ETHICAL ISSUES IN HEALTH SERVICES ABOUT TELLING THE TRUTH Assist.Prof.Dr. Mehmet KARATAS Dept. of History of Medicine & Ethics.

... konulu sunumlar: "ETHICAL ISSUES IN HEALTH SERVICES ABOUT TELLING THE TRUTH Assist.Prof.Dr. Mehmet KARATAS Dept. of History of Medicine & Ethics."— Sunum transkripti:

1 ETHICAL ISSUES IN HEALTH SERVICES ABOUT TELLING THE TRUTH Assist.Prof.Dr. Mehmet KARATAS Dept. of History of Medicine & Ethics

2 What does the patient (not) want to know? Diagnosis Treatment options Risks of the treatment Complications Possible results

3 Ethical Principles Respect for Autonomy Beneficience Non-maleficience Justice

4 Situations where truth cannot be told When the patient doesnt want to be informed Competence Emergency patients Psychiatric patients

5 Case1: 47 year-old woman Epigastric pain Inoperable stomach CA Diagnosis has not been determined She has been operated Radiotherapy Wants to stay in hospital Justice, respect for Autonomy

6 Case 2: 60 year old man Mass in thyroid and hoarseness Anaplastic thyroid carcinoma Has been operated but the mass wasnt removed completely Has been told the tumour was removed completely The patient doesnt know about lung/bone metastasis The family requested the disease remain confidential Receives chemotherapy and radiotherapy Has attempted suicide before Patient complain about how slow the recovery is

7 Legal Basis International Code of Ethics of Medicine (WMA) The Law on the Practice of Medicine and Medical Sciences Medical Ethics Charter Patients' Rights Directive Turkish Medical Association Code of Professional Ethics in Medicine

8 Medical Ethics Charter The physician should give hope to patients when consulting The diagnose should be told to the patient very clearly unless such info has the possibility of making the patients conditions worse

9 Medical Ethics Charter In the case of a poor prognosis, such info can be made out to the patient or family very carefully If the disease is fatal in the course of fate, the prognosis may be hidden from the patient

10 References F. Başak ÇAKMAK/Bilal GÜNENÇ, İnönü Üniversitesi Tıp Fakültesi, translation Tolga GÜVEN, Marmara Üniversitesi Tıp Tarihi ve Etik AD ders notları Gürkan SERT, Hasta Hakları Robert M VEATCH, Medical Ethics Emine ATABEK, Mebrure DEĞER, Tıbbi Deontoloji Konuları Hasta Hakları Yönetmeliği, 1998 Klinik Araştırmalar Hakkında Yönetmelik, 2011 Çağlar Boyu Tıp, Roche Yayınları http://en.wikipedia.org/wiki/Main_Page