Cinsel Bütünlüğe Müdahalelere İlişkin Doğal İradenin Önemi

Bu çalışmada ayırt etme gücünden yoksun kişiler adına tıbbi müdahalelere ilişkin karar alma süreci eleştirel bir yaklaşımla tartışılmıştır. Ayırt etme gücünden yoksun kişiler adına tıbbi kararları alma konusunda hukuk düzeni genellikle yasal temsilciyi yetkilendirmektedir. Acil olmayan tıbbi müdahalelerde müdahalenin gerekli olup olmadığına karar verilirken tıbbi endikasyonu aşan gerekçeler de müdahaleyi hukuka uygun kılabilir. Bu bağlamda özellikle müdahaleden beklenen yararlar ile riskler karşılaştırılır. Tıbbi açıdan gerekli olmayan müdahalenin geri dönüşünün olup olmaması, hangi amaçla yapıldığı kararın bir başkasına bırakılıp bırakılamayacağı hususunda önemli kriterler haline gelir. Cinsel bütünlüğe ilişkin tıbbi müdahalelerin ilgili kişinin yaşamında ciddi nitelikte psikososyal etkileri bulunmaktadır. İlgili kişinin yaş küçüklüğü veya engellilik sebebiyle ayırt etme gücünden yoksun olmasına karşın onun doğal iradesi göz ardı edilemez. Özerklik hakkının bir sonucu olarak, ilgili kişi kendini ifade edebilmekte veya muhakeme edebilmekte yeterli olmasa veya bunun için yaşı çok küçük olsa bile duyguları ve düşünceleri salt canlı bir varlık olduğu için önem taşır. Sünnet, kürtaj, sterilizasyon ya da cinsiyet atama veya geçiş operasyonları gibi müdahalelerde böyle müdahaleleri zorunlu kılan üstün özel yarardan söz edilemez. Dahası böyle müdahaleler heteronormatif veya ayrımcı saiklerle gerçekleştirilebilmektedir. Gebeliği sona erdirmeye veya sterilizasyona zorlamak kadar gebeliği sürdürmeye zorlama toplumsal cinsiyete dayalı bir şiddet biçimi sayılmaktadır, bu halde gebeliği salt isteğe bağlı olarak sona erdirmeye karar verme olanağının salt zihinsel engelli veya çocuk olduğu gerekçesiyle gebe olan kişiden esirgenmesinin haklı bir sebebi bulunmamaktadır. Bu nedenle tıbbi müdahale ilgili kişi için gereklilikten ve ivedilikten uzaklaştıkça ilgili kişinin doğal iradesi yasal temsilcinin veya hâkimin kararı yönünden daha belirleyici hale gelmelidir.

Anahtar Kelimeler:

özerklik, sünnet, interseks, doğal irade, varsayımsal rıza, kürtaj

The Significance of Natural Will Relating to Interventions in Sexual Integrity

In this paper, the procedure of decision-making on behalf of mentally incapable persons within medical interventions is discussed with a critical approach. The legal system generally authorizes the legal representative to take medical decisions on behalf of persons who lack the mental capacity. When deciding whether the intervention is necessary in non-emergency medical interventions, reasons beyond the medical indication may also render the intervention legal. In this context, especially the expected benefits of the intervention are compared with the risks. However, the irreversibility of the intervention, which is not medically necessary, and the purpose for which it is performed become important criteria in determining whether the decision can be left to someone else. Medical interventions related to sexual integrity have significant psychosocial effects upon the person involved. Despite the person involved does not have legal capacity because of minority or disability, her/his natural will cannot be denied. As a consequence of the right to autonomy, even if the involved person is too young or unable to express herself/himself or unable to discern things properly, her/his feelings and ideas are essential just becauses/he is alive. In interventions like circumcision, abortion, sterilization or sex/gender assignment surgeries, there is no prevailing personal interest requiring such interventions. Even, such interventions can be carried out with heteronormative or/and discriminative motives. For this reason, if medical intervention is not necessary and urgent for the person involved, her/his natural will should be the deciding factor for her/his legal representative. Forcing the termination of pregnancy or sterilization, as well as forcing the continuation of pregnancy, is considered a form of gender-based violence. So there is no justifiable reason to deny the pregnant person the opportunity to decide to terminate the pregnancy just voluntarily on the grounds that she is mentally disabled or a child. Therefore, the further the medical intervention becomes from necessity and urgency for the person concerned, the more the natural will of the person concerned should become decisive for the decision of the legal representative or the judge.

Keywords:

Abortion, autonomy, circumcision, intersex, natural will, proxy consent,

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ISSN: 2148-5917
Yayın Aralığı: Yılda 4 Sayı
Başlangıç: 2014
Yayıncı: Türkiye Biyoetik Derneği

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