Bioethics committees and examining consent within the patient-physician relationship in Turkey

Abstract

Clinical exercises include questions about a physician's behaviour, decision making process, values, rights and responsibilities, as much as the scientific-technical questions concerning the disease. Some of these questions may be easily answered, for there are well constructed activity options that have found widespread acceptance regarding what has to be done. However, it is quite difficult to answer the questions with problematic options, or the ones on which a compromised attitude is not present. Patient participation in treatment-related decision-making has been promoted as being ethically and clinically desirable in Western countries. Several studies have indicated that patient participation in decision-making has a positive influence on their health outcomes, thereby increasing patient satisfaction regarding medical care and promoting patient autonomy. Over the last decade, patient involvement in treatment-related decision-making has been widely advocated in Turkey, where patient physician encounters are still under the influence of the long-standing tradition of paternalism. Despite this profound change in clinical practice, studies investigating the actual preferences of Turkish people regarding involvement in treatment-related decision-making are limited. In Turkey, to protect the rights of patients, current Govermental requirements mandate that all human biomedical research and medical intervention be accompanied by a consent form that contains the information necessary for an informed decision. In addition, they require that the information provided to the subject or the representative shall be explained in appropriate language. Especially after the new regulations in the Turkish Penal Code, physicians and nurses have started to be more sensitive towards informed consent and have become more conscious about their responsibilities. It has started to be questioned more, and as a result, the problems experienced about patient consent in medical applications created new ethical dilemmas. Informed consent is acknowledged to be the most essential constituent of patient rights today. In this paper, after introducing a general overview of the significance and requirements of informed consent, we will consecutively discuss the decision making and informed consent process, legal arrangements concerning this issue in Turkey, the approaches of physicians and patients towards the topic, and regarding informed consent, we will discuss the responsibilities of hospital ethics committees.