Education of Medical Ethics at Istanbul and Uludag Universities, Turkey

- A.D.Erdemir, M.D.
Department of Medical Ethics, Faculty of Medicine, University of Uludag, Bursa, Turkey
- O.Oncel, M.D.
Department of Medical Ethics, Faculty of Medicine, University of Istanbul, Istanbul, Turkey
Email: ademirer@yahoo.com
Eubios Journal of Asian and International Bioethics 11 (2001), 189-191.


B>Introduction

It is known that the problems of physician-ship had various periods. These problems have been investigated in a modern way for many years. Today, we must emphasize medical ethics more than we did in the ancient ages. A physician is always responsible for all moral dilemmas of medicine. The duties and the responsibilities of physicians are important subjects of medical ethics. Furthermore, today, the main subjects of medical ethics are morality and moral justification, types of ethical theory, respect for autonomy, the relation of physician-patient, truth telling, the control of reproduction, euthanasia, organ and tissue transplantations, medical genetics, the responsibility of physician, quackery, consultation etc. The rights of patient are very important from the point of view of the medicial law. Lectures of medical ethics help that the medical students to solve moral dilemmas of medical cases they will face.

Education Of Medical Ethics in Turkey

The lectures of medical ethics were given as a volunteer by some professors until 1933 in Turkey. The first Turkish modern medical school was founded in Istanbul in Turkey in 1839. Nahabet Roussignan (1819-1876) gave the lectures of Medical History, Deontology and Philosophy in Mekteb-i Tibbiye-i Shahane (Medical School) in Turkey in 1876. He was born in Kayseri in Turkey. Moreover, Dr.Joseph Nouridjan (1827-1898) gave the lectures of medical ethics with the name of _lm-i Edeb and Vezaif-i Etibba (The Science of Ethics and the Duties of Physicians in English) in the Medical School in Istanbul in 1877-1881 (4). The examinations of this lectures were in the first class. Afterwards, Dr.HŸseyin Hulki Bey (1862-1894) translated the French ethical books of Dr.Joseph Nouridjan from French to Turkish with the Turkish name of MŸslŸmanlarin Tababete Ettikleri Hizmet (The Services of Moslems to Medicine in English) (1,2). Furthermore, Dr.HŸseyin Remzi Bey and other Turkish physicians gave these lectures as a volunteer. Some ethical parts were also present in the book of Dr.Remzi Bey named Tarih-i Tip (Medical History). Prof.Dr.Weiting Pasha published a book, called Tahsil-i Tababetin Islahi Hususunda Layiha in 1909. In this book, medical ethics was also present among other lessons. This book contained a plan of lessons belonging to every class. Ethics was given in the 5th class and its period was two hours. The name of this lesson was Tababetin Tarihi and Usul-Ÿ _timaiye. Moreover, this lesson had to be given by an associate professor.

Civilian and Militarian Medical Schools were united with the name of Haydarpasha Medical Faculty in 1909. In the same faculty, Dr.Zoeros Pasha gave the lectures of Medical Ethics and Medical History in 1909-1913 and the name of this lecture was Tarih-i Tip and Vezaif-i Etibba (Medical History and the Duties of Physicians in English). The name of this lecture also was Ethical Rules and Medical History in 1915 (3).

Some scientific investigations were made at the beginning of the XXth century in medical ethics. Thus, Prof.Dr.Mustafa MŸnif Pasha (1855-1937) wrote an unpublished book, called _lm-i Vazaif-i Tibbi (The Science of the Medical Duties). The lectures of medical history were given in the first semester in 1925-1927 and its name was medical history and deontology. In these years, these lessons were also lectured by Dr.Galib Ata Atac in the tenth semester. But, this department was closed in 1927 (11). Prof.Dr.Akil Muhtar …zden also gave lectures about medical ethics and medical history in the medical faculty in 1932-1933.

Prof.Dr.A.SŸheyl †nver founded the department of medical history and deontology in Istanbul Medical Faculty in 1933. Today, many medical faculties are present in Turkey and these faculties have the departments of medical ethics. But, these lectures are given together with medical history. These lectures are 30 hours in many medical faculties in Turkey. Approximately, 15 hours belong to medical history and 15 hours to medical ethics. In these faculties, moral dilemmas are solved together with clinicians at the bed-side of the patient. Some lectures are given with video.

We can give some knowledge from two medical faculties about their subjects on medical ethics in Turkey. These faculties are Istanbul Medical Faculty in Istanbul and Uludag University Medical Faculty in Bursa. Istanbul Medical Faculty is the first medical faculty in Turkey and it is in Istanbul.

Istanbul Medical Faculty has the department of medical history and medical ethics and this departmentŐs professors give the lectures of medical ethics together with medical history over 27 hours in two semesters. These lessons are given in the third class and we see a classical system in the medical education of this faculty. The lectures of medical ethics also are 13 hours.

The subjects on the medical ethics in this faculty are as follows:
1. Modern Medicine and Medical Ethics. The Education of Medical Ethics in the World and in Turkey.
2. The Oath of Physician.
3. PatientŐs Rights and Secret of Physician.
4. Duties of Physicians, Responsibility of Physician.
5. International Codes.
6. Ethical Boards in the World and in Turkey.
7. The Place of Medical Experiments in Medical Ethics and the Problems on Clonning.
8. Tissue and Organ Transplantations and Ethical Problems.
9. Euthanasia and Ethical Problems.
10.Consultation and Medical Reports.
11.Abortion, Family Planning and Ethical Problems.
12.Artificial Fecundation and Tube Baby and Ethical Problems.
13.Gene Manipulations and Ethical Problems.

Postgraduate education is present in this department. Many subjects of dcotorate on medical ethics are also investigated.

Another sample on the education of medical ethics can be given from Uludag University, Medical Faculty. Uludag University was founded in 1972 in Brussa. Brussa is a neighbour of Istanbul and it is an antique city. The lectures of medical ethics were given by the professors of other departments until 1980 in this faculty. The department of medical ethics and medical history was founded in 1980. The lectures of medical ethics are given together with medical history in this department. The lectures of medical ethics are 20 hours. These lectures are taught in the third class in this faculty. Integrity system is applied in the medical education of this faculty. The subjects on the medical ethics are as follows:
1. The meanings of medical deontology and medical ethics.
2. Ethical Rules.
3. Ethical Principles, Respect for Autonomy, Nonmaleficence, Beneficence, Justice, Paternalism, Veracity, Privacy, Confidentiality, Fidelity and Ethical Problems (13,14).
4. Types of Ethical Rules.
5. The Responsibility of Physician (7).
6. The Relations of Patient-Physician.
7. Human Rights, PatientŐs Rights, PhysicianŐs Rights.
8. Informed Consent.
9. Quackery, Consultation, Medical Secret, Medical Reports and Ethical Problems.
10.Euthanasia, Organ Transplantation.
11.Reproduction and Ethical Problems.
12.Genetical Problems and Ethics (8,9,10).
13.Hibernation and Ethics.
14.Ethical Boards, Education of Medical Ethics.
15.Medical Experiments and Ethics.

Ethical Dilemmas on some medical cases are discussed with the medical students (15,16,17). The students try to solve these kinds of ethical problems and so, they learn some truths in these lessons.

Conclusion

Medical Ethics tries to solve the ethical dilemmas between patient and physician (5,6). Therefore, the education of medical ethics develops in a modern form in all the medical faculties in Turkey.

References

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2. Yildirim, N.: Nahabed Roussignan, The First Professor of Deontology at the Royal School of Medicine. Yeni Tip Tarihi Arastirmalari. Ist. 1995. pp.148-165.
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10.Garrison, F.: An Introduction to the History of Medicine, Press of W.B. Saunders, London, 1929.
11.Sehsuvaroglu, B.N.: Tibbi Deontoloji Dersleri, HŸsnŸtabiat Matbaasi, Ist. 1975, pp.29-30.
12.Margalith, D.: The Doctor in Ancient Hebrew Writings, Journal of the History of Medicine and Allied Sciences, 12:37-41, 1957.
13.Bok, S. Lying: Moral Choice in Public and Private Life. New York, Vintage Books. 1973.
14.Demirhan, E.A. Lectures on Medical History and Medical Ethics, Nobel Tip Kitabevleri, Istanbul. 1995. pp.100-120.
15.Cade, J.: An Evaluation of early patient contract for medical students. Medical Education, 27:205-210 (1993).
16.Harris, J.: The Value of Life, London. 1997, pp.1-25.
17.Beauchamp, T.L., Childress, J.F.: Principles of Biomedical Ethics, New York. 1994. pp.120-395.

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