Öz
Günümüz sağlık hizmetlerinin belirlenmesinde, üretilmesinde ve sunumunda kalite ve etik iki vazgeçilmez olgudur. Sağlık hizmetlerinin kabul edilebilirlik derecesi, bu iki olgunun hayata geçirilmesiyle doğru orantılıdır. Ancak, kalite ve etik kavramlarının neyi ifade ettikleri ve bunların birbirleriyle olan ilişkinin ne yönde olduğu hususları yeterli açıklıkta değildir. Bu sebeple, işbu makalede, kalite ve etik kavramlarının kısaca tarif edilmesi, bu kavramların sağlık hizmetlerinde nasıl anlaşılması gerektiği ve bahsi geçen iki kavramın birbiriyle olan ilişkisinin ne olduğunun izah edilmesi amaçlanmıştır. Normatif bir bakış açısıyla yapılan değerlendirmede, kalite kavramının, farklı paydaşların farklı beklentileri, ihtiyaçları ve amaçları doğrultusunda farklı biçimde tarif edildiği ve bu durum sebebiyle, sağlık hizmetlerinde kalitenin, direkt bir tanım yerine, 6 bileşen kapsamında ele alındığı anlaşılmıştır. Diğer yandan, sağlık sistemindeki politikaların, kararların ve uygulamaların ahlaken doğruluğunu ve yanlışlığını inceleyen etik, söz konusu analiz ve değerlendirmelerini biyoetik ilkeler vasıtasıyla yerine getirmektedir. Kalite bileşenleri ile biyoetik ilkelerin bir arada ele alınmasında, bunların aynı amaçları taşıdıkları veya benzer hususlara işaret ettikleri görülmüştür. Bu çerçevede, etik bakış açısının ve etik ilkelerin, kalite bileşenlerinin gerçekleştirmede ve kalite uygulamalarına meşruiyet kazandırmada zorunlu unsurlar olduğu sonucuna varılmıştır.
Anahtar Kelimeler
Kaynakça
- Beachamp, TL. ve Childress, JF. (2013). Principles of Biomedical Ethics, 7. Baskı. New York: Oxford University Press.
- Bendik-Keymer, J. (2013). The Moral and the Ethical: What Conscience Teaches Us about Morality. Vasil Gluchman içinde Morality: Reasoning on Different Approaches (s. 11-23). Amsterdam: Rodopi.
- Bynum, W. (2008). History of Medicine: A Very Short Introduction. Oxford; New York: Oxford University Press.
- Cambridge Online Sözlük, Erişim 2 Şubat 2022, https://dictionary.cambridge.org/.
- Chakrapani, C. (1998). How to Measure Service Quality and Customer Satisfaction: The Informal Field Guide for Tools and Techniques. Chicago: American Marketing Association.
- Chandrupatla, TR. (2009). Quality and Reliability in Engineering. New York: Cambridge University Press. Cheng, YC ve Tam, WM (1997). Multi-models of Quality in Education. Quality Assurance in Education, 5(1), 22-31.
- Chua, C. (2004). Perception of Quality in Higher Education. AUQA Occasional Publication, 1-6.
- Crosby, PB. (1979). Quality is Free: The Art of Making Quality Certain. New York; St. Louis; San Francisco: McGraw-Hill Book Company.
- Deming, WE. (1986). Out of the Crisis, second printing. Cambridge: Massachusetts Institute of Technology Center for Advanced Engineering Study.
- Doherty, GD. (2008). On Quality in Education. Quality Assurance in Education, 16(3), 255-265.
- Donabedian, A. (2003). An Introduction to Quality Assurance in Health Care, Rashid Bashshur (Ed.). New York: Oxford University Press.
- Donabedian, A. (1968). The Evaluation of Medical Care Programs. Bulletin of the New York Academy of Medicine, 44(2), 117-124.
- Edelstein, L. (1967). Ancient Medicine, Owsei Temkin and C. Lilian Temkin (Eds.), C. Lilian Temkin (Terc.). Baltimore: The Johns Hopkins University Press.
- Garvin, DA. (1984). What Does “Product Quality” Really Mean?” Sloan Management Review, 25-43.
- Gert, B. (2005). Morality: Its Nature and Justification. Oxford; New York: Oxford University Press.
- Hhs.gov. Belmont Report, Erişim 4 Şubat 2022, https://www.hhs.gov/ohrp/sites/default/files/the- belmont-report-508c_FINAL.pdf.
- Institute of Medicine (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, D.C.: National Academy Press.
- Institute of Medicine (1990). Medicare: A Strategy for Quality Assurance Volume I, Kathleen N. Lohr (Ed.). Washington, D.C.: National Academy Press.
- Jonsen, A R. (1998). The Birth of Bioethics. New York: Oxford University Press.
- Juran, JM. (1988) The Quality Function. J. M. Juran and Frank M. Gryna içinde Juran’s Quality Control Handbook, 4. Baskı. (s. 2.1-2.13). New York; St. Louis; San Francisco: McGraw-Hill Book Company.
- Miles, SH. (2004). The Hippocratic Oath and the Ethics of Medicine. New York: Oxford University Press.
- Prisacariu, A. ve Shah, M. (2016). Defining the Quality of Higher Education around Ethics and Moral Values. Quality in Higher Education, 22(2), 152-166.
- Rich, KL. (2016). Introduction to Ethics. Janie B. Butts ve Karen L. Rich içinde Nursing Ethics: Across the Curriculum and into Practice, 4. Baskı (s. 3-30). Burlington: Jones & Bartlett Learning, Burlington.
- Türk Dil Kurumu Sözlüğü, Erişim 2 Şubat 2022, https://sozluk.gov.tr/.
- World Health Organization (2006). Quality of Care: A Process for Making Strategic Choices in Health Systems. Geneva: WHO Press.
Öz
Quality and ethics are two indispensable phenomena in the determination, production, and delivery of contemporary healthcare services. The degree of acceptability of healthcare services is directly proportional to the realization of these two phenomena. However, it is questionable what the concepts of quality and ethics mean and how they relate to each other. For this reason, the paper aims to briefly describe the concepts of quality and ethics, explain how these concepts should be understood in healthcare services, and what the relationship between these two concepts is. The normative assessment demonstrated that the concept of quality is defined differently in line with different stakeholders’ different expectations, needs, and purposes, and due to this situation, instead of a direct definition, quality in healthcare is considered within the scope of 6 components. On the other hand, ethics, which examines the moral rightness and wrongness of policies, decisions, and practices in the health system, carries out these analyzes and evaluations through bioethical principles. Evaluating quality components and bioethical principles together showed that they have the same goals or point out similar issues. In this context, the presentation concluded that the ethical perspective and ethical principles are necessary elements in the realization of quality components and in legitimizing quality practices.
Anahtar Kelimeler
Kaynakça
- Beachamp, TL. ve Childress, JF. (2013). Principles of Biomedical Ethics, 7. Baskı. New York: Oxford University Press.
- Bendik-Keymer, J. (2013). The Moral and the Ethical: What Conscience Teaches Us about Morality. Vasil Gluchman içinde Morality: Reasoning on Different Approaches (s. 11-23). Amsterdam: Rodopi.
- Bynum, W. (2008). History of Medicine: A Very Short Introduction. Oxford; New York: Oxford University Press.
- Cambridge Online Sözlük, Erişim 2 Şubat 2022, https://dictionary.cambridge.org/.
- Chakrapani, C. (1998). How to Measure Service Quality and Customer Satisfaction: The Informal Field Guide for Tools and Techniques. Chicago: American Marketing Association.
- Chandrupatla, TR. (2009). Quality and Reliability in Engineering. New York: Cambridge University Press. Cheng, YC ve Tam, WM (1997). Multi-models of Quality in Education. Quality Assurance in Education, 5(1), 22-31.
- Chua, C. (2004). Perception of Quality in Higher Education. AUQA Occasional Publication, 1-6.
- Crosby, PB. (1979). Quality is Free: The Art of Making Quality Certain. New York; St. Louis; San Francisco: McGraw-Hill Book Company.
- Deming, WE. (1986). Out of the Crisis, second printing. Cambridge: Massachusetts Institute of Technology Center for Advanced Engineering Study.
- Doherty, GD. (2008). On Quality in Education. Quality Assurance in Education, 16(3), 255-265.
- Donabedian, A. (2003). An Introduction to Quality Assurance in Health Care, Rashid Bashshur (Ed.). New York: Oxford University Press.
- Donabedian, A. (1968). The Evaluation of Medical Care Programs. Bulletin of the New York Academy of Medicine, 44(2), 117-124.
- Edelstein, L. (1967). Ancient Medicine, Owsei Temkin and C. Lilian Temkin (Eds.), C. Lilian Temkin (Terc.). Baltimore: The Johns Hopkins University Press.
- Garvin, DA. (1984). What Does “Product Quality” Really Mean?” Sloan Management Review, 25-43.
- Gert, B. (2005). Morality: Its Nature and Justification. Oxford; New York: Oxford University Press.
- Hhs.gov. Belmont Report, Erişim 4 Şubat 2022, https://www.hhs.gov/ohrp/sites/default/files/the- belmont-report-508c_FINAL.pdf.
- Institute of Medicine (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, D.C.: National Academy Press.
- Institute of Medicine (1990). Medicare: A Strategy for Quality Assurance Volume I, Kathleen N. Lohr (Ed.). Washington, D.C.: National Academy Press.
- Jonsen, A R. (1998). The Birth of Bioethics. New York: Oxford University Press.
- Juran, JM. (1988) The Quality Function. J. M. Juran and Frank M. Gryna içinde Juran’s Quality Control Handbook, 4. Baskı. (s. 2.1-2.13). New York; St. Louis; San Francisco: McGraw-Hill Book Company.
- Miles, SH. (2004). The Hippocratic Oath and the Ethics of Medicine. New York: Oxford University Press.
- Prisacariu, A. ve Shah, M. (2016). Defining the Quality of Higher Education around Ethics and Moral Values. Quality in Higher Education, 22(2), 152-166.
- Rich, KL. (2016). Introduction to Ethics. Janie B. Butts ve Karen L. Rich içinde Nursing Ethics: Across the Curriculum and into Practice, 4. Baskı (s. 3-30). Burlington: Jones & Bartlett Learning, Burlington.
- Türk Dil Kurumu Sözlüğü, Erişim 2 Şubat 2022, https://sozluk.gov.tr/.
- World Health Organization (2006). Quality of Care: A Process for Making Strategic Choices in Health Systems. Geneva: WHO Press.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makale |
| Yazarlar | |
| Yayımlanma Tarihi | 11 Kasım 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 20 Sayı: 1 |
Sağlık Hizmetleri Genel Müdürlüğü
Sağlıkta Performans ve Kalite Dergisi