Elderly people are a particularly vulnerable group in society and have special health problems. The world population of older people is increasing. People who are 65 years or older constitute 6% of the Turkish population, 90% of whom have chronic health problems. In Turkey, there is a high possibility that elderly people’s requirements are not met by today’s health care system in the way they would wish. They prefer not to be hospitalized when they have health problems. From a wider (...) perspective, various countries are still seeking how to provide the best care for elderly people. Our goal was to characterize home-based care for elderly people using an ethical approach as an area of interest for nurses and other health care professionals now and in the future, both for Turkey specifically and from a global perspective. We studied four case histories and then prepared a composite scenario and a short questionnaire for elderly people living in a specific district of Istanbul to evaluate their expectations from the health care system. We compared our findings with situations in other countries and have proposed some practical solutions. The results showed that these older people preferred to receive nursing care at home instead of in hospital in Turkey, and also in many other countries. In this article we discuss our findings, comparing them with those in the literature, and suggest that there should be nursing care at home with insurance coverage while using a proper ethical approach. (shrink)

This article describes stigmatization and its impact on the mentally ill and on the advancement of psychiatry. The article highlights an ethical review of stigmatization establishing a link between the psychosocial factors, culture and moral development. This paper offers an examination of studies conducted in Turkey and the Western world, and socio-cultural frameworks for dealing with ethical values and psychosocial development. The paper then argues for the need to discuss moral, psychosocial and cultural meanings embedded in various ethical issues in (...) arriving at conclusions and suggestions to prevent stigmatization.The paper concludes by emphasizing the importance of ethical training, cultural diversity and moral development giving reasons and examples why these are important against stigmatization and suggesting ways of handling mentally ill. (shrink)

Sadece tarihi ilgilendiriyor gibi görünen felsefenin başlangıcı problemi, şüphesiz tarihsel bir meseledir, ama aynı zamanda felsefenin kendisine de ait bir konudur, çünkü bu probleme ilişkin değerlendirmeler zorunlu olarak felsefenin doğasını açığa vurmaktadır. Felsefeyi Miletli Thales’in başlattığına ve ilk filozof olduğuna dair yerleşik bir gelenek söz konusudur; bununla birlikte, felsefe kendine özgü belirlenimler kazanıp kendini belirlemesini sağlayan belli bir gelişme sürecinin ürünüdür ve bu bakımdan birçok filozofun emeğine gerek duymuştur. Felsefe tarihinin ilk döneminde Grek filozoflar yeni başlangıçlar yapmışlar ve böylelikle felsefenin (...) yeni yönlerinin açığa çıkmasına hizmet etmişlerdir. Bu çalışmada, felsefenin sadece bir kurucusu değil kurucuları olduğunu vurgulamak üzere Thales’ten Aristoteles’e dek Grek filozofların felsefenin oluşumuna sağladıkları katkı irdelenecektir. (shrink)

Cinsiyet gelişim bozukluklarını/CGB (hermafroditizm/interseksüalite/hünsâlık) İslamî biyoetiğe göre inceleyen bu makale, merkeze İslam hukukunu konumlandırarak CGB’li bireyler için dü-zenlenen dinî normların ardında yatan etik değerleri yansıtmaktadır. Makale, İslam hukukunda erken dönemlerden itibaren cinsiyet gelişim bozukluklarıyla ilgili normlar düzenlenirken etik değerlerin de dikkate alındığını iddia eder. Bu bağlamda makalenin kategorizasyonunda tarihsel ayrım tercih edilerek klasik dönemlerden çağdaş dönemlere İslam hukukçularının cinsiyet gelişim bozuklukları konusunda dikkate aldıkları etik değerler vurgulanmıştır. Sonuç olarak klasik İslam hukukunda cinsiyet gelişim bozukluklarına etik yaklaşımın daha çok insan onurunun (...) gözetilmesi ve mahremiyetin korunması amacıyla olası psikolojik komplikasyonların engellenmesi bağlamında şekillendiği saptanmıştır. Zamanla yaşanan tıbbî gelişmeler, CGB’li bireylerin bedenlerinden karşı cinse ait dokuları uzaklaştırma imkanı tanıyınca İslamî etik değerlerde bir kırılma yaşanmıştır. Klasik dönemlerde, olası psikolojik komplikasyonların engellenmesi şeklinde gelişen etik yaklaşım, cinsiyet düzeltme operasyonlarının hükmü, helal olması halinde delilleri, dinî meşruiyet parametreleri ve aydınlatılmış onam doktrini gibi daha çok CGB için tıbbî bakım standartları geliştirmeye evrilmiştir. (shrink)

Çağdaş zihin felsefesi tartışmalarında baskın pozisyon şüphesiz ki fizikalizmdir. Ancak fizikalizmin nesnel bakış açısı ile fenomenal bilinci açıklayabilen kuşatıcı bir bakış açısı sunulamamaktadır. İçsel deneyimin içeriklerine ait fenomenal nitelikleri, fiziksel niteliklere indirgeyen açıklama modellerine getirilen güçlü itirazlar ile zihinsel ve fiziksel karşıtlığını kabul eden felsefecilerin sayısı giderek artmaktadır. Bu da çağdaş zihin felsefesinde düalizmin yeniden yükselişi anlamına gelmektedir. Bu yükseliş, töz düalizminden yana değil, bedenin hem fiziksel hem zihinsel nitelikleri olduğunu kabul eden nitelik düalizminden yanadır. Bir yandan anti-fizikalist argümanlar, nitelik (...) düalizmi için destekleyici savlar olarak değerlendirilmekte, bir yandan da töz düalizminin açmazları için nitelik düalizmi bir çözüm olarak görülmektedir. Bu çalışmada, nitelik düalizminin fizikalizme karşı töz düalizminden daha güçlü bir alternatif oluşturup oluşturmadığı iki yönlü olarak ele alınmaktadır. İlk olarak, fizikalizme getirilen itirazların nitelik düalizmine olduğu gibi töz düalizmine de dayanak sağlayabileceği ihtimali irdelenmekte, ikinci adımda ise töz düalizminin yol açtığı problemlerin nitelik düalizmi tarafından çözülüp çözülemediği tartışılmaktadır. (shrink)

Neural tube defects (NTDs) are very serious malformations for the fetus, causing either low life expectancy or a chance of survival only with costly and difficult surgical interventions. In western countries the average prevalence is 1/1000-2000 and in Turkey it is 4/1000. The aim of the study was to characterize ethical approaches at institutional level to the fetus with an NTD and the mother, and the role of health care professionals in four major centers in Turkey. The authors chose perinatology (...) units of four university hospitals and prepared questionnaires for the responsible professionals concerning their own and their institution’s ethical approaches to the fetus with an NTD and the mother. The investigation revealed that there were no institutional ethical frameworks or ethics committees available to professional teams in the units. The roles of the health care professionals and their individual decisions and approaches based on ethical principles are described. The ethical decision-making process concerning fetuses with NTDs, examples of institutional approaches to the topic and institutional frameworks, and the role of nurses and other health care professionals are all discussed, based on a literature review. The authors suggest that institutional ethical frameworks, ethics committees, professionals’ ethics education and multidisciplinary teamwork should be established for critical situations such as fetuses with an NTD. (shrink)

Some compatibilists believe that the principle of alternative possibilities has been shown to be false by Frankfurt-style arguments, and this gives way to the compatibility of causal determination with moral responsibility. Those incompatibilists who defend the principle of alternative possibilities, on the other hand, insist on the truth of the principle and on the incompatibility of causal determination with moral responsibility. In this article, I argue that Frankfurt-stylecounterexamples are unsuccessful in indicating the falsity of the principle of alternative possibilities, and (...) yet this failure is inconclusive to prove the correctness of incompatibilism. In fact, the principle of alternative possibilities is, I show, compatible with causal determination and thus with compatibilism on a specificunderstanding of determinism and compatibilism. (shrink)

Background The Covid-19 pandemic has impacted compassion fatigue and the mental health of health care providers, particularly midwives and nurses. Although there are studies involving health workers such as nurses and physicians affected by the pandemic’s compassion fatigue, few studies include midwives. Research objective The present study seeks to investigate the effects of compassion fatigue experienced by midwives working under intense stress during the third wave of the COVID-19 pandemic on the level of moral sensitivity. Research design This is a (...) descriptive-correlation study. Participants The statistical population consisted of all the midwives in Türkiye hospitals in 2021. This cross-sectional study was collected through a questionnaire using convenience sampling. Three hundred and ten midwives working in different units of the country participated in the study. Ethical considerations Approval from the researcher’s university Institutional Review Board for ethical review was obtained with the code of IRB 20/510. Findings The average age of the midwives is 34.29 ± 8.39. It has been noticed that 43.5% of the midwives work in public hospitals and 38.1% in family health and community health centers. Midwives’ mean MR-CS score is 67.11 ± 25.13, secondary trauma sub-dimension average 15.77 ± 6.23, and occupational burnout sub-dimension 40.69 ± 16.35. The mean moral sensitivity questionnaire score is determined as 93.86 ± 19.51. It has been observed that the working style and working time are effective on compassion fatigue. In the linear regression model, 98% of compassion fatigue was explained. Age, secondary trauma, and occupational burnout sub-dimensions affect the model. Discussion Working year, working style, second trauma, age, and occupational burnout parameters may help explain some of the links between midwives’ symptoms of compassion fatigue. Conclusion The pandemic affects the compassion fatigue of midwives. It is crucial to provide social support to midwives and health workers to prevent compassion fatigue and examine and control groups at risk in mental health. (shrink)

A petition signed by Turkish and Kurdish intellectuals denouncing the attacks in South East of Turkey and demanding a return to peace opens up to question how this intellectual movement can be evaluated as a political action and/or a form of resistance. Here I will try to analyze it from two different aspects: 1) the role of intellectuals leading social change; 2) the form of this movement. The first aspect is associated with the relation of theory to praxis that matters (...) most. The questions are: Is the role of intellectuals in society only educative or pedagogical? Or can they also play the role of directors, organizers, and illuminators of larger groups? Regarding the second aspect, we should ask whether or not the movement led by this petition is spontaneous or organizational, which addresses us to the form of resistance. For this purpose, firstly, I will use Antonio Gramsci's theory of intellectuals. In the Prison Notebooks, Gramsci considers the problem not only as a cultural problem but as a problem directly linked to the concept of hegemony, praxis, and ideology. I will concentrate on some paragraphs in his fourth, twelfth, and eleventh Notebooks. Secondly, I will try to analyze this movement through Luxemburg’s concept of spontaneity and her understanding of consciousness especially by use of Mass Strike and Stagnation and Progress of Marxism. (shrink)

Background: Food is an important part of nursing care and recognized as a basic need and a human right. Nutritional care for older adults in institutions represents a particularly important area to address in nursing education and practice, as the right to food can be at risk and health personnel experience ethical challenges related to food and nutrition. Objective: The present study investigates the development of coursework on nutritional care with a human rights perspective in a nursing programme for first-year (...) nursing students and draws upon reflections and lessons learned. Research design: The study utilized educational design research. The coursework, developed through two rounds, combined on-campus learning and clinical placement in nursing homes. Nursing studentsʼ perspectives and experiences gathered through focus groups and a written assignment informed the development and evaluation of the coursework. Participants and research context: In the first round, multistage focus group interviews were conducted with 18 nursing students before, during and after placement. In the second round, four focus group interviews with 26 nursing students were conducted shortly after placement. Ethical consideration: The study was approved by the Norwegian Centre for Research Data. Findings: Three main ʽlessons learnedʼ emerged regarding introducing a human rights perspective in nursing education: 1) the contribution of the human rights perspective in changing the narrative of ʽvulnerable and malnourished patientsʼ, 2) the importance of relationships and experiences for learning about human rights and 3) the benefit of combining development of ethical competence with a human rights perspective. Conclusion: A human rights perspective enabled the students to give meaning to nutritional care beyond understanding of food as a basic physical need. Incorporating human rights in nursing education can support nursing students and nurses in recognizing and addressing ethical and structural challenges and being able to fulfil the right to food for patients. (shrink)