Psikiyatrinin etkin biyolojik tedavisi olan elektrokonvülsif tedaviye tıp etiği ve hukuku açısından güncel bir bakış

Yıl 2016, Cilt: 30 Sayı: 3, 243 - 249, 31.12.2016

Yasin Hasan Balcıoğlu Filiz Ekim Çevik İbrahim Balcıoğlu

https://izlik.org/JA74LM57EP

Öz

Elektrokonvülsif terapi EKT birçok psikiyatrik hastalığın tedavisinde kullanılan etkili bir biyolojik sağaltım yöntemidir. Bu tedavinin etik ve hukuki boyutu, ruhsal hastalıkların tedavisinde kullanılmaya başlandığından beri tartışılmaktadır. Uzun süredir kullanılan bir tedavi olmasına rağmen, elektrokonvülsif terapi alan hastaların olumsuz ifadeleri, sağlık çalışanları ve kitle iletişim araçlarının uygulamayı “şok tedavisi” olarak nitelendirmeleri, tedaviyle ilgili çeşitli konularda standart yaklaşımların net olmaması, uygulamanın yöntemsel sorunları elektrokonvülsif terapinin toplum nezdinde tedaviden ziyade ceza yöntemi olarak görülmesine ve önyargı oluşmasına sebep olmuştur. Psikiyatrik bozukluğu olan hastaların klinik araştırma ve tedaviye katılma konusundaki karar verme yeterliği hem yasal hem de tıp etiği zemininde hala tartışılan bir konu olmakla birlikte yaygın bir şekilde araştırılmaktadır. Psikiyatrik hastaların zorunlu ve istemsiz şekilde yatırılarak tedavi edilme gerekliliği birçok ülkede müstakil ruh sağlığı yasalarıyla güvence altına alınmıştır. Ancak, ülkemizde farklı yönetmelik ve yasa maddelerinin varlığı bu hastaların gözlem ve tedavileri hususunda sağlık profesyonellerini çoğu zaman zaman ikilemde bırakmaktadır. Ülkemizde 2006 yılında yürürlüğe giren EKT yönergesi uygulamanın esaslarını belirtse de, hukuki açıdan geçerliği ve Hasta Hakları Yönetmeliği ile çelişen içeriği, benzer ikilemlerin EKT uygulamalarında da kimi zaman yaşanmasına neden olmaktadır. Bu yazıda, elektrokonvülsif terapinin etik ve hukuki boyutu güncel yaklaşımlar ve bilgiler ışığında irdelenmiştir.

Anahtar Kelimeler

Elektrokonvülsif terapi , etik , hasta hakları yönetmeliği , ruh sağlığı

Current ethical and medicolegal perspectives on electroconvulsive therapy, an effective biological treatment of psychiatry, at a glance

https://izlik.org/JA74LM57EP

Öz

Electroconvulsive therapy ECT is an effective biological treatment method used in the treatment of many psychiatric disorders. The ethical and legal aspects of the aforementioned treatment have been discussed since it began to be applied in the treatment of mental illnesses. Although it has been used for a long time, negative feedback of patients about ECT, derogatory definition of ECT as “shock therapy” by health professionals and the mass media, the lack of clear standards and well defined scientific approach of the various issues related to the treatment and methodological problems regarding the treatment caused a prejudice for the society, and therefore ECT is considered as a punishment rather than a treatment. Decision-making competence of patients with psychiatric disorder in clinical research and their participation in the treatment process are still a matter of discussion in terms of both legal and medical ethics and the aforementioned issues are still being investigated. The necessity of hospitalization of psychiatric patients in forced and involuntary way is assured by extensive mental health laws in many countries. However, most of the time the existence of different regulations and legal provisions in our country leave the health professionals in dilemma regarding observation and treatment of these patients. In our country, ECT directive that came into force in 2006 define the principles of the treatment, nevertheless, legal validation and contradictory context of the legal framework with respect to the Patients’ Rights Directive cause similar dilemma. In this paper, the ethical and legal aspects of electroconvulsive therapy were examined in the light of current scientific approaches and knowledge.

Anahtar Kelimeler

Electroconvulsive therapy , ethics , mental health , patients’ rights directive

Kaynakça

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