Right to refuse treatment in Turkey: a diagnosis and a slightly less than modest proposal for reform

Abstract

This paper examines the current state of right to refuse medical treatment in Turkey. Even though there are only a few studies carried out with Turkish physicians on their attitude towards the right to refuse treatment, I argue that recent studies on physicians' views on informed consent and honest disclosure show that Turkish physicians do not tend to recognise their patients' right to decline treatment. This is because the refusal of treatment crucially requires that patients be properly informed and asked for their consent before the treatment. Turkish physicians and healthcare providers' tendency to ignore the right to decline medical treatment cannot be separated from their paternalistic approach to patients and their rights. I argue that part of the problem is the legal framework, which, in essence, is still paternalistic. More specifically, the frequent appearance of the phrase 'medical necessity' in the relevant legislation is conveniently used to justify medical intervention against a patient's will. I conclude the paper by proposing reforms in the legal documents defining and regulating patient rights, including the Constitution of the Turkish Republic, and I will argue that these reforms will help enhance patient rights in Turkey. Turkey has been discussing a new Constitution for the past several years, so my proposal should best be understood as contributing to public discussion of the new Constitution by initiating debate about medical paternalism and patient autonomy in Turkish medicine.

Unintended Consequences of Gender Equality Promotion in Swedish Multicultural Contraceptive Counseling: A Discourse Analysis

“…West-Oram and Buyx (2016, p. 336) have, in a recent publication, discussed a "worrying trend in healthcare policy" in Western countries, namely, that women's reproductive rights to autonomous decisions are increasingly challenged by principles favoring clinicians' rights not to provide care that violates their personal ideological beliefs (West-Oram & Buyx, 2016). If ideological beliefs are given priority, it could exemplify what some scholars would probably define as a type of paternalism (De Zordo, 2012;Irmak, 2016;Larivaara, 2010), in light of which providers are enabled to "expand their own view of the good into the public arena, thereby restricting the freedoms of other people to live according to their own views of the good" (West-Oram & Buyx, 2016, p. 340). This could plausibly endanger patients' perceptions of contraceptive counseling as reliable, trustworthy, and evidence-based, and, in a worst-case scenario, influence peoples' willingness to seek care (see Higgins, Kramer, & Ryder, 2016).…”

Clinicians’ perspectives as medical teachers: A qualitative study

“…The medical paternalist approach as a personal attitude of the clinicians may be one of the reasons for this barrier. The studies in our country show that the paternalist approach still has an undeniable effect on clinicians [21,22]. The paternalist approach of the clinicians may cause the teacher-centred approach in the clinicians' teaching role.…”