Children's Health Rights in Turkey
Kirimlioglu and Omur Elcioglu Ph.D
Eubios Journal of Asian and International Bioethics 12 (2002), 221-3.
Osmangazi University School of
Medicine, Department of Medical Ethics and History of Medicine, Eskisehir , TURKEY
right to health is one of the significant examples of social rights and
includes the tasks that the state must perform. Citizens should expect positive
things from the state. In Turkey, legally each individual who is between 0-18 years of age is a child. This paper introduces some
legal rights of children related to medical ethics. Parents of a child who is
under age and mentally retarded are responsible for giving the necessary
education to him/her (Civil Law clause 264 ).If it is not possible for parents
to take the necessary precautions due the mental disorders of their children,
parents have the right to want the judge to take necessary precautions and
expenses to be paid by the government (Civil law clause 273).If parents neglect
their responsibilities seriously, it allows maximum interference with
sovereignty of children and in such a case, sovereignty rights of parents may
be taken away by the judge (Civil Law clause 274). There are also certain
sentences concerning Child Health in Criminal law. From this respect, a parent
who leaves an ailing child belonging to him or her is punised (Turkish
Criminal Law clause 473). Under the
Criminal Law, sexual crimes
committed against children are punished more severely, and if these crimes are
committed by those who have authority on the children , than those persons are
punished much more severely (Turkish Criminal Law clause 415 and 417).
abuse and negligence continues to be one of the most important threats to the
healthy and normal development of children all over the world. First of all,
negligence, in other words "careless taking care of the children" is a
problem or a behavior seen in a family atmosphere. But, this problem grows up
gradually in other atmospheres as well. Child abuse is a subject that is
evaluated in various disciplines. Medical, legal, psychological and
sociological approaches all handle the different dimensions of this subject.
Naturally, it is observed that, these approaches, even in the description of
the "abuse", are in different dimensions about the subject that includes a
lot of perspectives and a lot of variables. How can we describe the behaviours
that are directed toward the children and collected under the title of
"child abuse" all over the world? The first question that needs to be
asked is, which behaviours are included under the title of "harassment of
that prevent the healthy and normal development of a child can be called as
"harassment of children". The answer of the question, "how can
they be encountered?" is: "Child and teenager abuse can either be in
physiological, mental, sexual, emotional or negligence form.Child abuse is a disease that is
related with all parts of the society." Because there were a lot of
descriptions about child abuse, the World Health Organisation assembled experts
of the subject to discuss the matter in 1985 and as a result, the following
description was accepted: "The intentional and unintentional behaviours
which affect a child's physiological and psycho-social development, towards the
children by adults, society and country are called as child abuse. This
description also includes actions, which a child doesn't percept and adults
don't accept. For a behaviour to
be a child abusing subject, this behaviour doesn't need to be percepted by a
child and adults as child abusing subject. (2)."
and their Health Rights
this study, beginning with the descriptions of "child abuse" and
"mistreatment of a child", and thinking that negligence of the children's
health right is also a child abuse, we targeted to examine children's health
rights in our country's legal texts. A child is dependent to his parents in the
period from his/her birth to his/her adolescence. This phase is very important
because children are weak both physically and mentally in this period (1).
can be deceived, directed, formed and are weak. For that reason, their
interests must be protected carefully. Separating children's rights from the
"human rights" which was recognized for all human beings to not be
different, is still a necessity because of the special conditions that children
are in as stated above.
25/2nd article of Universal Declaration of Human Rights expresses
that "Motherhood and childhood are entitled to special care and
assistance" and bases the fundamentals of law studies on mother and child,
which develops day by day and in international field and affects the nations
(4). Children's rights is a concept that cares about the special conditions of
children who are accepted as the most desperate. All rights, basically, remind
some obligations and responsibilities. These are the obligations and
responsibilities of adults to children, obligations and responsibilities of
powerful people to weak people (1).
basic responsibility of a country is to protect "rights of living" of its
people (7). providing it depends on protecting the health rights of the people.
Health rights are described as the right, which provides protection, and
development of an individual's health. Protecting an individual's health, both
directly and via the cooperation of private enterprise and local
administration, is one of the basic obligations of a country (8).
are in very different health standards in our world. The most affected people
from these different standards are the children. The serious conditions of innocent
children, which come into being due to miscare and lack of the good care, are
very important for human rights and important unsolved ethical problems. Giving
equal opportunity for all people in health is basic element of being human (9).
A child's health right begins with the time that she goes into womb. It's
related with the mother health in the first degree during the pregnancy of the
mother and suckling period. Then, it continues to be related with society's
health in different phases (10).
3. Children's Rights in National and International
The "Geneva Children's Rights
Declaration" which was accepted by United Nations on 26th September
1924, is the source of basics of the current Turkish civilized Children's Bill
of Rights and had been accepted and signed by our first president Atatčrk in
1928. In the 4th article of this declaration, it is accepted that
children have the right to benefit from health rights beginning with birth, and
it still keeps its importance (11).
strategies, first for children under risquÄ, to protect world children's rights
are defined clearly in the frame of the United Nations Children's Rights
Proclamation on 20th November 1959 and United Nations Children's
Rights Convention on 20th November 1989. Our country signed this on
14th September 1990, the Grand National Assembly of Turkey approved
it on 27th January 1995 published it as law code on the official
gazette numbered as 4058. It is on the 24th article of this law
named as "Beneficing from Health Approaches." (12).
24: Health and Health Services.
of the Convention cannot be separated and they complete each other. The 24th
article cannot be thought to be different from other articles.
principles need to be thought over carefully.
2. Authorized people recognize all of the children's rights without separating
33 (1): Child benefit is the basic in the actions related with children.
6: The living right of children is recognized and it is mandatory to provide a
child to live as much as possible and to develop.
Article 12: Necessary attention is shown
for a child to express his/her own points of view about every subjects related
with him/her. This is the same for the judicial and administrative
related articles with the 24th article in practice include:
5: Guiding by parents and
improvements of child skills
17: the functions of the mass media and reaching necessary information
18: Parent's responsibilities and
19: Protecting form all kind of mistreatment
23: The rights of disabled children
25: Looking over the medical treatment and the other conditions of children,
27: Rights of reaching sufficient life standards
28: Education right
29: Objectives of Education
32-36: Protection form various forms of exploitation and abuse
39: Recovering of the unjustly treated children and making them part of the
"Global Health Strategy" which was accepted in 1981, is foreseeing
institutional cooperation internationally for the year 2000. In the frame of
the action which came to realization in the United Nations' headquarters in
1990, WHO and UNICEF argued that all the world's children should have health
rights taken into consideration in a detailed way, in the declaration related
with children' survival, projection and developments. The health rights of children in this declaration and action
healthy environment conditions and giving health education for the children
between 0 and 18 years of age (especially for before birth and infant period)
are committed and decisions were made about pulling back the infant death ratio
to minimum level and national and international cooperation in this field."
Bali Declaration, which is the new looked over form by World Doctor's Unity of
Lisbon Patient's Right Declaration, has some regulations for children. In
accordance with the 5th article of this declaration, patients who
don't have legal rights should have some rights, not only the guardian of the
child but also children should have right on health decisions.
accordance with 5th article of this declaration for patients who
doesn't have legal right; states 1) It is necessary for a patient's guardian to
decide about patient if the patient is a child or doesn't have legal right.
However these kinds of patients should also take part in the decision-making
process in accordance with their conditions; 2) If the patient, who doesn't
have legal rights, is able to make rational decision, it is necessary to
respect to this decision. In this case, patient has the right to refuse inform
his/her guardian; and 3) In the case that the guardian or the person who was
given authority by the patient, refuses to approve the decision about patient,
and if the doctor's decision is on behalf of the patient, decision making
should belong to legal authorities (13).
proclamation about "the right of the children who are hospitalized"
published by the world doctors' Unity Day on 22nd October 1996.
Health care of the hospitalized children has very close relationship with the
processes that affect recovery of the patient such as medical, social,
financial conditions. For that reason, special care should be taken in the
rights of the hospitalized children. That the evaluating and taking care of the
bitterness that the children suffer and insufficiency of the treatment on
hospitalized children have been well known. For finding the sources to support
these children, it is necessary to emphasize the hospitalized children's rights
for doctors and public. For
children these include:
The rights of receiving effective treatment and taking
advantages of the present attempts in order to be saved form the sufferings.
The right of receiving necessary health care convenient
to his/her age and sex and illnesses, taking advantage of the treatments
convenient to the medical science from the health institutions including
The right to be able to hospitalized on time, to be
discharged form the hospital as soon as possible.
The right of receiving treatment with love, convenient
to his/her honor and privacy.
The right to be in the recovery process actively, and
to take information from the doctors when it is possible about his illnesses.
The right to share the same atmosphere with his age
groups and to take the care from the people who got health education for this
The right to see his parents and other family members
including children, unless doctors prohibit it.
The right to suck his/her mother when he/she is in the
To continue his/her education when in the hospital.
children should have the right to reach sufficient life standards for their
physical, mental, psychological, moral, and social developments. According to
the studies, the factors that define the health levels of the countries are the
criteria related with basic needs. There is no chance for a child to reach the
required success level when failed to support him with shelter, nourishment,
education, and other environmental factors no matter, how health services a
country gives for the children.
For that reason, the subjects related with life standards of a society
have been the important subjects of health officials. Four important
principles, for both children and adults, indispensable in health services are
equity, productivity, affectivity, respect for humanity. Taking the subject in
this context, it is concluded that, health of the children is indexed, on a
large scale, to the life standards.
statements related with life standards include:
17(1): Everybody has right to protect and improve his/her material and
41(2): State takes the necessary measurements to protect the welfare and happiness of the family an
especially for protecting mother and children and establishes the structure to
provide family planning education and practice.
49(2): State takes the necessary measurements to raise the life standards of
the workers, to protect the working life for widening it, to support the
workings and to prevent the unemployment.
59(1): States takes the necessary measurements to develop the physical and
mental health of the Turkish citizens...
statements related with life standards and children's rights conventions
6: The children's right to live, and to have the best health and development
10: The education (reaching) right.
12: The right to receive health services.
24: the right to take advantage of health and health services.
27: The right of a child to reach the basic life level.
28: The education right of a child (12).
Turkish Republic as a state receives that everybody, who was born in the border
of Turkey, has the right to take advantage of the health services from birth.
Carrying out this responsibility is given to State by the 56th
article of the constitution. The duty of putting into force of crucial subjects
such as planning, presenting, eliminating the deficiencies, adapting the new
methods, is given to the Health Ministry by the governmental decree numbered as
181, by Turkish State. When carrying out this duty in the name of State,
principles such as equity, attainability, social justice are taken account by
Health Ministry (15).
addition to the aforementioned articles of Turkey's Constitution, in the
statement in the 1st article of subject law, "Improvement of
the health condition of the country, struggling against the harmful factors and
disease that threats society's health, providing the future generation be
healthy, supporting the citizens with medical and social aid are forms the
general health services of the state" is expressed.
is expressed in the 3rd article of the same law that "Health
Ministry takes the necessary measurements directly to protect the health of the
mother after delivery and to protect the health of the children and adults and
to provide the all other services "
151st article of the law, it is stated that the "Health
Ministry establishes the necessary institutions and mages them to protect the
children and to lower the child death ratio, and takes the measurements that
will help people to learn the advantageous of protecting their health (15).
related articles of Patient's Right Regulations dated as 1st August
1998 and numbered as 23420 are:
26: Participation of a child or a person. Even in the situation that the
permission of the guardian of a child is required and this permission is
enough, children or persons who are under 18 years of age are listened to and
their participation is provided to the medical intervention.
35: The situation of children and
the persons who are over18 years of age. No medical intervention, which has no
use of treatment, can be done to the persons who are under 18 years of age and
not adult in any circumstances. It depends on the decision of the guardians of
the persons who are under 18 years of age and not adult to do the medical
intervention in the case intervention has positive effect on the patient's
the aforementioned articles of our constitution, the 165th, 163th
and 176th articles of General Hygiene Law; the 550, 445, 446, 477,
478, 414, 415, 417, 179, 180th articles of Turkish Criminal Code, and the 267,
273rd articles of Turkish Civil Code are related with protection of
children and prevention for child abuse (17).
our children to reach the goodness and happiness that they deserve, as in the
world in our country, children must take the priority. On one hand, it is
necessary to take the health services equally, continuously, sufficiently and
in a balanced way to every body and everywhere to protect and make the keep the
children alive. On the other hand, it is necessary to make the protective
health services prevalent, effective, and continuous (15).
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