However despite these guidelines these services cannot be well provided due to lack of personnel and equipment as well as disorganization. The guideline suggests the personnel in health care centres to visit these patients regularly, keep their records, refer them to appropriate health care institutions if needed, planning their nursing care at home, provide their medicine, and guide their families. The case especially applies to the terminal patients that need palliative care.Īccording to "Guideline for Health Care Services" (Ministry of Health, 2001:41) it is health centres' duty to provide services for patients with chronic and terminal diseases at the first level of health care services. (The World Bank, 1997:44) This situation prevents doctors to keep patients for long in hospitals. As it is seen in Table 1, the number of beds per 10,000 patients is only 25.8, which is 67 in Japan, 97 in Germany, 101 in France and 51 in UK. In terms of palliative care Turkey has its own limitations. These figures indicate that, although it is not sufficient, the health care services, especially to inpatients have significantly improved in last few decades. Table 1 gives some figures (Ministry of Health, 2001). Despite these negativities many other services are quite well developed in recent years.
Turkey still has some problems in basic health services and preventive care, and the high infant mortality rate (39 deaths per 1000 births) compare to other European countries is an indication of this. In each of these categories, the issues might be similar but the solutions differ significantly from country to country.
Another important category, although much smaller in number, are critically ill or extremely low birth weight babies. Although most attention in the West has focused on the elderly as terminal patients, in some countries the major focus might be on younger adult AIDS patients or on children dying from malnutrition or infectious diseases. (Republic of Turkey, Prime Ministry State Institute of Statistics, 2002) Turkey is a unique country in its region as a Muslim State officially committed to adapt western life style and tradition.Įvery country has its own priorities in health services. The rate of population over 65 is 8%, and the life expectancy at birth is 70.2. Although Turkey is a secular state by its governmental system, since there is such a great majority of Muslims with a long tradition, religion plays a significant role in ethical reasoning in public mind, though not in official level. There are some Jews, Christians and others. The major faith tradition in Turkey is Islam (95%). It has a young population with 55% under the age of 20 (Republic of Turkey, Prime Ministry State Institute of Statistics, 2002). The male and female populations are almost equal to each other. Turkey is a nation state with almost 68 million population comprising people from different ethnic backgrounds. This, inevitably, brings the problem of the distribution of limited sources into discussion (Aksoy, 1998:419).īefore getting into detail on end of life decision-making, it is of benefit to give some basic information about the country. The diseases encountered in old age are mostly chronic and long lasting, which necessitate the provision of health care services in long and costly manner. Much research has indicated that almost in every country, particularly in the developed countries, aged population increases, which brings extra burden to the health care systems and social services. Although the moment of death may be at any time, for some reason, it has been perceived as identical with the old age. It is not the death but the process of dying worries people.
Therefore it has always been the major concern of people to meet with it. Ethical Considerations on the End of Life Issues in Turkey - Sahin Aksoy M.D., Ph.D.ĭepartment of Medical Ethics and History of Medicine,Įmail: the end of life, is one of the most real things in life. Eubios Ethics Institute | Book List | TOP - Asian Bioethics in the 21st CenturyĤ.2.
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