Research Article


DOI :10.26650/JARHS2021-945971   IUP :10.26650/JARHS2021-945971    Full Text (PDF)

Normative Analysis and Ethical Evaluation of Clinical Ethical Guidelines Published in the Context of Intensive Care Triage During Covid-19 Pandemic

Esra AksoyMerve Nur Koçak Öztürkİlhan İlkılıç

Throughout the COVID-19 pandemic, the rapid increase in the number of cases during certain periods has caused a high occupancy rate in intensive care units. Faced with a sudden and rapid increase in the number of patients, a lack of medical resources or its possibility led to ethical discussions on the immediate and equitable distribution of resources in intensive care units. This has not only given impetus to the ethical debate, but many medical professional organisations in Europe have published guidelines for triage of critical care which contain ethical criteria. In this study, some of the ethical triage guides have been normatively analyzed and ethically evaluated. Objective: The aim of this study is to identify and determine the parameters and normative concepts contained in the guidelines for triage published by the intensive care associations of Germany, Austria, Belgium, France, England, Switzerland and Italy. The results of this investigation were also critically and ethically evaluated and reflected. Materials and Methods: Critical normative analysis and ethical evaluation of clinical ethical guidelines published by intensive care and anaesthesia associations of the above-mentioned countries. Results: Although the studied triage guides used common parameters and similar normative concepts, there are significant differences between them. These differences were determined to be related to the triage criteria used, triage objectives, age factor, priority given to certain social groups and the application of different treatments to Covid-19 patients. Conclusion: Although the European countries that have published triage guides come from the same cultural tradition, the normative criteria and concepts they used in the triage guides are considered different values and priorities in their rankings. These differences may be due to the current political and ethical culture, also to the current economic and socio-cultural resources and their strategies for using their resources. Because of these facts and the reasons which we found, they should be considered in the preparation of ethical triage guidelines in Turkey.

DOI :10.26650/JARHS2021-945971   IUP :10.26650/JARHS2021-945971    Full Text (PDF)

Covid-19 Pandemisinde Yoğun Bakım Triyajı Bağlamında Hazırlanan Klinik Etik Rehberlerin Normatif Analizi ve Etik Değerlendirmesi

Esra AksoyMerve Nur Koçak Öztürkİlhan İlkılıç

Covid-19 Pandemisi sürecinde vaka sayılarının belli dönemlerde hızla yükselmesi yoğun bakım ünitelerinde yüksek doluluk oranlarına sebep olmuştur. Hasta sayısında yaşanan bu ani ve hızlı yükseliş karşısında tıbbi kaynakların yetersiz kalması ihtimali ve tecrübeleri yoğun bakım hizmetlerinde kaynakların acil ve adil dağıtımı ile ilgili etik tartışmaları başlatmıştır. Bu durum sadece etik tartışmalara ivme kazandırmakla kalmamış aynı zamanda Avrupa’daki birçok tıbbi meslek kuruluşu yoğun bakım triyajı için etik kriterler içeren rehberler yayınlamıştır. Bu çalışmada Avrupa’da yayınlanan bazı klinik-etik triyaj rehberleri normatif analize tabi tutularak etik açıdan değerlendirilmiştir. Amaç: Almanya, Avusturya, Belçika, Fransa, İngiltere, İsviçre ve İtalya’nın yoğun bakım derneklerinin triyaj için yayınlamış olduğu rehberlerin içerdikleri genel parametreleri ve normatif kavramları belirlemek ve bunların eleştirel bir değerlendirmesinden ortaya çıkan sonuçları tespit etmektir. Gereç ve Yöntem: Yukarıda adı geçen ülkelerin yoğun bakım ve anestezi derneklerinin Covid-19 pandemisi bağlamında yayınladıkları triyaj rehberlerinin eleştirel normatif analizi ve etik prensiplere göre değerlendirilmesi. Bulgular: İncelenen triyaj rehberleri ortak parametreler ve benzer normatif kavramlar kullanmış olmasına rağmen, birbirleri arasında önemli farklar bulunmaktadır. Bu farklılıkların kullanılan triyaj kriterleri, triyaj hedefleri, yaş faktörü, bazı sosyal gruplara öncelik verilmesi, ilk müdahale yapılması ve Covid-19 hastalarına farklı uygulama yapılması alanlarında olduğu tespit edilmiştir. Sonuç: Triyaj rehberlerini yayınlayan Avrupa ülkeleri aynı kültür geleneğinden gelse bile triyaj rehberlerinde kullandıkları kriterlere ve normatif kavramlara farklı değerler atfedilmiş ve farklı öncelikler verilmiştir. Bu farklılıkların oluşmasında güncel siyasi yaklaşımlar ve geçerli etik kültür etkili olabildiği gibi, o ülkenin hali hazırdaki maddi ve sosyo-kültürel kaynakları ve bu kaynakların kullanılmasındaki stratejileri de önemlidir. Bu bağlamda ülkemizde etik triyaj rehberlerine ihtiyaç duyulduğunda acilen hazırlanmalı ve hazırlanma sürecinde tüm bu noktalar göz önüne alınmalıdır. 


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APA

Aksoy, E., Koçak Öztürk, M., & İlkılıç, İ. (2021). Normative Analysis and Ethical Evaluation of Clinical Ethical Guidelines Published in the Context of Intensive Care Triage During Covid-19 Pandemic. Journal of Advanced Research in Health Sciences, 4(1), 19-36. https://doi.org/10.26650/JARHS2021-945971


AMA

Aksoy E, Koçak Öztürk M, İlkılıç İ. Normative Analysis and Ethical Evaluation of Clinical Ethical Guidelines Published in the Context of Intensive Care Triage During Covid-19 Pandemic. Journal of Advanced Research in Health Sciences. 2021;4(1):19-36. https://doi.org/10.26650/JARHS2021-945971


ABNT

Aksoy, E.; Koçak Öztürk, M.; İlkılıç, İ. Normative Analysis and Ethical Evaluation of Clinical Ethical Guidelines Published in the Context of Intensive Care Triage During Covid-19 Pandemic. Journal of Advanced Research in Health Sciences, [Publisher Location], v. 4, n. 1, p. 19-36, 2021.


Chicago: Author-Date Style

Aksoy, Esra, and Merve Nur Koçak Öztürk and İlhan İlkılıç. 2021. “Normative Analysis and Ethical Evaluation of Clinical Ethical Guidelines Published in the Context of Intensive Care Triage During Covid-19 Pandemic.” Journal of Advanced Research in Health Sciences 4, no. 1: 19-36. https://doi.org/10.26650/JARHS2021-945971


Chicago: Humanities Style

Aksoy, Esra, and Merve Nur Koçak Öztürk and İlhan İlkılıç. Normative Analysis and Ethical Evaluation of Clinical Ethical Guidelines Published in the Context of Intensive Care Triage During Covid-19 Pandemic.” Journal of Advanced Research in Health Sciences 4, no. 1 (Dec. 2021): 19-36. https://doi.org/10.26650/JARHS2021-945971


Harvard: Australian Style

Aksoy, E & Koçak Öztürk, M & İlkılıç, İ 2021, 'Normative Analysis and Ethical Evaluation of Clinical Ethical Guidelines Published in the Context of Intensive Care Triage During Covid-19 Pandemic', Journal of Advanced Research in Health Sciences, vol. 4, no. 1, pp. 19-36, viewed 9 Dec. 2021, https://doi.org/10.26650/JARHS2021-945971


Harvard: Author-Date Style

Aksoy, E. and Koçak Öztürk, M. and İlkılıç, İ. (2021) ‘Normative Analysis and Ethical Evaluation of Clinical Ethical Guidelines Published in the Context of Intensive Care Triage During Covid-19 Pandemic’, Journal of Advanced Research in Health Sciences, 4(1), pp. 19-36. https://doi.org/10.26650/JARHS2021-945971 (9 Dec. 2021).


MLA

Aksoy, Esra, and Merve Nur Koçak Öztürk and İlhan İlkılıç. Normative Analysis and Ethical Evaluation of Clinical Ethical Guidelines Published in the Context of Intensive Care Triage During Covid-19 Pandemic.” Journal of Advanced Research in Health Sciences, vol. 4, no. 1, 2021, pp. 19-36. [Database Container], https://doi.org/10.26650/JARHS2021-945971


Vancouver

Aksoy E, Koçak Öztürk M, İlkılıç İ. Normative Analysis and Ethical Evaluation of Clinical Ethical Guidelines Published in the Context of Intensive Care Triage During Covid-19 Pandemic. Journal of Advanced Research in Health Sciences [Internet]. 9 Dec. 2021 [cited 9 Dec. 2021];4(1):19-36. Available from: https://doi.org/10.26650/JARHS2021-945971 doi: 10.26650/JARHS2021-945971


ISNAD

Aksoy, Esra - Koçak Öztürk, Merve Nur - İlkılıç, İlhan. Normative Analysis and Ethical Evaluation of Clinical Ethical Guidelines Published in the Context of Intensive Care Triage During Covid-19 Pandemic”. Journal of Advanced Research in Health Sciences 4/1 (Dec. 2021): 19-36. https://doi.org/10.26650/JARHS2021-945971



TIMELINE


Submitted31.05.2021
Accepted29.07.2021
Published Online20.10.2021

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