ETHICAL ISSUES IN BARIATRIC SURGERY: A SYSTEMATIC REVIEW

Yıl 2024, Cilt: 6 Sayı: 2, 167 - 180

Dolunay Özlem Zeybek , Vahit Yiğit

Öz

Bariatric surgery (BS) is an effective treatment method used in the management of obesity. With the increasing prevalence of obesity, the number of individuals treated through BS continues to rise. Ethical analysis is one of the nine dimensions of Health Technology Assessment (HTA). Ethical debates surrounding the treatment of obesity through BS are ongoing. The aim of this study is to systematically review research examining the ethical issues related to BS. A systematic search was conducted in the PubMed database from 2000 to 2023, resulting in 549 articles. Ten articles were included in the study based on inclusion and exclusion criteria. Half of the studies addressed ethical issues related to BS in the general obese population. The other studies focused on ethical concerns in obese children, adolescents, and individuals with intellectual and developmental disabilities. Ethical issues discussed in relation to BS include the medicalization of obesity, risks and complications, uncertainty, insufficient scientific knowledge, informed consent, justice, autonomy, access, equity, stigma, cost, and societal perception. The treatment of obese children and adolescents with BS is one of the most debated ethical issues. To effectively combat this condition in Turkey, health policies should be developed to increase public awareness about obesity and encourage individuals to adopt healthy eating and regular physical activity habits. Additionally, conducting cost-effectiveness analyses of obesity treatment programs is recommended.

Anahtar Kelimeler

Bariatric Surgery, Obesity Surgery, Systematic Review, Ethics

BARİYATRİK CERRAHİNİN ETİK SORUNLARI: SİSTEMATİK BİR İNCELEME

Öz

Bariyatrik cerrahi (BC) obezite tedavisinde kullanılan etkili bir tedavi yöntemidir. Obezite oranının artmasıyla birlikte BC yöntemiyle tedavi edilen birey sayısı da her geçen gün artmaktadır. Etik analiz, Sağlık Teknolojisi Değerlendirme (STD)'nin dokuz boyutundan biridir. Obezitenin BC ile tedavisinde etik tartışmalar devam etmektedir. Bu çalışmanın amacı BC ile ilgili etik konuları inceleyen araştırmaları sistematik olarak incelemektir. Sistematik taramada 2000-2023 yılları arasında Pubmed veri tabanı taranmış ve 549 makaleye ulaşılmıştır. Dahil etme ve dışlama kriterleri kapsamında 10 makale çalışmaya alınmıştır. Çalışmaların yarısı genel obez bireylerde BC ile ilgili tartışılan etik konuları ele almıştır. Diğer çalışmalarda ise çocuklar, ergenler ile zihinsel ve gelişimsel bozukluğu olan engelli obezlerde etik sorunlar incelenmiştir. BC ile ilgili tartışılan etik konular; obezitenin tıbbileştirilmesi, risk ve komplikasyonlar, belirsizlik, yetersiz bilimsel bilgi, bilgilendirilmiş onam, adalet, özerklik, erişim, eşitlik, damgalama, maliyet ve toplumsal algıdır. Çocuk ve ergen obez hastaların BC ile tedavi olması, etik olarak tartışılan en önemli konulardan biridir. Türkiye’de bu hastalıkla etkin şekilde mücadele etmek, toplumun obezite ile mücadele konusunda bilgi düzeyini artırarak bireylerin sağlıklı beslenme ve düzenli fiziksel aktivite alışkanlığı kazanmalarını teşvik edecek sağlık politikaları geliştirilmelidir. Ayrıca obezite ile mücadele kapsamında yürütülen programın maliyet etkililik analizlerinin yapılması önerilmektedir.

Anahtar Kelimeler

Bariyatrik Cerrahi, Obezite Cerrahisi, Sistematik Tarama, Etik

Etik Beyan

Çalışma sistematik tarama olduğu için etik kurul izni gerektirmemektedir.

Destekleyen Kurum

Destekleyen kurum ve kuruluş yoktur.

Kaynakça

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