Ömer Faruk BORAN, Ercan AVCI, Maruf BORAN

Covid-19 Pandemisinin Türkiye’de Çalışan Hekimlerde Aydınlatılmış Onam Üzerinde Etkisi

Amaç: Çalışma Covid-19 pandemisinin, Türkiye’de çalışan hekimlerin hasta / hasta yakını bilgilendirme davranışlarını niçin, nasıl ve niye değitirdiğini saptamayı amaçlamaktadır. Material ve Metod: Covid 19 tedavisi ile uğraşan hekimlere kartopu örneklem yöntemi ile online anket uygulaması yapıldı ve toplam 528 anket yanıtı alındı. Bulgular: Katılımcıların % 60,4’ü (n=317) Covid-19 pandemisinin bilgilendirme yaklaşımını etkilediğini belirtir iken, % 39,6’sı (n=211) pandeminin hasta / hasta yakını bilgilendirme alışkanlıkları üzerine etkisi olmadığını belirtti. Çalışmaya katılan hekimlerin çoğu, hastalığa bağlı yüksek mortalite oranı, hastalığın standart tedavisi olmaması ve hasta / hasta yakınlarının daha fazla bilgi istemesi sebebi ile daha fazla bilgilendirme yaptıklarını belirtti. Diğer taraftan, 58 katılımcı (% 18,3) bilgilendirme için yeterli zaman olmaması, acil tedavi gereksinimi ve uygulanan tedavinin risk, fayda ve sonuçları ile ilgili yeterli bilgi olmadığından daha az bilgi verdiklerini belirtti. Sonuç: Covid 19 pandemisi, Türkiye’de çalışan hekimlerin çoğunda bilgilendirme davranışları üzerinde etki göstermektedir.

Anahtar Kelimeler:

Aydınlatılmış onam, Covid-19 pandemisi, hekim yaklaşımı, Türkiye

The Impact of the Covid-19 Pandemic on Physicians in Turkey Towards Informed Consent

Background: The study aimed to figure out whether, how, and why the COVID-19 pandemic has changed physicians’ attitudes toward informed consent in Turkey. Materials and Methods: An online questionnaire was distributed to physicians through the snowball sampling method and 528 physicians treating COVID-19 patients turned in the questionnaire. Findings: Most of the physicians (n= 317) indicated that the COVID-19 pandemic has influenced their attitudes on informed consent, while 39.96% of them (n= 211) stated that the pandemic did not change their behaviors on informing patients and/or families. An overwhelming majority of the physicians (n= 259) emphasized the impact of the higher mortality rate of the disease, the lack of standard treatment for the disease, and the higher demand from patients and families for information on providing patients and/or families with more information. On the other hand, 18.30% (n= 58) of the physicians admitted that the pandemic has caused them to disclose less information because of the lack of time to provide information, the need for urgent treatment, and the lack of information regarding the risks, benefits, and outcomes of applied treatments. Conclusion: COVID-19 pandemic affected the majority of the physicians attitudes and behaviors toward informed consent.

Keywords:

Informed consent, COVID-19 pandemic, physicians’ attitude, Turkey,

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1. Jonsen AR, Siegler M, Winslade WJ. Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine, 8th Edition, New York: McGraw Hill Education; 2015:100.
2. Lo B. Resolving Ethical Dilemmas: A Guide for Clinicians. 6th Edition. Philadelphia: Wolters Kluwers; 2020:22-23.
3. English DC. Valid informed consent: a process, not a signature. Am Surg. 2002;68(1):45–8.
4. Stunkel L, Benson M, McLellan L, Sinaii N, Bedarida G, Emanuel E, et al. Comprehension and Informed Consent: Assessing the Effect of a Short Consent Form. IRB. 2010;32(4):1–9.
5. Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 7th Edition. New York: Oxford University Press; 2013:124-125.
6. Covid-19-favipiravirpdf.pdf [Internet]. [cited 2021 March 9]. Available from: https://covid19.saglik.gov.tr/Eklenti/40620/0/covid-19-favipiravirpdf.pdf
7. Alberto Julius Alves W, Ana Paulo DL, Reitan R, Heber Salvador de Costa R, Rodrigo Nascimento P, Glauco B, et al. Risks of COVID-19 for surgical cancer patients: The importance of the informed consent process. J Surg Oncol. 2020;1-3.
8. Bryan AF, Milner R, Roggin KK, Angelos P, Matthews JB. Unknown Unknowns: Surgical Consent During the COVID-19 Pandemic. Ann Surg. 2020;272(2):e161–e162.
9. Pilkington V, Pepperrell T, Hill A. A review of the safety of favipiravir - a potential treatment in the COVID-19 pandemic? J Virus Erad. 2020;6(2):45–51.
10. Echeverría-Esnal D, Martin-Ontiyuelo C, Navarrete-Rouco ME, De-Antonio Cuscó M, Ferrández O, Horcajada JP, et al. Azithromycin in the treatment of COVID-19: a review. Expert Rev Anti Infect Ther. 2021;19(2):147–63.
11. Carnevale FA, Vissandjée B, Nyland A, Vinet-Bonin A. Ethical considerations in cross-linguistic nursing. Nurs Ethics. 2009;16(6):813–26.
12. Turnham HL, Dunn M, Hill E, Thornburn GT, Wilkinson D. Consent in the time of COVID-19. J Med Ethics. 2020;46(9):565–8.
13. Desouky E. Urological surgery in the COVID-19 era: Patient counselling and informed consent. Arab J Urol. 2020;18(2):62–4.
14. Garg PK, Kaul P, Choudhary D, Yendamuri S. Informed surgical consent during the COVID-19 pandemic: Exploring the risk of unknown. J Surg Oncol. 2020;122(6):1257–8.
15. Bhattacharya N, Bhattacharya K. Informed Consent for Surgery During COVID-19. Indian J Surg. 2020;82(3):271–3.
16. Egri M, Celbis O, Karaca M, Ozdemir B, Kok AN. The informed consent status for surgery patients in eastern Turkey: a cross-sectional study. Indian J Med Ethics. 2008;5(1):26–8.
17. Sahin N, Oztürk A, Ozkan Y, Demirhan Erdemir A. What do patients recall from informed consent given before orthopedic surgery? Acta Orthop Traumatol Turc. 2010;44(6):469–75.