Doğumun Yönetimi ve Etik
Özet
Doğum süreci, hem anne hem bebek için fiziksel ve psikolojik açıdan hassas bir dönemdir. Bu süreç yalnızca biyolojik değil, aynı zamanda etik duyarlılığın en yüksek düzeyde olması gereken bir sağlık hizmetidir. En sık karşılaşılan etik sorunlar; doğum şeklinin kadının rızası dışında belirlenmesi, obstetrik şiddet, sağlık çalışanlarının ihmali, tıbbi hatalar (malpraktis), mahremiyetin ihlali ve bilgilendirilmiş onamın eksikliğidir. Hemşireler, doğum sırasında kadına en yakın sağlık profesyonelleri olarak kritik bir rol üstlenirler. Mahremiyetin korunması, hastanın haklarına ve tercihine saygı gösterilmesi, açık ve anlaşılır bilgilendirme yapılması hemşirelerin temel etik sorumlulukları arasındadır. Etik ilkelere bağlı bir hemşirelik yaklaşımı, kadının doğum deneyimini olumlu yönde etkilerken, sağlık çalışanlarının etik ve hukuki sorunlarla karşılaşmasını da önler. Bu nedenle doğum hizmetlerinde görev yapan hemşirelerin etik bilgi düzeylerinin yüksek olması, insan haklarına duyarlı bir bakım anlayışına sahip olmaları ve etik ikilemler karşısında bilinçli kararlar alabilmeleri büyük önem taşımaktadır. Böylece kadın için onurlu, güvenli ve saygılı bir doğum süreci sağlanabilir.
Referanslar
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Referanslar
Şahin E. Gebeli̇k-Doğum Yöneti̇mi̇ ve Eti̇k. İçinde: Hemşirelik ve Etik [İnternet]. Istanbul University Press; 2024 [a.yer 13 Mart 2025]. s. 439-59. Erişim adresi: https://iupress.istanbul.edu.tr/tr/book/hemsirelik-ve-etik/chapter/gebelik-dogum-yonetimi-ve-etik
Carlton T, Callister LC, Stoneman E. Decision Making in Laboring Women: Ethical Issues for Perinatal Nurses. The Journal of Perinatal & Neonatal Nursing. Nisan 2005;19(2):145-54.
Malesela JML. Personal Values Required for Ethical Best Practice during Intrapartum Care. Africa Journal of Nursing and Midwifery. 04 Aralık 2018;20(2):20 pages-20 pages.
Sezaryen Doğum Hızları İle İlgili DSÖ Açıklaması [İnternet]. [a.yer 20 Şubat 2025]. Erişim adresi: https://iris.who.int/bitstream/handle/10665/161442/WHO_RHR_15.02_tur.pdf;jsessionid=0B0729C597E8753B3A4D606EA4A06B48?sequence=11
Topaktaş G, Beylik U. TÜRKİYE SEZARYEN ORANI DURUM ANALİZİ VE POLİTİKA ÖNERİLERİ. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 30 Haziran 2024;21(2):102-13.
Ulgu MM, Birinci S, Altun Ensari T, Gözükara MG. Cesarean section rates in Turkey 2018-2023: Overview of national data by using Robson ten group classification system. tjod. 01 Eylül 2023;20(3):191-8.
Casella C, Capasso E, Bianco C, Saccone G, Guida M, Graziano V, vd. Elective cesarean section on maternal request: ethical and legal considerations. Perinatal J. 01 Aralık 2020;28(3):154-6.
Silva CHM, Laranjeira CLS, Melo CSB de, Brandão LV, Oliveira GC, Brandão AHF, vd. Perinatal complications of the maternal–Fetal dyad in primiparous women subjected to vaginal delivery versus elective cesarean section: A retrospective study of clinical results associated with bioethical precepts. PLOS ONE. 17 Ekim 2023;18(10):e0292846.
Mirzaee M, Mirzaee F. Medical ethics in childbirth: a structural equation modeling approach in south of Iran. BMC Med Ethics. 26 Haziran 2024;25(1):76.
ACOG Committee Opinion No. 761: Cesarean Delivery on Maternal Request. Obstetrics & Gynecology. Ocak 2019;133(1):e73-7.
Loke AY, Davies L, Mak Y wah. Is it the decision of women to choose a cesarean section as the mode of birth? A review of literature on the views of stakeholders. BMC Pregnancy Childbirth. Aralık 2019;19(1):286.
Barnea ER, Inversetti A, Di Simone N, the FIGO Childbirth and Postpartum Hemorrhage Committee. FIGO good practice recommendations for cesarean delivery: PREP‐FOR‐LABOR triage to minimize risks and maximize favorable outcomes. Intl J Gynecology & Obste. Ekim 2023;163(S2):57-67.
Spong CY, Berghella V, Wenstrom KD, Mercer BM, Saade GR. Preventing the First Cesarean Delivery: Summary of a Joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, and American College of Obstetricians and Gynecologists Workshop. Obstetrics & Gynecology. Kasım 2012;120(5):1181-93.
Jansen LA. Medical Beneficence, Nonmaleficence, and Patients’ Well-Being. J Clin Ethics. 2022;33(1):23-8.
Bobadilla Ubillús LE, León Jimenez F. En torno a las cesáreas en el Perú: ¿solo un problema de cifras? Rev peru ginecol obstet. 28 Ocak 2018;63(4):659-60.
Habek D, Prka M, Čartolovni A, Cerovac A, Dokozić D. Caesarean section between doctrine to heresis. Medicoethical and deontological view of caesarology: an opinion. Clin Exp Obstet Gynecol. 15 Şubat 2021;48(1):1.
Romanis EC. Why the Elective Caesarean Lottery is Ethically Impermissible. Health Care Anal. Aralık 2019;27(4):249-68.
Ralston SJ, Farrell RM. The Ethics of Access: Who Is Offered a Cesarean Delivery, and Why? Hastings Center Report. Kasım 2015;45(6):15-9.
Varkey B. Principles of Clinical Ethics and Their Application to Practice. Med Princ Pract. 2021;30(1):17-28.
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