciplinary team approach, ethics consultancy services, and training programmes as well as the publication of ethical guidelines tailored to the oncology field.
The purpose of this study was to determine the professional and personal values among midwifery students in Turkey and to identify whether the years of study affected these values. A total of 192 participants were asked to prioritize 16 professional and 36 personal values. The relationship between the year of study and value ranking was analyzed by Kruskal-Wallis test. The first three of the professional values were justice, equality, and human dignity. Equality ranked sixth among the personal terminal values, and it increased with the years of study. Of personal instrumental values, responsibility and cleanliness ranked second and fifth, which are of central importance for the profession of midwifery. However, the other two important values, privacy and preventing unnecessary suffering, ranked lower when the years of study increased, in other words when the students confront clinics. Since these values are important for midwifery, ethics courses should be given throughout the midwifery education to prepare students for the challenges they face in the clinical environment.
Background: Compassion-based practices in midwifery are the most important expression of the depth of care quality. This concept is insufficiently represented in literature, therefore, studies on this subject are of utmost importance. Objectives: This study aims to determine the levels of compassion of midwives working in the delivery room and the factors affecting these levels. The study was carried out in Kocaeli, Turkey. Methods: This descriptive study was carried out from 1 February to 15 April 2019 in delivery rooms of six different hospitals located in the provincial centre of Kocaeli, Turkey, with 78 actively working midwives. Data were collected using a ‘Compassion Scale’ and analysed using the Mann–Whitney U test, the Kruskal–Wallis H test and the Spearman correlation test. Ethical considerations: This study was conducted according to ethical scientific guidelines. Results: The compassion score of the midwives were found to be 4.19 ± 0.39. The total compassion score was affected by professional factors such as number of patients, alternating shift work, number of traumatic births and work satisfaction. While the kindness subscores decreased depending on shift work and number of traumatic births, it was determined that the midwives who were satisfied with their work had higher kindness scores than those who were not. Also, as the age and professional experience of the midwives and the number of traumatic births increased, their indifference score also increased. Midwives who reported that they were not satisfied with their job had higher scores regarding separation and disengagement scores than those who were satisfied with their job. Conclusion: It was determined that the compassion levels of midwives were found to be negatively affected by factors such as age, professional experience, job satisfaction and number of monthly traumatic births in a month. They should be reminded that compassionate midwifery care for women is a basic human right.
BackgroundIn Turkish hospitals, in addition to health care professionals, there are people who are also a significant part of the health care services; even though they are not professionals. In Turkey, these people are known as refakatçi (a patient's companion).ObjectivesThe purpose of this study was to identify and describe the concept of the patient's companion from their own perspective and to evaluate the concept of the patient's companion in terms of biomedical ethics.MethodsThis was a descriptive study. Personal interviews were conducted via a structured questionnaire containing open‐ended questions with the patients' companions. Thematic text analysis method was used to analyze the open‐ended questions. The study was conducted at a University Research and Training Hospital in the Aegean Region of Turkey.ResultsA total of 118 patient companions participated in the study. These patient companions stayed with the patients because of their concerns about trusting the health care professionals in caring for the patients. During their stay, the companions encountered several problems, including staying in ward‐type rooms and resting in a single armchair, as well as staying for a mean time span of 4 days, primarily for 24 consecutive hours in each day. Despite these conditions, most of the companions surprisingly declared their satisfaction with their stays.ConclusionsPatients' companions should be defined as bioethical subjects; more specifically, they should be defined as vulnerable subjects and should not be taken advantage of. The description of patient companions as a vulnerable group allows for the ethical evaluation of similar systems, such as those in Israel, Greece, Korea, and Iran, and could allow for the development of a common solution for these systems. Moreover, such a definition provides an important basis for social, ethical, or legal studies on the health care systems in all of these countries.
It is important to define and practice ethical rules and codes for professionalisation. Several national and international associations have determined midwifery ethical codes. In Turkey, ethical rules and codes that would facilitate midwifery becoming professionalised have not yet been determined. This study was planned to contribute to the professionalisation of midwifery by determining national ethical values and codes. A total of 1067 Turkish midwives completed the survey. The most prevalent values of Turkish midwives were care for mother-child health, responsibility and professional adequacy. The preferred professional codes chosen by Turkish midwives were absence of conflicts of interest, respect for privacy, avoidance of deception, reporting of faulty practices, consideration of mothers and newborns as separate beings and prevention of harm. In conclusion, cultural values, beliefs and expectations of society cannot be underestimated, although the international professional values and codes of ethics contribute significantly to professionalisation of the midwifery profession.
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